2.The Clinical Analysis of Endometrial Cancer by Surgical Staging.
Korean Journal of Gynecologic Oncology and Colposcopy 1999;10(4):368-379
In 1988, the International Federatioa of Gynecology and Obstetrics(FIGO) Cancer Committee changed the staging of endometrial carcinoma from a clinical one to a surgicopathologic one. The emphasis in the new FIGO system was changed to the pathologic findings in the uterus, cervix, adnexae, and pelvic and/or periaortic nodes, and peritoneal cytologic findings. The major changes in this staging system were the use of the depth of myometrial invasion and the identification of tumor cells in peritoneal cytologic examination and of invasion in the retroperitoneal lymph nodes, Preoperative endocervical curettage was no longer necessary. This is a reflection of the increase in the primary surgical approach to the treatment of this disease and has allowed the identification of a number of prognostic factors on which postoperative therapy can be based. This retrospective study was based on a clinical review of 45 patients with endometrial carcinoma from Jan, 1985 through Jan, 1996 who underwent primary surgical evaluation at the Department of Obstetrics and Gynecology, Kyungpook National University Medical College. The results obtained are as follows; l. Age distribution of endometrial cancer was concentrated on the age group of 50-59(55.6%) and mean age was 53.9 years. 2. The mean parity and mean BMI(Body Mass Index) of endometrial cancer were 3.8 and 25.0(cm/kg2). 3. The Menstrual status at the time of development of endometrial cancer showed that 24 cases (53.3%) were postmenopausal, 11 cases (24.4%) were premenopausal and 10 cases(22.2%) were menstruating. 4. According to the clinical stage adopted by FIGO classification, stage I was found in 71.1%, stage II in 17.8%, stage III in 2,2%, stage IV in 0.0%. 5. Surgical restaging according to new FIGO classification(1988), stage IA was found in 4.4%, stage IB in 37.8%, stage IC in 28.9%, stage IIA in 0.0%, stage IIB in 0.0%, stage IIIA in 6.7%, stage IIIB in 4.4%, stage IIIC in 8.9%, stage IVA in 2.2% and IVB in 6.7%. 6. According to WHO histopathological classification, the percentage of the adenocarcinoma was 86.7%, adenoacanthoma 4.4%, papillary serous adenocarcinoma 2.2%, and adenosquamous cell carcinoma 6.7%. 7, The relationship between histologic grade and depth of invasion was somewhat correlated but no staistical significance. 8. There was no correlation between BMI(Body Mass Index) and histologic grade, depth of invasion. 9. Surgery upstaged 15.6% of clinical stage I patients and 62,5% of clinical stage II, but 37.5% of clinical stage II patients was downstaged. 10. All cases were primarily treated by surgery. Regarding the types of operation, total abdominal hysterectomy with bilateral salpingoophorectomy was performed in 44.4%, radical hysterectomy with both pelvic lymphadnectomy in 42.2%, total abdominal hysterectomy with bilateral salpingoophorectomy with selective pelvic lymph node dissection in 8.9%, and laparoscopic assisted vaginal hysterectomy in 2.2%. 11. The mean follow up interval was 38.6 months. 28 cases were followed up and 10 cases of surgical stage I revealed over 5 year salvage. 5-year survivals for surgical stage IA, IB, IC, III, and IV were 100, 100, 92.3, 88.9, and 100%, respectively.
Adenocarcinoma
;
Age Distribution
;
Cervix Uteri
;
Classification
;
Curettage
;
Endometrial Neoplasms*
;
Female
;
Follow-Up Studies
;
Gyeongsangbuk-do
;
Gynecology
;
Humans
;
Hysterectomy
;
Hysterectomy, Vaginal
;
Lymph Node Excision
;
Lymph Nodes
;
Neoplasm Staging
;
Obstetrics
;
Parity
;
Retrospective Studies
;
Uterus
3.Vitrectomy in Complicated Pars Planitis.
Journal of the Korean Ophthalmological Society 1991;32(9):761-769
Consecutive twelve patients' twelve eyes with complicated pars planitis underwent pars plana vitrectomy at our center in the period from January 1988 to December 1990. Patients' ages ranged from 24 to 60(mean 39.9)years and all were male. Nine patients had histories of topical or systemic steroid therapy and at the time of surgery, all eyes were quiet from active inflammation. With various degrees of vitreal opacities, five eyes had macular pucker or membrane only and in other seven eyes, retinal detachments of either tractional or tractional-rhegmatogenous origin were arisen. In the later group, macular hole was associated in two eyes. Surgical procedures combined were membrane peeling(five eyes), scleral buckling(ten eyes), fluid/air-gas exchange(eight eyes), lensectomy(two eyes) and photocoagulation(two eyes). During the follow-up period ranged from four to twenty-one(mean 7.75)months after first operations, the uveitis recurred or continued to be activated in four eyes and as a complication, retinal detachment occurred in two eyes which had macular pucker only preoperatively. One refused reoperation and the other was reattached successfully by second operation. Final visual acuities were improved in eight eyes, stationary in one and worsen in three. The causes of worsen vision were retinal detachment, macular edema and macular slanting by buckle respectively. Preoperatively, the majority of eyes(10 eyes: 84%) had less than 0.09 vision and postoperative vision turned over better than 0.09 in 7 eyes(59%). Although we did not confirm extinguished therapeutic effects of vitrectomy on the pars planitis perse, our results revealed some positve role of surgical intervention in the complicated pars planitis.
