PURPOSE: This study was designed to examine the effects of a solution-focused group counseling program on the family burden, active coping, expressed emotion, and family support in schizophrenic patients and their families. METHOD: The subjects consisted of 48 schizophrenic patients and 56 families. Twenty-four schizophrenic patients and 28 families were assigned to both the experimental and control groups. The solution-focused group counseling program was conducted for the families of the experimental group, but not for the control group or the patients of the experimental group. RESULT: There was a significant greater decrease in scores of family burden and expressed emotion in the experimental groups than the control groups. There was a larger increase in active coping scores in the experimental groups than the control groups, but it was not significant. There was no significant difference between the two groups in family support scores. CONCLUSION: This program may be an effective nursing intervention program for families with schizophrenic members.
Adaptation, Psychological ; Adult ; Aged ; *Counseling ; Expressed Emotion ; Family/*psychology ; Female ; Humans ; Middle Aged ; *Schizophrenia ; Social Support

PURPOSE: Tumor invasion and metastasis are multistep phenomina, involving proteolytic degradation of extracellular matrix (ECM) and alteration of cell adhesion. It is another oncologic therapeutic strategy to block tumor invasion and metastasis through analyzing the molecules which are involved in these processes. We examined the expressions of some of matrix metalloproteinases (MMPs) in colorectal cancer and analyze the correlation with clinical factors and survival. METHODS: Fifty-five patients with colorectal cancer who underwent surgical resection were included. The expressions of the MMP-2, -7, -9, and -12 in tumor tissue and normal mucosa using RT-PCR technique was carried out. We evaluated and analyzed the correlation among these molecules, clinical characteristics, and survival. RESULTS: Expressions of MMP-7, -9, and -12 were significantly higher in tumor tissue than in normal mucosa (P=0.00). The expressions of MMP-2 between cancer and normal mucosa had no significant difference but it had a significant difference according to the lymph node (LN) invasion (P=0.03) in tumor tissues. Three-year overall survival was worse in patient with high expression of MMP-2 compared to low expression. CONCLUSION: The expressions of MMP-7, -9, -12 in tumor tissue were higher than in normal mucosa and MMP-2 expression of tumor tissues had a significant difference according to LN invasion. MMP-2 overexpression seems to be a prognostic factor for 3-yr overall survival. But, large scale study with long term survival analysis will be needed for the prognostic significance of MMPs.
Cell Adhesion ; Colorectal Neoplasms ; Extracellular Matrix ; Humans ; Lymph Nodes ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinases ; Mucous Membrane ; Neoplasm Metastasis

PURPOSE: Cortical dysplasia (CD) designates a diverse group of malformations resulting from one or more abnormalities in the development of the cerebral cortex. We investigated the findings of interictal SPECT and the diagnostic usefulness of interical and ictal SPECT according to pathological grading (PG) in comparison with MRI. MATERIALS AND METHODS: This study included 16 patients (M:F=9:7, age: 19.9+/-11.8 yrs) with pathologically proven CD. Tc-99m ECD SPECT was performed in all patients: interictal 11, interictal and ictal 3, ictal 2. MRI were obtained in all patients and image analysis was done blindly as to the result of SPECT. Pathologic findings of CD were classified into grade 1 (G1, dyslamination), grade 2 (G2, dysplastic neurons) and grade 3 (G3, balloon cells). We compared SPECT with MRI in lesions-to-lesions and analyzed the result according to PG. RESULTS: In SPECT and MRI, 38 and 27 lesions were visually recognized. In 14 interictal SPECT, variable findings in 35 lesions were demonstrated: 26 were hypoperfusion, 7 hyperperfusion, 2 heterotopic perfusion in the white matter. By comparison between two studies, missed lesions were founded: SPECT were 1 lesion, MRI 12. Review of missed 12 lesions of MRI were followed according to PG; G1 patients were 16.7% (4/19), G2 40.0% (6/15), and G3 50% (2/4). CONCLUSION: Interictal SPECT in CD showed variable findings such as hypoperfusion, hyperperfusion or heterotopic perfusion. However, for detection of missed CD on MRI, SPECT may help to detect a functional abnormality of the lesion with high PG.
Cerebral Cortex ; Humans ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: Crohn's disease is a chronic inflammatory disease that despite the advances in medical therapy is difficult to treat requiring surgery in a large proportion of patients as a result of complications. The aim of this study was to assess the clinical features of Crohn's disease patients who underwent one or more surgical interventions during a ten-year period and to establish the indications and surgical procedures in this group of patients. METHODS: The medical records of 22 patients with Crohn's disease, who were treated by surgery at the Ewha Womans University Hospital between October 1993 and February 2004, were reviewed. RESULTS: The male to female ratio was 4.5: 1 and the mean age at surgery was 29.7+/-11.5 years. There were an increasing number of patients who were being treated with surgery particularly male patients. The most common symptom was abdominal pain. The main indications for abdominal surgery were an abdominal obstruction and bowel perforation. Fourteen patients were diagnosed with Crohn's disease after surgery by a pathologic examination. Five patients had a history of taking anti-tuberculous medication. The re- operation rate was 9.1%, and there were no deaths. CONCLUSION: The number of surgical interventions for Crohn's disease patients appears to be increasing due to the growth of cases diagnosed and the change in the alert for Crohn's disease. Therefore, a surgeon must consider the possibility of Crohn's disease when a young male patient presents non-specific symptoms of acute abdominal pain.
Abdominal Pain ; Crohn Disease* ; Female ; Humans ; Male ; Medical Records

