Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus

BACKGROUND: DNA content analysis of human solid tumor is now widely performed by flow cytometric study. One of the most interesting and potentially observation in this field is that proliferative activity(S-Phase fraction of cell cycle) may profoundly affect the prognosis. METHOD: S-Phase fraction(SPF) have been measured by flow cytometric method using tumor cells isolated from paraffin embedded tissue. To evaluate the prognostic significance, SPF of small lung cancer cell was assessed in 42 patients who died after receiving anticancer chemotherapy. RESULTS: 1) Mean survival time of patients with small cell lung cancer was 190(± 156) days, Survival time were shortened, when TNM stage and PS scale were advanced. 2) Mean value of SPF of patients with small cell lung cancer was 27.4(±8.5)%. SPF had nothing to do with advance of TNM stage and PS scale. 3) In each identical TNM stage, there were not statistic significance between SPF and survival times. 4) There was a tendency like that higher SPF, better chemotherapeutic CONCLUSION: We could not find statistic significance between SPF and survival times, but SPF was a good predictive factor for chemotherapeutic response.
DNA ; Drug Therapy ; Humans ; Lung Neoplasms* ; Lung* ; Paraffin ; Prognosis ; Small Cell Lung Carcinoma ; Survival Rate

No abstract available.

Spinal instrumentation is popular nowadays. After applying the Harrington distraction rod, there might be a severe, tragic complication, paraplegia. Recently SSEP is widely used to detect the early change of the spinal cord dysfunction. The force to correct the spinal deformity is usually distraction. The distraction force will stretch the spinal dura. But the relation of neural deficit between distraction force and duration is not clearly determined yet. Also the anatomical level of neural deficit is not known. The purpose of this study is to find that the distraction force of 200gm on the spinal dura will change the SSEP by the stimulation of the posterior tibial nerve and if there is change of SSEP, what portion of nerve stimulation pathway is responsible for. Results are as followings. 1) The distraction force of 200gm makes change of SSEP wave. 2) P2 wave is most susceptible, N1 wave is less susceptible and P1 is relatively contant for one hour dural traction. 3) After release of traction, the wave is partially reversible but not completely for next one hour recovery period. 4) While the wave of SSEP is changed by the dural distraction force, the nerve conduction between the nerve root just outside of the spinal dura and calf shows constant latency. That means the anatomical level responsible for the change of SSEP wave is proximal to the spinal dura, not the peripheral nerve distal to the spinal dura.
Animals ; Congenital Abnormalities ; Dogs ; Evoked Potentials ; Evoked Potentials, Somatosensory ; Neural Conduction ; Paraplegia ; Peripheral Nerves ; Spinal Cord ; Tibial Nerve ; Traction

No abstract available.
Equidae*

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

BACKGROUND: After the group education program for the families of stroke patients, we found there were improvement in family members' mental health state and coping skills. However, we also found that family caregiver's burden varied depending on patient and family factors. The purpose of this study, therefore, were to explore which factors affected caregiver's burden on family members of stroke patients and to make a background for suggesting an effective intervention strategies for them. METHOD: The subjects of this study were 187 family members of stroke patients who received the treatment from Hospital located in Seoul and Kyunggi area and they completed the written questionnaire. RESULTS: While Family member's health state, share of care responsibility, patient's functional status and family and friends support were predictors of subjective care burden, patients age and left hemiparesis among patient's functional status were predictors of objective care burden. CONCLUSIONS: Family members play a critical role in the long-term rehabilitation of a stroke patient. Hence reducing family members' care burden is very important for a patient as well as their family members. Therefore if we make intervention strategies considering these influential factors, it could be more effective to reduce family caregiver's burden.
Adaptation, Psychological ; Caregivers* ; Education ; Friends ; Gyeonggi-do ; Humans ; Mental Health ; Paresis ; Surveys and Questionnaires ; Rehabilitation ; Seoul ; Stroke*

OBJECTIVE: To compare pregnancy and delivery complications in first births between women 35 years or older and those who are younger. METHODS: Matemal and newborn records for first births at Chonnam university hospital from January 1, 1988 to December 31, 1996 were studied. The study group included 123 women who were 35 years or older. A control group consisting of 120 younger women was used for comparison. The X2 test was used to identify trends in individual variables and outcomes. RESULTS: Premature rupture of membrane, uterine myoma, and malpresentation were much mare prevalent in the older nullipara. However, there were no significant differences in incidences of preeclampsia, placenta previa, and pyelonephritis between the older nullipara and younger nullipara groups. Older nullipara had a significantly higher incidence of Cesarean delivery than younger women, Elective cesarean section was performed only in the older nullipara and it was the most common indication for Cesarean delivery in older nullipara. Fetal distress and breech presentation as indications for Cesarean delivery were significantly more common in the older study group. There were no noticeable differences in postpartal complication between the groups. Pretam birth and low birth weight were much more common in the older nullipara. but there were no significant differences in small for gestational age, low Apgar score, perinatal morbidity and deaths between the groups. CONCLUSION: From the results, it was difficult to conclude that women 35 or older are pmne to higher risk pregnancies, compared to their younger counterparts. Although more incidences of premature rupture of membrane, preterm delivery, and Cesarean delivery were observed, there were no significant differences in other pregnancy and delivery complications. With appropriate obstetric care, it is most probable that first time pregnancies in older women will result in similar outcome as those in younger women.
Apgar Score ; Birth Order ; Breech Presentation ; Cesarean Section ; Female ; Fetal Distress ; Gestational Age ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Jeollanam-do ; Leiomyoma ; Membranes ; Parturition ; Placenta Previa ; Pre-Eclampsia ; Pregnancy ; Pyelonephritis ; Rupture

BACKGROUND: An accurate and rapid method for specise identification of coagulase negative staphylococci(CNS) has been increasingly necessary for the clinical significance and planning the management of patients with staphylococcal infections. Recently, it has been reported that there is a highly conserved area on their 60KDa heat shock protein(HSP60) gene sequences between the interspecies of CNS and it can be amplified by a set of universal degenerate primer. This led us our attention to focus on whether the PCR-based RFLP method using Mse / restriction enzyme could be a useful tool for the species identification of CNS. METHODS: In the present study, we performed PCR-based RFLP analysis using a set of degenerate primers covering HSP60 and Mse / restriction enzyme on the reference strains and 25 clinical isolates(10 of S. epidermidis, 10 of S. haemolyticus, 4 of S. lugdunensis and 1 of S. warneri) which were previously identified by the API-STAPH, Vitek GPI card and/or with conventional biochemical test. RESULT: All the seven reference strains revealed that each strain has a distinct electrophoresed band patterns with combination of different number (up to 8) and size of fragments. And these distinct band patterns showed remarkable concordance with the seven reference strains and 25 clinical isolates. CONCLUSION: These result strongly suggest that the PCR-RFLP method using degenerate primers covering the HSP60 gene and Mse / digestion enzyme offer a convenient and accurate tool for species-specific identification of CNS.
Chaperonin 60* ; Coagulase* ; Digestion ; Heat-Shock Proteins* ; Hot Temperature* ; Humans ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Shock ; Staphylococcal Infections

59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during taperring and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0% ) between non-recurrent and recurrent group.
Child ; Electroencephalography ; Epilepsy* ; Gangwon-do ; Humans ; Nervous System Diseases ; Pediatrics ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Seizures