No abstract available.

No abstract available.

PURPOSE: To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy. MATERIALS AND METHODS: Between May 1995 and Dec. 1997, ten patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1~1.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of high dose rate, iridium-192 implant which delivered 12~15 Gy to 1 cm distance from the center of source axis with 2~2.5 Gy/fraction, twice a day, starting on 6th day after the surgery. Within one month after the surgery, total dose of 50~55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. RESULTS: All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12~41 months), no local recurrences were observed. And there was no severe form of chronic complication (RTOG/EORTC grade 3 or 4). CONCLUSION: The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.
Axis, Cervical Vertebra ; Brachytherapy* ; Catheters ; Diagnosis ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Radiotherapy ; Recurrence ; Sarcoma* ; Tissue Expansion Devices

In the thyroid tissue, thyrotrophin(TSH) and IGF-I played major role of the goitrogen. But the evidences and precise mechanism of these two factors were not known so much. Actually local secretion of thyroid IGF-I was originated from its fibroblasts mainly. We guessed major roles of IGFs in the thyroid tissue were local paracrine effect of thyroid cells proliferation and differentiation which concert with TSH. Recently, some reporters described the source of thyroid IGF-I were partly from thyroid follicular cells and its action were synergistic with TSH. We measured TSH, IGF-I and IGFBP-3 from sera and thyroid cystic fluids in 36 patients with simple thyroid cyst and examined into correlation between TSH, IGF-I and IGFBP-3.1) According to cyst/serum TSH ratio, we classified two groups(Group I; c/s TSH <1, n=19. Group II; c/s TSH >1, n=17). This classification criteria means that cystic TSH level were increased than that of serum or not.2) The serum TSH, IGF-I and IGFBP-3 levels are not difference between group I and II.3) Cystic TSH were dependent on the serum TSH in Group I, but negative correlation in Group II. In Group II, cystic TSH was significant increased.4) Serum IGF-I were positive correlation in each Group5) In Group II, cystic IGF-I was not exceed than those of serum IGF-I, but some cystic IGFBP-3 were more increased than those of serum.6) In Group II, cystic IGFBP-3 increased than serum TSH, and cystic IGFBP-3 was positive correlation with cystic TSH and cystic IGF-I.As these data suggested that cystic TSH and cystic IGF-I levels may influence cystic IGFBP-3 level. The main effect for maintenance of cyst was mediated by cystic TSH and cystic IGFBP-3. But the cystic IGFBP-3 has major role for thyroid cyst than cyst TSH.
Classification ; Fibroblasts ; Humans ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Thyroid Gland

The Acknowledgements was published incorrectly. The authors apologize for any inconvenience that it may have caused.

BACKGROUND: Knowledge about the degree of risk and location of multiple primary cancers can facilitate the targeting of screening and surveillance practices on follow-up after treatment of cervical cancer. PURPOSE: The retrospective study was performed to evaluate the characteristics of multiple primary malignancies in patients treated for cervical carcinoma. METHOD: From data base file of gynecologic cancer patients between 1976 and 1995, total 20 patients were found to have cervical cancer and another primary malignancy. Their medical records and pathologic slides were reviewed. Follow-up information was obtained from medical records or by telephone. RESULT: There were 8 synchronous and 12 metachronous multiple primary cancers (MPC) among 20 patients. Their mean age was 51 years (range 23 ~ 68 years). The distribution of FIGO stage of the patients with cervical cancer was classified into stage I, 6 patients; stage II, 9 ; and stage III, 5. All patients showed squamous cell type histology of cervical cancer. Eight(40 %) of 20 patients developed second cancer in uterus : 6 malignant mixed Mllerian tumors(MMMT), one endometrial stromal sarcoma, and one endometrial adenocarcinoma. Seven of 8 synchronous type MPC patients are alive (median follow-up, 27 months). In contrast, only one out of 12 metachronous type MPC patients is alive(median follow-up, 114 months). The occurrence of eight malignancies including 6 MMMT, one bladder cancer, and one rectal cancer might be related with previous radiation therapy for cervical cancer. CONCLUSION: These results suggest that routine screening and surveillance work-up might not be necessary in most of patients with cervical cancer. However, the patients with cervical cancer undergoing radiation treatment have to be followed carefully with the consideration of possibility for developing second cancer in the field of irradiation.
Adenocarcinoma ; Follow-Up Studies ; Humans ; Mass Screening ; Medical Records ; Neoplasms, Second Primary ; Rectal Neoplasms ; Retrospective Studies ; Sarcoma, Endometrial Stromal ; Telephone ; Urinary Bladder Neoplasms ; Uterine Cervical Neoplasms ; Uterus

