OBJECTIVE: To analyze the factors affecting on the level of the quality of life of stroke patients and their family caregivers. METHOD: Among the stroke patients receiving rehabilitation treatment at forty three out patient clinic in university hospitals, 289 stroke patients who scored over 24 out of 30 points in MMSE-K and their family caregivers were interviewed using questionnaires. RESULTS: The main contributory variable on the quality of life (QOL) of caregivers was the socio-demographic factor and QOL of caregivers was improved with decreasing age, the higher level of education, the less burden of care and the better condition of patient. High correlation coefficients were showed between QOL of stroke patients and ADL, QOL of caregivers and burden of care, and the burden of care and the neurological impairment. The main contributory variable on the QOL of stroke patients was clinical characteristics factor and QOL of stroke patients was improved with increasing the levels of cognitive function and ADL performance, decreasing the level of neurological impairment, the more social support from friends and the less burden of caregivers. CONCLUSION: In order to improve the QOL of stroke patients, not only patients' physical factors, but psychological factors, socio-demographic factors and QOL of caregivers should also be considered.
Activities of Daily Living ; Caregivers* ; Education ; Friends ; Hospitals, University ; Humans ; Psychology ; Quality of Life* ; Surveys and Questionnaires ; Rehabilitation* ; Stroke*

To determine whether the p53 expression might be a predictor for treatment sponse and overall survival in nodal non-Hodgkin's lymphoma (NHL), we analyzed e expression of p53 in 69 NHL patients. p53 protein expression was analyzed by munohistochemistry with long-term follow up (1-148 months: median 12.2). p53 pression was noted in 23/69 (33.3%) patients. Complete response (CR) rate to stemic chemotherapy was correlated with stage (I/II) (p=0.038), but not with 3 expression (p=0.2856). Poor overall survival was associated with stage =0.0010) or IPI score (p=0.0076), but not with p53 expression (p=0.8601). From ratification analysis by stage, in stage III/IV patients, the p53 positive oup had a trend to be associated with poor overall survival than the p53 gative group. Multivariate analysis revealed that p53 positive group was sociated with less CR rate compared to the p53 negative group (p=0.046), ereas overall survival was correlated with stage (p=0.0320), not with p53 atus. p53 expression was associated with less CR rate in patients with DLBL. rther studies with large numbers of samples and homogenous group of NHL are eded to determine the prognostic value of cell cycle regulator, p53 in NHL.
Antibodies, Monoclonal ; Cell Cycle Proteins/biosynthesis ; Female ; Gene Expression ; Human ; Immunohistochemistry ; Immunophenotyping ; Lymph Nodes/pathology* ; Lymph Nodes/metabolism* ; Lymphoma, Non-Hodgkin/pathology* ; Lymphoma, Non-Hodgkin/metabolism* ; Lymphoma, Non-Hodgkin/genetics ; Lymphoma, Non-Hodgkin/drug therapy ; Male ; Middle Age/Mpartment of Microbiology ; Prognosis ; Protein p53/immunology ; Protein p53/genetics ; Protein p53/biosynthesis*

Chronic infection with Epstein-Barr virus (EBV) without previous immunodeficiency or immuno-suppressive therapy is relatively rare. Severe chronic active EBV (SCAEBV) infection was reported for the first time in 1984 as 'chronic mononucleosis syndrome', and diagnostic criteria were proposed. It is characterized by clinical features including fever, severe hepatosplenomegaly, lymphadenopathy, hematologic features such as anemia and thrombocytopenia, and elevated antibody titers to EBV. We experienced a 21-year-old woman who initially presented with fever and chronic fatigue; however, no definite diagnosis could be made at the time of admission. Three months after the initial admission, there was evidence of only splenomegaly and the patient had persistent, multiple, paraaortic lymphadenopathies in abdominal CT. Diagnostic splenectomy was performed, and SCAEBV infection with T-cell lymphoproliferative disorder was ultimately diagnosed.
Adult ; Chronic Disease ; Diagnosis, Differential ; Epstein-Barr Virus Infections/*complications/*diagnosis ; Female ; Humans ; Lymphoproliferative Disorders/*diagnosis/pathology/virology ; Severity of Illness Index ; Splenectomy ; *T-Lymphocytes ; Tomography, X-Ray Computed

