Our experience of surgical management of 20 adrenal tumors was present during the period from June, 1988 to May, 1993. The results of clinical study were as follows ; 1. Average age of patients was 40.9 years with the highest incidence in sixth decade occupying 40% and male to female ratio was 1:1 and right to left ratio was equal also. 2. The adrenal tumors consist of 8 adrenocortical adenoma( including 3 primary aldosteronisms and 1 Cushing syndrome), 4 adrenocortical carcinoma(including 1 Cushing syndrome), 7 pheochromocytomas and l neuroblastoma. 3. The 11 functioning adrenal tumors( including 4 adrenocortical adenomas, 1 adrenocortica1 carcinoma and 6 pheochromocytomas) showed specific symptoms and signs and the majority symptom and sign of the 9 non-functioning adrenal tumors( including 4 adrenocortical adenomas, 3 adrenocortical carcinomas, 1 neuroblastoma and 1 pheochromocytoma) showed abdominal discomfort and pain. 4. For initial diagnosis of the adrenal tumors, USG, CT, MRI and angiography are reliable but IVP was reliable in large adrenal tumor 5. The surgical approaches were transperitoneal in 18 patients and retroperitoneal in 2 patients and postoperative surgical complication occurred in 3 patients of transperitoneal approaches that were prolonged ileus, spleen injury and pancreatic injury with pleural effusion.6. The tumor masses were 12gm to 4,000gm in weight (mean: 616gm). The adrenal benign and malignant tumor were significantly different in weight ( 120gm : 1817gm).
Adrenocortical Adenoma ; Adrenocortical Carcinoma ; Angiography ; Diagnosis ; Female ; Humans ; Ileus ; Incidence ; Magnetic Resonance Imaging ; Male ; Neuroblastoma ; Pheochromocytoma ; Spleen

A case of contact dermatitis due to herb onintment is described in a 24 year-old female patient. After topical application of herb ointment, she developed erythematous papules and plaques on the face and neck. Patch test revealed positive reactions to ammoniated mercury, thimerosal, and the herb ointment. Energy-dispersive X-ray microanalysis of the herb ointment showed a striking peak for mercury.
Dermatitis, Contact* ; Electron Probe Microanalysis ; Female ; Humans ; Neck ; Patch Tests ; Strikes, Employee ; Thimerosal ; Young Adult

We measured serum CA19-9 from March 1990 to June 1992 in 63 cases of normal controls, 56 cases or bladder cancer, 32 cases of renal cell carcinoma, 8 cases of prostatic carcinoma, 4 cases of penile cancer. 2 cases of testicular cancer and 3 cases of carcinoma of gastrointestinal tract with metastasis to the retroperitoneum. The results of this study were that serum levels of CA19-9 in urinary bladder cancer, renal cell carcinoma and prostatic carcinoma were statistically significant. However, sensitivity was low, 14. 29% for urinary bladder cancer, 18.75% for renal cell carcinoma. 12.5 % for prostatic carcinoma and specificity was 95.2%. In renal cell carcinoma, there was no change in serum level between stages. However there was a statistically significant difference (p<0.05) between low stage(A, B) and high stage(C, D) urinary cancers. We suggest that serum CA19-9 levels cannot be used as a screening test or prognosis indicator in tumors of the genitourinary tract ; however it can be helpful in differentiating between low and high stage urinary bladder cancers.
Carcinoma, Renal Cell ; Gastrointestinal Tract ; Male ; Mass Screening ; Neoplasm Metastasis ; Penile Neoplasms ; Prognosis ; Sensitivity and Specificity ; Testicular Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urogenital Neoplasms*

The phenomenon of multiple primary malignant tumors in one patient synchronously or metachronously is no more curiosity. So, careful follow up study and early diagnosis of those lesions, based on an awareness of the possibility of the second cancer, will substantially increase the survival of these patients. We collected nine cases of multiple primary cancers according to Moertel's classification histologically proved and treated from 1985 to l992 at Kosin Medical Center. The results were as follows; 1. The average age of the patients was 60.9 years with dominance in seventh decade 2. The male to female ratio was 7: 2 with significant dominance in male. 3. The synchronous to metachronous ratio was 6: 3, in metachronous cases the average time interval between 1st and 2nd cancers was 122 months. 4. In 6 cases of synchronous cancers, there were penile cancer and hepatoma, renal cell carcinoma and bladder cancer, prostatic cancer and bladder cancer, bladder cancer and colon cancer, and prostatic cancer and lung cancer. In 3 cases of metachronous cancers, there were bladder cancer and uterine cervical cancer, bladder cancer and stomach cancer, and renal cell carcinoma and synovial sarcoma. 5. In 3 cases of metachronous cancers, adjuvant therapy was performed in 2 cases after operation including one case of chemotherapy and another case of radiotherapy.
Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Classification ; Colonic Neoplasms ; Drug Therapy ; Early Diagnosis ; Exploratory Behavior ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Male ; Neoplasms, Second Primary ; Penile Neoplasms ; Prostatic Neoplasms ; Radiotherapy ; Sarcoma, Synovial ; Stomach Neoplasms ; Urinary Bladder Neoplasms ; Uterine Cervical Neoplasms

No abstract available.
Breast Implants* ; Breast* ; Contracture* ; Pregnancy*

We managed the two cases of small cell carcinoma of prostate, which has been reported only 20 cases in the world literature. It has not been reported in our country. It`s prognosis is very poor and it may have neurosecretory manifestation. Small cell carcinoma of the prostate combined with adenocarcinoma or previous history of adenocarcinoma is found in 50% cases. The diagnosis was established by pathologic findings with special stain (neuron specific enolase) and electromicroscopic examination.
Adenocarcinoma ; Carcinoma, Small Cell* ; Diagnosis ; Prognosis ; Prostate*