This study was performed to demonstrate the efficacy of combination of cold-knife conization and cold-coagulation for the treatment of cervical intraepithelial neoplasia(CIN). In addition, the accuracy of the colposcopic biopsy and Pap smear compare to conization was determined. Cold-coagulation was performed simultaneously in 151 patients after cold-knife conization for diagnosis and treatment of CIN from Jan. 1995 to Dec. 1996. Medical records and pathologic slides of those patients were reviewed. Histologic comparison between the Pap smear and conization specimens showed agreement with 70 % within one grade difference ; Histologic comparison between the colpodirected punch biopsy and conization specimens showed agreement with 80 %. The margin involvement of conization was seen in 35 patients(23 %). There was a tendency of increasing rate of positive cone margin with grade of the lesion : 14 %(1/7) in CIN 1, 20 %(2/10) in CIN 2, 35 %(31/88) in CIN 3, and 33 %(1/3) in microinvasive cervical cancer. Among these 35 patients, 11 patients underwent hysterectomy and showed residual disease in 4 patients(36 %). Recurrence of CIN was found in 4 patients(16 %) with positive cone margin and 1 patient(0.9 %) with negative cone margin. Bleeding was observed in 13 patients(9 %). Two patients underwent hysterectomy because of severe bleeding. These results suggest that cold-knife conization with cold-coagulation is an effective procedure to reduce recurrence rate of the patients with CIN regardless of status of cone margin and to reduce the severity of bleeding after conization.
Biopsy ; Cervical Intraepithelial Neoplasia* ; Conization* ; Diagnosis* ; Hemorrhage ; Humans ; Hysterectomy ; Medical Records ; Recurrence ; Uterine Cervical Neoplasms

Psoriasis is a dermatological disease which has various clinical presentation. Thick red plaques with clear margin and silvery scale characterize psoriasis. Recurrent tonsillitis infected by streptococcus has been reported to be related with Guttate psoriasis. Psoriasis is treated dermatologically by phototherapy, photochemical therapy, retinoid therapy, local steroid therapy and antibiotics. The authors report a case of the 33-year-old female with Guttate psoriasis treated by tonsillectomy. She has experienced that her psoriatic skin lesions got worse every time she suffered from tonsillitis, but Guttate psoriatic skin lesions have disappeared after tonsillectomy.
Adult ; Anti-Bacterial Agents ; Female ; Humans ; Palatine Tonsil ; Phototherapy ; Psoriasis* ; Skin ; Streptococcus ; Tonsillectomy* ; Tonsillitis

