BACKGROUND: To evaluate depressure effect and safety of delapril, a new ACE inhibitor, in Korea. METHOD: Thirty three patients, aged 37-69, with mild to moderate essential hypertension were first observed for 2 weeks with placebo followed by administration of 15mg of delapril twice daily for 2 weeks, then doubled dosage to 30mg b.i.d. and combined with 25mg of dihydrochlorothiazide if optimal BP were not obtained at the end of 4th week, continued the same dose until the end of 10 week's trial period. RESULT: BP dropped 15/9mmHg inaverage at the end of 10th week rewarding 70% of cumulative effectiveness. Most frequent side reaction was dry cough, occurred in 9% of patients followed by chest tightness, headache, constipation and transient elevation of GPT. CONCLUSION: Delapril 15-30mg twice daily as monotheraphy or combined with diuretics is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Constipation ; Cough ; Diuretics ; Headache ; Humans ; Hydrochlorothiazide ; Hypertension* ; Korea ; Reward ; Thorax

BACKGROUND: This study was designed to evaluate the antihypertensive efficacy and safety of nifedipine gastrointestinal system push-pull osmotic pump formulation in patients with mild to moderate essential hypertension. METHODS: After 2 weeks placebo run-in period, nifedipine 60 mg was administered once daily for 8 weeks in thirty-two patients with mild to moderate essential hypertension. RESULTS: At the end point of treatment, sitting blood pressure decreased as much as 33/16mmHg in average and rewarded 88% of efficacy and 69% of normalization. The ambulatoy blood pressure monitoring in 10 patients also revealed 11% decrease in 24 hr mean diastolic blood pressure and 32% decrease in % elevated blood pressure. The most frequent side reactions were constipation in 7 patients and polyuria in 6 patients which were tolerated during entire trial period. There were no significant changes in biochemical parameters and hematologic data, thus making the rate of safety 91% and overall rating of usefulness was 84%. CONCLUSION: Nifedipine GITS 60 mg once daily regimen is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Blood Pressure Monitors ; Constipation ; Humans ; Hypertension* ; Nifedipine* ; Polyuria ; Reward

PURPOSE: This study was designed to explore the quality of life (QOL) for breast cancer patients who survived after operation by using the World Health Organization Quality of Life (WHOQOL) instrument-Korean version. METHODS: Fifty patients with breast cancer were recruited after their operations, and an informed consent was obtained from each of them. Hospital staff members served as the controls. The 100 item-WHOQOL instrument included questions on the physical, psychological, social, independence, environmental and spiritual domains, and it was employed for testing the all subjects. RESULTS: The physical, psychological, independence and social domains were shown to have a worsened quality of life for patients with breast cancer who survive after their operations. Quality of life in the physical and social domains were perceived as worse by patients having advanced stage tumor, with mastectomy. Patients with mastectomy who survived their cancer felt a worse quality of life in the psychological domain. The quality of life scores for patients having advanced stage tumor with mastectomy, during the early postoperative period (< or =2 years) was lower for the independence domain. Patients at middle postoperative period (2~5years) felt a better quality of life in spiritual domain. CONCLUSION: Not only is the objective medical success important to female breast cancer survivors, but the individual subjective perception of their condition is also important. The psychological status of these women needs to be considered when managing patients with breast cancer after their surgical operation. In this context, the WHOQOL reflects a measurement of a multi-dimensional state of well- being, and it could be a useful tool across a variety of cultural and value systems in the world.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Informed Consent ; Mastectomy ; Postoperative Period ; Quality of Life* ; Survivors ; World Health Organization

PURPOSE: This study was designed to investigate the validity of the WHOQOL-BREF (Brief form of the World Health Organization Quality of Life Assessment Instrument) and explore the quality of life (QOL) of breast cancer patients who survived after an operation, using the Korean version of the WHOQOL-BREF. METHODS: Fifty (50) breast cancer patients after their operations and obtaining their informed consent were recruited. Hospital staff members served as the controls. The 100 item-WHOQOL instrument was employed for testing all the subjects. The scores of the WHOQOL-BREF, which is a short version (26 questions) of the WHOQOL, includes four domains (physical, psychological, social, and environmental), were compared with those of the WHOQOL. RESULTS: The scores of the WHOQOL-BREF were significantly correlated with those of the WHOQOL in all domains. The physical, psychological, and environmental domains were associated with a worse quality of life in patients with breast cancer. CONCLUSION: The WHOQOL-BREF is a valid and useful instrument for evaluating the quality of life in patients with breast cancer.
Breast Neoplasms* ; Breast* ; Humans ; Informed Consent ; Quality of Life* ; World Health Organization

