No abstract available.
Quinolones* ; Vibrio vulnificus* ; Vibrio*

PURPOSE: The prognosis for early gastric cancer (EGC) is favorable, and the 10-year disease-specific survival rate is reported to be around 90%. The absolute number of recurred EGC is too small to assess the risk factors, so recruitment of a large number of cases for statistical analysis is very difficult. We carried out this study to analyze the incidence and the patterns of recurrence of EGC and to identify the clinicopathological risk factors for recurrence of EGC. MATENRIALS AND METHODS: The authors retrospectively investigated the follow-up records of 1418 patients who underwent a curative resection for EGC from Jan. 1984 to Dec. 1999 at the Korea Cancer Center Hospital and analyzed them with special reference to cancer recurrence. Results: In this retrospective study of 1418 cases, 43 patients died of a recurrence of gastric cancer, and 105 patients died of unrelated causes. The five-year and the ten-year overall survival rates were 89.6% and 81.7%, respectively, while the five-year and the ten-year disease- specific survival rates were 96.5% and 94.3%, respectively. The recurrence patterns of the 45 recurred EGC were hematogenous metastasis (19 cases), lymph node (L/N) metastasis (8 cases), locoregional recurrence (2 cases), peritoneal seeding (3 cases), and combined form (13 cases). The mean time interval to recurrence was 38.6 months, and the number of delayed recurred cases after 5 years was 10 (22.2%). Of the clinicopathologic factors, depth of invasion, L/N metastasis, macroscopic type, lymphatic invasion, and vessel invasion, were significant risk factors in the univariate analysis. However, in the multivariate analysis, only L/N metastasis was an independent prognostic factor. CONCLUSION: Based on the results of this study, L/N metastasis is an independent prognostic factor. Thus, in patients with node-positive disease, adjuvant therapy might be considered, and long-term close follow-up might facilitate early detection and treatment of recurrent disease due to delayed recurrence.
Follow-Up Studies ; Humans ; Incidence ; Korea ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms* ; Survival Rate

PURPOSE: The prognosis for early gastric cancer (EGC) is favorable, and the 10-year disease-specific survival rate is reported to be around 90%. The absolute number of recurred EGC is too small to assess the risk factors, so recruitment of a large number of cases for statistical analysis is very difficult. We carried out this study to analyze the incidence and the patterns of recurrence of EGC and to identify the clinicopathological risk factors for recurrence of EGC. METHODS: The authors retrospectively investigated the follow- up records of 1,418 patients who underwent a curative resection for EGC from Jan. 1984 to Dec. 1999 at the Korea Cancer Center Hospital and analyzed them with special reference to cancer recurrence. RESULTS: In this retrospective study of 1418 cases, 43 patients died of a recurrence of gastric cancer, and 105 patients died of unrelated causes. The five-year and the ten-year overall survival rates were 89.6% and 81.7%, respectively, while the five-year and the ten-year disease-specific survival rates were 96.5% and 94.3%, respectively. The recurrence patterns of the 45 recurred EGC were hematogenous metastasis (19 cases), lymph node (L/N) metastasis (8 cases), locoregional recurrence (2 cases), peritoneal seeding (3 cases), and combined form (13 cases). The mean time interval to recurrence was 38.6 months, and the number of delayed recurred cases after 5 years was 10 (22.2%). Of the clinicopathologic factors, depth of invasion, L/N metastasis, macroscopic type, lymphatic invasion, and vessel invasion, were significant risk factors in the univariate analysis. However, in the multivariate analysis, only L/N metastasis was an independent prognostic factor. CONCLUSION: Based on the results of this study, L/N metastasis is an independent prognostic factor. Thus, in patients with node-positive disease, adjuvant therapy might be considered, and long-term close follow-up might facilitate early detection and treatment of recurrent disease due to delayed recurrence.
Follow-Up Studies ; Humans ; Incidence ; Korea ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms* ; Survival Rate

