BACKGROUND: Analysis of mutations in the epidermal growth factor receptor gene (EGFR) is important for predicting response to EGFR tyrosine kinase inhibitors. The overall rate of EGFR mutations in Korean patients is variable. To obtain comprehensive data on the status of EGFR mutations in Korean patients with lung cancer, the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists initiated a nationwide survey. METHODS: We obtained 1,753 reports on EGFR mutations in patients with lung cancer from 15 hospitals between January and December 2009. We compared EGFR mutations with patient age, sex, history of smoking, histologic diagnosis, specimen type, procurement site, tumor cell dissection, and laboratory status. RESULTS: The overall EGFR mutation rate was 34.3% in patients with non-small cell lung cancer (NSCLC) and 43.3% in patients with adenocarcinoma. EGFR mutation rate was significantly higher in women, never smokers, patients with adenocarcinoma, and patients who had undergone excisional biopsy. EGFR mutation rates did not differ with respect to patient age or procurement site among patients with NSCLC. CONCLUSIONS: EGFR mutation rates and statuses were similar to those in published data from other East Asian countries.
Adenocarcinoma ; Asian Continental Ancestry Group ; Biopsy ; Carcinoma, Non-Small-Cell Lung* ; Diagnosis ; Epidermal Growth Factor* ; Female ; Humans ; Lung Neoplasms ; Mutation Rate ; Pathology ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor* ; Smoke ; Smoking

BACKGROUND/AIMS: Anxiety and depression are associated with reflux symptoms in patients with gastroesophageal reflux disease (GERD). The purpose of this study is to investigate whether the anxiety and depression in patients with GERD will improve with anti-secretory treatment. MATERIALS AND METHODS: Participants who had taken upper endoscopic evaluation and who had symptoms of heartburn or acid regurgitation more than once a week were included through questionnaires. The hospital anxiety and depression scale was used to compare the scores before and after anti-secretory drug (proton pump inhibitor [PPI] or histamine-2 receptor blocker [H2 blocker]) treatment for four weeks. RESULTS: Eighty-four out of a total 94 patients were randomly assigned to a four week treatment, in which, 46 and 38 patients were each assigned to PPI and H2 blocker, respectively. Regardless of the type of treatment, anxiety scores decreased significantly from 5.8+/-3.8 to 5.2+/-3.9 after treatment (P=0.033). Depression scores of 6.3+/-3.4 before treatment reduced to 5.5+/-3.4 after treatment (P=0.011). Anxiety scores and depression scores decreased significantly after treatment in the H2 blocker group. In the response group, anxiety and depression showed significant improvement (P=0.008, P=0.011). CONCLUSIONS: Regardless of the type of drugs, anti-secretory therapy is helpful in treating symptomatic GERD patients, not only in relieving symptoms, but also in relieving anxiety and depression accompanied with GERD.
Anxiety ; Depression ; Gastroesophageal Reflux ; Heartburn ; Histamine H2 Antagonists ; Humans ; Proton Pump Inhibitors ; Surveys and Questionnaires

BACKGROUND/AIMS: Anxiety and depression are associated with reflux symptoms in patients with gastroesophageal reflux disease (GERD). The purpose of this study is to investigate whether the anxiety and depression in patients with GERD will improve with anti-secretory treatment. MATERIALS AND METHODS: Participants who had taken upper endoscopic evaluation and who had symptoms of heartburn or acid regurgitation more than once a week were included through questionnaires. The hospital anxiety and depression scale was used to compare the scores before and after anti-secretory drug (proton pump inhibitor [PPI] or histamine-2 receptor blocker [H2 blocker]) treatment for four weeks. RESULTS: Eighty-four out of a total 94 patients were randomly assigned to a four week treatment, in which, 46 and 38 patients were each assigned to PPI and H2 blocker, respectively. Regardless of the type of treatment, anxiety scores decreased significantly from 5.8+/-3.8 to 5.2+/-3.9 after treatment (P=0.033). Depression scores of 6.3+/-3.4 before treatment reduced to 5.5+/-3.4 after treatment (P=0.011). Anxiety scores and depression scores decreased significantly after treatment in the H2 blocker group. In the response group, anxiety and depression showed significant improvement (P=0.008, P=0.011). CONCLUSIONS: Regardless of the type of drugs, anti-secretory therapy is helpful in treating symptomatic GERD patients, not only in relieving symptoms, but also in relieving anxiety and depression accompanied with GERD.
Anxiety ; Depression ; Gastroesophageal Reflux ; Heartburn ; Histamine H2 Antagonists ; Humans ; Proton Pump Inhibitors ; Surveys and Questionnaires

