PURPOSE: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. MATERIALS AND METHODS: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. RESULTS: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. CONCLUSION: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.
Amputation ; Carcinoma, Squamous Cell ; Extremities ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Recurrence ; Skin ; Survival Rate ; Transplants

PURPOSE: Growth hormone(GH) has not only growth promoting effect but also various metabolic effects. We evaluated GH effects by anthrometric data, biochmical data, electrolytes and simple CT in patients with Prader-Willi syndrome. METHODS: Nine children with Prader-Willi syndrome(PWS) were studied. The children were treated with GH(0.6U/kg/week) for 6 months. Before and after therapy we measured height, weight, waist, hip, and thigh. Blood sampling for eletrolytes, HgA1C, lipid profiles and other biochemistry were done in all patients before and after therapy. We also compared fat distribution with scan. RESULTS: Height standard deviation (SD) score increased from -0.7 to -0.5 and weight SD score decreased from 5.3 to 4.9. Body mass index(BMI) decreased from 28.2kg/m2 to 27.2kg/m2. But the changes in height, weight and BMI were not significant statistically. The waist/hip ratio decreased from 1.04 to 0.97(P<0.05), Thigh circumference had been decreased from 58.2+/-21.7cm to 49.9+/-6.9cm insignificantly. The visceral fat were decreased from 7,613+/-1,760 to 5,022+/-1,533 after GH therapy, and thigh muscle mass was increased from 6,358+/-1,616 to 7,175+/-2,155 (P<0.05). Total cholesterol and triglyceride decreased and HDL cholesterol increased after therapy although they were insignificant statistically. There were no differences in electrolytes, HgA1C, other biochemistry(Ca, P, protein, albumin, BUN, Cr) before and after therapy. CONCLUSION: In children with PWS, waist/hip ratio and fat mass were reduced and muscle mass was increased after GH therapy. There was tendency that total cholesterol and triglyceride decreased and HDL cholesterol increased after therapy. We confirmed that GH therapy had not only growth promoting effect but also metabolic effect on lipid and protein metabolism in children with PWS.
Biochemistry ; Child ; Cholesterol ; Cholesterol, HDL ; Electrolytes ; Growth Hormone* ; Hip ; Humans ; Intra-Abdominal Fat ; Metabolism ; Prader-Willi Syndrome* ; Thigh ; Triglycerides

No abstract available.
Diabetes Insipidus*

PURPOSE:Growth retardation is a serious clinical problem in children with chronic renal failure(CRF). Dialysis and renal transplantation do not provide an improvement in growth velocity. Possible causes of growth retardation are nutritional deficiency, electrolyte imbalance, uremia, renal asteodystrophy and chronic anemia. However, catch-up growth cannot be achieved after correcting these factors. There is no concordance about disturbances of growth hormone(GH)-insulin-like growth factor-I (IGF-I) axis. in CRF. This study was designed to evaluate the growth status, IGF-I, GH and the effect of GH in CRF. METHODS:Twelve children with CRF(five were treated conservative, seven were transplanted) were included. IGF-I, stimulated GH, 24 hour integrated concentration of GH (IC-GH)were measured. Six were given rhGH(0.1U/kg/day) for average one year. RESULTS: 1)Growth velocity(GV) was 3.2+/-0.8cm/yr(conservative therapy:3.3+/-0.7, transplanted:2.9+/-0.8). Height standard deveation score(SDS) was -2.4+/-1.3cm/yr(conservative therapy group:-3.3+/-1.4, transplanted group:-1.3+/-0.4). Bone age lagged 2.1+/-13yr behind chronological age. 2) IGF-I concentrations were normal. 3)Stimulated GH levels were normal(16.6+/-3.3ng/ml) except one patient. Twenty- four hour IC-GH were less than 3.2ng/ml in 4 patients. 4)After GH therapy, GV increased 3.3+/-0.7cm/yr to 5.4+/-0.8cm/yr and Ht SDS increased -3.3+/-1.4 to -2.9+/-1.5 in the conservatively treated group. GV increased 2.9+/-0.8cm/yr to 5.5+/-1.8cm/yr and Ht SDS increased -1.3+/-0.4 to -0.8+/-0.5 in the transplanted group. CONCLUSION: Stimulated GH was normal but spontaneous secretion of GH was decreased in some patients with CRF. This neurosecretory dysfunction may be one causative factor in CRF. For these patients GH replacement therapy will be effective in promoting growth.
Anemia ; Axis, Cervical Vertebra ; Child* ; Dialysis ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor I ; Kidney Failure, Chronic* ; Kidney Transplantation ; Malnutrition ; Uremia

