No abstract available.
Skin* ; Spinal Cord Injuries* ; Spinal Cord*

OBJECTIVES: This study was done to examine the risk factors for the dyspnea of retired coal miners in Korea. METHODS: Eight hundred and sixteen male workers who took the health examination for retired coal miners in the T hospital were recruited, in this study and their health examination records were employed to assess the risk factors for dyspnea. Both univariate and multiple logistic regression analyses were used to estimate the relationship between known risk factors and the presence of dyspnea. RESULTS: Variables in the univariate analysis, which showed a significant relationship with dyspnea were age(>or=60 years) (OR : 2.20, 95% CI : 1.63-3.00), work duration(>or=2 0 years) (OR : 1.67, 95% CI : 1.24-2.25), profusion of small opacity(>or=1/0) (OR : 1.81. 95% CI : 1.30-2.51), large opacity(>or=A) (OR : 2.19, 95% CI : 1.30-3.70), and the ratio of the distance between the start of the first division of the right and left main pulmonary arteries divided by the transverse diameter of the thorax (cor pulmonale index)(>or=0 . 3 6 ) (OR : 2.37, 95% CI : 1.77-3.17). The multivariate analysis using logistic regression analysis showed age(>or=60 years)(OR : 1.69, 95% CI : 1.28-2.21), smoking amount(>or=1 filters/day) (OR : 1.61, 95% CI : 1.06-2.45), no experience of having quit smoking (OR : 1.40 95% CI : 1.06-1.84), and the cor pulmonale index(>or=0.36)(OR : 1.75, 95% CI : 1.34-2.29) were associated with an increased risk for dyspnea. CONCLUSIONS: These results suggests that the cor pulmonale index is the most significant risk factor in predicting dyspnea in retired coal miners. In addition, this study also revealed that workers aged 60 years or more or smokers were more likely to experience dyspnea as compared to those aged 60 years or less and nonsmokers.
Coal* ; Dyspnea* ; Humans ; Korea* ; Logistic Models ; Male ; Multivariate Analysis ; Pulmonary Artery ; Pulmonary Heart Disease ; Risk Factors ; Smoke ; Smoking ; Thorax

Purpose: The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. Methods: Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. Results: The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital.Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. Conclusion This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses’ retirement are needed.

The excitotoxic effect of kainic acid on dendrites and neuronal cell bodies of hippocampus and dentate gyrus was studied with time (1, 4, 8, 16 hours, 2, 7, 14 days) light and electron microscopically by intraperitonial injection into rat. The results obtained were as follows. 1) The acute dendrotoxic effect was observed as laminar pattern of swelling along pyramidal cell body layer and dendritic fields and was most prominently at 2-4 hours after kainic acid injection. In ultractructural study, the acute change occurred in dendrites of pyramidal cells in hipocampus because the synapses between nerve terminals and swollen components were not destroyed and remained intact and, identified the swollen structures as dendrites. So, it was obvious from the results that the acute change by kainic acid was osmolysis and was continued till initial 4 hours but was finally faded out. 2) The distribution of kainic acid receptor within hippocampus was different because the prominent dendritic swelling occurred in proximal basilar dendritic field of CA 3 and 4 and the proximal and distal basilar dendritic fields of CA 1 and 2, and no change was observable in dentate granule cell. The sensitivity of hippocampal dendritic fields to kainic acid could be put in decreasing order as CA3, CA4, CA1, CA2 and dentate granule cell 3) With the elapse of time, the acute change disappeared and pyramidal cells began to degenerate by the chronic reaction about 7 days after kainic acid injury, and the pyramidal cell density in CA regions greatly decreased. Almost all pyramidal cells degenerated the dentate granule cells were not affected to kainic acid throughout the time. In conclusions, hippocampal neurons were postulated to be very sensitive to kainic acid, and in contrast to the gradual disappearance of acute change within several hours, the degeneration of pyramidal neurons by chronic change was developed within several days regardless of acute change.
Animals ; Brain* ; Dendrites ; Dentate Gyrus ; Hippocampus ; Kainic Acid* ; Neurons* ; Pyramidal Cells ; Rats* ; Receptors, Kainic Acid ; Synapses

