No abstract available.

The purpose of this study was to evaluate self perception of occlusal status and recognition for ortho?dontic treatment as well as the prevalence of orthodontic treatment need objectively and subjectively. 3979 (male 2107, female 1872) school students of age 7~18 were analyzed by questionnaire and clinical examination and the results were as follows. 1. Perception of occlusal status on one's own was more generous than that of orthodontist's and it was affected by the factors such as age, patterns of malocclusion. 2. Recognition of subjective need for orthodontic treatment was more generous than that of objective need for the treatment, and factors such as age and sex of patient, parents' age and rate of education, income, occupation, classification of malocclusion and regional discrepancy were influenced. 3. Negative aspect of orthodontic treatment was influenced by the environmental factors. 4. A survey of want for orthodontic treatment showed one's alteration in recognition of the occlusal status with age and esthetic component was much more emphasized than functional component. 5. The multivariate discriminanat analysis for orthodontic treatment group showed that mother's rate of education, classification of malocclusion, demographic characteristics were critical in the determination of treatment group. 6. Test of inter-examiner reliability showed moderate coincidence.
Adolescent* ; Classification ; Education ; Female ; Humans ; Malocclusion* ; Occupations ; Prevalence ; Surveys and Questionnaires ; Self Concept

PURPOSE: In spite of a very poor prognosis for primary gastric cancer invading neighboring organs, combined resection of the involved adjacent organ may improve. Whether pancreaticoduodenectomy in advanced distal gastric cancer improves the survival is controversial. We conducted this study to evaluate the results of pancreaticoduodenectomy in advanced distal gastric cancer. METHODS: We retrospectively analysed 29 patients who underwent surgery at the Department of Surgery, Yonsei University College of Medicine, between January 1994 and December 2001. Patients included in this study had locally advanced distal gastric cancer, without evidence of distant metastases, which had invaded to the duodenum and/or pancreas head, or conglomerated infrapyloric lymph nodes. Patients were divided into two groups: pancreaticoduodenectomy (PD) (n=12), or palliative subtotal gastrectomy (PSTG) (n=17). We compared the clinicopathologic features, operative outcomes, recurrence and survival between these two groups. RESULTS: There were no differences in clinicopathologic features between the two groups. Operation time, incidence and amount of perioperative transfusion, postoperative hospital stay and morbidity were greater in the PD group than in the PSTG group. However, there was no postoperative mortality in either group. Five patients had systemic recurrence (liver, lung, and paraaortic LN metastases) in the PD group, while most patients experienced regional disease progression in the PSTG group. The survival of the PD group was significantly better than that of the PSTG group (P=0.0006). CONCLUSION: Pancreaticoduodenectomy can be safely performed and improves the prognosis for patients with locally far advanced distal gastric cancer that is associated with invasion into the duodenum and/or pancreas head, or conglomerated infrapyloric lymph nodes.
Disease Progression ; Duodenum ; Gastrectomy ; Head ; Humans ; Incidence ; Length of Stay ; Lung ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Pancreas ; Pancreaticoduodenectomy* ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

Gastric cancer imposes a global health burden. Although multimodal therapies have proven to benefit patients with advanced diseases after curative surgery, the prognosis of most advanced cancer patients still needs to be improved. Surgical extirpation is the mainstay of gastric cancer treatment. Indeed, without curative surgery, variations and combinations of chemotherapy and/or radiation cannot bring clinically meaningful success. Centered around D2 surgery, adjuvant and peri-operative multimodal therapies have improved survival in a certain group of gastric cancer patients. Moving toward a personalized cancer therapy era, molecular targeted strategies have been tested in clinical trials for gastric cancer. With some success and failures, we have learned valuable lessons regarding the biology of gastric cancer and the clinical relevance of biological therapies in addition to conventional treatments. Future treatment of gastric cancer will be shifted to molecularly tailored and genome information-based personalized therapy. Collaboration across disciplines and actively adopting emerging anti-cancer strategies, along with in-depth understanding of molecular and genetic underpinnings of tumor development and progression, are imperative to realizing personalized therapy for gastric cancer. Although many challenges remain to be overcome, we envision that the era of precision cancer medicine for gastric cancer has already arrived and anticipate that current knowledge and discoveries will be transformed into near-future clinical practice for managing gastric cancer patients.
Combined Modality Therapy ; Female ; Gastrectomy ; Humans ; *Precision Medicine ; Prognosis ; Stomach Neoplasms/*surgery

PURPOSE: Adenosquamous carcinoma, a rare malignant tumor of the stomach, is characterized by two different cell components, one adenomatous and the other squamous component. Its clinicopathologic feature and prognosis are quite different from the ordinary adenocarcinomas. We report our experience of 9 such cases. MATERIALS AND METHODS: Clinical and pathologic features were reviewed for the 9 patients who undenwent gastrectomies and were confirmed as adenosquamous carcinoma by pathologists during the 10-year period of from 1987 to 1998. Postoperative adjuvant therapy and prognosis were also reviewed. RESULTS: The ages of 6 male and 3 female patients ranged from 30 to 59, with the median age of 48. Total gastrectomy was done in 4 cases, while other underwent subtotal gastrectomy. Curative resection was done in four cases. Fourteeen additional organs were resected concomitantly due to suspicious tumor invasion and among them 9 organs were histologically confirmed for tumor invasion. The mean tumor size was 7.4 cm (2.5-27 cm) and all cases were pathologically advanced. One case showed peritoneal seeding and 3 cases showed hepatic metastases. There were 7 cases of stage IV disease by the UICC TNM classification (5th ed.) and the other two were stage II and stage IIlb respectively. Eight cases received postoperative adjuvant chemotherapy comprising S-FU, DDP, adriamycin, picibanil or VP-16. Of 9 patients, 6 died and the overall 5-year survival rate was 15.3%. CONCLUSION: Adenosquamous cancer of stomach is regarded as a disease of unfavorable prognosis, which was confirmed by this study. The treatments were not quite different from those for other stomach cancers. Although more cases and further investigations are essential for complete understanding of the clinical prognosis and proper treatment of the gastric adenosquamous cancer, early diagnosis, curative resection and close postoperative follow-ups are currently available options for better outcome of this disease.
Adenocarcinoma ; Carcinoma, Adenosquamous* ; Cellular Structures ; Chemotherapy, Adjuvant ; Classification ; Doxorubicin ; Early Diagnosis ; Etoposide ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Male ; Neoplasm Metastasis ; Picibanil ; Prognosis ; Stomach ; Stomach Neoplasms ; Survival Rate

