One hundred fifty-seven patients wha underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB and IIA carcinoma of the cervix between February l975 and May 1987 were retros-pectively analysed to identify specific risk factors associsted with treatment failures. Prognostic factors inciuded clinical stage, histologic cell type, degree of differentiation, size of primary tumor, depth of stromal invasian, lymph-vaseular space invasion, and lymph node metastasis. Treatment results were evaluated according to the recurrence rate and 2-year absolute recurrence-free survival(NED) rate by the prognostie faetors and treatment modalities. Patients with lymph node me tases had a significantly higher incidence of bulky primary(-> 4cm), depth of stromal invasion(> 60% thickness), and lymph-vascular invasion(P<0.005). There was significant difference in the recurrence rate and 2-year, NED rate between cervical carcinoma stage IB and I1A(P <0.005). The pat,ients who had bulky primary tum~or(>4cm) and/or depth of stromal invasion (>60% thickness) had a higher recurrence and lower 2-year NKD rate(P<0.025, P<0.005), Unfortunately, it was not possible to demonstrate that these detrimentel effects could be overeorne by postoperetive radiation. When adjoined for these risk group, traditionally reported poor prognostic factors such as nodal metatasis, cell type and differentiation, lyrnphi-vascular mvasion assume less importance in our studies. In this study, prognosis is most inf1ueneed by clinical stage, depth of stromal invasion, and size of primary tumor,
Cervix Uteri* ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors ; Treatment Failure*

PURPOSE: This study was conducted to develop a Web-based learning program on cardiopulmonary emergency care for clinical nurses and to evaluate learners' responses. METHODS: Based on the assessment of learning needs of clinical nurses, a total of three self-directed learning modules were developed according to the procedure of the ADDIE (assessment, design, development, implementation, & evaluation) model. RESULTS: Each learning module included the emergency treatments and drugs used in the real patients' situations with cardiopulmonary crisis, which had been adopted from the emergency department of a C University hospital located in G-city. Real video clips for endotracheal intubation and ACLS (advanced cardiac life support) were developed with the help of the staff of the department of emergency medicine using a human simulator, SimMan(R). The program published on the Web was evaluated by 20 clinical nurses who are working in the emergency department and wards of a C-University hospital. About 80% of the respondents were satisfied with the program contents, design, and learning strategy. CONCLUSION: Web-based learning programs on cardiopulmonary emergency care are needed for clinical nurses as educational material for staff education to increase their knowledge for making immediate clinical decisions and in giving skilled care in emergency situations.
Advanced Cardiac Life Support ; Computer-Assisted Instruction ; Surveys and Questionnaires ; Education, Nursing ; Emergencies ; Emergency Medical Services ; Emergency Medicine ; Emergency Treatment ; Humans ; Intubation, Intratracheal ; Learning

No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.

No abstract available.
Cervix Uteri* ; Female ; Hysterectomy*

BACKGROUND: To study the prognosis of patients with lung cancer, many investigators have reported the methods to detect cell proliferation in tissues including PCNA, thymidine autoradiography, flow cytometry and Ki-67. PCNA, also known as cyclin, is a cell related nuclear protein with 36KD intranuclear polypeptide that is maximally elevated in S phase of proliferating cells. In this study, PCNA was identified by paraffin-embedding tissue using immunohistochemistry which has an advantage of simplicity and maintenance of tissue architecture. The variation of PCNA expression is known to be related with proliferating fraction, histologic type, anatomic(TNM) stage, degree of cell differentiation, S-phase fraction and survival rate. We analyzed the correlation between PCNA expression and S-phase fraction, survival. METHODS: To investigate expression of PCNA in primary lung cancer, we used immunohistochemical stain to paraffin-embedded sections of 57 resected primary non-small cell lung cancer specimen and the results were analyzed according to the cell type, cell differentiation, TNM stage, S-phase fraction and survival. RESULTS: PCNA expression was dMded into five group according to degree of staging(-, +, ++, +++,++++). Squamous cell type showed high positivity than in adenocarcinoma. Nonsignificant difference related to TNM stage was noticed. Nonsignificant difference related to degree of cell differentiation was noticed. S-phase fraction was increased wit advance of PCNA positivity, but t could not reach the statistic significance. The 2 year survival rate and median survival time were -50% 13 months, +75% 41.3 months, ++73% 33.6 months, +++67% 29.0 months, ++++25% 9 months with statistic significance (P<0.05, Kaplan-Meier, generalized Wilcox). CONCLUSION: From this study. PCNA expression was high positive n squamous cell cancer. And, there was no relationship between PCNA positivity and TNM stage, cellular differentiation or S-phase fraction. But, the patients with high positive PCNA staining showed poor survival rate than the patients with lower positive PCNA. It was concluded that PCNA immunostaining is a simple and useful method for survival prediction in paraffin embedded tissue of non-small cell lung cancer.
Adenocarcinoma ; Autoradiography ; Carcinoma, Non-Small-Cell Lung* ; Cell Differentiation ; Cell Proliferation ; Cyclins ; Flow Cytometry ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Neoplasms, Squamous Cell ; Nuclear Proteins ; Paraffin ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Research Personnel ; S Phase ; Survival Rate* ; Thymidine

