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OBJECTIVE@#SC-E3 is a polyherbal formula that contains five medicinal herbs used frequently in traditional herbal medicine. In our previous study, we demonstrated the antioxidant and anti-inflammatory effects of SC-E3. The present study examined the effects of SC-E3 in a mouse model of type-II collagen-induced arthritis (CIA).@*METHODS@#In vivo, male DBA/1J mice were immunized by intradermal injection of bovine type-II collagen and complete or incomplete Freund's adjuvant, to induce arthritis. SC-E3 was orally administered daily for 23 days. In vitro, bone marrow-derived macrophages (BMMs) were treated with macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor-κB ligand (RANKL) in the absence or presence of SC-E3.@*RESULTS@#Administrations of SC-E3 were found to have anti-arthritic effects in the joints of CIA mice, as evidenced by reduced paw swelling, bone erosion and deformation, inflammatory cell infiltration, and inflammation in synovial membrane. SC-E3 also reduced serum levels of tumor necrosis factor-α, interleukin-1β, aspartate aminotransferase and alanine aminotransferase. Furthermore, tartrate-resistant acid phosphatase-positive osteoclast numbers in the joints were significantly lower in SC-E3-treated CIA mice than in CIA mice. In addition, the differentiations of BMMs to multinucleated osteoclasts induced by M-CSF and RANKL stimulation were dose-dependently reduced by SC-E3.@*CONCLUSION@#These results suggest that SC-E3 possesses substantial anti-arthritic activity because it inhibits pro-inflammatory cytokines and osteoclastogenesis, and that SC-E3 has potential therapeutic use for the treatment of rheumatoid arthritis.
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OBJECTIVE: This study was to investigate and develop a training program that integrated and strengthened clinical competence and capacity of hospital pharmacists which would be implemented at the pharmacy department of Ewha Womans University Mokdong Hospital. METHODS: We assessed the training programs of hospital pharmacists in the United Kingdom, the United States and Japan and compared those of major hospitals in Seoul and Gyeonggi provinces in Korea. The survey assessed the satisfaction on the current educational programs for pharmacists at Ewha Womans University Mokdong Hospital and a newly designed education program was suggested. RESULTS: The major differences of the programs among the Korean hospitals and Mokdong Hospital were the training period and contents of the entry-level pharmacist education program. The overall satisfaction of the training program was >3 points on 5-Likert scale in the survey. There was no significant difference of the satisfaction level based on the employment period of pharmacists. The pharmacists were in more than 7 training programs of clinical support work. We proposed the clinical support training for the new pharmacists to be separated from orientation and concentrated on actual work duty. In order to improve the competency, it was encouraged to participate the in-house seminar or certify the related fields provided by Korean Society of Health-system Pharmacists. CONCLUSION: The education program was assessed among different countries and hospitals of Korea. We suggested to update education program in the hospital to enhance pharmacists' competency.
Subject(s)
Female , Humans , Clinical Competence , Education , Employment , United Kingdom , Japan , Korea , Mental Competency , Pharmacists , Pharmacy , Seoul , United StatesABSTRACT
OBJECTIVE: An automated process for medication preparation and dispensing is essential to improve the quality of work. To reduce night pharmacy workload, a new automated dispensing cabinet system was implemented in a hospital emergency medical center. The purpose of this study is to verify that implementation of an automated dispensing cabinet system will influence the efficiency of night pharmacy work. METHODS: To evaluate the new system implementation, a retrospective study and survey was performed in the Ewha Womans University medical center. We compared the dispensing and near-miss error rates between the automated dispensing cabinet system and a night pharmacy. The degree of satisfaction of night shift workers with the new system was surveyed. RESULTS: This study showed significantly reduced dispensing rates of night medications (56.1% and 37.3%; p < 0.01) and near-miss night medications (0.27% and 0.17%; p < 0.01). Thirty-two persons responded to the survey, and the satisfaction score for the new system was 4.0 (±0.8). The scores were high in order of efficiency, management, and convenience. Time requirement was also reduced because of the simple step of only reviewing in the pharmacy with the new system. CONCLUSION: Due to system implementation, workload was reduced and time was saved for not only night shift workers but also patients receiving emergency discharge medicine. It was suggested that this will have a positive effect on pharmacist medical service and patient safety.