4.Complications after Excimer Laser Photorefractive Keratectomy in Myopia.
Journal of the Korean Ophthalmological Society 2000;41(12):2527-2541
No Abstract Available.
Lasers, Excimer*
;
Myopia*
;
Photorefractive Keratectomy*
5.Clinical Study of Fracture of the Intercondylar Eminence of the Tibia
Chang Dong HAN ; Jin Young LEE
The Journal of the Korean Orthopaedic Association 1985;20(5):927-934
Fracture of intercondylar eminerce of the tibia indicate probable alteration of the cruciate ligament stability in the knee and occur from hyperextension injury of the knee and violent internal rotation of the tibia. Fracture of intercondylar eminence of the tibia has been classified by Meyer and Mckeever(1959, 1970) according to the degree of displacment and this classification is important as it pertains to the proper selection of treatment. The author studied 24 cases in 24 patients of fracture of the intercondylar eminerce of the tibia at the Department of Orthopedic Surgery of Severance Hospital during a 10 year period from Januaary, 1975 until December, 1984. The aim of this study was to find out incidence, cause and associated injury of the fracture of the intercondylar eminece of the tibia and was to asses the comparative results of the conservative and surgical treatment. The result of this study ase as follows ; 1. There is a predisposition for make in a ration of 3:1 and there is no age preponderance in occurance. 2.Majority of cause of injury was traffic accident(62.5%). 3.Isolated fracture of intercondylar eminence of the tibia was 15 cases (62.5%) associated knee joint injury shows 9 cases (37.5%). Among the associated knee joint injury, rupure of medial collateral ligament was 4 cases(44.4%), rupture of medial meniscus was 3 cases(33.3%) and rupture of lateral colateral ligament was 2 cases (22.2%). 4.By Meyer and Mckeever's classification, Type 2(41.7%) fracture of intercondylar eminence of the tibia was most common, and then Type 1(37.5%) and Type 3(20.8%) occured in order of frequency. 5. Type 1 and Type 2 fracture of the intercondylar eminence of the tibia resulted in good prognosis with only conservative treatment, and open reduction is not indicated. 6. Type 3 fracture of the intercondylar eminence of the tibia can be treated with conservative treatment if there is no associated injury of the knee joint.
Classification
;
Clinical Study
;
Collateral Ligaments
;
Equidae
;
Humans
;
Incidence
;
Knee
;
Knee Joint
;
Ligaments
;
Menisci, Tibial
;
Orthopedics
;
Prognosis
;
Rupture
;
Tibia
6.Salmonella Osteomyelitis of the patella: A Case Report
The Journal of the Korean Orthopaedic Association 1990;25(5):1572-1575
A 48 years old male was visited with complaining of painful swelling of the left knee joint for 2 weeks duration. On radiological finding of the patella, there was found local rarefaction and osteolytic change in the inferior pole. It was diagnosed as Salmonella osteomyelitis of the patella and was confirmed by bacteriological study. Osteomyelitis of the patella caused by Salmonella group C as an etiological factor has not been reported. It was treated by conservative method with satisfactory result.
Humans
;
Knee Joint
;
Male
;
Methods
;
Osteomyelitis
;
Patella
;
Salmonella
7.The Role of Cytokines In bronchoalveolar Lavage Fluid in the Pathogenesis of the Neonatal Chronic Lung Disease.
Joon Young LEE ; Woo Ryoung LEE ; Dong Whan LEE
Journal of the Korean Society of Neonatology 1998;5(1):19-26
PURPOSE: Chronic lung disease is a cause of significant morbidity and mortality in the neonatal respiratory distress syndrome. Although the exact mechanisms leading to the development of chronic lung disease are unknown, there is increasing evidence indicating that pulmonary inflammation contributes to the pathogenesis. The proinflammatory cytokines, interleukin(IL)-1beta, IL-8 may have a role to play in initiating the inflammatory response that is seen in chronic lung disease. In contrast, IL-10 is an antiinflammatory cytokine. The abnormal persistent inflammatory process in chronic lung disease may be due to dysregulation of these proinflammatory cytokines. So, to describe cytokine profiles of chronic lung disease in neonate, we analysed the IL-1beta, IL-8 and IL-10 levels in bronchoalveolar lavage fluid by ELISA technique. METHODS: We obtained bronchoalveolar lavage samples from 14 respiratory distress syndrome infants without chronic lung disease and 8 respiratory distress syndrome infants with chronic lungisease. The cytokine levels were assayed. RESULTS: The results were as follows: 1) IL-1beta levels were higher in chronic lung disease group(205.16+/-360.21pg/rnl) than group without chronic lung disease(21.21+/-26.14pg/ml)(P<0.05). 2) IL-8 levels were also higher in chronic lung disease group(166.16+/-347.26pg/ml) than group without chronic lung disease(49.85+/-105.27pg/ml)(P>0.05). 3) In contrast, IL-10 levels were lower in chronic lung disease group(78.29+/-138.69pg/ml) than group without chronic lung disease(111.29+/-155.27pg/ml)(P>0.05). CONCLUSION: These results suggest that the dysregulation of cytokines contributes to the pathogenesis of chronic lung disease. The difference in cytokine levels of bronchoalveolar lavage fluid can be used as a predictor for development of chronic lung disease.
Bronchoalveolar Lavage Fluid*
;
Bronchoalveolar Lavage*
;
Cytokines*
;
Enzyme-Linked Immunosorbent Assay
;
Humans
;
Infant
;
Infant, Newborn
;
Interleukin-10
;
Interleukin-8
;
Lung Diseases*
;
Lung*
;
Mortality
;
Pneumonia
;
Respiratory Distress Syndrome, Newborn
8.National Guidelines for Breast Cancer Screening.
Keun Young YOO ; Dong Young NOH ; Eun Sook LEE
Journal of the Korean Medical Association 2002;45(8):992-1004
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
9.A Clinical Observation of Meconium Aspiration Syndrome.
Chul LEE ; Kook In PARK ; Jean Young LEE ; Dong Gwan HAN
Journal of the Korean Pediatric Society 1984;27(10):958-964
No abstract available.
Infant, Newborn
;
Meconium Aspiration Syndrome*
;
Meconium*
10.Negative Association between Schizophrenia and Rheumatoid Arthritis : Epidemiology and Prolactin and Estrogen as Protective Factors.
Dong Sung AHN ; Young Ho LEE ; Yoon Woo LEE
Journal of the Korean Society of Biological Psychiatry 1999;6(1):125-134
The purposes of this study were to test the negative association between schizophrenia and rheumatoid arthritis(RA) and to clarify the role of prolactin and estrogen as protective factors in this association. The author compared the prevalence rate of RA between 561 patients with schizophrenia and 222 patients with mood disorder. For investigating the role of estrogen and prolactin, the author checked the plasma prolactin and estradiol level in 80 patients with paranoid schizophrenia and 77 patients with RA. The results were as follows. 1) Epidemiological data The prevalence rate of RA in the schizophrenic group was 0/561 and that of RA in the mood disorder group was 2/222. To compare these results between two groups, the author applied the Binomial test using the average prevalence rate of RA(0.8%) in the general population as a reference rate. The prevalence rate of RA in the schizophrenic group was significantly lower than that of RA in the general population. However, the prevalence rate of RA in the mood disorder group was not significantly different to that of RA in the general population. 2) Comparison of plasma prolactin and estradiol level between two groups. The plasma level of prolactin in the schizophrenic group was significantly higher than that of prolactin in th RA group(p=0.000). However, the plasma level of estradiol in the schizophrenic group was significantly lower than that of estradiol in the RA group(p=0.017). These results were not consistent across gender. To contrast with the results in the female group, which were consistent with the results in the total subjects, for the male group, the plasma levels of prolactin and estradiol in the schizophrenic group were significantly higher than those of prolactin and estradiol in th RA group. These results support the results of previous studies which confirm the negative association between schizophrenia and RA. These results also suggest that the elevation of plasma prolactin level in the patient with schizophrenia has a antirheumatic effect while the elevation of plasma estradiol level in the patients with RA has a anti-schizophrenic effect, and that these effects act as a possible mechanism in the negative association between two disorders. However, these results suggest that this association is specific to female patients.
Arthritis, Rheumatoid*
;
Epidemiology*
;
Estradiol
;
Estrogens*
;
Female
;
Humans
;
Male
;
Mood Disorders
;
Plasma
;
Prevalence
;
Prolactin*
;
Schizophrenia*
;
Schizophrenia, Paranoid