• Archives of Plastic Surgery
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• 제39권2호
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• pp.154-157
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• 2012

Lymphedema is a common complication after mastectomy in breast cancer patients. Many treatment options are available, but no treatment results in a complete cure. We report a case of lymphedema that occurred after modified radical mastectomy in a breast cancer patient who showed objective improvement after delayed breast reconstruction with an latissimus dorsi myocutaneous flap. A 41-year-old female patient with left breast cancer had undergone modified radical mastectomy with axillary lymph node dissection and postoperative radiotherapy 12 years previously. Four years after surgery, lymphedema developed and increased in aggravation despite conservative treatment. Eight years after the first operation, the patient underwent delayed breast reconstruction using the extended latissimus dorsi myocutaneous flap method. After reconstruction, the patient's lymphedema symptoms showed dramatic improvement by subjective measures including tissue softness and feeling of lightness, and by objective measures of about 7 mL per a week, resulting in near normal ranges of volume. At a postoperative follow-up after 3 years, no recurrence was observed. Delayed breast reconstruction with extended latissimus dorsi myocutaneous flaps may be helpful to patients with lymphedema after mastectomy. This may be a good option for patients who are worried about the possibility of the occurrence or aggravation of secondary lymphedema.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6955-6959
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• 2013

The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

• 대한핵의학회지
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• 제28권2호
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• pp.214-219
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• 1994

유방종괴의 감별진단을 위해 탈륨스캔을 시행하여 다음과 같은 결과를 얻었다. 1) 유방암 11예 중 10예에서 양성소견을 보였다(sensitivity 90.9%). 2) 위음성 1예는 화학요법을 받았던 환자로 종괴의 크기는 직경 1cm이하였다. 3) 병리조직학적으로 양성인 17예와 추적관찰상 악성을 의심할 수 없었던 3예 등 20예 중 17예에서 탈륨섭취가 없었다(specificity 85% ) 4) 섬유낭성 질환(fibrocystic disease)13예 중 3예에서 위양성 소견을 보였으며 섬유선종(fibroadenoma)3예와 1예의 엽상낭육종(cystosarcoma phyllodes)에서는 섭취를 보이지 않았다. 5) 이상의 결과 악성과 양성 감별의 정확도는 87.1%로써 유방종괴의 감별진단에 탈륨 스캔이 한 방법이 되리라 생각된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권1호
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• pp.17-27
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• 2021

Objectives: Deliberate self-poisoning (DSP) is the most common suicide method and can be life-threatening. The purpose of this study was to investigate the factors related to the lethality of DSP and the characteristics of the adolescent group. Methods: A retrospective study was conducted on patients who had visited an academic hospital's regional emergency medical center between 2015 and 2018. The data reviewed through their medical records included sociodemographic factors, clinical variables, and psychiatric treatment. Four groups (Q1-Q4) were categorized by descriptive analysis using the risk-rescue rating scale. Results: A total of 491 patients were enrolled in this study. This study showed that high lethality had statistically significant associations with male sex, older age, admitting suicidal intentions, and the use of herbicides for suicide. Logistic regression analyses showed a significant association between high-lethality and female [odds ratio (OR)=0.50, 95% confidence interval (CI)=0.30-0.81, p=0.01], non-psychiatric drugs (over-the-counter drug: OR=2.49, 95% CI=1.08-5.74, p=0.03; herbicide: OR=8.65, 95% CI=3.91-19.13, p<0.01), and denial of suicide intent (OR=0.28, 95% CI=0.15-0.55, p<0.01). Conclusion: This study showed the clinical factors associated with the high lethality of DSP and suggested that efforts were needed to care for and thoroughly examine patients with DSP.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6277-6283
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• 2012

Background: Northern Iran counts as one of the highest prevalence regions for esophageal cancer (EC) worldwide. This study was designed to assess the epidemiologic aspects of EC in north central and northwest Iran over a 10 year period. Materials and Methods: The Guilan cancer registry study (GCRS) is a population-based cancer registry study featuring retrospective (1996-2003) and prospective (2004-2005) phases. A detailed questionnaire based on WHO standards for cancer registratration was applied to gather the required information. Two trained physicians coded information using ICD-O-3 in close coordination with an expert pathologist. Results: A total of 19,936 cases of malignancy (mean age $55.4{\pm}18.0$ years, range: 1-98 years) were registered, including 1,147 cases (670 males, 447 female; mean age: $64.0{\pm}11.5$ years) of EC. In 1996 the male/female ratio among patients with EC was 1.25 which increased to 1.53 in 2005. The lower third of the esophagus still remained the most common site of tumors. The average age-standardized rate (ASR) was 6.9 and 4.1 per $10^5$ men and women, respectively. In 1996, the ASRs were 7.2 and 5.2 per $10^5$ men and women which decreased to 6.9 and 4.1 per $10^5$ in 2004-2005. Squamous cell carcinoma (SCC) was the most prevalent histological subtype of EC accounting over 80% of cases. Conclusions: However the prevalence of adenocarcinoma (ADC) showed an increase to 18.4%. Guilan province may be considered a relatively low incidence region for EC.

