• Title/Summary/Keyword: Presentation Age

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Analysis of Survival and Prognostic Factors in Soft Tissue Sarcomas (연부 조직 육종의 생존 및 예후 인자 분석)

  • Kim, Han-Soo;Seong, Sang-Cheol;Choi, In-Ho;Chung, Chin-Youb;Cho, Tae-Joon;Kim, Sang-Rim;Jeong, Jin-Young;Han, Il-Kyu;Lee, Han-Koo;Lee, Sang-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.4
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    • pp.208-215
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    • 1999
  • The purpose of this study was to identify the independent clinicopathologic prognostic factors of soft tissue sarcoma affecting local recurrence, metastasis and survival. Retrospectively collected data from 130 patients with soft tissue sarcoma were analyzed. Patient, tumor and pathologic factors were analyzed by univariate and multivariate methods for the endpoints of local recurrence, metastasis and survival. In univariate analysis, wide surgical margin, adjuvant radiotherapy and age younger than 40 years reduced local recurrence. Tumor size larger than 5cm was related with a higher rate of metastasis. Patients with metastasis at initial presentation and with a large tumor size had a low survival rate. In multivariate analysis, adjuvant radiotherapy and young age were significantly correlated with a low local recurrence rate. In conclusion, patients with metastasis at initial presentation and a large tumor size had a reduced survival rate. Independent adverse prognostic factors for local recurrence were old age and not undergoing adjuvant therapy.

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Characteristics of elderly patients with acute poisoning (노인 중독 환자의 특성)

  • Kim, Bo-Kyeong;Jung, Si-Young;Jung, Koo-Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.8 no.2
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    • pp.61-68
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    • 2010
  • Purpose: Poisoning is a major health problem for the elderly, and poisoning can cause fatal side effects. However, the characteristics and clinical features of elderly patients with acute poisoning have not been well studied in the previous domestic research. So, we tried to analyze the clinical characteristics and toxic substances of the patients who were 65 years old or older and who were admitted to the regional emergency medical center due to acute poisoning. Methods: We retrospectively reviewed the medical records and poisoning protocols of the patients who were 65 years of age or older and who had with acute poisoning and who visited the ED in our emergency center from January 2005 to December 2009. We collected the demographic information, the gender, the underlying diseases, the causes and toxic substances, the initial presentation, the treatment and the outcomes. Results: A total of 2179 poisoned patients visited the hospital during 5 years, and among them 244 were 65 years of age or older (11.2%). The mean age was $75.6{\pm}6.9$ years and the male:female ratio was 1:1.7. The most common cause of poisoning was suicide (73.4%) and the most common source of poisonous substances was their own drugs. Of the substances used for poisoning, benzodiazepine was the most common drug (25.8%), followed by sedatives other than benzodiazepine (25.4%), insecticide (12.7%), chemical agents (12.3%) and herbicides (8.2%). The most common initial presentation was mental change (64.8%). When comparing the factors between the three elderly groups, there was no difference in gender, the cause, the substances and the underlying disease. The outcomes of treatment included ICU admission (56.1%), a good condition at discharge (12.7%) and admission to a general ward (12.7%). The overall mortality rate was 10.2% for the elderly patients. Conclusion: In this Korean study, unlike the foreign studies, the most common cause of poisoning in elderly patients was intentional poisoning. The admission rate was 68.8% and mortality rate was 10.2%.

