No abstract available.
Female ; Humans ; Marriage*

Basal cell carcinoma (BCC) is the most common skin cancer in humans. It usually develops on sun-exposed areas of the head and neck but can occur anywhere on the body. The various clinical features include nodules, ulcers, bleeding, crust, or scale. Thus, it is important to distinguish BCC from other diseases with similar clinical features. The umbilicus is one of the sun-protected sites where BCC rarely develops. Herein, we describe 71-year-old woman with umbilical BCC initially misdiagnosed as pyoderma.
Aged ; Carcinoma, Basal Cell ; Female ; Head ; Hemorrhage ; Humans ; Neck ; Pyoderma ; Skin Neoplasms ; Ulcer ; Umbilicus

BACKGROUND: This study was intended to present the importance of insight status concerning the abstinence of alcoholics. METHODS: The 214 subjects, who participated in insight improving programs during hospitalization in an alcohol treatment center, were followed up for their abstinent status during the 12 month period after discharge. The relation between their abstinence results and insight status was investigated. To find out the influence of other factors upon abstinence, stepwise multiple regression was performed over variables including disease severity, sociodemographic, therapeutic and familial features. RESULTS: The 73 individuals (34.1%) had 'no remission', 110 (51.4%) 'early full remission', and 31 (14.5%) 'sustained full remission'. The insight degree was significantly correlated with both 'initial consecutive months of sobriety'(IMS) after discharge and 'total months of sobriety'(TMS) during the follow up. The 153 subjects (71.5%) relapsed within four months after discharge, and the rate of continuous abstinence at each month differed significantly among three insight groups. On the inter group shifts during hospitalization, the abstinent months were greater in the group whose insight changed from 'poor ' to 'good insight' than the one from 'fair ' to 'good insight'. By stepwise multiple regression analysis, the higher insight scores, older age and shorter hospital days, in a decreasing order of association, the longer IMS and TMS, while absence of religion and lower MAST scores was associated only with IMS, with their overall R2 value of 18.5% and 20.8%, respectively. CONCLUSION: The insight degree was related to the length of abstinence and thus it is necessary to develop insight improving programs which can be of help to recovering patients.
Alcoholics ; Alcoholism ; Follow-Up Studies ; Hospitalization ; Humans ; Prognosis

BACKGROUND: With increased prevalence of colorectal cancer, it is important to establish the risk factors of colorectal cancer. The prevalence of the metabolic syndrome (MS) is also increasing. Insulin resistance may play an important role in the pathogenesis of MS and colorectal polyps. The aim of this study was to assess the relationship between MS and colorectal polyps. METHODS: A total 558 subjects underwent colonoscopic examination from April 2004 to July 2005 at the health promotion center of Bundang CHA Hospital. According to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III definition of MS, the waist circumference, blood pressure (BP), fasting blood glucose (FBG), triglyceride (TG) and HDL cholesterol were measured. Alcohol consumption, smoking and other confounding factors were assessed by a self-administered questionnaire. RESULTS: The incidence of MS and colorectal polyps was 16.3% and 33.0%, respectively. In subjects with polyps, the number of men, smokers and drinkers were higher than in subjects without polyps. In subjects with polyps, BP, FBG and TG were also higher than in subjects without polyps. After adjustment for possible confounding factors, MS was associated with increased risk of colorectal polyps (odds ratio, 1.74; 95% confidence interval, 0.94~3.22). MS strongly increased the risk of colorectal polyps in men (odds ratio 2.19; 95% confidence interval, 1.07~4.45), but not in women. CONCLUSION: We concluded that MS is a risk factor for colorectal polyps in asymptomatic Korean adults and this suggests that insulin resistance may play an important role in the development of colorectal polyps.
Adult ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Cholesterol ; Cholesterol, HDL ; Colorectal Neoplasms ; Education ; Fasting ; Female ; Health Promotion ; Humans ; Incidence ; Insulin Resistance ; Male ; Polyps* ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Waist Circumference ; Surveys and Questionnaires