PURPOSE: To compare various breath-hold T2 weighted sequences in imaging normal pancreas with a phased-arraycoil. MATERIALS AND METHODS: Eighteen patients without pancreatic disease were studied with breath-hold turbo spinecho (TSE) (TR/TE/ETL, 3500/138/29), TSE with fat suppression (FS-TSE), half-Fourier acquisition single-shot turbospin echo (HASTE) (TE/ETL, 87/128) and HASTE with fat suppression (FS-HASTE) at 1.0T magnet strength and using aphased-array coil. Signal difference-to-noise ratio (SD/N) between the pancreas and peripancreatic fat wasmeasured ; the delineation of the pancreatic border and pancreatic duct, and the amount of artifact were evaluatedby two radiologists who reached a consensus. RESULTS: HASTE showed a higher SD/N than TSE or FS-HASTE (p < 0.01),TSE was superior to FS- TSE or HASTE in the delineation of pancreatic border(p < 0.001). HASTE was superior to TSEin the delineation of pancreatic duct(p < 0.001). TSE showed more artifacts than FS-TSE(p < 0.001) ; HASTE andFS-HASTE showed no artifact. CONCLUSION: TSE is better than HASTE for the delineation of pancreatic margin but HASTE shows less artifacts and a more conspicuous pancreatic duct. Fat suppression decreases artifacts but makes the pancreatic margin indistinct.
Artifacts ; Consensus ; Humans ; Magnetic Resonance Imaging* ; Pancreas* ; Pancreatic Diseases ; Pancreatic Ducts

Over the last 20 years, the frequency of multiple pregnancy has increased mainly because of the introduction of exogenous pituitary gonadotropins in the treatment of infertility. Since the advent of assisted reproductive technology, the concern about ectopic implantation of embryos has increased dramatically and it continues to be a major complication of in vitro fertilization and embryo transfer (IVF-ET). Bilateral tubal pregnancy is the least common type of ectopic implantation of two embryos. Of all extrauterine pregnancies, 1:725~1:1580 are bilateral1,2. Simultaneous tubal pregnancies have been reported in natural cycles, recently, after ovulation induction, in-vitro fertilization2,3. The high incidence of ectopic pregnancy associated with IVF-ET continues to be a problem and frequencies of between 2.4 and 12.4% have been only a few reports of simultaneous bilateral tubal pregnancies following IVF-ET4. This paper describes a case of a simultaneous bilateral tubal pregnancy after IVF-ET in a 33 year old patient. The diagnosis was confirmed by diagnostic laparoscopy performed 25 days after embryo transfer(sixth week of gestation), which revealed bilateral tubal pregnancy. Bilateral salpingectomy was performed. With a review of the literature on this topic, diagnostic aspects and treatment options are discussed.
Adult ; Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro ; Fertilization* ; Gonadotropins, Pituitary ; Humans ; Incidence ; Infertility ; Laparoscopy ; Ovulation Induction ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Multiple ; Pregnancy, Tubal* ; Reproductive Techniques, Assisted ; Salpingectomy

BACKGROUND: Essential hyperhidrosis is a pathologic condition caused by excessive secretion of the eccrine sweat glands. This is an embarrassing condition, which severely reduces the quality of life and may result in psychological disturbance. Our purpose was to determine the therapeutic efficacy of oral glycopyrrolate in term of its strength, safety, and side effects. METHODS: Oral glycopyrrolate was given to 104 patients, 53 men and 51 women with a mean age of 24 years. Patients controlled the dosage of glycopyrrolate for a week. Attention was focused on patient satisfaction, onset time, duration, degree of reducing perspiration and side effects. RESULTS: Ninety eight of 104 patients (94%) were satisfied with their improved condition. The most common maximum dose/day was 2 mg. The overall mean onset time was 2.3 hours and the duration of the effect was 7.4 hours. Dry mouth occurred in 40 patients. Sixty eight of patients (65%) experienced reduced excessive sweating caused by oral glycopyrrolate. CONCLUSIONS: The administration of oral glycopyrrolate is a safe and effective method of treating essential hyperhidrosis, and appears to be an acceptable therapeutic option in any form of hyperhidrosis.
Female ; Glycopyrrolate* ; Humans ; Hyperhidrosis* ; Male ; Mouth ; Patient Satisfaction ; Quality of Life ; Sweat ; Sweat Glands ; Sweating

