PURPOSE: To assess the locoregional recurrence rate, survival rate and prognostic factors after modified radical mastectomy and postoperative adjuvant radiation therapy with or with chemotherapy in high-risk breast cancer patients. METHODS: Between 1984-1995, 48 patients underwent postoperative irradiation to the regional lymphatics and chest wall due to large tumor size (> or = 5 cm) or small tumor size (<5 cm) with axillary lymph node involvement after modified radical mastectomy. The median age of the patients was 47 years (range, 31-79 years). The clinical tumor size was <2 cm in 1 patient, 2-5 cm in 15 patients, and >5 cm in 32 patients. Thirty two patients had positive axillary lymph nodes. Forty two patients were irradiated to the chest wall and regional lymph node and 6 patients were irradiated in the chest wall only. Radiation dose to the chest wall and regional lymph node was 5040 cGy/28 fraction. The median follow-up time was 61 months. RESULTS: Locoregional recurrence rate was 8% and distant metastatic rate was 14%. The actuarial overall survival rate and disease-free survival rate was 63% and 62% at 5 years, respectively. The median survival time was 67 months. Five-year overall survival rate by the stage is 70% in IIB and 58% in IIIA. The significant prognostic factor for survival on multivariate analysis was the stage. CONCLUSION: Postoperative adjuvant radiation therapy in high-risk breast cancer can reduce the locoregional recurrence rate and increase the survival time by combined chemotherapy. The significant prognostic factor for survival rate was the stage.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mastectomy, Modified Radical ; Multivariate Analysis ; Recurrence ; Survival Rate ; Thoracic Wall

Cancer is the most common cause of death in Korea. Therefore, the care of terminally ill cancer patients represents a major issue of Korean welfare. Because of lack of hospice and palliative care education and government support, most terminally ill cancer patients are not given proper care with due human dignity. The hospice and palliative care education include a change of physicians attitudes toward patients and their family members control of symptoms, such as pain, for a high quality of life, total care with a team approach, and home care. When the physicians' attitudes become changed, the patient and his or her family would feel that they still retain human dignity and experience the best quality of life with the help of team approach. For the symptom control in terminally ill cancer patients, control of pain is most important and is possible in 97% of patients with opioids. Also, the medical costs are highest in terminal stage of cancer and hospice may be a solution to reduce the cost. The hospice insurance for the terminally ill cancer patients is covered by government in many oriental countries, such as Japan, Hongkong, Singapore, and Taiwan, because it can reduce medical costs and improve the welfare of patients. The joint committee of Korean Society of Hospice·Palliative care, Korean Hospice Care, and Catholic Hospice Care have been asking for the national hospice insurance to the Korean government since 1988, to no effect. In conclusion, the hospice and palliative care should be supported by government as well as medical field.
Analgesics, Opioid ; Cause of Death ; Education ; Home Care Services ; Hong Kong ; Hospice Care ; Hospices ; Humans ; Insurance ; Japan ; Joints ; Korea ; Palliative Care ; Personhood ; Quality of Life ; Singapore ; Taiwan ; Terminally Ill

The rapid progress of molecular genetic methods over the past two decades has necessitated the development of methods to detect and quantify genetic activity within living bodies. Reporter genes provide a rapid and convenient tool to monitor gene expression by yielding a readily measurable phenotype upon expression when introduced into a biological system. Conventional reporter systems, however, are limited in their usefulness for in vivo experiments or human gene therapy because of its invasive nature which requires cell damage before assays can be performed. This offers an unique opportunity for nuclear imaging techniques to develope a novel method for imaging both the location and amount of gene expression noninvasively. Current developments to achieve this goal rely on utilizing either reporter enzymes that accumulate radiolabeled substrates or reporter receptors that bind specific radioligands. This overview includes a brief introduction to the background for such research, a summary of publis hed results, and an outlook for future directions.
Gene Expression* ; Genes, Reporter ; Genetic Therapy ; Humans ; Molecular Biology ; Phenotype

