Medroxyprogesterone acetate(MPA) is one of the most commonly used hormonal agents for the treatment of advanced or recurrent endometrial adenocarcinoma. However, the progesterone receptor content of endometrial carcinoma varies directly to the degree of differentiation and inversely with stage of the tumor. Thus one would predict that MPA therapy would be less effective in advanced and poorly differentiated tumors. In addition, MPA has been shown to reduce progesterone receptor content of both normal and malignant endometrial cells, which could result in loss of hormone responsiveness. Tamoxifen, which is often used in breast cancer therapy, has also been used in the treatment of patients with advanced and recurrent endometrial carcinoma. Tamoxifen is known to have some estrogenic effects at low concentration and one of these effects is induction of progesterone receptor both in normal and malignant endometrium. This property has focused interest on sequential or simultaneous use of tamoxifen and MPA in the therapy of endometrial carcinoma. The growth inhibitory effects of MPA and tamoxifen were tested on six longestablished endometrial carinoma cell line(HEC-1-A, HEC-1-B, RL 95-2, AN3CA, KLE) and on SCHE-1, a new endometrial carcinoma cell line established in our laboratory. MPA and tamoxifen were used in growth experiments either alone, simultaneously or sequentially. The MCF-7 breast cancer cell line was used as a control. Only 20% reduction in cell number was achieved after 10 days of exposure to the drug, even with the highest MPA concentration tested(10micronm) in endometrial carcinoma cell lines. But in MCF-7 cells, 60% reduction in cell number was achieved with the same concentration of MPA(10um). Ten days of feeding with 5micronm tamoxifen produced a 96% reduction in cell number in MCF-7, a 91% reduction in HEC-1-A, a 88% reduction in HEC-1-B, a 98% reduction in AN3CA and a 71% reduction in KLE cultures. In SCHE-1 cultures a 83% reduction in cell growth was seen and no viable cells remainde in RL 95-2 cultures after 10 days of feeding with a 5uM tamoxifen. In AN3CA cultures, simultaneous exposure to 5um tamoxifen and 5um MPA resulted in partial reversal of the tamoxifen-induced growth inhibition. In RL 95-2, HEC-1-A and HEC-1-B cultures, simultaneous use of these drugs had the same effect as tamoxifen alone, whereas in KLE and SCHE-1 cultures a slight additive growth effect was observed. All six endometrial carcinoma cell lines resumed logarithmic growth when medium containing tamoxifen of logarithmic growth under these conditions was slower than that in the other endometrial carcinoma cultures. Our results show that MPA does not have growth inhibitory effects in these endometrial carcinoma cell cultures, whereas tamoxifen has been shown to have potent endometrial carcinoma cells. These findings are of special importance since patients who are most likely to need adjuvant therapy for advanced or recurrent endometrial carcinoma are those with estrogen receptor and progesterone receptor negative tumors.
Adenocarcinoma ; Breast Neoplasms ; Cell Count ; Cell Culture Techniques ; Cell Line* ; Endometrial Neoplasms* ; Endometrium ; Estrogen Receptor Modulators* ; Estrogens ; Female ; Humans ; MCF-7 Cells ; Medroxyprogesterone ; Receptors, Progesterone ; Tamoxifen*

Ecologic studies are widely used in all fields of public health on account of accesibility of data. However, two problems related to these studies have been brought up. The first is ecological fallacy occurred in the course of interpreting the ecologic level of exposure-disease associations into individual level. The second is exposure isclassification which leads to serious bias. Nevertheless there is few methodologic study dealing joint effects of the two problems in ecologic study. This study was conducted to suggest an ecologic model not having an ecologic fallacy due to model linkage failure and a methodology for correcting the misclassification bias due to exposure-confounder misclassification. Finally, we suggest a criteria for the ecologic model selection. Main results are as follows: 1. A linear ecologic regression model has a serious ecological fallacy due to model linkage failure and the misclassification bias due to the exposure-confounder misclassification. 2. An interaction ecologic regression model has no ecological fallacy due to model linkage failure, but it is affected seriously by the exposure misclassification. However misclassification bias could be removed mathematically if the information related to the misclassification was known. 3. A log-linear ecologic regression model has an ecological fallacy due to model linkage failure. It is seriously biased as the individual risk ratio are increased, but relatively less affected by the exposure misclassification than interaction ecologic regression model. 4. One of the two ecologic regression model-interaction ecologic regression model and log-linear ecologic regression model- would be selected according to the information of individual risk ratio and exposure misclassification. But using a linear ecologic regression model should be avoided in any circumstance. The above results are only valid in case that there is no other source of ecological fallacy except model linkage failure. Also exposure and confounder are independent each other, measured binary, and having nondifferential misclassification. Since the above assumptions are somewhat strong in considering the real situations of ecologic studies, it is necessary to extend the scope of this study.
Bias (Epidemiology) ; Joints ; Odds Ratio ; Public Health

No abstract available.
Neck*

PURPOSE: This study was done to examine the association among irrational belief, mental health, and self-efficacy, and explored the mediation of self-efficacy in the relationship between irrational belief and mental health of Korean soldiers. METHODS: A cross sectional study design was employed. The participants were 118 soldiers who signed consent forms. Data were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple regression analysis. RESULTS: Irrational beliefs were positively correlated with mental health problems, and self-efficacy was negatively correlated with irrational beliefs and mental health problems. Self-efficacy acted as a mediator in the relationship between irrational beliefs and mental health problems. CONCLUSION: The study results suggest that effective interventions to reduce mental health problems of soldiers should apply strategies to change irrational belief and increase self efficacy. These results also provide more empirical support to the hypothesis that self-efficacy serves as a mediator in a mental health.
Consent Forms ; Humans ; Mental Health* ; Military Personnel* ; Negotiating* ; Self Efficacy

The purpose of this study was to investigate the level of anxiety for the mothers of leukemic children and to provide the fundamental data for the better performance of caring to them. The subject were 292 mothers : 100 mothers whose children had a leukemia, 80 mothers whose children had taken a tonsillectomy, 112 mothers whose children with medical disease except cancer. The data were collected through the state-Trait Anxiety Inventory of Spilberger and analyzed by t-test, ANOVA, Scheffe test. The results were as follows ; 1. The state anxiety mean score of mothers with leukemic children was 54.16. 2. The state anxiety of mothers with leukemic children was higher than that of the rest (F=8.00, P=0.0004). 3. There was no significant difference in anxiety of mothers with leukemic children in relation to leukemic children's and their mother's general characteristics.
Anxiety* ; Child* ; Humans ; Leukemia ; Mothers* ; Tonsillectomy ; Child Health

PURPOSE: This study was done to provide information on issues of nursing core competencies needed in the fields of nursing practice for graduates in nursing, from the perspective of nursing managers, and to make suggestion for improving nursing education programs. METHODS: Ten nursing managers participated in this study. They were in charge of clinical nursing education in the fields of nursing practice. Data were collected using focus group interviews and analyzed with the content analysis methodology of Downe - Wamboldt's. RESULTS: Six types of nursing core competency - therapeutic nursing competency, professional nursing competency, administrative nursing competency, humanistic nursing competency, relational nursing competency, and personal nursing competency - were identified as nursing core competencies needed in the fields of nursing practice for graduates in nursing. CONCLUSION: Results of the study show important evidence for decision-making about nursing curriculum revision based on nursing core competency, both in the classroom and in nursing practice areas. These results should contribute to the development of evaluation indicators for nursing students or new nurses. Further research is required to measure degree of nursing core competency in graduates of nursing and to identify the effect of competency-based education for improving nursing core competency.
Competency-Based Education ; Curriculum ; Education, Nursing ; Fees and Charges ; Focus Groups ; Humans ; Professional Competence ; Students, Nursing

