Idod (Immediate Dissolved Oxygen Demand) is a value of the oxygen demand after 15 minute of inoculation by inorganic reducing salts. Industrial development and urban enlargement are bringing water pollution deeply, and industrial waste waters are the source of the inorganic reducing salts. Author investigated the IDOD value change according to the inorganic salts and gained the following results: 1. IDOD value influenced by Na2SO3 is 81.4 ppm. 2. Generally sulfur compounds are highly effecting on IDOD. 3. The nitrite salt had little influence on IDOD.
Industrial Waste ; Oxygen ; Salts* ; Sulfur Compounds ; Water Pollution

Hypospadias can be repaired in the majority cases in 1-stage with a high success rate. We reviewed clinical experience of 50 patients who underwent primary hypospadias repair by 1 surgeon using 1-stage repairs except 3 cases in a 30-month period. The results were 1). The half of patients were younger than 5 years (48%). 2). A total of 34 cases (68.0%) had an associated ventral curvature. The dorsal tunica albuginea plication to correct intrinsic curvature was done in 21 cases (61.8%) and dividing the urethral plate in only 3 cases (8.8%). 3). Associated anomalies were cryptorchidism in 7, hydrocele in 3 and severe penoscrotal transposition in 8 cases. 4). 19 cases of anterior hypospadias were repaired by meatoplasty using Heineke-Mikulicz tissue rearrangement (9 cases), MAGPI (3 cases), pyramid procedure (4 cases), Mathieu urethroplasty (2 cases) and onlay island flap (1 case). Of the 31 cases of middle and posterior hypospadias onlay island flap repair was performed in 24 cases (77.4%). 5). The success rates in anterior, middle and posterior hypospadias were 94.7, 64.7 and 42.9%, respectively. The overall success rate was 70%. 6). The most commonly used procedure was onlay island flap urethroplasty. Only 14 of 25 cases (56.0%) were successful with this method but the last 8 cases were repaired with no complications. 7). The most common complications were urethrocutaneous fistula (11 cases) and meatal retraction (3 cases). The complications were managed by rotational advancement flap (11 cases), meatal based flap (2 cases) and urethral advancement (1 case) and the success rate was 73.3%. In conclusion, to achieve more satisfactory results the choice of operation depends on the configuration of either glans or meatus, presence or absence of chordee and status of ventral penile skin in anterior hypospadias. Although the 2-stage repair remains a safe and reliable alternatives for severe hypospadias 1-stage repair was more useful except severe hypospadias combined with penoscrotal transposition."
Cryptorchidism ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays ; Male ; Skin

Transcatheter arterial chemoembolization(TACE) was performed in a 61 year old male patient with hepatocellular carcinoma with 10 cc of Lipiodol and 50 mg of doxorubicin. Three days later, he complained of dyspnea and dry cough. The arterial blood gas study revealed moderate hypoxemia and hypocarbia. The chest PA showed acute pulmonary edema with bilateral pleural effusion. To rule out the possibilities of acute respiratory failure caused by infection, pulmonary embolism or congestive heart failure, we performed several laboratory studies. The blood and sputum culture studies revealed negative results for bacterial growth. The echocardiogram was normal. The abdominal CT scan and MR imaging revealed no thrombus or mass lesion in the inferior vena cava. So we concluded pulmonary oil embolism induced by lipiodol as the cause of acute lung injury. Four weeks later, clinical symptoms and chest x-ray were markedly improved with conservative care. We report a case of acute lung injury after TACE with lipiodol and doxorubicin, with review of literatures.
Acute Lung Injury* ; Anoxia ; Carcinoma, Hepatocellular* ; Cough ; Doxorubicin ; Dyspnea ; Embolism ; Ethiodized Oil ; Heart Failure ; Humans ; Magnetic Resonance Imaging ; Male ; Pleural Effusion ; Pulmonary Edema ; Pulmonary Embolism ; Respiratory Insufficiency ; Sputum ; Thorax ; Thrombosis ; Tomography, X-Ray Computed ; Vena Cava, Inferior