No abstract available.
Ankle* ; Foot* ; Humans ; Outpatients*

This study tried to find the prevalence and distribution of temporo-mandibulr disorders(TMD) for workers (employee) in Seoul area to investigate the correlation between TMD and possible etiological factors such as general muscle and joint symptoms, headache, unilateral chewing and parafunction. This study was an epidemiological investigation of answers obtained from 282 persons by questionaire from Aug. 1995 to Nov. 1995. The major findings from the questionaire were as follows. (1) 43.26% of the subjects(282 persons) has TMD. (41.88% of man and 43.26% of women) (2) The more often people have general muscle and joint symptoms and -headache, the more susceptible they are to TMD. Their correlation was very significant(p<0.001). (3) The more people have bad oral habits such as bruxism, clenching and biting habit, the more likely they have TMD. The more sensitive people are to stress, the more frequently they have bad oral habits such as bruxism, clenching and biting habit. (4) Unilateral chewing has higher TMD index than bilateral chewing. There is no relationship between ache areas and TMD index.
Bruxism ; Epidemiology* ; Headache ; Humans ; Joints ; Mastication ; Prevalence ; Seoul* ; Temporomandibular Joint Disorders

Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.
Antidepressive Agents ; Chronic Pain ; Citalopram ; Dopamine ; Epidemiology* ; Fibromyalgia ; Fluvoxamine ; Headache ; Humans ; Nausea* ; Norepinephrine ; Psychiatry ; Psychophysiologic Disorders ; Serotonin ; Sertraline ; Treatment Failure ; Vomiting* ; Weight Gain*

No abstract available.
Adenoma*

PURPOSE: This study is used to investigate the correlation among a stroke patient family's health, burden and quality of life. METHOD: Data was collected from one hundred twenty family care-givers registered at K and H Hospital in Seoul. Questionnaire data was drawn up by personal interviews aided by the staff nurses. The analyses of collected data are based on the rate of 100 percentage to the average, t-test, ANOVA, DMR, Pearson Correlation. Result: (1) The influential factors on physical health proved to be age, sex, academic career, matrimonial status, present occupation, economic situation, the relationship with the patient, the patient-caring term, and the family-formation. The psychological health issues were age, final academic career, matrimonial status, the relation with patient and the family-formation. Burdens were shown to be age, matrimonial status, the relation with patient, and the patient-caring term. The quality of life was determined by age, final academic career, matrimonial status, and the relationship with the patient, the patient- caring term, and the family-formation. (2) The rate of the physical condition was 2.87, the psychological condition 2.43, the sense of burden 3.08, and the quality of life was 2.42. (3) The rate of correlation between the burden and the quality of life was (r= -.547), the psychological health and the burden was (r= -.531), the physical health and the burden was (r= -.263), physical health and quality of life was (r= .301), psychological health, and quality of life was (r= .413). CONCLUSION: It follows from this study that there is a very close correlation among the stroke patient family's health, the burden, and quality of life. Therefore it is necessary that we should find various nursing intervention ways in order to mitigate the burden of family when caring for the stroke patients.
Humans ; Nursing ; Occupations ; Quality of Life ; Surveys and Questionnaires ; Seoul ; Stroke*

No abstract available.
Thorax*

The congenital cutis aplasia mainly occurs in head, sometimes involving the skull and dura mater. It's cause and the rate of falling ill are not known yet, it is the disease that rate of death is high by the infection, such as, the injured vascular hemorrhange of meningitis. Craniosynostosis is the disease the appears the skull as well as the facial deformity with growing, has from the developmental difficiency, visual distibance, motor disturbance, convulsion to the neurologic impairment of mental retardation, and accompanies the each characteristic deformity follwing the suture fused. Satsifactory results was achieved by local flap surgery and conservative treatment on the infant, diagnosed as the congenital cutis aplasia. case 1 Also successful treatment experiences of craniosynostosis(oxycephaly, brachycephaly, trigonocephaly, cloverleaf deformity) through the frontal bone advancement and the barrel stave asteotomy, were reviewed & pursues and investigates the intracranial volume of before and after of surgery, and then reports with the literature investigation.
Congenital Abnormalities ; Craniosynostoses* ; Dura Mater ; Frontal Bone ; Head ; Humans ; Infant ; Intellectual Disability ; Meningitis ; Seizures ; Skull ; Sutures