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Water beads are small, colorful toys that swell over the time in water. We report 2 cases of intestinal obstruction by unwitnessed ingestion of water beads. The diagnosis of each case was made by exploratory laparoscopy or comprehensive ultrasonography. The water beads were removed surgically in both cases. Since their ingestion can cause intestinal obstruction, water beads should not be allowed as toys for children.
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Clonorchis sinensis is the most common fish-borne intestinal parasite in Korea. The aim of the present investigation was to survey the status of C. sinensis infection and analyze associated risk factors in residents of Haman-gun, Gyeongsangnam-do. A total of 5,114 residents from 10 administrative towns/villages voluntarily agreed to participate in the study, which comprised fecal examination, a questionnaire survey for risk factors, ultrasonography, and enzymelinked immunosorbent assay for cancer biomarker detection in the blood. We detected C. sinensis eggs in 5.3% of the subjects. By region, Gunbuk-myeon had the highest number of residents with C. sinensis eggs. The infection rate and intensity were higher in male than in female residents. Based on the risk factor questionnaire, infection was highly associated with drinking, a history of C. sinensis infection, and the practice of eating of raw freshwater fish. Extension of the bile duct, infection intensity, and cancer biomarker detection significantly correlated with the presence of eggs in the study population. In conclusion, the development of feasible, long-term control policies and strategies for the elimination of C. sinensis in Korea is still required.
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Clonorchis sinensis is the most common fish-borne intestinal parasite in Korea. The aim of the present investigation was to survey the status of C. sinensis infection and analyze associated risk factors in residents of Haman-gun, Gyeongsangnam-do. A total of 5,114 residents from 10 administrative towns/villages voluntarily agreed to participate in the study, which comprised fecal examination, a questionnaire survey for risk factors, ultrasonography, and enzymelinked immunosorbent assay for cancer biomarker detection in the blood. We detected C. sinensis eggs in 5.3% of the subjects. By region, Gunbuk-myeon had the highest number of residents with C. sinensis eggs. The infection rate and intensity were higher in male than in female residents. Based on the risk factor questionnaire, infection was highly associated with drinking, a history of C. sinensis infection, and the practice of eating of raw freshwater fish. Extension of the bile duct, infection intensity, and cancer biomarker detection significantly correlated with the presence of eggs in the study population. In conclusion, the development of feasible, long-term control policies and strategies for the elimination of C. sinensis in Korea is still required.
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PURPOSE: This study aimed to examine the perception of food allergy among parents and school health instructors in Korea. METHODS: A nationwide epidemiological survey in Korea was conducted in September 2015. From 17 cities and provinces, a total of 1,000 elementary, middle and high schools were selected by stratified random sampling. Parents and school health instructors were surveyed using a questionnaire on the perception of food allergy. RESULTS: The prevalence of food-induced anaphylaxis was 22.3%. Of 252 children with anaphylaxis, 47.6% were prescribed epinephrine auto-injector (EAI). Forty-three parents (37.7%) were educated about the use of EAI. Parents carrying their own EAI at all times or keeping them at schools were 5.6% and 3.8%, respectively. For the food allergen-labeling system, 42.1% of parents read food labels, and 32.1% were satisfied with the system. Only 35.2% of school health instructors received education on food allergy and anaphylaxis, and 42.5% of them knew how to use EAI. There were 70 children (9.4%) with anaphylaxis in school, and 75.9% of schools had the emergency management system. CONCLUSION: The awareness of Korean parents and school health instructors on food allergy is still low, and many parents are dissatisfied with the food allergen labeling system. Many school health instructors have difficulty in using EAI in case of anaphylaxis and are insufficiently educated about food allergy. Therefore, it is necessary to establish more systematic food allergy management plans by providing high-quality education to parents and school health instructors and by utilizing legal systems.