Traumatic pseudoaneurysms of the cavernous portion of the internal carotid artery(ICA) presenting with epistaxis are uncommon and potentially lethal complication of head injury. Because the onset of delayed bleeding from the time of injury is variable, prompt diagnosis and treatment of cavernous ICA pseudoaneurysm is important. A patient with a giant traumatic pseudoaneurysm of the left ICA presented with massive epistaxis 5 months after a head trauma. This patient was treated with occlusion of the opening of pseudoaneurysm and ICA by a detachable balloon and fibered coils.
Aneurysm, False* ; Balloon Occlusion ; Carotid Artery, Internal* ; Craniocerebral Trauma ; Diagnosis ; Epistaxis ; Hemorrhage ; Humans

Traumatic pseudoaneurysms of the cavernous portion of the internal carotid artery(ICA) presenting with epistaxis are uncommon and potentially lethal complication of head injury. Because the onset of delayed bleeding from the time of injury is variable, prompt diagnosis and treatment of cavernous ICA pseudoaneurysm is important. A patient with a giant traumatic pseudoaneurysm of the left ICA presented with massive epistaxis 5 months after a head trauma. This patient was treated with occlusion of the opening of pseudoaneurysm and ICA by a detachable balloon and fibered coils.
Aneurysm, False* ; Balloon Occlusion ; Carotid Artery, Internal* ; Craniocerebral Trauma ; Diagnosis ; Epistaxis ; Hemorrhage ; Humans

BACKGROUND: Diagnosis of AMI in the patients presenting with chest pain of an atypical nature or with a nondiagnostic ECG requires the evaluation of certain biochemical markers. Biochemical markers most often used for the early detection of myocardial damage are CK-MBact, troponin, and myoglobin. The clinical value of measuring serum myoglobin was compared to that of troponin and CK-MBact in the patient with acute chest pain syndrome. METHOD: We studied timed, sequential measurements of serum myoglobin, CK-MBact and troponin-T obtained from 72 patients who were admitted for the evaluation of suspected AMI within 12 hours after the chest pain onset. Patients with a history of recent trauma, cardiogenic shock, renal failure, or who had received recent cardiopulmonary resuscitation were excluded. We calculated the sensitivity, specificity, negative predictive value, and positive predictive value. Data were analyzed with the Chi-square test for differences in proportion. A value of p<0.05 was considered statistically significant. RESULT: 1) The mean time from symptom onset to arrival at the emergency department was 3.5+/-0.6 hours. 2) There were no statistical differences in age, sex and risk factors between AMI, angina pectoris and atypical chest pain group. 3) The negative predictive value of myoglobin was significantly higher than those of CK-MBact and troponin-T from 3 to 6 hours after the onset of chest pain. 4) The time to peak of myoglobin level was shorter than those of CK-MBact and troponin-T in AMI patients. CONCLUSION: Within 3 to 6 hours after the onset of symptoms, myoglobin is a better marker than CK-MBact or troponin-T in ruling out AMI for the patient with acute chest pain syndrome.
Angina Pectoris ; Biomarkers* ; Cardiopulmonary Resuscitation ; Chest Pain ; Diagnosis ; Electrocardiography ; Emergency Service, Hospital ; Humans ; Myocardial Infarction* ; Myoglobin* ; Renal Insufficiency ; Risk Factors ; Sensitivity and Specificity ; Shock, Cardiogenic ; Troponin ; Troponin T

Anesthesia, General ; Animals ; Blood Platelets ; Latency Period (Psychology) ; Mandible ; Mandibular Osteotomy ; Osteoblasts ; Osteogenesis ; Osteogenesis, Distraction ; Osteotomy ; Platelet-Rich Plasma ; Rabbits ; Transplants