The method of ankle arthrodesis is variable but compression arthrodesis has been widely used because of better results than non-compression arthrodesis. Twenty-one cases of ankle arthrodesis were carried out at department of orthopaedic surgery of Korea Veterans Hospital from January 1980 to June 1986, and were analysed clinically. The results obtained were as follows; l. Among 11 cases of compression arthrodesis, Charnleys method was done in 8 cases and Monofixateur in 3 cases. 2. Among 10 cases of non-compression arthrodesis, Chuinard-Peterson method was done in 7 cases and anterior 'sliding graft in 3 cases. 3. The average duration of immobilization after ankle arthrodesis was 11.7 weeks, and average 4.2 weeks were less needed in the compression arthrodesis than non-compression arthrodesis. 4. The postoperative complications were developed in 8 cases (38%): wound infection in 4 cases,skin necrosis in 3 cases and incisional neuroma in 1 case. 5. Bony union was obtained in 20 cases(95.2%) out of 21 cases at average 15.7 weeks, and in the non-compression arthrodesis and in the cnmpression arthrodesis, respectively, 90% at 17.7 weeks and 100% at 13.9 weeks.
Ankle Joint ; Ankle ; Arthrodesis ; Hospitals, Veterans ; Immobilization ; Korea ; Methods ; Necrosis ; Neuroma ; Postoperative Complications ; Transplants ; Wound Infection

Stickler syndrome is an autosomal dominant disorder of connective tissue with a wide range of expressivity and incomplete penetrance which is called hereditary progressive arthro-ophthalmopathy. Affected neohates may present with the Pierre-Robin syndrome, progressive myopia, retinal detachment, flat face, hypertelorism, progressive arthritis. Early recognition of the syndrome is important, not only for genetic counselling but also to offer a more precise prognosis and proper treatment of many serious disorders that may occur in affected children. We experienced a case of Stickler syndrome with large eyeballs in a 3-day-old female baby who showed Pierre-Robin anomaly, flat face, hypertelorism, epicanthal folds, long philtrum, micrognathia, deft palate, high congenital myopia, chorioretinal degeneration, thin habitus and hyperextensible joints.
Arthritis ; Child ; Connective Tissue ; Female ; Humans ; Hypertelorism ; Joints ; Lip ; Myopia ; Myopia, Degenerative ; Palate ; Penetrance ; Pierre Robin Syndrome ; Prognosis ; Retinal Detachment

A ‘collision’ tumor refers to the existence of two different neoplasms within the same tumor. Sometimes, the term ‘biphasic tumor’ is also used. However, a ‘collision’ tumor is defined as the occurrence of two neoplasms within proximity of each other yet maintaining distinctly defined, separate boundaries. In contrast, a ‘biphasic’ tumor demonstrates two or more phenotypically distinct neoplastic cell populations merging within the same space. Here, we report a case of collision tumor associated with sarcomatoid eccrine porocarcinoma and basal cell carcinoma arising in a 57-year-old male patient.
Carcinoma, Basal Cell* ; Eccrine Porocarcinoma* ; Humans ; Male ; Middle Aged

BACKGROUND: Recent studies have documented increased release of endothelin(ET) during acute attack of asthma. The purpose of this study is to observe the link between plasma level and urinary excretion of each and changes during acute exacerbation. METHOD: Plasma and 24 hour urine were collected from sixteen asthmatics during acute exacerbation, twice ; first day of symptomatic exacerbation and two weeks after treatment. Controls were ten healthy normal subjects. All patients were treated with corticosteroid and beta-2 adrenergic agonist on admission. ET was determined by radioimmmunoassay and had 100% cross reactivity with ET-1, 67% with ET-2, 84% with ET-3, and 8% with Big-ET. RESULTS: Plasma ETs were significantly elevated during acute attack of asthma compared with those in remission and controls. However, there was no significant changes in urine ET concentrations or total ET amounts in 24 hour urine during exacerbation upto two weeks. Those levels of urine ET in asthmatics were still higher than controls. ET concentrations in plasma or urine were not correlated with pulmonary functional parameters and hypoxemia. CONCLUSION: The findings suggests that increased plasma ETs are related with exaggerated release during acute asthma. Urinary ET excretion is increased in asthma. However, urine ET changes during exacerbation should be observed in a larger and longer scale.
Adrenergic Agonists ; Anoxia ; Asthma* ; Endothelin-2 ; Endothelins* ; Humans ; Plasma*