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Niño , Humanos , Anafilaxia , Educación , Urgencias Médicas , Epinefrina , Hipersensibilidad a los Alimentos , Corea (Geográfico) , Padres , Prevalencia , Servicios de Salud EscolarRESUMEN
Glucose is essential for testicular function; the uptake of carbohydrate-derived glucose by cells is mediated by glucose transporters (GLUTs). In the present study, we investigated the activity of GLUT1 and GLUT3, the two main isoforms of GLUTs found in testes, in the left scrotal and right abdominal testes of a German Shepherd dog. Immunohistochemical analysis showed that GLUT1 immunoreactivity was absent in the scrotal and abdominal testes. In contrast, weak to moderate GLUT3 immunoreactivity was observed in mature spermatocytes as well as spermatids in the scrotal testis. In the abdominal testis, relatively strong GLUT3 immunoreactivity was detected in Leydig cells only and was absent in mature spermatocytes and spermatids. GLUT3 immunoreactivity was significantly decreased in the tubular region of abdominal testis and significantly increased in the extra-tubular (interstitial) region of abdominal testis compared to observations in the each region of scrotal testis, respectively. These results suggest that GLUT3 is the major glucose transporter in the testes and that abdominal testes may increase the uptake of glucose into interstitial areas, leading to an increased risk of developing cancer.
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Animales , Perros , Masculino , Criptorquidismo , Proteínas Facilitadoras del Transporte de la Glucosa , Glucosa , Células Intersticiales del Testículo , Isoformas de Proteínas , Espermátides , Espermatocitos , TestículoRESUMEN
PURPOSE: This study aimed to determine the prevalence of immediate-type food allergy (FA) among schoolchildren in Korea. METHODS: A nationwide, cross-sectional study was performed in September 2015. A stratified random sample of 50,000 participants was selected from children and adolescents aged 6-7 years (n=17,500), 9-10 years (n=17,500), 12-13 years (n=7,500), and 15-16 years (n=7,500). Parents were asked to complete a questionnaire on the detailed history of immediate-type FA. RESULTS: A total of 32,001 (64.0%) responded to the questionnaire survey, and 29,842 children (59.7%) were analyzed after adjusting for missing data. The number of the cases in each age group was 9,671 (6-7 years), 9,756 (9-10 years), 5,169 (12-13 years), and 5,246 (15-16 years). The prevalence of lifetime perceived FA was 15.82%. The prevalence of current immediate-type FA was 4.06% in total, with 3.15% in 6- to 7-year-olds, 4.51% in 9- to 10-year-olds, 4.01% in 12- to 13-year-olds, and 4.49% in 15- to 16-year-olds. Among individual food items, peanut (0.22%) was the most frequent causative food, followed by hen's egg (0.21%), cow's milk (0.18%), and buckwheat (0.13%). Among the food groups, fruits (1.41%), crustaceans (0.84%), tree nuts (0.32%), and fish (0.32%) were the most common offending foods. The prevalence of food-induced anaphylaxis was 0.97%. The most frequent causative food of anaphylaxis was peanut (0.08%), followed by cow's milk (0.07%), buckwheat (0.06%), and hen's egg (0.06%), while fruits (0.28%), crustaceans (0.18%), tree nuts (0.12%), and fish (0.09%) were the most commonly responsible food groups. CONCLUSIONS: The prevalence of current immediate-type FA and food-induced anaphylaxis in Korean schoolchildren in 2015 was 4.06% and 0.97%, respectively. Peanuts, cow's milk, hen's egg, fruits, crustaceans, and tree nuts are common allergens.
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Adolescente , Niño , Humanos , Alérgenos , Anafilaxia , Arachis , Estudios Transversales , Fagopyrum , Hipersensibilidad a los Alimentos , Frutas , Corea (Geográfico) , Leche , Nueces , Óvulo , Padres , Prevalencia , ÁrbolesRESUMEN
4-Hydroxy-3-methoxybenzaldehyde (vanillin) and 4-hydroxybenzyl alcohol (4-HBA) are natural phenolic compounds, which present in many plants and have diverse biological properties. In this study, we examined effects of vanillin and 4-HBA on learning and memory function, cell proliferation, and neuroblast differentiation in the hippocampal dentate gyrus in a mouse model of scopolamine-induced amnesia. Scopolamine (SCO; 1 mg/kg/day, intraperitoneally), vanillin, and 4-HBA (40 mg/kg/day, orally) were administered for 28 days. Treatment with scopolamine alone impaired learning and memory function in the Morris water maze and passive avoidance tests, in addition, the treatment significantly reduced cell proliferation and neuroblast differentiation in the dentate gyrus, which were examined by immunohistochemistry for Ki-67 (a classic marker for cell proliferation) and doublecortin (a marker for neuroblasts). However, treatment with vanillin or 4-HBA significantly attenuated SCO-induced learning and memory impairment as well as the reduction of cell proliferation and neuroblast differentiation in the dentate gyrus. These results indicate that vanillin and 4-HBA may be helpful in improving cognitive function and in increasing endogenous neuronal proliferation in the brain.
