Intravesical thio-tepa instillations for 25 patients with superficial bladder tumors were evaluated postoperatively to reconfirm its usefulness as a prophylactic agent. The over-all recurrence rate to prophylactic thio-tepa was 28%, with minor toxicity observed in 32% of the Cases. Thio-tepa Can be given safely in the postoperative period and is effective in decreasing the recurrence rate and prolonging interval free of disease of superficial bladder tumors.
Humans ; Postoperative Period ; Recurrence ; Thiotepa* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Intravesical thio-tepa instillations for 25 patients with superficial bladder tumors were evaluated postoperatively to reconfirm its usefulness as a prophylactic agent. The over-all recurrence rate to prophylactic thio-tepa was 28%, with minor toxicity observed in 32% of the Cases. Thio-tepa Can be given safely in the postoperative period and is effective in decreasing the recurrence rate and prolonging interval free of disease of superficial bladder tumors.
Humans ; Postoperative Period ; Recurrence ; Thiotepa* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Adenoma, Pleomorphic ; Aged ; Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Ear ; Facial Nerve ; Humans ; Parotid Gland ; Parotid Neoplasms ; Recurrence

PURPOSE: The TNM classification for carcinoma of the colon and the rectum provides more detail than other staging systems. This study was performed to evaluate the effectiveness of AJCC staging system (5th ed., 1997) for the colorectal cancer in predicting prognosis. METHODS: We analyzed a data base of 1,233 colorectal cancer patients (M:F=673:560) who underwent surgery in Asan Medical Center during July 1989-December 1996. Survival analysis was performed between the stages and the subgroups in same stage by using Kaplan-Meier method and log rank test. Borderline subgroup comparison between the stages was performed, also. Significance was assigned to a P value of <0.05. RESULTS: Mean age of the patients was 57 (19-90) years old. Median follow-up period was 42 (6-129) months. The number of patients in each stage were 0: 15, I: 152, II: 390, III: 465, IV: 199. The 5 year overall & disease free survival rates of each stage were 100%, 100% (in stage 0), 96.4%, 93.6% (in stage I), 82.7%, 82.2% (in stage II), 59.9%, 55.3% (in stage III), and 7.3%, 24.9% (in stage IV), respectively (P=0.000). Subgroup analysis in stage I (T1N0 vs. T2N0) and II (T3N0 vs. T4N0) revealed no differences. However, in stage III, N1 (n=246) group showed better survival than N2 (n=219) group (70.3%, 65.5% vs. 49.2%, 44.6%: P=0.000). Borderline survival analysis between stage I and II (T2N0 vs. T3N0) was significantly different (96.6%, 95.7% vs 82.7%, 82.3%: P=0.006). However, between stage II and III (T4N0 vs. T1N1), appropriate analysis was impossible due to small number of cases. CONCLUSIONS: AJCC staging system for colorectal cancer was reliable and effective in predicting prognosis. However, substages are needed in stage III.
Chungcheongnam-do ; Classification ; Colon ; Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Prognosis ; Rectum

