PURPOSE: The role of radiotherapy in the management of patients with locoregional recurrent cervix cancer after radical surgery were retrospectively analyzed. METHODS AND MATERIALS: Twenty-eight patients treated with radiotherapy for locoregional recurrence after primary surgery for carcinoma of the cervix between 1989 and 1993 were analyzed. The median follow-up of survivors was 15 months (ranged 7-43 months). Eight patients had their disease confined to the vagina and 19 patients(68%) had pelvic mass as part of their locoregional recurrent disease. Within 24 months after the initial surgery, 82% of recurrences manifested themselves. All patients had whole pelvic irradiation with or without intracavitary radiotherapy(ICR). RESULTS: Complete response(CR) was achieved in 18 patients(64%). Five of eighteen patients(28%) with initial CR developed second locoregional recurrence. Response to radiotherapy correlated strongly with tumor volume, site of recurrence and total radiation dose. The overall 2 year survival rate was 43% and the disease free survival was 31%. Survival rate was significantly influenced by the factors of interval from operation to recurrence, size and site of recurrent tumor, radiation dose, response of radiotherapy, lymph node status as initial presentation. The principal cause of death was lung metastasis(36%). CONCLUSION: Radiotherapy is an excellent modality for control of locoregional recurrent cervix cancer. To improve local control and survival rate, whole pelvic external radiotherapy in addition to ICR with more than 75.0Gy at the depth of 1.0cm from vaginal mucosa is needed and frequent follow up and early detection of recurrence is suggested as well.
Cause of Death ; Cervix Uteri* ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung ; Lymph Nodes ; Mucous Membrane ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Survival Rate ; Survivors ; Tumor Burden ; Uterine Cervical Neoplasms* ; Vagina

This study was conducted to investigate the nutritional knowledge and eating behavior of elementary school senior students in Incheon area and to develope education program appropriate for them. Questionnaire was developed and distributed to 551 fifth and sixth grade students of fourteen elementary schools in Incheon area. The data was analyzed using ANOVA. According to the results on nutritional knowledge and attitude, senior students were aware of major sources of some nutrients, but didn't seemed to know about the role of some nutrients. Nevertheless, it was favorable that they took various food from major food groups. But the proportion of students skipping breakfast and taking instant food was high. Their table etiquette was not good at home, but attitude for food hygiene was comparatively good. They recognized Korean traditional food more nutritious than fast food. Even though they understood what was right for eating behavior, they didn't practice it correctly. From these results, it seemed that follow-up study or intervention is necessary to improve nutritional knowledge and eating behavior of the students. Qualified teachers, nutrition specialists, are required in order to develop and apply systematic nutrition education program for correcting inappropriate eating behavior of the students. Furthermore, nutrition education for their parents will be more effective.
Breakfast ; Eating* ; Education ; Fast Foods ; Feeding Behavior* ; Follow-Up Studies ; Humans ; Hygiene ; Incheon* ; Parents ; Surveys and Questionnaires ; Specialization

Twenty five patients with tumors of the brain stem were treated with radiotherapy between 1979 and 1987. Histological diagnosis could be obtained in 6 cases, and other 19 patients were diagnosed by neurologic findings and CT or MRI. Eighteen patients were treated by radical radiotherapy and 6 patients received both operation and radiotherapy, while 1 patient received chemotherapy after radiotherapy. Total dose ranged from 50 Gy to 55 Gy. By an clinical scoring scale at 2 months after radiotherapy, no complete response was obtained, but 16 cases achieved partial response, 2 cases were stable, and 4 cases were deteriorated. The overall survival rate at 3 years was 36%. Age, performance status at diagnosis, degree of cranial nerve involvement, CT pattern of post-contrast enhancement, and clinical response by scoring scale were correlated with survival.
Brain Stem Neoplasms* ; Brain Stem* ; Brain* ; Cranial Nerves ; Diagnosis ; Drug Therapy ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Radiotherapy* ; Survival Rate

