OBJECTIVES: The aims of this study were to know the prevalence of cognitive disorders in patients with thyroid cancer, and identify related variables to them. METHODS: Subjects were consisted of fourty-two patients with thyroid cancer, who were admitted for radioiodine ablative therapy at 6-12 months after total thyroidectomy. The data were obtained from interviews about history and assessments of depression and cognitive function(Korean Version of the Montreal Cognitive Assessment, MoCA-K). RESULTS: 1) Among subjects, those with below 22 of total score of the MoCA-K were twenty-one(50.0%). 2) Upon age, education, Pre-radioiodine therapy thyroid stimulating hormone(TSH), there were statistically significant difference between subgroup with above 23 of the total MoCA-K score and those below 22. 3) The total scores of the MoCA-K in subjects had significant correlation with age, education, comorbidity, Pre-radioiodine therapy TSH, total score of the HDRS-17. CONCLUSIONS: Cognitive disorders were more prevalent among patients with thyroid cancer before radioiodine therapy. Therefore, further study should be needed to clarify the mechanism for the cognitive disorders in thyroid cancer. Furthermore, physicians should pay attention to the cognitive function and prepare preventative measures for cognitive disorder during management of thyroid cancer.
Carcinoma, Papillary* ; Comorbidity ; Depression ; Education ; Humans ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin

Following results were obtained from the light microscopic and stereomicroscopic observations of the breasts of rats treated with 9, 10-Dimethyl-1,2-Benzanthracene(DMBA). 1) Adenocarcinomas developed in 17 rats (24%) among 70 DMBA-treated rats. 2) Terminal and buds (TEB) were observed longer in DMBA-treated rats than in control group, but they finally disppeared 4 monthes after treatment. 3) Many hyperplastic alveolar nodules (HAN) developed in DMBA-treated rats. 4) There were no transitional lesions between TEB and adenocarcinoma or HAN and adenocarcinoma. 5) The number of lobules was decreased in DMBA-treated rats. On the other hand, terminal ducts were increased in number. These findings suggest that DMBA stimulate the regression of lobules and induce to form terminal ducts from which adenocarcinomas and HAN develop independently.
Rats ; Animals ; Adenocarcinoma ; Breast Neoplasms

No abstract available.
Vasodilation*

PURPOSE: Under the rising demand of health services, the critical pathway (CP) which standardizes the practice guideline was introduced as a means to provide quality healthcare service. CP may increase the patient's satisfaction rate by providing systematic and consistent service. We aimed to evaluate the significance of CP by development and application of CP to patients undergoing laparoscopic cholecystectomy. METHODS: From June 2010 to July 2011, 148 patients underwent elective laparoscopic cholecystectomy. Patients were divided into two groups, including 57 patients in the CP group and 91 patients in the non-CP group. In a retrospective review, related hospital costs were analyzed and compared for both groups. Survey results on satisfaction for the CP group were also analyzed. RESULTS: The mean age was 22.7 years in the CP group and 37.9 years in the non-CP group. Number of hospitalized days was one day for the CP group and 2.51 days for the Non-CP group with p<0.001. In cost analysis all variables showed a significant reduction in the CP group compared to the Non-CP group. The satisfaction rate in the CP group scored 8 points out of 10. CONCLUSION: Results have shown benefit from the financial point of the view for the CP group. Current inclusion criteria for CP are limited and still in development for a solid protocol. Further efforts with a large-scale comparative study to broaden the indication for CP are desired.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Costs and Cost Analysis ; Critical Pathways* ; Delivery of Health Care ; Health Services ; Hospital Costs ; Humans ; Retrospective Studies

PURPOSE: We performed to reveal the association between the Helicobacter pylori infection and body weight among children. METHODS: Out retrospective study included patients who underwent the H. pylori immunoglobulin G testing at Konyang University Hospital between March 2011 and June 2014. These patients were classified as seropositive (28 boys, 27 girls; mean age: 9.89±3.28 years) or seronegative (55 boys, 54 girls; mean age: 9.84±3.02 years). Next, we compared various characteristics between the seropositive and negative groups, as well as between obese children (body weight ≥90th percentile) and non-obese children (body weight <90th percentile). Furthermore, we compared the change in body weight after 2 months of treatment with amoxicillin, clarithromycin and omeprazole among the 55 seropositive children (14 treated children and 41 non-treated children). RESULTS: There were no differences in the weights and laboratory data for the 55 seropositive children and 109 seronegative children (weight; 40.96±18.11 kg vs. 36.85±13.72 kg, respectively; p=0.14). And, there was no difference in the prevalence of H. pylori infection among the 29 obese and 135 non-obese children (p=0.581). However, after 2 months of eradication, the 14 treated patients exhibited a significant weight gain (+0.91±0.52 kg), compared to the 41 non-treated patients (-0.29±1.16 kg, p=0.025). CONCLUSION: Our findings present that obesity was not associated with the H. pylori infection, although H. pylori eradication led to significant increase in body weight.
Amoxicillin ; Body Weight* ; Child* ; Clarithromycin ; Disease Eradication ; Female ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Obesity ; Omeprazole ; Prevalence ; Retrospective Studies ; Weight Gain ; Weights and Measures