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Animales , Ratones , Amnesia , Encéfalo , Proliferación Celular , Cognición , Trastornos del Conocimiento , Giro Dentado , Hipocampo , Inmunohistoquímica , Aprendizaje , Memoria , Neurogénesis , Neuronas , Fenol , Escopolamina , AguaRESUMEN
The genus Populus (poplar) belonging to the Salicaceae family has been used in traditional medicine, and its several species show various pharmacological properties including antioxidant and anti-inflammatory effects. No study regarding protective effects of Populus species against cerebral ischemia has been reported. Therefore, in the present study, we examined neuroprotective effects of ethanol extract from Populus tomentiglandulosa (Korea poplar) in the hippocampal cornu ammonis (CA1) area of gerbils subjected to 5 minutes of transient global cerebral ischemia. Pretreatment with 200 mg/kg of P. tomentiglandulosa extract effectively protected CA1 pyramidal neurons from transient global cerebral ischemia. In addition, glial fibrillary acidic protein immunoreactive astrocytes and ionized calcium binding adapter molecule 1 immunoreactive microglia were significantly diminished in the ischemic CA1 area by pretreatment with 200 mg/kg of P. tomentiglandulosa extract. Briefly, our results indicate that pretreatment with P. tomentiglandulosa extract protects neurons from transient cerebral ischemic injury and diminish cerebral ischemia-induced reactive gliosis in ischemic CA1 area. Based on these results, we suggest that P. tomentiglandulosa can be used as a potential candidate for prevention of ischemic injury.
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Humanos , Astrocitos , Isquemia Encefálica , Calcio , Etanol , Gerbillinae , Proteína Ácida Fibrilar de la Glía , Gliosis , Hipocampo , Medicina Tradicional , Microglía , Neuronas , Fármacos Neuroprotectores , Populus , Células Piramidales , SalicaceaeRESUMEN
BACKGROUND: The results of previous studies on the association between blood mercury (Hg) and bone mineral density (BMD) are inconsistent. We therefore used a large-scale nationwide representative sample of Korean men to investigate the relationship between these two parameters. METHODS: A nationwide cross-sectional study was conducted using data from the 2008 to 2010 Korean National Health and Nutrition Examination Survey to evaluate the relationship between blood Hg and BMD and the prevalence of osteopenia or osteoporosis in 1,190 men over 50 years of age. BMD was measured by dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed for each body site according to World Health Organization T-score criteria. RESULTS: After adjusting for age, body mass index, caloric energy and calcium intake, vitamin D levels, fish consumption, alcohol consumption, smoking, and exercise, quartiles of blood Hg were positively associated with femur neck T-scores in multiple linear regression analysis (β=0.06, P-value=0.03). Compared with the lowest blood Hg quartile, the odds ratios and 95% confidence intervals for diagnosis of osteopenia or osteoporosis in the second and fourth quartiles were 0.63 (0.41–0.99) and 0.57 (0.36–0.91), respectively, in the femur neck after adjusting for the same co-variables. CONCLUSION: High blood Hg levels were associated with reduced odds of decreased femur neck BMD in Korean men. However, subgroup analysis did not show a significant protective effect of blood Hg on osteoporotic fractures. Further research is necessary to clarify the association between blood Hg and BMD.
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Humanos , Masculino , Absorciometría de Fotón , Consumo de Bebidas Alcohólicas , Índice de Masa Corporal , Densidad Ósea , Enfermedades Óseas Metabólicas , Calcio , Estudios Transversales , Diagnóstico , Cuello Femoral , Modelos Lineales , Encuestas Nutricionales , Oportunidad Relativa , Osteoporosis , Fracturas Osteoporóticas , Prevalencia , Humo , Fumar , Vitamina D , Organización Mundial de la SaludRESUMEN
PURPOSE: The purpose of this study was to analyze the prevalence, risk factors of metabolic syndrome, and lifestyle in religious women by age and metabolic syndrome status between the metabolic syndrome group and the normal group. METHODS: As the subjects for this study, 125 religious women in the city of D, H, S, Y, participated in this study. The diagnostic criterion of metabolic syndrome used was the National Cholesterol Education Program Adult Treatment Panel III. RESULTS: The prevalence of metabolic syndrome was higher as the religious women got older. The metabolic syndrome group in their forties showed higher waist circumference, triglycerides, and lower HDL- cholesterol than the normal group. Among those in their fifties, the metabolic syndrome group had higher waist circumference, fasting glucose, triglyceride and lower HDL-cholesterol than the normal group. In their sixties, the metabolic syndrome group had higher fasting glucose, triglyceride and systolic blood pressure than the normal group. CONCLUSION: The metabolic syndrome group in their forties showed that their practice rate of 'trying to avoid stresses at work', 'taking prescription medicines' was low. For those in their fifties, the practice rate of 'reducing overeating' and 'choice of low fat meats' was low. Finally, in the group of those in their sixties, 'reducing fried foods' was low.
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Adulto , Femenino , Humanos , Presión Sanguínea , Colesterol , Educación , Ayuno , Glucosa , Estilo de Vida , Prescripciones , Prevalencia , Factores de Riesgo , Triglicéridos , Circunferencia de la CinturaRESUMEN
Cerebral amyloid angiopathy (CAA) is common in patients with Alzheimer's disease (AD) and may contribute to cerebral hemorrhage. We previously demonstrated that tissue plasminogen activator (tPA) and plasminogen (PLG) accumulated at the periphery of compact amyloid-cored plaques and in the walls of CAA-containing blood vessels in the brains of Tg2576 mice, a widely used AD mouse model. We had also observed that zinc-triggered tPA and PLG induction were observed in mouse cortical cultures. Because zinc also accumulates in amyloid plaques and blood vessel walls in AD brains, we examined whether zinc increases mRNA and protein levels of tPA and PLG in brain endothelial cells and pericytes. Four hours after the exposure of brain endothelial cells (bEnd.3) to 40 microM zinc, the mRNA and protein expressions of tPA and its substrate PLG were significantly increased. In the case of brain pericyte cultures, increases in tPA and PLG expression were also detected 2 hr after treatment. However, amyloid-beta (Abeta)1-42 oligomers did not augment tPA and PLG expression in bEnd.3 cells and pericytes, suggesting that zinc but not Abeta induces tPA and PLG accumulation in CAA found in the AD brain.
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Animales , Humanos , Ratones , Enfermedad de Alzheimer , Vasos Sanguíneos , Encéfalo , Angiopatía Amiloide Cerebral , Hemorragia Cerebral , Células Endoteliales , Pericitos , Placa Amiloide , Plasminógeno , ARN Mensajero , Activador de Tejido Plasminógeno , ZincRESUMEN
Adequate assessment of plaque deposition levels in the brain of mouse models of Alzheimer disease (AD) is required in many core issues of studies on AD, including studies on the mechanisms underlying plaque pathogenesis, identification of cellular factors modifying plaque pathology, and developments of anti-AD drugs. The present study was undertaken to quantitatively evaluate plaque deposition patterns in the brains of the two popular AD models, Tg2576 and Tg-APPswe/PS1dE9 mice. Coronally-cut brain sections of Tg2576 and Tg-APPswe/PS1dE9 mice were prepared and plaque depositions were visualized by staining with anti-amyloid beta peptides antibody. Microscopic images of plaque depositions in the prefrontal cortex, parietal cortex, piriform cortex and hippocampus were obtained and the number of plaques in each region was determined by a computer-aided image analysis method. A series of optical images representing a gradual increase of plaque deposition levels were selected in the four different brain regions and were assigned in each with a numerical grade of 1-6, where +1 was lowest and +6, highest, so that plaques per unit in mm2 increased "sigmoidally" over the grading scales. Analyzing plaque depositions using the photographic plaque reference panels and a computer-aid image analysis method, it was demonstrated that the brains of Tg2576 mice started to accumulate predominantly small plaques, while the brains of Tg-APPswe/PS1dE9 mice deposited relatively large plaques.
