No abstract available.
Estrogen Replacement Therapy* ; Estrogens* ; Female ; Gonadotropins* ; Humans ; Ovariectomy*

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

Screw fixation of the tibial component offers advantages in initial fixation in cementless total knee replacement. But the high incidence of screw related osteolysis was reported. The purpose of this study is to evaluate clinical results of cementless total knee replacement and to look for radiographic changes at the screw-bone interface. From January 1988 to December 1991, primary cementless total knee replacements with Miller Galante I (Zimmer, Warsaw. IN) were performed to 53 knees at Kyung Hee university hospital. Among them, 21 cases which could be followed-up for more than 4 years were studied retrospectively about the clinical and radiographic results. The mean follow-up period was 5.5 years(ranged from 4.2 years to 8 years). At the last follow-up period, knee scores of Hospital for Special Surgery were improved from mean 56 points to 90 points and the range of motion from 72 degrees to 110 degrees. In the last follow-up radiographs, osteolysis around screw was classified as linear(type I ), cystic(type II ) and cavitary(type III ) according to the width of the lucency around screws. Among 21 cases, radiographic findings of osteolysis around screw were detected in 10 cases but not in 11 cases. But clinical results were similar between these two groups. Among the total 84 screws(4 screws in each case), 21 screws(25%) showed screw related osteolysis typed as I in 13 screws(15.4%), II in 4 screws(4.8%) and III in 4 screws(4.8%). Among the 13 cases that followed-up more than 6 years, 20 screws(38%) showed screw related osteolysis typed as in 11 screws(21.2%), I in 5 screws(9.6%) and II in 4 screws(7.8%). The most frequently involved site of screw was anteromedial(33.3%). In conclusion, after mean 5.5 year follow-up, the clinical results were satisfactory but the development of osteolysis around screw might be an indicator of the implant failure.
Arthroplasty, Replacement, Knee* ; Follow-Up Studies ; Incidence ; Knee ; Osteolysis* ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: Extra-thyroidal extension has been recognized as a poor prognostic factor for increased regional recurrence risk in papillary thyroid carcinoma, and is known to require treatment that is more aggressive. In the recent UICC TNM 6th Classification, an extra-thyroidal extension was divided into a minimal extra-thyroidal extension (T3) and a massive extra-thyroidal extension (T4). The aim of this study was to investigate the clinical effect of a minimal extra-thyroidal extension of a papillary carcinoma for the recurrence of regional cervical lymph nodes. METHODS: We retrospectively studied 154 patients with papillary thyroid carcinoma where a thyroidectomy was performed from Feb. 2003 to May. 2006 at the Department of Surgery, with the exclusion of 6 patients with a massive extra-thyroidal extension. We divided the cases into a no extra-thyroidal extension group and a minimal extra-thyroidal extension group according to the grading of the extra-thyroidal extension. The grading of the extra-thyroidal extension was based on both pathological findings and intraoperative surgical findings. Clinicopathological factors associated with each group were analyzed by univariate and multivariate analysis. We divided the cases into two groups according to age (<45 yrs, > or =45 yrs) and lymph node status (positive, negative), and compared each group with regards to disease free survival according to the grading of the extra-thyroidal extension. RESULTS: By univariate analysis, a minimal extra-thyroidal extension was related to lymph node metastasis, tumor size, mutifocality (P<0.05), and was not related to cervical lymph node recurrence statistically (P=0.108). Cervical lymph node recurrence was related to being male, lymph node metastasis and tumor size (P<0.05). By multivariate analysis, a minimal extra-thyroidal extension was independently related to tumor size, multifocality, and lymph node metastasis (P<0.05). In both groups with regards to age and lymph node status, a minimal extra-thyroidal extension was not statistically related to disease free survival (P>0.05). CONCLUSION: We need to downstage to less than T3 for a minimal extra-thyroidal extension because there is no significant difference in disease free survival according to the grading of an extra-thyroidal extension in patients with papillary thyroid carcinoma.
Carcinoma, Papillary ; Classification ; Disease-Free Survival ; Humans ; Lymph Nodes* ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: The development of publicized screening methods for breast carcinoma detection has led to a marked increase in the discovery of ductal carcinoma in situ (DCIS) or DCIS with microinvasion (DCIS-MI). Axillary lymph node status has been believed to be not only an indicator of prognosis, but also a direction of adjuvant therapy. But the incidence of axillary metastasis in DCIS or DCIS-MI has diversely found in from 0% to 20%. This study was performed to analyze the incidence of axillary metastasis and the predictive factors associated with axillary lymph node metastasis in DCIS or DCIS-MI. METHODS: Patients with DCIS or DCIS-MI and axillary lymph node dissection from 1987 to 2004 were selected from Korea University Medical Center. We reviewed their medical records for age, palpability and size of the tumor, histolgic subtype, nuclear grade, hormone receptor status, and pathologic slides. RESULTS: Fifty two patients in DCIS and Thirty eight patients in DCIS-MI were included in the study. Axillary lymph node metastases were identified in 2 patients (3.8%) in DCIS and 4 patients (10.5%) in DCIS-MI. Tumor size and nuclear grade in DCIS had a borderline significance in association with microinvasion. We could not be able to find any predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. CONCLUSION: Axillary lymph node metastasis in DCIS or DCIS-MI appeared to be not low and there was no predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. But DCIS patients with large tumor size and poor nuclear grade have the high possibility associated with microinvasion, therefore, in that cases, there is a need to consider the possibility of axillary metastasis.
Academic Medical Centers ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Mass Screening ; Medical Records ; Neoplasm Metastasis* ; Prognosis