PURPOSE: This study was designed to investigate the reliability and validity of the World Health Organization Quality of Life Assessment Instrument (WHOQOL) in patients with breast cancer according to depressive symptoms. METHODS: One-hundred seventeen patients with breast cancer who had undergone a radical operation were recruited. The 100 item-WHOQOL instrument and Hamilton Rating Scale for Depression were used to measure all the subjects. The five domain scores, except for the WHOQOL spiritual domain, were compared between patients with and without depressive symptoms, and then the reliability and validity of the five domains were calculated. RESULTS: Depressed patients with breast cancer had lower scores in all five domains of the WHOQOL than those who were not depressed in all five domains of WHOQOL [df=(1, 115), F=46.6, p<0.001]. Reliability and validity in the physical domain of depressed patients with breast cancer decreased markedly. CONCLUSION: WHOQOL is a valid and useful instrument for evaluating the quality of life in patients with breast cancer, but is limited in scoring of depressed patients with breast cancer, particularly in the physical domain. Therefore, quality of life must be interpreted with carefully hand in depressed patients with breast cancer.
Breast ; Breast Neoplasms ; Depression ; Hand ; Humans ; Quality of Life ; Reproducibility of Results ; World Health ; World Health Organization

PURPOSE: We measured and compared the uPA, plasminogen activator inhibitor-1 (PAI-1) and uPA receptor (uPAR) levels in breast cancer tissues and blood of the patients to evaluate their clinical relevance for biotherapy. MATERIALS AND METHODS: uPA, PAI-1 (Monozyme, Netherland), uPAR (American Diagnostics, USA) levels were measured by ELISA assay in 192 breast cancer tissues, in 18 normal breast tissues and in 163 blood from breast cancer patients. RESULTS: There was a tendency of uPA increment from ductal carcinoma in situ while increment of PAI-1 and uPAR occurred from Ti. With the progression of cancer, uPA, PAI-1, uPAR tended to decrease; however, the uPA/uPAR, uPA/PAI-1 ratios remained unchanged. There was a correlation of uPA expression between normal and cancer tissues ( r(2)= 0.49). Correlation of uPA and PAI-1 was found in normal tissue and stage I cancer tissue while correlation of uPAR and PAI-1 was found with cancer progression. Between cancer tissue and blood significant correlations were found in uPA, PAI-1, uPAR levels. CONCLUSION: uPA, PAI-1, uPAR levels in cancer tissue elevated from the early stage maintaining correlative expressions with cancer progression. A positive correlation between cancer tissue and blood level suggested the applicability of the levels of uPA, PAI-1 or uPAR for detecting patients for biotherapy.
Biological Therapy* ; Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Enzyme-Linked Immunosorbent Assay ; Humans ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Urokinase-Type Plasminogen Activator*

PURPOSE: Radio-guided sentinel node biopsy has become a standard method for evaluating the axillary status. However, there is no guideline for the optimum extent of sentinel lymphadenectomy. The object of this study was to assess the probability of metastases according to the sequence of radioactivity in the sentinel nodes and to determine the accuracy of the methods for evaluating metastases. METHODS: 80 consenting patients underwent sentinel lymph node biopsy using 99mTc-phytate. All the lymph nodes that showed radioactivity higher than surroundings were excised and labeled as SN1 to SN5 according to the sequential radioactivity. All the excised sentinel nodes were evaluated by frozen sectioning (FS) and permanent sectioning (PS). The sensitivity, specificity, negative predictive value and accuracy of the procedure were then analyzed according to the evaluation method. RESULTS: All 80 patients showed a variable number of axillary sentinel node sites (SN1-SN5) and 19 patients (23.8%) had three or more sentinel node sites, with an average number of 1.98. The sensitivity, specificity, NPV and accuracy were higher on PS (94.4%, 100%, 98.4% and 98.8% respectively) than on FS (88.9%, 100%, 96.9% and 97.5% respectively). 20 patients were found to have metastatic breast cancer within the sentinel lymph nodes by IHC, but one case of a metastatic, non-sentinel node was found in the 60 patients with negative sentinel nodes, so that the final false negative rate was 4.8%. In 18 of the 20 sentinel node-positive patients(90.0%), the most radioactive lymph node (SN1) was a positive node. The removal of the most radioactive sentinel node and the 2nd most radioactive sentinel node accurately staged all 20 sentinel node-positive patients. CONCLUSION: Careful evaluation of the sentinel nodes with FS, PS and IHC study is essential to reduce the false negative results. In addition, excision of the highest and the 2nd highest lymph nodes is essential and the excision of the 3rd highest node if any, should also be considered for obtaining a better treatment results.
Biopsy* ; Breast Neoplasms* ; Breast* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Radioactivity* ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy