The frequency and extent of the existence of a familial suicide prevention plan may differ across cultures. The aim of this work was, therefore, to determine how common it was for families to develop a suicide prevention plan and to compare the main measures used by families with and without such a plan, after an attempt to commit suicide was made by a member of a family living in a rural area of Korea. On the basis of the presence or absence of a familial suicide prevention plan, we compared 50 recruited families that were divided into 2 groups, with Group A (31 families) employing a familial suicide prevention plan after a suicide attempt by a family member, and Group B (19 families) not doing so. The strategy that was employed most frequently to prevent a reoccurrence among both populations was promoting communication among family members, followed by seeking psychological counseling and/or psychiatric treatment. Contrary to our expectation, the economic burden from medical treatment after a suicide attempt did not influence the establishment of a familial suicide prevention plan. It is a pressing social issue that 38% (19 of 50) of families in this study did not employ a familial suicide prevention plan, even after a family member had attempted suicide. Regional suicide prevention centers and/or health authorities should pay particular attention to these patients and their families.
Family ; Female ; Hospitalization/*economics ; Humans ; Male ; Middle Aged ; Patient Care Planning/*statistics & numerical data ; Republic of Korea ; Risk Factors ; Suicide, Attempted/*prevention & control ; Surveys and Questionnaires

PURPOSE: Angiogenesis is involved in the pathogenesis of chronic rhinosinusitis with nasal polyps. We aimed to investigate the effects of prostaglandin E2 (PGE2) on vascular endothelial growth factor (VEGF) production, the role of E-prostanoid (EP) 4 receptors, and the signal transduction pathway mediating VEGF production in nasal polyp-derived fibroblasts (NPDFs). METHODS: Eight primary NPDF cultures were established from nasal polyps, which were incubated with or without PGE2. Reverse transcription-polymerase chain reaction amplification of EP receptors (EP1, EP2, EP3, and EP4) and immunofluorescence staining for VEGF production were performed. VEGF production via the cyclic adenosine monophosphate (cAMP)-dependent protein kinase A (PKA) and phosphatidylinositol 3-kinase (PI3K) pathways was evaluated by enzyme-linked immunosorbent assay. RESULTS: All EP receptors were expressed in NPDFs. PGE2 significantly increased VEGF production concentration- and time dependently, and VEGF production was regulated by an EP4 receptor. Activation of intracellular cAMP regulated VEGF production. VEGF production was decreased by PKA and PI3K inhibitors via intracellular cAMP. CONCLUSIONS: PGE2 stimulates VEGF production via the EP4 receptor in NPDFs. These results indicate that PGE2-induced VEGF production is mediated, at least partially, through cAMP-dependent signaling pathways. Therapies targeting the EP4 receptor may be effective in inhibiting the development of nasal polyps.
Adenosine Monophosphate ; Cyclic AMP-Dependent Protein Kinases ; Dinoprostone ; Fibroblasts ; Fluorescent Antibody Technique ; Nasal Polyps ; Negotiating ; Phosphatidylinositol 3-Kinase ; Signal Transduction ; Vascular Endothelial Growth Factor A