BACKGROUND: CD44 is a cell surface adhesion molecule which has been implicated in various biologic functions as lymphocyte homing and activation, cellular migration and extracellular matrix adhesion. Over-expression of CD44v8- 10 has been found in several cancers and is considered to be associated with tumor progression and metastasis. Recently, a novel molecular method, CD44v8- 10/CD44v10 competitive reverse transcription-polymerase chain reaction(RT-PCR) has been developed for detecting cancer cells over-expressing CD44v8-10. METHODS: We analyzed from benign and malignant pleural effusion and ascites by CD44 competitive RT-PCR and compared to the conventional cytology. RESULTS: The CD44 competitive RT-PCR analysis showed that all the 24 samples associated with benign disease presented a predominant expression of the CD44v10 transcript (v8-10/v10 ratio: 0.126-0.948), whereas 6 of 7 malignant pleural samples associated with cytology positive cancer expressed the CD44v8-10 transcript (v8-10/v10 ratio > 1.00). CONCLUSION: These results indicate that CD44 competitive RT-PCR assay is a useful and adjunct to cytological examination in cancer diagnosis, especially in detecting exfoliated cancer cells in pleural effusion.
Adult ; Aged ; Aged, 80 and over ; Antigens, CD44/analysis* ; Ascites/pathology* ; Ascites/immunology* ; Base Sequence ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/immunology ; Comparative Study ; Female ; Gastrointestinal Neoplasms/pathology ; Gastrointestinal Neoplasms/immunology ; Human ; Lung Neoplasms/pathology ; Lung Neoplasms/chemistry ; Male ; Middle Age ; Molecular Sequence Data ; Pleural Effusion, Malignant/pathology* ; Pleural Effusion, Malignant/chemistry* ; Reverse Transcriptase Polymerase Chain Reaction* ; Sensitivity and Specificity ; Support, Non-U.S. Gov't

Malignant eccrine poroma is a rare skin appendage tumor, originating from the intraepidermal and upper dermal eccrine ducts. It is a locally aggressive neoplasm with a high propensity to metastasize. A 47-year-old woman was admitted to the hospital because of dyspnea. One and half years before admission, she had been diagnosed porocarcinoma of left sole and treated with wide local excision. One months after excision, examination had revealed an inguinal lymph node metastasis and she had been treated with lymph node resection and radiotherapy. During the two weeks before admission, the patient had increasing exertional dyspnea, which was accompanied by Rt-sided chest wall pain. On admission right pleural effusion and multiple nodular densities were noted at initial chest radiograph. A computed tomographic (CT) scan of the chest showed lymphatic and hematogenous lung metastasis with pleural seeding of unknown primary tumor. Fine-needle aspiration biopsy of the pleura revealed typical cytologic findings of porocarcinoma. She was treated with therapeutic thoracentesis and pleurodesis with bleomycin. Because porocarcinoma is resistant to chemotherapy and radiotherapy, she has been treated with conservative treatment.
Biopsy, Fine-Needle ; Bleomycin ; Drug Therapy ; Dyspnea ; Eccrine Porocarcinoma* ; Female ; Humans ; Lung* ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Neoplasms, Unknown Primary ; Pleura ; Pleural Effusion ; Pleurodesis ; Radiography, Thoracic ; Radiotherapy ; Skin ; Thoracic Wall ; Thorax

Vascular endothelial growth factor (VEGF) is known to play a key role in tumor angiogenesis. The tumor-suppressor gene p53 has been thought to regulate VEGF. We investigated the effect of VEGF on esophageal carcinoma and the correlation between VEGF and p53. Tissue samples were taken from 81 patients with esophageal carcinoma after surgery. VEGF and p53 expressions were examined by immunohistochemical staining. Microvessels in the tumor stained for CD34 antigen were also counted. VEGF and p53 expressions were observed in 51.3% (41/80) and 51.9% (41/79), respectively. The microvessel density was 70.9+/-6.7 (mean+/-SE) in VEGF-positive group and 68.7+/-5.1 in VEGF-negative group. However, no correlation was noted between VEGF and p53 expression. Whereas the tumor size, nodal status, depth of invasions, and tumor stage were associated with poor overall survival, VEGF expression or p53 expression was not. These results indicate that VEGF and p53 are highly expressed in esophageal carcinomas. Since the VEGF expression is not correlated with the p53 expression, microvessel density or clinicopathological findings, further studies with other angiogenic molecules are needed to determine the role in esophageal carcinomas.
Adult ; Aged ; Capillaries ; Carcinoma, Squamous Cell/classification/*metabolism/pathology ; Endothelial Growth Factors/*biosynthesis ; Esophageal Neoplasms/classification/*metabolism/pathology ; Female ; Humans ; Lymphatic Metastasis ; Lymphokines/*biosynthesis ; Male ; Middle Aged ; Neoplasm Staging ; *Neovascularization, Pathologic ; Prognosis ; Retrospective Studies ; Tumor Suppressor Protein p53/*biosynthesis ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors