OBJECTIVE: The purpose of this study is to evaluate effect of patient age amenorrhea duration, motivation, purpose, regimen, side effect on compliance to hormonal replacement therapy(HRT). METHODS: Compliance to HRT was assessed in 86 postmenopausal women who began HRT in the Shin ob & gyn clinic. Fifty six women who had intact uterus received continuous combined therapy with 2 mg of Estradiol hemihydrate and 1mg of Norethinsterone acetate. Thirty women who were hysterectomized received only 0.625mg of conjugated equaine estrogen(premarin) RESULT: A total of 34(39.9%) women reported that they continued HRT at least for one year. Continuation of HRT was significantly more common among women who started HRT because of reconmendation by gyneocologist after hystectomy for improvement sexual function(p<0.05), A greater percentage of women who received only premarin without uterus continuous combined therapy(p<0.05) Duration of amenorrhea, reason for taking HRT and side effect such as irregular bleeding or breast tenderness were not related to the continuation of HRT. CONCLUSION: Education of menopausal women about the improvement of sexual function/ risk and side effect of HRT may be critical in improving compliance.
Amenorrhea ; Breast ; Compliance* ; Education ; Estradiol ; Estrogens, Conjugated (USP) ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Motivation ; Postmenopause* ; Uterus

No abstract available.
Dyspnea*

No abstract available.
Hospice Care* ; Hospices* ; Internationality* ; Palliative Medicine*

No abstract available.

BACKGROUND: Cell-cell adhesion in tissue is mainly regulated by hornotypic interaction of cadherin molecules, which are anchored to the cytoskeleton via cytoplasmic proteins, including a-and / 3-catenin. Loss of E-cadherin and catenin have been attributed a pathogenetic role in tumor invasion. METHODS: We examined the expression of E-cadherin and a-catenin in human thyroid carcinoma by immunohistochemistry. RESULTS: Normal tissue strongly expressed E-cadherin and a-catenin. However, E-cadherin and a-catenin expression were frequently reduced in thyroid carcinoma (E-cadherin: 62.5%, a-catenin: 81.3%). But the expression of E-cadherin and a-catenin in tumors with metastatic spreading were not different with tumors without metastasis. CONCLUSION: These results suggest that reduced E-eadherin and a-catenin expression may be a sensitive marker for disturbance in the adhesive function of the junctional complex, but further evaluation with more cases is needed for confirmation of the result of the same degree of expression in tumors with metastasis.
Adhesives ; Cadherins* ; Cytoplasm ; Cytoskeleton ; Humans ; Immunohistochemistry ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. METHODS: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. RESULTS: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. CONCLUSIONS: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.
Adult* ; Demography ; Elbow* ; Follow-Up Studies ; Fractures, Open ; Humans ; Humerus ; Joints ; Outcome Assessment (Health Care) ; Radius ; Retrospective Studies ; Shoulder ; Ulna ; Visual Analog Scale

OBJECTIVE: p16INK4 and p15INK4B genes are known to be tumor suppressor genes which reside in p21 region of chromosome 9 and are related to cell cycle control as an inhibitor of cyclin-dependent-kinase. We designed this study to search for deletion and decreased expression of p16INK4 and p15INK4B genes in advanced ovarian carcinomas. METHODS: Polymerase chain reaction (PCR)-based analysis was performed to search for deletion of p16INK4 and p15INK4B using DNA extracted from frozen tissue in liquid nitrogen of thirty-one advanced ovarian carcinoma patients. The intensities of PCR bands were analyzed using an imaging densitometer to determine gene dosage in tumor samples and the relative gene dosage was calculated by comparing band intesity of p16INK4 or p15INK4B with that of beta-globin gene. Homozygous deletions were assigned to tumors in which the ratio was reduced to less than 25% in any one of exons of p16INK4 and p15INK4B. Immunohistochemical techniques were used to study the expression of p16INK4. p16-negative cells were characterized by the absence of nuclear staining, whereas cytoplasmic staining was variable. Clinico-pathologic features, complete remission rates and survivals were analyzed according to the status of p16INK4 and p15INK4B genes. RESULTS: Homozygous deletion of p16INK4 was detected in 12.9% of advanced ovarian carcinoma patients and that of p15INK4B in 35.5%. Clinico-pathologic features such as FIGO stage, histological grade, serum CA-125 levels were not different from groups with homozygously deleted p16INK4 and p15INK4B to those with normal genes. The survival of patients (13 [6-20] months) with homozygously deleted p16INK4 was significantly shorter than that (30 [8-52] months) of patients with normal p16INK4 (p=0.046; Log-rank test). CONCLUSION: These observations indicate that deletions of p16INK4 and p15INK4B gene might be involved in tumorigenesis of ovarian carcinoma and could be useful as a prognostic factor. A prospective, controlled study with more patients will be mandatory in the future.
beta-Globins ; Carcinogenesis ; Cell Cycle Checkpoints ; Chromosomes, Human, Pair 9 ; Cytoplasm ; DNA ; Exons ; Gene Dosage ; Genes, Tumor Suppressor ; Humans* ; Immunohistochemistry ; Nitrogen ; Polymerase Chain Reaction

Optic ataxia is characterized by an impaired visual control of the direction of arm reaching to a visual target, accompanied by defective hand orientation and grip formation. In humans, optic ataxia is associated with lesions of the superior parietal lobule, which also affect visually guided saccades and other forms of eye-hand coordination. A 67-year-old woman presented with sudden, unilateral, direct optic ataxia in the right homonymous half field and saccadic abnormalities which consisted of prolonged latency, undershoot dysmetria, and decreased velocity. Brain MRI showed a left parieto-occipital watershed infarction. It is suggested that lesions of the superior parietal lobule and the adjacent parietal eye field are responsible for optic ataxia and saccadic abnormalities, respectively.
Aged ; Arm ; Ataxia* ; Brain ; Cerebellar Ataxia ; Female ; Hand ; Hand Strength ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Rabeprazole ; Saccades

No abstract available.
Capsaicin* ; Lymphocytes* ; Lymphoid Tissue*

Adenosine deaminase(ADA) is an enzyme capable of catalysing the pathway from adenosine to inosine. Previous studies have shown that this enzyme may be useful in recognition of a tubeculous etiology of pleural, peritoneal, or meningeal effusions. ADA activity was studied in 42 patients with large amount of pericardial effusion. Patients were subdivided into the following four group : (A) 15 cases of tuberculous effusions : (B) 4 with pyogenic effusions : (C) 15 with idiopathic effusions : (D) 9 with malignant effusions. The results were as follows ; 1) The mean ADA activities assessed in pericardial effusions were 134.0+/-77.6U/L in group A : 93.8+/-43.8 in group B : 38.3+/-23.2 in group C : 27.3+/-20.8 in group D. Comparing the level achieved in group A with all others, the difference is significant at the P<0.001 level. 2) The mean ADA activities assessed in sera were 50.7+/-57.2 U/L in group A : 63.5+/-24.1 in group B : 25.9+/-12.0 in group C : 14.0+/-7.5 in group D. Comparing the level achieved in group A with all others, there is no significant difference. 3) Specificity(0.87) and sensitivity(0.93) of the test for the differential diagnosis of patients with tuberculous effusion from those with idiopathic effusion is high, when a value of more than 50 U/L is considered. In conclusion, the assessment of ADA in pericardial effusions is of great value in the diagnosis of tuberculous pericarditis.
Adenosine Deaminase* ; Adenosine* ; Diagnosis ; Diagnosis, Differential ; Humans ; Inosine ; Pericardial Effusion* ; Pericarditis, Tuberculous