The authors performed reconstructive surgery for three cases of extensive upper and lower lid defects using modified Hughes procedure during the past one year. Two cases were upper lid reconstruction for the recurrent sebaceous carcinoma and the upper lid coloboma due to thermal bum. The other one was the adenoid cystic carcinoma of the lower lid. The first stage of this procedure was performed by tarsoconjunctival flap. The second procedure was performed after 6 weeks. This lid sharing technique was excellent for both cosmesis and lid function. All of the three patients have been very happy without any complications such as malposition of the lid margin, lid retraction or blepharoptosis.
Blepharoptosis ; Carcinoma, Adenoid Cystic ; Coloboma ; Humans

The purpose of this study was to describe the differences in three phenomenological research methods used to understand the experience of families of patients with cancer and so provide as guideline to novices first attempting qualitative research. The subjects were 3 family members - spouse, daughter, daughter-in-law -of cancer patients at S-hospital. Unstructured deep interviews were carried out and taped for further analyzed. Interviews were analyzed using three phenomenological methods ; Giorgi's, Colazzi's, and Van Kaam's. The results are as follows: The experience of family the analyzed using Giorgi's method showed different characteristics according to the family members' role. According to Colaizzi's method, they experienced burden, a willingness to care, role conflict, thanks to family and significant others, and ambivalence about treatment. Using Van Kaam's methodology, two categories were identified ; change of family function and burden. Themes in change of family function were positive attitude(9), role conflict(6), negative attitude(5), active attitude(2), and passive attitude(2) ; Themes in burden were emotional burden, physical burden, and economic burden. The result from using Giorgi's method were centered or individual characteristics and these results constituteds situational structured description and a general structured description. From Colaizzi's method the focus was on the common experience of all fo the subjects. In Van Kaam's method, subthemes (13), themes(8), and categories(2) were identified. So researchers should choose the qualitative method according to their research goals and methodological characteristics.
Humans ; Nuclear Family ; Qualitative Research ; Research Design* ; Spouses

BACKGROUND: Tissue factor (TF) is a main physiological initiator of blood coagulation and may be important in the biology of a variety of solid malignancies, particularly where angiogenesis is a critical factor. In liver cirrhosis, hyperfibrinolysis is frequently observed in patients with the decompensated state and which may be secondary to the increased production of thrombin. Many studies have shown that the expression of TF in tumors contributes not only to tumor-derived procoagulant activity but also to hematogenous metastasis and tumor angiogenesis. The aim of this study was to evaluate how plasma TF concentration was correlated with the severity of liver cirrhosis and the progression of hepatocellular carcinoma. METHODS: This study consisted of 23 patients with liver cirrhosis (LC) and 37 patients with hepatocellular carcinoma (HCC). HCC patients was graded by TNM staging system of The Union Internationale Contre le Cancer (UICC). Plasma TF concentration was measured by the enzyme linked immunosorbent assay (ELISA). The severity of the liver disease was estimated by Child-Pugh classification. The correlation of TF concentration in patients with LC and HCC in diffenrent classifications was evaluated. RESULTS: There was no difference between LC and HCC in the plasma TF concentration (p=0.236). The TF concentration was different according to Child-Pugh score (p=0.024) and proportion to Child-Pugh score in class B and C (p<0.05). The TF concentration of HCC patients was not different between the classes of severity of underlying LC and the TF concentration of stage IVA was higher than that of stage I, II, III in HCC patients (p=0.039). CONCLUSION: The plasma concentration of TF was correlated with the degree of severity of liver disease in cirrhotic patients and increased in the advanced stages of HCC.
Biology ; Blood Coagulation ; Carcinoma, Hepatocellular* ; Classification ; Enzyme-Linked Immunosorbent Assay ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Neoplasm Metastasis ; Neoplasm Staging ; Plasma* ; Thrombin ; Thromboplastin*

BACKGROUND: Carcinoma of the ampulla of Vater is rare and its pathogenesis is unclear. The role of epigenetic changes in the APC or CDH1, in the Wnt pathway, has not been reported in ampullary carcinomas. METHODS: We performed immunohistochemistry on 73 sporadic ampullary carcinomas to identify Wnt-related molecules (APC, beta-catenin, E-cadherin, c-erbB2, cyclin D1) and examined mutations in the CTNNB1, loss of heterozygosity of 5q21, and the methylation status of the CpG island of APC and CDH1. RESULTS: Thirteen tumors (17.8%) showed abnormal nuclear localization of beta-catenin; this was more prominent in the intestinal type than in the pancreaticobiliary type (p=0.01). The loss of APC correlated with the loss of beta-catenin or c-erb B2 (p<0.01). The prognosis was worse in the group with APC loss than when APC was maintained (p<0.05). There was no mutation identified in CTNNB1. Six (24%) out of 25 informative cases had 5q21 allelic loss. CpG island methylation in APC and CDH1 was detected in 33 (45.2%) and 29 (31.5%) cases, respectively. CONCLUSIONS: The absence of mutations in CTNNB1 and the epigenetic alteration of APC and CDH1, might be characteristic changes in the Wnt/beta-catenin signaling pathway during the carcinogenesis of ampullary carcinomas.
Ampulla of Vater* ; beta Catenin ; Cadherins ; Carcinogenesis ; CpG Islands ; Cyclins ; Epigenomics* ; Immunohistochemistry ; Loss of Heterozygosity ; Methylation ; Prognosis ; Wnt Signaling Pathway