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Botulinum Toxin Therapy in a Patient with HHH Syndrome with Gait Disturbance: A Case Report

  • Kim, Dong-Hyun;Choi, Yoon-Hee
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.2
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    • pp.105-108
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    • 2021
  • Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

Cervical Precancerous Lesions and Cancer among Patients in the Gynaecology Outpatient Department at a Tertiary Hospital in South Africa

  • Hank, Edward;Hoque, Muhammad Ehsanul;Zungu, Lindiwe
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4903-4906
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    • 2013
  • Background: The purpose of this study was to determine proportional rates of cervical precancerous lesions and cancer, and associations with socio-demographic variables, HIV status, and CD4 cell count. Materials and Methods: A retrospective comparative study was conducted targeting the medical records of all women over age 18 that were diagnosed histologically through colposcopy with cervical precancerous lesions and cancer from 1 December 2011 to 30 November 2012. Results: A total of 313 patient records were used for data analysis. The average age was 39.1 (SD=2.04) years. More than a third (37.1%) of the patients had CIN III or cervical cancer. There was a significant association between age, CD4 cell count, HIV status, and cervical lesions (p<0.05). Age was found to be an influential predictor of cervical lesions (OR=0.67, 95%CI: 0.46-0.98). Conclusions: There exists an association between age and cervical lesions, with presentation of cervical precancerous lesions and cervical cancer at a younger age among HIV reactive patients. The National Guidelines should be brought in line with the National HIV Counseling and Testing Policy to offer Pap smears to all sexually active women that test HIV reactive during routine HIV Testing.

Renal and Renovascular Hypertension in Children (소아의 신성 고혈압)

  • Hahn, Hye-Won
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.1-13
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    • 2011
  • Hypertension is a major risk factor of atherosclerosis which results in cardiovascular disease, and remains a major health problem worldwide. While children are more likely to have secondary hypertension, recent studies support the theory that the prevalence of essential hypertension in children and adolescents is increasing with the global epidemic of childhood obesity, and close attention is needed. Evaluation of hypertension in the pediatric age group should be guided by the age at presentation, and renal diseases must be considered in every child with hypertension, because of the prevalence of renovascular and renal parenchymal disorders as the etiology in any age group. The majority of children with chronic kidney disease are hypertensive, and many have associated end organ damage. Thus, once hypertension has been confirmed, end organ care as well as pharmacologic therapy must be continued. In renovascular hypertension, as cure could be gained with surgical/endovascular intervention, accurate diagnosis is important and it is recommended that every suspected child should undergo angiography.

Minimally Invasive Suturectomy and Postoperative Helmet Therapy : Advantages and Limitations

  • Chong, Sangjoon;Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.59 no.3
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    • pp.227-232
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    • 2016
  • Various operative techniques are available for the treatment of craniosynostosis. The patient's age at presentation is one of the most important factors in the determination of the surgical modality. Minimally invasive suturectomy and postoperative helmet therapy may be performed for relatively young infants, whose age is younger than 6 months. It relies upon the potential for rapid brain growth in this age group. Its minimal invasiveness is also advantageous. In this article, we review the advantages and limitations of minimally invasive suturectomy followed by helmet therapy for the treatment of craniosynostosis.

Determination of a Change Point in the Age at Diagnosis of Breast Cancer Using a Survival Model

  • Abdollahi, Mahbubeh;Hajizadeh, Ebrahim;Baghestani, Ahmad Reza;Haghighat, Shahpar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.5-10
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    • 2016
  • Breast cancer, the second cause of cancer-related death after lung cancer and the most common cancer in women after skin cancer, is curable if detected in early stages of clinical presentation. Knowledge as to any age cut-off points which might have significance for prognostic groups is important in screening and treatment planning. Therefore, determining a change-point could improve resource allocation. This study aimed to determine if a change point for survival might exist in the age of breast cancer diagnosis. This study included 568 cases of breast cancer that were registered in Breast Cancer Research Center, Tehran, Iran, during the period 1986-2006 and were followed up to 2012. In the presence of curable cases of breast cancer, a change point in the age of breast cancer diagnosis was estimated using a mixture survival cure model. The data were analyzed using SPSS (versions 20) and R (version 2.15.0) software. The results revealed that a change point in the age of breast cancer diagnosis was at 50 years age. Based on our estimation, 35% of the patients diagnosed with breast cancer at age less than or equal to 50 years of age were cured while the figure was 57% for those diagnosed after 50 years of age. Those in the older age group had better survival compared to their younger counterparts during 12 years of follow up. Our results suggest that it is better to estimate change points in age for cancers which are curable in early stages using survival cure models, and that the cure rate would increase with timely screening for breast cancer.

