PURPOSE: According to the staging system for breast cancer by the 2003 revised American Joint Committee on Cancer (AJCC), the patients with 10 or more positive axillary nodes are classified as N3 and also as a new stage, i.e., stage IIIC. The aim of this study was to investigate the prognosis of patients with 10 or more positive nodes. METHODS: The database of 125 patients with 10 or more positive axillary nodes who underwent surgery at Korea Cancer Center Hospital between 1997 and 2001 were reviewed. The age of the patients, the T stage, the number and site of the positive nodes, the hormone receptor status, the HER-2 over-expression, and the treatment modalities were examined in reference to the disease-free survival (DFS). RESULTS: At the median follow-up time of 40 months, 16 cases (13%) of locoregonal recurrence and 57 cases (46%) of systemic relapse had developed in 67 patients (54%). The DFS and overall survival rates at 5 years were 46% and 55%, respectively. On univariate analysis, the T stage (p<0.001), hormone receptor status (p=0.001), and neoadjuvant chemotherapy (p=0.014) were predictive factors of recurrence. On multivariate analysis, the T stage (p=0.002) and hormone receptor status (p=0.02) were independent predictors of recurrence. The patients with hormone receptor positive tumor had a 58%, 5-year DFS rate. On the contrary, in 9 of 10 patients with T4 tumor, recurrence developed within 2 years after the initial treatment. CONCLUSIONS: This study showed that stage IIIC according to the revised AJCC staging system was not a prognostically homogeneous group. Some notably high survival rates were observed in a subgroup of patients, and especially for those patients with hormone receptor positive tumor. In contrast, the prognosis of patients with T4 tumor was significantly worse than that of the patients with the other stage IIIC disease. Thus, we suggest that the stage IIIC group in the new AJCC staging system needs to be refined to provide more reliable prognostic information for the patients with advanced breast cancer.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Joints ; Korea ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Staging ; Prognosis* ; Recurrence ; Survival Rate

BACKGROUND: In Korea, the separation of prescribing and dispensing medicine was finally accepted as a medical policy in July, 2000, after a long period of discussion and study which was started in 1963. Now a year after the policy started, we investigated the knowledge, attitude, and practice of separation of prescribing and dispensing medicine. METHODS: Information, concerning whether the policy was effectively carried out and well understood, were gathered from 383 patients, who visited an university hospital from August 20 to September 1, 2001. RESULTS: The results revealed that 73.1% of the subjects knew the policy precisely. However, only 1.6% of them could answer all four questions on the purpose of the policy. The old-aged, the low educated, the low socioeconomic groups and the residents in agricultural area revealed poor understanding of the policy (P<0.05). Among the total, 74.9% showed negative response toward the policy. Time and cost increment were 75.7% and 75.2%, respectively. Among them 61.1% revealed negative attitude towards continuance the policy and 93.2% revealed dissatisfaction of the policy. CONCLUSION: The knowledge of the policy was relatively high. However, negative attitudes prevailed on the continuance of the policy. Therefore, more solutions and better strategies for the problems of prescribing and dispensing medicine would be needed.
Humans ; Korea

Actins ; metabolism ; Adult ; Desmin ; metabolism ; Electromyography ; Humans ; Male ; Microscopy, Electron, Transmission ; Muscle, Skeletal ; pathology ; ultrastructure ; Myopathies, Nemaline ; metabolism ; pathology

PURPOSE: Breast carcinoma presenting with nipple discharge is not uncommon. However, few studies have addressed the clinicopathological characteristics and optimal surgical management of breast carcinoma with nipple discharge. The aims of this study were to determine the clinicopathologic characteristics of breast carcinoma that presents with nipple discharge and the feasibility of breast conservation for these patients. METHODS: We retrospectively reviewed the medical records of the patients with breast carcinoma who presented with nipple discharge and who also underwent curative surgery at Korea Cancer Center Hospital between January 1999 and December 2003. RESULTS: During the study periods, 40 of 1,442 (2.7%) breast cancer patients presented with nipple discharge, and among them, 28 (70%) patients were accompanied by a palpable breast mass. Their median age was 44 yr. Thirty-seven (93%) patients were treated with mastectomy and only 3 (7%) patients were treated with breast conservation. Eleven patients had ductal carcinoma in situ, 17 had stage I disease, 8 had stage II disease and 4 had stage III disease. On the pathologic evaluation, multifocality or multicentricity were found in 7 of 37 (19%) mastectomy specimens, and occult nipple-areola complex (NAC) involvement was found in 3 (8%) cases. In 23 of 37 (62%) mastectomy specimens, we didn't find any evidence of extensive disease (stage III, multicentricity or multifocality or occult NAC involvement) that may preclude breast conservation. Locoregional recurrence was not detected in any of these cases, and 37 of 40 patients are free of disease with a median follow-up of 55 months. CONCLUSION: In this retrospective study, we found that 23 of 37 (62%) women with breast carcinoma associated with nipple discharge and who also underwent mastectomy had no evidence of extensive disease. Thus, we suggest that breast conservation can be done for these patients with performing careful patient selection and appropriate adjuvant therapy.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Follow-Up Studies ; Humans ; Korea ; Mastectomy ; Medical Records ; Nipples* ; Patient Selection ; Recurrence ; Retrospective Studies