The brain metastasis of prostatic carcinoma is rare and is distinguished by its poor prognosis in cases which are not surgically resectable. Herein we described a 72 year old male with brain metastasis from prostatic carcinoma, which regressed with chemotherapy. Pathological examination of a transrectal needle biopsy disclosed moderatedly differentiated adenocarcinoma of the prostate. Magnetic resonance imaging of brain demonstrated a brain tumor at the occipital lobe suspected to be a metastasis of prostatic carcinoma. The tumor could not be detected on the brain MRI after 3 months of chemotherapy.
Adenocarcinoma* ; Aged ; Biopsy, Needle ; Brain Neoplasms ; Brain* ; Drug Therapy* ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis* ; Occipital Lobe ; Prognosis ; Prostate

BACKGROUND: The urinary protein to creatinine ratio in a single voided random urine sample has been widely used as an estimation of 24 hour urine protein excretion because of inconvenience and frequent collection errors during timed collection of 24 hour urine. But the protein to creatinine ratio also showed frequent estimating error, overestimation or underestimation. We thought that protein to creatinine ratio adjusted by daily creatinine excretion estimated by Cockroft-Gault equation can be more accurate than protein to creatinine ratio and compared them as follows. METHODS: This study consisted of 81 patients whose 24 hour urine protein excretion and random spot urine protein to creatinine ratio were measured concomitantly. There was no significant change of body weight or serum creatinine change around the study day. The modified protein to creatinine ratio could be estimated from the measured protein to creatinine ratio in a random spot urine sample by multiplying the ratio by the expected daily creatinine excretion estimated by Cockroft-Gault equation. These results were compared with well collected 24 hour urine protein. RESULTS: The difference between protein to creatinine ratio and 24 hour urine protein was 0.87+/-1.13, on the other hand, the difference between modified protein to creatinine ratio and 24 hour urine protein was 0.52+/-0.65 (p<0.05). Correlation coefficients between protein to creatinine ratio, modified protein to creatinine ratio and 24 hour urine protein were 0.877, 0.957 respectively. CONCLUSION: The protein to creatinine ratio modified by the expected daily creatinine excreation rate calculated by Cockfort-Gault equation was more accurate than simple protein to creatinine ratio.
Body Weight ; Creatinine* ; Hand ; Humans

We evaluated gastric emptying time (GET) by using Tc99m-sulfur colloid gastric emptying scintigraphy in 11 patients with CAPD (6 male, 5 female) and 14 healthy volunteers. We investigated the effect of dialysate dwelling on GET by studying twice, once without dialysate in the abdomen (drained) and once with 2 L of dialysate in the abdomen (full), and the relationship between body surface area (BSA) and delayed gastric emptying. 1) The mean of gastric emptying rate in 120 minute in patients with CAPD when drained (67.8+/-13.4%) was not different from that in healthy volunteers (65.4+/-8.6%) 2) The mean of gastric emptying rate in 120 minute when full (55.6+/-14.6%) was significantly lower than that when drained (67.8+/-13.4%) (P<0.05). In four of the 11 patients (36.4%), gastric emptying was extremely delayed from normal to abnormal range when full. 3) The BSA (1.5+/-0.11m2)of patients who had extremely delayed GET from normal to abnormal range was smaller than that (1.74+/-0.22m2) of patients who had minimal delayed or unchanged GET when full. This study showed the patient with CAPD had normal gastric emptying when drained, and that gastric emptying was delayed by dialysate dwelling, especially in the patients who has less than 1.5m2 of body surface area. Therefore, we suggest that intermittent nocturnal peritoneal dialysis or a small volume of dialysate may be considered for the patient with small body surface area based on the adequacy.
Abdomen ; Body Surface Area ; Colloids ; Gastric Emptying* ; Healthy Volunteers ; Humans ; Male ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Radionuclide Imaging

Diarrea-associated hemolytic uremic syndrome (HUS) is very rare in adults. Few reports are available on clinical features and plasma exchange in adult patients with diarrhea-associated HUS in Korea. We retrospectively examined the records of five adult patients with diarrhea-associated HUS admitted to Samsung Seoul Hospital between January 1995 and December 1997. If the patient had neurologic abnormalities, or there was rapid clinical deterioration, with the hematocrit decreasing below 20%, the platelet count falling below 10,000/mm3, the creatinine concentration increasing above 5.0 mg/dl, plasma exchange was begun. There were 4 females and 1 male. Patients ranged in age from 16 to 61 years. All patients presented with diarrhea and abdominal pain, and 3 patients had bloody diarrhea. The mean time between the onset of diarrhea and thrombocytopenia was 4.4+/-1.9 days (range, 1 to 6). All patients received 7 to 24 plasma exchanges. The mean exchanged plasma volume was 1.1+/-0.2 times of patients own plasma volume. The pattern of clinical response to plasma exchange was initial normalization of platelet count (8.0+/-3.8 days), followed by normalization of LDH level (20.2+/-14.5 days) and creatinine concentration (25.8+/-13.8 days). Metabolic alkalosis developed in two patients undergoing daily plasma exchange. We successfully managed the metabolic alkalosis with continuous venovenous hemofiltration. The mean duration of hospitalization was 28.8+/-11.2days (range, 20 to 42). All patients successfully recovered without any sequale. Although this study is based on small case series, we suggested that plasma exchange may improve the outcome in adult diarrhea-associated HUS.
Abdominal Pain ; Adult* ; Alkalosis ; Creatinine ; Diarrhea ; Female ; Hematocrit ; Hemofiltration ; Hemolytic-Uremic Syndrome* ; Hospitalization ; Humans ; Korea ; Male ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Platelet Count ; Retrospective Studies ; Seoul ; Thrombocytopenia