Transitional cell carcinoma(TCC) of the urinary bladder shows marked heterogeneity in biological behaviors. Evidence has accumulated that biological markers may provide significant information to predict the potential aggressiveness of TCC. We have assessed the expression of the epidermal growth factor receptor (EGF-R), c-erbB-2 and p53 proteins in 56 cases of TCC to investigate the prognostic significance of differential expression of these oncoproteins using an immunohistochemical method. We analysed the expression patterns of these oncoproteins according to tumor stage and grade. And we assessed the probability of progression-free survival in stage T1 tumors according to their expressions. Positive rates of EGF-R (>+3 staining intensity), c-erbB-2 (intense membrane staining) and p53 proteins (>20% positive cells) were 73.2%, 37.5% and 42.9%, respectively. Invasive tumors had significantly higher positive rates of all three factors than did superficial tumors (p<0.005 for EGF-R and c-erbB-2, p<0.05 for p53). High grade tumors had significantly higher positive rates of c-erbB-2 and p53 proteins (p<0.005). In superficial tumors, T1 tumors had higher positive rate of p53 protein compared with Ta tumors (p<0.05). Twelve cases of superficial tumors (34.3%) were positive for EGF-R and negative for c-erbB-2 and p53 proteins. Nine cases of superficial tumors(25.7%) were negative for all three factors. In invasive tumors, however, 42.5% of the cases were positive for all three factors. The overexpression of p53 protein was the only useful marker to predict the rapid progression in stage T1 tumors (p<0.05, log-rank test). These results suggest that the differential overexpression of EGF-R, c-erbB-2 and p53 proteins could be useful to depict tumor aggressiveness of TCC of the urinary bladder. And, the overexpression of a p53 protein may be a useful marker to predict the possibility of rapid progression in stage T1 tumors.
Biomarkers ; Carcinoma, Transitional Cell* ; Disease-Free Survival ; Epidermal Growth Factor* ; Immunohistochemistry ; Membranes ; Oncogene Proteins ; Population Characteristics ; Receptor, Epidermal Growth Factor* ; Staphylococcal Protein A* ; Urinary Bladder*

PURPOSE: The aim of this study was to understand and describe difficulties and needs experienced by head nurses in the clinical practice education of nursing students. METHODS: A qualitative descriptive method was employed. A convenience sampling method was used to recruit participants from four hospitals in South Korea. Twenty-one head nurses participated in the first interview and 17 of them participated in the second interview. Data were collected through two in-depth interviews and field notes were written. Qualitative content analysis method was utilized for data analysis using ATLAS.ti 6.2 software. RESULTS: Thirty-one codes and twelve categories were identified. Four themes emerged from data analysis, which included ‘too many tasks’, ‘limitations of student education’, ‘many differences’, and ‘lack of support and resources.’ CONCLUSION: This qualitative study described head nurses' many difficulties and needs in the clinical practice education of nursing students. The results of this study provide valuable understanding and knowledge of head nurses' experiences in students' clinical education, which leads to improvement of the quality of clinical education for nursing students.
Education* ; Head* ; Humans ; Korea ; Methods ; Nursing* ; Nursing, Supervisory ; Qualitative Research* ; Statistics as Topic ; Students, Nursing*

GH concentration in plasma decline with age. GH and GH response to GHRH are influenced by sex hormones, thereby changing around the menopause. In several aspects, features of aging resemble those of a state of GH deficiency. It has been argued the declining GH function, along with other factors, might be a causal factor in osteoporosis. The purpose of this study was to investigate that postmenopausal osteoporosis in ovariectomized rat could be prevented by rhGH. Fifty-four Sprague-Dawley rats(weight 140-200g) were devided 3 groups. Group 1(n=18) was sham operation; Group 2(n=18) was ovariectomized and received subcutaneous injection with 0.05 cc normal saline; Group 3(n=18) was ovariectomized and received subcutaneous injection with 0.2 IU rhGH. Group 2 and 3 were injected daily, 6 day per week. Each group was devided three subgroups(n=6) and were sacrificed at 6 week, 10 week, 14 week, respectively. Group 2 showed a significant increase in body weight, femur length, serum IGF-1 level, serum PICP and ICTP level at 6 weeks, 10 weeks, 14 weeks and a significant decrease in ash weight of tibia, width of bony spicules, at 14 weeks than Group 1. Group 3 demonstrated a significant increase in body weight, femur length, serum IGF-1, serum PICP and ITCP levels and a insignificant decrease in ash weight of tibia and width of bony spicules, at 6 weeks, 10 weeks, 14 weeks than Group 1. At 14 weeks, Group 3 showed a significant increase in serum IGF-1, Serum PTH, Serum PICP. From these data, we conclude that although rhGH administration leads to an activation of bone turnover and more stimulation of bone formation, it does not prevent a bone loss in ovariectomized rat.
Aging ; Animals ; Body Weight ; Female ; Femur ; Gonadal Steroid Hormones ; Humans* ; Injections, Subcutaneous ; Insulin-Like Growth Factor I ; Menopause ; Osteogenesis ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Ovariectomy ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Tibia