PURPOSE: This study was attemped to investigate the prognostic factors for the outcome of stage I renal cell carcinoma after radical nephrectomy. MATERIALS AND METHODS: Twenty nine patients treated from 1984 to 1995 at Kyung Hee University Medical Center were studied retrospectively. All of them were diagnosed with pathologic Robson stage I renal cell carcinoma after radical nephrectomy. RESULTS: Males were affected three times more frequently than females. The tumor was detected on the right kidney in 15 cases, and on the left in 14. Average follow up period was 36.6 months, average disease free interval was 29.4 months and median survival was 30 months. During the follow up, 9 patients (31.0%) expired due to liver and lung metastasis at postoperate 21.6 months on average. Eleven patients (37.9%) developed distant metastasis in the follow up. There was no local recurrence of tumor. Seventeen patients were diagnosed incidentally without clinical symptoms. In our retrospective study for stage I renal cell carcinoma, there were no predictive prognostic parameters for predicting the outcome of patients, except for the incidental diagnosis of the tumor. CONCLUSIONS: These results suggest that incidental diagnosis of the tumor may be the most important prognostic factor for the outcome of stage I renal cell carcinoma. Although the patients were confirmed as stage I renal cell carcinoma pathologically after radical nephrectomy, close follow up is very important, because of high incidence of metastasis. We recommand that chest X-ray, abdominal ultrasonogram and bone scan should be checked at 3 months interval for postoperative one year even though stage I renal cell carcinoma.
Academic Medical Centers ; Carcinoma, Renal Cell* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney ; Liver ; Lung ; Male ; Neoplasm Metastasis ; Nephrectomy ; Recurrence ; Retrospective Studies ; Thorax ; Ultrasonography

PURPOSE: To elucidate whether there is a delay of adjuvant treatment or detection of recurrences, or an increasing of the recurrence of tumorsin clinically advanced breast cancer patients. METHODS: The study group included 55 patients underwent mastectomy with immediate reconstruction (IBR), and 563 patients who received the mastectomy without reconstruction (non-IBR), and who were stage IIB and IIIA breast cancer patients, at Asan Medical Center between Jun 1993 and December 2000. We retrospectively assessed the comparative outcomes through using follow-up data. RESULTS: Out of 2,057 patients who had undergone the mastectomy on during the period, 175 (8.5%) underwent immediate reconstruction. 55 of them (31.6%) were stage IIB and IIIA patients, a similar portion (29.9%) was seen in the 563 patients of same stages without reconstruction. The mean ages of these groups were 37.1 and 46.9 years, that is, the reconstruction group was about 10 years younger. All these patients voluntarily underwent immediate reconstruction. For the patients who were followed up, the local recurrence was 3.6% (2/55) for the IBR group and 5.2% (29/563) for the non-IBR group. On the other hand, the distant relapse rates were 12.7% and 13.9%. The administration of adjuvant chemotherapy was not delayed and radiotherapy was used as an adjuvant treatment after reconstruction in nine of the cases (16.4%). Chemotherapy was also conducted in 98.2% of the IBR group and 77.3% of the non-IBR group. While radiotherapy was used in the IBR group less frequently, there was no statistical difference between the two groups (P=0.63). CONCLUSION: Immediate reconstruction following mastectomy for the treatment of breast cancer is now more frequently performed. IBR can be done in clinically advanced breast cancer without increasing the risk of treatment failure or modification.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Drug Therapy ; Female ; Follow-Up Studies ; Hand ; Humans ; Mammaplasty* ; Mastectomy* ; Radiotherapy ; Recurrence ; Retrospective Studies ; Treatment Failure

PURPOSE: Cancers are highly individual in their response to chemotherapy, however attempts to predict tumor response to drugs using in vitro cell culture have largely failed. A new technology, the histoculture drug response assay (HDRA), appears to have solved many previous problems. The purpose of this study is to evaluate the reliability of HDRA in a chemosensitivity test for breast cancer. MATERIALS AND METHODS: Tumor specimens from breast cancer patients were evaluated by HDRA using different chemotherapeutic agents. Each specimen was tested using a blind method in order to determine the reproducibility of HDRA results for the same tissue and with a triplicated assay in order to determine reproducibility by different examiners. The evaluative power of this assay and the chemosensitivity of drugs for each specimen was determined. RESULTS: Specimens of 92.9% (65/70) were successfully cultured and evaluated for chemosensitivity. The reproducibility of HDRA for the same tissue was 75% (100% agreement) and 100% (over 70% agreement), respectively. And the reproducibility by different examiners was 78.9% (100% agreement) and 94.7% (over 70% agreement), respectively. Each specimen demonstrated a response to at least one agent. CONCLUSION: The evaluative power and reproducibility of HDRA were high, therefore it might serve as a reliable clinical method for chemosensitivity testing. However, there is a need for clinical trial in which patients are initially randomized for treatment either by HDRA direction or by clinician's choice.
Breast Neoplasms* ; Breast* ; Cell Culture Techniques ; Drug Therapy ; Humans

