Pain is the most persistent and incapacitating symptom of recurrent or metastatic cancer. About 60~90% of patients with metastatic cancer have pain long before the terminal stage of their illness. According to a recent report, in Korea, the proportion of cancer patients who have pain is 52.1% and 62.6% of them are not given adequate analgesia. Despite widespread knowledge about many aspects of pain relief and the availability of appropriate opioid analgesics, inadequate pain management in cancer patients remains pervasive. The reasons can be classified into three categories ; societal barriers, knowledge deficits, and influenced of governmental regulations. Cancer pain can be effectively treated in 85 to 95% of patients with an integrated program of systemic, pharmacologic, and anticancer therapy. However, pain relief in cancer patients remains inadequate because it is not given priority and there is a lack of education and inappropriate understanding of the nature of cancer pain. To overcome these barriers, professional education needs to be focused on the proper assessment of pain, the management of side effects, and the use of adjuvant medications. A better understanding of the pharmacology of opioid analgesics is also needed. In addition, physicians should educate patients to report pain and to take the medications prescribed for pain management effectively.
Analgesia ; Analgesics, Opioid ; Education ; Education, Professional ; Humans ; Korea ; Pain Management ; Pharmacology ; Social Control, Formal

Cancers of the stomach rank first in cancer deaths in Korea with a high fatality rate. As for the adjuvant treatment of gastric cancer, a meta-analysis of adjuvant chemotherapy trials suggested a limited survival benefit for adjuvant chemotherapy compared with surgery alone. Most of the trials used combination chemotherapy, usually based on fluorouracil or cisplatin. Although the large intergroup trial 116, comparing surgery alone to surgery followed by postoperative fluorouracil, leucovorin, and radiotherapy, indicated a significant survival benefit for postoperative chemoradiotherapy, inadequate surgical resection of regional lymphnodes was an important issue of this trial. Future trials should address the extensive lymphnode dissection, the inclusion of newer chemotherapeutic agents, the use of preoperative chemotherapy, and the use of intraperitoneal therapy. Randomized trials are mandatory for the establishment of a satisfactory strategy.
Chemoradiotherapy ; Chemotherapy, Adjuvant* ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination ; Fluorouracil ; Korea ; Leucovorin ; Radiotherapy ; Stomach ; Stomach Neoplasms*

BACKGROUND: Current studies on multimodal strategy for N2 non-small cell lung cancer are being high interest have drawn much attention. N2 lung cancer, however, is composed of is divided into several subgroups with that have different prognoses. The prognostic factors still ramain controversial. METHODS: Between January 1990 and June 1999, 180 patients with N2 lung cancer who underwent surgical resection were investigated, excluding 10 of these for surgical mortality. All patients underwent mediastinal lymph node dissection. 20 clinicopathologic factors were investigated by univariable and multivariable analyses to identify significant prognostic factors among resected N2 disease. RESULTS: The overall 5-year survival rate was 20.6%. Multivariable analyses among overall patients revealed 3 significant prognostic factors:Age, Histologic type, Vascular invasion. Based on the result, 49 patients with both age more than 60 and pathologic Non-squamous cell showed a 5-year survival of 5.0%, whereas 37 patients with neither of the factors showed a 5-year survival of 56.6%(p<0.001). And 12 patients with both vascular invasion and pathologic Non-squamous cell showed a 5-year survival of 11.9%, whereas 67 patients with neither of the factors showed a 5-year survival of 33.6%(p=0.01). CONCLUSION: The prognosis of surgically resected N2 disease varies according to the 2 significant prognosis factors. Tumor size may be an additional influencing factor in the prognosis of N2 disease.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Neoplasms ; Lung* ; Lymph Node Excision ; Lymph Nodes* ; Mortality ; Neoplasm Metastasis* ; Prognosis ; Survival Rate

