No abstract available.
Bupivacaine* ; Morphine* ; Prospective Studies*

No abstract available.
Aneurysm*

Carcinoembryonic antigen (CEA) in now the most widely used and the most useful marker for many cancers, including those of the colon, lung, pancreas, and breast. Also CEA is widely used for detection, staging, recurrence, and assessing the response to therapy in colorectal cancer. METHODS: From 1992 to 1998 the clinical value of the pre- and postoperative serum levels of CEA who underwent curative surgery at Department of General Surgery, College of Medicine, Dongguk University KyungJu Hospital, in 140 s patient with colorectal cancer with abnormal levels of CEA (>or=5 ng/ml) was investigated. RESULTS: The results are as follows: 1) The positive rate of preoperative CEA level was 47%, so preoperative CEA level measurement was not useful as screening test for colorectal cancer. 2) There was no significant association between abnormal CEA level and the location of tumor. 3) There was significant association between increased levels of preoperative serum CEA and lymph node metastases. 4) The incidence of preoperatively elevated CEA levels in Dukes stages A, B, C, and D was 0%, 27%, 63%, 71%, respectively. There was significant association between increased levels of the preoperative serum CEA and the progressive stages of colorectal cancers. 5) There was no significant association between abnormal CEA level and histologic differentiation of tumor. In addition, there was no significant association between abnormal CEA level and ploidy status of tumor. 6) The recurrence rate was 20% and 77% in patients with preoperative levels of CEA<5 ng/ml and >5 ng/ml, respectively. 7) The recurrence rate was 11% and 64% in patients with postoperative levels of CEA <5 ng/ml and >5 ng/ml, respectively. 8) Considering as normal CEA levels up to 5.0 ng/ml, sensitivity was found to be 77%, specificity, 80%, and predictive value of an elevated CEA concentration, 77%. CONCLUSIONS: In conclusion, it is suggested that measurement of preoperative and serial postoperative CEA is very useful in assessing the prognosis and in detecting recurrences in colorectal cancer.
Breast ; Carcinoembryonic Antigen* ; Colon ; Colorectal Neoplasms* ; Gyeongsangbuk-do ; Humans ; Incidence ; Lung ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Pancreas ; Ploidies ; Prognosis ; Recurrence ; Sensitivity and Specificity

INTRODUCTIONThere is no consensus on the extent of lymphadenectomy and the appropriate patients for lymphadenectomy in low-risk patients with endometrial cancer. This study aimed to evaluate the feasibility and effectiveness of laparoscopic lymphadenectomy for low-risk patients with endometrial cancer.

MATERIALS AND METHODSFrom January 2004 to May 2008, we reviewed the medical records of 28 patients with low-risk, endometrial cancer; endometrioid type, grade 1 or 2, and with a depth of myometrial invasion of less than one-half of the myometrium. All patients underwent laparoscopically-assisted staging surgery.

RESULTSThe median age and body mass index were 56 years (range, 28 to 75) and 25.5 kg/m(2) (range, 21.3 to 37.2). The median operating time, estimated blood loss, and length of hospital stay were 142 minutes (range, 110 to 410), 215 mL (range, 100 to 700), and 7 days (range, 3 to 19), respectively. No conversion to laparotomy was noted. The median number of harvested lymph nodes was 21 (range, 10 to 48) pelvic nodes and 12 (range, 4 to 21) para-aortic nodes. One (3.6%) patient presented pelvic lymph node metastasis and 2 (7.1%) presented isolated para-aortic lymph node metastasis. The complication rate was 14.3%. No recurrence in the vaginal vault, distant metastasis, port site metastasis was noted up to the last follow-up.

CONCLUSIONSystemic pelvic and para-aortic lymphadenectomy should be considered in all low-risk patients with endometrial cancer until it is concluded to be clinically insignificant through large-scale prospective research in the future. However, it will be difficult to explain statistical differences in survival rates according to lymphadenectomy, because the increase of the survival rate resulting from lymphadenectomy will fall within the margin of statistical error.

