Household ecology and out-migration among ethnic Karen along the Thai-Myanmar border

Local migration in developing-world settings, particularly among rural populations, is an important yet understudied demographic process. Research on migration in such populations can help us test and inform anthropological and demographic theory. Furthermore, it can lead to a better understanding of modern population distributions and epidemiologic landscapes

Differentiation between Metastasis and Synchronous Double Cancers of the Esophagus

Simultaneously two independent tumors were detected in the esophagus. Histological examination could not necessarily distinguish the two tumors from double cancers. It is emphasized that cellular DNA analysis by using FCM is of great benefit for this purpose. It is difficult to determine clinically whether double cancers are simultaneously existing two cancers or cancerous lesion accompanying metastatic lesions. Until recently histologic finding was the only method to identify them. The criteria of identifying double cancers from primary cancer with metastasis are that different types of histology should be individually revealed and no histologic sequence between both. lesions should be defined with or without submucosal lymphatic involvement. It is well known that malignant tumors are characterized by abnormalities in cellular DNA content. However, it is no doubt that metastatic tumors arising from the primary one display a similar pattern of DNA, suggesting identical stem cells with an original tumor when surgeons encounter in independent cancerous lesions in the same surgical specimen, two separated cancerous lesions should be identified whether double primary cancers or metastasis. Flow cytometry (FCM) provides a fast and precise means for determination of DNA-aneuploidy index. we experienced with independent double cancerous lesions in the esophagus and these were regarded as primary cancer with skipping metastatic lesions with the help of analysis of DNA histogram

Evaluation of Surgical Treatment for Breast Cancer

The prognosis of breast cancer is evaluated with respect to age. In theis is study, the patients\u27 age was divided into the three catgories, younger (under age 35), middle-aged (over age 36 and under age 65), and older (over age 66) patients. The survival rates among the three goups were almost the same according to age and disease stage. However, the prognosis in younger patients with advanced disease stage was unsatisfactory and it was inferior to that in older ones. It is concluded that advanced disease in younger patients contributed to poor prognosis in reflection of changes in hormonal circumstances such as pregnancy, delivery and lactation

Clinical Application of Lung Cancer Cell DNA Analysis

Nuclear DNA patterns were evaluated for 115 lung cancers which were surgically resected. Seventeen percent showed diploidy pattern and 83% were aneuploidy. The 3-year survival was 90% in those who showed diploid and 58% in those who revealed aneuploid in analysis of nuclear DNA patterns. In conclusion determination of nuclear DNA pattern for lung cancer cells is of clinical value to assess the surgical outcome besides the histochemical evaluation

Bilateral Breast Cancer

Fifteen patients with bilateral breast cancer were clinically analyzed on the basis of a result of surgical treatment, in whom eight patients had bilateral synchronous breast cancer, four were non-synchronous and the remaining three were metastatic breast cancer, respectively. The prognosis of patients with bilateral breast cancer was not pessimistic, indicating that it depended on the disease stages of each cancer. On the other hand, it was emphasized that the prognosis of patients with bilateral metastatic breast cancer was extremely poor. Surgeons should be aware of high risk of contralateral breast cancer in careful follow-up following mastectomy for breast cancer. It is generally accepted that patients with cancer of one breast have a higher than average risk of developing cancer of the opposite breast. It is not so rare that bilateral breast tumors are seen in an identical patient on account of the effectiveness of high resolution mammography and sonography in early detection. It is known that a cancer of one breast means the most frequent precancerous lesion of the opposite breast. Bilateral breast cancer may occur in any of the following ways. 1. Bilateral simultaneous breast cancer occurring independently in both breasts and at the same time (syncronous). 2. Bilateral primary non-simultaneous breast cancer occurring independently in each breast but at different times (asynchronous). 3. Bilateral secondary breast cancer occurring either simultaneously or non-simultaneously but as one of the manifestations of metastatic dissemination. However, despite these simple definitions, there is often great difficulty in determining the exact type of bilateral breast cancer under consideration, in particular, identifying second primary cancer from metastatic one. In this study, bilateral breast cancers were clinicopathologically reviewed on the basis of a result of surgical treatment at the First Department of Surgery, Nagasaki University School of Medicine

