No abstract available.
Domestic Violence*

Ouarian tumors of low malignant potential(OTLMP) or borderline tumors account for approximately 10% of all ovarian neaplasms. Borderline tumors have some but not all of the histologic characteristics af ma lignancy : stratification of epitheliial cells, with some degree of nuclear atypia a,nd inereased mitotic actitity but. without stromal invasion. We reviwed 20 published Rnglish written articlea from 1978 to 1992 and Korean gynecologic cancer regestry of 1990. In this review, we tried to concentrate on several debating is sues in OTLMP: 1) What kind of surgery is needed for each stages?, 2) Is postoperative adjuvant t.herapy needed?, 3) Jf needed, which type? Following result were obtained from the besis of 1516 patients with OTLMP. Patients withh OTLMIP are younger than those with invasive ovarian cancers', mean age was in their forties. The majority of patients(74.5%) had stage I disease, and the incidence dropped ahruptly to 9.4% for stage ll, 15.7% for stage III and 0.4% for stage IV. The most cammon histologic subtype was serous(56.7%), followed by muci noua(38.1%), However, interestingly in Korea and Japan, the mucinous type was the most common one. The primary treatment for OTLMP was surgery, and the conservative surgery to preserve fertility in young women was sufficient for stage I disease with careful follow-up. The majority of patients(79.1%) with stage I disease were treated by surgery alone. Adjuvant such as chemotherapy (CT) and/or radiotherapy(RT) could prolong the recurrence of disease a little later, but failed to increase diaease-free survival significantly in stage I disease. In stageII disease, the surgery should be a total abdominal hysterectomy and bilateral salpingo-oophorectomy with multiple sampling of the peritoneal cavity. About a third of patients with stageII disease received no adjuvant therapy and the others received CT and/or RT, however, there was no difference in outcome of recurrence and survival. In advanced stage. 15% of patients received no adjuvant therapy after initial debulking surgery, and the rest of patients received CT and/or RT. No differences in recurrence and survival between each groups were noticed , too. The status of second-look laparotomy(SLL) did not depend on the stage of the disease. Positive rate of SLL for stage I diaease was not statistically different from that for the combined stages II-IV. Survival for stage I at 5 years was reported to range from 80 to 100%, and even stage III had survival ranging from 64 to 96%. Long-term survival at 15~20 years was also good. Although it is quite difficult to make conclusions because of the lack of prospective randomized studies from this review, it appears clear that surgical removal of the tumor and careful follow-up of patients are all that are necessary in stage I disease and further multi-center prospective study for the effect of adjuvant therapy in advanced disease is definitely needed.
Drug Therapy ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Incidence ; Japan ; Korea ; Mucins ; Peritoneal Cavity ; Prospective Studies ; Recurrence

The depth of wound level is as important as the level of the tendon injury itself. And the timing of the operative procedure is an important factor. As a rule, tendons injured outside of the flexor sheath yield much better results than those injured within the sheath. The nutritional supply of the flexor tendons is not completely understood. Many elaborate studies have outilned the vascular anatomy of these tendons, and not all authors are in agreement. It is now clear that synovial fluid within the sheath supplies nutrition to the tendon much as synovial fluid in a joint supports cartilage. With this in mind, the present study was designed to determine the effect of exposing tendons for varying periods of time on the viability of the tendon and sequential morphological changes. The results are as follows: 1. Twelve hours after tendon sheath removal, collagen fibrillar dissociation and irregular surface of the tendon sheath were noted on the chicken flexor tendons by electronmicroscopy. 2. Superficial tenocyte necrosis was created after 24 hours of tendon exposure. 3. At 3 days, inflammatory cell infiltration and thickening of the outer synovial layer were noted. After 7 days, fibrosis of the degenerated tendon started from the exposed surface. 4. The fibrous connective tissue and new blood vessel infiltration into the tendon were progressed after 7 days. From these morphological results, any interference with the synovial environment leads to a regressive change of the flexor tendons immediately. It is suggested that delayed primary wound covering procedure within three days an after exposed tendon injury is ideal, and it should by done at least 7 days after tendon exposure.
Blood Vessels ; Cartilage ; Chickens ; Collagen ; Connective Tissue ; Equipment and Supplies ; Fibrosis ; Joints ; Necrosis ; Surgical Procedures, Operative ; Synovial Fluid ; Tendon Injuries ; Tendons ; Wounds and Injuries

No abstract available.

No abstract available.
Replantation*

No abstract available.
Absorptiometry, Photon* ; Bone Density*

Periodic examination of patients after potentially curative treatment for breast cancer is routine practice. The objectives of such follow up are 1) surveillance for cancer recurrence 2) monitoring for toxicities related to therapy 3) maximizing overall health and quality of life for cancer survivors. However, recent literatures suggest that routine intensive follow up studies for asymptomatic breast cancer patients after primary treatments, showed no survival benefit. Also, there is controversy between aggressive and minimal policy for breast cancer patients follow up after primary treatment still exist. We administrated a mailed survey to The Korea Breast Cancer Society (KBSC) members (N=136,1996) to study the methods of preoperative evaluation and post-treatment follow up, as practicing in Korea and determine whether an accepted standard exists, or whether difference in practice occurred, base on physicians factors (years of physician experience, age of physician, number of breast cancer treated annually, practice type). The survey response yield was 45.59% (62/136), and mean age of the respondent was 43.7 years (range 33-67). There was roughly equal distribution of respondents by region (capital/noncapital area:27/31), and practice type (university hospital/general hospital: 37/21). The average practice in breast disease treatment of respondents (most of them were surgeon: N=57) was 8 years, and breast-conserving rate of respondents in 1996 was 210.2%. The considerable factors in follow up practice were 1) stage, 2) symptoms, 3) age, 4) operation methods, 5) demand of patient, 6) education level of patient in orders. Most frequently used tests for intial work up and base line follow up study for breast cancer patient were history, physical examination, mammography, breast US, chest X-ray, bone scan, FNA, open biopsy, CBC/ ESR, SMA, CEA, CA15-3 respectively. In this study, we proposed the model of breast cancer follow up which is practicing among the KBCS members and also we concluded as follows 1) This follow up model is more aggressive than other foreign cancer center follow up protocol 2) The KBCS members survey for non-breast cancer second malignancy less frequently than others 3) It seems to need concensus conference for Korea guideline model of breast cancer follow up.
Biopsy ; Breast Diseases ; Breast Neoplasms* ; Breast* ; Surveys and Questionnaires ; Education ; Follow-Up Studies* ; Humans ; Korea ; Mammography ; Neoplasms, Second Primary ; Physical Examination ; Postal Service ; Quality of Life ; Recurrence ; Survivors ; Thorax

PURPOSE: The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. MATERIALS AND METHODS: Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant 2.0(TM), and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. RESULTS: The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. CONCLUSION: Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.
Bone Density ; Cone-Beam Computed Tomography ; Data Interpretation, Statistical ; Dental Implants ; Molar ; Prostheses and Implants ; Tooth ; Transplants

The aim of this study was to investigate viral etiology in dilated cardiomyopathy (DCM) by polymerase chain reaction (PCR) or nested reverse tanscription PCR (RT-PCR), and characterize the enteroviral RNA presented in the clinical specimens. Twenty-eight paraffin-embedded heart tissue samples were assayed to detect cytomegalovirus, herpes simplex virus type 1, type 2, parvovirus, adenovirus, and enterovirus (EV) with each specific primer. Of these 28 patients (mean age: 27, M: 24, F: 4), 26 were histologically diagnosed as DCM and 2 as myocardial infarction (MI). Nested RT-PCR detected enteroviral RNA in 7 (26.9%) of 26 patients with DCM, and none of patients with MI. And none of DNA viruses tested were detected from the samples. Amplified products were also genotyped by single-variation of EV is present in the explanted heart tissues from patients with DCM. Although most of the sequences among the wild isolates have the greatest similarity to those of coxsackievirus B3, there are specific regions of variable sequences (no 490 - no 510). The data suggest that enterovirus may be a major viral pathogen for the DCM in Korea and nucleotide sequence data indicate that coxsackievirus B3 may be a leading etiologic agent of DCM.
Adenoviridae ; Base Sequence ; Cardiomyopathy, Dilated* ; Cytomegalovirus ; DNA Viruses ; Enterovirus ; Heart* ; Herpesvirus 1, Human ; Humans ; Korea ; Myocardial Infarction ; Parvovirus ; Polymerase Chain Reaction ; RNA*

PURPOSE: The relationship between menopausal status at diagnosis and the prognosis in breast carcinoma remains uncertain. However, it is widely considered that breast cancer in young women is more lethal than in older patients. We therefore attempted to determine whether menopausal status could be a useful prognostic factor for breast cancer. METHODS: A retrospective study was conducted of premenopausal women who had undergone a definite operation between Jan. 1997 and Dec. 1998 in the Department of Surgery, Samsung Medical Center. Clinical features, histopathologic findings, and prognostic factors were evaluated and compared with those for the equivalent surgical group of postmenopausal women. RESULTS: There were 207 cases (86.3%) of infiltrating ductal carcinomas, 10 (4.2%) of infiltrating lobular carcinomas, 6 (2.5%) of ductal carcinomas in situ, and 16 (6.7%) of special type cancers which showed good prognosis. There were some differences in these incidences from those of the postmenopausal women, but they were not statistically significant (P>0.05). Tumor size and lymph nodal status showed no difference between the two groups (P=0.288), nor were there any significant differences in terms of TNM stage, ER/PR status, nuclear or histologic grade (P>0.05). CONCLUSION: There were little differences in pathologic and prognostic factors between premenopausal and postme no- pausal breast cancer patients. Premenopausal status and young age did not have poorer prognostic factors and were predicted to have not worse prognosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Incidence ; Prognosis ; Retrospective Studies