OBJECTIVE: We investigated the influence of social support on health, quality of life (QOL), and the risk of depression in elderly Korean people. METHODS: This study was conducted as a part of the Korean Longitudinal Study on Health and Aging (KLoSHA). A total of 787 nondemented community-dwelling elderly aged 65 years or older were recruited and underwent clinical evaluations for dementia and psychiatric disorders conformed to Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Clinical Assessment Battery (CERAD-K) and the Korean version of the Mini-International Neuropsychiatric Interview (MINI), respectively. Social support was assessed using the Medical Outcome Study Social Support Survey (MOS-SSS). Poor social support (PSS) was defined as having a MOS-SSS score below the 25th percentile of the entire sample. General health status was comprehensively evaluated using the modified Cumulative Illness Rating Scale (CIRS), the Korean version of the Geriatric Depression Scale (GDS-K), Mini-Mental Status Examination (MMSE-KC), Korean Activities of Daily Living (KADL), and Korean Instrumental Activities of Daily Living (KIADL). Health-related QOL was evaluated using the Short Form 36 (SF-36). RESULTS: Low educational attainment and living alone were associated with PSS. Geriatric depression was more prevalent in the PSS group (OR=3.05, 95% CI=1.77-5.27) than in the normal social support (NSS) group. Among the various forms of social support, positive social interaction was significantly associated with risk of geriatric depression (OR=2.25, 95% CI=1.07-4.73). Although health-related QOL was lower in the PSS group than in the NSS group, the ADL and IADL scores of the subjects in the PSS group were better than those of the subjects in the NSS group. In the subjects with geriatric depression, PSS was associated with more severe depression, higher medical morbidity, and poor QOL. CONCLUSION: PSS had a negative influence on the general health status and QOL among community-dwelling elderly and was an independent risk factor of geriatric depression.
Activities of Daily Living ; Aged* ; Aging* ; Alzheimer Disease ; Dementia ; Depression ; Humans ; Interpersonal Relations ; Longitudinal Studies* ; Outcome Assessment (Health Care) ; Quality of Life ; Risk Factors

PURPOSE: Sarcomas arising in intraperitaneal cavity and retroperitoneal space are relatively uncommon. Thus, studies characterizing the results of long-term follow-up are limited. The purpose of this study was to identify the clinicopathologic features and prognostic factors of intraperitoneal and retroperitoneal sarcomas. Materials and Method: Thirtyeight patients with intraperitaneal or retroperitoneal sarcoma who had been treated at Department of Surgery, Korea Cancer Center Hospital during the period from January 1987 to December 1997 were reviewed retrospectively. RESULTS: The ratio between male to female was 0.9: 1. The mean age of the patients was 48.3 (32-75) years. The most common symptom was abdominal pain or discomfort (61%), followed by palpable mass (55%), GI bleeding (34%), weight loss (26%), and change of bowel habits (21%). The most comman histologic type was leiomyosarcoma (73.7%), followed by liposarcoma (23.7%), and malignant fibrous histiocytoma (2.6%). The mean tumor size was 15.5 x12.1 x 8.7 cm. Among 38 cases, 25 cases developed in intraperitoneal cavity and 13 cases arose in retroperitoneal space. Overall, 44 operations were performed in 31 patients. Among them, complete surgical resection constituted 73%. In 20 cases, combined resection of adjacent organ was performed to accomplish complete surgical resection of tumors. During the median follow up period of 23 months (3~116 months), the overall 5-year survival rate was 34.7%. The patients who had been treated by complete surgical resection showed better survival than those in whom palliative resection or biopsy only was performed (38.6% vs 0% of 5 YSR, P=0.015). Liposarcoma showed better prognosis than leiomyosarcoma (41.7% vs 34.2% of 5 YSR, P=0.0000). The size of tumor (10 cm>vs 10 cm< or =) was not a statistically significant prognostic factor. CONCLUSION: In this series, The histologic type and complete surgical resection were important factors that can affect the survival of the patients. Aggressive surgical resections are therefore wananted to obtain better outcome of the patients with intraperitoneal and retroperitoneal sarcomas.
Abdominal Pain ; Biopsy ; Female ; Follow-Up Studies ; Hemorrhage ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Leiomyosarcoma ; Liposarcoma ; Male ; Prognosis ; Retroperitoneal Space ; Retrospective Studies ; Sarcoma* ; Survival Rate ; Weight Loss

