Purpose: The activity and safety of neoadjuvant nivolumab plus gemcitabine/cisplatin (N+GC) were tested in patients with muscle-invasive bladder urothelial carcinoma (MIBC). Materials and Methods: In a prospective phase II trial, patients with cT2-T4a N0 MIBC who were eligible for cisplatin and medically appropriate to undergo radical cystectomy (RC) were enrolled. Treatment with nivolumab 3 mg/kg on days 1 and 15 plus GC (cisplatin 70 mg/m2 on day 1, and gemcitabine 1,000 mg/m2 on days 1, 8, and 15) was repeated every 28 days up to 3 or 4 cycles, depending on the surgery schedules. The primary endpoint was pathologic complete response (pCR, ypT0). Secondary endpoints included pathologic downstaging (≤ ypT1), disease-free survival (DFS), and safety. Results: Between September 2019 and October 2020, 51 patients were enrolled. Neoadjuvant N+GC was well tolerated. Among 49 patients who completed neoadjuvant N+GC, clinical complete response (cCR) was achieved in 59% of intent-to-treat (ITT) population. RC was performed in 34 (69%) patients. pCR was achieved in 24% (12/49) of ITT population and 35% (12/34) of RC patients. Median DFS was not reached. Over a median follow-up of 24 months, 12 patients experienced disease recurrence and were treated with palliative therapy or surgery. Although 12 patients declined surgery and were treated with concurrent chemoradiotherapy, DFS was longer in patients with cCR after neoadjuvant therapy than those without. Preoperative programmed death-ligand 1 (PD-L1) did not correlate with pCR or pathologic downstaging rates. Conclusion Neoadjuvant N+GC was feasible and provided meaningful pathologic responses in patients with MIBC, regardless of baseline PD-L1 expression (ONO-4538-X41; CRIS.nih.go.kr, KCT0003804).

BACKGROUND AND PURPOSE: The pathogenesis of mitochondrial disease (MD) involves the disruption of cellular energy metabolism, which results from defects in the mitochondrial respiratory chain complex (MRC). We investigated whether infants with MRC I defects showed ultrastructural changes in skeletal muscle. METHODS: Twelve infants were enrolled in this study. They were initially evaluated for unexplained neurodegenerative symptoms, myopathies, or other progressive multiorgan involvement, and underwent muscle biopsies when MD was suspected. Muscle tissue samples were subjected to biochemical enzyme assays and observation by transmission electron microscopy. We compared and analyzed the ultrastructure of skeletal muscle tissues obtained from patients with and without MRC I defects. RESULTS: Biochemical enzyme assays confirmed the presence of MRC I defects in 7 of the 12 patients. Larger mitochondria, lipid droplets, and fused structures between the outer mitochondrial membrane and lipid droplets were observed in the skeletal muscles of patients with MRC I defects. CONCLUSIONS: Mitochondrial functional defects in MRC I disrupt certain activities related to adenosine triphosphate synthesis that produce changes in the skeletal muscle. The ultrastructural changes observed in the infants in this study might serve as unique markers for the detection of MD.
Adenosine Triphosphate ; Biopsy ; Electron Transport* ; Energy Metabolism ; Enzyme Assays ; Humans ; Infant* ; Lipid Droplets ; Microscopy, Electron, Transmission ; Mitochondria ; Mitochondrial Diseases ; Mitochondrial Membranes ; Muscle, Skeletal* ; Muscular Diseases

PURPOSE: The purpose of this study was to provide a basis for improvement and enhancement of nursing education by investigating learning outcomes that apply to fundamentals of nursing and teaching methods used in classes. METHODS: Data were collected from 111 professors of fundamentals of nursing who responded to the self-report questionnaire. Data were analyzed using chi-square test. RESULTS: For learning outcomes in fundamentals of nursing the most frequent number of outcomes was two (35.2%), or three (32.4%). For learning outcomes in fundamentals of nursing practicum, the most frequent number of outcomes was two (32.4%), or three (31.6%). In fundamental nursing classes, teaching methods used most frequently were lectures (98.2%) and videos (60.4%), and in practice classes, demonstration (98.2) and open laboratory (90.9%). Constructivist teaching methods that were utilized in fundamental nursing were team-based learning (19.8%) and case-based learning (19.8%), and for practice classes, objective structured clinical examination (29.7%). In the cross analysis, 28.8% of the nursing professor used the constructivist teaching methods in fundamental nursing and in practice classes. CONCLUSION: There is a need to continue to improve teaching methods for new nurse-educators and professors and to discuss learning outcomes of fundamental nursing.
Education ; Education, Nursing ; Learning* ; Lectures ; Nursing* ; Teaching*

BACKGROUND: Analysis of mutations in the epidermal growth factor receptor gene (EGFR) is important for predicting response to EGFR tyrosine kinase inhibitors. The overall rate of EGFR mutations in Korean patients is variable. To obtain comprehensive data on the status of EGFR mutations in Korean patients with lung cancer, the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists initiated a nationwide survey. METHODS: We obtained 1,753 reports on EGFR mutations in patients with lung cancer from 15 hospitals between January and December 2009. We compared EGFR mutations with patient age, sex, history of smoking, histologic diagnosis, specimen type, procurement site, tumor cell dissection, and laboratory status. RESULTS: The overall EGFR mutation rate was 34.3% in patients with non-small cell lung cancer (NSCLC) and 43.3% in patients with adenocarcinoma. EGFR mutation rate was significantly higher in women, never smokers, patients with adenocarcinoma, and patients who had undergone excisional biopsy. EGFR mutation rates did not differ with respect to patient age or procurement site among patients with NSCLC. CONCLUSIONS: EGFR mutation rates and statuses were similar to those in published data from other East Asian countries.
Adenocarcinoma ; Asian Continental Ancestry Group ; Biopsy ; Carcinoma, Non-Small-Cell Lung* ; Diagnosis ; Epidermal Growth Factor* ; Female ; Humans ; Lung Neoplasms ; Mutation Rate ; Pathology ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor* ; Smoke ; Smoking

PURPOSE: The purpose of this research was to assess the methodological quality of non-randomized studies published in the Journal of Korean Fundamentals of Nursing. METHODS: A search of non-randomized studies assessing intervention effects was conducted among all articles published in the Journal of Korean Fundamentals of Nursing between 2011 and 2013. Articles were assessed for quality using the Methodological Index for Non Randomized Studies (MINORS). For each index item, the frequency and percentage of articles meeting the criteria were calculated, along with mean scores by research method, publication year, and research topic. RESULTS: A total of 22 studies were included. The mean score for studies without control groups was 11.75 (range 0-16), and for those with control groups, 19.27 (range 0-24). Results show that improvement is needed on several items: "endpoints appropriate to the aim of the study," "unbiased assessment of the study endpoint," "follow-up period appropriate to the aim of the study," "loss to follow up less than 5%," and "contemporary groups." CONCLUSION: Although the quality of articles published in the Journal of Korean Fundamentals of Nursing has consistently increased, more emphasis should be placed on using rigorous research methods.
Follow-Up Studies ; Clinical Trial ; Nursing* ; Publications

Hyperkalemia is a common adverse effect of treatment for heart failure and is associated with high mortality and morbidity. The cardiac manifestations of hyperkalemia include various electrocardiogram changes. We describe a case of a 74-year-old woman with heart failure and permanent atrial fibrillation who reverted to normal sinus rhythm during recovery from hyperkalemia.
Aged ; Atrial Fibrillation ; Electrocardiography ; Female ; Heart Failure ; Humans ; Hyperkalemia