BACKGROUND: Recently, allogeneic peripheral blood stem cell transplantation (Allo-PBSCT) instead of bone marrow transplantation (BMT) has been widely used with the benefits of an earlier recovery of blood cells and a lower incidence of graft failure because of higher CD34+ cell dose. However, recent studies suggested that the higher dose of CD34+ cells might be related to the lower survival and the higher morbidity due to chronic graft versus host disease (cGVHD). We have analyzed the impact of transplanted CD34+ cell dose on clinical outcomes in unmanipulated allo-PBSCT from HLA identical siblings. METHODS: Thirty-one consecutive adult patients with hematological diseases, who survived until at least day 90 after allo-PBSCT and were evaluable for cGVHD, were included. Peripheral blood stem cells were collected from HLA-matched sibling donors mobilized with G-CSF and/or GM-CSF. The patients were classified into a "low" or "high" CD34+ cell dose group based on whether they received less or more than a median CD34+ cell dose of 11.17X10(6)/kg, respectively. RESULTS: The median CD34+ cell dose was 11.17X10(6)/kg (range, 4.12-58.80X10(6)/kg). Acute GVHD (grade II-IV) appeared in 24 patients (77.4%) and extensive cGVHD in 14 patients (45.2%). During the follow-up (median: 340 days, range: 111-1263 days), relapses were observed in 12 patients (38.7%) and 19 patients are still alive. There was a significant difference in the incidence of extensive cGVHD (20.0% vs 68.8%, P=0.011) and relapse (60.0% vs 18.8%, P=0.029) between low and high CD34+ cell dose groups, but no difference of the incidence of acute GVHD or the days of engraftments between the two groups. The estimated survival rate was significantly different between the two groups (3 year survival rate, 31.5% vs 79.8%, P=0.022) and the patients with extensive cGVHD showed a higher survival rate than those without extensive cGVHD (55.6% vs 12.5%, P=0.013). CONCLUSION: Better survival rate was observed in high CD34+ cell dose group for alloPBSCT, while a higher incidence of extensive cGVHD was noted. The optimal dose of CD34+ cells need to be determined to minimize the morbidity related to cGVHD and to improve survival.
Adult ; Male ; Female ; Humans ; Incidence ; Bone Marrow Transplantation

PURPOSE: The selective spinal nerve root block is one of the preoperative diagnostic tool to identify and confirm the lesion site of primary cause of pain. The purpose of this study was to ascertain the correlation between diagnostic selective spinal nerve root blocks and outcome following surgical treatment of selected levels of both lumbar herniated intervertebral disc (HIVD) and spinal stenosis. MATERIAL AND METHOD: In a total 341 selective nerve root blocks in 169 patients who were diagnosed as lumbar HIVD and spinal stenosis from Jan. 1993 to Jun. 1997 with performed in a retrospective study, two groups of patients were chosen for this study. The result of pain change of selective nerve root block were judged by Denis' pain scale, the end-result selective spinal nerve root and operative treatment used by Kim's criteria. RESULT : 1. The end-results of selective spinal nerve root block, excellent and good results were 64 cases (67.3%) in lumbar HIVD group and 50 cases (67.5%) in spinal stenosis group. The end-results of selective spine surgery, at last follow up, excellent and good results were 82 cases (86.2%) in lumbar HIVD group and 56 cases (75.7%) in spinal stenosis group. RESULT: 2. The predictive value of selective spinal nerve root block was 68.4% in lumbar HIVD group and 74.3% in spinal stenosis group. In addition, statistical analysis with regression analysis, to show any significant correlation between the selective spinal nerve root block results and the outcome of operative treatment, especially in spinal stenosis group. CONCLUSION: The selective spinal nerve root block is one of the valuable procedure that helpful and predictors of outcome selective operative treatment of lumbar spinal stenosis.
Follow-Up Studies ; Humans ; Intervertebral Disc ; Retrospective Studies ; Spinal Nerve Roots* ; Spinal Nerves* ; Spinal Stenosis ; Spine*

PURPOSE: Insulin-like growth factors (IGF) regulate a wide range of biological functions including cell proliferation, differentiation, and apoptosis through paracrine and autocrine mechanisms. Accordingly, the present study analyzed polymorphisms of IGF genes and their impact on the prognosis for patients with colorectal cancer. MATERIALS AND METHODS: Four hundred and two consecutive patients with curatively resected colorectal adenocarcinoma were enrolled in the present study. The genomic DNA was extracted from fresh colorectal tissue and 8 polymorphisms of IGF genes determined using a real-time polymerase chain reaction genotyping assay. RESULTS: Pathologic stages after surgery were as follows: stage 0/I (n=85, 21.1%), stage II (n=147, 36.6%), stage III (n=145, 36.1%), and stage IV (n=25, 6.2%). Multivariate survival analysis including stage, age, site of disease, and carcinoembryonic antigen level showed that the progression-free survival for patients with the IGF2 +1280 GG genotype was slightly better than for the patients with the combined IGF2 +1280 AA and AG genotype (p=0.056), although there was no significant difference in the overall survival. However, the other polymorphisms were not associated with survival. CONCLUSION: None of the 8 IGF1 or IGF2 gene polymorphisms investigated in this study were found to be independent prognostic markers for Korean patients with surgically resected colorectal cancer.
Adenocarcinoma ; Apoptosis ; Carcinoembryonic Antigen ; Cell Proliferation ; Colorectal Neoplasms ; Disease-Free Survival ; DNA ; Genotype ; Humans ; Polymorphism, Genetic ; Prognosis ; Real-Time Polymerase Chain Reaction ; Somatomedins