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Animales , Humanos , Ratones , Enfermedad de Alzheimer/genética , Precursor de Proteína beta-Amiloide/genética , Modelos Animales de Enfermedad , Ratones Transgénicos , Placa Amiloide/patologíaRESUMEN
Carcinosarcoma of gallbladder (CSGB) is a rare malignancy characterized by malignant epithelial and mesenchymal components. Its pathogenesis is unknown and most CSGBs are associated with poor survival because the disease normally presents at an advanced stage, and as a result, curative resection is uncommon. This report describes a case that underwent curative resection. A 77-year-old woman presented with right upper quadrant pain. The preoperative diagnosis was gallbladder (GB) cancer, and thus, curative radical cholecystectomy was performed. However, pathologic examination of the surgical specimen revealed that the tumor was composed of two histologic components of squamous cell carcinoma and spindle cell sarcoma, which was consistent with a diagnosis of carcinosarcoma. The tumor was found to extend to the perimuscular connective tissue and to have metastasized to one lymph node (LN). The prognosis of CSGB remains poor despite curative resection, and thus, the authors recommend that effort be made to improve surgical outcomes.
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Anciano , Femenino , Humanos , Carcinoma de Células Escamosas , Carcinosarcoma , Colecistectomía , Tejido Conectivo , Vesícula Biliar , Ganglios Linfáticos , Pronóstico , SarcomaRESUMEN
PURPOSE: The laparoscopic appendectomy has been a basic part of the principal of a more complex laparoscopic technique for the surgical trainee. As the number of laparoscopic appendectomies performed by surgical trainees has increased, we are trying to check the stability of, which is controversial, and the learning curve associated with a laparoscopic appendectomy. METHODS: We studied the demographics, histologic diagnoses, operative time, the number of complicated cases, and hospital duration of one hundred and three patients who underwent an open appendectomy (group A, 53) or a laparoscopic appendectomy (group B, 50) retrospectively through a review of their medical records. The learning curve for the laparoscopic appendectomy was established through the moving average and ANOVA methods. RESULTS: There were no differences in the operative times (A, 64.15 +/- 29.88 minutes; B, 58.2 +/- 20.72 minutes; P-value, 0.225) and complications (A, 11%; B, 6%; P-value, 0.34) between group A and group B. Group B was divided into group C who underwent the operation in the early period (before the learning curve) and group D who underwent the operation in the later period (after the learning curve). The average operative time for group C was 66.83 +/- 21.55 minutes, but it was 45.25 +/- 10.19 minutes for group D (P-value < 0.0001). Although this difference was statistically significant, no significant difference in the complication rate was observed between the two groups. CONCLUSION: A laparoscopic appendectomy, compared with an open appendectomy, performed by a surgical trainee is safe. In this study, the learning curve for a laparoscopic appendectomy was thirty cases.
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Humanos , Apendicectomía , Demografía , Laparoscopía , Aprendizaje , Curva de Aprendizaje , Registros Médicos , Tempo Operativo , Estudios RetrospectivosRESUMEN
PURPOSE: False negative results obtained with the use of a sentinel lymph node biopsy (SLNB) can result in down staging of tumors, whereas the use of a more elaborated pathological examination of sentinel lymph nodes might lead to upstaging of tumors. The purpose of this study was to compare results after performing only an SLNB as compared with performing conventional axillary lymph node dissection (ALND) without an SLNB in pathologically node negative (pN0) breast cancer patients. METHODS: From April 2004 to June 2007, SLNBs were performed for patients with primary breast cancer who had no clinical evidence of a lymph node metastasis. A total of 272 patients were treated with only an SLNB. During the same period, 278 patients were confirmed as pN0 after conventional ALND without an SLNB. A prospectively collected database and medical records of these patients were reviewed. RESULTS: For patients that had undergone only an SLNB, there was no local or regional recurrence. A distant metastasis developed in four patients (1.5%). In patients that had undergone ALND without an SLNB, a recurrence was found in 13 patients (4.7%). Patients that had undergone only an SLNB showed significantly better disease-free survival as compared to patients that had undergone ALND without an SLNB (p=0.032). CONCLUSION: pN0 patients treated with only an SLNB showed a significantly better outcome as compared to patients treated with conventional ALND without an SLNB. These results suggest that performing an SLNB might result in the upstaging of a subset of patients who would have been understaged by the use of conventional ALND.
