No abstract available.
Animals ; Fetus* ; Mice* ; Paraquat*

No abstract available.
Pregnancy*

BACKGROUND: The frequency of invasive lobular carcinomas is about 3% to 15% of all breast carcinomas. It is known that an invasive lobular carcinoma is different from other forms of breast cancer in the aspect of clinical characteristics and metastatic pattern. METHOD: To search of clinical characteristics of invasive lobular carcinomas, we restrospectively investigated 31 cases of invasive lobular carcinomas that had been treated from 1985 to 1996 at the Department of Surgery, Severance Hospital. RESULTS: The peak incidence was in the 40's (12 cases, 38.7%), and the average age was 45.8. The main clinical manifestation was a palpable mass on the breast at the time of visit to the hospital (30 cases, 96.8%), and the most frequent site was the upper outer quadrant (18 cases, 58.1%), followed by the upper inner quadrant (6 cases, 19.4%), of the breast. The most prevalent tumor size was 2-4 cm (14 cases, 45.2%), and the mean size was 3.27 cm. The negativity of the axillary nodes for invasive lobular carcinoma was 67.7%. According to the TNM system, there was 5 casess (16.1%) in stage I, 17 cases (54.8%) in stage IIa, 7 cases (22.6%) in stage IIb, and 2 cases (6.5%) in stage IIIb. The positivity of the estrogen receptor (ER) was 35.7%, and the positivity of the progesterone receptor (PR) was 54.5%. The overall 5-year survival rate was 82%, the overall 5-year disease-free survival was 70%, and the mean survival was 108 months. CONCLUSION: The clinical characteristics of an invasive lobular carcinoma seem to be similar to those of an invasive ductal carcinoma. Further studies are required to search for the clinical characteristics and for an adequate treatment.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Lobular* ; Disease-Free Survival ; Estrogens ; Incidence ; Receptors, Progesterone ; Survival Rate

INTRODUCTION There are three factors for successful implantation. These are embryo quality, uterine receptivity, and synchronization between embryonic and endometrial development. Despite remarkable progress in investigating embryos in human IVF, there has been slow progress in exploring the implantation process. It may be due to two reasons as follow. First, it is difficult to directly investigate the mechanism of implantation in the human, because of ethical considerations. Second, there is no sensitive and widely accepted marker for assessing endometrial development. Since the finding of a novel standard for dating endometrial biopsy by Noyes et. al.,. in 1950, there have been many attempts to identify suitable markers for uterine receptivity. Those include ultrasonographic changes (Ueno et.al., 1991; Grunfeld et al.,1991), three dimensional morphological changes of the endometrium such as pinopode formation (Market or alphaf., 1987; Mantel or alphaf., 1991; Nikas et al., 1995; Psychoyos & Nikas, 1994), integrin expression (Ilesanmi et al., 1993; Lessey et.al., 1992; Lessey, 1994), and measurement of endometrial proteins (Hell, 1986;Fay & Crudzinskas, 1991). Investigations in the rat (cartel et al., 1991)and human (cartel et al., 1987; Nikas et al., 1995; Psychoyos & Nikas, 1994) suggested the presence of pinopodes as a marker for the receptive phase.4 chronological barrier in uterine receptivity could be one of the major factors limiting IVF pregnancy rates. If we were able to manage the 'implantation window' we may be able to improve implantation and pregnancy rates in the human IVF program. In 1987, Martel et al., found early appearance of pinopodes in stimulated cycles for IVF compared to natural cycles in humans (Marcel et al., 1987). This effect was found in patients stimulated with clomephene citrate/hMG/hCG. The purpose of the present study was to evaluate the endometrial development in IVF patients stimulated with either by FSH/hMG/hCG or with GnRH agonist down regulation.
Animals ; Biopsy ; Down-Regulation ; Embryonic Structures ; Endometrium ; Female ; Gonadotropin-Releasing Hormone ; Humans* ; Oocyte Retrieval* ; Oocytes* ; Pregnancy Rate ; Rats