PURPOSE: Insulin-like growth factors (IGF) regulate a wide range of biological functions including cell proliferation, differentiation, and apoptosis through paracrine and autocrine mechanisms. Accordingly, the present study analyzed polymorphisms of IGF genes and their impact on the prognosis for patients with colorectal cancer. MATERIALS AND METHODS: Four hundred and two consecutive patients with curatively resected colorectal adenocarcinoma were enrolled in the present study. The genomic DNA was extracted from fresh colorectal tissue and 8 polymorphisms of IGF genes determined using a real-time polymerase chain reaction genotyping assay. RESULTS: Pathologic stages after surgery were as follows: stage 0/I (n=85, 21.1%), stage II (n=147, 36.6%), stage III (n=145, 36.1%), and stage IV (n=25, 6.2%). Multivariate survival analysis including stage, age, site of disease, and carcinoembryonic antigen level showed that the progression-free survival for patients with the IGF2 +1280 GG genotype was slightly better than for the patients with the combined IGF2 +1280 AA and AG genotype (p=0.056), although there was no significant difference in the overall survival. However, the other polymorphisms were not associated with survival. CONCLUSION: None of the 8 IGF1 or IGF2 gene polymorphisms investigated in this study were found to be independent prognostic markers for Korean patients with surgically resected colorectal cancer.
Adenocarcinoma ; Apoptosis ; Carcinoembryonic Antigen ; Cell Proliferation ; Colorectal Neoplasms ; Disease-Free Survival ; DNA ; Genotype ; Humans ; Polymorphism, Genetic ; Prognosis ; Real-Time Polymerase Chain Reaction ; Somatomedins

BACKGROUND/AIMS: The International Prognostic Index (IPI) and absolute lymphocyte count (ALC) are prognostic factors in diffuse large B cell lymphoma (DLBCL). Nevertheless, in the Rituximab era, a new predictive marker related to Rituximab might be needed. We evaluated prognostic factors for survival in patients with early stage DLBCL after R-CHOP (Rituximab, cyclophosphamide, adriamycin, vincristine, prednisolone) treatment. METHODS: From Aug 2003 to Nov 2007, 78 patients with early stage DLBCL, who finished R-CHOP as scheduled, were reviewed retrospectively. Survival analyses were performed according to clinical parameters (age, performance status, lactate dehydrogenase (LDH), extra-nodal involvement, stage, ALC, and the rates of reduction of the white blood count (WBC) and ALC). RESULTS: Of the 78 patients with early stage DLBCL, 26 (33.3%) were classified as stage I. Seventy-three patients (93.6%) presented with a good performance status, while LDH was elevated in 20 patients (25.6%). According to the IPI, 67 (85.9%), 8 (10.3%), and 3 (3.8%) patients were classified in the low, low-intermediate, and high-intermediate risk groups, respectively. The overall response rate was 100%, including a 94.8% complete response. Survival analysis demonstrated that the rate of reduction of ALC following the first cycle of the R-CHOP regimen was the only factor associated with time-to-progression (p=0.037), whereas age was the single most important prognostic factor for overall survival (p=0.006). CONCLUSIONS: In our study, the rate of reduction of ALC in addition to age and IPI was found to be a significant prognostic factor in patients with early stage DLBCL treated with the R-CHOP regimen.
Antibodies, Monoclonal, Murine-Derived ; Cyclophosphamide ; Doxorubicin ; Humans ; L-Lactate Dehydrogenase ; Lymphocyte Count ; Lymphocytes ; Lymphoma, B-Cell ; Retrospective Studies ; Vincristine ; Rituximab

PURPOSE:Hypoxic injury during delivery and subsequent ischemic encephalopathy is still remained as one of the important cause of neonatal death and associated with neurologic complication. We investigated the predicting factors for neurologic outcome in full-term hypoxic-ischemic encephalopathy (HIE). METHODS:Twenty-two full-term neonates with HIE stage II or III from Jan. 2001 to Dec. 2004 were enrolled. We reviewed the medical records retrospectively including obstetric history, initial pH, creatine kinase (CK), ionized calcium, seizure type and duration, EEG, cranial sonography, CT or MRI, and neurologic outcome. RESULTS:Among 22 patients, outborn was 86.3%, vaginal delivery 68.2%, and male 72.7%. Regarding the obstetrical events, two-thirds had meconium staining or aspiration and prolonged rupture of membrane. Initial arterial pH, CK and ionized calcium were not significantly different between normal and abnormal neurologic outcome group. All of 5 patients recovered from seizure after more than 5 days had neurologic sequelae (P= 0.008). Eight of 16 cases with abnormal EEG showed abnormal development, and all of 4 cases with normal EEG showed normal development. Eight of 12 cases with abnormal imaging study showed neurologic sequelae, however, all of 10 cases with normal study showed normal outcome (P=0.005). CONCLUSION:This study suggests that seizure duration and imaging study are the best predicting factors for prognosis in full-term HIE. Although the EEG finding was not signigicant, the normal finding is expected to have good prognosis. The initial laboratory findings had no prognostic significance because of delayed blood sampling in most patients, who transferred from other hospitals after immediate postnatal resuscitation. We encourage the maternal transport especially when the high-risk delivery is anticipated.
Brain Ischemia ; Calcium ; Creatine Kinase ; Electroencephalography ; Humans ; Hydrogen-Ion Concentration ; Hypoxia-Ischemia, Brain* ; Infant, Newborn* ; Magnetic Resonance Imaging ; Male ; Meconium ; Medical Records ; Membranes ; Prognosis ; Resuscitation ; Retrospective Studies ; Rupture ; Seizures