OBJECTIVE: This study aims to provide the information of the stigmas of mental illness such as psychosis, alcoholism, attempt suicide, and depression among North Korean defectors. METHODS: We examined stigma for the mental illnesses of 639 North Korean defectors aged 19 to 65 years who live in the Settlement Support Center for North Korean Refugees. The stigmas of mental illnesses were assessed using the Perceived Devaluation-Discrimination Scale We directly compared the stigma level between North Korean defectors and the general population of South Korea. RESULTS: North Korean defectors had higher perceived stigmas of psychosis and alcoholism and lower perceived stigmas of depression than South Koreans. Perceived stigma associated with attempted suicide was similar for North Korean defectors and South Koreans. Only marital status in sociodemographic variables had associations with higher perceived stigma of psychosis, alcoholism, and depression in the North Korean defectors. North Korean defectors, who spent more than one year in transit country, had associations with lower perceived stigma of psychosis and alcoholism. North Korean defectors, who had the experience of compulsory repatriation to North Korea or North Korean family in South Korea, had an association with higher perceived stigma of depression. CONCLUSION: North Korean defectors had higher perceived stigmas of psychosis and alcoholism and lower perceived stigmas of depression than South Koreans. Further studies are needed to document serial changes in stigmas for mental illnesses associated with the receipt of education at the Settlement Support Center for North Korean defectors.
Alcoholism ; Democratic People's Republic of Korea ; Depression ; Education ; Humans ; Korea ; Marital Status ; Psychotic Disorders ; Refugees ; Suicide ; Suicide, Attempted

OBJECTIVES: The purpose of this study is to investigate the clinical characteristics of neurocognitive functions in patients with traumatic brain injury referred for mental disability evaluation. METHODS: The neurocognitive functions of 293 patients, who were referred for mental disability evaluation, were assessed using a computerized neurocognitive test. The patients were divided into three groups according to head trauma history and brain imaging studies. We also measured their intelligence and memory, using the K-WAIS and the Rey-Kim Memory Test. RESULTS: The group with organic mental disorder showed more impaired concentration, language, memory, intelligence, executive function and visuospatial function than those with nonorganic mental disorder without traumatic brain injury. The group with organic mental disorder also showed greater impairments in selective attention, some part of language, long-term memory, and hypothesis formation than those with postconcussional disorder. The group with organic mental disorder obtained lower intelligence and memory test scores than those with postconcussional disorder and nonorganic mental disorder without traumatic brain injury. There was no difference in intelligence or memory between postconcussional disorder and nonorganic mental disorder without traumatic brain injury. CONCLUSION: Patients with postconcussional disorder share the characteristics of neurocognitive function with organic mental disorder and nonorganic mental disorder without traumatic brain injury. We suggest the computerized neurocognitive test that evaluated details of neurocognitive functions for patients with traumatic brain injury referred for mental disability evaluation.
Brain ; Brain Injuries ; Craniocerebral Trauma ; Neurocognitive Disorders ; Disability Evaluation ; Executive Function ; Humans ; Insurance ; Intelligence ; Memory ; Memory, Long-Term ; Mental Disorders ; Neuroimaging