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PURPOSE: The aim of this study was to examine the level of problem drinking and assess factors that influence problem drinking in Korean college women. METHODS: The participants were 500 students who took part in a self-administered online survey. AUDIT, BDI-II, AES, PSS, and PES were included in the survey used in this study. Collected data were analyzed using descriptive statistic, t-test, ANOVA, Pearson correlation coefficient, and multiple regression with SPSS/WIN 23.0 program. RESULTS: The average score for AUDIT was 8.98±6.38 and the proportion of the problem drinking was 50.8%. Significant factors that influenced problem drinking were depression, alcohol expectations, age of first drink and family income. CONCLUSION: Findings from this study suggest that the need to develop nursing intervention programs for early prevention of excessive alcohol use and recovery for college women who have a drinking problem.
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Female , Humans , Depression , Drinking , NursingABSTRACT
PURPOSE: The purpose of this study was to assess the value of adding digital breast tomosynthesis (DBT) to full-field digital mammography (FFDM) in the diagnostic workup of breast cancer and to determine which lesion variables affect cancer detectability in the combined modality. METHODS: Between March and May 2012, paired FFDM and DBT images were obtained from 203 women as part of a diagnostic workup for breast cancer. Images from FFDM alone, DBT alone, and DBT combined with FFDM were reviewed in separate sessions by six blinded readers. Jackknife alternative free-response receiver operating characteristic (JAFROC) figure of merit (FOM), sensitivity, and specificity were compared between the modalities. Lesion characteristics affecting the cancer detection rate when using the combined modality were also analyzed. RESULTS: Among the 203 women, 126 women had a total of 129 malignancies and 77 women had total of 77 benign lesions. The overall JAFROC FOM of the combined modality was higher than that of FFDM alone (0.827 vs. 0.775, p<0.001) and that of DBT alone was higher than that of FFDM alone (0.807 vs. 0.775, p=0.027). The overall sensitivity of the combined modality was higher than that of FFDM alone (80.0% vs. 73.2%, p<0.001) and that of DBT alone was higher than that of FFDM alone (78.3% vs. 73.2%, p=0.007). Compared to FFDM alone, the combined modality detected an additional 48 cancers. Using the combined modality, the presence of masses or microcalcifications was significantly associated with the cancer detection rate (p<0.001). CONCLUSION: The combination of DBT with FFDM results in a higher diagnostic yield than FFDM alone. Additionally, DBT alone performs better than FFDM alone. However, even when DBT is combined with FFDM, breast cancers with no discernible masses and those lacking calcifications are difficult to detect.
Subject(s)
Female , Humans , Breast Neoplasms , Breast , Early Detection of Cancer , Imaging, Three-Dimensional , Mammography , ROC Curve , Sensitivity and SpecificityABSTRACT
Many researchers have found that one of the most important characteristics of the structure of linkage disequilibrium is that the human genome can be divided into non-overlapping block partitions in which only a small number of haplotypes are observed. The location and distribution of haplotype blocks can be seen as a population property influenced by population genetic events such as selection, mutation, recombination and population structure. In this study, we investigate the effects of the density of markers relative to the full set of all polymorphisms in the region on the results of haplotype partitioning for five popular haplotype block partition methods: three methods in Haploview (confidence interval, four gamete test, and solid spine), MIG++ implemented in PLINK 1.9 and S-MIG++. We used several experimental datasets obtained by sampling subsets of single nucleotide polymorphism (SNP) markers of chromosome 22 region in the 1000 Genomes Project data and also the HapMap phase 3 data to compare the results of haplotype block partitions by five methods. With decreasing sampling ratio down to 20% of the original SNP markers, the total number of haplotype blocks decreases and the length of haplotype blocks increases for all algorithms. When we examined the marker-independence of the haplotype block locations constructed from the datasets of different density, the results using below 50% of the entire SNP markers were very different from the results using the entire SNP markers. We conclude that the haplotype block construction results should be used and interpreted carefully depending on the selection of markers and the purpose of the study.
