Purpose: Cancer-related fatigue (CRF) is an important health concern among breast cancer survivors. However, CRF is apt to be dismissed as a minor discomfort by medical professionals. This study aimed to understand the experience of CRF in breast cancer survivors. Methods: We conducted a qualitative study using in-depth interviews and thematic analysis. The 14 participants were over the age of 40, complained of fatigue, and had been battling breast cancer for at least eight months to up to 16 years. Results: The analysis revealed four themes: traces of fighting cancer, inseparable part of the self, difficulty in daily life, and the body’s signals for care.Chronic fatigue initially disrupted the daily lives of the participants. As time passed, fatigue made it difficult for patients to fulfill their roles within their families, and gradually alienated friends and neighbors. Nevertheless, they tried to overcome the symptoms of fatigue by responding sensitively to the warning signs or changes in their bodies. Conclusion Breast cancer survivors often worry about relapse due to persistent fatigue after treatment completion. Therefore, the results of this study may be useful in developing strategies tailored for managing CRF using a multifaceted approach.

Twin pregnancy is at increased risk for congenital anomalies. Although twins were relatively infrequent, they accaunted for a disproportionately large portion of adverse pregnancy outcome, primarily as a consequence of preterm delivery, gestational diabetes, and pregnancy induced hypertension. In case of twin pregnancy with a single anomalous fetus, the clinicians are faced with difficult decision-making processes regarding the route of delivery, when to deliver, how aggressively to attempt to prevent delivery. Twin pregnancy discordant for a fetal abnormality can be managed expectantly or by selective fetocide of abnormal twin. Recently we experienced two cases of twin pregnancy with a single anornalous fetus. We reported cases with concerned literatures.
Diabetes, Gestational ; Female ; Fetus* ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Twin*

To compare the differences between hemodialysis and essential hypertension patients and its affecting factors of left ventricular hypertrophy and left ventricular systolic dysfucntion in patients with hemodialysis, M-mode and two dimensional echocardiography were performed in 77 essential hypertension without azotemia and 78 chronic renal failure patients receiving maintenance hemodialysis. M-mode measurement including LV mass (192.56+/-63.6g vs 300.01+/-95.99g, P=0.000), r/th (radius/LV thickness, 4.41+/-0.97 vs 4.74+/-1.0, P=0.039), LV dimemsion and fractional shortening (4.68+/-0.6 vs 5.63+/-0.97, P=0.000, 30.0+/-19.7% vs 36.6+/-97%, P=0.000 respectively) showed more severe eccentric LV hypertrophy and LV dysfunction in patients with hemodialysis than those of essential hypertension. Using Pearson correlation in hemodialysis patients, Interdialytic weight gain was positively correlated with LVEDD (r=0.318, P=0.005). In addition to the determinant, serum PTH level was negatively (r=-0.344, P=0.002) and Kt/V (r= 0.0487, P=0.003) was positively correalated with systolic function. The hypertension and dialysis duration, patient's age, had no relationship with LV function and mass in this study. In Conclusion, LV hypertrophy and LV systolic dysfunction occur more frequently in hemodialysis patients than in essential hypertension patients. And the LV systolic dysfunction, which is acutally related with the patient's quality of life, was partially explained by serum parathyroid level and Kt/V. But additional laboratory and prospective clinical studies are needed to further elucidate the mechanisms involved in the development of LVH and LV impairment in hemodialysis patients.
Azotemia ; Dialysis ; Echocardiography* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis* ; Ventricular Dysfunction, Left ; Weight Gain

OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Amniocentesis ; Ascites ; Ascitic Fluid* ; Cell Count ; Cytogenetics* ; Diagnosis* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotyping ; Leukocytes ; Lymphocytes ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography ; Ultrasonography, Prenatal

A long-term effect of pentobarbital on the atrial natriuretic peptide (ANP) system was investigated. The experimental group of rats (Sprague-Dawley, male) was one week previously treated with pentobarbital (50 mg/kg, intraperitoneal), and the control was an age-matched group of rats which had never been anesthetized. ANP reaponse to volume-expansion (VE) induced by intravenous infusion of iso-oncotic saline over 30 min (total volume infused amounted up to 5% body weight) was examined under thiopental anesthesia (50 mg/kg, intraperitoneal). Basal plasma ANP level did not significantly differ between the experimental and control groups. Following VE, while the plasma ANP five-fold increased in the control, it rather decreased in the experimental group. Despite the different ANP responses, the magnitude of urinary responses (volume and sodium excretion) to VE did not differ between the two groups. Right and left atrial tissue contents of ANP were significantly lower in the experimental group than in the controL In another series of experiments, the two-kidney, one clip rats were made under either pentobarbital or ether anesthesia and the blood pressure and ANP responses were compared. While the magnitude of blood pressure increases did not differ, the plasma ANP level measured on Day 12 after the clipping was lower in the pentobarbital group than in the ether group. These results suggest that pentobarbital has a long-term inhibitory effect on the ANP system. Its physiological significance in blood pressure and body fluid homeostasis remains to be determined.
Anesthesia ; Animals ; Atrial Natriuretic Factor ; Blood Pressure ; Body Fluids ; Ether ; Homeostasis ; Infusions, Intravenous ; Pentobarbital* ; Plasma ; Rats* ; Sodium ; Thiopental

