Choriocarcinoma associated with a normal pregnancy is rare. Futhermore, choriocarcinoma coexistent with a viable pregnancy is even rarer and associated with a greater risk of hepatic and cerebral involvement. So timely diagnosis of the disease is important for successful treatment and aggressive diagnostic procedures may therefore warranted. The patient should be treated with primary intensive combination chemotherapy(EMA-CO) and the selective use of irradiation and surgical therapy. We experienced a case of metastatic choriocarcinoma of lung and kidney following preterm delivery at 34th week of pregnancy and so present it with brief review of literature.
Choriocarcinoma* ; Diagnosis ; Female ; Humans ; Kidney ; Lung ; Pregnancy ; Pregnancy*

PURPOSE: Loneliness may be a typical psychological consideration in chronically ill patients, linking with low life satisfaction. We aimed to determine if loneliness would be independently associated with life satisfaction in pneumoconiosis patients hospitalized in long-term care facilities. METHODS: We recruited 164 patients from 3 pneumoconiosis-specialized hospitals in M and S cities, South Korea, and measured loneliness and life satisfaction by using the University of California Los Angeles loneliness and life satisfaction index-Z scales. The Multiple regression analysis was performed to examine an independent association between loneliness and life satisfaction after adjustment for age, the levels of dyspnea and bronchitisemphysema symptom, length of institutionalization, marital status, previous coal work experience, perceived socioeconomic status, and presence of caregivers. RESULTS: The mean of loneliness was 46.4. We found a significant association between loneliness and life satisfaction (standardized beta=-0.16, p=0.049), independent of all the covariates. Conclusions: Loneliness was an independent associate of life satisfaction in patients with pneumoconiosis who were institutionalized in long-term care facilities. Thus, a nursing intervention strategy for relieving loneliness is needed to increase life satisfaction in these patients.
California ; Caregivers ; Chronic Disease ; Coal ; Dyspnea ; Humans ; Institutionalization ; Loneliness ; Long-Term Care ; Los Angeles ; Marital Status ; Pneumoconiosis ; Republic of Korea ; Social Class ; Weights and Measures

Familial adenomatous polyposis(FAP) is an inherited autosomal dominant disorder characterized by the appearance in early life of numerous adenomas of colon and rectum. According to the recent studies, familial polypolis is a disease which produces polypoid lesions not only in the large intestine but also in the stomach duodenum, ileum and jejunum. The natural course of extracolonic lesions is variable, but the colonic polyps are associated with high incidence of cancer. The risk of malignant change is virtually 100% if untreated. The authors report a case of FAP in a 36-year-old-female who presented colorectal polyposis with multiple adenomas of the gallbladder. A review of literature with emphasis on the association of adenoma of the gallbladder was made.
Adenoma ; Adenomatous Polyposis Coli* ; Colon ; Colonic Polyps ; Duodenum ; Gallbladder* ; Ileum ; Incidence ; Intestine, Large ; Jejunum ; Polyps* ; Rectum ; Stomach

This study was undertaken for the clinical analysis and evaluation on 121 patients with incompetent internal os of the cervix, who were admitted and treated with McDonald operation or Shirodkar operation at the Soonchounhyang Medical Center from January 1991 to December 1995. The results of this study were as follows : 1. The incidence of this IIOC was 1.1% of 11,116 cases of total delivery. 2. The mean age of IIOC was 31.7 years old. 3. The average number of gravida was 3.2. 4. The most common contributary factor was previous history of artificial abortion (51.2 %), and midtrimester abortion (17.4 %), cervical laceration due to previous vaginal delivery (8.3 %) etc. was followed. 5. The success rate of operation was 76 %, and the highest success rate (85.7 %) was reveald with period from 15th weeks to 16th weeks of gestation. 6. When cervical dilatation was abscent or small, the success rate of operation was high. 7. The factors of failed operation were preterm labor (58.7 %), PROM (34.5 %), and PIH, bleeding. 8. The delivery method after operation was vaginal delivery in 83 cases (68.6%) and cesarean section in 38 cases (31.4 %).
Cervix Uteri* ; Cesarean Section ; Female ; Hemorrhage ; Humans ; Incidence ; Labor Stage, First ; Lacerations ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second

