Background: Breast cancer is mostly the disease of postmenopausal women but very young affected women are seen more than occasionally in developing countries. We reviewed our cases of very young breast cancer in order to help in better understanding of such cases. Materials and Methods: The records of patients 25 years of age or less who had been admitted for breast cancer surgery in the Cancer Institute of Tehran from 1979 to 2012 were reviewed and relevant data were extracted. Results: From 5,265 cases of breast cancer, 62 patients had 25 years of age or less. There were 55 cases of breast adenocarcinoma, all female. More than 78% of the patients had presented with a palpable mass, the family history was positive in 2% of cases, and about 94% of the histologies were invasive ductal carcinoma. Gestational breast cancer constituted 10% of the cancers; another 10%were bilateral. The median size of the tumors was 5.72 centimeters, 63.2% of them had axillary lymphatic involvement, and more than half were negative for hormone receptors. Conclusions: Our study shows an incidence of 1.17% for very young breast cancer and a 10% rate of bilaterality which probably warrants special guidelines for contralateral screening. Cancer stage and features were poor in comparison with breast cancer in all ages.
Background: Differences in clinicopathological characteristics of gastric cancer (GC) between young and older patients are controversial and a matter of debate. Determining the statistical significance of clinicopathological information with respect to age might provide clues for better management and treatment ofGC. Materials and Methods: A total ofl03 Indiao GC patients were enrolled for study and specimens were classified according to the AjCC-TNM system. Patients were grouped into two age-wise categories, young patients (<40 years; n=13) and older patients (${\geq}40$ years, n=90). The clinicopathological features of both groups were retrospectively examined and compared. p53 alterations were analyzed by polymerase chain reaction-single strand conformational polymorphism and immunohistochemistry methods at gene and protein levels respectively. The cases were considered p53 over-expressed if it was present in more than 25% of the tumor cells and p53 alterations was correlated with the clinicopathological characteristics of the patients as well as etiological factors for GC in both groups. Results: We found significant association of young patients with cancer stage (p=0.01), and very strong association with histology grade (p=0.064) and poorly differentiated (p=0.051) state of GC. However, neither young nor elderly patients showed associations with location, gender, etiological factors and p53 expression and alteration. Overall the male-to-female ratio of GC patients was 3.12 and the value was higher in the young (5.5) than in the older group (2.91). Conclusions: Clinicopathological features of GC like caocer stage, cell differentiation and histological grades were significantly different among young and old age cohorts. We observed a male predominance among the young group that decreased significantly with advancing age. More awareness of GC onset is required to detect cancer at an early stage for successful treatment.
This study is intended to investigate medication compliance and polypharmacy of the diabetic patients by age group in order to determine the major factors that influence their compliance. 198 ambulatory diabetic patients were interviewed, and the sample was divided into three groups based on the age: Young age group under 55, Borderline age group between 55 - 65, Old age group over 65. According to the study results, medication compliance for the old age group was 72.6% whereas 85.1% for the young age group. Medication compliance significantly decreased as the age of the patients increased. Also the degree of polypharmacy, the rate which patients take more than 6 prescription drugs, was 45.9% for the old group, whereas 31.2% for the young group. As the most important factor of polypharmacy, the number of doctors was statistically significant. With regard to prescription factors related to medication compliance, the amount of prescribed medication is statistically significant between the compliance group and non-compliance group. In addition, the amount of information provided to patients by pharmacists was determined to be a very significant factor. Also the level of ease in understanding the medication instructions varied significantly between the compliance group and the non-compliance group. In light of the empirical data and results for the diabetic patients, it is necessary to develop and implement various programs to improve medication compliance and to decrease the level of polypharmacy among the elderly, or "old", diabetic patients. patients.
Buerger's disease is a nonatherosclerogic occlusive inflammatory disease of medium and small arteries, and veins, of unknown cause. It occurs predominantly in young males who are habitual tabacco users. These patients often complain of painful ulcerations of their digits. The care of this disease is very difficult when the treatment is delayed. Consequently, early treatments are most important to patients with Buerger's disease. This disease can be treated with sympathetic block such as stellate ganglion block for upper extremities and lumbar epidural block, and lumbar sympathetic block for lower extremities. Intravascular regional sympathetic block can be another method of treatment. However, discontinuation of smoking is the most basic and essential treatment for Buerger's disease. We treated 43 Buerger's disease patients with stellate ganglion block and laser therapy. The treatment was not effective for three patients who definitely required amputation.
Objectives: The purpose of the study was to investigate the awareness toward the informed consent in the dental hygienists and the patients before treatment. Methods: A self-reported questionnaire was completed by 200 dental hygienists and 200 dental patients in Changwon after explaining the purpose of the study from June 15 to September 15, 2014. The questionnaire was developed as two types for the dental hygienists and the patients. The questionnaire consisted of general characteristics of the subjects, awareness toward the informed consent before treatment, and experience before the treatment. Results: In the necessity of informed consent, 49.5% of dental hygienists and 72.0% of the patients answered that informed consent is very necessary. In the written informed consent, 33.3% of dental hygienists and 54.9% of the patients answered that the dispute can always happen during treatment. Conclusions: The informed consent is recognized as a defensive means for medical malpractice. For the sake of the dental hygienists and the patients, mutual respect and compromise is the very important factor.