This study investigated the actual status of constipation. In total, 978 female students in Korea participated. We identified the relationship among constipation and life style, clothing patterns, housing patterns, dietary habits, and dietary intake in a constipation symptom group and a normal group. The actual constipation rate based on the Rome II criteria was 27.0% (n = 264). Body weight (p < 0.05) and body mass index (p < 0.05) in the constipation group were significantly higher than those in the normal group. The incidence of functional bowel disease and irritable bowel syndrome in the constipation group were significantly higher than those in the normal group. The discomfort of wearing underwear was significantly higher in the constipation group than that in the normal group. The constipation group revealed a significantly higher rate of irregular dietary habits than those in the normal group. The dietary diversity score of the normal group was 4.22 (p < 0.05), which was significantly higher than that of constipation group (4.12). No significant difference in life style factors was observed. It is necessary for university female students to correct their dietary habits, maintain food intake of three times per day, and select diverse foods. Furthermore, it is necessary for university female students to wear comfortable clothing to lessen symptoms and improve constipation rates.
Body Mass Index ; Body Weight ; Clothing ; Constipation ; Eating ; Female ; Food Habits ; Housing ; Humans ; Incidence ; Irritable Bowel Syndrome ; Korea ; Life Style ; Rome

PURPOSE: We purpose to determine the correlation of HER-2/neu and paxillin expression in ductal carcinoma in situ (DCIS), invasive ductal carcinoma with ductal carcinoma in situ (IDC with DCIS) and mucinous carcinoma. METHODS: To evaluate the expression of HER-2/neu and paxillin, the immunohistochemical staining was performed for 13 cases of DCIS, 13 cases of IDC with DCIS and 6 cases of mucinous carcinoma. RESULTS: The DCIS and IDC were associated with infiltration of the inflammatory cells, especially in the comedo type and solid type of tumor. In cases with infiltration of the inflammatory cells, HER-2/neu and paxillin were strongly expressed. When comparing the expression level of HER-2/neu from adjacent normal tissue between DCIS and IDC with DCIS, expression of HER-2/neu was similar to that of normal tissue adjacent to DCIS. However, in the adjoining normal ductal epithelial cells, paxillin was highly expressed in cells of all of the tumor types, and especially for IDC with DCIS. HER-2/neu and paxillin were not expressed in mucinous carcinoma cells in all cases. CONCLUSION: HER-2/neu in the DCIS and IDC with infiltration of inflammatory cells shows higher expression than non-inflammatory DCIS and IDC. If normal duct epithelial cells show a high level of HER-2/neu expression, the epithelial cells have a high probability of transformation into anaplastic cells. However, paxillin appears to have no value as a prognostic factor. The difference of expression of HER-2/neu between IDC with DCIS and DCIS suggests a different origin of tumor cells. The growth pattern of mucinous carcinoma cell is different from the that of DCIS or IDC cell, which grow slowly.
Adenocarcinoma, Mucinous ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Epithelial Cells ; Mucins ; Paxillin