Anal cancer is a relatively rare disease to supply consistent therapeutic modality. We analysed 18 anal cancer patients treated from 1989 to 1996 at the Department of Surgery, Asan Medical Center, to evaluate two categories of the treatment e.g. initial surgery followed by radiochemotherapy and radiochemotherapy Preceding surgery. The aim of this study is to evaluate the advantage and pitfall of both therapeutic options. Among 18 patients presenting with carcinoma of the anus, the dominant histologic type was squamous followed by cloacogenic and verrucous carcinoma, 72%, 17%, 11% respectively According to the staging system of AJCC/UICC, T1 and T2 were 12 patients, NO were 7 patients. According to the treatment options, abdominoperineal resection preceding radiochemotherapy were performed in 8 patients, Whereas surgery after radiochemo-therapy were in 10 patients. Among the 8 patient with prior surgery, two patients developed recurrent disease and one patient was dead. Among the 10 patient with prior radiochemotherapy, two patients developed recurrent disease and two patients were dead. Histological differentiation of squamous cell carcinoma was significantly related with survival. The metachronous lymph nodes metastasis showed poorer prognosis than the synchronous metastasis. Radiochemotherapy shoud be considered as primary therapy of anal cancer that obviated wide excision sacrificing anorectal function.
Anal Canal ; Anus Neoplasms* ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous ; Chemoradiotherapy ; Chungcheongnam-do ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Rare Diseases

PURPOSE: To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and lll rectal cancer who had undergone curative resection were randomized to early radiotherapy group (arm I) or 'late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. MATERIALS AND METHODS: From January 1996 to March 1999, 3 13 patients with curatively resected stages II and III rectal cancer have been randomized to early' or late radiation therapy group and recei ved combined chemotherapy (5-FU 375 mg/m/day, leucovorin 20 mg/m, IV bolus daily D1-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was performed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. RESULTS: Local recurrence occurred in 11 patients (9.7%) for arm I and 9 patients (8%) for arm II. There was no significant difference between both groups (p=0.64). However, distant metastasis was found in 22 patients (19.5%) for arm I and 35 patients (31.0%) for arm II and which showed statistically significant difference between the two groups (p=0.046). And neither 3-year disease-free survival (70.2% vs 59.2%, p=0.2) nor overall survival (89.4% vs 88.0%, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3% and 79.9% respectively but leukopenia more than RTOG grade 3 was only 2.1% and 6.0% respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2% vs 4 1.6%, p=0.02) but this complication was controlled with supportive cares. CONCLUSION: Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy a fter curative resection for rectal cancer, local recurrence rate was low with combined chemoradiotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.
Arm ; Chemoradiotherapy ; Chemotherapy, Adjuvant* ; Compliance ; Diarrhea ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Incidence ; Leucovorin ; Leukopenia ; Neoplasm Metastasis ; Pelvis ; Prospective Studies* ; Radiotherapy* ; Radiotherapy, Adjuvant ; Rectal Neoplasms* ; Recurrence ; Survival Rate

PURPOSE: An individualized surveillance protocol based on stratified prognostic factors is needed for the early detection of recurrent disease. The aim of this study was to determine both the clinicopathological characteristics for early-recurring colorectal cancer and the impact on survival. METHODS: From January 1996 to September 2000, 1,504 patients with curatively resected colorectal cancer were recruited. The primary goal of this study was to evaluate the time interval until first loco-regional or distant recurrence, and the secondary goal was the last survival status. Early recurrence was defined as recurrence within the first 12 months postoperatively. Clinicopathologic data and preoperative CT records were reviewed. The follow-up period was over 48 months. RESULTS: The 5-year recurrence rate was 25.4%, and 39.5% of these were detected within the first 12 months postoperatively. In the multivariate analysis, the independent prognostic factors for early recurrence were cell differentiation (PD/MUC/SRC), lymphovascular invasion, and absence of adjuvant chemotherapy in stage III and curatively resected colorectal cancer in stage IV. Inaccurate interpretation by a low-quality CT scan resulted in a stage III cancer being understaged preoperatively. The 5-year overall survival rate according to the recurrent time interval was significantly different (early recurrence: 7.4% vs. late recurrence: 23.6%, P<0.05). The resection rate was similar in both groups (early recurrence: 22.7% vs. late recurrence: 27.6%, P=0.392). CONCLUSIONS: Colorectal cancer that recurred within 12 months showed more aggressive biologic behaviors and poor survival. Understaging caused by incomplete preoperative evaluation for disease extension may cause treatment failure.
Cell Differentiation ; Chemotherapy, Adjuvant ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Recurrence ; Survival Rate ; Treatment Failure