BACKGROUND: As brain tumor cells are immunologically active, they release various factors like a cytokine, growth factor and express a death domain on their surfaces. Accordingly they support proliferation, vascularity, invasiveness and maintain immune privileged sites. However, the relationship between tumor cells and surrounding neuron cells have been rarely reported in tumor patients with epilepsy that inhibitory neuron cells have been lost around peritumoral sites. This study was designed to address that tumor cells directly damage neuron cells. METHODS: Using LDH assay and special stain, we investigated whether or not cultured supernatants of astrocytoma cells induce the damage of neuron cells. RESULTS: The neuron cells were killed by tumor cells supernatant and increased by pretreatment of neuron cells supernatant and lysates. Protein extracted tumor cells supernatant also damage neuron cells. It was proved by Annexin-PI stain and DNA fragmentation that neuronal death by tumor cells was apoptosis. The more malignant tumor cells, the more neuronal death was induced and the more their cytokines were expressed. In comparison with various cytokine expressions in tumor cells, it can be assumed that the released protein from tumor cells was associated with TNF (tumor necrosis factor)-alpha. CONCLUSIONS: Brain tumor cells are active processing cells that they recognize surrounding normal neuron cells, release death factors and induce apoptosis of neuron cells. Released death factors are related toTNF-alpha. (J Korean Neurol Assoc 19(3):266~277, 2001)
Apoptosis* ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Cytokines ; DNA Fragmentation ; Epilepsy ; Humans ; Necrosis ; Neurons*

PURPOSE: Refractory small-cell lung cancer (SCLC) has a poor prognosis, and current salvage chemotherapy for refractory SCLC, such as CAV (cyclophosphamide, adriamycin, vincristine) or topotecan, has an unsatisfactory outcome, with a response rate and overall survival of less than 10% and 6 months, respectively. This phase II study evaluated the role of topotecan combined with etoposide in SCLC patients that have progressed, or relapsed, within 3 months following completion of the initial chemotherapy. MATERIALS AND METHODS: Twenty-seven patients were entered into this study. Eligible patients had an ECOG performance status of less than, or equal to, 2, at least one bidimensionally measurable lesion and adequate end organ function. IV topotecan, 1.0 mg/m2/d for 5 consecutive days, and etoposide, 100 mg/m2/d through days 1 to 3, were administered every 3 weeks until disease progression or undue toxicity. RESULTS: The major toxicity was myelosuppression. Grade 3/4 anemia, granulocytopenia, and thrombocy-topenia occurred in 14.2, 34.8, and 27.3% of cycles, respectively. There was no treatment-related death, and other non-hematologic toxicities were generally mild. Four patients achieved partial responses, with a response rate RR of 14.8%. The progression-free survival PFS ranged from 1 to 7 months, with a median of 2.0 months (95% confidence interval 1.22~2.78 months). Twenty-five patients died, with a median overall survival of 5.5 months (ranging from 1 to 21 months, 95% CI 4.32~6.68 months), and the 6-month survival rate was 32.1% (95% confidence interval 14.4~49.8%). CONCLUSION: The combination of topotecan and etoposide chemotherapy showed a modest response rate, but failed to prolong survival of refractory SCLC patients compared to topotecan monotherapy.
Agranulocytosis ; Anemia ; Carcinoma, Small Cell ; Disease Progression ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Etoposide* ; Humans ; Lung Neoplasms* ; Lung* ; Prognosis ; Survival Rate ; Topotecan*

Male pseudohermaphroditism can result from defects in androgen synthesis, androgen action, and mullerian duct regression, and from other uncertain causes. A rare form of male pseudo- hermaphroditism is characterized by the persistence of mullerian derivative in phenotypic male. The retention of mullerian structures can be ascribed to failure of the Sertoli cells to synthesize mullerian duct inhibitory factor, a defect in the response of the duct to that factor, or possibly discordant timing of the release of that factor. We experienced a case of persistent mullerian duct syndrome, which is phenotypically normal male with a right inguinal hernia and a left undescended testis, bilateral fallopian tubes and a uterus. Herein we report a case of early orchiopexy with this syndrome and brief review of the literatures.
46, XY Disorders of Sex Development ; Cryptorchidism ; Disorders of Sex Development ; Fallopian Tubes ; Female ; Hernia, Inguinal ; Humans ; Male ; Orchiopexy ; Sertoli Cells ; Uterus

OBJECTIVE: Environmental pollutants, especially environmental toxins (ET), may have the potential to disrupt neurodevelopmental pathways during early brain development. This study was designed to test our hypothesis that mothers with autism spectrum disorder (ASD) children would have less knowledge about ET and more chance to be exposed to ET than mothers with healthy children (MHC). METHODS: One hundred and six biologic mothers with ASD children (MASD) and three hundred twenty four biologic mothers with healthy children MHC were assessed using two questionnaires asking about ET. RESULTS: The total score in response to questions related to knowledge about ET in MHC was higher than that in MASD. The possibility of exposure to ET was higher in MASD than MHC. MASD showed higher sub-scale scores in terms of exposures to canned food, plastics, waste incinerators, old electronics, microwavable food, and textiles. CONCLUSION: The current results show that reduced knowledge about ET and greater exposure to ET may be associated with autism spectrum disorder.
Autistic Disorder ; Brain ; Child ; Autism Spectrum Disorder ; Electronics ; Electrons ; Environmental Pollutants ; Food, Preserved ; Humans ; Mothers ; Plastics ; Surveys and Questionnaires ; Textiles