PURPOSE: Primary sarcoma and SMC (sarcomatous metaplastic carcinoma) of the breast are very rare tumors, accounting for less than 1% of all breast malignancies. There are many controversies concerning the biological characteristics, prognosis and optimal treatment of these tumors owing to the rarity of incidence. The aims of this study were to elucidate the clinicopathologic characteristics of these tumors and to assist in elucidating the optimal treatment plan for the disease. MATERIALS AND METHODS: 13 cases of primary sarcoma and 10 cases of SMC that had been treated at KCCH between 1984 and 2001 were retrospectively reviewed. Phyllodes tumors were excluded from our study. RESULTS: Among the 13 cases of primary sarcoma included, stromal sarcoma occurred in 5 cases, osteosarcoma in 3 cases, angiosarcoma in 3 cases and spindle cell sarcoma in 2 cases. The mean age of the patients with primary sarcoma and SMC was 39.7 years and 55.1 years respectively (p=0.002). When survival rates were compared according to histologic types, size of tumor, histologic grade, type of surgery and use of adjuvant therapy, both size of tumor (p=0.0256) and histologic grade (p=0.0197) were shown to be prognostic factors. CONCLUSION: There were no significantly different features between primary sarcoma and SMC in terms of biologic characteristics or survival rates, with the exception that patients with SMC were older than those with primary sarcoma. Histologic grade and size of tumor were significant prognostic factors of these tumors.
Breast Neoplasms ; Breast* ; Hemangiosarcoma ; Humans ; Incidence ; Osteosarcoma ; Phyllodes Tumor ; Population Characteristics ; Prognosis ; Retrospective Studies ; Sarcoma* ; Survival Rate

OBJECTIVE: We developed a Revised Korean version of the Geriatric Depression Scale (GDS-KR) and examined its reliability, validity, and factor structures. We also estimated its optimal cutoff scores for major depressive disorder (MDD) and minor depressive disorder (MnDD) stratified by age and education. METHODS: The GDS-KR was administered to 888 subjects (61 MDD patients, 45 MnDD patients, and 782 normal elders). Its internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D-K) and Hamilton Depression Rating Scale (HAM-D). The mean GDS-KR scores of the MDD patients, MnDD patients and normal elders were compared to evaluate its discriminant validity. To evaluate its construct validity, a principal component analysis with varimax rotation was performed. Receiver operator characteristic (ROC) curve analyses were performed to evaluate its diagnostic ability. RESULTS: Chronbach's coefficient alpha for the GDS-KR was 0.90 and the test-retest reliability was 0.91 (p<0.01). The Pearson correlation coefficients of the GDS-KR scores with the CES-D-K and HAM-D scores were 0.63 (p<0.01) and 0.56 (p<0.01), respectively. The GDS-KR consisted of 5 factors. The optimal cut-off scores of the GDS-KR were 16/17 for MDD only and 15/16 for both MDD and MnDD. The optimal cutoff scores of the GDS-KR were higher in the less educated and younger subjects. The diagnostic accuracy for MDD of the GDS-KR was higher than that of the CES-D. CONCLUSION: The GDS-KR was found to be a reliable and valid questionnaire for screening MDD and MnDD in late life.
Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Education ; Epidemiologic Studies ; Factor Analysis, Statistical ; Humans ; Mass Screening ; Principal Component Analysis ; Surveys and Questionnaires