• Tuberculosis and Respiratory Diseases
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• 제44권2호
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• pp.223-231
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• 1997

A total of 322 patients with endobronchial tuberculosis (8.1%) out of 3,982 subjects who had a flexible fiberoptic bronchoscopic examination at the Department of Pulmonary Medicine of Hanyang University Hospital between the beginning of March 1982 and the end of April 1996 were included in this study. The peak incidence occurred in the second decade, and the male to female was 1 : 3.0. The barking cough with variable amounts of sputum was the most common chief complaint in 56.9% of the 313 patients. Other complaints included dyspnea, chest pain, fever, hemoptysis, and generalized weakness. Localized wheeze was heard over the chest in 16.9% of the 313 patients. Infiltration/consolidation was the most common roentgenographic finding of the chest in 64.2%. Bronchoscopically, hypertrophy with luminal narrowing was the most common findings in 32.3% of the 322 patients and left main bronchus was the most frequently involved in 24.0%. Using fiberoptic bronchoscopy allows not only substantial meaningful assessment of endobronchial tuberculosis but also makes a differential diagnosis of lung cancer in older patients. We need further evaluations of standard bronchoscopic classification of endobronchial tuberculosis, diagnostic accuracy of endobronchial tuberculosis by PCR, a large prospective study of effects of corticosteroids in endobronchial tuberculosis patients, and appropriate treatment of atelectasis by endobronchial tuberculosis.

• 대한한방내과학회지
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• 제38권2호
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• pp.235-239
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• 2017

This case study describes the effect of Bojungikki-tang on chemotherapy-induced alopecia. Alopecia is a well-documented cause of distress to patients undergoing cancer treatment, but no approved pharmacological treatment exists for chemotherapy-induced hair loss. A 70-year-old female diagnosed with a cholangiocarcinoma and liver metastasis received chemotherapy, including gemcitabine and cisplatin, every three weeks. As a result of the continuous chemotherapy, she suffered various toxicity-related side effects, including bone marrow suppression, general weakness, nausea, peripheral numbness, and hair loss. Bojungikki-tang was initially administered to improve the patient's general weakness and fatigue. After three months of treatment, the patient's hair loss and general condition improved, and the color of the new hair was dark, despite the chemotherapy. The treatment did not improve other symptoms, such as bone marrow suppression and peripheral numbness. This case suggests that Bojungikki-tang could have a beneficial effect on chemotherapy-induced alopecia.

• 정신신체의학
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• 제14권2호
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• pp.73-80
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• 2006

갑상선질환은 비교적 흔한 질환으로 임상의사들이 쉽게 접할 수 있다. 그러나 갑상선질환 환자들은 전형적인 증상을 호소하는 경우부터 흔치 않는 임상상으로 병원을 찾는 경우까지 매우 다양하다. 간혹 정신과의사들이 심한 갑상선기능항진증을 조증 또는 가벼운 정신분열증으로 또는 심한 갑상선기능저하증을 우울증으로 자칫 오진하기 쉽다. 또한 갑상선 종양은 촉지되지 않는 경우까지 포함하여 전인구의 30% 이상에서 발견되고, 이중 최소 5% 이상은 악성종양이므로 갑상선 종양 환자의 접근 및 치료에 대해서도 개괄적인 이해가 필요하다.

• Journal of Gastric Cancer
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• 제10권2호
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• pp.84-86
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• 2010

Bezoars are retained concretions of undigested animal or vegetable material that can produce gastrointestinal obstruction, ulceration, and bleeding. Therapeutic options for gastric bezoars include enzyme therapy (papain, cellulase, or acetylcysteine), endoscopic disruption and removal, and surgical removal. Multiple large gastric bezoars generally require conventional surgical management through an upper abdominal incision. With the recent improvement of laparoscopy, a lot of portions of abdominal operations have been performed laparoscopically. We successfully removed multiple large gastric phytobezoars in a 52-year-old female completely through laparoscopy. This supported the feasibility of laparoscopic surgery for patients with gastric bezoars.

• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.3907-3909
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• 2014

Background: Cytogenetic abnormalities have important implications in diagnosis and prognosis of acute leukemia and are now considered an important part of the diagnostic workup at presentation. Karyotype, if known at the time of diagnosis, guides physicians to plan appropriate management strategies for their patients. Aim and Objectives: To determine the cytogenetic profile of acute lymphoblastic leukemia (ALL) in Pakistani children in order to have insights regarding behavior of the disease. Materials and Methods: A retrospective analysis of all the cases of ALL (<15years old) diagnosed at Aga Khan University from January 2006 to June 2011 was performed. Cytogenetic analysis was made for all cases using the trypsin-Giemsa banding technique. Karyotypes were interpreted using the International System for Human Cytogenetic Nomenclature (ISCN) criteria. Results: A total of 153 patients were diagnosed as ALL during the study period, of which 127 samples successfully yielded metaphase chromosomes. The male to female ratio was 1.8:1. A normal karyotype was present in 51.2% (n=65) of the cases whereas 48.8% (n=62) had an abnormal karyotype. Most of the abnormal cases showed hyperdiploidy(13.4%) followed by t(9;22)(q34;q11.2) (7.08%). Conclusions: This study revealed a relative lack of good prognostic cytogenetic aberrations in Pakistani children with ALL.