PURPOSE: To evaluate the morphologic differential diagnosis of benign and malignant ductal breast tumors, as seen on US. MATERIALS AND METHODS: US findings in 29 pathologically proven cases of ductal breast tumor were retrospectively reviewed. All patients were female and their mean age was 42 years. Nineteen tumors were benign and ten were malignant, and all ductal or cystic lesions showed solid masses. According to the location of the mural nodule, we classified the sonographic appearance of these tumors into three types : intraductal, intracystic and amorphic. The intraductal type was divided into three subtypes: incompletely obstructive, completely obstructive and multiple mural nodules. For the intracystic type, too, three subtypes were designated : the intracystic mural nodule (mural cyst), intracystic mural nodule with the duct (mural cyst+duct) and intracystic multiple mural nodules. The amorphic type is defined as an atypical ductal tumor with the mural nodule extending into adjacent parenchyma. RESULTS: The margin of the duct or cyst was smooth in 68.4% of benign, and irregular in 90% of malignant ductal tumors. Internal echogeneity of the duct or cyst usually showed homogeneity in both benign and malignant tumors. 73.7% of tumors connecting the duct were benign and 50% were malignant. In benign tumors, 52.6% of mural nodule had an irregular margin, while in malignant tumors, the corresponding proportion was 100% ; both types usually showed heterogeneous hypoechogeneity. Among benign tumors, the most common morphologic type was the intraductal incompletely obstructive subtype (36.8%) ; among those that were malignant, the amorphic type was most common, accounting for 40% of tumors. No amorphic type was benign and no incompletely obstructive subtype was malignant. CONCLUSION: When ductal breast tumors are morphologically classified on the basis of sonographic findings, the intraductal incompletely obstructive subtype suggests benignancy, and the amorphic type, malignancy. The morphologic classification of ductal breast tumors based on sonography is therefore useful for the differential diagnosis of benignancy and malignancy.
Breast Neoplasms* ; Breast* ; Classification* ; Diagnosis, Differential* ; Female ; Humans ; Retrospective Studies ; Ultrasonography*

PURPOSE: To clarify the distribution of joint effusion, and the relationship between type of injury andamount of joint effusion seen in traumatic knee joint magnetic resonance imaging (MRI). MATERIALS AND METHODS: Weretrospectively reviewed the MR images of 400 patients with traumatic knee joint effusion. The knee joint spacewas divided into four compartments: central portion (para-ACL, para-PCL), suprapatellar pouch, posterior femoralrecess, and subpopliteal recess, and we then compared the amount and distribution of effusion. For statisticalanalysis, the chi-square test was used. RESULTS: Among 400 MRI examinations of joint effusion, 383 knees (96%)showed homogeneous low intensity on T1-weighted images, and - except for ten cases of fluid-fluid levels-homogeneous high intensity on T2-weighted images. Knee joint effusion was clearly shown to be distributed mainlyin the suprapatellar pouch (345, 86%), followed by the central posterior femoral recess, and the subpoplitealrecess (p<0.001). Extensive joint effusion was less frequently found in the normal group, but was occasionallyfound in the combined injury group (p<0.001). The relationship between amount of joint effusion and type ofinjury was statistically significant (p<0.001), except in the case of medial and lateral collateral ligamentinjury. CONCLUSIONS: The distribution of joint effusion in patients with traumatic knee disorders is a reflectionof anatomic communication, and whether the amount of joint effusion was small or large depended on the anatomicallocation and type of injury.
Humans ; Joints* ; Knee Joint* ; Knee* ; Magnetic Resonance Imaging

PURPOSE: Nutrition status is regarded as an important factor for postoperative morbidity in cancer surgery. The aim of this study was to evaluate the impact of the malnutrition risk, determined by Seoul National University Hospital-Nutrition Screening Index (SNUH-NSI), on operative morbidity after gastrectomy for gastric cancer. METHODS: This study enrolled 246 patients who had undergone gastrectomy for gastric cancer at Seoul National University Hospital from March 2009 to February 2010. We collected general patient information, SNUH-NSI at administration and related parameters (serum albumin, cholesterol, total lymphocyte counts, hemoglobin and body mass index), operative method, hospital stay and operative morbidity. RESULTS: The patients' mean age was 59.6+/-11.3 years, and 9.4% (n=23) of patients were rated as severe malnutrition risk. There was no difference in operative morbidity by age or sex. The patients with high risk of malnutrition by SNUH-NSI or with advanced gastric cancer showed higher operative morbidity (P<0.01). There were no relationships between biochemical parameters and operative morbidity. On multivariate analysis, the significant independent risk factors were severe malnutrition by SNUH-NSI (OR 2.627, 95% CI 1.033~6.679; P<0.05) and advanced gastric cancer (OR 2.023, 95% CI 1.074~3.811; P<0.05). CONCLUSION: Overall nutritional status, rather than single data, is more related to operative morbidity in gastrectomized patients. Especially severe malnutrition as determined by SNUH-NSI, is an independent risk factor for operative morbidity. Nutritional support to severely malnourished patient by SNUH-NSI is expected to be an effective approach in preventing complications after gastrectomy.
Cholesterol ; Gastrectomy ; Hemoglobins ; Humans ; Length of Stay ; Lymphocyte Count ; Malnutrition ; Mass Screening ; Multivariate Analysis ; Nutritional Status ; Nutritional Support ; Risk Factors ; Stomach Neoplasms

