No abstract available.
Colitis, Ischemic* ; Colon*

No abstract available.

No abstract available.
Extremities*

No abstract available.

Congenital scoliosis is a structural deformity due to congenital anomaly of the spine. After Winter's report in 1973, congenital scoliosis is said to be progressive in 75% of cases, and 50% are rapidly progressive, serious and demand treatment. And thus, most of them need more aggressive and early treatment compared with idiopathic scoliosis. The prognosis depends on the type, angle and flexibility of the curvature, and the age of patient. The authors reviewed the results of operative treatment for the congenital scoliosis that had been treated from Jan. 1984 to Dec. 1993 at the orthopedic department of Yonsei University College of Medicine, and the results as follows. 1. The age distribution of the patients was from 2 years to 14 years, and the mean was 8.4 years. Five male patients and two female patients were operated. 2. The involved spinal segments of the primary curve were 2 cases of thoracolumbar, 3 cases of lumbar. There were two cases of double major curves. 3. According to MacEwen's classification, the types of vertebral anomaly were 4 cases of hemivertebra, 2 cases of miscellaneous and one case of wedge vertebra. 4. The levels of apical vertebra were each 1 case of T3, T9, Ll, L2, L4 respectively and each 2 cases of T12, L3 respectively. 5. The methods of operation included 1 case of resection of rib, 4 cases of posterior fusion, 1 case of combined anterior and posterior hemiepiphysiodesis and fusion, and 1 case of hemivertebra excision with spine fusion. 6. The curvature of spine on admission ranged form 10 degrees to 63 degrees, and the mean angle was 35.5 degrees. And, we followed up postoperatively from 1 year to 10 years, and the mean follow up period was 32 months. The final correction angles were from
Age Distribution ; Classification ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Pliability ; Prognosis ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

Three patients had cervical draining sinus communicating with the pyriform sinus and one patient had acute suppurative thyroiditis resulting from infection through the pyriform sinus. There was a moderate to severe perithyroidal inflammation in all 4 cases. The age of onset ranged from 7 to 18 years old (mean; 12) but that of confirmation 9, 15, 18 and 67 years of age. Three of the patients were male and 3 of the cases involved the left side. All patients had suffered from several recurrences of cervical abscess, ranged from 2 to 7 times (mean; 4). Characteristic clinical features included 1) onset at a young age 2) frequent recurrence unless the fistula was extirpated completely 3) presenting with cervical draining sinus after repeated incision and drainage. It is supposed that the fistula is a route of infection mainly in the perithyroidal space and subsequently into the thyroid gland. When the fistula communicates directly with the thyroid gland, it can cause primary acute suppurative thyroiditis. Chronic cervical draining sinus with histories of repeated incision and drainage may be the clue to the diagnosis. A barium paste swallow study is the radiologic procedure of choice and complete removal of the fistula is the treatment of choice.
Adult ; Aged ; Case Report ; Child ; Female ; Fistula/radiography/radionuclide imaging/*surgery ; Human ; Male ; Neck Muscles ; Pharyngeal Diseases/radiography/radionuclide imaging/*surgery ; Radionuclide Imaging ; Thyroid Diseases/radiography/radionuclide imaging/surgery ; Tomography, X-Ray Computed

Adjuvant hormonal therapy is used as the first target-specific approach in curing breast cancers due to its high efficacy and mild side effects. Five years of tamoxifen therapy has been the gold standard for women with estrogen receptor-positive breast cancer irrespective of age or menopausal and nodal status. After the emergence of 3rd generation aromatase inhibitors (AI), the use of either tamoxifen or tamoxifen plus ovarian function suppression for 5 years has been proposed as an acceptable standard for premenopausal women while AI should form part of standard endocrine therapy for the postmenopausal women as established at the St. Gallen Concensus Conference. The addition of luteinizing-hormone-releasing hormone (LHRH) analogs might be beneficial for the younger patients who remain premenopausal after chemotherapy, however controversies over the addition of LHRH analogs remains. Further, it has been suggested that CYP2D6 polymorphisms and concomitant use of CYP2D6 inhibitors which reduce CYP2D6 activity may influence the clinical outcomes of adjuvant tamoxifen therapy. The androgen receptor has been evaluated as a prognostic or predictive marker for endocrine responsiveness in a few studies; however, there are many issues to be answered and ongoing clinical trials will provide the answers. Until then, it would be important for clinicians to carefully evaluate the risk factors of patients, monitor the compliance of those patients who are under endocrine therapy, and take care in selecting antidepressants when coprescription with tamoxifen is necessary. In the future, tailored therapy will be designed based on the target molecular profiling of the tumors, pharmacogenomics, and improved understanding of receptor signaling biology. More attention should be given to explore molecular markers that could differentiate the subsets for tailoring.
Antidepressive Agents ; Antineoplastic Agents, Hormonal ; Aromatase Inhibitors ; Biology ; Breast ; Breast Neoplasms ; Compliance ; Cytochrome P-450 CYP2D6 ; Estrogens ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Organothiophosphorus Compounds ; Pharmacogenetics ; Receptors, Androgen ; Risk Factors ; Tamoxifen