OBJECTIVES: The objective of this study was to investigate the clinical decision support (CDS) functions and digitalization of clinical documents of Electronic Medical Record (EMR) systems in Korea. This exploratory study was conducted focusing on current status of EMR systems. METHODS: This study used a nationwide survey on EMR systems conducted from July 25, 2018 to September 30, 2018 in Korea. The unit of analysis was hospitals. Respondents of the survey were mainly medical recorders or staff members in departments of health insurance claims or information technology. This study analyzed data acquired from 132 hospitals that participated in the survey. RESULTS: This study found that approximately 80% of clinical documents were digitalized in both general and small hospitals. The percentages of general and small hospitals with 100% paperless medical charts were 33.7% and 38.2%, respectively. The EMR systems of general hospitals are more likely to have CDS functions of warnings regarding drug dosage, reminders of clinical schedules, and clinical guidelines compared to those of small hospitals; this difference was statistically significant. For the lists of digitalized clinical documents, almost 93% of EMR systems in general hospitals have the inpatient progress note, operation records, and discharge summary notes digitalized. CONCLUSIONS: EMRs are becoming increasingly important. This study found that the functions and digital documentation of EMR systems still have a large gap, which should be improved and made more sophisticated. We hope that the results of this study will contribute to the development of more sophisticated EMR systems.
Appointments and Schedules ; Decision Support Systems, Clinical ; Electronic Health Records ; Health Information Exchange ; Hope ; Hospitals, General ; Humans ; Inpatients ; Insurance, Health ; Korea ; Medical Informatics ; Medical Records ; Medical Records Systems, Computerized ; Surveys and Questionnaires

OBJECTIVES: Schizophrenic patients have been reported to be associated with abnormal performance on a broad range of neuropsychological tests. But it has been a persistent controversy in the neuropsychology of schizophrenia whether this disorder is characterized by generalized deficits or specific deficits. The purpose of this study was to investigate, using standardized Benton Neuropsychological Assessment(BNA), whether the specific pattern of neurocognitive deficits is found in schizophrenics. METHODS: The subjects were composed of (1) 30 schizophrenic inpatients who were diagnosed as paranoid subtype according to DSM-IV diagnostic criterior and (2) 30 normal subjects with matching demographic variables(i.e. age, sex, educational level). All tests of BNA were given to schizophrenic patients and normal subjects, and the performances of schizophrenic patients and normal subjects were compared on all aspects of BNA. Schizophrenic symptoms were assessed via Positive and Negative Syndrome Scale(PANSS) to determine the relationship between clinical symptoms and schizophrenic cognitive deficits. RESULTS: Of 12 tests of BNA, schizophrenic patients' performances on Serial Digit Learning(SDL), Facial Recognition Test(FR), Tactile Form Perception(TFP), Finger Localization(FL) were significantly lower than those of normal subjects. In addition, schizophrenic patients showed significantly lower performances than those of normal subjects on Right Hand, Left Hand, Identification of two simultaneously touched fingers of FL, and more Peripheral Error on Visual Form Perception Test(VFPT). Finally, no significant correlation was found with respect to the relationships between total scores, positive symptom scores, negative symptom scores of PANSS, and all scores of BNA tests in schizophrenic patients. CONCLUSION: These results suggest that schizophrenic patients may have a specific pattern of neurocognitive deficits in verbal working memory, learning, attention, and complex sensory information processing in visual and haptic modality such as facial perception skills, tactile information processing, independent of psychotic symptoms. The pattern of deifcits is at least in partial, in agreement with many previous study results. On the tests of linguistic functions, visuospatial perception, and constructional abilities, schizophrenic patients' performances were not significantly different from those of normal subjects. The findings on visuospatial perception and constructional abilities imply that some posterior cortical zones may be relatively uncompromised in schizophrenia. Both poor performances on object recognition tests relative to normal performances on object location tests and verbal working memory dysfunction may be associated with the putative dysfunction of the reciprocal connections either (1) between the prefrontal and parietal cortex or (2) between the prefrontal cortex and hippocampal formation. This tentative explanation remains to be confirmed.
Automatic Data Processing ; Diagnostic and Statistical Manual of Mental Disorders ; Fingers ; Form Perception ; Hand ; Hippocampus ; Humans ; Inpatients ; Learning ; Linguistics ; Memory, Short-Term ; Neuropsychological Tests ; Neuropsychology ; Prefrontal Cortex ; Rabeprazole ; Schizophrenia*