Subject(s)
Humans , Chromosomes, Human, Pair 22 , Dataset , Genome , Genome, Human , Haplotypes , HapMap Project , Linkage Disequilibrium , Polymorphism, Single Nucleotide , Recombination, GeneticABSTRACT
OBJECTIVE: To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. MATERIALS AND METHODS: A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. RESULTS: Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. CONCLUSION: Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Biopsy , Breast/pathology , Breast Neoplasms/diagnosis , Mammography/methods , ROC Curve , Radiographic Image Enhancement/methods , Retrospective Studies , Sensitivity and Specificity , Ultrasonography, Mammary/methodsABSTRACT
PURPOSE: To report clinical aspects of children diagnosed with refractive accommodative esotropia after wearing their first glasses to correct hyperopia accompanied with esodeviation. METHODS: The present study included 75 children followed up for at least 24 months. Age, spherical equivalent of refractive error, angle of deviation and presence of amblyopia were analyzed according to the duration between first wearing glasses and control of esotropia within 8 PD (2 months). RESULTS: The mean age was 4.48 +/- 2.08 years and mean follow-up was 50.17 months. Initial deviation angle without glasses was 25.43 +/- 10.07 PD at far, 27.72 +/- 11.45 PD at near, spherical equivalent was +4.86 +/- 2.41 D in right eyes, +5.05 +/- 1.06 D in left eyes and 8 of 75 patients (10.67%) had 2 months had less hyperopia (+4.02 D vs. 5.17 D), more severe esodeviation both at far (30.79 +/- 10.79 PD vs. 24.17 +/- 9.56 PD, p = 0.03) and at near distance (34.00 +/- 14.20 PD vs. 26.25 +/- 10.31 PD, p = 0.02) and higher initial amblyopia prevalence rates (71.5% vs. 47.5%). CONCLUSIONS: Several patients needed longer follow-up until esotropia was controlled within 8 PD after wearing hyperopic glasses considering the amount of hyperopia and angle of esodeviation.
Subject(s)
Child , Humans , Amblyopia , Esotropia , Eyeglasses , Follow-Up Studies , Glass , Hyperopia , Prevalence , Refractive ErrorsABSTRACT
PURPOSE: Purpose was to explore associations between sleep duration and metabolic syndrome (MS) risks, and to determine factors associated with self-rated health (SRH) of adults with MS compared to other adults. METHODS: This is a secondary data analysis based on the Fifth Korea National Health and Nutrition Examination Survey KNHANES V (N=12662). Study instruments included sleep duration, MS risk factors, SRH and health-related quality of life (HRQoL). RESULTS: Mean age of participants was 43.68+/-12.26 years. Fifty-eight percent were women, and 18.3% were identified as having MS. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and SRH were significantly different according to sleep duration (p<.05) among all participants. In the non MS group, male gender, younger age (19~30 and 41~50 age brackets) upper income level, sufficient sleep duration, and high density lipoprotein (HDL) were positively associated with SRH, whereas, lower education levels (< or = middle school), glucose level, and waist circumference were negatively associated with SRH (p<.05). In the MS group, lower income, lower education levels (< or = middle school), glucose level, and waist circumference were negatively associated with SRH, whereas, having an occupation was positively associated with SRH (p<.05). CONCLUSION: Results suggest that tailored approaches are required for prevention and control of MS and sleep duration of each individual should be considered rather than applying standardized guidelines. However, as sleep quality was not included in the analysis, further investigations regarding influence of sleep quality on MS and SRH and controlling for other lifestyle and health behavior factors are required.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Blood Glucose/analysis , Blood Pressure/physiology , Cholesterol, HDL/blood , Health Status , Metabolic Syndrome/physiopathology , Odds Ratio , Quality of Life , Risk Factors , Self Report , SleepABSTRACT
PURPOSE: This study was done to evaluate the Military Mental Health Promotion Program. The program was an email based cognitive behavioral intervention. METHODS: The research design was a quasi-experimental study with a non-equivalent control group pretest-posttest design. Participants were 32 soldiers who agreed to participate in the program. Data were collected at three different times from January 2012 to March 2012; pre-test, post-test, and a one-month follow-up test. The data were statistically analyzed using SPSS 18.0. The effectiveness of the program was tested by repeated measures ANOVA. RESULTS: The first hypothesis that the level of depression in the experimental group who participated in the program would decrease compared to the control group was not supported in that the difference in group-time interaction was not statistically significant (F=2.19, p=.121). The second and third hypothesis related to anxiety and self-esteem were supported in group-time interaction, respectively (F=7.41, p=.001, F=11.67, p<.001). CONCLUSION: Results indicate that the program is effective in improving soldiers' mental health status in areas of anxiety and self-esteem.