Adult ; Aged ; Carcinoma, Endometrioid ; pathology ; surgery ; Endometrial Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; methods ; Middle Aged ; Neoplasm Staging ; Retroperitoneal Space ; surgery ; Retrospective Studies

BACKGROUND: Adhesion molecules are related to cell-to-cell interaction and inflammatory interaction. In addition, adhesive interactions between tumor cells and adjacent cells and/or extracellular matrix play important roles in the complex process of tumor growth and development. Among these adhesion molecules, expression of intercellular adhesion molecule-1 (ICAM-1) has been identified in colon cancer, bladder cancer, lung cancer, melanoma, pancreatic cancer and hepatocellular carcinoma. In the current study, we analyzed serum ICAM-1 concentrations to investigate the relationship between the serum ICAM-1 level and prognosis in patients with lung cancer METHODS: Serum ICAM-1 was measured in 84 patients with lung cancer according to the pathologic type and clinical stage using the ICAM-1 ELISA kit. The Kaplan-Meier method was used to analyse survival time. RESULTS: There was no difference in serum ICAM-1 concentration among the different stages of lung cancer. Furthermore, there was no difference observed between histologic tumor type with regard to serum ICAM-1 concentration. Although the difference was not significant, the overall survival times of patients with a low serum ICAM-1 concentration (< 306 ng/mL) was longer than that of patients with a high concentration (> or=306 ng/mL) in non-small cell lung cancer patients. CONCLUSION: These results suggest that high levels of serum ICAM-1 reflect poor prognosis for patients with non-small cell lung cancer.
Aged ; Carcinoma, Non-Small-Cell Lung/*blood/mortality/pathology ; Carcinoma, Small Cell/*blood/mortality/pathology ; Female ; Human ; Intercellular Adhesion Molecule-1/*blood ; Lung Neoplasms/*blood/mortality/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Analysis

Solid and papillary neoplasms of the pancreas, a rare tumor usually found in young female patients, seldom presents with metastasis since it is a tumor with low potential for malignancy. The prognosis for this lesion is much more favorable than that for other pancreatic neoplasms. In an attempt to understand the characteristics and prognosis of this lesion, we reviewed twenty cases treated at the Department of Surgery, Severance Hospital, Yonsei University from 1985 to 1994. The mean age of the patients was 25.6 years (range: 13 to 39 years), and 19 (95%) were women. Chief complaints were palpable mass (50%), pain (45%), and indigestion(5%). In laboratory studies, tumor markers, including CEA, CA125, CA19-9, and aFP were studied in eight patients, and found negative. Other laboratory findings were also nonspecific. These tumors may occur anywhere in the pancreas. In our studies, the tumor was most often located in the tail (45%), and the head (40%) of the pancreas. These were treated by distal pancreatectomy and splenectomy (55%), Whipple's operation (20%), pylorus preserving pancreatoduodenectomy (10%), enucleation (10%) or excision (5%). Significant morbidity or mortality was not observed during hospitalization, and no recurrence or malignant degeneration occurred during the mean follow-up period of 4 years (range: 1 month to 9 years). In conclusion, this study has suggested that the patients with a solid and papillary neoplasm of the pancreas have a good prognosis for successful treatment, if the disease is diagnosed early and the tumor is completely resected. A higher index of suspicion, and more aggressive diagnostic workups are needed in dealing with this disease entity.
Adolescent ; Adult ; Carcinoma, Papillary/diagnosis/*pathology/surgery ; Female ; Follow-Up Studies ; Human ; Male ; Pancreatic Neoplasms/diagnosis/*pathology/surgery

BACKGROUND: Adhesion molecule is related to cell-cell interaction and inflammatory interaction. In addition, adhesive interactions between tumor cells and adjacent cells and/or extracellular matrix are important role in the complex process of tumor growth and develpment. Of these adhesion molecules, expression of intercellular adhesion molecule-1 (ICAM-1) have been identified in colon cancer, bladder cancer, lung cancer, melanoma, pancreatic cancer, hepatocellular carcinoma. In the current study, we analyzed serum ICAM-1 concentrations to investigate the relationship between the sICAM-1 level and the prognosis of the disease in patients with lung cancer METHODS: Serum sICAM-1 was measured in 84 patients with lung cancer according to the pathologic types and clinical staging using ICAM-1 ELISA kit. The Kaplan-Meier method was used to analyse survival time. RESULTS: There was no difference in sICAM-1 concentration among the stage of lung cancer. And no difference was observed among histologic tumor types with regard to sICAM-1 concentration. The overall survival of patients with low sICAM-1 concentration (<306 ng/mL) were longer than that of patients with high concentration (>or=306 ng/mL) in non-small cell lung cancer patients, but no difference was observed in small cell lung cancer patients. CONCLUSION: These results suggest that high levels of sICAM-1 reflect the poor prognosis of patients with non-small cell lung cancer.
Adhesives ; Carcinoma, Hepatocellular ; Carcinoma, Non-Small-Cell Lung ; Colonic Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Extracellular Matrix ; Humans ; Intercellular Adhesion Molecule-1* ; Lung Neoplasms* ; Lung* ; Melanoma ; Pancreatic Neoplasms ; Prognosis* ; Small Cell Lung Carcinoma ; Urinary Bladder Neoplasms

