No abstract available.
Dislocations* ; Elbow*

PURPOSE: The genetic polymorphism and intracellular activity of methylenetetrahydrofolate reductase (MTHFR) and thymidylate synthase (TS) is clinically associated with carcinogenesis and biological therapeutic effect in gastrointestinal malignancies. We aimed to elucidate the susceptibility of gastric cancer according to MTHFR and TS gene polymorphism. METHODS: This study was designed as a hospital-based case-control study in a single institute. The gastric cancer group (n=300) for the study was diagnosed at first time as tubular adenocarcinoma, and the control group (n=100) was diagnosed as no malignancy in the endoscopic biopsy. The genetic polymorphism of TS and MTHFR were confirmed by PCR. RESULTS: The MTHFR mutant type had a more than 2-fold increased risk of developing gastric cancer (RR: 2.341). But, only heterozygote type (677CT) revealed significantly higher susceptibility compared to wild type (RR: 2.581). In TS gene genotype, the mutant genotype rate (2R/3R and 3R/3R) was significantly higher in gastric cancer group compared to control group (P=0.008), and the mutant type had a more than 3-fold increased risk of developing gastric cancer (RR: 3.222). In combined MTHFR and TS, 677CT+2R/3R and 677CT+3R/3R there was more than a 3-fold increased risk rate of developing gastric cancer compared with other combinations (RR, 3.474 in 677CT with 2R/3R; RR, 3.895 in 677CT with 3R/3R). CONCLUSION: This study shows a significant association between the MTHFR and TS polymorphisms and susceptibility to gastric cancer, providing a genetic basis. The polymorphisms study of two genes could be applied as susceptibility markers, clinically, for gastric cancer.
Adenocarcinoma ; Biopsy ; Case-Control Studies ; Genotype ; Heterozygote ; Methylenetetrahydrofolate Reductase (NADPH2) ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Stomach Neoplasms ; Thymidylate Synthase

PURPOSE: To evaluate the usefulness of ultrasonography in the diagnosis of local recurrent soft tissue tumors. MATERIALS AND METHODS: We retrospectively analysed the results of 113 sonographic examinations in 102 patients (38males, 64 females) after surgical treatment of soft tissue tumors (82 malignancies, 20 benignancies) during thelast five years. Follow-up included physical and sonographic examinations using a 5-10MHz transducer every twomonths. In 17 cases, MR images were obtained The criterion for local recurrence was discrete mass, and size,shape, margin, echogenicity, and homogeneity were also analysed. Forty-one patients underwent surgery. RESULTS: Among 113 cases, 41 local recurrences were proven by surgery and histological analysis; well-defined, ovoid,homogeneous hypoechoic masses of various sizes were apparent. Sonographic sensitivity and specificity were both97%. MR sensitivity and specificity were 83% and 100% respectively, but in most cases in which MR had been usedthe masses were greater than 3cm in diameter. Two cases were false positive; these were thought to be granulomas,but were shown during follow-up lasting 36 and 14 months, respectively, to be unchanged hypoechoic nodules. Onecase was false negative. CONCLUSION: For the diagnosis of local recurrent soft tissue tumors, ultrasonography isvery useful. For early detcction, it is superior to MR imaging.
Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Transducers ; Ultrasonography

The CT findings of pulmonary paragonimiasis are well known. However, the pathologic findings of nodular opacity have not been studied sufficiently. To clarify the nature of nodular opacity on CT in patient with paragominiasis, we reviewed CT scans of 9 patients retrospectively. Five of them were compared with pathologic findings of the resected specimen. Other four patients were confirmed by needle aspiration biopsy. CT scans showed nodular opacities of 5 to 30mm in diameter which were accompanied with perinodular air-space consolidations in all patients. The usual location of nodular opacities were peripheral zone of the lung. Correlation with pathologic findings demonstrated That the nodular opacity on CT scans corresponded to the parasitic granuloma with central ova and intracystic worm. The most frequent CT finding of pulmonary paragonimiasis was nodular opacities with perinodular airspace consolidations caused by parasitic granuloma or intracystic worm.
Biopsy, Needle ; Granuloma ; Humans ; Lung ; Needles ; Ovum ; Paragonimiasis ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: This study was performed to determine the outcome after treatment of osteosarcoma with intraarterial cisplatin as a preoperative chematherapy regimen. MATERIALS AND METHODS: Twenty five patients with extremity osteosarcoma were treated with intraarterial cisplatin at Seoul National University Children's Hospital from January 1987 to April 1996. The dose of cisplatin was 130 mg/m2 and three to six courses were repeated two- to three-week intervals, Systemic doxorubicin was added to six of these patients. This was followed by surgical resection(limb salvage or amputation) and postoperative adjuvant chemotherapy. RESULTS: Limb-salvage was possible in twenty of these twenty five patients. Pulmonary metastasis was present in five patients at diagnosis and developed later in three patients. In six patients treated with systemic doxorubicin, pulmonary metastasis was absent at diagnosis and during follow-up period. Local recurrence after limb salvage was occurred in one patient and treated with amputation and systemic chemotherapy. Seven patients died from pulmonary metastssis and one from unknown cause. The follow-up duration of these patients was three to eighty eight months(median twenty two months) and the overall five-year survival and event free survival rate were 62.1% and 57.5%, respectively. CONCLUSION: These data demonstrate that intraarterial cisplatin can be used as an effective regimen preoperatively for pediatric patients with extremity osteosarcoma. The combined use of systemic doxorubicin is expected to improve survival in patients with pulmonary metastasis.
Amputation ; Chemotherapy, Adjuvant ; Cisplatin* ; Diagnosis ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Extremities ; Follow-Up Studies ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma* ; Recurrence ; Seoul ; Survival Rate

BACKGROUND: Angiotensin converting enzyme inhibitor or Angiotensin II type 1 receptor blocker is usually recommended for hypertensive patients with diabetes mellitus. No reports have been made on antihypertensive agents prescribed for these patients in private practice. METHODS: During a one month period of December 2004, 169 hypertensive patients with diabetes mellitus on their prescribed antihypertensive agents by ten family physicians were analyzed. The influencing factors for such prescriptions were analyzed by directly visiting each physicians who prescribed them. RESULTS: A total of 21 antihypertensive agents were prescribed by these family physicians. Single calcium channel blocker therapy was the most common with 55 cases (32.5%), followed by 20 cases (11.8%) of single angiotensin converting enzyme inhibitor therapy and 16 cases of single therapy of Angiotensin II type 1 receptor blocker. The low frequency of prescribing the Angiotensin II type 1 receptor blocker was due to insufficient effect (7), lack of information (5), resistance from the patients from changing the medications (4) and expensive costs (4). CONCLUSION: In prescribing antihypertensive agents for patients with diabetes mellitus, angiotensin converting enzyme inhibitor or Angiotensin II type 1 receptor blocker were chosen less. In order to decrease the incidence of complications in these patients, such agents should be prescribed more.
Antihypertensive Agents* ; Calcium Channels ; Diabetes Mellitus* ; Humans ; Hypertension ; Incidence ; Peptidyl-Dipeptidase A ; Physicians, Family ; Prescriptions ; Primary Health Care* ; Private Practice ; Receptor, Angiotensin, Type 1