This is the report of the use of a gracilis transplant in the correction of a refractory urethro-rectal fistula associated with congenital imperforate anus in a 26 year old male. Three days after birth anoplasty had been performed. Thereafter three further procedures (Swenson type pull-through, direct perineal repair and repeat pull-through with omental interposition) all failed. Success was finally obtained by use of a gracilis transplant introduced via a perineal incision in order to place viable healthy muscle between the urethral closure (performed through perineal incision) and the rectal mucosal closure (performed via posterior prostotomy). Good continence was achieved.
Adult ; Anus, Imperforate ; Fistula* ; Humans ; Male ; Parturition

During an analysis of 27 patients cases of advanced renal cell carcinoma, eleven of which patients had pulmonary metastases. The case of a 53 year old male who underwent spontaneous regression of his lung metastases was found. This patient underwent right radical nephrectomy leaving some gross disease in the right lobe of the liver. Postoperatively regression was noted within 4 weeks and substantial decrease in the size of the metastatic lesions was noted before velban and Depoprovera were instituted 6 weeks after surgery. Complete disappearance of multiple pulmonary metastases was noted on the chest PA 8 weeks after surgery. At the time of the last clinic visit one year postoperatively, the pulmonary metastatic lesions had regressed entirely on the chest PA, leaving only micronodular hilar and Lt. lower lobe lesions on the chest CAT scan.
Ambulatory Care ; Animals ; Carcinoma, Renal Cell* ; Cats ; Humans ; Liver ; Lung ; Male ; Medroxyprogesterone Acetate ; Middle Aged ; Neoplasm Metastasis* ; Nephrectomy ; Thorax ; Vinblastine

Yonsei Cancer Center developed an RF(Radiofrequency) capacitive type heating device, GHT-RF8(Greenytherm) in cooperation with Green Cross Medical Corp., Korea in 1986 for the first time in Korea. Cooperative clinical studies of hyperthermia for the treatment of cancer using GHT-RF8 were conducted by Yonsei Cancer Center in collaboration with the Presbyterian Medical Center, Chonju, Korea. A total of forty patients with various histologically proven malignant tumors, including superficial (N = 13) and deep-seated tumors (N = 27), were treated with this newly developed heating device in conjunction with radiotherapy (N = 38) or chemotherapy (N = 2) at two different institutes between October 1986 and September 1987. These patients were locally far advanced or recurrent cases and considered to be refractory to conventional cancer treatment modalities. Radiotherapy was given in 200cGy per day, five times a week fractionations with a total tumor dose of 50-60Gy in 5-6 weeks. Within an hour after radiotherapy, the RF capacitive type of hyperthermia was given two times a week for a total of 4-10 treatment sessions and an attempt was made to maintain the tumor temperature at 41-45 degrees C for 30-60 minutes. Of forty patients treated, 14 patients with deep-seated tumors showed complete response and 20 patients showed partial response. The overall response rate was 85% (34 out of 40 patients) and only 6 patients showed no response. Complications from this treatment were mainly burns, superficial first degree burn in 2 cases, second degree in 4 cases and subcutaneous fat necrosis was observed in 2 cases.
Adolescent ; Adult ; Aged ; Equipment Design ; Female ; Heating/*instrumentation ; Human ; Hyperthermia, Induced/adverse effects/*instrumentation ; Male ; Middle Age ; Neoplasms/radionuclide imaging/therapy ; Support, Non-U.S. Gov't ; Tomography, X-Ray Computed

Renal Cell Cancer often presents late, the tumor having extended beyond the site of origin. Therapeutic management under such circumstances is not subject to clear guidelines: whether resectional surgery, radiotherapy, chemotherapy, hormone therapy, or even immunotherapy is of value is not clearly established. The authors have collected a series of 33 cases of Stage III and Stage IV renal cell cancer managed over a 20-year period and have analyzed in order to obtain a better understanding of the natural process of this neoplastic disease, is patterns of spread, its sites of metastasis, and the effectiveness of various therapeutic modalities. Their conclusions: 1. Mean survival time was 24.1 months when radical nephrectomy was employed in comparison with 17.1 months when simple nephrectomy was done and 8.6 months when only a biopsy could be performed. 2. The best results were obtained when combined therapy using radical surgery, radiation and chemotherapy was employed. this resulted in a 35.5 months average survival, as compared with 20.5 months when nephrectomy alone was performed. 3. Presence of a solitary metastasis was associated with an average survival of 25.3 months, whereas two metastatic sites lowered survival to 16.1 months and three sites to 10.7 months. 4. The survival time for Stage III disease was 21 months as compared 17.5 months for Stage IV disease.
Biopsy ; Carcinoma, Renal Cell* ; Drug Therapy ; Follow-Up Studies* ; Immunotherapy ; Neoplasm Metastasis ; Nephrectomy ; Radiotherapy ; Survival Rate

We investigated the expression of MAGE-1, -2, and -3 genes in tissues of 51 gastric carcinomas from Korean patients and in 11 gastric cancer cell lines established in Korea using reverse transcriptase-polymerase chain reaction along with immunohistochemical analyses and DNA sequencing. Among the 51 gastric carcinomas, MAGE-1, -2, and -3 genes were expressed in 16 (31%), 22 (43%), and 17 (33%), respectively, and 31 (60%) expressed at least one of the three genes. In contrast, none of the three MAGE genes were expressed in normal sites of gastric tissue from each cancer patient. Out of 11 gastric cancer cell lines, MAGE-1, -2, and -3 genes were expressed in two (18%), five (46%), and four (36%), respectively. According to the clinicopathological analysis, the expression of any of the three MAGE genes was not significantly correlated with several clinicopathological factors except histologic types (p= 0.067). Immunohistochemical analyses identified positive staining with monoclonal antibodies 77B and 57B specifically against MAGE-1 and -3 proteins, respectively, in nuclei and cytoplasms of cells in mRNA-positive tumor tissue. These findings suggest the possibility as a target for tumor-specific immunotherapy for Korean patients.
Antigens, Neoplasm/genetics* ; Female ; Human ; Immunohistochemistry ; Male ; Middle Age ; Neoplasm Proteins/genetics* ; Neoplasm Proteins/analysis ; RNA, Messenger/analysis ; Reverse Transcriptase Polymerase Chain Reaction ; Stomach Neoplasms/therapy ; Stomach Neoplasms/pathology ; Stomach Neoplasms/metabolism* ; Tumor Cells, Cultured