PURPOSE: This retrospective study was performed to identify the clinical characteristics of influenza B infection and compare to influenza A infection. METHODS: Medical records of patients diagnosed with influenza using a multiplex PCR test, admitted to Seoul St. Mary's Hospital, during the 2011-2012 influenza season were analyzed. Clinical and laboratory characteristics of influenza B patients were investigated and compared with those of influenza A patients. RESULTS: A total of 145 influenza patients were enrolled during this study period. Among these, 66 and 78 patients were diagnosed with influenza A and B, respectively, and 1 patient was diagnosed with co-existing influenza A and B. Cough (88.2%), rhinorrhea (77.1%) and sputum (60.4%) were the most common symptoms among these influenza patients, and most were diagnosed with upper respiratory infection (31.9%) or lower respiratory infection (49.3%). In comparison to influenza A patients, influenza B patients were older (4.7+/-4.1 years vs. 3.3+/-2.5 years, P=0.016), and the number of fever days before hospitalization were longer (3.0 days vs. 2.5 days, P=0.043). While sore throat (10.3% vs. 1.5%, P=0.039) and vomiting (20.5% vs. 6.1%, P=0.012) were more common in influenza B patients than in influenza A patients, other clinical and laboratory characteristics were not significantly different between the two groups. CONCLUSIONS: No significant differences in clinical and laboratory perspectives were manifested in influenza A and B infections. Preventive measures should be emphasized over treatment in influenza B due to prolonged fever duration before admission.
Child ; Cough ; Fever ; Hospitalization ; Humans ; Influenza B virus ; Influenza, Human ; Medical Records ; Multiplex Polymerase Chain Reaction ; Pharyngitis ; Retrospective Studies ; Seasons ; Sputum ; Vomiting

PURPOSE: Oncogen or growth factor receptor such as phospholipase C isoenzyme gamma-1 (PLC gamma-1), epidermal growth factor receptor (EGFR), and Her-2/neu which related with tyrosin kinasemay and then regulating vell proliferation may have a role as prognostic factors for breast cancer. MATERIAL AND METHODS: With assumption that expression of PLC gamma-1, EGFR and Her-2/neu oncogene has close relationship with prognosis of breast cancer, 59 breast cancer patients who were operated upon at Korea University Hospital during a period of 6 years starting June 1988 to May 1994 were selected for this study. This study was carried out by comparing between expression of PLC gamma-1, EGFR and Her-2/neu oncogene and patient's survival rate. These expression were also compared with TNM system, estrogen and progesterone receptor and at same time these expressions were compared with each other to see whether there are any relationship among these expression. RESULTS: Expression of PLC gamma-1, EGFR and Her-2/neu were present in 42% (25/59), 46% (27/59) and 20% (12/59). The expression of PLC gamma-1 was closely related with the expression of EGFR (p<0.05) and Her-2/neu (p<0.05), but there were no relationship between the expression of PLC gamma-1 and hormonal receptors and TNM stage (p>0.05). The expression of EGFR was closely related with the expression of Her-2/neu (p<0.05) and hormone receptors (p<0.05), but there were no relationship between the expression of EGFR and pathologic TNM stage (p>0.05). The expression of Her-2/neu was not closely related with hormone receptors and TNM stage except axillary lymph node metastasis. There were close relationship between overall and disease free survival and PLC gamma-1 and Her-2/neu. But EGFR had only related with disease free survival rate. CONCLUSION: In conclusion, the expression of PLC gamma-1, EGFR and Her-2/neu oncogene in human breast cancer may be useful prognostic factors independently and it may potentiated its individual value as a prognostic factors if use them together.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Epidermal Growth Factor* ; Estrogens ; Humans* ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Phospholipases* ; Prognosis ; Receptor, Epidermal Growth Factor* ; Receptors, Progesterone ; Survival Rate ; Type C Phospholipases*

Primary malignant melanoma arising from the leptomeninges is a rare entity. We report two cases of primary intracranial melanoma developed in one aged 65 years female and the other 70 years male. One case died 2 years after the operation, and the other case is still living more than 1 year after operation. Both cases seems to have a relatively long survival. The literature on this subject is briefly reviewed.
Female ; Humans ; Male ; Melanoma*