OBJECTIVE: To assess the impacts of stroke on sexual activities and functioning of patients with stroke and to study the associations of clinical and psychosocial factors with sexual changes following stroke. METHOD: Ninety-seven patients with stroke were interviewed and completed questionnaire concerning their prestroke and poststroke coital frequency, sexual satisfaction, and sexual functions such as erection, ejaculation, and vaginal lubrication. RESULTS: Sexual activities such as coital frequency and sexual satisfaction were decreased in patients after stroke. Sexual dysfunctions including impotence (68%), a decline in ejaculation (66.7%), and a decline in vaginal lubrication (89.5%) were high. Subjective reasons for decreased sexual life after stroke were denial of spouse, impotence, decreased libido, no opportunity of sexual activity due to hospitalization or no sexual partner, fear of relapse, physical discomfort due to hemiparesis and so on. Comparing sexual group with no sexual group after stroke, there were different in age (p=0.040), brain lesion site (p=0.036), prestroke coital frequency (p=0.048), erectile ability (p=0.005), and ejaculation (p<0.001). CONCLUSION: The decline in sexual activities and functioning was due to interpersonal, physical, psychological factors among patients following stroke.
Brain ; Coitus ; Denial (Psychology) ; Ejaculation ; Erectile Dysfunction ; Hospitalization ; Humans ; Libido ; Lubrication ; Male ; Paresis ; Psychology ; Surveys and Questionnaires ; Recurrence ; Sexual Behavior ; Sexual Partners ; Spouses ; Stroke

BACKGROUND: Chronic discogenic pain is commonly intractable to various conservative treatments and anatomic correction through operation. Nowadays, a radiofrequency thermocoagualation technique applying the pathophysiologic mechanism that cause discogenic pain and the pathways of transmission of discogenic pain have been successfully tried. This study was performed to evaluate the efficacy of radiofrequecy thermocoagulation of the ramus communicans nerve in patients who suffered from intractable discogenic pain even after intradiscal electrothermal therapy. METHODS: The authors evaluated 13 cases in which radiofrequency thermocoagulation of the ramus communicans nerve was used for patients suffering from chronic discogenic pain even after intradiscal electrothermotherapy. Ten weeks after the procedure, we compared VAS scores of the pre- procedure and post-procedure state. RESULTS: Fifty-four percent of patients had an excellent decrease in the VAS score (VAS < 3). One patient complained of a mild motor weakness of the lower extremity but recovered completely by postoperative day 26. CONCLUSIONS: In the cases of intractable chronic discogenic pain, it is valuable to perform a rhizotomy of the ramus communicans nerve with radiofrequency.
Electrocoagulation ; Humans ; Lower Extremity ; Rhizotomy

BACKGROUND: Depression is common in chronic renal failure patients and usually associated with poor appetite. Malnutrition with poor appetite is known to be associated with increased mortality in chronic hemodialysis (HD) patients. So we evaluated the prevalence, risk factors of depression and effects of depression to nutritional status in chronic HD patients. METHODS: Sixty two HD patients (age 48.8+/-11.1 years, diabetes 29%) were investigated. Each patients were interviewed and completed the Beck depression inventory (BDI, 21 items, 0-3 point). To exclude the possible confounding effects of illness and treatment symptoms, cognitive depression index (CDI, a cognitive subset of 15 items selected from BDI) was used as a measure of depression. KT/V and nutritional parameters such as serum albumin, normalized protein catabolic rate (nPCR), subjective global assesment (SGA), body mass index (BMI), triceps skinfold thickness (TSF) and midarm muscle circumference (MAMC) were also measured. RESULTS: Corrected BDI score (CDI score multiplied by 21/15) was 24.9+/-12.7 and the prevalence of depression (corrected BDI score > or = 21) was 64.5%. DM patients had higher CDI score than non DM patient (22.9+/-7.2 vs 15.6+/-9.0). In univariate analysis, CDI score was correlated with age (r=0.39, p<0.01), serum albumin (r=-0.37, p<0.005), nPCR (r=-0.30, p<0.05), SGA (r=-0.42, p<0.05), BMI (r=-0.28, p<0.05), TSF (r=-0.41, p<0.05) and MAMC (r=-0.50, p<0.01). In multivariate analysis, CDI score was the strongest correlate of nPCR, SGA, BMI, TSF and MAMC. But KT/V, hematocrit, erythropoietin usage, plasma bicarbonate, serum parathyroid hormone, c-reactive protein concentration and HD duration had no relationship with CDI score. CONCLUSION: The prevalence of depression in chronic HD patients was high. Diabetes and old agewere important risk factors for depression. It was also concluded that severity of depression was correlated with markers of malnutrition and depression could be a independent risk factor of malnutrition in chronic HD patients.
Appetite ; Body Mass Index ; C-Reactive Protein ; Depression* ; Equidae ; Erythropoietin ; Hematocrit ; Humans ; Kidney Failure, Chronic ; Malnutrition ; Mortality ; Multivariate Analysis ; Neurobehavioral Manifestations ; Nutritional Status ; Parathyroid Hormone ; Plasma ; Prevalence ; Renal Dialysis* ; Risk Factors* ; Serum Albumin ; Skinfold Thickness