PURPOSE: The clinicopathological significance of a colorectal mucinous carcinoma remains controversial. Previous reports have suggested that mucinous carcinomas affect young patients, are more advanced at diagnosis, and have a worse prognosis than non-mucinous carcinomas, but more recent reports have refuted those results. The principal aim of this study was to evaluate whether colorectal mucinous carcinomas are associated with a worse prognosis than colorectal non-mucinous carcinomas for patients who undergo curative surgery. METHODS: A total of 534 patients with colorectal carcinomas, including 42 cases of mucinous carcinomas, underwent surgery in the Department of Surgery of Gil Medical Center, Gachon Medical School, between March 1997 and February 2003. Of these, we retrospectively evaluated 33 patients with mucinous carcinomas and 407 patients with non-mucinous carcinomas who had undergone a curative resection. The age and the sex distributions, the primary location of the tumor, the stage at diagnosis, the curability, and the 3-year survival of mucinous- carcinoma patients were compared with those of non- mucinous-carcinoma patients. Thirteen patients were lost to follow-up, so we evaluated 427 patients for the overall survival rate by using the Kaplan-Meier method and the long-rank test for quality of curves. RESULTS: The proportion of mucinous carcinomas was 7.8% (42/534). There were no significant differences in sex and curability, but the mucinous-carcinoma patients were found to be younger (P=0.014), to have a Right-side dominancy (P=0.038), and to have a more advanced stage at diagnosis (P=0.004). The 3-year survival rates in stage-B patients with mucinous carcinomas and non-mucinous carcinomas were 92.3% and 80.9%, respectively (P>0.05); in stage C, they were 62.2% and 73.8%, respectively (P>0.05). The difference of the survival rates for each stage was not statistically significant. CONCLUSIONS: Many reports suggest that patients with colorectal mucinous carcinomas have worse survival than patients with non-mucinous carcinomas. However, there was no significant difference in the 3-year survival rates between patients with mucinous carcinomas and those with non-mucinous carcinomas in our study.
Adenocarcinoma, Mucinous* ; Colorectal Neoplasms ; Diagnosis ; Humans ; Lost to Follow-Up ; Mucins* ; Prognosis ; Retrospective Studies ; Schools, Medical ; Sex Distribution ; Survival Rate

OBJECTIVE: The aim of this study was to investigate the gene expression profiles using GeneFishing(TM) DEG kit in Korean women with cervical squamous cell carcinoma. METHODS: Cervical cancer biopsies were obtained from patients at the Department of Obstetrics and Gynecology, St. Mary's hodpital. In this study, we used a common reference that was mixed with an equal amount of RNA extracted from non-cervical cancer patients. The profiles of expression genes between cervical normal and squamous cell carcinoma tissue were identified using GeneFishing(TM) DEG Kit and screened by BLAST search. RESULTS: Almost 100 differential expressed genes were identified in universal control and cervical squamous cell carcinoma, 53 of differential expressed genes, up-regulated expression of 32 and 21 down-regulated expression was sequenced. Up-regulated genes were calcylin, calgranulin A, TRK oncogene, HLC5, fibrillarin, collagene type I alpha1 etc. and down-regulated genes were galectin 1, PRP8 pre-mRNA precessing factor 8 homology, clusterin etc. CONCLUSION: We identified gene expression profile in cervical squamous cell carcinoma using GeneFishing(TM) Kit in Korean women. The functional genomics of these genes should be further studied.
Biopsy ; Calgranulin A ; Carcinoma, Squamous Cell* ; Clusterin ; Collagen ; Female ; Galectin 1 ; Gene Expression* ; Genomics ; Gynecology ; Humans ; Obstetrics ; Oncogenes ; Polymerase Chain Reaction* ; RNA ; RNA Precursors ; Transcriptome ; Uterine Cervical Neoplasms

PURPOSE: Colorectal cancers occurring in young people are usually found in advanced stage and have worse prognosis. The aim of this study was to investigate the clinical characteristics of young patients with colorectal cancer and survival rate of patients with colorectal cancer younger than 40 years. METHODS: The total of 534 patients with colorectal cancer underwent surgeries between March 1997 and February 2003. 487 patients were 40 or older than 40 years (control group) and the remaining 47 patients were younger than 40 years (study group). We compared age, sex, curability, tumor location, stage, histological type between the two groups. The survival rate by stages and overall survival rate were retrospectively analyzed. RESULTS: No significant difference was shown in the comparison of the distribution by stage and histologic grade at the time of diagnosis. There were more female in the study group (P=0.005). The three-year and five-year overall survival rates were 79.3% and 74.0% in study group, and 68.2% and 60.2% in control group (P>0.05). The three-year and five-year survival rates according to stage were not significantly different between the two groups. CONCLUSION: In the comparison of patients with colorectal cancer younger than 40 years old and 40 or older than 40 years old, no significant difference was shown in clinical characteristics and survival rate except sex distribution.
Adult ; Colorectal Neoplasms* ; Diagnosis ; Female ; Humans ; Prognosis ; Retrospective Studies ; Sex Distribution ; Survival Rate*

