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

PURPOSE: To analyze localized RNFL defect cases that were identified in retinal nerve fiber layer (RNFL) fundus photographs but not in optical coherence tomography (OCT). METHODS: Analysis of OCT scans and images was performed for 14 eyes (17 locations) that showed localized RNFL defects in RNFL fundus photographs but not in RNFL thickness average analysis. RESULTS: With respect to the range of RNFL defects, 41.2% were less than 10degrees, 47.0% were 11 to 20degrees, and 11.8% were 21 to 30degrees. In 71.4% of the RNFL cases the defects were less than 10degrees and the decrease of RNFL thickness was not readily observable on the OCT scan images. In all cases of RNFL defects in the 11 to 30degrees range the decrease in RNFL thickness could be assessed on the OCT scan images. Nonetheless, the decrease of RNFL thickness could not be seen on the OCT analysis images in which the results of the RNFL thickness made through an automated computer algorithm were displayed. CONCLUSIONS: The range of localized RNFL defects that were difficult to detect with OCT consisted of those cases that were almost less than 20degrees. The limitations of the OCT scan itself in patients with RNFL with an angular width defect less than 10degrees and the problems of RNFL thickness analysis processing in patients with an angular width of 11 to 30degrees may decrease the sensitivity of OCT in diagnosing RNFL defects.
Eye ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence

No abstract available.

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

OBJECTIVE: To study the clinical characteristics of pregnancy induced hypertension(PIH). METHODS: Five hundred seventy-five cases of PIH and 7,702 cases of normotensive pregnancies who were delivered their infants at Wonkwang University Hospital from January, 1994 to December, 1998 were selected for the study. The data were collected by review of the hospital record and the statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence of PIH was 7.1% of total deliveries. Among the PIH, the incidence of mild preedampsia was found in 59%, severe preeclampsia in 36%, and edampsia in 5%. The most prevalent gestational period was 38-42wks gestation in mild PIH and 33-37wks gestation in severe PIH & eclampsia. The incidence of cesarean section was significantly higher in severe PIH & eclampsia(72.2%) than in mild PIH(48.7%) and normotensive pregnancies(39.7%). The incidence of hypoalbuminemia, preterm labor, placental abruption, disseminated intravascular coagulation, and pulmonary edema were significantly higher in severe PIH & edampsia than in mild PIH and normotensive pregnancies. Compared with normotensive pregnancies or mild PIH, severe PIH & eclampsia had significantly elevated risks for low birth weight, intrauterine growth retardation, fetal distress, low apgar score, meconium stained, and neonatal deaths. CONCLUSION: The incidence of PIH is not decreasing and it still an important role in the cause of maternal and perinatal mortality and morbidity in Korea. So, further studies are necessary to prepare a guide for the treatment of PIH.
Abruptio Placentae ; Apgar Score ; Cesarean Section ; Disseminated Intravascular Coagulation ; Eclampsia ; Female ; Fetal Distress ; Fetal Growth Retardation ; Hospital Records ; Humans ; Hypertension, Pregnancy-Induced* ; Hypoalbuminemia ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Meconium ; Obstetric Labor, Premature ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy* ; Pulmonary Edema

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