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.

PURPOSE: Lymph-node metastasis is considered as critical prognostic factor in colorectal cancer. A preoperative evaluation of lymph-node metastasis can also help to determine the range of distant lymph node dissection. However, the reliability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of lymph-node metastasis is not fully known. METHODS: The medical records of 433 patients diagnosed with colorectal cancer were reviewed retrospectively. FDG-PET/CT and CT were performed on all patients. Lymph nodes were classified into regional and distant lymph nodes according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th edition. RESULTS: The patients included 231 males (53.3%) and 202 females (46.7%), with a mean age of 64.7 +/- 19.0 years. For regional lymph nodes, the sensitivity of FDG-PET/CT was lower than that of CT (57.1% vs. 73.5%, P < 0.001). For distant lymph nodes, the sensitivity of FDG-PET/CT was higher than that of CT (64.7% vs. 52.9%, P = 0.012). The sensitivity of FDG-PET/CT for regional lymph nodes was higher in patients with larger primary tumors. The positivity of lymph-node metastasis for FDG-PET/CT was affected by carcinoembryonic antigen levels, tumor location, and cancer stage for regional lymph nodes and by age and cancer stage for distant lymph nodes (P < 0.05). CONCLUSION: The sensitivity of FDG-PET/CT for regional lymph-node metastasis was not superior to that of CT. However, FDG-PET/CT provides helpful information for determining surgical plan especially in high risk patients group.
Carcinoembryonic Antigen ; Colorectal Neoplasms* ; Electrons* ; Female ; Humans ; Joints ; Lymph Node Excision ; Lymph Nodes ; Male ; Medical Records ; Neoplasm Metastasis ; Neoplasm Staging ; Positron-Emission Tomography ; Retrospective Studies

PURPOSE: The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. MATERALS AND METHODS: We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4+/-7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class I , II). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6+/-19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propagation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis RESULTS: CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=0.01) and age (p=0.02) were related to the development of CCH. CONCLUSION: Crossed cerebellar hyperperfusio ictal brain SPECT did not help differentiate mesial from lateral temporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.
Brain* ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Logistic Models ; Retrospective Studies ; Technetium Tc 99m Exametazime* ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: Livin is associated with drug response in several cancers. The aim of this study was to investigate the effect of silencing the livin gene expression on anticancer drug response in colorectal cancer. METHODS: siRNA was transfected at different concentrations (0, 10, and 30nM) into HCT116 cells, then cells were treated with either 5-fluorouracil (FU)/leucovorin (LV) or oxaliplatin (L-OHP)/5-FU/LV. Cellular viability and apoptosis were evaluated following silencing of livin gene expression combined with treatment with anticancer drugs. RESULTS: Livin gene expression was effectively suppressed by 30nM siRNA compared with control and 10nM siRNA. The 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay showed that proliferation was effectively inhibited in cells treated with a combination of both siRNA and an anticancer drug, compared to cells treated with siRNA-Livin or anticancer drug alone. In particular, the combination of 30nM siRNA and L-OHP/5-FU/LV resulted in a 93.8% and 91.4% decrease, compared to untreated control or L-OHP/5-FU/LV alone, respectively. Cellular proliferation was most effectively suppressed by a combination of 30nM of siRNA and L-OHP/5-FU/LV compared to other combinations. CONCLUSION: siRNA-mediated down-regulation of livin gene expression could significantly suppress colon cancer growth and enhance the cytotoxic effects of anticancer drugs such as 5-FU and L-OHP. The results of this study suggest that silencing livin gene expression in combination with treatment with anticancer drugs might be a novel cancer therapy for colorectal cancer.
Apoptosis ; Cell Proliferation ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Down-Regulation ; Fluorouracil ; Gene Expression ; HCT116 Cells ; RNA, Small Interfering