OBJECTIVES: This paper presents the information on the incidence of cancer from the population-based cancer resistry in Kangwha County. Material and METHODS: This investigation is based on Kangwha cancer registry. The data included cases of cancer diagnosed from 1986 through 1992. The diagnosis of cancer was confirmed by a team of physicians and nurses with the medical records kept in the clinics and hospitals based on the diagnostic criteria recommended by WHO. Home visitings were also made to cancer patients confirmed in every 6 months for the follow up and for the collection of relevant information directly from the patients. RESULTS: A total of 992 cancer cases were registered during 1986 - 1992. The age-adjusted cancer incidence rate of all site is 201.7 in men and 110.7 in women. The most common cancer is the stomach cancer in both sexes. The age-adjusted incidence rate of the stomach cancer is 65.9 in men and 25.0 in women per 100,000 population. The lung cancer(33.8) and liver cancer(27.7) are next common cancers in men. The cervical cancer(21.8) and lung cancer(8.4) are next in women. CONCLUSION: The most common cancer is the stomach cancer in both sexes. The annual age-adjusted incidence rate of the stomach cancer is 65.9 in men and 25.0 in women per 100,000 population.
Diagnosis ; Female ; Follow-Up Studies ; House Calls ; Humans ; Incidence* ; Liver ; Lung ; Male ; Medical Records ; Stomach Neoplasms

PURPOSE: To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures MATERIALS AND METHODS: Radiation doses were measured both inside and outside the apron(0.5mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolizations (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PCNA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. RESULTS: Average protective effect of the apron was 72.8%. Average radiation exposure(unit:micro Sv/procedure) was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. CONCLUSION: Radiation exposure was not proportionally related to the duration of fiuoroscopy, but influenced by wearing an apron, various types o[procedure and operator's skills.
Aspirations (Psychology) ; Film Dosimetry ; Fluoroscopy ; Needles ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Prospective Studies

PURPOSE: To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. MATERIALS AND METHODS: Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. RESULTS: The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheters were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted , namely the one case of thrombophlebitis. CONCLUSION: Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein.
Azygos Vein ; Catheter-Related Infections ; Catheters* ; Central Venous Catheters ; Constriction, Pathologic ; Embolism, Air ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins* ; Thrombophlebitis ; Thrombosis ; Venous Thrombosis

PURPOSE: We investigated the feasibility and clinical applicability of sentinel lymph node biopsy (SLNB) in patients with neoadjuvant chemotherapy, tumor size > 2 cm, and privious excisional biopsy. METHODS: 175 patients with 176 breast cancer underwent aLNB between October 2001 and October 2002. Among them twenty-five patients with locally advanced breast cancer underwent SLNB after neoadjuvant chemotherapy. Eighty-nine (50.6%) had primary tumor > 2 cm. The recent biopsy method used before SLNB was excision in thirty-one (17.6%) procedures. The identification rate, false-negative rate, negative prediction value and accuracy of SLNB were determined. RESULTS: SLNB was successful in 164 of 176 cases (detection rate, 93.2%). The identification rate of patients who had neoadjuvant chemotherapy was 68% and lower than that of who had not (97.3%), significantly (P=0.00). However, mapping success was not influenced by large tumor size (> 2 cm) or previous excisional biopsy. The false-negative rate and accuracy were 16.5% and 91.5, respectively. The false negative rate was 21.3% (3/14) in those patients received neoadjuvant chemotherapy compared with a 15.5% in those patents not received neoadjuvant chemotherapy (P> 0.05). In addition, Tumor size > 2 cm and previous excision did not adversely impact the false negative rate and accuracy. CONCLUSION: Neoadjuvant chemotherapy was associated with a lower identification rate for SLNB. But if detected, SLNB after neoadjuvant chemotherapy might reliably predict axillary status. SLNB is feasible and accurate in patients with large tumor (> 2 cm) and previous excision.
Biopsy ; Breast Neoplasms ; Drug Therapy* ; Humans ; Sentinel Lymph Node Biopsy*

Cholangiocarcinoma has an extremely poor prognosis and the majority of patients have an incurable disease at the time of presentation. These patients should be offered palliative drainage management. The aims of palliation are to prevent cholangitis or bile peritonitis in the course of follow-up or chemotherapy, and to preserve the functional volume of the liver as much as possible. Endoscopic or percutaneous drainage has become increasingly important in the palliative care of patients with unresectable cholangiocarcinoma. Compared to the percutaneous approach, endoscopic biliary stenting is less invasive, more comfortable, and results in a reduced hospital stay. Therefore, endoscopic biliary stenting should be considered the first-line therapy for jaundice palliation in unresectable cholangiocarcinoma.
Bile ; Biliary Tract Neoplasms ; Cholangiocarcinoma ; Cholangitis ; Drainage ; Humans ; Jaundice ; Length of Stay ; Liver ; Palliative Care ; Peritonitis ; Prognosis ; Stents