Impact of behavioral/developmental disorders comorbid with conduct disorder

Aims: The aim of the present study was to verify the comorbidity of conduct disorder (CD) and behavioral/developmental disorders in children and adolescents, and to examine the traits of CD comorbid with them. Methods: Subjects were 64 children (60 boys, four girls) who were resident at three institutions for delinquent children or who were conduct-disordered outpatients of a university hospital aged under 18 years. A diagnostic interview was carried out by experienced child psychiatrists and the intelligence score and the Adverse Childhood Experiences score were measured by a licensed psychologist. Results: A total of 57 children were diagnosed as having CD, of whom 26 (45.6%) were diagnosed with comorbid attention-deficit-hyperactivity disorder (ADHD), 12 were diagnosed with comorbid pervasive developmental disorder (PDD, 21,1%), and 19 (33.3%) had no comorbidity of either disorder. Six children (18.8% of CD comorbid with ADHD) met the criteria for both ADHD and PDD. The group with comorbid PDD was significantly younger at onset (F = 6.51, P = 0.003) and included unsocialized type more frequently (KH2 = 6.66, P = 0.036) compared with the other two groups. Conclusions: Clinicians should be aware that not only ADHD but also PDD may be comorbid with CD. Establishment of the correct diagnosis is important because recognizing the presence of PDD will enable us to provide appropriate treatment and guidance, which may improve prognosis.ArticlePSYCHIATRY AND CLINICAL NEUROSCIENCES. 63(6):762-768 (2009)journal articl

Sternal Resection and Reconstruction for Recurrence of Breast Cancer

We report 4 cases of sternal resection and reconstruction for para-sternal recurrence after radical mastectomy for breast cancer. All 4 had partial sternotomy combined with rib resection. Double Marlex mesh and muscular or myocutaneous flap were employed to close the sternal defect. Postoperative complications occurred in 2 cases : respiratory failure and partial skin necrosis. All patients are alive 12, 59, 77 and 117 months after sternal resection. Surgical management for parasternal recurrence after radical mastectomy can provide long-term survival and improve the quality of life of patients, especially those with solitary recurrences

Carcinoembryonic Antigen Production and Serum Levels in Esophageal Cancer

In the forty-four patients with esophageal cancer, serum carcinoembryonic antigen (CEA) levels were evaluated between pre- and postoperative periods in comparison with patients between positive and negative tissue CEA staining. Serum CEA levels were generally lower in patients with esophageal cancer and these showed less alteration in the postoperative period as compared with those in preoperative period. It is interest to emphasize that the survival following surgery in patients with negative tissue CEA staining in poor in this study. This study indicated that low serum CEA levels were shown in spite of local production of CEA in cancer cells, reflecting a blockage to release CEA to blood stream. It is believed that the variety of expression of cancer associated antigens is based on multiclonarity of cancer cells and/or alteration of expression of antigens with advances in tumor growth. However, it is dubious that CEA generated by carcinoma of the esophagus is indicative of aggressive behavior of the tumor and poor prognosis. Few reports are available in regard to expression of CEA antigen in patients with esophageal cancer. The pre-and postoperative CEA levels in patients with esophageal cancer remained unclear. The purpose of this study is to clarify clinical values of CEA measurement in patients with esophageal cancers

Postoperative Complications and Mortality of the Patients with Esophagectomy for Esophageal Carcinoma

Between 1970 and 1989, 154 patients underwent esophagectomy for esophageal cancer in our department. One hundred and twenty-one patients underwent esophageal resection and reconstruction and 14 had esopahgectomy alone without reconstruction. There were 26 operative deaths within 30 days after operation. However, the mortality rate was 29.1% during the 1970 to 1979 period, and 10.1% after 1980. Predominant postoperative complications were anastomotic leak, pneumnia, sepsis and recurrent laryngeal nerve paralysis. The rates of postoperative complications during 1970 to 1970, was 67.3% and was 43.3% after 1980. The rate of anastomotic leak was 45.4% in the former years, but it improved to 26.6% in the later period. To prevent the postoperative complications, careful perioperative management of the patients are essential