Purpose: The purpose of this study was to identify differences between intake and output balance and body weight changes and to identify factors related to differences in critically ill patients. Methods: The participants for this descriptive correlational study were 65 medical surgical ICU patients. The data were collected from patient medical records. Results: Mean age of the patients was 63.80 years (${\pm}15.21$). Body weight changes for 48 hours averaged 281.54g (${\pm}2210.48$). I&O balance for 48 hours corrected for insensible loss averaged 398.1ml. Differences ranged from 45mL to 7,535mL. In the distribution of absolute difference between body weight change and intake and output balance, only 40% of the patients were within less than 1,000 mL. Factors relating to accurate measure of intake and output were ventilation methods, respiration patterns, and edema status. Conclusion: Although mean values of weight change and I&O balance for all patients were very close, the range of differences was very wide indicating that, for many patients, intake and output is not an appropriate indicator of body fluid balance. Therefore, because of the frequency fever and/or hyperventilation, nurses need to use caution when using intake and output balance only to estimate current body fluid status for critically ill patients.
Objectives: To compare the clinicalpathological features and prognosis between premenopausal breast cancer patients aged of <35 and ${\geq}35$ years old. Methods: The clinical data and survival status of 1498 cases premenopausal operable breast cancer treated in our hospital from 2002.1 to 2004. 12 were collected, 118 cases were aged <35. They were divided into 4 groups: Luminal A, Luminal B, HER2-positive, Triple-negative. The disease free survival (DFS) and overall survival (OS) were identified. Results: The 5-year DFS and OS rates were significantly lower in age<35 than in $age{\geq}35$ patients. In the Luminal B, HER2-positive, Triple-negative group, the 5-year recurrence risk was higher in age<35 than in $age{\geq}35$ patients, and age<35 patients' 5-year death risk was higher only in Luminal B, Triple-negative group. Regardless of whether lymph node involved, age<35 patients had a bad prognosis in both DFS and OS. Conclusions: Compared with premenopausal age ${\geq}35$ breast cancer, age<35 patients had a worse outcome.
Osteoarthritis is a disease that has considerable effect on both individuals and economy. The number of osteoarthritis patients are gradually increasing as people get to enjoy longevity. This study was conducted to examine 30 osteoarthritis patients. Following is the report which shows the effectiveness of KJ27 based on statistical data analysis. Among 5 who have reported that they were not able to walk or use their knees at all, 80% of them were completely recovered. Among 18 who have stated that it was very hard for them to walk for more than a kilometer, 66.7% were completely recovered. Among 7 who have reported that it was little bit difficult for them to walk, 71.4% were completely recovered. Among 25 out of 30 who were very unsatisfied with former treatments, 70% of them stated that they were very satisfied with KJ27 treatments, and 30% of them stated that they were satisfied with it. Among 5 who had not had any type of osteoarthritis treatments, 100% have stated that they were very satisfied with the treatment. 18 patients who were under this treatment for a month were completely recovered; 10 patients who were under this treatment for 2 months were completely recovered; and finally 2 patients who were under this treatment for 3 months and longer were completely recovered. It is not clearly understood whether KJ27 will eradicate the entire symptoms of osteoarthritis, yet. Numerous case studies and experiments should be conducted to improve and apply KJ27.
Objective : Complex aneurysms such as fusiform and very small aneurysms (< 3 mm) are challenging in neurovascular and endovascular surgery. Author reports follow-up results of 9 cases treated by sole stent technique with pertinent literature review. Methods : A retrospective study was made of 9 patients who were treated by sole stenting technique for cerebral aneurysm between January 2003 and January 2009. Two of them had fusiform aneurysm, 5 had very small aneurysm, and 2 had small saccular aneurysm. Five patients had ruptured aneurysms and four had unruptured aneurysms. Seven aneurysms were located in the internal carotid artery (ICA), 1 in the middle cerebral artery (MCA) and 1 in the basilar artery. Follow-up cerebral angiography was performed at post-procedure 3 months, 6 months, and 12 months. Mean follow-up period is 30 months (ranged from 3 days to 30 months). Results : Aneurysm size was decreased in 6 of 9 cases on follow-up images and was not changed in 3 cases. Although total occlusion was not seen, patients had stable neurological condition and angiographic result. The procedural complication occurred in 2 cases. One was coil migration and the other was suboptimal deployment of stent, and both were asymptomatic. Re-bleeding and thromboembolic complication had not been occurred. Conclusion : Sole stenting technique is relatively effective and safe as an alternative treatment for fusiform and very small aneurysms.
Purpose: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. Methods: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggido. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. Results: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). Conclusion: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.
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