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Humanos , Mama , Neoplasias de la Mama , Supervivencia sin Enfermedad , Escisión del Ganglio Linfático , Ganglios Linfáticos , Registros Médicos , Metástasis de la Neoplasia , Nitrilos , Estudios Prospectivos , Piretrinas , Recurrencia , Biopsia del Ganglio Linfático CentinelaRESUMEN
PURPOSE: The purpose of this study is to evaluate the changing pattern of communication skills of medical students according to length and methods of training. METHODS: We evaluated a 1-week communications training course in 2003, a 1-year course in 2004, and a 1-semester course in 2005 during development of our curriculum. We have conducted the 10-minute CPX on abdominal pain annually since 2002 to assess the clinical performance of medical students who have completed the 3rd year clerkship. We selected CPX videos that were appropriate for assessment. One hundred sixty-four videos were available (1-week didactics: 42 cases, 1-week training: 28 cases, 1-semester training: 50 cases, 1-year training: 44 cases). We developed a 10-item global rating checklist to assess communication skills. A 5-point Likert scale was used to evaluate each item (4-very likely, 0-least likely). Two expert standardized patient (SP) raters evaluated the communication skills of students independently. We analyzed the outcomes based on the training length and methods. The reliability (G coefficient) was 0.825 with 2 SPs and 1 station. RESULTS: The communication skills of students improved with practice and longer training, especially with regard to opening the interview, expressing empathy, understanding the patient's perspective, and preparing for the physical examination. Rapport-building, organization of the interview, understandable explanation, nonverbal communication, active listening and consideration during the physical examination was unchanged between durations of training. The scores for empathetic expression, active listening and understanding the patient's perspective were low across all groups. CONCLUSION: We should concentrate our efforts to improve students' skills in empathetic expression, active listening and understanding the patient's perspective.
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Humanos , Dolor Abdominal , Lista de Verificación , Curriculum , Evaluación Educacional , Empatía , Comunicación no Verbal , Examen Físico , Reproducibilidad de los Resultados , Estudiantes de MedicinaRESUMEN
PURPOSE: Apocrine carcinoma of the breast, a specific histologic type of human breast cancer, is a rare malignant tumor. Because of the rarity of apocrine carcinoma and lack of a standardized definition, the clinicopathologic features have not been definitively determined. In this study, we present a single institution analysis of the clinicopathologic features of 19 cases of apocrine carcinoma and contrast them with those seen in infiltrating ductal carcinoma, not otherwise specified (NOS). METHODS: We respectively reviewed the records of 19 patients with apocrine carcinoma who underwent surgery at Korea Cancer Center Hospital between October 1997 and April 2007. RESULTS: The mean patient age was 52.8 years. Eight patients (42.1%) were under 50 years of age. In all patients, the initial symptom was a breast mass. Twelve (63.2%) of 19 tumors were located in the right breast and the other 7 cases (36.8%) were located in the left breast. The average tumor size was 2.19 cm (range 0.7-7 cm). Two patients had axillary lymph node metastasis. Estrogen receptor (ER) was positive in 3 cases (16.7%). The HER-2 overexpression rate was 35.3%. There was no locoreginal recurrence, distant metastasis, or death during the median follow-up period of 35.4 months (range 4-114 months). CONCLUSION: Compared with the alleged characteristics seen in Korean breast cancer patients, apocrine carcinoma was characterized by an older age at the time of diagnosis and a higher incidence of hormone receptor negatively. The HER-2 overexpression rate was similar to the rate for other tumors. Although there was a relatively low incidence ER positivity, there was no recurrence or death. Therefore, apocrine carcinoma appears to be clinically distinct from infiltrating ductal carcinoma, NOS.
