The purposes of this study were to investigate the pathway which stroke patients take in seeking medical care and to identify factors which influence that pathway. This study was conducted by a survey. The subjects were 130 adults, who were diagnosed with a stroke between January and April of 2000. Data was collected by means of a interview, questionnaires, and an Activity Index. The result of this study are summarized as follows: 1. The mean age of subject was 61.58 years. Forty-nine percent were men and fifty percent were women. The majority of the subjects were married. For educational level, thirty-three percent finished elementary school, and twenty-three percent, high school. Most of the subjects reported 'middle' economic status. Ninety-two percent lived with their spouse and children. The diagnosis for seventy-two percent was ischemic stroke and for twenty-two percent, hemorrhagic stroke. 2 The most frequent early sign of stroke was hemiplegia(43.3%), loss of consciousness (36.7%), dysarthria(33.3%). The type of hospital first used was a herb hospital(40.8%), or a western hospital(59.2%). The factors in their choice were ; distance from the hospital to the place that the stroke occurred(47.5%), desire for a herb hospital(15.8%), and an invitation(12.9%). The ischemic stroke patients preferred herb hospitals, but hemorrhagic stroke patients preferred a western hospitals. 3. The pattern of stroke patients seeking medical care was that forty-three percent of stroke patients pass through step 1, forty-six percent, through step 2, and 8.5% through step 3. The more steps, the higher the use of herb hospitals. 4. The factors influencing the pathway of stroke patients seeking medical care were diagnosis, and level of consciousness. Ischemic stroke patients used herb hospitals, more frequently hemorrhagic stroke patients, who used western hospitals. The alert patient preferred a herb hospital, but stupor patients preferred a western hospital. 5. The Activity Index was not related to the pathway which stroke patients used in seeking medical care.
Purpose: Basal cell adenoma of the salivary gland is an uncommon type of monomorphic adenoma. The most frequent location is parotid gland. It usually appears as a firm, mobile and slow-growing mass. Originally the term "basal cell adenoma" is described as a benign salivary gland tumor comprised of uniform appearing basaloid cells which are arranged in solid, trabecular, tubular, and membranous patterns. But the myxoid and chondroid mesenchymal like component as seen in pleomorphic adenoma is lacking in basal cell adenoma. We report a case of basal cell adenoma of parotid gland with review of the literatures. Methods: The 59-year-old female patient was referred to our department with a painless palpable mass in the left preauricular region for about 1 year. Movable and nontender subcutaneous mass was palpable. There was no evidence of cervical metastasis in computed tomography and ultrasonography. On fine needle aspiration cytology, pleomorphic adenoma was suspected. Under general anesthesia, superficial parotidectomy including tumor was performed. The biopsy result was basal cell adenoma. Results: Long-term follow-up for 54 months showed favorable result without evidence of recurrence except for temporary facial nerve weakness right after the surgery. Conclusion: Basal cell adenoma is the third most frequent benign tumor of the salivary gland, following pleomorphic adenoma and Warthin's tumor, although the incidence is low. The typical clinical feature of the basal cell adenoma is slowly growing, asymptomatic, and freely movable parotid mass. Basal cell adenoma should be also considered as a differential diagnosis of the parotid gland benign tumor.
Nowadays, plastic surgical operations are increasingly being performed in Korea. We have gained added interest in this because some professional pictures contain plastic surgery in their venue. In the films, we intend to see the recognition of society for plastic surgeons and which field of plastic surgery. The list of movies for analysis were 'Plastic Beauty (1975)', 'Penthouse Elephant (2005)', '200 Pounds Beauty (2006)', 'Cinderella (2006)', and 'Time (2006)'. The TV dramas were 'She is looking (2005)', 'Lovers (2006-2007)', and 'Before & After Plastic Surgery Clinic (2008)'. Films were analyzed according to the following: the chief complaints and names of the operations, character of plastic surgeons, result of the operation and its possibility in reality, and its effect of plastic surgery on the life of the patients. Most of the film contained facial transplantation or the change of the face or body different from the original shape. Character type of the plastic surgeons was mostly medical realism, rather than ideal humanism. Most of the plastic surgeons have capability as a doctor; however, some of them had extramarital affairs. The surgery was successful in most of the cases, but were the patients happy with the results? This was not the case in the movies. In only one movie, '200 Pounds Beauty', the patient became happy; rest of them were eminently unhappy with the outcome. Why the discrepancy? It is difficult to analyze the minds of the people in the films, but considering that the majority of the characters in the films were rather unsavory, one may deduce that a crooked mind functions differently. Perhaps it is too much to hope for a day that will come when we will see a film that portrays the mental anguish that accompanies each and every procedure the Korean plastic surgeons make.
