We conducted a retrospective study of 41 cases of clinically localized renal cell carcinoma (RCC) treated with radical nephrectomy by our department between January 1987 and December 1993. The prognostic pathological parameters considered were tumor extension (pT stage), nuclear grading, histological grading, cell type, histologic growth pattern and tumor size. In the univariate analysis by log-rank test, three parameters showed prognostic significance, including pT stage, nuclear grading and tumor size. However, in the multivariate analysis using Cox's regressional hazard model, only two parameters including pT stage (p<0.001), nuclear grade (p<0.05) were found to have significantly independent prognostic value. But, nuclear grade considered in a given stage provided no significant influence (p>0.05). We think that nuclear grading cannot predict the outcome of patients at the same surgical stage. These results suggest that pathological stage of RCC may be the most important prognostic factor and the nuclear grade of tumor may provide additional important prognostic information.
Carcinoma, Renal Cell* ; Humans ; Multivariate Analysis ; Nephrectomy ; Proportional Hazards Models ; Retrospective Studies

Many patients whose chief complaint is headache caused by accident such as traffic accident, falling, or assaults visit to emergency center. Majority of these patients has mild or moderate symptoms, and there is no need to treat surgically. However, the fact that head injury can cause SIADH(syndrome of inappropriate secretion of antidiuretic hormone) is likely to be overseen. Acute hyponatremia might have been associated with death or permanent brain damage. Hyponatremia is best handled by early recognition and correction of a downward trend in the serum sodium. Unfortunately, this is often difficult in the head-injured patient, where hyponatremia may occur fairly rapidly and is confused by symptoms of head injury. when moderate to severe hyponatremia occurs, it is important to determine its etiology and expeditiously initiate corrective action. There has not been any reported case of the occurrence of symptomatic SIADH after mild head injury in Korea yet. The authors report the experience of three cases of symptomatic SIADH after mild head injury with review of the literatures.
Accidents, Traffic ; Brain ; Craniocerebral Trauma* ; Emergencies ; Head* ; Headache ; Humans ; Hyponatremia* ; Inappropriate ADH Syndrome ; Korea ; Sodium

No abstract available.
Blood Glucose* ; Glucose* ; Humans ; Infant, Newborn*

No abstract available.
Primary Myelofibrosis*

The prognostic significance of vascular (blood and lymphatic vessels) invasion was evaluated in a retrospective review of 27 patients with upper urinary tract transitional cell carcinoma from January 1985 to December 1993, who underwent a nephroureterectomy with bladder cuff resection. Vascular invasion was found in 10 patients (37%). The incidence of vascular invasion was well correlated with tumor grade and stage. The incidence of postoperative metastases was significantly higher in the patients with (70%) than without (17.6%) vascular invasion (p<0.05). The survival rate of the patients with vascular invasion was significantly lower than in those without vascular invasion (p<0.01). In multivariate Cox`s regressional analysis the prognostic value of vascular invasion was independent of tumor grade and stage. These results indicate that vascular invasion should predict a more unfavorable outcome in patients with upper urinary tract transitional cell carcinoma as an independent morphological indicator.
Carcinoma, Transitional Cell* ; Humans ; Incidence ; Lymphatic Vessels* ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Urinary Tract*