OBJECTIVES: The aims of this study were to know the frequency of cognitive dysfunction among patients with autoimmune thyroid disorders, and to reveal influencing factors on it, especially to clarify association with autoimmune thyroid antibodies. METHODS: From sixty-five female patients with autoimmune thyroid disorders, demographic data were obtained by structured interview. Their cognitive funtions were measured using the MMSE-K and the MoCA-K tests. Depression was evaluated by the K-HDRS. RESULTS: 1) Among patients with autoimmune thyroid disorders, 7.69% of them were below 24 on the MMSE-K, while 10.77% were below 22 on the MoCA-K. The frequency of cognitive deficit was not significantly different according to having positivity to antimicrosomal antibodies or not. 2) The antimicrosomal antibody-positive patients had significantly higher antithyroglobulin antibody titers, antimicrosomal antibody titers, and TSH concentration, while had significantly lower free T4 levels(p<0.05, respectively). 3) The total scores of the MMSE-K and the MoCA-K had significant correlation with age, marital status, antithyroglobulin antibody titers and K-HDRS(p<0.05, respectively). 4) The regression analysis revealed that variables such as age, education, autoimmune thyroid antibodies, thyroid function and depression did not influence on cognitive function of patients with autoimmune thyroid disorders. CONCLUSIONS: Our results could not support that cognitive function of patients with autoimmune thyroid disorders had correlation with autoimmune thyroid antibodies.
Antibodies ; Cognition ; Cognition Disorders ; Depression ; Education ; Female ; Humans ; Marital Status ; Thyroid Gland*

PURPOSE: Sporadic colorectal cancer with micosatellite instability (MSI) is supposed to have a distinct molecular profile, distinct clinocopathologic feature, and a distinct prognosis. However, the test for MSI is still expensive, and a big machine is needed for routine screening. This study was performed to examine the clinicopathologic of characteristics of MSI sporadic colorectal cancer and the efficacy of immunohistochemical staining for hMLH1 and hMSH2. METHODS: Five hundred sixty nine colorectal adenocarinomas resected from September 2003 to August 2004 at Asan Medical Center were prospectively collected. FAP (familial adenomatous polyposis), HNPCC (hereditary non-polyposis colo-rectal cancer), and incomplete tests of immunohistochemical staining or MSI were excluded. The MSI status was determined by using PCR (polymerase chain reaction). A first round of immunohistochemical staining for hMLH1/hMSH2 was performed, and a second round was performed for cases showing a disparity between the two exams. The clinicopathologic variables regarding the MSI status were analyzed, and the sensitivity and the specificity of immunohistochemical staining were evaluated. RESULTS: Sporadic colorectal cancers with MSI-H were 8.4% (n=48) and were associated with age (< or = 60 years), colorectal cancer familial history, synchronous colorectal cancer, right side tumor location, and poorly differentiated or mucinous cell type. However, age, synchronous colorectal cancer, and right side tumor location were associated an the multivariate analysis. In the first round of immunohistochemical staining, no expression of hMLH1 and/or hMSH2 was obserred in 71 cases (12.5%), and the sensitivity and the specificity were 50.0% and 91.9%, respectively. After repetitive immunohistochemical staining for the 71 cases showing disagreement with the to MSI status, the sensitivity and the specificity of the second round of immunohistochemical staining were 53.3% and 97.6%, respectively. CONCLUSIONS: Sporadic colorectal cancer with MSI appears to have distinct characteristics. However, immunohistochemical staining for hMLH1 and hMSH2 is not accurate enough to be used instead of MSI.
Chungcheongnam-do ; Colorectal Neoplasms* ; Mass Screening ; Microsatellite Instability* ; Microsatellite Repeats* ; Mucins ; Multivariate Analysis ; Polymerase Chain Reaction ; Prognosis ; Prospective Studies ; Sensitivity and Specificity