Background: The advance in microsurgical technique has facilitated a proper approach for reconstruction of extensive head and neck defects. For the success of free tissue reconstruction, selection of the recipient vessel is one of the most important factors. However, the vascular anatomy of this region is very complex, and a clear guideline about this subject is still lacking. In this study, we present our 30 years of experiences of free tissue reconstruction for head and neck defects. Methods: In this retrospective study, we analyzed a total of 138 flaps in 127 patients who underwent head and neck reconstruction using free tissue transfer following tumor resection between October 1986 to August 2019. Patients who underwent facial palsy reconstruction were excluded. Medical records including patient's demographics, detailed operation notes, follow-up records, and photographs were collected and analyzed. Results: Among a total of 127 patients, 10 patients underwent a secondary operation due to cancer recurrence. The most commonly used type of flap was radial forearm flap (n=107), followed by the anterolateral thigh flap (n=18) and fibula flap (n=10). With regard to recipient vessels, superior thyroid artery was most commonly used in arterial anastomosis (58.7%), and internal jugular vein (51.3%) was the first choice for venous anastomosis. The flap survival rate was 100%. Four cases of venous thrombosis were resolved with thrombectomy and re-anastomosis. Conclusion: Superior thyroid artery and internal jugular vein were reliable choices as recipient vessels. Proper recipient vessel selection could improve the result of head and neck reconstruction.
Purpose: This study examined the corrosion level by alloy type and pH, and used the corrosion levels as the dental health data. The study utilized one Ni-Cr alloy for the full and removable partial denture metal frameworks and two Ni-Cr alloys for porcelain-fused-to-metal crown, among the non-beryllium dental casting non-precious Ni-Cr alloys. Methods: The alloy specimens were manufactured in $10cm^2$ and stored in the corrosive solution(pH 2.2-4.4) in the electrical water bath($37^{\circ}C$) for seven days. Afterwards, the metal ions were quantitatively analyzed using the ICP. Results: Of the three metal alloys, Bellabond-Plus$^{(R)}$alloy and SOLIBOND N$^{(R)}$alloy, with 22% or higher chrome chemical contents, had higher corrosion resistance than Jdium-100$^{(R)}$alloy with 20% chrome chemical content. In all three alloys, the corrosion of Ni was highest, and metal ion corrosion was higher in the pH 2.2 corrosive solution. Conclusion: Although Ni-Cr alloy was not very corrosive, a Ni-allergic patient should not have Ni-Cr alloy prosthesis. The Ni-Cr alloy for porcelain-fused-to-metal crown should be designed for the dental porcelain to cover the whole crown.
Thyroglossal duct cysts (TGDC) are the most common type of congenital developmental anomaly encountered in the anterior midline of the neck in childhood. The aim of the study was to evaluate the clinical characteristics of TGDC and identify any factors that could be related to recurrence after surgery. This study consisted of a retrospective chart review of 45 patients treated at Kyungpook National University Hospital for TGDC between 1990 and 2008. All records were reviewed for age and sex, length of history, presentation, diagnostic methods, sizes and locations of cyst, surgical management, histopathology of the lesion and recurrences. The statistical analysis of risk factors for recurrence was made using the Fisher's exact test with a significance level of p (0.05. The male to female ratio was 2.2:1 with a male preponderance. The mean age at operation was 5 years and 2 months (4 months - 17 years). The most common presenting symptom was a nontender cervical mass (78 %). Most TGDC were found in the midline position. Twenty four were infrahyold, 17 were hyoid, and 4 were suprahyoid level. Forty one (91 %) patients received the Sistrunk operation, and 4(9 %) patients received Cyst excision. Postoperative a seroma developed in six patients in the early postoperative days. There were a total of 3(6.6 %) recurrences, 2 in patients who had excision only and in one patient who had the Sistrunk operation. Univariate analysis for risk factors with recurrence showed that there was no statistical relationship between the presence of preoperative infection and the development of recurrence. The removal of hyoid bone along with TGDC was a statistically significant risk factor for recurrent disease. This study suggests that the Sistrunk operation Is the treatment of choice for TGDC in order to reduce recurrence.
Breast metastases of extramammary malignant neoplasms are rare, with an incidence of 0.3%-2.7% among all malignant mammary tumors. Breast metastases from gastric carcinoma are very rare (<0.1%), and this event is even rarer during pregnancy. Herein, we describe a 39-year-old Caucasian woman with a history of an Epstein-Barr virus-associated gastric carcinoma (EBVaGC) that was characterized by prominent tumor infiltrating lymphocytes. Three years after undergoing radical surgery, the patient developed bilateral breast nodules during her pregnancy. A breast biopsy was performed, and histology confirmed a diagnosis of EBVaGC; tumor cells showed positivity for cytokeratin 8/18 and E-cadherin, and negativity for cytokeratin 7, cytokeratin 20, cytokeratin 5/6, caudal type homebox 2, androgen receptor, mammaglobin, gross cystic disease fluid protein-15, and estrogen and progesterone receptors. We also discuss the main diagnostic pitfalls. To our knowledge, this is the first report of an EBVaGC with lymphoid stroma that developed breast metastases during pregnancy.