No abstract available.
Child* ; Diabetes Mellitus* ; Humans ; Insulin* ; Sex Hormone-Binding Globulin*

PURPOSE: Short stature is the most constant finding in Turner syndrome. Short stature in Turner syndrome has lately received considerable attention, mostly because of recent attemp to improve growth by hormonal treatments; growth hormone, oxandrolone, estrogen. The aim of this study was to find out whether growth promoting treatment would improve final height in girls with Turner syndrome. METHODS:Seventy-one girls with the clinical chracteristics Turner syndrome verified by karyotype analysis were entered into this study. The following selection criteria for final adult height were used; Chronological age of more than 14years old, bone age of more than 15years old and growth velocity of less than 0.5cm per 6months. Analysis was performed by means of multiple regression analysis between descriptive data; modality of treatment with oxandrolone and/or estrigen, parental height, karyotype and final adult height. RESULTS: 1) The final adult height of untreated Turner syndrome was 138.9+/-3.9cm. 2)The final adult height in 29 GH treated Turner girls was 143.9+/-6.5cm, significant higher value than 42 GH untreated Turner girls height, 139.8+/-5.2cm(p<0.01). 3) The final height in GH only group and combined group were 141.2+/-6.0cm, 146.2+/-6.2cm, respectively. The combined therapy was more effective than GH therapy(p<0.01). 4) The final height in 32 patients with karyotype of 45,X was 141.6+/-5.6cm, and that of 31 structural aberration group was 140.3+/-6.2cm. There was no significant difference between two groups. But in mosaicism, only numeric abnormalities, the final height 145.9+/-6.1cm was much more higher than other two groups(p<0.05). 5) The final adult height in Turner syndrome was in good correlation with target height. Final adult height(cm)= 1.01*Target height(cm)- 4.97 r=0.51, p<0.05. 6) There was positive correlation between final adult height and height SDS at start GH treatment and negative correlation with age at start GH treatment. The delta height (final height - height at start treatment) correlate with GH treatment duration. CONCLUSIONS:The final adult height in Turner syndrome in a given ethinic or national population varies in the same way as adult height in normal women. Growth hormone therapy may increase final height in Turner syndrome irrespective of ethinic or national difference. Further growth was observed in GH combined with estrogen or oxandrolone.
Adult* ; Estrogens ; Female ; Growth Hormone ; Humans ; Karyotype ; Mosaicism ; Oxandrolone ; Parents ; Patient Selection ; Turner Syndrome*

PURPOSE:Factors influencing postnatal growth are innumerable. It is known that genetic factors such as parental height and environmental factors such as nutrition, economic status and hormonal effects are important factors. The purpose of this study was to examine the factors affecting final adult height in normal children. METHODS:753 high school students (513 boys, 240 girls) who live in Seoul were studied. Height and body weight were measured and questionaires about sexual development were examined. We included the subjects who reached fianl adult height. The criteria of final adult height was as following: ages over 17 years in the boys and over 15 years in the girls and growth velocity was less than 1 cm per year. They had no systemic diseases and height standard deviation scores were more than -2.5. RESULTS: 1)Final adult heights were 173.1+/-.1cm in boys and 160.9+/-.7cm in girls. 2)Final adult height significantly correlated with father height(r=0.13, p<0.01), mother height(r=0.25, p<0.01), midparental height(r=0.25 p<0.01) and birth weight (r=0.16, p<0.01). 3)In short final adult height groups, birth weight and midparental height were significantly lower(p<0.05), but puberty onset age, body mass index and economic status were similar to normal stature groups. 4)Final adult height significantly correlated with target height.(r=0.43, p<0.01). In boys, the final adult height was 1.7cm taller than target height on the average. In girls, final adult height was 1.6cm taller than target height on the average. 5)In the group in which final adult height is less than target height, birth weights were significantly lower than those of the groups in which final height is greater than target height. CONCLUSIONS:Among factors affecting final adult height, parent height and birth weight were important. To predict final adult height, target height can be used simply and target height showed significant correlation with final adult height. In the case of showing differences between final adult height and target height, many factors including birth weight will influence the outcome.
Adolescent ; Adult* ; Age of Onset ; Birth Weight ; Body Mass Index ; Body Weight ; Child ; Fathers ; Female ; Humans ; Mothers ; Parents ; Puberty ; Seoul ; Sexual Development