Although paraovarian cysts rarely cause symptoms, they may be complicated due to massive size, torsion or internal hemorrhage from rupture. Moreover, benign or malignant neoplasms may occasionally develop in paraovarian cysts. We present a case of a 73-year-old patient who suffered from a twisted large left paraovarian cyst. The patient visited emergency room with a chief complaint of acute abdominal pain. The patient was treated with good result by laparoscopic surgery. The maximum diameter of the mass was 10cm which was twisted 3 1/2 times clockwise. In conclusion, paraovarian cysts, even in elderly patients, can reach large sizes requiring awareness of the possible complications caused by large cyst which could be treated successfully by laparoscopy.
Abdominal Pain ; Aged ; Emergencies ; Hemorrhage ; Humans ; Laparoscopy ; Rupture

PURPOSE: A pelvic organ prolapse (POP) has various pelvic symptoms, including urinary and fecal incontinence. However, the accurate prevalence and problems in South Korea are not well known. The purpose of this study was to determine the relationship of pelvic floor symptoms in patients with a POP. MATERIALS AND METHODS: Between March 2003 and March 2004, 74 consecutive patients, with over stage II POP quantification (POP-Q) staging, were enrolled. No abnormal neurological signs were detected in 66 women after evaluation. On physical examination, these 66 patients were divided into 3 groups (A=cystocele only, B=rectocele only and C=cystocele rectocele). RESULTS: The prevalence of urinary incontinence was 28.8%, and with fecal incontinence was 9.1%. The prevalence of fecal incontinence and fecal symptoms, with the exception of fecal incontinence were 28.8 and 74.2%, respectively. With regard to the stage of POP-Q, fecal incontinence (II= 25.0%, III=27.8%, IV=75.0%) and fecal symptoms (II=77.3%, III=66.7%, IV =75.0%) were observed. Each group presented with fecal incontinence (A=38.4%, B=44.4%, C=20%) and fecal symptoms (A=56.3%, B=100%, C=74.3%). CONCLUSIONS: In this study, the prevalence of urinary incontinence was 28.8%, that of fecal incontinence was 28.8% and that of both urinary and fecal incontinence was 9.1%. The mixed symptoms may cause a dilemma in relation to the formal treatment. Our study suggests urologists should be aware of coexisting fecal symptoms associated with a pelvic organ prolapse.
Fecal Incontinence ; Female ; Humans ; Korea ; Pelvic Floor ; Pelvic Organ Prolapse* ; Physical Examination ; Prevalence* ; Prolapse ; Urinary Incontinence

Cervical pregnancy is a rare form of ectopic gestation in which the blastocyst implants in the cervical mucosa below the histologic cervical os. Because of the serious vaginal bleeding, hysterectomy was usually done in the management of cervical pregnancy. Howerver, conservative treatment is desirable for women who want to be pregnancy in the future. Methotrexate has been utilized recently for conservative management of cervical pregnancy. We report a case of cervical pregnancy which was treated succesfully with intramuscular methotrexate injection.
Blastocyst ; Female ; Humans ; Hysterectomy ; Methotrexate* ; Mucous Membrane ; Pregnancy* ; Uterine Hemorrhage