The prognoses for the gastric cancer patients treated with total gastrectomies are known to be unsatisfactory due to the low survival rates, the high frequency of postoperative mortality or morbidity, and long-term complications such as nutritional deficiency. The authors evaluated the 5-year survival rates and analyzed the prognostic factors in 557 patients with gastric cancer who underwent total gastrectomies during the period between Jan. 1987 and Dec. 1993. The overall 5-year survival rate was 49.7%, and the survival rates according to the stage were stage Ia, 92.0%; Ib, 85.5%; II 64.1%; IIIa 55.0%; IIIb 26.5%; and stage IV, 6.3%. Postoperative mortality rate was 1.1%. By using univariate analysis to evaluate the prognostic factors, factors such as age, depth of invasion, extent of lymph node metastasis (according to the Japanese rule), number of involved nodes, lymph node ratio, distant metastasis (peritoneal and/or hepatic), size of the tumor, gross type, histological type, the surgical curability and the TNM stage were found to be related with the survival of the patients. In a multivariate analysis using 11 variables, the TNM stage was the single most significant prognostic factor. Besides the TNM, depth of invasion (ratio of risk (R.R)=1.50), extent of lymph node metastasis (R.R=1.83), number of involved nodes (R.R=1.64), lymph node ratio (R.R=1.91), and peritoneal metastasis (R.R=3.11) were found to be independent prognostic factors influencing survival. It was thought that the radicality of surgery could be reflected in the number of removed nodes per specimen. In this study, the average number of removed nodes was 42.3 per case. Hence, it may be said that adequate lymphadenectomy was performed for almost all the grossly curable cancers. The 5-year survival rate in stage IV patients with tertiary node (N3) metastasis and no peritoneal or hepatic metastasis was 16.8%; in patients with peritoneal or hepatic metastasis, the survival rate was 0%. There was a significant survival difference between these two groups (p<0.05). This result suggests that the tertiary node metastasis is a potentially curable factor, and that it should be classified differently in the current TNM system. In conclusion, the overall survival rates in the patients treated with total gastrectomies were favorable compared with the results in other reports. Depth of invasion, extent of lymph node metastasis, number of involved nodes, lymph node ratio were important prognostic factors for survival after a total gastrectomy. The current TNM staging system appears to be a reasonable one, except that the probable curability of tertiary node metastasis may need to be taken into consideration.
Asian Continental Ancestry Group ; Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Malnutrition ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms* ; Survival Rate

There has been a considerable controversy on the prognosis of the mucinous gastric adenocarcinoma(MGC). In this study we analyzed the clinicopathologic differences between MGC and non-mucinous gastric carcinoma(NMGC). In addition, the relationship between mucin content and other clinicopathologic variables, including prognosis in MGC was examined. We reviewed 2118 patients with pathologically confirmed gastric cancer who had underwent gastrectomy at the department of surgery of Yonsei University College of Medicine, during the period between Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric cancer with extracellular mucin(MGC) and 1988 patients had gastric carcinoma without extracellular mucin(NMGC). We studied the MGC patients into two groups according to mucin content: mucin content involving over 50% of the tumor(dominant type, n=94) and mucin content involving less than 50% of the tumor area(partial type, n=36). The results are as follows: The MGC was more common in male then NMGC. The size of tumor in MGC was larger than that of NMGC. The patients with MGC had higher incidence of Borrmann type IV, more frequent serosal invasion, lymph nodes metastasis and peritoneal metastasis than the patients with NMGC. The patients with MGC had more advanced stage at the time of diagnosis and worse overall 5-year survival rate than the patients with NMGC. But the 5-year survival rate according to the stage of MGC was similar to that of NMGC. There were no significant differences between the mucin content and other pathologic variables including prognosis. So we suggested that MGC has worse prognosis than NMGC and it is reasonable to consider the carcinoma with mucin content involving less than 50% of the tumor area as MGC.
Adenocarcinoma* ; Diagnosis ; Gastrectomy ; Humans ; Incidence ; Lymph Nodes ; Male ; Mucins* ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms ; Survival Rate

PURPOSE: We wanted to compare the accuracy between a newly suggested sonography-guided extramedullary alignment guide system and an ordinary intramedullary alignment guide system for the femoral component alignment in Total Knee Arthroplasty (TKA). MATERIALS AND METHODS: Among the patients who underwent TKA from December 2006 to May 2007, an intramedullary technique was applied in 50 cases (the IM group) and an extramedullary technique was used in 50 cases (the EM group). The femoral component alignment angle was measured and compared postoperatively by using an anteroposterior (AP) radiograph of the knee. RESULTS: The average femoral component alignment angle was 94.96degrees (92~98degrees) in the IM group and 95.36degrees (90~99degrees) in the EM group. Both groups didn't show a significant difference. 45 cases (90%) in the IM group and 43 cases (86%) in the EM group were included in the optimal range of the femoral coronal angle (95degrees+/-2). CONCLUSION: There was no significant difference regarding the accuracy of the sonography-guided extramedullary and intramedullary femoral component alignment guide systems for performing Total Knee Arthroplasty.
Arthroplasty ; Humans ; Knee