PURPOSE: The purpose of this study was to explore the subjective experiences of stigma among mentally ill persons. METHODS: Phenomenological methodology was used for the study. Participants were twelve people with mental illness enrolled at the S community mental health center in GyeongGi-Do. Data were collected via in-depth interviews from August 30 to October 1, 2010 and analyzed using Colaizzi's framework. RESULTS: Four themes and sixteen formulated meanings were identified for the stigma experiences of participants with mental illness. The four themes were 'Incapable of struggling against unfair treatment', 'Living as an outsider', 'Being constrained by oneself', 'Being in suspense over disclosure of oneself'. CONCLUSION: The results from this study underscore the need for an educational and awareness programs to reduce public stigma among the general population and self-stigma among people with mental illness. In addition, efforts are also needed to prioritize mental illness stigma as a major public health issue at the government and community level.
Adult ; Female ; Hospitals, Psychiatric ; Humans ; Interviews as Topic ; Life Change Events ; Male ; Mentally Ill Persons/*psychology ; Middle Aged ; Qualitative Research ; *Social Stigma

PURPOSE: This study was done to evaluate the persistency of effects of an integrated nursing simulation program on interest in learning, recognition of importance of communication, communication skills, and problem-solving abilities. METHOD: Forty-seven nursing students were recruited for this quasi-experimental design research. The experimental group (n=23) performed the simulation program for two weeks, and the control group (n=24) performed traditional clinical nursing practice for two weeks. Data were collected at baseline, immediately after the intervention, at 4 weeks, and finally at 8 weeks. RESULTS: With respect to all variables, no significant differences were found between the experimental group and the control group. Interest in learning showed a significant increase in the control group (F=3.59, p=.018) at 4 weeks, and there was a significant increase in problem-solving abilities in the experimental group (F=4.98, p=.004) immediately after the intervention. CONCLUSION: Findings from this study suggest that the integrated nursing simulation program is as effective as the traditional clinical nursing practice, and the integrated nursing simulation program could be used as an alternative.
Humans ; Learning ; Methods ; Nursing* ; Patient Simulation ; Program Evaluation* ; Students, Nursing

To evaluate the historical trend of anesthetic experience for the past 22 years a total of 68,473 cases which were performed at the National Medical Center from 1959 to 1981 were studied. To simplify the analysis statistically, the author selected the anesthetic cases every other year(12 years). 1) General anesthesia was performed in more than 78% of the total cases and of this number endotracheal intubation has been used with increasing frequency(average 92.8%). 2) For intravenous induction, thiopental sodium was used as the main agent, in more than 90% since 1980. 3) Trichlorethylene, cyclopropane and ethylchloride which had been used since 1961, were abandoned from 1978 except for training purposes. Methoxyflurane was used from 1973 to 1979, but given up there after because of it's nephrotoxicity. The use of halothane has steadily increased(86% of the total inhalation anesthetics) and ethrane has also been used with increasing frequency since 1980. 4) Pancuronium has been used as a primary muscle relaxant instead of gallamine and D-tubocurarine which had been used as the main durgs from 1959 till 1979. 5) Innovar and morphine as intravenous anesthetics, have recently been with increasing grequency.
Anesthesia, General ; Anesthetics, Intravenous ; Enflurane ; Gallamine Triethiodide ; Halothane ; Inhalation ; Intubation, Intratracheal ; Methoxyflurane ; Morphine ; Pancuronium ; Thiopental ; Tubocurarine

BACKGROUND: There have been few reports suggesting involvement of mast cell and neutrophil to induce bronchoconstriction in aspirin-sensitive asthrna. OBJECTIVE: To evaluate mast cell and neutrophil activation in pathogenesis of aspirin-sensitive asthma. MATERIAL AND METHOD: We observed changes of serum NCA and MPO levels during L-ASA bronchoprovocation test in 14 subjects with aspirin-sensitive asthma. RESULTS: Serum NCA was significantly increased at 30 min(p=0.01) after the inhalation of L-ASA and then, no significant changes were noted at 240 min (p=0.14). NCA was significantly higher in subjects with late asthmatic responses than in those without it (p=0.04). Serum MPO level tended to increase at 30 min with no statistical significance (p=0.08), and then it significantly decreased at 240 min (p=0.05). There was no significant correlation between serum NCA and MPO level (r=0.22, p=0.58). CONCLUSION: These results support the view that NCA derived from mast cell may contribute to neutrophil recruitment into the airway in aspirin-sensitive asthmatic patients.
Asthma ; Bronchoconstriction ; Humans ; Inhalation ; Mast Cells ; Neutrophil Activation ; Neutrophil Infiltration ; Neutrophils*