BACKGROUND: Herpes zoster is an important and troublesome disease. OBJECTIVE: The purpose of this study was the elucidation of the epidemiological and clinical characteristics of herpes zoster through patient assessrnent. METHODS: During a 5- Year period, January 1990 to December 1994, 215 patients with herpes zoster were assessed with regard to annual and monthly frequency in occurrence, age and gender incidence. Associated conditions, dermatomic distributions, the relationship of onset of pain and skin lesions, Multi-CMI test and complications were also evaluated. RESULTS: 1. The annual freguency of herpes zoster ranged from 0.88% to 1.78% (mean 1.23%) during the 5-year period. The highest number of herpes zoster patients was observed in winter (p<0.001) especially in January. 2. Herpes zoster was found to most frequently afflict persons aged 50-59 (27.9%). 71% of the patients were over 40 years of age. 3. In 76 patients (41.8%), neuralgia occurred several days (4 days mean) before the development of skin lesions. In 92 patients (50.5%), pain and skin lesions developed simultaneously while skin lesion development occurred before the onset of pain in 14 patients (7.7%). 4. Among the patients, 42.8% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, pharyngitis, fracture, etc. 5. The dermatomic invclvement of herpes zoster patients having one dermatome was most frequent in thoracic dermatome ca. es (52.6%). Others included cervical (16.7%), trigeminal (11.6%), sacral (6. 0%), lumbar (4.2%), facial (0.5%). Cases having two different dermatomes constituted 8.4%. 6. The most common complication of herpes zoster was postherpetic neuralgia although instance of ophthalmologic compiications, secondary bacterial infection, scar formation, Ramsay-Hunt syndrome, keloid formation, and urinary difficulty were also documented. 7. Multi-CMI (Cell-mediated immunity) tests were done on 88 herpes zoster patients. Thirteen of them (14.8%) were found to have comparatively depressed scores. Ten of the 79 single dermatome involvement patients (12.7%) and three of the 9 two dermatome involvement patients (33.3%) exhibited similar scores. CONCLUSION: These results are in accordance with those of previous reports with the exception of the higher incidence ot two different dermatome involvements and seasonal variation.
Bacterial Infections ; Cicatrix ; Diabetes Mellitus ; Herpes Zoster* ; Humans ; Hypertension, Pulmonary ; Hypothyroidism ; Incidence ; Keloid ; Liver Diseases ; Neuralgia ; Neuralgia, Postherpetic ; Peptic Ulcer ; Pharyngitis ; Seasons ; Skin ; Tuberculosis

We report a case of mycosis fungoides with small follicular papules and plaques on the trunk. Histopathological findings showed lymphocytic infiltration within and around the follicular epithelium and Pautrier's microabscess in the epidermis. Immunohistochemical studies showed atypical T lymphocytes infiltrating the follicles and electron microscopic examination revealed the presence of lymphocytes with large convoluted nuclei around the follicles. These findings suggest that the follicular lesions were specific for a special variant of mycosis fungoides.
Epidermis ; Epithelium ; Lymphocytes ; Mycosis Fungoides* ; T-Lymphocytes

In the present study, we investigated the effects of exhaustive exercise and recovery on inflammatory, pro-apoptotic, and anti-oxidative responses in human peripheral blood mononuclear cells (PBMCs). Sixteen volunteers participated in a guided physical activity program in which they were subjected to progressive exercise on the treadmill until they were exhausted followed by an 1-hour recovery period. Isolated human PBMCs were collected before exercise, immediately after exercise, and after 1-hour recovery. Exhaustive exercise induced expression of heme oxygenase-1 and glutamate cysteine ligase catalytic subunit and activation of NF-κB and NF-E2 related factor 2 (Nrf2). Apoptosis, as measured by activity and cleavage of caspase-3 and its substrate PARP also significantly increased. However, induction of redox signaling and the pro-apoptotic response fully returned to the baseline level during the 1-hour recovery period. On the other hand, COX-2 expression was continuously elevated after exercise cessation throughout the 1-hour recovery period. Taking all these findings into account, we conclude that exhaustive exercise transiently induces Nrf2-mediated antioxidant gene expression and eliminates damaged cells through apoptosis as part of an adaptive cytoprotective response against oxidative and inflammatory stress.

No abstract available.
Disabled Persons* ; Female ; Humans ; Menarche*

No abstract available.

PURPOSE: Alteration of p53 and telomerase activity may be responsible for gastric carcino- genesis. In this study, we tried to observe modulation of telomerase activity by wild type p53 in gastric cancer cell lines. MATERIALS AND METHODS: We used five gastric cancer cell lines (KATO-III, AGS, SNU-1, SNU-5, SNU-16). In order to find p53 mutation, we used western blot and PCR-SSCP. The TRAP-eze kit which supplied by Oncor (Gaithersburg, MD) was used to detect telomerase activity of the five gastric carcinoma cell lines. The wild type p53 gene was transfected by electroporation method. RESULTS: The expression of p53 protein was increased in four gastric carcinoma cell lines and one cell line (KATO-III) did not express. We found p53 point mutation in exon 5 and 8, and the p53 gene was deleted in KATO-III. The telomerase activity were observed in all five gastric carcinoma cell lines and there were no difference in telomere repeat length among five cell lines. After transfection with wild type p53, we could not find the change of telomerase activity in KATO-III. CONCLUSION: Although activation of telomerase activity and mutation of p53 gene may be needed in gastric carcinogenesis, the telomerase activity was not affected by restoration of p53 function in gastric carcinoma cell lines.
Blotting, Western ; Carcinogenesis ; Cell Line* ; Electroporation ; Exons ; Genes, p53* ; Point Mutation ; Stomach Neoplasms ; Telomerase* ; Telomere ; Transfection

No abstract available.