No abstract available.
Cell Line* ; Humans* ; Interferon-gamma* ; Matrix Metalloproteinases* ; Tumor Necrosis Factor-alpha* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Cell Line* ; Humans* ; Interferon-gamma* ; Matrix Metalloproteinases* ; Tumor Necrosis Factor-alpha* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: To determine renal toxicity through changes in renal function after the injection of CT and MRI contrast media into rats in which acute renal failure (ARF) was induced. MATERIALS AND METHODS: To cause acute renal failure, the abdominal cavity of 110 male rats each weighing 250-300 gm was opened via a midline incision under anesthesia. Microvascular clamps were placed on both renal arteries and veins to completely block renal blood flow for 45 minutes, and were then removed, allowing blood flow to return to the kidneys. ARF, defined as a two-fold difference in the creatinine level before ARF and 48 hours after, was successfully induced in 60 of the rats. These were divided into two groups: one was injected with CT contrast medium and the other with MRI contrast medium. Each CT and MRI group was divided into a low dose (0.5 cc/kg, 0.2 ml/kg), standard dose (2 cc/kg, 0.8 ml/kg), and high dose (8 cc/kg, 3.2 ml/kg) sub-group; thus, there was a total of six groups with ten rats in each. Blood samples were obtained before ARF, 48 hours after, and 48 hours after contrast injection, and CT scanning and MRI were performed after blood sampling at 48 hours. In each group, creatinine levels 48 hours after contrast injection were compared by means of the ANOVA test. RESULTS: There were no significant differences in creatinine levels between the CT and MRI contrast medium groups (p=0.116), nor between the animals to which different doses of CT and MRI contrast medium, were administered. After both standard and high doses, CT and MRI provided good images. CONCLUSION: In rats in which acute renal failure was induced, renal function did not change according to whether CT or MRI contrast medium was injected. Thus, the two media induce similar levels of toxicity.
Abdominal Cavity ; Acute Kidney Injury* ; Anesthesia ; Animals ; Contrast Media ; Creatinine ; Humans ; Kidney ; Magnetic Resonance Imaging ; Male ; Models, Animal* ; Rats* ; Renal Artery ; Renal Circulation ; Tomography, X-Ray Computed ; Veins

BACKGROUND: At present, there are many instruments to diagnose anxiety and depression. However, most of the instruments have a number of questions. Therefore, we have many difficulties in applying them to the primary care. The purpose of this study was to measure the reliability and the validity of a Korean-translated Goldberg s short screening scale for anxiety and depression, which were developed for screening of anxiety and depression in primary care. METHODS: 178 asymtomatic subjects and 58 patients(anxiety 15, depression 43) aged from 18 to 64 years old were selected. The patients were diagnosed by psychiatrist according to DSM-IV criteria. This study was performed for 3 months, from May to August 1996. The reliability of this instrument was measured by internal consistency reliability. The validity of this instrument was measured by three methods. The first method was the comparison of the score between the patients and the control group. The second method was to measure the relationships of this instrument with the other instruments such as Self-rating Depression Scale and State-Trait Anxiety Inventory. The last method was to measure the relationship of this instrument with Comprehensive Global Assessment. In addition, we calculated the sensituvity and specificity at the cut off values. RESULTS: The Cronbach's a value was 0.736 for the anxiety and 0.749 for the depression. Goldberg anxiety scale was significantly associated with state in STAI(r=0.279, P<0.001), and trait in STAI(r=0.125, P=0.041). However, Goldberg depression scale was not sigficantly associated with SDS. Goldberg anxiety scale as well as Goldberg depression scale were significantly associated with CGA(r=0.433, P=0.001; r=0.695, P=0.001). The seore of Goldberg anxiety scale was significantly higher in the anxious patients than in the control group(P=0.047). The score of Goldberg depression scale was significantly higher in the depressive patients than in the control group(P<0.001). For anxiety scale of Goldberg scale, the sensitivity and the specificity was 60% and 68% at score 3. For depression scale of Goldberg scale, the sensitivity and the specificity was 80% and 68% at score 2. CONCLUSIONS: We concluded that the value of Cronbach's a in Goldberg scale was 0.736 for anxiety and 0.749 for depression. For the validity, the scores of Goldberg scale were higher in patient group than in asymptomatic group. However, the relationships of Goldberg scale with other screening instruments were variable. So further study for the validity of Goldberg scale is requested.
Anxiety* ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening* ; Middle Aged ; Primary Health Care ; Psychiatry ; Sensitivity and Specificity