The purpose of this study was to assess the feasibility and efficacy of stereotactic ablative radiotherapy (SABR) for liver tumor in patients with Barcelona Clinic Liver Cancer (BCLC)-C stage hepatocellular carcinoma (HCC). We retrospectively reviewed the medical records of 35 patients between 2003 and 2011. Vascular invasion was diagnosed in 32 patients, extrahepatic metastases in 11 and both in 8. Thirty-two patients were categorized under Child-Pugh (CP) class A and 3 patients with CP class B. The median SABR dose was 45 Gy (range, 30-60 Gy) in 3-5 fractions. The median survival time was 14 months. The 1- and 3-yr overall survival (OS) rate was 52% and 21%, respectively. On univariate analysis, CP class A and biologically equivalent dose > or = 80 Gy10 were significant determinants of better OS. Severe toxicity above grade 3, requiring prompt therapeutic intervention, was observed in 5 patients. In conclusion, SABR for BCLC-C stage HCC showed 1-yr OS rate of 52% but treatment related toxicity was moderate. We suggest that patients with CP class A are the best candidate and at least SABR dose of 80 Gy10 is required for BCLC-C stage.
Adult ; Aged ; Carcinoma, Hepatocellular/mortality/*radiotherapy ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Liver Failure/etiology ; Liver Neoplasms/mortality/*radiotherapy ; Male ; Middle Aged ; Myelitis/etiology ; Neoplasm Staging ; Prognosis ; Radiation Dosage ; Retrospective Studies ; Severity of Illness Index ; Stereotaxic Techniques ; Survival Rate

OBJECTIVE: Human papillomavirus(HPV) is an important pathogenetic agent in the uterine cervical carcinoma. It has been known that E6 and E7 proteins of high risk HPV viruses abolish the action of tumor suppressor genes, Rb and p53, resulting in cellular proliferation. This study was designed to determine the incidence of Ki-ras and p53 mutations in uterine cervical carcinomas and evaluate the results of mutations according to the status of HPV infection. METHODS: Paraffin-embedded tissue samples obtained from 42 CIN III and 70 invasive carcinomas of the uterine cervix(56 squamous, 7 adenosquamous and 7 adenocarcinomas). Ki-ras codon 12 mutation was analysed by PCR-RFLP method and p53 exons 5, 6, 7 and 8 mutations by PCR-SSCP. The presence of HPV was detected by PCR using consensus primers for high risk viruses(HPV 16, 18, 31, 33, 35, 52b, and 58) and low risk viruses(HPV 6 and 11). RESULTS: HPV viruses were detected in 83.3% of CIN III and 90% of invasive carcinomas; 71.4% of adenocarcinomas, 91.7% of squamous cell carcinomas and 100% of adenosquamous carcinomas. Ki-ras codon 12 mutation was detected in 4.7% of CIN III and 11.4% of invasive carcinomas, and p53 mutations in 4.8% of CIN III and 7.1% of invasive carcinomas. There was no significant difference of Ki-ras mutation between HPV-positive group(9.2%) and HPV-negative group(7.1%). However, p53 mutation was more frequent in HPV-negative group(28.6%) than HPV-positive group(3.1%). (p=0.0002) CONCLUSIONS: HPV is an agent which is detected in high frequency of uterine cervical carcinomas and p53 mutation may have a role in the HPV-negative uterine cervical carcinomas. However, the relationship between Ki-ras gene and HPV in uterine cervical carcinogenesis remains to be defined.
Adenocarcinoma ; Carcinogenesis ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Cell Proliferation ; Codon ; Consensus ; Exons ; Genes, ras ; Genes, Tumor Suppressor ; Humans ; Incidence ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

This paper concerns professional socialization of medical students. Professional socialization, in the context of this paper, means the process through which a layperson becomes a doctor equipped with professional identity and values. While medical education does not include such process in the curriculum, medical students obtain certain values and identity informally. The dependent variables were professional values and professionalism. The former means the desirable attributes required to conducting professional works such as humane attitudes, science-oriented mind, capability for organizational management. The latter means socio-political reasoning with which doctors can rationalize their privileges such as autonomy. A specially designed questionnaire was developed. The data were collected from five medical schools for 1,318 students in 1994. A total of 1,070 cases were finally included in the statistical analysis. The students emphasized the human factor in the professional values. Their attitude did not change with the grade. Other independent variables such as motives for entering a medical school, socioeconomic status, satisfaction with medical education, etc. also did not influence professional values. It implies that professional values were not consolidated among the students. However, the factors of professionalism change significantly with the grade. It implies that the students paid more attention to socio-political issues related to doctor`s interests as the grade went up. And the factor scores for professionalism were higher for those students who had more positive attitude towards doing medical practice for profit, expected higher income, and were more conservative about social reform. Other independent variables did not influence professionalism. It seems that the students also give emphasis on professionalism, like current medical doctors, mainly because of their concern with recent unfavorable changes in economic conditions of medical care providers.
Curriculum ; Education, Medical ; Humans ; Surveys and Questionnaires ; Schools, Medical ; Social Class ; Socialization* ; Students, Medical*