No abstract available.
Glaucoma* ; Humans ; Nerve Fibers* ; Photography* ; Retinaldehyde*

Mycophenolate mofetil (MMF) is a novel new immunosuppressant which suppress proliferation of T and B lymphocytes by inhibiting inosine monophosphate dehydrogenase. Even though the results we can get now are still preliminary but the positive result such as low incidence of acute rejection episode, is very attractive to clinical therapist. It also has certain effect on rescue therapy of steroid resistant acute rejection. There is little proven report of long-term follow up of this drug but the improvement of early graft survival suggest better long-term result. From March 1997, we used MMF as one of the primary immunosuppressant with cyclosporine and steroid in 47 renal allograft recipient (MMF group) and the early result of this protocol is compared with control group using conventional two drug regimen (cyclosporine and steroid)in 96 recipients. The 2 g of MMF were given daily from 2nd post-transplant day. The acute rejection episode within 3 and 6 months are 12.1 and 12.8% in MMF group and these are statistically significant difference with the results of control group (36.5% and 38.5% respectively, P<0.005). The response rate of acute rejection to steroid pulse therapy was 66.7% in MMF group but has no statistical difference with that of conventional group (84.1%). Steroid resistant severe acute rejection that needed to use OKT3 was developed in 1 case (2.1%) in MMF group but 7 (7.3%) in control group. Among the complication, post-transplant infection occurred in 6 cases (12.8%) of MMF group but in 8 cases (8.3%) in control group. Diarrhea that needed medication developed in 8 cases of MMF group (17.0%), but only one of them is necessary to change his immunosuppressive regimen. Leukopenia also developed in 1 case of each group. In summary, the incidence of acute rejection episode and steroid resistant rejection that is necessary to use OKT3 is significantly decreased in MMF group but the response rate to steroid pulse therapy and complications of both groups showed no statistical difference.
Allografts* ; B-Lymphocytes ; Cyclosporine ; Diarrhea ; Graft Survival ; Incidence ; Inosine Monophosphate ; Kidney Transplantation ; Kidney* ; Leukopenia ; Muromonab-CD3 ; Oxidoreductases

OBJECTIVE: This study examined medication adherence rate and associated factors with medication adherence in patients who had been diagnosed as having dementia through the nationwide project for early detection of dementia in South Korea. METHODS: This study enrolled a total of 131 patients, who were diagnosed as having dementia through utilization of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet at the Namgu Dementia Center in Incheon, from January 1, 2012 through December 31, 2012. Telephone interview was done with principal caregivers of dementia patients at least 18 months after they had been diagnosed. RESULTS: Out of 131 patients, 83 caregivers of patients completed telephone interview. 62 (72.9%) patients were currently being treated with antidementia drugs, and the proportion of patients being treated at the psychiatric clinic was 54.8%. Sociodemographic variables and clinical rating scales included in the study had no statistically significant effect on the medication adherence. The most common cause of nonadherence was a misconception of dementia diagnosis and treatment (28.6%). CONCLUSION: The major cause of nonadherence was a misconception of dementia diagnosis and treatment, therefore, education on misconception may enhance a patient's medication adherence. Sociodemographic variables and clinical rating scales included in the study had no statistically significant effect on the medication adherence.
Alzheimer Disease ; Caregivers ; Dementia* ; Diagnosis ; Early Diagnosis ; Education ; Follow-Up Studies* ; Humans ; Incheon ; Interviews as Topic ; Korea ; Medication Adherence* ; Weights and Measures