PURPOSE: The objective of this study was to assess the supportive needs of breast cancer patients and determine the socio-demographic and clinicopathological predictors of those unmet needs. METHODS: Of 302 eligible breast cancer patients, attending Yonsei University Severance Hospital, 250 completed the surveys. The supportive care needs were assessed by administering a Supportive Care Needs Survey. RESULTS: Of the ten highest perceived needs items, 7 items were related to the health system and information domain and 2 to the psychological domain. The univariate analysis in each domain showed education (P=0.083) and chemotherapy (P=0.042) were significant predictors in the psychological domain; education (0=0.000), time since surgery (P=0.009), node metastasis (0.022), chemotherapy (P=0.001) and radiation therapy (P=0.003) in the physical and daily living domain; age (P=0, 009) and duration of marriage (P= 0.004) for sexuality; node metastasis (P=0.048), TNM stage (P=0.036), and recurrence (P=0.010) in the health system and information domain and religion (P=0.016) in the care and support domain. A multivariate analysis showed age (P=0.0253) and chemotherapy (P=0.0517) as significant independent predictors in the sexuality domain; education (P=0.0010), chemotherapy (P=0.0011), radiation therapy (P= 0.0133) and time since surgery (P=0.036) in the physical and daily living domain; recurrence (P=0.0324) in the health system and information; domain and education (P=0.0134) and chemotherapy (P=0.0207) in psychological domain. CONCLUSION: Breast cancer patients experience high levels of unmet supportive needs across each domain, but especially in the health systems and information domain. Also, the types of needs varied according to the patient subgroups. This study suggests considerable improvements be made in terms of supportive care of breast cancer patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Education ; Humans ; Marriage ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Sexuality

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Neuroma*

The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.
Aged ; Humans ; Spine ; Vertebral Artery

No abstract available.
Carcinoma, Endometrioid*

PURPOSE: Joubert syndrome presents neonatal respiratory abnormalities and other clinical manifestations. Pathologically the patients show hypoplasia or agenesis of cerebellar vermis and other intracranial anomalies. Our purpose is to evaluate the clinical manifestations and MR findings of Joubert syndrome. MATERIALS AND METHODS: Among the patients presenting with clinical stigmata of Joubert syndrome and agenesis of vermis on MR imaging, eight patients who did not satisfied the criteria of Dandy-Walker malformation, tectocerebellar dysraphia and rhombencephalosynapsis were selected. MR findings and clinical manifestation were analyzed. RESULTS: On MR imaging, agenesis of the cerebellar vermis (all cases), hypoplasia of the cerebellar peduncle (6cases), fourth ventricular contour deformity(6cases), tentorial elevation (4cases), deformity of the lateral ventricles (4cases), dysgenesis of the straight sinus (3cases) were demonstrated. Other findings were abnormalities of corpus callosum (3cases), falx anomalies (3 cases), occipital encephalomeningocele (2 cases) and fluid collection in posterior cranial fossa (2cases). Clinical manifestations were developmental delay (5cases), abnormal eyeball movement (3cases), hypotonia (2 cases), neonatal rerspiratoy abnormality (2cases), etc. CONCLUSION: Joubert syndrome showed various clinical manifestations and intracranial anomalies. MR imaging is an useful modality in detection of the cerebellar vermian agenesis and other anomalies of the patients.
Christianity ; Congenital Abnormalities ; Corpus Callosum ; Cranial Fossa, Posterior ; Dandy-Walker Syndrome ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging* ; Muscle Hypotonia

Magnetic resonance (MR) imaging of thirteen patients with tuberous sclerosis were reviewed. Seven patients underwent computed tomography (CT). The characteristic MR finding of tuberous sclerosis was those of subependymal nodules which were best seen on short repetition time (TR) spin-echo images. Hypointensities within the nodules consistent with calcification were most evident on long TR images. Contrast enhancing lesions, indicative subependymal giant cell astrocytoma, occurred in four cases. Cortical tubers (n=11) and white matter lesions(n=8) exhibited long T1 and T2 relaxation characteristics although reversed pattern was noted in one newborn patients. Cortical tubers and white matter lesions had more irregular shapes in early childhood patients. MR imaging is the sensitive method in detection of gyral tubers and white matter lesions and also valuable in detecting giant all astrocytoma.
Astrocytoma ; Humans ; Infant, Newborn ; Magnetic Resonance Imaging ; Methods ; Relaxation ; Tuberous Sclerosis* ; White Matter