Adolescent menstrual disorders (청소년의 월경 장애)

  • Hong, Chang-Ho
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1257-1262
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    • 2006
  • The age of puberty represents a very critical time in the life history of every young woman. The menarche stands as primary indicator of the onset of sexual maturation in females. By late adolescence, 75% of girls experience some problem associated with menstruation. Delayed, irregular, painful, and heavy menstrual bleeding are leading reasons for physician office visits by adolescents, and dysmenorrhea is the leading reason for school absenteeism among girls. This article discusses normal menstrual function during adolescence, then reviews the clinical presentation, evaluation, and management of adolescent dysmenorrhea, dysfunctional uterine bleeding, amenorrhea, and polycystic ovary syndrome.

A Study on Life Changes of Temporomandibular Disorder Patients through SRRS (SRRS를 이용한 측두하악장애환자의 생활변화에 관한 연구)

  • Park, June Sang;Ko, Myung Yun
    • Journal of Oral Medicine and Pain
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    • v.12 no.1
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    • pp.63-74
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    • 1987
  • The life changes of TMJ patients were evaluated through the Social Readjustment Rating Scale (SRRS) questionnaire. 61 female TMJ patients and 80 dental new female outpatients were studied at the TMJ Clinics, Department of Oral Diagnosis, PNUH from February to September 1987. The obtained results were as follows; 1. The life change unit (LCU) totals and number of life events in the TMJ patients were significantly higher than those in the control subjects, especially during the 1-6 months before presentation for the hospital. 2. There was no significant difference in the number of the high-scored (over 150 LCU totals) between the TMJ patients and the control subjects. 3. There was a significant difference in LCU totals and life events between the TMJ patients and the control subjects by age, despite no difference in LCU totals and life events between the young and the advanced subgroups. 4. The LCU totals and the number of life events in the TMJ patients over 13-year-school age were significantly higher than those in the control subjects over 13-year-school age and the TMJ patients under 12-year-school age. 5. The married subgroup in the TMJ patients showed no significant difference in LCU totals and life events as compared with the unmarried one. 6. Categorizing life events into 6 items (marital life, health, occupation, family, finances and social), the TMJ patients had the higher frequencies in marital life and occupation than the control.

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Peripheral Arterial Injuries in Pediatric Age Group

  • Ammar, Ahmed AbdulRaouf
    • Journal of Trauma and Injury
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    • v.29 no.2
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    • pp.37-42
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    • 2016
  • Purpose: Arterial injury in children is a challenging problem for its special characteristics. It is rare even during warfare. This review described a personal experience in the management and outcome of acute pediatric arterial injuries of extremities. Methods: Thirty-six children below age of 13 years were studied during period from 2004 through 2014 in Iraq. Results: Male patients were 27 (75%) and female were 9 (25%). Seven to twelve years old was the most affected age group. The incidence of iatrogenic injuries was greater in infants and toddlers while penetrating injuries were the most common in older children. Upper limbs arteries were affected in 17 (47.2%) and lower limb in 19 (52.8%) patients. Hard signs were the commonest mode of presentation (83.3%). Lateral wall tear and complete transection were the most frequent types of arterial injury (36.1% and 27.8% respectively). The most frequent procedures performed were end-to-end anastomosis and lateral arteriorrhaphy. Surgical outcome was good. In 27 cases distal pulsations were regained. Seven cases had impalpable distal pulses but still viable limbs. Limb length discrepancy was detected in one case. One case was complicated with limb loss. No death was recorded. Conclusion: Arterial injuries in children are age related. The proper treatment of arterial injuries in children requires high index of suspicion, early operative intervention and continuous postoperative follow-up throughout years of active growth. Angiogram has a limited role as a diagnostic tool in acute arterial injuries.