BACKGROUND: CHOP (cyclophosphamide, adriamycin, prednisolone, vincristine) regimen is still the standard therapy for non-Hodgkin's lymphoma, but its complete response rate & long-term survival rate are 45~55% and 30%, respectively. New chemotherapy regimen will be required for enhancing response rate and duration of survival. We tried to treat non-Hodgkin's lymphoma with newly developing CHEP-OB (cyclophosphamide, adriamycin, etoposide, prednisolone, vincristine, bleomycin) combination chemotherapy which include etoposide, bleomycin in preexisting CHOP regimen. METHODS: 51 patients with non-Hodgkin's lymphoma who admitted to Busan Paik Hospital Inje University between January 1996 and August 2002 were selected. They were treated with CHEP-OB combination chemotherapy given every 3~4 weeks for total 6 cycles. RESULTS: Objective response was achieved in 82.4% of the patients. Complete response (CR) and partial response (PR) rates were 66.7% and 15.7%, respectively. CR rate was significantly lower in patients with T cell immmunophenotype. Five year overall (OS) and failure-free survival (FFS) rate were 61.9%, 54.7%, respectively. Multivariate analysis showed that sex, stage and attainment of CR were factors independently predictive for OS and that stage and attainment of CR were factors independently predictive for FFS. Major side effect was myelotoxicity. CONCLUSION: CHEP-OB combination chemotherapy might be useful as a treatment strategy in non-Hodgkin's lymphoma considering similar response and survival rate, lower toxicity when it is compared with 3rd generation combination chemotherapy. But more effective chemotherapeutic regimen needs to be explored.
Bleomycin ; Busan ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide ; Humans ; Lymphoma, Non-Hodgkin* ; Multivariate Analysis ; Prednisolone ; Survival Rate ; Vincristine

PURPOSE: Submucosal gastric carcinomas metastasize to lymph nodes more often than the intramucosal gastric carcinomas. The objectives of this study are to clarify the characteristics of submucosal gastric carcinomas, especially in reference to the status of lymph node metastasis, and to explore the possibility of a minimally invasive operation. MATERIALS AND METHODS: The clinicopathologic features of 88 patients with submucosal gastric carcinoma, all of whom were treated with a D(2)(+)alpha gastrectomy between January 1994 and December 1999, were examined retrospectively with respect to the status of lymph nodes. The size, depth of submucosal invasion, histologic differentiation, location, and macroscopic finding of the tumor were investigated in association with the presence or the absence of lymph node metastasis. RESULTS: Among the 88 patients, 15 (17.05%) had lymph node metastasis, and the status of metastasis was significantly correlated with tumor size and depth of submucosal invasion. The frequency of metastasis was 0% (0/7) of up to 1.0cm and 18.5% (15/81) over 1.0 cm in size (P=0.034) and 6.1% (2/33) of up to 1.0 mm and 23.6% (13/55) over 1.0 mm in depth of submucosal invasion (P=0.042). CONCLUSION: The tumor size and depth of submucosal invasion are useful indicators of lymph node metastasis in submucosal gastric carcinoma. A minimally invasive operation can be applied for submucosal gastric carcinoma up to 1.0 cm in size. Further studies are needed to limited surgery for depth of submucosal invasion.
Gastrectomy ; Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Retrospective Studies