The nephrotic syndrome has been reported in association with a wide variety of neoplastic disease. The relationship between early gastric cancer and glomerulonephritis has not been well elucidated. Only 6 cases (5 cases in Korea and 1 case in Japan) have been reported associated with glomerulonephritis by this time. 5 cases in Korea included three cases of membranous glomerulonephritis, one case of IgA nephropathy and membranoproliferative glomerulonephritis. Four out of six cases including presented case were mucin secreting adenocarcinomas of stomach. Minimal change disease associated with solid tumors has been reported very rarely. Three cases of colon adenocarcinoma have been reported in association with minimal change disease by this time. Complete remission of nephrotic syndrome with tumor resection without corticosteroid therapy was reported in one of three cases, but two of them had to be on corticosteroid therapy in addition to tumor resection to get complete remissions. We report a 44-year-old man case with nephrotic syndrome associated with early gastric cancer. Renal biopsy findings were indicative of minimal change disease but with scanty IgA deposition. Low grade IgA nephropathy was suggested. Endoscopic biopsy on stomach demonstrated the adenocarcinoma with signet ring cells. Serum IgA concentration was 543 mg/dL, and decreased to 336 mg/dL after tumor resection. But, owing to persistent proteinuria and acute renal failure complicated, corticosteroid therapy was applied on the 30th day after operation. So we could not prove definite relationship between early gastric cancer and the development of IgA nephropathy mimicking minimal change disease. But, it is regarded that normalized serum IgAlevel and the complete remission of nephrotic syndrome with tumor resection and corticosteroid therapy can be indirect evidences for the relationship between early gastric cancer and the development of IgA nephropathy mimicking minimal change disease.
Acute Kidney Injury ; Adenocarcinoma ; Adult ; Biopsy ; Colon ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Humans ; Immunoglobulin A* ; Korea ; Mucins ; Nephrosis ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Proteinuria ; Stomach ; Stomach Neoplasms*

Paraquat, a very potent herbicide, has produced many fatalities through indiscriminate usage and suicides. It is known that with ingestion of more than one mouthful of 20% paraquat, death usually occurs by pulmonary fibrosis. We experienced two cases of successful outcome in patients with paraquat poisoning complicated with pulmonary fibrosis through active, intensive treatment from the early phase after ingestion. They swallowed one to two mouthfuls of the 20% commercial paraquat, and received hemoperfusion within 2-3 hours after ingestion. Then, combination therapy with steroid, vitamin C, D-penicillamine, allopurinol, colchicine was administered from the early phase. They showed moderate to severe hypoxemia and pulmonary fibrosis on chest HRCT during hospital course, but recovered from hypoxemia and remained very well on follow up over 3 months and 12 months after ingestion, respectively. We report these cases with literature review on treatment and prognosis of paraquat poisoning.
Allopurinol ; Anoxia ; Ascorbic Acid ; Colchicine ; Eating ; Follow-Up Studies ; Hemoperfusion ; Humans ; Mouth ; Paraquat* ; Penicillamine ; Poisoning* ; Prognosis ; Pulmonary Fibrosis* ; Suicide ; Thorax