PURPOSE: It has long been controversial whether breast cancer of the younger women is more aggressive than that of older women and remains unclear whether the dismal outcome seen in the younger age group is a reflection of more advanced disease at the time of diagnosis or whether it is due to a difference in the underlying tumor biology. To investigate the outcome of primary breast cancers treated with breast conservation surgery according to the patient's age, we undertook this study. METHODS: One hundred and eighty-five patients with breast carcinoma, that underwent breast conservation surgery at the Severance Hospital, Yonsei University College of Medicine, during the period between July 1988 and December 1996, were divided into two groups on the basis of age 35 (patient group: age 35 or younger, and control group: over 35 years of age). Tumor stage by the American Joint of Committee on Cancer (AJCC) classification, histologic grade, adjuvant therapy, and the incidence of local or systemic recurrences were analyzed. Finally 10-year loco-regional recurrence free, distant relapse free (DRFS) and overall survival (OS) were estimates determined by Kaplan-Meier analysis. RESULTS: Among 185 patients, 42 women (22.7%) were included in the patient young group and the other 143 in the control group. There were no significant differences between the two groups in terms of the distribution of T stages, N stages, histologic subtypes, hormonal receptorexpressions, and mean follow-up duration. The younger group had higher 10-year local recurrence (14.3%) and systemic recurrence (28.6%) rates than the control group (4.2% and 12.6%), respectively (p<0.05). The younger group also had a significantly worse 10-year overall survival rate of 78.6% (p<0.01). CONCLUSION: These results indicate that breast cancer patients younger than 35 years of age have higher local and systemic recurrences and poorer DRFS and OS than their older counterparts. These differences may reflect difference in tumor biology and imply that younger patients with breast cancer need both more aggressive and adequate systemic treatment after surgery.
Biology ; Breast Neoplasms ; Breast* ; Classification ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Kaplan-Meier Estimate ; Recurrence ; Survival Rate

No abstract available.
Acetylcholinesterase* ; Aluminum* ; Animals ; Brain* ; Choline O-Acetyltransferase* ; Choline* ; Rats*

PURPOSE: The objective of this study was to assess the supportive needs of breast cancer patients and determine the socio-demographic and clinicopathological predictors of those unmet needs. METHODS: Of 302 eligible breast cancer patients, attending Yonsei University Severance Hospital, 250 completed the surveys. The supportive care needs were assessed by administering a Supportive Care Needs Survey. RESULTS: Of the ten highest perceived needs items, 7 items were related to the health system and information domain and 2 to the psychological domain. The univariate analysis in each domain showed education (P=0.083) and chemotherapy (P=0.042) were significant predictors in the psychological domain; education (0=0.000), time since surgery (P=0.009), node metastasis (0.022), chemotherapy (P=0.001) and radiation therapy (P=0.003) in the physical and daily living domain; age (P=0, 009) and duration of marriage (P= 0.004) for sexuality; node metastasis (P=0.048), TNM stage (P=0.036), and recurrence (P=0.010) in the health system and information domain and religion (P=0.016) in the care and support domain. A multivariate analysis showed age (P=0.0253) and chemotherapy (P=0.0517) as significant independent predictors in the sexuality domain; education (P=0.0010), chemotherapy (P=0.0011), radiation therapy (P= 0.0133) and time since surgery (P=0.036) in the physical and daily living domain; recurrence (P=0.0324) in the health system and information; domain and education (P=0.0134) and chemotherapy (P=0.0207) in psychological domain. CONCLUSION: Breast cancer patients experience high levels of unmet supportive needs across each domain, but especially in the health systems and information domain. Also, the types of needs varied according to the patient subgroups. This study suggests considerable improvements be made in terms of supportive care of breast cancer patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Education ; Humans ; Marriage ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Sexuality