PURPOSE: To determine whether neoadjuvant androgen deprivation therapy (NADT) improves clinical outcomes in patients with prostate cancer treated with definitive radiotherapy. MATERIALS AND METHODS: We retrospectively reviewed medical records of 201 patients with prostate cancer treated with radiotherapy between January 1991 and December 2008. Of these, 156 patients with more than 3 years of follow-up were the subjects of this study. The median duration of follow-up was 91.2 months. NADT was given in 103 patients (66%) with median duration of 3.3 months (range, 1.0 to 7.7 months). Radiation dose was escalated gradually from 64 Gy to 81 Gy using intensity-modulated radiotherapy technique. RESULTS: Biochemical relapse-free survival (BCRFS) and overall survival (OS) of all patients were 72.6% and 90.7% at 5 years, respectively. BCRFS and OS of NADT group were 79.5% and 89.8% at 5 years and those of radiotherapy alone group were 58.8% and 92.3% at 5 years, respectively. Risk group (p = 0.010) and radiation dose > or =70 Gy (p = 0.017) affected BCRFS independently. NADT was a significant prognostic factor in univariate analysis, but not in multivariate analysis (p = 0.073). Radiation dose > or =70 Gy was only an independent factor for OS (p = 0.007; hazard ratio, 0.261; 95% confidence interval, 0.071-0.963). CONCLUSION: NADT prior to definitive radiotherapy did not result in significant benefit in terms of BCRFS and OS. NADT should not be performed routinely in the era of dose-escalated radiotherapy.
Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Prostatic Neoplasms* ; Radiotherapy* ; Radiotherapy, Intensity-Modulated ; Retrospective Studies

No abstract available.
Adult* ; Humans ; Molecular Epidemiology* ; Oxalobacter formigenes* ; Seoul*

PURPOSE: With the process of neoangiogenesis being linked to the growth and metastasis of various tumors, anticancer therapeutics with a basis in the suppression of neoangiogenesis has recently been receiving attention. In this study, we tried to clarify the immunoreactivities of vascular endothelial growth factor (VEGF), major angiogenic inducer and thrombospondin-1 (TSP-1), major angiogenic inhibitor in human Wilms' tumor and its clinicopathological significance. MATERAILS AND METHODS: Utilizing immunohistochemical staining, we assessed the immunoreactivities of VEGF and TSP-1 in archival tissues of 29 Wilms' tumors and 25 normal kidneys. Also, we assessed the relationship between expression of each factor and clinicopathological parameters in 29 cases of Wilms' tumors. RESULTS: Immunoreactivities of VEGF and TSP-1 were detected mainly in the cytoplasm of the tubular cells in normal kidneys. In Wilms' tumors, whereas VEGF was detected in the cytoplasm of the tumor cells and peritumoral stromal tissues, but TSP-1 only in the peritumoral stromal tissues. Immunohistochemical expression patterns of each factor were divided into two groups according to the area of immunoreactivity (negative:<10%, positive: > OR =10%). VEGF immunoreactivity was detected in 25 (100%) normal kidneys and in 20 (69%) Wilms' tumors. However, TSP-1 immunoreactivity was detected in 24 (97%) normal kidneys and in 3 (10%) Wilms' tumors. Therefore, although no significant difference was observed between the expressions of VEGF and TSP-1 in normal kidney, the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors. A relatively higher rate of positive expression of TSP-1 was observed in the patients with no demonstrable lymph node metastasis. Also, as for the VEGF, maximal diameter of the tumor was larger in the positive expression group. However, it proved otherwise for TSP-1 as the negative expression group demonstrated tumors with larger maximal diameters. CONCLUSIONS: Our study demonstrated that the TSP-1 immunoreactivity was significantly lower than VEGF immunoreactivity in Wilms' tumors, and disease progression has a tendency to be found in the VEGF-positive cases and TSP-1 negative cases. We suggest that the growth and metastasis of Wilms' tumor may be influenced mainly by TSP-1 decrease rather than VEGF increase.
Cytoplasm ; Disease Progression ; Humans ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Thrombospondin 1 ; Vascular Endothelial Growth Factor A* ; Wilms Tumor*

Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered.
Biopsy/adverse effects/methods ; Carcinoma, Renal Cell/*pathology ; Early Detection of Cancer/adverse effects/*methods ; Humans ; Incidental Findings ; Kidney/*pathology ; Kidney Neoplasms/*pathology

Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered.
Biopsy/adverse effects/methods ; Carcinoma, Renal Cell/*pathology ; Early Detection of Cancer/adverse effects/*methods ; Humans ; Incidental Findings ; Kidney/*pathology ; Kidney Neoplasms/*pathology

No abstract available.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen*

No abstract available.
Humans ; Male ; Prostate* ; Prostate-Specific Antigen*

For the better correction of strabismus surgery, various adjustable surgical technics are performed with general or retrobulbar anesthesia. Topical anesthetics with IV analgesics (Fentany 1 citrate) and sedative (Valium) can induce adequate pain control without inhibiting extraocular muscle activities and enable intraoperative adjustment easily and conveniently without the troublesome maneuver of postoperative adjustment and accompanying risk of infection Intraoperative adjustable surgery is better than postoperative adjustable surgery because it is easier to perform due to less tissue edema, enables to avoid the risk of retrobulbar or peribulbar anesthesia, and the risk of infection. We operated 20 strabismic patients aging 10 to 48 years using the intraoperative adjustment and topical anesthetics with the good success rate 90%, within +/- 10 delta after 5 weeks follow-up.
Aging ; Analgesics ; Anesthesia ; Anesthetics* ; Edema ; Follow-Up Studies ; Humans ; Strabismus*

For the better correction of strabismus surgery, various adjustable surgical technics are performed with general or retrobulbar anesthesia. Topical anesthetics with IV analgesics (Fentany 1 citrate) and sedative (Valium) can induce adequate pain control without inhibiting extraocular muscle activities and enable intraoperative adjustment easily and conveniently without the troublesome maneuver of postoperative adjustment and accompanying risk of infection Intraoperative adjustable surgery is better than postoperative adjustable surgery because it is easier to perform due to less tissue edema, enables to avoid the risk of retrobulbar or peribulbar anesthesia, and the risk of infection. We operated 20 strabismic patients aging 10 to 48 years using the intraoperative adjustment and topical anesthetics with the good success rate 90%, within +/- 10 delta after 5 weeks follow-up.
Aging ; Analgesics ; Anesthesia ; Anesthetics* ; Edema ; Follow-Up Studies ; Humans ; Strabismus*

Pseudoxanthoma elasticum associated with angioid streaks has been called rthe Gronblad-Strandberg Syndrome. A 30-year-old female patient showed circumscribed, cream-colored, crepelike, redundant plaques on neck, axillae, periumbilical area, and inguinal regions. The histopathologic findings of the skin taken from the axilla revealed extensive basophilic degeneration of the elastic tissue and calcium deposition in the middle and lower dermis. Both fundi showed irregular angioid streaks radiating from the optic disk on ophthalmoscopy, and hyperfluorescence of angioid streaks was noted with fluorescein angiography.
Adult ; Angioid Streaks ; Axilla ; Basophils ; Calcium ; Dermis ; Elastic Tissue ; Female ; Fluorescein Angiography ; Humans ; Neck ; Ophthalmoscopy ; Optic Disk ; Pseudoxanthoma Elasticum* ; Skin