PURPOSE: This study to identify the current status of cancer centers in Korea in terms of organization ofhospital. METHODS: 21 cancer centers, from regional cancer centers to the largest hospitals, were surveyed from October to November 2014. The questionnaire was developed by the board members of the Oncology Nursing Society. RESULTS: Centers specializing in cancer treatment were either cancer hospitals or centers affiliated with larger hospitals. 81% operated wards solely for cancer patients. The average number of beds was 354.2, and each center had independent laboratories, chemotherapy infusion rooms and pharmacies. Degree of nursing staff varied from grades 1 to 3. The nursing department and ward were jointly responsible for educating new nurses. In cancer nursing, the policy varied according to institution. For patient education, the oncology Advanced Practice Nurse (APN) mainly informed patients of the adverse effects of chemotherapy and central line care. 90.5% appointed oncology APNs, who were variously designated (47.6%). 10.5% of APNs held concurrent positions. CONCLUSION: As cancer has increased medical professional organizations have shown a variety of forms of organization and human resources management. A political approach seems to be required for institutions for nursing care, patient education, the role and qualifications of APN.
Cancer Care Facilities ; Drug Therapy ; Humans ; Korea* ; Nursing ; Nursing Care ; Nursing Staff ; Oncology Nursing ; Patient Education as Topic ; Pharmacies ; Societies

Purpose: Medial epicondyle fractures are a common elbow injury in pediatric and adolescent patients. The management of these fractures continues to be debated. This study aims to review the long-term clinical and radiological outcomes of operative treatment of medial epicondyle fractures in pediatric and adolescent patients. Methods: In this study, 24 consecutive patients were categorized into two groups as follows: group 1, 10 patients undergoing internal fixation with Kirschner wires (K-wires) and group 2, 14 patients undergoing internal fixation with cannulated screws. To assess clinical outcomes, Mayo Elbow Performance Score were used in addition visual analogue scale for pain, subjective range of motion, ulnar nerve irritation symptoms, residual instabilities and requirement for secondary surgery were checked. To access the radiological outcomes, check the bone union and possible deformities secondary to the medial epicondyle fractures were examined. Results: There were no cases of immediate or residual ulnar nerve irritation symptoms and no cases of residual deformity or valgus instability. There was no radiological evidence of loss of reduction and all patients had achieved bone union at last follow-up. And all patients had performed secondary surgery for hardware removal regardless of symptomatic hardware irritation. Conclusion Both K-wires fixation for younger children and screw fixation for near skeletal maturity children may provide favorable clinical and radiological outcomes at long-term follow-up, with low morbidity and radiographic deformity. In the K-wire fixation group, it is thought that preoperative explanation is needed because the K-wires tends to be removed earlier than screw fixation group due to hardware irritation.

Post-transplantation lymphoproliferative disorder (PTLD) is a serious complication that can develop after either solid organ or hematopoietic stem cell transplantation (HSCT). The incidence of Hodgkin's lymphoma (HL) ranges from 0.5-1.0% of PTLD after HSCT without T-cell depletion. Here, we report a case of HL-PTLD that occurred after autologous peripheral blood stem cell transplantation for an angioimmunoblastic T-cell lymphoma (AITL). A 36-year-old patient developed fever and chills with multiple lymphadenopathies at day 673 after auto-HSCT for AITL. Three months after the transplant, the patient developed fever with elevated plasma Epstein-Barr virus (EBV)-PCR values. The excisional biopsy revealed HL at Ann Arbor stage IIIB. A total of 8 cycles of chemotherapy with ABVD please define were performed, and the patient has remained disease-free. To our knowledge, this is first case report of HL-PTLD after auto-PBSCT in Korea.
Adult ; Biopsy ; Chills ; Drug Therapy ; Fever ; Hematopoietic Stem Cell Transplantation* ; Herpesvirus 4, Human ; Hodgkin Disease* ; Humans ; Incidence ; Korea ; Lymphoma, T-Cell* ; Lymphoproliferative Disorders ; Peripheral Blood Stem Cell Transplantation ; Plasma ; T-Lymphocytes

OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy of continuous low-dose temozolomide (TMZ) chemotherapy for recurrent and TMZ-refractory glioblastoma multiforme (GBM) and to study the relationship between its efficacy and microvessel density within the tumor. METHODS: Thirty patients who had recurrent GBM following Stupp's regimen received TMZ daily at 50 mg/m2/day until tumor progression between 2007 and 2013. The median duration of continuous low-dose TMZ administration was 8 weeks (range, 2-64). RESULTS: The median progression-free survival (PFS) of continuous low-dose TMZ therapy was 2 months (range, 0.5-16). At 6 months, PFS was 20%. The median overall survival (OS) from the start of this therapy to death was 6 months (95% CI : 5.1-6.9). Microvessel density of recurrent tumor tissues obtained by reoperation of 17 patients was 22.7+/-24.1/mm2 (mean+/-standard deviation), and this was lower than that of the initial tumor (61.4+/-32.7/mm2) (p-value=0.001). It suggests that standard TMZ-chemoradiotherapy reduces the microvessel density within GBM and that recurrences develop in tumor cells with low metabolic burden. The efficacy of continuous low-dose TMZ could not be expected in recurrent GBM cells in poor angiogenic environments. CONCLUSION: The efficacy of continuous low-dose TMZ chemotherapy is marginal. This study suggests the need to develop further treatment strategies for recurrent and TMZ-refractory GBM.
Disease-Free Survival ; Drug Therapy* ; Glioblastoma* ; Humans ; Microvessels* ; Recurrence ; Reoperation

No abstract available.

OBJECTIVE: This prospective study evaluated the ability of indirect 16-row multidetector CT venography, in comparison with Doppler sonography, to detect deep vein thrombosis after total hip or knee replacement. MATERIALS AND METHODS: Sixty-two patients had undergone orthopedic replacement surgery on a total of 30 hip joints and 54 knee joints. The CT venography (scan delay time: 180 seconds; slice thickness/increment: 2/1.5 mm) and Doppler sonography were performed 8 to 40 days after surgery. We measured the z-axis length of the beam hardening artifact that degraded the image quality so that the presence of deep vein thrombosis couldn't be evaluated on the axial CT images. The incidence and location of deep vein thrombosis was analyzed. The diagnostic performance of the CT venograms was evaluated and compared with that of Doppler sonography as a standard of reference. RESULTS: The z-axis length (mean +/- standard deviation) of the beam hardening artifact was 4.5 +/- 0.8 cm in the arthroplastic knees and 3.9 +/- 2.9 cm in the arthroplastic hips. Deep vein thrombosis (DVT) was found in the popliteal or calf veins on Doppler sonography in 30 (48%) of the 62 patients. The CT venography has a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 90%, 97%, 96%, 91% and 94%, respectively. CONCLUSION: The ability of CT venography to detect DVT was comparable to that of Doppler sonography despite of beam hardening artifact. Therefore, CT venography is feasible to use as an alternative modality for evaluating post-arthroplasty patients.
Adult ; Aged ; Aged, 80 and over ; *Arthroplasty, Replacement, Hip ; *Arthroplasty, Replacement, Knee ; Artifacts ; Female ; Humans ; Leg/*blood supply ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Venous Thrombosis/etiology/*radiography/*ultrasonography

We report a case of 15-year-old man with beneficial effects of short term growth hormone treatment presenting with cardiomyopathy combined with neuromuscular dystrophy. Transthoracic echocardiography revealed that LV chamber was markedly dilated and global LV systolic function was severely reduced. The findings of electromyography were compatible with neuromuscular dystrophy. Under the impression of cardiomyopathy combined with neuromuscular disease, maximal medical treatments such as inotropic agents, diuretics and ACE inhibitor were tried but we could not attain remarkable clinical improvement. Finally, we started growth hormone injection and after treatment for 3 months, we could attain remarkable clinical and hemodynamic improvement without any side effect.
Adolescent ; Cardiomyopathies* ; Diuretics ; Echocardiography ; Electromyography ; Growth Hormone* ; Heart Failure* ; Heart* ; Hemodynamics ; Humans ; Neuromuscular Diseases