PURPOSE: Acute lymphoblastic leukemia (ALL) accounts for approximately 75% of all cases of childhood leukemia. We investigated epidemiology, clinical and laboratory features and treatment outcome of the children with ALL in Korea during recent 5 years. METHODS: One thousand forty nine patients were enrolled between January 1994 and December 1998 from 37 major hospitals in Korea. The data regarding the clinical and laboratory features including age, WBC counts at diagnosis, immunophenotype, morphology, cytogenetics and treatment outcome of patients were analyzed retrospectively by review of patient's medical records. Kaplan-Meier survival curves were constructed. The differences between groups analyzed by log-rank test. RESULTS: There were 597 males and 452 females. The distribution between the age 2 and 5 years is most common in 46.1%. The annual incidence rate per 100,000 population varied from 1.6 to 2.2. The 5 year event free survival (EFS) rates according to good prognostic factors were as follows: 67% bet ween 1-9 year of age at diagnosis, 69% in under 10,000/mm3of initial WBC count, 74% in early pre-B cell CALLA ( ) immunophenotype, 65% in L3 morphology, 68% in no CNS invasion. Most of patients were treated by CCG treatment protocol. The 5 year EFS was 63%. Main complications were sepsis (21.8%) and hemorrhage (12.5%). The relapse rate was 15.6%. The common causes of death were sepsis, DIC, pneumonia, relapse. CONCLUSION: Our results could provide the most recent and important information about acute lymphoblastic leukemia of children in Korea.
Cause of Death ; Child ; Clinical Protocols ; Cytogenetics ; Dacarbazine ; Diagnosis ; Disease-Free Survival ; Epidemiology* ; Female ; Hemorrhage ; Humans ; Incidence ; Kaplan-Meier Estimate ; Korea* ; Leukemia ; Male ; Medical Records ; Pneumonia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor Cells, B-Lymphoid ; Recurrence ; Retrospective Studies ; Sepsis ; Treatment Outcome

PURPOSE: Meconium peritonitis is a form of aseptic, chemical peritonitis that results from a perforation of the gut during the intrauterine or perinatal period. The rarity of the disease resulted in few survivors up to the 1950's. However, the constantly increasing survival rate has followed an aggressive surgical management, along with a more thorough understanding of the etiological and pathological variations likely to be encountered. This study was performed to analyze our past 10 years' experience with meconium peritonitis. METHODS: The hospital records of 15 patients treated between January 1991 to December 2000 were retrospectively reviewed. RESULTS: The male to female sex ratio was 2:1, and the age at surgery varied from at the time of birth to 48 days. The clinical manifestations included marked abdominal distension (13 cases), respiratory distress (8 cases), billous vomiting (5 cases) and scrotal swelling (1 case). Radiological findings included air-fluid level (7 cases), calcification (4 cases) and pneumoperitoneum (3 cases). The prenatal ultrasonography demonstrated dilated loops of bowel, septated fetal ascites and calcification. The leading cause of perforation was small bowel atresia (8 cases). A primary end-to-end anastomosis was performed in 10 cases. Generalized type (8 cases) was the most common finding of meconium peritonitis. 86% of patients survived without long-term complications. CONCLUSION: Early recognition and proper management offer the greatest opportunity for survival in cases of meconium peritonitis.
Ascites ; Female ; Hospital Records ; Humans ; Male ; Meconium* ; Parturition ; Peritonitis* ; Pneumoperitoneum ; Retrospective Studies ; Sex Ratio ; Survival Rate ; Survivors ; Ultrasonography, Prenatal ; Vomiting

PURPOSE: Submucosal gastric carcinomas metastasize to lymph nodes more often than the intramucosal gastric carcinomas. The objectives of this study are to clarify the characteristics of submucosal gastric carcinomas, especially in reference to the status of lymph node metastasis, and to explore the possibility of a minimally invasive operation. MATENRIALS AND METHODS: The clinicopathologic features of 88 patients with submucosal gastric carcinoma, all of whom were treated with a D2+alpha gastrectomy between January 1994 and December 1999, were examined retrospectively with respect to the status of lymph nodes. The size, depth of submucosal invasion, histologic differentiation, location, and macroscopic finding of the tumor were investigated in association with the presence or the absence of lymph node metastasis. RESULTS: Among the 88 patients, 15 (17.05%) had lymph node metastasis, and the status of metastasis was significantly correlated with tumor size and depth of submucosal invasion. The frequency of metastasis was 0% (0/7) of up to 1.0 cm and 18.5% (15/81) over 1.0 cm in size (p=0.034) and 6.1% (2/33) of up to 1.0mm and 23.6% (13/55) over 1.0 mm in depth of submucosal invasion (p=0.042). CONCLUSION: The tumor size and depth of submucosal invasion are useful indicators of lymph node metastasis in submucosal gastric carcinoma. A minimally invasive op-eration can be applied for submucosal gastric carcinoma up to 1.0 cm in size Further studies are needed to limited surgery for depth of submucosal invasion.
Gastrectomy ; Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Retrospective Studies