PURPOSE: In 2010, the new UICC/AJCC TNM classification for gastric cancer was declared. The new classification for gastric cancer has several changes from the 6th classification. We evaluated the prognostic values and differences according to the new UICC/AJCC TNM classification. METHODS: From 2000 to 2004, 1,196 patients who underwent curative resection with D1+beta or more lymph node dissection and with 15 or more lymph nodes retrieved were studied retrospectively. We analyzed clinical characteristics and survival outcomes retrospectively from medical records. RESULTS: According to UICC/AJCC 7th TNM classification, the 5-year survival rate (5YSR) of each group for depth of invasion and node metastasis were significantly different. The 5YSR of stage II in 6th classification was 82.4% and the 5YSR of stage IIa and IIb in 7th classification were 92.2% and 82.9%. The 5YSR of stage IIIa and IIIb in 6th classification were 56.3% and 33.0%. The 5YSR of stage IIIa, IIIb and IIIc in 7th classification were 72.7%, 48.4% and 26.1%. In our Cox regression multivariate analysis, N stage of the 6th UICC/AJCC TNM classification was the main independent prognostic factor. CONCLUSION: N stage of the 6th UICC/AJCC TNM classification is a more reliable prognostic factor than N stage of the 7th UICC/AJCC TNM classification. Further study should be performed to confirm the appropriateness of N stage TNM classification for gastric cancer.
Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

No abstract available.

Solitary fibrous tumors (SFTs) are an uncommon neoplasm characterized by the proliferation of spindle cells. The diagnostic criteria of malignant solitary fibrous tumors (MSFTs) include high cellularity, high mitotic activity (4>10 HPF), pleomorphism, hemorrhage and necrosis. This tumor frequently involves the pleura and MSFTs of retroperitoneum mimicking gastric submucosal tumor are very rare. We report a rare case of MSFT that presented as a gastric submucosal tumor. A gastroscopic examination showed a large bulging mucosa in the gastric body. Abdominal computed tomography revealed a well-defined heterogeneous enhancing mass between the left hepatic lobe and gastric body. Surgical resection was performed and histologic features were consistent with a MSFT.
Antigens, CD34/metabolism ; Gastroscopy ; Humans ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Retroperitoneal Neoplasms/*diagnosis/pathology/surgery ; Solitary Fibrous Tumors/*diagnosis/pathology/surgery ; Stomach Neoplasms/diagnosis ; Tomography, X-Ray Computed

PURPOSE: Peritoneal seeding of gastric cancer is known to have a poor prognosis. With the diagnosis of peritoneal seeding, there is no effective treatment modality. Gastrectomy with chemotherapy or primary chemotherapy is basically one of major options for this condition. This study was conducted to compare the clinical outcomes of these treatments and to identify the better way to improve the prognosis of patients with peritoneal seeding. MATERIALS AND METHODS: Between 2001 and 2007, gastric cancer patients with peritoneal seeding by preoperative or intraoperative diagnosis were reviewed retrospectively. The enrolled patients were divided as primary gastrectomy and primary chemotherapy group. Clinicopathologic characteristics and clinical outcomes of groups were analyzed and compared. RESULTS: Fifty-four patients were enrolled. 21 patients belonged to the group of primary gastrectomy and 33 patients were to the primary chemotherapy group. Among 33 patients of the primary chemotherapy group, 17 patients were received only chemotherapy and 16 patients were received gastrectomy due to the good responses of primary chemotherapy. The 3 years survival rates were 14% in primary gastrectomy group, 55% in patients who received gastrectomy after primary chemotherapy, and 0% in patients with primary chemotherapy only. CONCLUSIONS: Although this study had many limitations, some valuable information was produced. In terms of survival benefits for the gastric cancer patients with peritoneal seeding, primary gastrectomy and additional gastrectomy after primary chemotherapy revealed the better clinical outcomes. But, prospective randomized clinical study and multi-center study are should be performed to decide proper treatment for gastric cancer patients with peritoneal seeding.
Gastrectomy ; Humans ; Prognosis ; Retrospective Studies ; Seeds ; Stomach Neoplasms ; Survival Rate