A 63-year-old woman was referred to a breast surgeon with a breast mass discovered incidentally during follow-up study after colon cancer surgery. Invasive adenocarcinoma was revealed on core needle biopsy. Wide excision of the breast including the tumor was performed. On standard histological examination the tumor showed features of moderately differentiated adenocarcinoma. The immunohistochemistry study revealed positive results for cytokeratin (CK)20 and CDX2, but negative for CK7. These are typical characteristics for colon cancer. Considering her history of subtotal colectomy for sigmoid colon cancer, it is presumable that the mass in the breast was of colonic origin, and it was an extremely rare case of metastasis to the breast from primary colorectal neoplasm. Although the instance is rare, clinicians should keep the possibility of breast metastasis from colorectal cancer in mind for early and correct diagnosis.
Adenocarcinoma ; Biopsy, Large-Core Needle ; Breast ; Colectomy ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Keratins ; Middle Aged ; Neoplasm Metastasis ; Sigmoid Neoplasms

PURPOSE: This study is to introduce our preliminary experience of the Doppler-guided hemorrhoidal artery ligation and Rectoanal repair (DG-HAL & RAR) as a new treatment for symptomatic or prolapsed hemorrhoids. METHODS: A Doppler probe incorporated proctoscope was inserted under the lithotomy position and the location of the hemorrhoidal artery was identified. The identified artery was ligated as a 'figure of eight' method with an absorbable suture into the submucosa. Then the prolapsed hemorrhoidal pile was lifted at the rectal mucosa by continuous suture to 5 mm above the dentate line and tied. The procedure was repeated at the 1, 3, 5, 7, 9, and 11 o'clock positions. We evaluated post-operative hospital stay, degree of pain, time to return to work, and recurrence. RESULTS: The patient's mean age was 50.2+/-15 years old and the mean follow-up time was 415+/-75 days. The constitution of the type of internal hemorrhoids was as follows: Grade II: 13, Grade III: 16, and Grade IV: 5. The mean operation time was 35 minutes and post-operative hospital stay was 1.4 days. The mean time it took to return to work was 1.8 days. There were no severe pains requiring injection of analgesics or other severe complications. So far, 2 patients have had recurrence of symptoms. CONCLUSION: The DG-HAL & RAR is a safe and less painful procedure. The DG-HAL & RAR is an effective alternative for the treatment of symptomatic or prolapsed hemorrhoids.
Analgesics ; Arteries ; Constitution and Bylaws ; Follow-Up Studies ; Hemorrhoids ; Humans ; Length of Stay ; Ligation ; Mucous Membrane ; Proctoscopes ; Recurrence ; Return to Work ; Sutures

no abstract available.