OBJECTIVES AND METHODS: To directly examine the function of the endothelial cell(EC) and smooth muscle cell in umbilical arteries acquired from preeclampsia patients between June 1998 to November 1999, using a conventional tension measurement and bioassay experiment. RESULTS: Relaxation responses to EC-dependent relaxing agents including bradykinin and A23187 in human umbilical artery rings were significantly decreased in preeclampsia(p<0.01). Relaxation responses to EC-independent agents(SNP and SNAP) were also inhibited in umbilical artery rings acquired from preeclampsia patients(p<0.01). To test the change of endothelial cell function in preeclampsia without involvement of smooth muscle dysfunction, we used human umbilical artery and rabbit femoral artery as a donor and detector, respectively, in bioassay experiment. Relaxation responses to EC-dependent agents(A23187 and bradykinin) showed similar results to conventional tension measurement (p<0.01). Relaxation responses to 8-bromo-cGMP in human umbilical artery rings were also significantly decreased in preeclampsia(p<0.01). CONCLUSIONS: It can be concluded that increased vascular resistance in preeclampsia is not only due to the disturbance of endothelial function, but also to smooth muscle dysfunction.
Biological Assay ; Bradykinin ; Calcimycin ; Endothelial Cells ; Femoral Artery ; Humans ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Pre-Eclampsia* ; Relaxation* ; Tissue Donors ; Umbilical Arteries* ; Vascular Resistance

The number of end-stage renal disease (ESRD) patients is progressively growing with more than 60,000 ESRD patients on renal replacement therapy in Korea. The mortality risk in ESRD patients is approximately 10 to 20-fold higher compared to the general population, which is mainly attributed to prevalent cardiovascular disease in these patients. However, the risk factors for cardiovascular disease in ESRD patients are different from the general population, and useful biomarkers for predicting cardiovascular mortality are not completely defined. The nationwide multicenter Clinical Research Center (CRC) for ESRD program was initiated in Korea not only to elucidate the incidence and prevalence of cardiovascular disease in ESRD patients but also to identify potential risk factors including various biomarkers for cardiovascular disease. A prospective cohort of 864 incident hemodialysis patients, from 34 dialysis centers of the CRC for ESRD in Korea, was followed up for 36 months, and the clinical outcome of these patients was reviewed. This article presents the recent data from the CRC for ESRD program, and, in addition, brief reviews on key risk factors and potential biomarkers for cardiovascular disease in ESRD patients.
Biomarkers ; Cardiovascular Diseases ; Cohort Studies ; Dialysis ; Humans ; Incidence ; Kidney Failure, Chronic ; Korea ; Prevalence ; Prospective Studies ; Renal Dialysis ; Renal Replacement Therapy ; Risk Factors

PURPOSE: To investigate the usefulness of carbon dioxide digital subtraction angiography (CO2-DSA) in direct puncture sclerotherapy of venous hemangiomas involving extremities. MATERIALS AND METHODS: Direct puncture sclerotherapy was performed in 12 patients with venous hemangioma of extremities. After direct puncture of the hemangiomas, 30-50 cc of CO2 was manually injected and digital subtraction angiograms were obtained. If draining vein was visualized, a tourniquet was applied at the proximal site to compress the draining veins. There after, radiopaque embolic materials such as 1:3 mixture of Lipiodol and absolute ethanol or ethanolamineoleate-Lipiodol-Avitene (microfibrillar collagen hemostat) mixture were slowly injected under the fluoroscopic guidance. RESULTS: Rapid injection of large amount of a CO2 enabled the visualization of wide areas of venous hemangiomas in 11 patients. Draining veins were reliably demonstrated in 10 patients and pulmonary embolism of embolic materials was effectively prevented by proximal tourniquet application. Because of radiolucent nature of CO2 retained in hemangiomas, we could clearly identify the distribution of radiopaque embolic materials under fluoroscopy. Retained CO2 also could be used as a guide for additional multiple puncture of hemangiomas. There was no systemic symptoms or complications related to CO2-DSA. CONCLUSION: CO2-DSA is a convenient, safe and useful angiographic technique in direct puncture sclerotherapy of hemangiomas involving extremities.
Angiography, Digital Subtraction* ; Carbon Dioxide* ; Carbon* ; Collagen ; Ethanol ; Ethiodized Oil ; Extremities ; Fluoroscopy ; Hemangioma* ; Humans ; Pulmonary Embolism ; Punctures ; Sclerotherapy* ; Tourniquets ; Veins

No abstract available.
Humans ; Somatoform Disorders*

BACKGROUND: The purpose of this study was to determine the shape of the distal femur of Korean women compared with the prostheses currently available in Korea. METHODS: Morphometric data (5 parameters) were measured in 356 resected femurs of Korean women undergoing primary total knee arthroplasty (TKA) utilizing the LCS knee implant (DePuy). The data were then compared with 5 additional contemporary TKA implant systems. RESULTS: Implant designs based on Caucasian population data do not ideally match the distal femoral morphology of Korean women. Overhang at the anterior mediolateral width was observed in 84.8% for the LCS while a gender-specific implant resulted in undercoverage of the bone in 86%. Posterior overhang was observed in up to 51.2%. Most implant designs have a narrower intercondylar notch than the morphologic data of Korean women. CONCLUSIONS: Since there is some difference between the shape of distal femur of Korean women and that of the implants, surgeons should have this in mind when selecting an implant for a patient. These data may also be used as a guideline for future prosthetic design options for Korean women population.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*instrumentation/statistics & numerical data ; Asian Continental Ancestry Group/*statistics & numerical data ; Cohort Studies ; Female ; Femur/*anatomy & histology/*surgery ; Humans ; Knee Joint/surgery ; Middle Aged ; Prosthesis Design ; Republic of Korea