No abstract available.
Carrier State*

BACKGROUND AND OBJECTIVES: Insulin resistance is associated with hyperlipidemia. Recently, visceral fat adiposity is reported to be associated with insulin resistance and hyperlipidemia. We investigated insulin resistance and visceral fat adiposity in hyperlipidemic patients. MATERIALS AND METHOD: Hyperlipidemic group included 14 hyperlipidemic patients (total cholesterol > or = 220 mg/dl and triglyceride < or = 400 mg/dl) without hypertension, angina, impaired glucose tolerance and diabetes mellitus (DM). Control group included age, sex and body mass index (BMI) matched 25 healthy volunteers. We measured plasma lipid profiles and the insulin and glucose during the oral glucose tolerance test. We measured visceral fat area and abdominal subcutaneous fat area with computed tomography (CT). RESULTS: There were no differences of age, sex and BMI in both group. Total cholesterol, LDL cholesterol and triglyceride increased significantly in hyperlipidemic group. Fasting plasma glucose, insulin, area under curve (AUC) of the glucose and insulin and the Insulin / Glucose (IG) ratio increased significantly in hyperlipidemic group. Significant positive correlations were demonstrated between visceral fat area and the fasting plasma glucose, AUC of glucose and insulin at 120 minutes after glucose load. However, there was no difference in visceral fat area between both groups. After adjustment of visceral fat area, fasting plasma glucose, insulin, area under curve (AUC) of the glucose and insulin and the Insulin / Glucose (IG) ratio still remained increased significantly in hyperlipidemic group. CONCLUSION: We observed significantly increased insulin resistance in hyperlipidemic group. There was partial relationship between visceral fat area and the glucose and insulin profile. However, we did not find increased visceral fat area in hyperlipidemic group.
Adiposity ; Area Under Curve ; Blood Glucose ; Body Mass Index ; Cholesterol ; Cholesterol, LDL ; Diabetes Mellitus ; Fasting ; Glucose ; Glucose Tolerance Test ; Healthy Volunteers ; Humans ; Hyperlipidemias* ; Hypertension ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat* ; Obesity* ; Plasma ; Subcutaneous Fat, Abdominal ; Triglycerides

Large intestinal Lipohyperplasia (LPH) is a poorly recognized lesion characterized by adipose tissue infiltration in the submucosal layer of the colon. Most of all, LPH developed at Ileoceal valve, especially upper lip which was called by ileocecal valve syndrome. For endoscopists and radiologists, it has often remained difficult to make a distinction from malignant neoplasia. We report here the case of a mild obese, 51-year-old man who had polypoid lipohyperplasia of the colon associated with extreme hyperplasia of the appendix. His chief complaint was recurrent intermittent abdominal pain. The colonoscopic finding was a submucosal tumor-like polypoid mass originating from appendix with smooth surface, But ileocecal valve was intact. Abdominal CT finding was 2.5 cm sized round heterogeneous low density mass like lesion with intratumoral fatty density of cecal tip area with enhancement of peripheral portion. In barium enema study, after retrograde filling of contrast, smooth extrinsic indentation of cecal tip with partial filling of appendix was seen. Histological exemination revealed infiltration of mature adipose tissue in the submucosal layer. Because of recurrent abdominal pain, ileocecal resection was performed at operation. We discuss the case and review the literatures on this subject.
Abdominal Pain ; Adipose Tissue ; Appendix* ; Barium ; Colon ; Enema ; Humans ; Hyperplasia ; Ileocecal Valve ; Lip ; Middle Aged ; Tomography, X-Ray Computed

Angiosarcoma is a rare primary malignancy occurring anywhere in the body, but most often in the skin, liver or breast. The radiological findings of angiosarcoma of the breast have rarely been reported. We encountered a case in which the condition involved a 32-year-old woman in whom mammography revealed a obscuved-marginated and lobular-shaped high-density lesion, and ultrasonography demonstrated an ovalshaped, microlobular-marginated, inhomogenous hypoechoic mass which metastasized to the whole body after surgery. We report the radiological findings of this case of angiosarcoma of the breast, and review the literature.
Adult ; Breast Neoplasms ; Breast* ; Female ; Hemangiosarcoma* ; Humans ; Liver ; Mammography ; Sarcoma ; Skin ; Ultrasonography

There have been a few reports of occupational asthma caused by Tetranychus urticae in fruit farmers or greenhouse workers. We report a case of bronchial asthma induced by Tetranychus urticae from a pear orchard in Cheonan city. An 18-year-old female student living around a pear orchard suffered from intermittent cough, rhinorrhea, and dyspnea for the 3 years. Her PC20 -methacholine was 0.15mg/ml, and skin prick test done with 55 inhalant allergens showed negative responses except Tetranychus urticae extract which was prepared with highly parasitized pear leaves. Bronchial provocation test with Tetranychus urticae extract showed a dual asthmatic response. These findings indicate that Tetranychus urticae, which include parasites in fruit trees, herba,ceous plants, and greenhouse cultures, can cause IgE-mediated bronchoconstriction in Korea.
Adolescent ; Allergens ; Asthma* ; Asthma, Occupational ; Bronchial Provocation Tests ; Bronchoconstriction ; Chungcheongnam-do ; Cough ; Dyspnea ; Female ; Fruit ; Humans ; Korea ; Parasites ; Pyrus* ; Skin ; Trees