PURPOSE: Growth patterns of colorectal carcinomas can be divided into polypoid growth (PG) and nonpolypoid growth (NPG). This study was intended to find characteristic clinicopathologic features and the expression status of p53, p21, and p16 with relation to growth patterns in colorectal carcinomas. METHODS: Sixty-one surgically resected colorectal carcinomas including 43 PG and 18 NPG carcinomas were reviewed in this study. Immunohistochemical stains for p53, p21, and p16 were done, and the results were analyzed with respect to growth patterns, and other prognosic parameters. RESULTS: PG carcinomas were significantly correlated with adenoma (p=0.0001), and with favorable histology group (p=0.04). On the contrary, NPG carcinomas were significantly correlated with unfavorable histology group (p=0.04). In NPG carcinomas, the frequency of positive expression of p53 was higher and the expression of p16 was lower than that of PG carcinomas. But there was no statistical significance (p=0.150, 0.210 respectively). The expression of p21 has no difference between NPG and PG carcinomas (p=0.953). CONCLUSIONS: As a result, it can be thought that the tendency of higher expression of p53 and lower expression of p16 in NPG carcinomas than in PG carcinomas may suggest more aggressive biologic behavior of NPG carcinomas.
Adenoma ; Colorectal Neoplasms* ; Coloring Agents ; Genes, Tumor Suppressor*

In patient treated by mastectomy for breast cancer, chest wall and skin recurrences are frequently encountered. Chest wall recurrence results in profound physical and psychological morbidity, and often heralds the appearance of other, more life threatening metastasis. Traditionally the two most common treatments have been site-specific radiation and resection. Photodynamic therapy (PDT) provided an alternative treatment modality using a photosensitizer and laser light to induce selective tumor necrosis. The patient was 64- years old female, had undergone breast conserving surgery for cancer of the right breast. Chest wall and skin metastasis recurred at 40 months after the adjuvant treatment of chemotherapy. The lesions were progressed despite 2nd, 3rd chemotherapy and hyperthermal therapy. The light was administered through a diode laser turned to 630 nm wave length (150 J/cm2 in light dosage, 200 mW/cm2 in intensity), 72 h after photosensitizing agent injection. There was clinical evidence of partial response, defined as granulation tissue with re-epitheliaization from the periphery of normal epithelium. PDT has demonstrated good results in other solid tumors at some hospitals, however there has been no application for breast cancer in Korea previously. Our experience suggests that PDT is non-invasive procedure that is highly tolerable, particularly when compared with other modalities, and an effective treatment method for chest wall or skin recurrence that shows no response to other treatments.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Epithelium ; Female ; Granulation Tissue ; Humans ; Korea ; Lasers, Semiconductor ; Mastectomy ; Mastectomy, Segmental ; Necrosis ; Neoplasm Metastasis ; Photochemotherapy* ; Recurrence* ; Skin* ; Thoracic Wall* ; Thorax*

Small cell carcinoma of the gallbladder is a rare neoplasm with a high malignant potential, representing about 4% of all carcinomas in this organ. It predominantly develops in older women with cholelithiasis and deaths usually occur within a few months after the diagnosis. We report a case with a small cell carcinoma of the gallbladder with literature review. A case of 74-year-old woman with fever and abdominal pain for days was temporarily diagnosed as empyema of the gallbladder and received emergency cholecystostomy. 15 days later, she underwent cholecystectomy. Pathological examination of the gallbladder revealed small cell carcinoma. Of the immunohistochemical stains for neuroendocrine and other tumor markers, this tumor was positive for cytokeratin, NSE, lysozyme, gastrin,p53 and p16 and negative for CEA, chromogranin, synaptophysin, somatostatin, serotonin and ACTH. The small cell was partially originated from the common premobial cell with bidirectional differentiation. She died of cancer cachexia 2 months after initial operation.
Abdominal Pain ; Adrenocorticotropic Hormone ; Aged ; Cachexia ; Carcinoma, Small Cell* ; Cholecystectomy ; Cholecystostomy ; Cholelithiasis ; Coloring Agents ; Diagnosis ; Emergencies ; Empyema ; Female ; Fever ; Gallbladder* ; Humans ; Keratins ; Muramidase ; Neuroendocrine Tumors ; Serotonin ; Somatostatin ; Synaptophysin ; Biomarkers, Tumor