OBJECTIVE: The purpose of this study was to determine whether cyclooxygenase [COX]-1 and COX-2 are expressed in the pregnant human uterine cervix and if they are expressed differentially between preterm and term pregnancies. METHODS: Fourteen patients delivered between 29 and 41 weeks of gestation were matched for obstetrical history and maternal age were divided into a preterm group who delivered between 29 and 36 weeks [n=7], and a term group who delivered between 37 and 41 weeks of gestation [n=7]. Immediately after vaginal delivery cervical biopsy samples were obtained and immunohistochemicaly stained for COX-1 and COX-2 and the degree of staining was evaluated by H-scoring system. RESULTS: Expression of COX-1 and COX-2 was found in all epithelial and stromal cells of uterine cervical tissues of pregnancy. The expression of COX-1 and COX-2 was significantly stronger in the term group compared to the preterm group in epithelial cells [HSCORE : 2.14+/-0.69 vs. 1.14+/-0.38 ; 3.71+/-0.76 vs. 1.86+/-0.90, p<0.05], but there was no significant differences in stromal cells [HSCORE : 3.43+/-0.53 vs. 2.86+/-0.38 ; 2.43+/-0.53 vs. 2.57+/-0.98, p>0.05]. CONCLUSION: In the pregnant human uterine cervix, COX-1 and COX-2 are found to be expressed, and both are strongly expressed in the cervical epithelial cells of term pregnancies compared to preterm pregnancies. It is suggested that the uterine cervix, under the control of prostaglandins, is actively involved in the process of labor, and that the role of COX-2 in epithelium is particularly significant in term pregnancies compared to preterm pregnancies.
Biopsy ; Cervix Uteri* ; Cyclooxygenase 1* ; Cyclooxygenase 2 ; Epithelial Cells ; Epithelium ; Female ; Humans* ; Maternal Age ; Pregnancy* ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Stromal Cells

BACKGROUND: Nonimmune hydrops fetalis has become an important perinatal problem since it was first described in 1943. Although recent advances in antenatal ultrasound have made it possible to detect and manage nonimmune hydrops fetalis in early pregnancy, the perinatal mortality is still high. OBJECTIVE: To obtain clinically useful data regarding antenatal diagnosis, management, and perinatal outcomes of nonimmune hydrops fetalis, and to assist clinicians offer proper antepartum counseling and obstetric management which may be able to improve prognosis. Study design: We retrospectively reviewed 33 cases of nonimmune hydrops fetalis delivered in our hospital over a 4-year period. RESULTS: The antenatal diagnosis was possible by ultrasonography in all cases. Accumulation of fluid in fetal serous cavity and generalized skin edema were observed in all cases. A probable etiology was found in 23 (69.7%) cases through ultrasonography, various laboratory studies including fetal karyotyping, and autopsies. These were cardiovascular (4), respiratory (6), chromosomal (4), skeletal (1), and others (8). Despite extensive diagnostic studies, no definite etiology was found in 10 (30.3%) cases. Excluding the ten fetuses delivered after induced abortion, eight infants were born alive and six died in the neonatal period. The mortality rate was 91.3% (21/23). CONCLUSION: Nonimmune hydrops fetalis represents a very poor perinatal outcome. It is suggested that to improve the prognosis, various antenatal and postnatal approaches to find associated etiologic factors should be performed, and intensive perinatal cares are needed.
Abortion, Induced ; Autopsy ; Counseling ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Infant ; Karyotyping ; Mortality ; Perinatal Mortality ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Retrospective Studies ; Skin ; Ultrasonography

The uterus with rudimentary horn occurs as a result of a lack of development during fetal life of the middle and lower parts of one of the Miillerian ducts, in which there is a failure of fusion of the two ducts, The incidence of this uterine anomaly is rare. Many cases of rudimentary uterine horn are not discovered since they do not become involved in a pregnancy, and thus remain symptomless and uncomplicated, and the diagnosis usually being made only with pregnancy with rupture. In this presentation, we describe a case of diagnosis and management of unruptured non-communicating rudimentary uterine horn pregnancy at the third trimester. The patient diagnosed by ultrasonography and MRI, was hospitalized for further evaluation and delivery under the impression of unruptured non-communicating rudimentary horn pregnancy. A living male infant weighing 1,930 gm was delivered by cesarean section at 33+l weeks due to impending preterm labor. Some articles concerned this subject were reviewed briefly to discuss relevant method of diagnosis, treatment, and clinical characteristics.
Animals ; Cesarean Section ; Diagnosis ; Female ; Horns* ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Obstetric Labor, Premature ; Pregnancy Trimester, Third* ; Pregnancy* ; Rupture ; Ultrasonography ; Uterus

A case of arthrogryposis multiplex congenita is an extremely rare and complex syndrome characterized by contractures of multiple joints in different parts of the body. Arthrogryposis multiplex congenita usually occurs alone but may be associated with other malformations. We experienced a case of arthrogryposis multiplex congenita, so report the case with relat ed literatures.
Arthrogryposis* ; Contracture ; Joints

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in South Korea. To decrease its mortality rate, its early detection is very important. Screening for HCC detection has been accepted as the management modality for patients with chronic liver disease. Reported herein is a case involving the marked rapid growth of HCC detected at an advanced stage in a screening test with a 3 months interval. A 49-year-old male patient with chronic hepatitis B was admitted to the hospital due to a liver mass detected on CT scan. The patient underwent a first CT scan 3 months earlier, and no tumor was detected. Follow-up CT scan was performed and showed a 9.1 cm HCC with portal vein thrombosis. Percutaneous liver biopsy was performed, and the diagnosis of hepatocellular carcinoma was confirmed. In the pertinent guidelines, the recommended screening interval for HCC is 6-12 months, but the screening interval and additional diagnostic methods should be considered due to the variation in the HCC growth rate according to the patient's clinical characteristics.
Biopsy ; Carcinoma, Hepatocellular ; Early Detection of Cancer ; Follow-Up Studies ; Hepatitis B, Chronic ; Humans ; Liver ; Liver Diseases ; Male ; Mass Screening ; Middle Aged ; Portal Vein ; Republic of Korea ; Thrombosis