OBJECTIVES: The EGFR plays an important role in tumorigenesis and tumor progression of colorectal cancer, and leads to the activation of intracellular signaling pathways. The use of anti-EGFR-targeted therapy has increased for patients with colorectal cancer, but patients with EGFR mutations will be resistant to anti-EGFR-targeted therapy. The identification of gene mutations is critical in cancer treatment; therefore, the aim of this study is to investigate the incidences of EGFR mutations in colorectal cancer patients in Korea. METHODS: We reviewed 58 colorectal cancer patients who underwent operations between 2003 and 2006, retrospectively. We analyzed their EGFR mutations in 4 loci by DNA sequencing. In addition, we analyzed the correlation between the presence of EGFR mutation and patients' clinicopathologic features. RESULTS: Of the 58 patients, 35 patients were male and 23 were female. Their mean age was 63.28+/-11.18 years. Two patients (3.45%) were diagnosed as stage Tis, 7 patients (12.07%) had stage I, 24 patients (41.38%) had stage II, 20 patients (34.48%) had stage III, and 5 patients (8.62%) had stage IV. As a result of mutational analysis, EGFR mutations on exon 20 were detected in 13 patients (22.41%, G-->A transitions). EGFR mutations on exon 18, 19 and 21 were not detected. EGFR mutation increased in the earlier stage and the absence of lymph node metastasis (P=0.028). CONCLUSION: The incidence of EGFR mutation in Korean colorectal cancer patients is 22.41%. In addition, EGFR mutation significantly increased in the earlier stage and the absence of lymph node metastasis.
Cell Transformation, Neoplastic ; Colorectal Neoplasms ; Exons ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Sequence Analysis, DNA

A 60-year-old woman, who had non-small-cell lung cancer (NSCLC) in left lower lobe underwent brain F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for evaluation of cerebral metastasis. On follow-up FDG-PET/CT, only hypometaolic lesion was detected and progressed in right frontal lobe at 6 months and 10 months, later. Hypermetabolic metastasis was not detected even at last scan time of FDG-PET/CT. Brain MRI showed brain metastasis in right frontal lobe. As might be expected, the physician should take cerebral metastasis into consideration even though there is only hypometabolic change on subsequent FDG-PET/CT in patients with NSCLC.
Brain ; Electrons ; Female ; Follow-Up Studies ; Frontal Lobe ; Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Neoplasm Metastasis

PURPOSE: For a left-sided colonic obstruction, the traditional method of a staged defunctioning colostomy and resection has been performed. Recently, there has been a trend towards a one-stage primary resection and anastomosis. The aim of this study was to assess the safety and the efficacy of a one-stage resection and anastomosis for obstructed left colon cancer. METHODS: We retrospectively reviewed the records of 29 patients who had been diagnosed as having an obstructed left-sided colon cancer during the period from January 1995 to December 2003 at Ewha Womans University Hospital. We compared two techniques, a one-stage operation (10 cases) and a staged operation (13 cases). RESULTS: The mean age of the one-stage group was 58.5+/-16.1, and that of the staged operation group was 65.0+/-13.4. Both groups had similar co-morbidities, TNM stages, and tumor locations. In the one-stage operation group, a subtotal colectomy (n=3), a resection and anastomosis with intraoperative lavage (n=5), and a resection and anastomosis following stent insertion (n=2) had been performed. Patients who had undergone a colostomy as the first operation, resection and anastomosis (n=3), and a resection and anastomosis following a defunctioning colostomy (n=10) were included in the staged operation group. The mean postoperative hospital stay showed no significant differences between the two groups. One patient who had undergone a one-stage operation presented with an intestinal partial obstruction five months later. There were no anastomotic leakages, intraabdominal absceses, and wound infections, nor were there any mortalities. CONCLUSIONS: A one-stage resection and primary anastomosis for obstructed left-sided colon cancer can be done safely without significant morbidity.
Anastomotic Leak ; Colectomy ; Colon* ; Colonic Neoplasms ; Colostomy ; Female ; Humans ; Length of Stay ; Mortality ; Retrospective Studies ; Stents ; Therapeutic Irrigation ; Wound Infection