PURPOSE: The reported clinical manifestations in Turner syndrome were different by karyotypes, countries and races. So, We evaluated the physical findings & medical problems in patient with Turner syndrome according to karyotype. METHODS: We examined prospectively 53 cases that diagnosed as Turner syndrome by chromosome study at the Pediatric Endocrine Clinic, YUMC from May 1999 to Aug 1999. According to the karyotype, they were divided into 3 groups:45, X(22 cases, 41.5%), mosaicism(18 cases, 34%) and structural aberration group(13 cases, 24.5%), and 53 cases were reevaluated by prepared protocol of 22 abnormal physical findings and 4 medical problems. Chi-square test was used for statistic analysis. RESULTS: 1)In case of 45, X group, they had short stature(100%), cubitus valgus(95.5%), widely spaced nipples(86.4%), shield chest(72.7%), low posterior hair line(68.2%), in case of mosaicism group, they had short stature(100%), cubitus valgus(72.2%), high arched palate(66.7%), widely spaced nipples(61.1%), short neck(61.1%) and in case of structural aberration group, they had short stature(100%), high arched palate (92.3%), widely spaced nipples(92.3%), low posterior hair line(76.9%), shield chest (76.9%), in frequency order. Short stature was the most common finding in Turner syndrome. The incidence of high arched palate was significantly higher in structural aberration group(P<0.05). 2)In case of 45, X group, they had otitis media(63.6%), thyroid problem(4.5%) and no renal problem and cardiac problem, in case of mosaicism group, they had otitis media(38.9%), thyroid problem(5.6%) and no renal problem and cardiac porblem and in case of structural aberration group, they had otitis media(61.5%), thyroid problem(15.4%), renal problem(7.7%) and cardiac problem(7.7%) in frequency order, they had no statistical difference in among three groups. CONCLUSION: In case of 45, X group, the incidence of cubitus valgus, webbed neck were more common findings and of high arched palate, micrognathia were less common findings compared to other group. In case of mosaicism group, the incidence of micrognathia, epicanthal fold were more common findings and wide spaced nipples, antimongoloid fissure were less common findings compared to other group. In case of structural aberration group, the incidence of high arched palate is most common finding among 3 group(P<0.05) and pigmented nevi and epicanthal fold were less common findings compared to other group. The incidence of medical problems such as otitis media and thyroid problem were than other foreign country reports.
Continental Population Groups ; Hair ; Humans ; Incidence ; Karyotype* ; Mosaicism ; Neck ; Nevus, Pigmented ; Nipples ; Otitis ; Otitis Media ; Palate ; Prospective Studies ; Thorax ; Thyroid Gland ; Turner Syndrome*

PURPOSE: This descriptive - comparison study was conducted to investigate the critical thinking disposition of senior nursing students in three types of nursing program. Method: The convenience sample was drawn from 472 nursing students. Instruments used in this study were made California Critical Thinking Disposition Inventory developed by Facione & Facione (1994). Data was analyzed by descriptive statistics, t-test, ANOVA, Scheffe test with SAS 6.12 program. RESULTS: 1. The total mean score of critical thinking disposition was 279.06. Inquisitiveness was the highest with an mean score 45.50, while systematicity was the lowest with mean score of 36.15. There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00)according to senior nursing students in three types of nursing programs. 2. There was a statistically significant difference in critical thinking disposition(F=5.53, p=.00) according to age, marital status(t=-3.15, p=.00), religion(F=3.26, p=.02) and critical thinking course taken previously(t=3.10, p=.00). CONCLUSION: There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00) according to senior nursing students in three types of nursing program. There was a statistically significant difference in Critical thinking disposition according to age, marital status, religion, logic, philosophy, critical thinking course.
California ; Humans ; Logic ; Marital Status ; Nursing ; Philosophy ; Students, Nursing ; Thinking*

PURPOSE: This descriptive - comparison study was conducted to investigate the critical thinking disposition of senior nursing students in three types of nursing program. Method: The convenience sample was drawn from 472 nursing students. Instruments used in this study were made California Critical Thinking Disposition Inventory developed by Facione & Facione (1994). Data was analyzed by descriptive statistics, t-test, ANOVA, Scheffe test with SAS 6.12 program. RESULTS: 1. The total mean score of critical thinking disposition was 279.06. Inquisitiveness was the highest with an mean score 45.50, while systematicity was the lowest with mean score of 36.15. There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00)according to senior nursing students in three types of nursing programs. 2. There was a statistically significant difference in critical thinking disposition(F=5.53, p=.00) according to age, marital status(t=-3.15, p=.00), religion(F=3.26, p=.02) and critical thinking course taken previously(t=3.10, p=.00). CONCLUSION: There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00) according to senior nursing students in three types of nursing program. There was a statistically significant difference in Critical thinking disposition according to age, marital status, religion, logic, philosophy, critical thinking course.
California ; Humans ; Logic ; Marital Status ; Nursing ; Philosophy ; Students, Nursing ; Thinking*