Endoscopic retrograde cholangiopancreatography(ERCP) is a new diagnostic method for pancreatic and biliarydiseases which has been made possible by the development of fiberoptic duodenoscopy. It has been thought that ERCPwell serve an important role in the early detection of pancreatic cancer, but in order to detect minor lesions ofthe pancreas and improve the diagnostic accuracy of resectable pancreatic cancer, Endoscopic RetrogradeParechymography of the pancreas (ERPP) was developed recently. The authors analyzed 117 cases of ERCP performed atthe Kwangju Christian Hospital between Jan. and Dec. 1980, and compared them with the final diagnosis. The resultswere as follows; 1. Out of 117 cases, successful visualization of the duct of concern was achieved in 105 cases.Of these, 25 cases were ERPP. 2. The ratio of males to female was 1.44:1. Most patients were in the 4th to 6thdecade. 3. The commmonest clinical manifestations were upper abdominal pain (77cases), jaundice(23 cases),indigestion, vomiting and abdominal mass, in order of frequency. 4. Out of 46 cases of suspected pancreaticdiseases, the pancreatic duct was visualized in 36 cases, and 24 cases revealed pathognomonic findings. These werediagnosed as 16 cases of pancreatic cancer, 4 cases of chronic pancreatitis, 2 cases of pancreatic pseudocyst and2 cases of periampullary cancer with pancreas invasion. In pancreatic cancer findings were; encasement, localdilatation, delayed excretion, poor filling, obstruction of pancreatic duct, accompanying C.B.D. obstruction orstenosis and so called double duct sign. The chronic pancreatitis findings included; ductal dilatation (with orwtihout) obstruction, tortuosity with dilated saccular lateral branching, stone formation and the parenchymalfilling defect. 5. Out of 71 cases of suspected biliary tract diseases, the biliary tract was visualized in 57cases, and in 31 cases abnormalities were suggested; such as 20 cases of biliary stone, 1 cases of ascariasis, 1case of clonorchiasis with cholangitis, 1 case of clonorchiasis with stone, 2 cases of C.B.D. ca. 2 cases of G.B.ca, 3 cases of intrahepatic disease, 1 case of stones in the biliary tree with ampullary ca. 6. Complications ofERCP and ERPP were extremely raare. Transient abdominal distention, abdominal discomfort and elevated serumamylase were noted, but were not clinically significant.
Abdominal Pain ; Ascariasis ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Clonorchiasis ; Diagnosis ; Dilatation ; Duodenoscopy ; Female ; Gwangju ; Humans ; Male ; Methods ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Vomiting

Endoscopic Retrograde Cholangiopancreatography(ERCP) is one of the important diagnostic methods for pancreaticcancer. It has an essential role in the early detection of pancreatic cancer. The ERCP findings of 35 cases ofpathologically proven pancreatic cancer during the period of five and a half years from April 1977 through Nov.1982 at Kwangju Christian Hospital were studied. The resuls were as follows; 1. The ratio of male of female was3.4:1, and most of the patients were over 40 years of age (88.5%). 2. The locations of the lesions were the headin 28 cases (80%), the body in 7 cases(20%), and the ail in 3 cases (8.6%). 3. The ERCP findings of pancreaticcancers were as follows; 1) Encasement or obstruction of common bile duct, 18 cases (51.4%). 2) Obstruction ofpancreatic duct, 16 cases (45.7%). 3) Irregular stenosis of pancreatic duct, 8 cases (22.3%). 4) Double duct sign,7 cases (20%). 5) Diffuse narrowing of pancreatic duct, 2 cases (5.7%).
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Constriction, Pathologic ; Female ; Gwangju ; Humans ; Male ; Pancreatic Ducts ; Pancreatic Neoplasms

BACKGROUND: Angiogenesis is crucial for many biological processes such as embryogenesis, cyclic changes in the endometrium and wound healing. It is also critical for the growth, invasion and metastasis of solid tumors. Vascular endothelial growth factor (VEGF) acts as a mitogen for endothelial cells and is expressed by the presence of various tumor cells. The objective of this study is to evaluate if angiogenesis is involved in the mouse skin carcinogenesis and if VEGF is related to angiogenesis. METHODS: We induced premalignant and malignant lesions on mouse (BALB/c) skin using the two stage chemical carcinogenesis moedl, DMBA (7,12-dimethylbenzanthracene) initiation and TPA (tetra decanoyl-phorbol-acetate) promotion. And we analysed the microvessel densities (MVD) and expression of VEGF in various stages of premalignant and malignant lesions by immunohistochemical studies. RESULTS: Squamous papillomas, keratoacanthoma, dermatofibroma, and squamous cell carcinomas were developed in 20 weeks. There were no differences in the incidence of benign and malignant tumors between 10-week and 20-week promotion groups. There were significant increases in MVD from normal and hyperplastic skin through premalignant lesion to invasive squamous cell carcinoma (p<0.0005). But the degree of VEGF expression neither correlated with neither MVD nor the tumor groups. CONCLUSIONS: Increased angiogenesis begins from the hyperplastic stage. VEGF produced by tumor cells may not play major roles in the angiogenesis in the two stage chemical carcinogenesis model of the mouse skin.
9,10-Dimethyl-1,2-benzanthracene ; Animals ; Biological Processes ; Carcinogenesis* ; Carcinoma, Squamous Cell ; Embryonic Development ; Endometrium ; Endothelial Cells ; Female ; Histiocytoma, Benign Fibrous ; Incidence ; Keratoacanthoma ; Mice* ; Microvessels ; Neoplasm Metastasis ; Papilloma ; Pregnancy ; Skin* ; Vascular Endothelial Growth Factor A* ; Wound Healing