Subject(s)
Humans , Male , Young Adult , Anxiety , Cognitive Behavioral Therapy , Depression/pathology , Electronic Mail , Health Promotion , Mental Health , Military Personnel/psychology , Program Evaluation , Surveys and Questionnaires , Self Concept , Severity of Illness IndexABSTRACT
PURPOSE: This descriptive study was done to develop a predictive model of depression in rural elders that will guide prevention and reduction of depression in elders. METHODS: A cross-sectional descriptive survey was done using face-to-face private interviews. Participants included in the final analysis were 461 elders (aged> or = 65 years). The questions were on depression, personal and environmental factors, body functions and structures, activity and participation. Decision tree analysis using the SPSS Modeler 14.1 program was applied to build an optimum and significant predictive model to predict depression in rural elders. RESULTS: From the data analysis, the predictive model for factors related to depression in rural elders presented with 4 path-ways. Predictive factors included exercise capacity, self-esteem, farming, social activity, cognitive function, and gender. The accuracy of the model was 83.7%, error rate 16.3%, sensitivity 63.3%, and specificity 93.6%. CONCLUSION: The results of this study can be used as a theoretical basis for developing a systematic knowledge system for nursing and for developing a protocol that prevents depression in elders living in rural areas, thereby contributing to advanced depression prevention for elders.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Activities of Daily Living , Cognition , Decision Trees , Depression/psychology , Motor Activity , Surveys and Questionnaires , Rural Population , Self Care , Self Concept , Sex Factors , Social BehaviorABSTRACT
While the ability to develop nanomaterials and incorporate them into products is advancing rapidly worldwide, understanding of the potential health safety effects of nanomaterials has proceeded at a much slower pace. Since 2008, Korea Food and Drug Administration (KFDA) started an investigation to prepare "Strategic Action Plan" to evaluate safety and nano risk management associated with foods, drugs, medical devices and cosmetics using nano-scale materials. Although there are some studies related to potential risk of nanomaterials, physical-chemical characterization of nanomaterials is not clear yet and these do not offer enough information due to their limitations. Their uncertainties make it impossible to determine whether nanomaterials are actually hazardous to human. According to the above mention, we have some problems to conduct the human exposure risk assessment currently. On the other hand, uncertainty about safety may lead to polarized public debate and to businesses unwillingness for further nanotechnology investigation. Therefore, the criteria and methods to assess possible adverse effects of nanomaterials have been vigorously taken into consideration by many international organizations: the World Health Organization, the Organization for Economic and Commercial Development and the European Commission. The object of this study was to develop risk assessment principles for safety management of future nanoproducts and also to identify areas of research to strengthen risk assessment for nanomaterials. The research roadmaps which were proposed in this study will be helpful to fill up the current gaps in knowledge relevant nano risk assessment.
Subject(s)
Humans , Commerce , Cosmetics , Hand , Korea , Nanostructures , Nanotechnology , Risk Assessment , Risk Management , Safety Management , Uncertainty , United States Food and Drug Administration , World Health OrganizationABSTRACT
OBJECTIVES: This report describes the development process of a drug dosing database for ethical drugs approved by the Korea Food & Drug Administration (KFDA). The goal of this study was to develop a computerized system that supports physicians' prescribing decisions, particularly in regards to medication dosing. METHODS: The advisory committee, comprised of doctors, pharmacists, and nurses from the Seoul National University Bundang Hospital, pharmacists familiar with drug databases, KFDA officials, and software developers from the BIT Computer Co. Ltd. analyzed approved KFDA drug dosing information, defined the fields and properties of the information structure, and designed a management program used to enter dosing information. The management program was developed using a web based system that allows multiple researchers to input drug dosing information in an organized manner. The whole process was improved by adding additional input fields and eliminating the unnecessary existing fields used when the dosing information was entered, resulting in an improved field structure. RESULTS: A total of 16,994 drugs sold in the Korean market in July 2009, excluding the exclusion criteria (e.g., radioactivity drugs, X-ray contrast medium), usage and dosing information were made into a database. CONCLUSIONS: The drug dosing database was successfully developed and the dosing information for new drugs can be continually maintained through the management mode. This database will be used to develop the drug utilization review standards and to provide appropriate dosing information.
Subject(s)
Humans , Advisory Committees , Databases, Pharmaceutical , Drug Utilization Review , Isothiocyanates , Korea , Pharmacists , RadioactivityABSTRACT
PURPOSE: To evaluate the effect of age wearing prescription glasses on changes in refractive error in accommodative esotropia. METHODS: We retrospectively reviewed the charts of 63 patients with accommodative esotropia. The patients were divided into three groups according to their age when glasses were prescribed. Changes of the refractive error between the three groups were compared. RESULTS: The mean age at the first visit was 4.1+/-2.0 years and the mean follow-up period was 5.7+/-2.7 years. In children that began wearing glasses before two years of age, the spherical equivalent (SE) refractive error initially increased, peaked 2.5 years after starting to wear glasses, and slowly decreased thereafter. In children who started wearing glasses after two years but not before four years of age the SE refractive error increased and peaked 1.5 years after starting to wear glasses. For children who began wearing glasses after four years of age the SE refractive error increased and peaked after one year. Changes in the refractive error in the youngest age group were significantly different from the other two groups (p=0.064). CONCLUSIONS: The age when glasses are prescribed may influence normal emmetropization in accommodative esotropia. However, further studies with longer follow-ups will be needed to determine the effect of wearing glasses on the final SE refractive error.
