To understand patients' perceptions of clinical trials (CTs) is the principal step in the enrolment of patients to CTs. However, these perceptions in eastern countries are very rare. From 12 February 2007 to 13 April 2007, we consecutively distributed the questionnaire to 842 cancer patients who initiated a first cycle of chemotherapy regardless of each treatment step in the Seoul National University Hospital. Younger age, higher educational degree, higher economic status, and possession of private cancer insurance were related with significantly higher awareness of CTs ( P =0.001, P =0.006, P =0.002, and P =0.009, respectively). However, unlike awareness, perceptions on benefits of CTs were not changed according to age, educational degree, and economic status ( P =0.709, P =0.920, and P =0.847, respectively). Willingness was also not changed according to age, educational degree, economic status, and private cancer insurance ( P =0.381, P =0.775, P =0.887, and P =0.392, respectively). Instead, males and heavily treated patients had more positive perceptions on benefits ( P =0.002 and P =0.001, respectively) and more willingness to participate in CTs (OR=1.17, 1.14–2.75: OR=1.59, 1.01–2.51, respectively). In summary, cancer patients' awareness of CTs, perceptions on the benefit in CTs, and willingness to participate are differently influenced by diverse medical and social conditions. This information would be very helpful for investigators to properly conduct CTs in eastern cancer patients.

To evaluate the role of preoperative bone scintigraphy in determining the operative treatment method for femoral neck fracture, we reviewed the data of 83 patients who underwent preoperative bone scanning after femoral neck fracture. Fractures were classified using the Garden staging system. Radioisotope uptake in femoral heads was evaluated visually. Of 28 patients with Garden stage I or II, radioactivity of the femoral head was normal in 26, partially reduced in one, and generally reduced in one patient. Twenty-seven patients were treated by closed reduction and multiple pinning, and one patient was treated by bipolar hemiarthroplasty. Of 55 patients with Garden stage III or IV, femoral-head radioactivity was normal in three, partially reduced in seven and generally reduced in 45 patients. Fifty-four patients were treated by bipolar hemiarthroplasty or total hip arthroplasty, and one patient was treated by closed reduction and multiple pinning. In only one of the 83 cases was the operative method changed because of bone scan findings. Isotope uptake of the femoral head after femoral neck fracture generally corresponded with the degree of fracture displacement. Preoperative bone scans appear to have no significant role to play in determining the operative treatment method for femoral neck fracture.Résumé Afin d'évaluer le rôle préopératoire de la scintigraphie osseuse dans les fractures du col du fémur, nous avons revu les dossiers de 83 patients qui ont présenté une fracture du col fémoral. La fracture a été classée selon la classification de Garden. Sur les 28 patients Garden I et II, la réponse scintigraphique de la tête fémorale est normale pour 26 patients, avec une hypofixation osseuse pour un patient et une fixation peu importante chez un autre patient. 27 patients ont été traités par réduction orthopé-dique et embrochage à foyer fermé, un patient par hémiarthroplastie. Pour les 55 patients présentant une fracture Garden III ou IV, la scintigraphie de la tête fémorale a été normale chez trois patients avec une hypofixation chez 7 patients, une fixation très réduite chez 45 patients. 54 patients ont été traités par hémi-arthroplastie ou par prothèse totale et un patient traité par réduction orthopédique et embrochage. Chez un seul des 83 patients, la méthode opératoire a été changée après les constatations scanographiques. La fixation isotopique après fracture du col fémoral correspond tout à fait au degré et au déplacement de la fracture. Le scanner préopératoire ne semble pas avoir d'intérêt pour déterminer le traitement optimum chez ces patients.

PURPOSE: This study was performed to evaluate the incidence of seizures with its implications on disease progression and the diagnostic value of post-ictal magnetic resonance images (MRI) during the management of highgrade gliomas (HGGs). PATIENTS AND METHODS: A total of 406 consecutive patients with newly diagnosed HGGs were retrospectively reviewed. The incidence of seizure attacks during the management was investigated. In patients who experienced a seizure, the causality between seizures and disease progression was assessed by pre-ictal, post-ictal (,1 month), and follow-up (,3 months) MRI. RESULTS: After a mean follow-up of 21.9 months (range, 0.1 -88.3), seizure attacks developed in 127 patients (31%). Of the 127 patients, radiological progression at the post-ictal MRI was found in 83 patients (65%) and the follow-up MRI confirmed progression in 79 patients (62%). However, other 4 patients (3%) were shown to be progression-free. Among those without radiological progression at the post-ictal MRI, the follow-up MRI confirmed progression-free in 31 patients (24%); however, 13 patients (10%) revealed eventual progression. In the patients with a seizure, absence of preoperative seizure (p ¼ 0.003), , 95% tumor resection (p ¼ 0.001), and pre-ictal Karnofski Performance Scale score ≤ 70 (p ¼ 0.025) were significantly associated with disease progression. CONCLUSION: During the management of HGG, 31% of patients experienced seizures; of these patients, 72% harbored progressive disease. The post-ictal MRI is useful for detecting disease progression; however, there are pitfalls. Clinical settings should be considered together for diagnosing disease progression in patients with seizures.

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