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

Development of the human colorectal cancer is associated with several distinct genetic abnormalities involving both dominant-acting oncogenes (K-ras, c-src) and tumor suppressor genes (APC, DCC, p53) which undergo inactivation or loss. In colorectal tumors, the common molecular alteration is localized in the 17p13 and 5q21 loci encoding the p53 and the APC gene, respectively. The identification of these genes may help the understanding of the pathogenesis of colorectal neoplasia. In order to determine whether the frequency of the genetic alterations varies with sex, age, tumor size, or site, including pathologic parameters, such as degree of differentiation, tumor stage, mucin component, lymphoid reaction, tumor invasion pattern, vein and nerve invasion, lymph node metastasis, and other parameters, such as disease-free survival, distant metastasis and patient outcome, the authors analyzed the loss of heterozygosity (LOH) of the APC and the p53 genes in paraffin-embedded specimens of 48 colorectal cancers by use of the polymerase chain reaction and restriction fragment length polymorphism. The results were as follows: the LOH affecting the APC was found in 15 out of 31 (48.4%) heterozygous patients, while the LOH of the p53 locus was observed in 11 out of 26 (42.3%) patients. Among 48 patients, the LOH at both the APC and the p53 loci was observed in five (10.4%) patient. No statistically significant associations were found between the LOH of the APC gene and the proposed parameters. The relationship between the LOH of the p53 and the histologic differentiation, lymphoid reaction was significant (P<0.05), but survival was not correlated. Statistically significant associations were found between overall survival of the colorectal cancer patients and distant metastasis, Astler-Coller stage, lymphoid reaction, invasion pattern, nerve invasion, vein invasion, lymph node metastasis, and disease free survival. The above results suggest that the LOH of the p53 genes could be involved in the progression of colorectal cancers. However, neither the LOH of the APC nor that of the p53 have significant association with survival of the colorectal cancer patients.
Colorectal Neoplasms* ; Disease-Free Survival ; Genes, APC ; Genes, p53 ; Genes, Tumor Suppressor* ; Humans ; Loss of Heterozygosity* ; Lymph Nodes ; Mucins ; Neoplasm Metastasis ; Oncogenes ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Veins

This report describes a primary malignant melanoma which developed in the anus, as documented by light microscopy and immunohistochemistry. A 53-year-old woman had a 4 month history of a protruding mass in the anal canal. The mass was located in the squamo-columnar junction of the anal canal, measuring 5.0x4.5 cm. Its cut surface was dark brown and poorly circumscribed. The histologic appearance was characterized by epithelioid or spindle cells with prominant nucleoli and frequent atypical mitosis. Melanin pigments were strongly seen in Fontana-Masson stain. Immunoreactivity revealed that the cytoplasm of tumor cells was strongly positive with antibody directed against S-100 protein, vimentin and it was focally positive with neuron specific enolase.
Female ; Humans