No abstract available.
Adrenal Gland Neoplasms/*diagnosis/pathology/ultrasonography ; Aged ; Diagnostic Errors ; Female ; Hemangioma/*diagnosis/pathology/ultrasonography ; Humans ; Pancreatic Neoplasms/diagnosis ; Tomography, X-Ray Computed

Gastric cancer is a global health burden and has the highest incidence in East Asia. This disease is complex in nature because it arises from multiple interactions of genetic, local environmental, and host factors, resulting in biological heterogeneity. This genetic intricacy converges on molecular characteristics reflecting the pathophysiology, tumor biology, and clinical outcome. Therefore, understanding the molecular characteristics at a genomic level is pivotal to improving the clinical care of patients with gastric cancer. A recent landmark study, The Cancer Genome Atlas (TCGA) project, showed the molecular landscape of gastric cancer through a comprehensive molecular evaluation of 295 primary gastric cancers. The proposed molecular classification divided gastric cancer into four subtypes: Epstein-Barr virus-positive, microsatellite unstable, genomic stable, and chromosomal instability. This information will be taken into account in future clinical trials and will be translated into clinical therapeutic decisions. To fully realize the clinical benefit, many challenges must be overcome. Rapid growth of high-throughput biology and functional validation of molecular targets will further deepen our knowledge of molecular dimensions of this cancer, allowing for personalized precision medicine.
Biology ; Chromosomal Instability ; Classification ; Far East ; Genome ; Humans ; Incidence ; Microsatellite Repeats ; Population Characteristics ; Stomach Neoplasms* ; Translational Medical Research

In this study, in order to survey the effect on public recognition in malocclusion and orthodontic treatment by brochures made by Korean orthodontic association, sample were divided into control and experimental group and a questionnaire was inguired and the results were as follows: 1. In the experimental group, frequency of recognition for the need of orthodontic treatment was high, and this indicates dental health behavior and recognition can be inspired by adequate giving of information. 2. Between the control and the experimental group, patterns of the negative opinion was different, and especially the demand for specific orthodontic treatment can be influenced by the content of brochures. 3. The brochures used in this study can call attention to develop the orthodontic aspect for the malocclusion, hereafter more systemic and active measures for development of public dental behavior and recognition should be needed.
Health Behavior ; Malocclusion* ; Pamphlets ; Surveys and Questionnaires

Traumatic intracranial aneurysm rarely occurs after a head injury. The authors report a case of a 51-year-old man in whom subarachnoid hemorrhage was developed as a result of delayed traumatic aneurysmal rupture of the distal portion of the middle cerebral artery following a minor, closed-head injury. The unruptured aneurysm had been evident on the magnetic resonance image taken two days prior to onset of the subarachnoid hemorrhage. The clinical presentation and possible underlying mechanism are discussed with a review of pertinent literature.
Aneurysm ; Craniocerebral Trauma ; Humans ; Intracranial Aneurysm* ; Middle Aged ; Middle Cerebral Artery ; Rupture ; Subarachnoid Hemorrhage*

BACKGROUND: Electrocardiographic variables such as changes in the ST-T segment, and increased QT interval have been found to predict the occurrence of myocardial ischemia. But disadvantages of most of these variables have poor reproducibility and require analysis of all ECG leads. If electrocardiographic T axis properly predicts myocardial ischemia, it can be used as a useful marker for diagnosing myocardial ischemia in primary practice. METHODS: We selected 147 persons, who visited the emergency room or an outpatient clinic because of chest pain, in whom coronary angiography was performod. We reviewed their medical records. Electrocardiographic T axis was classified as normal, borderline and abnormal T axis. We identified the relation between cardiovascular risk factors and electrocardiographic T axis, and also, the relation between ischemic electrocardiographic variables and T axis. We examined the relation between coronary angiographic results and electrocardiographic T axis. RESULTS: The sensitivity and specificity of electrocardiographic T axis was 26.7% and 86.9%, respectively. The positive predictive value and negative predictive value was 81.8% and 35.1%, respectively. The proportion of hypertension was 41.2% in normal T axis group, 65.5% in borderline T axis group, and 34.4% in abnormal T axis group, which was statistically significant (P=0.032). The relation between coronary angiographic results and electrocardiographic T axis was not statistically significant. The subjects with abnormal T axis were associated with ST depression (P=0.016). CONCLUSION: The T axis abnormality was not useful for screening myocardial ischemia, but it was useful to rule out other diseases due to its high specificity.
Ambulatory Care Facilities ; Axis, Cervical Vertebra* ; Chest Pain ; Coronary Angiography ; Depression ; Diagnosis* ; Electrocardiography* ; Emergency Service, Hospital ; Humans ; Hypertension ; Mass Screening ; Medical Records ; Myocardial Ischemia* ; Risk Factors ; Sensitivity and Specificity