OBJECTIVE: The aims of this study was to examine whether epileptic women with antiepileptic drugs(AEDs) treatment during pregnancy were associated with an increased risk of adversed pregnancy outcome. METHODS: The study design was a retrospective analysis of 91 epileptic pregnant women attending the Severance Hospital Yonsei Medical Center between January 1980 and June 1998. Of the 91 women, data from 84 were available for analysis. Adverse pregnancy outcome in 66 women who were exposed to AEDs during pregnancy were compared with those of 18 controls who were not. The main adverse pregnancy outcome included spontaneous abortions, perinatal deaths, preterm deliveries, fetal growth restriction and congenital anomalies. RESULTS: Epileptic women with AEDs treatment during pregnancy were not significantly different from their controls in the incidence of spontaneous abortions(1.5% vs, 5.5%), perinatal deaths(1.5% vs. 0%), preterm deliveries(3% vs. 5.5%), fetal growth restriction(3% vs. 0%), and congenital anomalies(3% vs 5.5%). An adverse outcome occurred in 8 of 66 women(l2%) in the study group and 3 of 18 control group(16.5%). This difference was not statisitically significant. CONCLUSION: Our study shows that epileptic women who were exposed to AEDs during pregnancy do not have an increased risk of adversed pregnancy outcome than the women who were not.
Abortion, Spontaneous ; Anticonvulsants* ; Female ; Fetal Development ; Humans ; Incidence ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Pregnant Women ; Retrospective Studies

BACKGROUND: It is well known that atrial fibrillation is common cardiac arrythmia in old age and poses a definitive risk factor of cerebral infarction. Therefore, effective treatment of atrial fibrillation is very important in the prevention of cerebral infarction. However, oral anticoagulant medication for the prevention of embolic ischemic stroke may be dangerous due to cerebral hemorrhage side effects. METHODS: This is a controlled case study designed to identify the risk factors in a large numbers of stroke and atrial fibrillation patients and to assess those patients with atrial fibrillation as a high risk group for cerebral infarction. All patient discharged from Chonnam National University Hospital were identified over a 42 month period who met our case standards of atrial fibrillation and ischemic stroke (n=62), and compared them with the control groups who were discharged with atrial fibrillation without stroke(n=68). We excluded the atrial fibrillation due to valvular heart disease, ischemic heart disease and congestive heart failure during the selection of subjects. RESULTS: Subjects and the controls were characteristically similar with common past medical histories of diabets, smoking, and hyperlipidemia. Sex, familial history, left ventricular hypertrophy in 2D-echocardiogram were also similar in both groups, however differences did exist. Subjects were significantly older than controls(68.9 : 63.9, p<0.001) and more likely to have a history of hypertension(56.5% : 23.5%, p<0.001) and left atrial enlargement(>40mm)(52.6% : 29.0%, p<0.001). Each of these 3 factors were assinged a measure of 1 point as a risk score, ischemic embolic stroke was found in 4 out of 28 patients(14.3%) with a risk score of 0, in 16 out of 39 patients(41.0%) with a risk score of 1, in 29 out of 41 patients(70.7%) with a risk score of 2, in 8 out of 11 patients(72.7%) with a risk score of 3. CONCLUSIONS: Based on the above results, a subject having more than two risk factors should be regarded as a high risk group for cerebral infarction and the long term anticoagulant therapy for the prevention of stroke may also be necessary even though some complications are present.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cerebral Hemorrhage ; Cerebral Infarction* ; Heart Failure ; Heart Valve Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy, Left Ventricular ; Jeollanam-do ; Myocardial Ischemia ; Patient Selection ; Risk Factors* ; Smoke ; Smoking ; Stroke

PURPOSE: We compared the outcome of transurethral resection of the prostate (TURP) with that of transurethral needle ablation(TUNA) of the prostate in patient with BPH. MATERIALS AND METHODS: From May 1996 to April 1997, 21 patients were treated with TURP and 25 with TUNA. In TURP group, the mean age was 67.2 years and mean prostatic volume was 52.7ml. In TUNA group, the mean age was 67.2 years and mean prostatic volume was 32.1ml. Assessment parameters were International Prostate Symptom Score(1-PSS), quality of life question, uroflowmetry and complications. Post-treatment morbidity was noted if the patients experienced erectile dysfunction, retrograde ejaculation or urinary incontinence. Patients were examined at 3 months from the day of treatment. RESULTS: At 3 months, the maximum flow rate improved from the mean of 10.2+/- 3.2m1/sec to 20.5+/-10.7m1/sec for the TURP group and 9.3+/-1.9m1/sec to 12.5+/-4.3 for the TUNA group. 1-PSS improved from the mean 22.0+/-7.6 to 6.4+/-4.6 for the TURP group and 21.2+/-6.6 to 13.1+/-6.8 for the TUNA group. Quality of life improved from the mean 3.8)1.6 to 1.3+/-1.0 for the TURP group and 4.3+/-0.9 to 2.9+/-1.1 for the TUNA group. Erectile dysfunction was reported in 43% (9/21) of TURP and 5%(1/20) of TUNA. Retrograde ejaculation was reported in 57%(12/21) and urinary incontinence was in 5%(1/21) of TURP. Retrograde ejaculation and urinary incontinence was not reported with TUNA. The mean operation time, hospital stay and a catheterization time in the TUNA group were 45.4min, 1.2days, 4.4days in comparison with 58.7min, 7.0days, 3.6days in the TURP group. CONCLUSIONS: After TURP and TUNA, there was significant improvement in all clinical parameters. But TURP was more effective in improving maximum flow rate, 1-PSS and quality of life. TUNA, however, produced minimal morbidity with no serious complication. With acceptable low morbidity, TUNA appears to be a safe and effective procedure in the treatment of BPH.
Catheterization ; Catheters ; Ejaculation ; Erectile Dysfunction ; Humans ; Length of Stay ; Male ; Needles* ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Transurethral Resection of Prostate* ; Tuna ; Urinary Incontinence