No abstract available.
Carcinoma, Small Cell* ; Prognosis*

BACKGROUND: The Technicon Immuno I utilizes various enzymatic kinetic analysis with colorimetric detection and magnetic particles. We evaluated this fully automated random-access immunoassay system which can perform latex agglutination and magnetic-separation sandwich/ competitive immunoassay. METHODS: We evaluated the assay precision, lower limits of detection, linearity, recovery, sample to sample carry-over, analytical interferences and comparison with other various methods for the following analytes: thyroxine (T4), thyroid stimulating hormone (TSH), free thyroxine (FT4), luteinizing hormone (LH), follicular stimulating hormone (FSH), prostate specific antigen (PSA), alpha-fetoprotein (AFP), carcino-embryonic antigen (CEA), CA 19-9, and digoxin. RESULTS: Satisfactory results were obtained for within-run and between-day precision in most analytes. Lower limits of detection were slightly higher than claimed by the manufacturer. The linearity was acceptable, but there were proportional errors for CEA and FT4. The recovery rates were also good except for PSA. Sample to sample carry-over was not detected. No significant analytical interference was caused by hemoglobin (up to 2,000 mg/L), lipid (up to 85 mmol/L) and bilirubin (up to 325 mol/L) except for digoxin, FT4 and PSA. The Technicon Immuno I assay correlated well with the comparison methods in most analytes, but the proportional biases were found for PSA and LH. CONCLUSIONS: The Technicon Immuno I is a satisfactory system for clinical use in most cases but more study would be requried for FT4. Especially, this system can replace the radioimmunoassay for FSH and LH.
Agglutination ; alpha-Fetoproteins ; Bias (Epidemiology) ; Bilirubin ; Digoxin ; Immunoassay* ; Latex ; Limit of Detection ; Luteinizing Hormone ; Prostate-Specific Antigen ; Radioimmunoassay ; Thyrotropin ; Thyroxine

BACKGROUND: Serum high density lipoprotein (HDL)-cholesterol level is used as an assessment of the risk of coronary heart disease. In this study, we evaluated direct measurement of HDL- cholesterol in serum with polyethylene-modified enzymes and sulfated alpha-cyclodextrin. METHODS: We evaluated the precision, the lower limit of detection, the recovery rate, the linearity, the interference for hemoglobin and the comparision with the result of HDL-cholesterol measured by selective precipitation method. We also studied the specificity of this direct method for very low density lipoprotein (VLDL) and low density lipoprotein (LDL). RESULTS: The total imprecision was 3.8% (low), 3.5% (middle), 3.2% (high). The lower limit of detection was 0 mg/L. The recovery rate was satisfactory. The linearity was also (r2=0.99). This method showed a good correlation (r2=0.97) with the selective precipitation method in HDL- cholesterol measurement. VLDL-cholesterol (up to 300 mg/L) increased HDL-cholesterol only less than 3% but increased VLDL-cholesterol to 400 mg/L, more than 750 mg/L caused 5% and 15% of overestimation of HDL-cholesterol, respectively. LDL-cholesterol (142-1,073 mg/L) increased or decreased HDL-cholesterol by some degree (about 15%). Hemoglobin (up to 3,000 mg/L) did not influence this assay. CONCLUSIONS: The direct measurement of HDL-cholesterol is satisfactory method in HDL- cholesterol measurement in good analytical performance and may be anticipated to reduce workload of laboratory because the sample pretreatment is not necessary.
Cholesterol* ; Coronary Disease ; Limit of Detection ; Lipoproteins* ; Sensitivity and Specificity