BACKGROUND: Family environment has an important effect on the development of children. During childhood and adolescence, depression and anxiety are common forms of psychopathology. Therefore, the relationship between family function and depression anxiety in children was investigated in this study. This research was intended to aid management of children in the field of primary care. METHODS: This study was based on the survey administered to 193, 4th grade students of two elementary schools in the area of Sung-buk in Seoul, Korea, in May, 2003. We investigated family function, depression and anxiety by self-rating using the Smilkstein's Family APGAR, the Kovacs's CDI and the Reynolds's RCMAS. At the same time, home environment characteristics (Family Structure, Parental Religion, Parental Education and Monthly Household Income) were investigated. RESULTS: There were no significant differences in home environment characteristics between Family APGAR groups (P>0.05). CDI scores were significantly higher for children whose parents had education levels of middle school or lower (P<0.05). However, there was no significant difference in RCMAS scores between home environment characteristics (P>0.05). CDI score was significantly different between Family APGAR groups (P <0.05). And, RCMAS scores was significantly higher in poor family function groups than good family function groups according to Family APGAR groups (P<0.01). Both CDI and RCMAS scores was negatively correlated with Family APGAR scores (r=-0.376, P<0.01) (r=-0.266, P<0.01) and CDI score was positively correlated with RCMAS scores (r=0.711, P<0.01). CONCLUSION: In groups where the Family APGAR score was lower, both CDI and RCMAS scores were significantly lower. Accordingly, when caring for children, family physicians should heed to their family function and know that it has an effect on children's emotions.
Adolescent ; Anxiety* ; Apgar Score ; Child* ; Depression* ; Education ; Family Characteristics ; Humans ; Korea ; Parents ; Physicians, Family ; Primary Health Care ; Psychopathology ; Seoul

PURPOSE: Replication error is an important mechanism in carcinogenesis. The microsatellite instability (MSI-H) of colorectal cancers is associated with the development of multiple cancers. The influence of MSI-H on the development of multiple gastric cancers in sporadic gastric cancer patients has not been defined. This study was performed to reveal the association between the clinicopathologic features and MSI in sporadic gastric cancers. MATERIALS AND METHODS: Between July 2004 and March 2009, the clinicopathologic characteristics, including MSI status, were evaluated in 128 consecutive patients with sporadic gastric cancers. None of the patients had hereditary non-polyposis colorectal cancer of familial gastric cancer. The markers that were recommended by the NCI to determine the MSI status for colorectal cancers were used. RESULTS: MSI-H cancers were found in 10.9% of the patients (14/128). Synchronous gastric cancers were shown in 4 patients (3.1%). Synchronous cancers were found in 2 of 14 patients with MSI-H gastric cancer (14.3%) and 2 of 114 patients with MSS gastric cancer (1.8%; P=0.059, Fisher's exact test). Among the patients with synchronous cancer 50% (2/4) had MSI-H cancer, but 9.7% of the patients (12/124) without synchronous cancer had MSI-H cancer. MSI-H (RR, 24.7; 95% CI, 1.5~398.9; P=0.024) was related with to synchronous gastric cancer, but age, gender, family history, histologic type, location, gross morphology, size, and stage were not related to synchronous gastric cancer. CONCLUSIONS: MSI is associated with the intestinal-type gastric cancer and the presence of multiple gastric cancers in patients with sporadic gastric cancer. Special attention to the presence of synchronous and the development of metachronous multiple cancer in patients with MSI-H gastric cancer is needed.
Colorectal Neoplasms ; Humans ; Microsatellite Instability ; Microsatellite Repeats ; Stomach Neoplasms ; Succinimides