BACKGROUND: To evaluate the effectiveness of minimally invasive surgery total hip arthroplasty (THA) using the two-incision technique as described by Mears. METHODS: From January 2003 to December 2006, sixty-four patients underwent total hip arthroplasty using the one-incision (group I) and two-incision (group II) technique by one surgeon. There were 34 hips in group I and 30 hips in group II. There was no difference in age, gender, and causes of THA between the two groups. We evaluated the operation time, bleeding amount, incision length, ambulation, hospital stay, and complications between the two groups. RESULTS: There was no difference in the bleeding amount between the two groups. Operation time was longer in the two-incision group than in the one-incision group. Operation time of the two-incision technique could be reduced after 15 cases. Patients started ambulation after surgery earlier in group II than group I, and the hospital stay was shorter in group II than in group I. There was no difference in clinical results between the two groups. There was no difference in component position of the acetabular cup and femoral stem between the two groups. Intraoperative periprosthetic fracture occurred in four cases (13.3%) in group II. CONCLUSIONS: Two-incision THA has the advantage of rapid recovery and shorter hospital stay. However, longer operation time and a high complication rate compared to one-incision are problems that need to be solved in the two-incision technique.
Arthroplasty, Replacement, Hip/*methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Surgical Procedures, Minimally Invasive/*methods

PURPOSE: To investigate the correlations between Seoul Neuropsychological Screening Battery (SNSB) scores and the gray matter volumes (GMV) in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) and cognitively normal (CN) elderly subjects with correcting the genotypes. MATERIALS AND METHODS: Total 75 subjects were enrolled with 25 subjects for each group. The apolipoprotein E (APOE) epsilon genotypes, SNSB scores, and the 3D T1-weighted images were obtained from all subjects. Correlations between SNSB scores and GMV were investigated with the multiple regression method for each subject group using both voxel-based and region-of-interest-based analyses with covariates of age, gender, and the genotype. RESULTS: In the AD group, Rey Complex Figure Test (RCFT) delayed recall scores were positively correlated with GMV. In the MCI group, Seoul Verbal Learning Test (SVLT) scores were positively correlated with GMV. In the CN group, GMV negatively correlated with Boston Naming Test (K-BNT) scores and Mini-Mental State Examimation (K-MMSE) scores, but positively correlated with RCFT scores. CONCLUSION: When we used covariates of age, gender, and the genotype, we found statistically significant correlations between some SNSB scores and GMV at some brain regions. It may be necessary to further investigate a longitudinal study to understand the correlation.
Aged ; Alzheimer Disease ; Apolipoproteins ; Brain ; Genotype* ; Humans ; Mass Screening* ; Methods ; Mild Cognitive Impairment ; Seoul* ; Verbal Learning

We report a case of perigastric histiocytic sarcoma (HS) involving the lesser omental sac in a 30-year-old man. HS is an exceedingly rare malignancy of mature tissue histiocyte. The tumor was a multi-lobulated, bulging enhancing mass in the lesser omentum with metastasis to lymph nodes and liver. The tumor consisted of diffuse non-cohesive proliferation of pleomorphic large oval to round neoplastic cells with giant cells showing vesicular chromatin and ample eosinophilic cytoplasm. In some areas, the tumor cells showed spindling with elongation of the nuclei and cellular shapes. Many of the tumor cells, especially giant forms contained phagocytosed lymphocytes. Immunohistochemical analysis of the tumor cells showed expression of leukocyte common antigen, CD68, lysozyme, vimentin, CD4, and CD163. Ki-67 index was 50-60%. After the operation, he was treated with chemotherapy, but the response was poor.
Adult ; Antigens, CD45 ; Chromatin ; Cytoplasm ; Eosinophils ; Giant Cells ; Histiocytes ; Histiocytic Sarcoma ; Humans ; Liver ; Lymph Nodes ; Lymphocytes ; Muramidase ; Neoplasm Metastasis ; Omentum ; Sarcoma ; Vimentin