No abstract available.
Chylothorax* ; Lymphangiectasis*

No abstract available.
Dermoid Cyst*

Purpose: To examine the usefulness of the prostate-specific antigen (PSA) density for selection of biopsy candidates with serum PSA levels between 4-10ng/ml, and determine the optimal PSA density (PSAD) cut off value for use in clinical practice. Materials and Methods: We retrospectively enrolled 705 patients with serum PSA levels between 4-10ng/ml. The patients were divided into the prostate cancer and the non-prostate cancer groups. The PSA level and PSAD in predicting prostate cancer were compared. A receiver operating characteristic (ROC) curve was generated, and utilized to evaluate the optimal PSAD cut off value. Results: One hundred and nineteen and five hundred and eighty six patients had prostate and non-prostate cancers, respectively, on pathological examination. The mean PSA values were not significantly different; 6.9 and 7.0ng/ml, respectively (p>0.05). However, the mean PSAD values were 0.168 and 0.213ng/ml/cc; significantly higher in the prostate cancer group than the BPH group (p<0.05). The ROC curves for the PSA level and PSAD demonstrated superior benefit for the PSAD. The sensitivity, specificity and positive predictive values of a PSAD cut off of 0.15ng/ml/ cc were 73.1, 45.9 and 21.5%, respectively. A PSAD cut off of 0.17ng/ml/cc showed the highest sensitivity and specificity, with sensitivity, specificity and positive predictive values of 63.9, 59.2 and 24.1%, respectively. Conclusions: The PSAD seems to be useful in the selection of biopsy candidates with serum PSA levels between 4-10ng/ml, and a PSAD cut off of 0.17ng/ml/cc would seem to be preferable to 0.15ng/ml/cc.
Biopsy ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

No abstract available.
Endocardial Cushion Defects* ; Endocardial Cushions* ; Hernia, Diaphragmatic*

Leser-Trelat sign is characterized by the sudden appearance and rapid increase in number and size of seborrheic keratoses associated with an internal malignancy. A 78-year-old woman showed multiple pea to bean sized dark brownish papules and plsques on the trunk. Skin lesions had appeared suddenly since 5 months ago and then rapidly increased in number and size. The histopathologic exsmination of the skin lesions revealed seborrheic keratoses. The chest roentgenogram revealed the mass shadow on the right hilar region and transbronchial lung biopsy revealed small cell carcinoma.
Aged ; Biopsy ; Carcinoma, Small Cell* ; Female ; Humans ; Keratosis, Seborrheic ; Lung* ; Peas ; Skin ; Thorax

Cutaneous metastases from internal malignancy are relatively rare. Three cases of cutaneous metastases, two from lung cancer and one from breast cancer are reported. Case 1-cutaneous metastasis from bronchioloalveolar carcinoma of the lung, where four erythematous to pinkish pea sized smooth surfaced nodules on the scalp were noticed for 2 years in a 48-year-old man. Case 2-cutaneous metastasis from adenocarcmoma of the lung, where two hard tender freely movable subcutaneous nodules, about 3 cm in diameter on the lateral chest wall were noticed for 6 months in a 61-year-old woman. Case 3-cutaneous metastasis from infiltrating ductal carcinoma of the right breast, where a hand, violaceous, non-tender plaque (8×6.5 cm) on the right areolar area was noticed for 4 months in a 47-year-old woman.
Adenocarcinoma, Bronchiolo-Alveolar ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Female ; Hand ; Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Peas ; Scalp ; Thoracic Wall

PURPOSE: To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy. MATERIALS AND METHODS: Between May 1995 and Dec. 1997, ten patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1~1.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of high dose rate, iridium-192 implant which delivered 12~15 Gy to 1 cm distance from the center of source axis with 2~2.5 Gy/fraction, twice a day, starting on 6th day after the surgery. Within one month after the surgery, total dose of 50~55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. RESULTS: All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12~41 months), no local recurrences were observed. And there was no severe form of chronic complication (RTOG/EORTC grade 3 or 4). CONCLUSION: The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.
Axis, Cervical Vertebra ; Brachytherapy* ; Catheters ; Diagnosis ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Radiotherapy ; Recurrence ; Sarcoma* ; Tissue Expansion Devices