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Humanos , Mama , Neoplasias de la Mama , Carcinoma Ductal , Estrógenos , Estudios de Seguimiento , Incidencia , Corea (Geográfico) , Ganglios Linfáticos , Metástasis de la Neoplasia , RecurrenciaRESUMEN
PURPOSE: The role and safety of aromatase inhibitors (AIs) in young breast cancer patients with chemotherapy-induced amenorrhea (CIA) has not been established. The goal of this study was to investigate the safety and efficacy of AIs in young breast cancer patients with CIA. METHODS: From December 2000 to December 2006, 58 patients with hormone receptor positive breast cancer under the age of 45 were treated with AIs as adjuvant therapy. All patients had amenorrhea for more than three consecutive months at the time of treatment. We evaluated the rates of recovery of ovarian function during the treatment, and analyzed the association of the recovery of ovarian function with age, body mass index (BMI), chemotherapy regimen, radiation therapy, and the use of tamoxifen. RESULTS: Recovery of ovarian function was observed in 16 patients (27.6%). The univariate analysis showed that ovarian function was more frequently recovered in patients younger than 40 yr of age, treated with chemotherapy regimens other than Cyclophosphamide, Methotrexate, 5-Flurouracil (CMF), without a history of tamoxifen therapy, and with a higher BMI. The multivariate analysis confirmed that the type of chemotherapy (p=0.034) and the history of tamoxifen therapy (p=0.043) were independent factors significantly associated with the restoration of ovarian function. CONCLUSION: The results of this study suggest that AIs should be considered, with caution in young women with CIA; these agents may promote the unwanted recovery of ovarian function. Especially, in those patients who were not treated with CMF chemotherapy or tamoxifen, where the rates of recovery of ovarian function were higher.
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Femenino , Humanos , Amenorrea , Aromatasa , Inhibidores de la Aromatasa , Índice de Masa Corporal , Mama , Neoplasias de la Mama , Ciclofosfamida , Metotrexato , Análisis Multivariante , TamoxifenoRESUMEN
PURPOSE: The aim of this study is to evaluate the students' clinical competency from the patient safety perspective. METHODS: We conducted this evaluation in 2006 at College of Medicine, Kangwon National University. We surveyed 50 fourth-year medical students after finishing all clinical clerkships. 49 Students evaluated their achievement with 5-Likert score scale. The questionnaires were composed 6 domains: communication skills, prevention & management of adverse events, using evidence and information techniques, teamwork & leadership, medical ethical behaviors, and procedural skills. The each domains were constituted several items. Total 53 items was evaluated. RESULTS: The students' preparedness was relatively low in 28 items of the total 53(difficult communication, detecting and managing medical errors, using evidence and information technique, understanding of complex systems, autonomy, and procedural skills). CONCLUSION: The items with low achievement were closely related with medical errors and patient safety. These findings suggest that the clinical education is insufficient for preventing medical errors by students. For patient safety, we should understand the importance of achievement of competency related with patient safety and establish a systematic clinical curriculum with explicit learning outcomes.
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Humanos , Prácticas Clínicas , Curriculum , Educación , Liderazgo , Aprendizaje , Errores Médicos , Seguridad del Paciente , Estudiantes de Medicina , Encuestas y CuestionariosRESUMEN
PURPOSE: Malignant phyllodes tumors are rare breast tumors. Information on the prognosis and optimal treatment of these lesions is not yet sufficient. The aim of this study was to determine parameters that predict the recurrence of malignant phyllodes tumors of the breast. METHODS: Retrospectively, we reviewed the medical records and pathological slides of 23 patients with malignant phyllodes tumors that had undergone surgical treatment from 1988 to 2006. The age of the patients, tumor size, type of surgery, resection margin, adjuvant therapy and pathological characteristics of the tumors such as stromal hypercellularity, cellular phleomorphism, mitosis, margins, and stromal pattern were examined. RESULTS: The mean age of the patients was 41 yr. The tumor size ranged from 1 cm to 25 cm, with a median of 7.42 cm. The median follow-up time was 29.0 months. Recurrence was observed in 6 patients (26.1%) and the 5-yr disease free survival was 48.9%. Risk factors for recurrence of a malignant phyllodes tumor were a mitotic index greater than 10 per high-powered field (p=0.0242) and an invasive margin (p=0.0437). CONCLUSION: Frequent mitosis and an invasive margin were the principal determinants of recurrence. Patients with poor prognostic components should be treated more aggressively and the patients need more close follow-up.