PURPOSE: To find the experience about clients with hypertension and to help them to care for themselves in the community. METHOD: All data was collected from August 1999 to October 1999, through in-depth interviews, observation, and telephone interview with 7 participants who have been diagnosed with hypertension for 1 to 10 years. According to Strauss and Corbin's Methodology, the data was continuously coded into concepts and categories, and then new data was analyzed simultaneously by a constant comparative method. RESULTS: There are 171 concepts, and then they were grouped into 34 the lower categories and 15 to the upper categories. The course of the coping of fear in hypertensive client consisted of 6 processes. The awareness of seriousness was context, and the fear was core phenomenon about the coping experience. We also found that hypertensive clients have 3 patterns, depending on the awareness degree of seriousness and the fear about hypertension. CONCLUSION: Our nurses should recognize the importance of effective management and seriousness about hypertension, offer clients the importance of family support and the information of etiology, symptoms and signs of hypertension, and provide the correct information on hypertensive medication. We should be able to guide their fear about hypertension to positive self-management, so that they may manage their disease thoroughly and effectively.
Humans ; Hypertension ; Interviews as Topic ; Self Care

OBJECTIVE: To describe the characteristics of specific swallowing abnormalities in children with cerebral palsy and identify the risk factors related to aspiration via videofluoroscopy. METHOD: Thirty-one children with cerebral palsy, aged from 1.3 years to 15.5 years, were investigated. After taking feeding history and physical examination, videofluoroscopic swallowing studies (VFSS) were performed according to the modified Logemann's protocol with liquid and puree mixed with barium. The swallowing patterns of oral and pharyngeal phase and presence or absence of aspiration were observed. RESULTS: In VFSS, children with cerebral palsy showed oral phase abnormalities in 87.1% (27/31) including impairment of bolus formation, food pocketing and pharyngeal phase abnormalities in 83.9% (26/31) including pooling in valleculae, weak pharyngeal peristalsis. CONCLUSION: The majority of children with cerebral palsy evaluated in this study had swallowing abnormalities. The main swallowing impairments were tongue movement in oral phase and pharyngeal peristalsis in pharyngeal phase.
Barium ; Cerebral Palsy* ; Child* ; Deglutition ; Deglutition Disorders* ; Humans ; Peristalsis ; Physical Examination ; Risk Factors ; Tongue

BACKGROUND: To ensure patient safety and improvements in the quality of hospital care, rapid response teams (RRTs) have been implemented in many countries, including Korea. The goal of an RRT is early identification and response to clinical deterioration in patients. However, there are differences in RRT systems among hospitals and limited data are available. METHODS: In Seoul St. Mary's Hospital, the St. Mary's Advanced Life Support Team was implemented in June 2013. We retrospectively reviewed the RRT activation records of 287 cases from June 2013 to December 2016. RESULTS: The median response time and median modified early warning score were 8.6 minutes (interquartile range, 5.6 to 11.6 minutes) and 5.0 points (interquartile range, 4.0 to 7.0 points), respectively. Residents (35.8%) and nurses (59.1%) were the main activators of the RRT. Interestingly, postoperative patients account for a large percentage of the RRT activation cases (69.3%). The survival rate was 83.6% and survival was mainly associated with malignancy, Acute Physiology and Chronic Health Evaluation-II score, and the time from admission to RRT activation. RRT activation with screening showed a better outcome compared to activation via a phone call in terms of the intensive care unit admission rate and length of hospital stay after RRT activation. CONCLUSIONS: Malignancy was the most important factor related to survival. In addition, RRT activation with patient screening showed a better outcome compared to activation via a phone call. Further studies are needed to determine the effective screening criteria and improve the quality of the RRT system.
Epidemiology* ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Mass Screening ; Patient Safety ; Physiology ; Reaction Time ; Retrospective Studies ; Seoul ; Survival Rate