Kumar, Shiyam;Burney, Ikram A;Zahid, Khawaja Farhan;Souza, Philomena Charlotte D;Belushi, Muna AL;Mufti, Taha Dawood;Meki, Waeil AL;Furrukh, Muhammad;Moundhri, Mansour S AL
Asian Pacific Journal of Cancer Prevention
/
제16권12호
/
pp.4853-4858
/
2015
Background: Colorectal cancer is the most common gastrointestinal cancer in Oman with an increasing incidence. We here report the presenting features, treatment outcomes and survival in a University hospital in Oman and compare our data with regional and international studies. Materials and Methods: Medical records of patients with colorectal cancer were reviewed retrospectively between June 2000 and December 2013 and were followed until June 2014. Results: A total of 162 patients were diagnosed with colorectal cancer. The majority were males (58.6%), with a median age of 56 years. Rectum was involved in 29.6% of patients, followed by ascending and sigmoid colon. The majority of patients had stage III (42.6%) and stage IV (32.7%) disease at presentation. K-Ras status was checked for 79 patients, and 41 (51.9%) featured the wild type. Median relapse free survival was 22 months. Median overall survival for all patients was 43 months. Observed 5 year overall survival (OS) for stages I, II and III was 100%, 60% and 60% respectively. On Log rank univariate analysis, age, BMI, diabetes, hypertension, metformin use, stage, clinical nodal status for rectal cancer, pathological T and nodal status, site of metastasis, surgical intervention, chemotherapy, radiotherapy, chemotherapy regimen, no of cycles of chemotherapy, response, RFS, site of recurrence and administration of $2^{nd}$ line chemotherapy were significant factors affecting OS. On Cox regression multivariate analysis none of the factors independently affected the OS. Conclusions: The majority of patients present with advanced disease and at young age. The survival rates are comparable to the published regional and international literature.
Background: Adrenal tumors are relatively uncommon, and have different presentations, so we decided to evaluate the clinico-pathological characteristics of benign and malignant tumors in a ten-year period. Materials and Methods: This cross sectional-analytical study was conducted on adrenal resection samples taken during 2004-2014 in three hospitals in Yazd province. Data were analyzed using SPSS software, version 17. Chi-square and Fisher's exact test were used as appropriate Results: A total of 71 patients with adrenal tumors were analyzed, including 32 (45.1%) men and 39 (54.9%) women with an overall mean age $37.7{\pm}19.9$ (range: 6-75 years). Some 50.7% of lesions were benign and 49.3% were malignant. Neuroblastoma was the most malignant lesion (32.3%) followed by adrenocortical carcinoma (8.4%). Among the benign lesions pheochromocytoma was the most common (25.3%) followed by adrenocortical adenoma (12.6%). While 64% of tumors were functional 36% were non functional. Significant correlation was seen between the age of patient and type of tumor (P=0.001). In patients between 14-40 years old no malignant lesions was found, although under 14 years old all of the tumors were malignant. Malignant lesions mostly presented with abdominal pain, abdominal mass and anorexia (57.2%, 45.7% and 45.7%) respectively. Benign lesions mostly presented with paroxysmal hypertension, headache and abdominal pain (61.2%, 47.2% and 44.4%) respectively. Conclusions: Since the trend of adrenal tumors is on the rise based on this and other studies, suspected cases should undergo prompt hormonal and radiological assessment. Early diagnosis and treatment could prevent tumor progression and reduce mortality and morbidity rates.
Background: In Morocco, the epidemiological profile of cervical cancer is not well established. The focus of the present study was both epidemiological and pathological characteristics. Methods: For all cases of cervical cancer treated between 2003 and 2007 in the National Institute of Oncology and the Oncology Department of the IbnRochd hospital (Casablanca), 900 cases were randomly selected. Results: The mean age was $52.1{\pm}11.8$ years. The most (90.5%) represented histological type was squamous cell carcinoma. For more than 57.0% cases the mean distance between patient's origin and center of treatment was greater than 100km. According to the FIGO classification, only 17.2% of patients were identified as being in early stages (0 and I). For 72.2% patients the follow-up did not exceed 2 years. At 1 year of following-up 55.8% of patients were alive and 43.4% were lost to following-up. Conclusion: Our study addressed the issue of the burden of cervical cancer in Morocco. The result provides a basis for decision-makers for the development of strategic measures to implement the fight against cervical cancer in Morocco.
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