Subject(s)
Child , Humans , Esotropia , Eyeglasses , Follow-Up Studies , Glass , Prescriptions , Refractive Errors , Retrospective StudiesABSTRACT
PURPOSE: This study was to investigate the factors influencing problem behaviors among adolescents. METHOD: The subjects for this study were 596 students in middle school in Seoul. The data was collected during the period from May to November, 2001 by use of questionnaires. The instruments used were the Child Problem Behavior list by Hong (1986), the Body Cathexis Scale by Secord and Jourard(1953), and the Beck Depression Inventory by Beck(1978). The data was analyzed by using the SPSS-Win program. RESULT: Problem behaviors showed a significant negative correlation with body image (r= -.310. p=.000) and positive correlation with depression (r=.674, p=.000). There were significant differences in the problem behavior scores of subjects according to sex, family status, economic status, and school scores. Female students were found to have a high degree of internalized problem behaviors. In addition, depression, body image, and sex were significant predictors to explain problem behaviors(47.3%). Depression, sex, grade, and school scores were significant predictors to explain externalized problem behaviors(21.9%) and depression and body image, internalized problem behaviors(51.4%). CONCLUSION: Since predicting factors of problem behaviors among middle school students by problem behavior type and sex were different, then practitioners should consider these differences when developing programs for them.
Subject(s)
Adolescent , Female , Humans , Male , Adolescent Behavior , Korea , Mental Disorders/etiology , StudentsABSTRACT
Koreans rarely complain of depression or other psychological problems because mental illness is viewed as a stigmatizing and threatening experience. This study examined the relationships among stressful life events, close relationships, self-esteem, and depression in 400 college women aged 18 to 30 years. Depression was positively related to stressful life events(r=.21 p=<.01). Depression and stressful life events were negatively associated with self-esteem(r=-.67: r=-.11, p<.01; p<.05 respectively). Close relationships with women and men friends were each negatively associated with depression (r=-.24; r=-.16, p<.05). Close relationships with women and men friends were positively associated with self-esteem (r=.23; r=.20, p<.01). Forty nine percent of variance in depression rates in this sample was explained. After adjustment for degrees of freedom, a total of 49% of the variance in depression was explained by self-esteem and stressful life event. This investigation into the relationships among the variables influencing depression for college women is a critical issue as health professional interventions are those designed for specific populations to meet unique care needs and since young Korean women may be at considerable risk for depression.
Subject(s)
Female , Humans , Male , Depression , Freedom , Friends , Health OccupationsABSTRACT
OBJECTIVES: This study was to investigate the effects of aesthetic surgery on mental health. METHOD: Sixty-four patients were assessed for their mental health and the degree of satisfaction with their body image before and after operations. The subjects' mental health was evaluated by the Korean version of Symptom Check List-90(SCL-90), a satisfaction scale with body image, and a questionnaire for demographic data and operation. RESULTS: 1) The average score of SCL-90 significantly improved from 68.17(S.D.+/-48.26) to 58.03(S.D.+/-46.93) after operation(p<0.01). The scores of all subscales for somatization symptoms, interpersonal sensitivity, depression, hostility and psychoticism improved significantly. Significant improvement was also found in patients who were in their 20's and 40's, had family support and had positive attitudes toward their operations. Family support had a more positive influence in the group who had a poorer state of mental health before the operation. 2) The average score of satisfaction with their body image improved significantly from 58.54(S.D.+/-23.14) to 78.14(S.D.+/-18.30)(p<0.01). The more they were satisfied with their body image, the more their mental health state improved. The degree of improvement in satisfaction was significant (p<0.01) in patients who had shown a poorer mental health state before operation. CONCLUSION: These results suggest that aesthetic surgery has positive influence on patients' mental health and improved satisfaction with their body image and also that, in selection of patients for aesthetic surgey, their age and possible family support should be considered.
