Breast cancer is the school most common cancer in Korea women. The incidence of breast cancer is around 25 per 100,000 women, and more than 5,500 women are diagnosed as breast cancer annually. Epidemics show that the incidence and mortality of breast cancer are increasing due to rapid changes of women's life style and westernized food and so on. The risk factors for breast cancer include hormone-related factors (early menarche, late menopause, no or late birth, hormone replacement therapy) and genetic background. It is hard to change risk factors for breast cancer but early detection strategies are best for decreasing the mortality rate from breast cancer. Breast self examination, clinical breast examination, and mammography can be used for screening of breast cancer. Breast self examination is not sensitive enough to detect a small cancer but monthly exam makes women be awakening about breast cancer and feel changes of her breast. Meta-analysis shows annual mammography reduces breast cancer mortality around 35% in the ages over 50. Some randomized clinical trials also showed mortality reduction by mammography in the ages of 40s. Surprisingly, breast cancer is rapidly increasing in late thirties with a peak incidence in forties among Korean women. Whether the early peak makes mammography less accurate is controversial. However, data from qualified screening centers showed mammography has same sensitivity with that in westerns. Korean Breast Cancer Society and National Cancer Center organized the 1st Consensus meeting for the national guidelines for breast cancer screening on July 24, 2001. We recommend that women should have monthly self examination beginning at age 30, should receive biannual clinical breast exam from healthcare providers from age 35, and should receive clinical breast exam and mammography at 1~2-year intervals after age 40.
Breast Neoplasms* ; Breast Self-Examination ; Breast* ; Consensus ; Female ; Genetic Background ; Health Personnel ; Humans ; Incidence ; Korea ; Life Style ; Mammography ; Mass Screening* ; Menarche ; Menopause ; Mortality ; Parturition ; Risk Factors ; Self-Examination

BACKGROUND: The pathogenesis of alopecia areata is still unknown, however autoimmune mechanism is strongly suggested. The topical immunotherapy using potent sensitizer has been used as new therapeutic modality. By this method in one half and to one third of the patients, hair growth is observed. OBJECTIVE: To evaluate the immunological profile between responders and non-responders to dphencyprone (DPCP) topical immunotherapy in alopecia areata patients. METHODS: Aker sensitization, DPCP was applied to the patients' scalp weekly for three months. Before and after treatment the therapeutic effect was evaluated by clinical observation by following items: complete baldness, baldness+vellus, baldness+terminal hair and normal hair. Peripheral T cell and T cell subsets, B cell and delayed hypersensitivity with various antigens were evaluated before and after treatment. RESULTS: The immunologic difference between responders and non-responders was not statistically different. CONCLUSION: It is suggested that no major immunologic difference was observed between responders and non-responders before and after DPCP topical immunotherapy. Local mechanism seems to be related in the response to immunotherapy.
Alopecia Areata* ; Alopecia* ; Hair ; Humans ; Hypersensitivity, Delayed ; Immunotherapy ; Methods ; Scalp ; T-Lymphocyte Subsets

BACKGROUND: The pathogenesis of alopecia areata is still unknown, however autoimmune mechanism is strongly suggested. The topical immunotherapy using potent sensitizer has been used as new therapeutic modality. By this method in one half and to one third of the patients, hair growth is observed. OBJECTIVE: To evaluate the immunological profile between responders and non-responders to dphencyprone (DPCP) topical immunotherapy in alopecia areata patients. METHODS: Aker sensitization, DPCP was applied to the patients' scalp weekly for three months. Before and after treatment the therapeutic effect was evaluated by clinical observation by following items: complete baldness, baldness+vellus, baldness+terminal hair and normal hair. Peripheral T cell and T cell subsets, B cell and delayed hypersensitivity with various antigens were evaluated before and after treatment. RESULTS: The immunologic difference between responders and non-responders was not statistically different. CONCLUSION: It is suggested that no major immunologic difference was observed between responders and non-responders before and after DPCP topical immunotherapy. Local mechanism seems to be related in the response to immunotherapy.
Alopecia Areata* ; Alopecia* ; Hair ; Humans ; Hypersensitivity, Delayed ; Immunotherapy ; Methods ; Scalp ; T-Lymphocyte Subsets

To evaluate the effectiveness of conization in the diagnosis of cervical cancer, the histopathologic finding of 464 consecutive cases were analized with respect to the cytology, punch biopsy and hysterectomy. Cold knife conization was performed under direct visualization(naked eye conization) from January, 1987 to Octorber 1994 at department of Obstetrics and Gynecology, Kosin Medical Center. The results were summerized as follows : 1. The rate of agreement and underdiagnosis of between pap smear and naked eye conization were 43.7% and 47%. 2. The rate of agreement and underdiagnosis of between punch biopsy and naked eye conization were 64.5% and 21.8% 3. Subsequent hysterectomy was done on the 382 case and their incidence of residual disease rate was 44.2%(169 cases). Their incidence of residual lesion was increased with severity of the carcinomatous change. 4. The rate of complication undergoing conization was 8.4%(39 cases).
Biopsy ; Conization* ; Diagnosis ; Gynecology ; Hysterectomy ; Incidence ; Obstetrics ; Uterine Cervical Neoplasms

PURPOSE: This study was to identify the influencing factors of the compliance level to a therapeutic regimen after a bone mineral densitometry test. METHOD: The sample for the study was 95 people who took the bone mineral densitometry test from March, 2002 to July, 2002. Data was collected by mail using aself reporting questionnaire on the selected variables such as the compliance level, self efficacy, health locus of control, susceptibility, severity, usefulness, barrier, and self esteem. RESULT: The average compliance level was 63.93. Through multiple regression, three independent variables including chance health locus of control on personality, the result of bone mineral density and self-efficacy were entered in the model as the significant determinants of the compliance level after a bone mineral densitometry test. The coefficients of determination of each variable were 10.9%, 8.3% and 8.1% respectively. CONCLUSION: The identification of the determinants of the compliance level to the therapeutic regimen after bone mineral densitometry is expected to contribute to the development of an intervention program to improve the compliance level to the therapeutic regimen in osteoporosis patients.
Aged ; *Bone Density ; Female ; Humans ; Male ; Middle Aged ; Osteoporosis/diagnosis/*therapy ; *Patient Compliance

For the clinical analysis and evaluation on the patients with gestational trophoblastic disease(GTD), a study was done retrospectively on 114 patients with GTD(60 in Hydatidiform mole, 10 in invasive mole, 44 in choriocarcinoma) treated from Jan. 1, 1985 to Dec. 31, 1994 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea. We obtained the following results ; The incidence of GTD was 1 per 73 deliveries in H. mole, 1 per 437 deliveries in invasive mole, and 1 per 99 deliveries in choriocarcinoma. The most prevalent age was 21-40 groups. Abnormal vaginal bleeding was a main symptom and sign. 30.6% of H. mole was managed by dilatation and curettage. 90.0% of invasive mole and 51.4% of choriocarcinoma were managed by surgical treatment and chemotherapy. The overall remissinon rate of choriocarcinoma was 71.4%(100.0% in stage I, 66.7% in stage II, 54.5% in stage III, 50.0% in stage IV).
Busan ; Choriocarcinoma ; Dilatation and Curettage ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Gynecology ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Incidence ; Korea ; Obstetrics ; Pregnancy ; Retrospective Studies ; Trophoblasts ; Uterine Hemorrhage

This study was undertaken to investigate immunological mechanisms in Behçet's syndrome, a function considered important in the pathogenesis of the disease. The activity of interleukin-2 (IL-2), which is believed, to play a central role in the regulation of both cell-mediated and humoral T cell-dependent immune responses, measured in 46 patients with complete, in-complete or suspected Behçet's syndrome. The results were as follows: 1 . There was no significant difference between the average IL-2 activity of patients and control group. 2. For each clinical subtype of Behçet's syndrome, IL-2 activity was lower than the control value, but the difference was not statistically significant. 3. In mucocutaneous and ocular types, the greater the clinical symptoms, the lower the value of IL-2 activity. However, the decrease of IL-2 activity was not statistically significant. In conclusion, IL-2 activity of phytohemaggludnin (PHIS-stimulated peripheral blood lymphocytes in patients with Behçet's syndrome was not significantly decreased compared to control population.
Humans ; Interleukin-2* ; Lymphocytes