Objectives: . The association between pet sensitization and pet ownership remains unclear. Therefore, we aimed to elucidate the association between pet sensitization and pet ownership by age. Methods: . We retrospectively reviewed 2,883 patients who visited our allergy clinic for nasal symptoms from January 2003 to December 2014, of whom 1,957 patients with data on skin-prick tests and questionnaire responses were included and divided into adults (age >19 years) and children (age ≤19 years). The association between pet sensitization and pet ownership was evaluated in both groups. Results: . Among children, dog and cat sensitization showed no associations with dog and cat ownership, respectively. However, among adults, dog sensitization was significantly associated with dog ownership (odds ratio [OR], 3.283; P<0.001), and cat sensitization with cat ownership (OR, 13.732; P<0.001). After adjustment for age, sex, familial history of allergy, sinusitis, diabetes mellitus, other pet ownership, and non-pet sensitization, significant associations remained between dog sensitization and dog ownership (adjusted OR [aOR], 3.881; P<0.001), and between cat sensitization and cat ownership (aOR, 10.804; P<0.001) among adults. Dog ownership did not show any association with allergic rhinitis, asthma, or atopic dermatitis, whereas atopic dermatitis had a significant association with cat ownership in adults (aOR, 4.840; P<0.001). Conclusion . Pet ownership in adulthood increased the risk of pet sensitization. However, pet ownership was not associated with the prevalence of atopic disorders, regardless of age, except for atopic dermatitis and cat ownership in adults.

Objectives: . The association between pet sensitization and pet ownership remains unclear. Therefore, we aimed to elucidate the association between pet sensitization and pet ownership by age. Methods: . We retrospectively reviewed 2,883 patients who visited our allergy clinic for nasal symptoms from January 2003 to December 2014, of whom 1,957 patients with data on skin-prick tests and questionnaire responses were included and divided into adults (age >19 years) and children (age ≤19 years). The association between pet sensitization and pet ownership was evaluated in both groups. Results: . Among children, dog and cat sensitization showed no associations with dog and cat ownership, respectively. However, among adults, dog sensitization was significantly associated with dog ownership (odds ratio [OR], 3.283; P<0.001), and cat sensitization with cat ownership (OR, 13.732; P<0.001). After adjustment for age, sex, familial history of allergy, sinusitis, diabetes mellitus, other pet ownership, and non-pet sensitization, significant associations remained between dog sensitization and dog ownership (adjusted OR [aOR], 3.881; P<0.001), and between cat sensitization and cat ownership (aOR, 10.804; P<0.001) among adults. Dog ownership did not show any association with allergic rhinitis, asthma, or atopic dermatitis, whereas atopic dermatitis had a significant association with cat ownership in adults (aOR, 4.840; P<0.001). Conclusion . Pet ownership in adulthood increased the risk of pet sensitization. However, pet ownership was not associated with the prevalence of atopic disorders, regardless of age, except for atopic dermatitis and cat ownership in adults.

No abstract available.
Adult* ; Humans ; Lip* ; Rhabdomyosarcoma, Alveolar*

Transient hyperammonemia in a newborn is an overwhelming disease manifested by hyperammonemic coma. The majority of affected newborns are premature and have mild respiratory syndrome. The diagnosis may be difficult to determine. This metabolic disorder is primarily characterized by severe hyperammonemia in the postnatal period, coma, absence of abnormal organic aciduria and normal activity of the enzymes of the urea cycle. Hyperammonemic coma may develop within 2-3 days of life, although its etiology is unknown. Laboratory studies reveal marked hyperammonemia (>4,000 micromol/L). The degree of neurologic impairment and developmental delay in this disorder depends on the duration of hyperammonemic coma. Moreover, the infant may succumb to the disease if treatment is not started immediately and continued vigorously. Hyperammonemic coma as a medical emergency requires dialysis therapy. Here, we report a case of severe transient hyperammonemia in a preterm infant (35 week of gestation) presented with respiratory distress, seizure, and deep coma within 48 hours and required ventilatory assistance and marked elevated plasma ammonia levels. He survived with aggressive therapy including peritoneal dialysis, and was followed 2 years later without sequelae.
Ammonia ; Coma ; Dialysis ; Emergencies ; Humans ; Hyperammonemia ; Infant ; Infant, Newborn ; Infant, Premature ; Peritoneal Dialysis ; Plasma ; Seizures ; Urea