A subset of patients of amyotrophic lateral sclerosis (ALS) present with mutation of Cu/Zn superoxide dismutase 1 (SOD1), and such mutants caused an ALS-like disorder when expressed in rodents. These findings implicated SOD1 in ALS pathogenesis and made the transgenic animals a widely used ALS model. However, previous studies of these animals have focused largely on motor neuron damage. We report herein that the spinal cords of mice expressing a human SOD1 mutant (hSOD1-G93A), besides showing typical destruction of motor neurons and axons, exhibit significant damage in the sensory system, including Wallerian-like degeneration in axons of dorsal root and dorsal funiculus, and mitochondrial damage in dorsal root ganglia neurons. Thus, hSOD1-G93A mutation causes both motor and sensory neuropathies, and as such the disease developed in the transgenic mice very closely resembles human ALS.
Amyotrophic Lateral Sclerosis/enzymology/*pathology ; Animals ; Axons/*pathology ; Disease Models, Animal ; Ganglia, Spinal/pathology ; Humans ; Mice ; Mice, Transgenic ; Mitochondria/pathology ; Motor Neurons/metabolism/pathology ; Mutation ; Nerve Degeneration/*pathology ; Sensory Receptor Cells/*pathology ; Spinal Cord/*pathology ; Superoxide Dismutase/genetics/*physiology

PURPOSE: p27Kip1 protein is an inhibitor of cyclin-dependent kinases and is thought to be a potential prognostic indicator for numerous human cancers. We investigated the expression of p27Kip1 in gastric cancer in order to estimate its clinical utility. METHODS: Immunohistochemical assay for p27Kip1 protein was performed in 64 patients with primary gastric cancer. The correlation between p27Kip1 and clinical-biological parameters including patient survival was analyzed. RESULTS: p27Kip1 expression was suppressed in 40 (62.5%) of 64 gastric cancer patients. Expression of p27Kip1 was significantly reduced in poorly differentiated cancers (82.1%, 23/28; P=0.015) and was also reduced in tumors with a high S-phase fraction as compared with tumors showing a low S-phase fraction (86.7%, 26/30, 41.2%, 14/34; P=0.0002). In univariate analysis, the extent of the disease (P<0.001), and reduced expression of p27Kip1 (P=0.0006) were statistically significant to predict the patient's outcome, however depth of invasion (P=0.008) and pathologic stage (P=0.009) emerged as significant prognostic indicators in the multivariate analysis. CONCLUSION: The expression of p27Kip1 is closely linked with cell proliferation and differentiation of human gastric cancer. p27Kip1 appears to have potential as a prognostic marker in the management of gastric cancer patients.
Cell Proliferation ; Cyclin-Dependent Kinase Inhibitor p27* ; Cyclin-Dependent Kinases ; Humans* ; Immunohistochemistry ; Multivariate Analysis ; Prognosis ; Stomach Neoplasms*

BACKGROUND: It is important to know one's own exact blood type. While the primary purpose of blood donation is an adequate blood supply, it is also an excellent opportunity for donors to confirm their blood type. Over 5% of the total population in Korea donated bloods in 1997. This study was carried out to investigate the relationship between increased participation in blood drives and an increase in members of the public's knowledge of their own blood type. METHODS: 271,346 blood donors at Dung-Bu Red Cross Blood Center answered to a questionnaire. The discrepancy ratio between perceived and actual ABO blood type was obtained through answerey questionnaire. Another 3,058 answered a more detailed questionnaire to probe their general knowledge of ABO and Rh(D) blood types were analyzed. RESLUTS: The discrepancy ratio between real and perceived ABO blood types was 1% but only 90.7% were confident of their ABO blood type. Only 58.3% were correctly answered to their Rh(D) blood type, and 98.7% of the donors who knew his or her Rh(D) blood type as negative were proved to be Rh(D) positive. The ABO discrepancy ratio was lower in females and it has decreased as blood donations increased (p<0.01). The discrepancy ratio increases with the age of the donor, and respondents over 30 had a higher discrepancy than those under 30 (p<0.01). Knowledge of Rh(D) blood type in transfusion was not well known to the general public. CONCLUSION: The study shows that the discrepancy ratio between real and perceived ABO blood type has decreased as a national blood donation rate has increased. Nevertheless, to increase the public's knowledge of blood type in relation to transfusion, especially to increase awareness of Rh(D) blood type, it is needed to conduct test exactly and to educate the result and general knowledge of blood type and tranfusion to the public.
Blood Donors ; Surveys and Questionnaires ; Female ; Humans ; Korea ; Questionnaires ; Red Cross ; Tissue Donors* ; Volunteers*

Aliquots of venous blood from healthy donor were collected in plastic blood storage bags with ACD, GMA or antioxidant solution (superoxide dismutase, SOD), respectively, and stored at 4 degrees C. After storage for varying periods, the parameters of the blood were detected in the blood samples. Results showed that the parameters of the blood stored at 4 degrees C for 75 days in SOD group were following: the recovery of RBC-Hb was 87.2%, plasma-Hb (mg/L) was 193.2, P50 (mmHg) was 34.0 (normal value was 33.1); deformability (DImax) was 0.2413 (74.3% of normal value). There was no evident hemolysis, color change, air bubble and clots. It was concluded that human RBC stored at 4 degrees C for 75 days with SOD solution, recovery of levels of RBC-Hb and plasma-Hb were accorded with the requirements of "Basic Demands of Blood Station" in China.
Antioxidants ; pharmacology ; Blood Preservation ; methods ; Cold Temperature ; Erythrocyte Deformability ; drug effects ; Erythrocytes ; drug effects ; metabolism ; Free Radical Scavengers ; pharmacology ; Hemoglobins ; drug effects ; metabolism ; Humans ; Superoxide Dismutase ; pharmacology ; Time Factors

OBJECTIVETo understand the national situation of quality and consumption of iodized salt at production and household levels.

METHODSDetailed surveillance method could be found in 'national iodized salt surveillance scheme', issued by MOH in 2004. The iodine concentrations in salt (except some special kinds of salt) were detected by direct titration with national standard of GB/T 13025.7-1999, in which the iodine content in qualified iodized salt was set as between 20 and 50 mg/kg and that in non-iodized salt was set as below 5 mg/kg.

RESULTSAt production level, the national lot qualified rate was 98.36% and all the provincial lot qualified rate of production level was over 90%. At household level, the national iodized salt coverage rate of household was 96.87% and the national qualified iodized salt coverage rate was 93.75%. 4 provinces (Tibet, Hainan, Xinjiang and Guangdong) had an iodized salt coverage rate lower than 90%. Further, the qualified iodized salt coverage rate of 5 provinces (Tibet, Hainan, Xinjiang, Guangdong and Qinghai) was below 90%. In 2006,80 counties did not conduct the iodized salt surveillance and non-iodized salt coverage rate of 185 counties was higher than 10%. In the respect of the qualified iodized salt coverage rate at household level, there were about 10 percent lagging behind the national goal that 95% of all the counties in China should achieve virtual elimination of iodine deficiency disorder before 2010.

CONCLUSIONAt national level,the lot qualified rate at production level and the iodized salt coverage rate at household level maintained comparatively well. However, at county level, there were 75 counties whose iodized salt coverage rate was below 70%.

Objective: : Oblique lateral interbody fusion (OLIF) is becoming the preferred treatment for degenerative lumbar diseases. As beginners, we performed 143 surgeries over 19 months. In these consecutive cases, we analyzed the learning curve and reviewed the complications in our experience. Methods: : This was a retrospective study; however, complications that were well known in the previous literature were strictly recorded prospectively. We followed up the changes in estimated blood loss (EBL), operation time, and transient psoas paresis according to case accumulation to analyze the learning curve. Results: : Complication-free patients accounted for 43.6% (12.9%, early stage 70 patients and 74.3%, late stage 70 patients). The most common complication was transient psoas paresis (n=52). Most of these complications occurred in the early stages of learning. C-reactive protein normalization was delayed in seven patients (4.89%). The operation time showed a decreasing trend with the cases; however, EBL did not show any significant change. Notable operation-induced complications were cage malposition, vertebral body fracture, injury to the ureter, and injury to the lumbar vein. Conclusion : According to the learning curve, the operation time and psoas paresis decreased. It is important to select an appropriately sized cage along with clear dissection of the anterior border of the psoas muscle to prevent OLIF-specific complications.