Thirty eight women with recurrent breast carcinoma involving chest wall and/or regional lymph nodes after surgery with or without systemic therapy were treated with radiation between 1979 and 1986. Among them, 5 patients were excluded from analysis because of incomplete treatment. The median follow up of survivors was 30 months (randged 1-79 months). Fifteen (45%) patients had their disease confined to the chest wall and eighteen patients had lymph node involvement as some of their locoregional recurrent disease. Within 36 months after the initial treatment, 87% of recurrences manifested themselves. All patients had radiotherapy to at least the site of involvement. In 8 patients, recurrent tumors were treated with complete excision followed by radiation. Of the remaining 25 patients, 18(72%) had complete response (CR) following radiotherapy. The actuarial 3-year survival of all patients following locoregional recurrence was 50%. Three year survival was 24% in those 25 patients who had recurrences within 24 months of the initial treatment. For those 8 patients whose recurrences occurred after more than 24 month disease free interval, the 3-year survival was 100%. For those patients with recurrences confined to chest wall alone, 3-year survival was 57%. The patients who had lymph node involvement as part of their locoregional recurrences had a 43% 3-year survival. The majority of them developed distant metastases. Those patients who had a CR showed 63% 3-year survival. On the other hand, 1 year survival was only 33% for those patients who had a less than CR. Three patients developed carcinoma of the contralateral breast following radiotherapy. Three year survival following locoregional recurrence was 40% for patients whose initial treatment for their primary breast carcinoma was surgery and adjuvant systemic therapy. For those patients whose primary breast carcinoma was treated by surgery alone, the 3-year survival following locoregional recurrence was 71%. In patients who had subsequent recurrence after radiotherapy, the actuarial survival was 25% at 2 years.
Breast Neoplasms* ; Breast* ; Female ; Follow-Up Studies ; Hand ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Survivors ; Thoracic Wall

PURPOSE: To compare the radiologic findings of pyogenic abscess(PA) and inflammatory cancer(IC) of the breast, as seen on mammograms, US, and MR images and to evaluate the usefulness of the differential diagnostic findings of MRI for differentiation of PA and IC of the breast. MATERIALS AND METHODS: We retrospectively analyzed the mammographic, US and MR findings of nine histopathologically proven cases of PA and four cases of IC of the breast. Parenchymal density, mass density, skin thickening and calcification were evaluated by mammography, and the extent of lesion and its morphologic characteristics and changes of dermal lymphatics by US and MRI. The latter was also used to analyse signal intensity and enhancement pattern. RESULTS: Mammographic findings for both lesions were nonspecific. US showed that the pyogenic abscess was a hypoechoic and anechoic complex lesion with posterior acoustic enhancement, while inflammatory cancer was a spiculated lesion with a heterogeneous hypoechoic echotexture. On 3D-GRE dynamic enhanced M-RI, PA was shown in six cases(66.7 %) to be a lesion with superficial periareolar involvement, in contrast to the deep parenchymal spread seen in all cases of IC. A central non- enhanced portion with an irregular thick peripheral enhanced rim was seen in eight cases of PA(88.9 %) , and in all cases of IC an inhomogeneously enhanced spiculated lesion in parenchyma and a diffusely enhanced dermal and subcutaneous layer was apparent. An MRI time-intensity curve showed that the enhancement pattern was slow in five cases of PA(55.6 % ) and irregular in four(44.4 %), while for IC it was rapid in three cases(33.3 %) and irregular in one(11.1 % ). CONCLUSION: As compared with mammography and US, 3D-GRE dynamic MRI was a useful method for the differential diagnosis of PA and IC of the breast. The characteristic MR findings of PA were a central non-enhanced portion with an irregularly thick peripheral enhanced rim, located mainly in the superficial periareloar area and spreading into the parenchymal layer. An inhomogeneously enhanced spiculated solid mass in the parenchyma associated with diffuse dermal thickening and lymphatic dilatation was more suggestive of IC.
Abscess* ; Acoustics ; Breast* ; Diagnosis* ; Diagnosis, Differential ; Dilatation ; Magnetic Resonance Imaging* ; Mammography ; Retrospective Studies ; Skin