No abstract available.
Priapism*

No abstract available.
Priapism*

The resistance of neoplastic cells to chemotherapeutic agents may develops by a variety mechanisms. One of these mechanisms seems to be the amplification or overexpression of the multidrug resistance(MDR) gene. The MDR phenotype is conferred by a 170kD membrane protein, P-glycoprotein. This protein acts as a drug efflux pump for a variety of structurally unrelated antineoplastic agents, especially hydrophobic natural products such as adriamycin and vincristine. In the present study, immunohistochemical stain for P-glycoprotein was performed in paraffin section of 41 specimens of transitional cell carcinoma of the bladder obtained prior to chemotherapy to investigate the usefulness of P-glycoprotein as a predictor of response to M-VAC ( methotrexate, vinblastine, adriamycin and cisplatin) chemotherapy. The overall clinical response rate to chemotherapy was 65.9%. The overall 3- year survival rate was 63%, with 80% in responder group( clinical complete and partial remission) and 36.3% non-responder group(minor response, stabilization and progression ) (P<0.05). In the responder group, 7.4% expressed strongly positive P-glycoprotein, 63% weakly positive and 29.6% negative. In the non-responder group, 28.6% expressed strongly positive P-glycoprotein, 64.3% weakly positive and 7.1% negative. The negative expression rate was high in responder group than non-responder, but this difference was not statistically significant. There was no correlation of expression of P-glycoprotein with either tumor stages or grades. In conclusion, these results suggest that tumors with negative expression of P-glycoprotein seem to have a better clinical response to chemotherapy, and further investigation of other mechanisms of cellular drug resistance should be required.
Antineoplastic Agents ; Biological Products ; Carcinoma, Transitional Cell* ; Doxorubicin ; Drug Resistance ; Drug Therapy* ; Membrane Proteins ; Methotrexate ; P-Glycoprotein* ; Paraffin ; Phenotype ; Survival Rate ; Urinary Bladder ; Urinary Bladder Neoplasms ; Vinblastine ; Vincristine

It is very important to select the appropriate operative method in cancer surgery. For proximal gastric cancer, a total gastrectomy (TG) has usually had less morbidity and mortality than an extended total gastrectomy (ETG). To compare and evaluate the results of a TG with those of an ETG, the authors analyzed 50 cases treated by a TG and 50 cases treated by an ETG during the last 12 years. The results were as follows: The post operative complication rates were 34% for a TG and 54% for an ETG, the average operation time was 3 hours 53 minutes for a TG and 3 hours 42 minutes for an ETG, the postoperative fasting period was 7.1 days for a TG and 6.5 days for an ETG, and the mean length of hospital stay was 21.4 days for a TG and 22.6 days for an ETG. the ETG had a higher complication rate than the TG, but there was no statistical difference between the operation times, the postoperative fasting periods, and the length of stay in the hospital. from our experience, it is suggested that the ETG is easier, or almost the same, to carry out than the TG procedure. Therefore, we recommend an ETG for proximal gastric cancer to achieve better curative results.
Fasting ; Gastrectomy* ; Length of Stay ; Mortality ; Stomach Neoplasms*

No abstract available.

No abstract available.
Humans ; Prostate* ; Prostatic Neoplasms*

PURPOSE: To evaluate the CT findings of pleural dissemination in primary lung cancer and the limitations of CT scanning in detecting pleural dissemination in primary lung cancer. MATERIALS AND METHODS: Primary lung cancer with pleural dissemination was diagnosed in 68 patients and confirmed by pleural biopsy, cytology and surgery, and these cases were the subject of this study. Adenocarcinoma accounted for 49, squamous cell carcinoma for 13 and small cell carcinoma for six. Eight CT features, namely the amount of pleural effusion, the contour, extent andlocation of pleural thickening, the shortest distance between pleura and mass, pleural calcification, pleural tailsign and the extent of extrapleural fat proliferation, were evaluated. RESULTS: Pleural effusion was noted in 51 of 68 patients(75%), though in most cases(70%), the amount of this was small. Among 42 patients(62%) in whom thickened pleura, were noted, pleural thickening was thin and irregular in 22(52%), thick and irregular in 16(38%), and thin and regular in 4(10%). The extent of pleural thickening was multifocal in 22 patients(52%),diffuse in 16(38%), and circumferential and single in two(5%). Pleural thickening was more frequently noted at theposterior than the anterior pleura. Pleural abutting was seen in 53 patients(78%). In ten patients(15%), chest CTscans revealed no perceptible pleural abnormalities. CONCLUSION: If in primary lung cancer, the primary lung masscontacts the pleura, and if pleural thickening, even when slight, shows marginal irregularity, pleuraldissemination should be considered. Although CT scanning is very useful for the detection of pleural disseminationin primary lung cancer, about 15% of patients showed no perceptible pleural abnormalities. Other diagnosticmodalities such as thoracoscopy are mandatory for the correct diagnosis of pleural dissemination in primary lung cancer.
Adenocarcinoma ; Biopsy ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Pleura ; Pleural Effusion ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed

This is a clinical analysis and review of one-hundred ninety-four patients with periappendiceal abscesses who were treated at the Departmeat of Surgery, Masan Samsung Hospital over a ten year period from January 1985 to December 1994. The following results were obtained. The incidence of periappendiceal abscesses was 7.24% of the total cases of appendicitis operated on during the same period, and most of the patients(43.8%) were over fifty years old. The male to female ratio was 1:1.02. 41.2% of the patients had operations within four days after their symptoms occurred. On admission, the most common physical finding was tenderness on the right lower quadrant of the abdomen (92.9%) and leukocytosis(> OR = 10,000/mm3) was noted on CBC in 82% of the patients. Abdominal sonograms revealed periappendiceal abscesses in 88% of the patients, 83% were revealed with barium enema and 88% with abdominal CT scan. Many patients(75.5%) visited the local clinic and were treated under the diagnosis of gastritis or enteritis instead of appendicitis. One-hundred eighty-three patients(94.3%) had appendectomies with drainages(94.3%), two patients had drainages of abscesses without appendectomy, six patients had ileocecal resections and three patients had right hemicolectomies. Microbiologically, E. coli was the most frequently cultured species(63%) from abscess, and Klebsiella, Enterococcus and Proteus were isolated in some cases. Postoperative complication occurred in seventy-five patients(38.6%) and the most frequent complication was wound infection(28.8%). There was no mortality and the mean hospital stay was fifteen days.
Abdomen ; Abscess* ; Appendectomy ; Appendicitis ; Barium ; Diagnosis ; Enema ; Enteritis ; Enterococcus ; Female ; Gastritis ; Humans ; Incidence ; Klebsiella ; Length of Stay ; Male ; Mortality ; Postoperative Complications ; Proteus ; Tomography, X-Ray Computed ; Wounds and Injuries

PURPOSE: Chronic prostatitis is clinically defined by symptoms consisting of pain, voiding complaints and sexual dysfunction. Determination of the severity and progression over time of the disease and an evaluation of the results of various therapies may be best assessed and monitored by a valid and reliable symptom scoring instruments. We evaluated the reliability, validity and responsiveness of the Korean version of NIH-CPSI and the characteristics of symptom index on chronic prostatitis. MATERIALS AND METHODS: All patients underwent a complete clinical evaluation and completed the Korean version of NIH-CPSI. The reliability of CPSI was examined by test-retest reliability and internal consistency for 41 chronic prostatitis patients. And the results in chronic prostatitis group were compared with those in 2 groups including 36 benign prostate hyperplasia patients and 46 healthy men. In 41 chronic prostatitis group including 28 IIIA and 13 IIIB patients, CPSI was reassessed after 6 weeks treatment and compared with those of pretreatment state. RESULTS: The Korean version of NIH-CPSI had excellent test-retest reliability (r=0.76 to 0.95) and high internal consistency (Crobach's alpha=0.86 to 0.97) during a 1 week period. The symptom score had significant difference in the each items and domains between chronic prostatitis and healthy control subjects (p<0.05). And the symptom score of each domains was sensitive to change with decreasing score after treatment (p<0.01). Chronic prostatitis had higher score of pain domain and BPH had higher score of urinary symptom domain. But the score of QOL domain was similar in both group. CONCLUSIONS: The NIH-CPSI is clinically reliable, valid, and responsive means of capturing the symptoms and impact of chronic prostatitis. It may be useful in clinical diagnosis and treatment of chronic prostatitis.
Diagnosis ; Humans ; Hyperplasia ; Male ; Prostate ; Prostatitis*

Purpose: To answer the questions of ambulation dependency for risk of urolithiasis, the urinary lithogenic factors in normal controls were compared with long hospital stay immobilized patients. Materials and Methods: Fifty immobilized patients and twenty normal controls, on usual constant regular diet, were evaluated with 24-hour urine for the excretion rate differences of lithogenic and inhibitory constituents, such as volume, pH, calcium, phosphorus, uric acid, oxalate, citrate, magnesium, sodium, potassium, chloride and creatinine. The incidence of metabolic abnormalities in the immobilized patients was also evaluated. Results: The immobilized patients showed significantly increased excretions of uric acid, oxalate, sodium, potassium, urine volume, but decreased excretions of citrate and magnesium (p<0.05). No differences were found between the two groups with regard to urinary excretions of calcium, phosphate, creatinine and chloride or in the pH of excretions. The frequent metabolic abnormalities in the immobilized patients were hypomagnesuria (92%), hypocitraturia (86%), hyperoxalaturia (82%), hypernatriuria (44%), hyperuricosuria (16%) and hypercalciuria (12%). Conclusions: These results reveal that hypomagnesuria, hypocitraturia and hyperoxalaturia were the most important risk factors for urolithiasis in the immobilized patients. However, a further controlled prospective study will be needed with regard to the influence of ambulation.
Calcium ; Citric Acid ; Creatinine ; Diet ; Humans ; Hydrogen-Ion Concentration ; Hypercalciuria ; Immobilization* ; Incidence ; Length of Stay ; Magnesium ; Oxalic Acid ; Phosphorus ; Potassium ; Risk Factors ; Sodium ; Uric Acid ; Urinary Calculi ; Urolithiasis ; Walking