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Purpose: Intravenous rt-PA therapy is effective, however the frequency of this therapy for cerebral infarctions in Japan is only 6 to 7 percent, and the roles of nurses after patients are admitted to hospitals vary depending on the institutions. This study aimed to identify the roles of nurses conducting this treatment. Methods: We conducted a questionnaire survey with 67 participating hospitals. Questions for supervisors were about institutional arrangements, and those for the nurse were about the role of nurses. The research was conducted with the approval of the Ethics Committee of Nakamura Memorial Hospital. Results: The facility size of 18 facilities was with less than 300 beds, 24 with 300 - 500 beds, and 26 with 500 beds or more. The facilities reported that they have ‘nursing service regulations’ (n = 55), ‘roles are clearly defined’ (n = 55), ‘arrangements for routine examinations’ (n = 65), ‘target time frames for each task’ (n = 53), and ‘meetings with other staff members involved’ (n = 35). In more than 80% of the facilities, nurses conduct ‘procedures for accepting patients’, ‘vital sign measurements’, and ‘‘physical preparation of the patient’. Few conducted the ‘NIHSS evaluation’, ‘information collection’, ‘ordering of pre-examinations’, and ‘confirmation of the results of blood samples’. About half of the facilities reported that the ‘NIHSS evaluation’ and ‘information collection’ are the roles of physicians and nurses in cooperation. Further, ‘blood sample collection and insertion of intravenous catheters,’ ( p =.004), ‘observing patients during pre-examination and transfer’, ( p =.008), and ‘insertion of urethral indwelling catheters’ ( p =.004) were significantly correlated with the number of beds, the roles of nurses in facilities with < 300 beds. Items in ‘patient’s observations during pre-examination and transfer,’ ( p =.006) were significantly different from the use of role allocation rules, and this role was conducted by nurses in facilities with clear role allocations. Conclusions: In this treatment, preparations for treatment and observing patients are commonly considered the roles of nurses, but nurses in smaller hospitals were assigned more roles, suggesting that the main factor behind this is the number of physicians available.

INTRODUCTION AND OBJECTIVES: There are more than 200,000 cases of renal cell carcinoma (RCC) each year in the world, accounting for approximately 2% of all cancers. RCC clear cell type (ccRCC) is the most common subtype of RCC and accounts for 75 to 80% of the cases with highest rates of local invasion, development of metastasis and mortality. New target therapy is based on antiangiogenic antibodies and molecules, changing the course of the disease, but the results so far are disappointing. Our aim is to study miRNAs and their target genes related to angiogenesis in ccRCC trying to bring some new knowledge to the molecular pathways related to the disease METHODS: The expression levels of miRNAs miR-99a, 99b, 100; 199a; 106a; 106b; 29a; 29b; 29c; 126; 200a, 200b and their respective target genes: mTOR, HIF1-a, VHL, PDGF, VEGF, VEGFR1 and VEGFR2 were evaluated using qRT-PCR.in snap-frozen tumor tissue samples from 56 patients diagnosed with ccRCC and 5 samples of benign renal tissue as control. The results were related to tumor size, Fuhrman nuclear grade and microvascular invasion, considering the risk criteria proposed by Dall’Oglio et al. (2007). RESULTS: We found an underexpression of the most genes except the VEGFA and PDGF, while the analysis of miRNAs showed underexpression only the miR 199a, 100 and 126. We compared the expression of genes with their possible regulatory miRNAs, and we found that mTOR was underexpressed while miR99a was overexpressed in most samples. This relationship also occurs between VEGFA and miR126 and between miRNAs 106a, 106b, and their target gene VHL. Considering the risk groups the overexpression of miR200b was associated with high-risk patients (p 1⁄4 0.01) and the overexpression of miR126 was associated with lower Fuhrman grade (I-II) (p 1⁄4 0.03). CONCLUSIONS: Our results show that in ccRCC there is an unbalance in the expression of genes and miRNAs related to angiogenesis and cell proliferation and survival. Furthermore with our findings we can speculate the role of miR200b and miR126 in the prognostic of ccRCC. We believe that the relationship between miRNAs and their respective genes should be more profoundly searched as markers and possible therapeutic agents in this neoplasia.

INTRODUCTION AND OBJECTIVES: There are more than 200,000 cases of renal cell carcinoma (RCC) each year in the world, accounting for approximately 2% of all cancers. RCC clear cell type (ccRCC) is the most common subtype of RCC and accounts for 75 to 80% of the cases with highest rates of local invasion, development of metastasis and mortality. New target therapy is based on antiangiogenic antibodies and molecules, changing the course of the disease, but the results so far are disappointing. Our aim is to study miRNAs and their target genes related to angiogenesis in ccRCC trying to bring some new knowledge to the molecular pathways related to the disease METHODS: The expression levels of miRNAs miR-99a, 99b, 100; 199a; 106a; 106b; 29a; 29b; 29c; 126; 200a, 200b and their respective target genes: mTOR, HIF1-a, VHL, PDGF, VEGF, VEGFR1 and VEGFR2 were evaluated using qRT-PCR.in snap-frozen tumor tissue samples from 56 patients diagnosed with ccRCC and 5 samples of benign renal tissue as control. The results were related to tumor size, Fuhrman nuclear grade and microvascular invasion, considering the risk criteria proposed by Dall’Oglio et al. (2007). RESULTS: We found an underexpression of the most genes except the VEGFA and PDGF, while the analysis of miRNAs showed underexpression only the miR 199a, 100 and 126. We compared the expression of genes with their possible regulatory miRNAs, and we found that mTOR was underexpressed while miR99a was overexpressed in most samples. This relationship also occurs between VEGFA and miR126 and between miRNAs 106a, 106b, and their target gene VHL. Considering the risk groups the overexpression of miR200b was associated with high-risk patients (p 1⁄4 0.01) and the overexpression of miR126 was associated with lower Fuhrman grade (I-II) (p 1⁄4 0.03). CONCLUSIONS: Our results show that in ccRCC there is an unbalance in the expression of genes and miRNAs related to angiogenesis and cell proliferation and survival. Furthermore with our findings we can speculate the role of miR200b and miR126 in the prognostic of ccRCC. We believe that the relationship between miRNAs and their respective genes should be more profoundly searched as markers and possible therapeutic agents in this neoplasia.

We investigated the usefulness of an Endoflex tracheal tube, the tip of which can be bent forward by pulling on a wire held in the hand, for oral and nasal endotracheal intubations without a stylet, in comparison with tracheal intubation using a conventional endotracheal tube and a stylet/Magill forceps.The study participants comprised 40 patients for oral intubation and 20 patients for nasal intubation. Each group was then divided into control and Endoflex subgroups. In the oral intubation study, controls were intubated using a standard Macintosh-type laryngoscope with a conventional endotracheal tube with adjuvant use of a stylet, whereas the Endoflex group was intubated using a Macintosh-type laryngoscope with an Endoflex tube. In the nasal intubation study, controls were intubated by a standard Macintosh-type laryngoscope with an endotracheal tube for nasal intubation. Under direct vision, Magill forceps were used to guide the tip of the endotracheal tube into the glottis. Patients in the Endoflex group were intubated using a Macintosh-type laryngoscope with an Endoflex tube.Although haemodynamic changes during tracheal intubation did not differ between the groups, the duration of intubation was significantly shortened in the Endoflex groups in both studies.The Endoflex endotracheal tube represents a beneficial tool for smooth oral and nasal intubation without requiring assistance or adjuvant equipment.