PURPOSE: Phyllodes tumor is a rare fibroepithelial tumor of the breast, first described by Johannes Muller in 1838. Much has been written about phyllodes tumor, but very few widely accepted conclusions about its clinical behavior, treatment modality, and prognosis have been reached. This study aims to analyze the clinical, radiological, and pathological characteristics of phyllodes tumor of the breast. METHODS: The medical records of 41 patients with phyllodes tumor who had been treated between February 1982 and August 1998 at the Department of Surgery, Seoul National University Hospital, were retrospectively reviewed for clinical, radiological and pathological findings, treatment modalities, and follow-up results. RESULTS: Of these 41 cases, there were 28 cases (68.3%) of benign tumors and 13 cases (31.7%) of malignanat tumors. All patients were females, and the mean ages of onset were 33.2 years for benign tumors and 40.8 years for malignant tumors. Most patients, 100% of benign and 92.3% of malignant, presented with a papable mass in the breast. The median duration of illness was 2 months for malignant tumors and 8 months for benign tumors. The tumor size was greater than 10 cm in diameter in 5 cases (38.5%) of malignant tumors and in 3 cases (10.7%) of benign tumors. Only 4 cases were preoperatively diagnosed as having a phyllodes tumor by using radiological and fine needle aspiration cytology. Out of the 10 malignant cases reviewed, 5 cases were confirmed as malignant, and 5 cases were confirmed as borderline phyllodes tumors. Cellularity was moderate or above in all 5 malignant and 5 borderline cases. Atypism above moderate degree was found in 4 of 5 (80%) malignant tumors, in 3 of 5 (60%) borderline tumors, and in 4 of 24 (16.7%) benign tumors. Mitotic counts in all 5 malignant cases were 5 or more per 10 high power field while those in the 5 borderline tumors were 2-5 mitoses per 10 high power field. The most commonly performed operative procedures were a simple mastectomy (50%) for malignant tumors and a simple excision (64.3%) for benign tumors. Post-operative adjuvant therapy was done for 4 cases; out of these, 1 case had been initially diagnosed as a malignant phyllodes tumor, but the diagnosis was changed to a benign phyllodes tumor upon review. Of the 27 follow-up cases, recurrences developed in 3 cases (16.7%) of benign tumors. CONCLUSION: From the above results, there were no specific clinical features for differentiating benign from malignant phyllodes tumor preoperatively; therefore, we cannot help depending on the pathologic findings. Pathologic reviews showed that among several criteria, atypism, cellularity, and mitotic count were the most definite pathologic characteristics in differentiating benign from malignant phyllodes tumor. But much more experience and long-term follow-up may be needed to define optimal treatments and to analyze the prognosis for phyllodes tumors of the breast.
Biopsy, Fine-Needle ; Breast* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Simple ; Medical Records ; Mitosis ; Phyllodes Tumor* ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Surgical Procedures, Operative

No abstract available.

PURPOSE: Leptomeningeal carcinomatosis occurs in about 5% of patients with solid tumor and is being diagnosed with increasing frequency as patients live longer and as neuro-imaging studies improve. In general, the most commom cancers that involved the leptomeninges are breast cancer, lung cancer, and malignant melanoma. MATERIALS AND METHODS: We investigated 25 patients presented with multiple neurologic symptoms and signs who were diagnosed with leptomeningeal carcinomatosis at the Yonsei Cancer Center from January 1990 to December 1999. RESULTS: The primary disease of leptomeningeal carcinomatosis were stomach cancer (10 cases), breast cancer (7 cases), lung cancer (5 cases), unknown primary cancer (2 cases) and common bile duct cancer (1 case). All patients were presented with multiple neurologic symptoms and signs involving the central nervous system (CNS), cranial nerve or spinal nerves. Twenty-one of twenty- five patients were treated with intrathecal chemotherapy, radiotherapy, or combination therapy. Fourteen of them (66.7%) experienced improvement or stabilization of neurologic symptom and sign. The median survival was 122 days (10-2190). CONCLUSION: In conclusion, although early diagnosis and active treatment of leptomeningeal carcinomatosis may improve the quality of life in selected patients, the median survival was relatively short. Therefore, new diagnostic and therapeutic strategy for leptomeningeal carcinomatosis were needed.
Breast Neoplasms ; Central Nervous System ; Common Bile Duct ; Cranial Nerves ; Drug Therapy ; Early Diagnosis ; Humans ; Lung Neoplasms ; Melanoma ; Meningeal Carcinomatosis* ; Neurologic Manifestations ; Quality of Life ; Radiotherapy ; Spinal Nerves ; Stomach Neoplasms