In 257 open fracture patients, treated from 1972 to 1979 at Kyung Hee University Hospital and analysed retrospectively, the infection rate was 35.8%. The factors thought to be associated with post-operative infection in open fracture were statistically analysed and discussed. The conclusions of this study were follows: 1. Open fractures require adequate debridement and irrigation. 2. Antibiotics should be administered as early as possible, especially before operation. 3. Early determination of local blood clrculation and its improvement are importent. 4. Contaminated open wound should be treated open, but if wound considered clean by adequate debridement may be closed primarlly. 5. If primary bone fixation is required, external flxation is recommended. Internal fixation should be avoided In grade I & II, but in grade III internal fixatlon is not contraindication for Improvement of blood circulation and open wound management.
Anti-Bacterial Agents ; Blood Circulation ; Debridement ; Fractures, Open ; Humans ; Retrospective Studies ; Wound Infection ; Wounds and Injuries

Neonatal hypocalcemia and congenital heart defects has been known as the first clinical manifestation of the chromosome 22q11.2 deletion syndrome (22q11DS). However, because of its wide clinical spectrum, diagnosis of 22q11DS can be delayed in children without classic symptoms. We report the case of a girl with the history of imperforate anus but without neonatal hypocalcemia or major cardiac anomaly, who was diagnosed for 22q11DS at the age of 11 after the onset of overt hypocalcemia. She was born uneventfully from phenotypically normal Korean parents. Imperforate anus and partial cleft palate were found at birth, which were surgically repaired thereafter. There was no history of neonatal hypocalcemia, and karyotyping by GTG banding was normal. At the age of 11, hypocalcemia (serum calcium, 5.0 mg/dL) and decreased parathyroid hormone level (10.8 pg/mL) was noted when she visited our Emergency Department for fever and vomiting. The 22q11DS was suspected because of her mild mental retardation and velopharyngeal insufficiency, and a microdeletion on chromosome 22q11.2 was confirmed by fluorescence in situ hybridization. The 22q11DS should be considered in the differential diagnosis of hypocalcemia at any age because of its wide clinical spectrum.
22q11 Deletion Syndrome* ; Anal Canal* ; Anus, Imperforate ; Calcium ; Child* ; Cleft Palate ; Delayed Diagnosis* ; Diagnosis ; Diagnosis, Differential ; DiGeorge Syndrome ; Emergency Service, Hospital ; Female* ; Fever ; Fluorescence ; Heart Defects, Congenital ; Humans ; Hypocalcemia* ; Hypoparathyroidism ; In Situ Hybridization ; Intellectual Disability ; Karyotyping ; Parathyroid Hormone ; Parents ; Parturition ; Velopharyngeal Insufficiency ; Vomiting

PURPOSE: The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio has recently been reported as a biomarker of cardiometabolic risk in obese children and adolescents. The purpose of this study is to describe the TG/HDL-C ratio and related factors in overweight and normal weight Korean children and to evaluate whether the high TG/HDL-C ratio is associated with insulin resistance in overweight children and adolescents. METHODS: Data from 255 overweight (aged 8.7±2.0 years) and 514 normal weight (aged 8.9±1.8 years) children and adolescents were evaluated. Glucose, insulin, total cholesterol (TC), HDL-C and TG levels were measured after overnight fasting, and the TG/HDL-C ratio, non–HDL-C and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. RESULTS: The TG/HDL-C ratio was higher in overweight group compared to normal weight group (P < 0.001). Among overweight children and adolescents, alanine aminotransferase (P=0.018), non–HDL-C (P < 0.001), and HOMA-IR (P=0.004) were different between the TG/HDL-C ratio tertile groups. The prevalence of elevated HOMA-IR was increased with increasing TG/HDL-C ratio tertiles (P for trend=0.003). On regression analysis adjusted for age and sex, the BMI (β=0.402, P=0.001) and TG/HDL-C ratio (β=0.251, P=0.014) were independently associated with HOMA-IR (adjusted R2=0.324). The TG/HDL-C ratio of 2.0 or more showed higher sensitivity (55.6%) and specificity (72.9%), when compared to TC (≥200 mg/dL), non–HDL-C (≥145 mg/dL), and LDL-C (≥130 mg/dL) for identifying overweight children with elevated HOMA-IR. CONCLUSION: The TG/HDL-C ratio is independently associated with insulin resistance in overweight children and adolescents, and it can be useful in identifying those at higher cardiometabolic risk.
Adolescent* ; Alanine Transaminase ; Child* ; Cholesterol* ; Dyslipidemias ; Fasting ; Glucose ; Homeostasis ; Humans ; Hypertriglyceridemia ; Insulin ; Insulin Resistance ; Lipoproteins* ; Obesity ; Overweight* ; Prevalence ; Sensitivity and Specificity