Subject(s)
Humans , Body Image , Depression , Hostility , Mental Health , Surveys and QuestionnairesABSTRACT
PURPOSE: The purpose of this study was to determine normal CT appearance of the neck after total laryngectomy and to evaluate the role of CT in accessing recurrent neoplasm. MATERIALS AND METHODS: In 65 patients who had undergone total laryngectomy, CT findings relating to shape of the neopharynx and alterations of normal anatomic structures were retrospectively reviewed. Fifty-five patients had also undergone neck dissection, and 47 patients had had adjuvant radiation therapy. RESULTS: In 27 patients, a normal neopharynx with a round or ovoid structure connecting the base of the tongue with the cervical esophagus had even wall thickness and iso- or slight hyperdensity to muscle. Fourteen of 32 patients with recurrent neoplasm showed an ill-defined, peripherally enhancing hypodense mass. Twenty-three patients developed metastatic lymphadenopathy and five patients developed coincidental local recurrent mass and lymphadenopathy. Hypodense masses mimicking recurrence were found in six patients and two cases revealed granulation tissues in the oropharynx(n = 2) and abscesses(n = 2). Another four patients were considered to be cases of immediate postoperative fluid collection or lymphocele. CONCLUSION: Aknowledge of normal CT findings of the neck after total laryngectomy is useful in the evaluation of recurrent laryngeal carcinoma.
Subject(s)
Humans , Esophagus , Granulation Tissue , Laryngectomy , Lymphatic Diseases , Lymphocele , Neck Dissection , Neck , Recurrence , Retrospective Studies , TongueABSTRACT
PURPOSE: The purpose of this study was to evaluate the usefulness of CT-guided percutaneous needle aspiration(PCNA) of paraaortic and pelvic lymph nodes in patients with uterine cervical carcinoma. MATERIALS AND METHODS: CT-guided PCNA was performed in 18 patients with treated cervical carcinoma. initial clinical stages were CIS in one, lb in three, lib in ten, and IIIb in four cases. We used 20 gauge Westcott needles for aspiration. Mean depth from skin to lymph nodes was 10.0cm in paraaortic group (n=13) and was 7.9cm in pelvic group (n=5). The size of lymph nodes ranged 1.0-3.0cm (mean :1.8) and 1.5-5.0cm (mean :2.6cm), respectively. RESULTS: All cases with paraaortic lymph node enlargement were proved to be metastatic lymphadenopathy. In five cases with pelvic lymph node enlargement, three were proved to be malignancy and two were negative. Among 16 cases with metastatic lymphadenopathy, eight patients were treated with chemotherapy, five with radiation therapy, and three with chemotherapy and radiotherapy. In two cases with negative results lymph nodes were disappeared or unchanged on follow up CT scans. No complications were encountered during CT-guided PCNA procedure. CONCLUSION: CT-guided PCNA of paraaortic and pelvic lymph nodes is a useful method in determining metastasis from cervical carcinoma and in planning further treatment.
Subject(s)
Humans , Biopsy, Fine-Needle , Drug Therapy , Follow-Up Studies , Lymph Nodes , Lymphatic Diseases , Needles , Neoplasm Metastasis , Proliferating Cell Nuclear Antigen , Radiotherapy , Skin , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To evaluate the effects and complications of self-expandable metallic stent for the treatment of malignant esophagogastric strictures. MATERIALS AND METHODS: From September 1991 to March 1995, 110 stents were placed under fluoroscopic guidance in 103 patients. Of the 103 patients, there were 73 patients with esophageal cancer, 14 patients with gastric cancer, 12 patients with recurrence after surgery, three patients with esophageal compression by metastatic mediastinal lymphadenopathy, and one patient with esophageal invasion by lung cancer. Seventeen patients had esophagorespiratory fistulas. Under fluoroscopic guidance, 113 self-expandable metallic stents (99 Song stents, 14 Strecker stents) were placed in 103 patients. RESULTS: After stent placement, 68 (66%) of the patients could ingest solid food, 26 (25.2%) could ingest soft food, whereas three (2.9%) were not able to have food. Esophagorespiratory fistulas were occluded immediately after stent insertion. All stents were placed without any technical failures or procedural morbidity or mortality. Complications included restenosis in 13, gastroesophageal reflux in 11, stent tube migration in eight, massive bleeding in four, delayed esophageal perforation in one, stent obstruction by food impaction in one patient. CONCLUSION: Self-expandable metallic stent seems to be relatively safe and effective procedure in the palliative treatment of malignant esophagogastric stricture.