Purpose: This study aimed to analyze the treatment outcomes of combined definitive radiation therapy (RT) and androgen deprivation therapy (ADT) for clinically node-positive prostate cancer. Materials and Methods: Medical records of 60 patients with clinically suspected metastatic lymph nodes on radiological examination were retrospectively analyzed. Eight patients (13.3%) were suspected to have metastatic common iliac or para-aortic lymph nodes. All patients underwent definitive RT with a dose fractionation of 70 Gy in 28 fractions. ADT was initiated 2–3 months before RT and continued for at least 2 years. Biochemical failure rate (BFR), clinical failure rate (CFR), overall survival (OS), and prostate cancer-specific survival (PCSS) were calculated, and genitourinary and gastrointestinal adverse events were recorded. Results: The median follow-up period was 5.47 years. The 5-year BFR, CFR, OS, and PCSS rates were 19.1%, 11.3%, 89.0%, and 98.2%, respectively. The median duration of ADT was 2.30 years. BFR and CFR increased after 3 years, and 11 out of 14 biochemical failures occurred after the cessation of ADT. Grade 2 and beyond late genitourinary and gastrointestinal toxicity rates were 5.0% and 13.3%, respectively. However, only two grade 3 adverse events were reported, and no grade 4–5 adverse events were reported. Patients with non-regional lymph node metastases did not have worse BFR, CFR, or adverse event rates. Conclusion This study reported the efficacy and tolerable toxicity of hypofractionated definitive RT combined with ADT for clinically node-positive prostate cancer. Additionally, selected patients with adjacent non-regional lymph node metastases might be able to undergo definitive RT combined with ADT.

Catamenial hemoptysis is a rare condition, characterized by recurrent hemoptysis associated with the presence of intrapulmonary or endobronchial endometrial tissue. Therapeutic strategies proposed for intrapulmonary endometriosis with catamenial hemoptysis consist of medical treatments and surgery. Bronchial artery embolization is a well-established modality in the management of massive or recurrent hemoptysis, but has seldom been used for the treatment of catamenial hemoptysis. We report a case of catamenial hemoptysis associated with pulmonary parenchymal endometriosis, which was successfully treated by a bronchial artery embolization.
Bronchial Arteries* ; Embolization, Therapeutic ; Endometriosis ; Female ; Hemoptysis*

BACKGROUND: In hemodialysis (HD) patients, traditional risk factors cannot explain all of the mortality and morbidity. This study was designed to investigate the effect of depression and health-related quality of life (HRQOL) on prognosis in maintenance HD patients. METHODS: In February 2008, the Beck's Depression Inventory and the Kidney Dialysis Quality of Life-Short Form were utilized to measure depression and HRQOL. Until February 2011, the mortality, cardiovascular events, infection, and hospitalization were investigated, retrospectively. RESULTS: Among the 166 patients, the 3-year cumulative survival rate was 88.8%, and the depression did not affect survival (depression vs. nondepression: 91.8% vs. 87.2%, P=0.437). The upper tertiles in physical component summary (PCS) were correlated with lower mortality (OR, 0.12; P=0.05) and fewer cardiovascular events (OR, 0.09; P=0.024) than the lower tertiles. The upper tertiles in kidney disease component summary (KDCS) were associated with less hospitalization than the lower tertiles (OR, 0.38; P=0.024). After adjusting for multiple variables including age, comorbidity index, and albumin, upper tertiles in PCS were correlated with fewer cardiovascular events than the lower tertiles (OR, 0.08; P=0.038). CONCLUSION: The cross-sectional survey of whether HD patients had depression was not significantly associated with mortality and morbidity. HRQOL was correlated with mortality, cardiovascular events and hospitalization.
Comorbidity ; Cross-Sectional Studies ; Depression ; Dialysis ; Hospitalization ; Humans ; Kidney ; Kidney Diseases ; Prognosis ; Quality of Life ; Renal Dialysis ; Risk Factors ; Survival Rate

The aim of the present study was to assess the clinical and histopathological findings in a canine model of ischemic stroke. Cerebral ischemic stroke was induced by middle cerebral artery occlusion in four healthy beagle dogs using silicone plugs. They showed neurological signs of forebrain dysfunction such as reduced responsiveness, head turning, circling, postural reaction deficits, perceptual deficits, and hemianopsia. These signs gradually regressed within 4 weeks without therapy. On magnetic resonance imaging, T2 hyperintensity and T1 hypointensity were found in the cerebral cortex and basal ganglia. These lesions were well-defined and sharply demarcated from adjacent brain parenchyma with a homogenous appearance. No abnormalities of the cerebrospinal fluid were observed. At necropsy, atrophic and necrotic lesions were observed in the cerebral cortex. The cerebral cortex, basal ganglia, and thalamus were partially unstained with triphenyl-tetrazolium chloride. Histopathologically, typical features of infarction were identified in cortical and thalamic lesions. This study demonstrates that our canine model resembles the conditions of real stroke patients.
Animals ; Behavior, Animal/physiology ; Brain/metabolism/pathology ; Cerebral Infarction/*etiology/*pathology ; Cerebrospinal Fluid/chemistry/cytology ; Disease Models, Animal ; *Dogs ; Infarction, Middle Cerebral Artery/*complications/*pathology ; Magnetic Resonance Imaging ; Male

BACKGROUND: MMPs and TIMPs are important factors for abnormal remodeling the pulmonary parenchyme in idiopathic interstitial pneumonia(IIP) This study evaluated the expression of MMPs and TIMPs in the tissue of IPF, NSIP and normal control subjects. METHOD: The MMP-2 and -9 activity in the lung tissue was studied by gelatin zymography, and the expression of MMP-1, -2 ,-9, TIMP-1 and -2 in the lung tissue was measured by immunohistochemistry. Thirty five patients, who were diagnosed with IIP (UIP ; 22, NSIP ; 13), were enrolled in the immunohistochemical study. Thirteen patients with IIP (UIP ; 9, NSIP ; 4) and five patients with lung cancer were enrolled in the zymographic assay. RESULTS: (1) The immunohistochemistry for MMP-1,-2,-9, TIMP-1 and-2 ; MMP-1,-9 and TIMP-2 were stained stronger in the UIP subjects than NSIP and the normal control. TIMP-2 was strongly stained in the UIP tissue. particularly the fibroblasts in the fibroblastic foci. (2) Zymography for MMP-2 and MMP-9 revealed MMP-2 to have prominent expression in the UIP tissue than in the NSIP tissue. CONCLUSIONS: These results suggest that the overexpression of the TIMPs and gelatinases in UIP might be? important factors in the irreversible fibrosis of the lung parenchyme.
Fibroblasts ; Fibrosis ; Gelatin ; Gelatinases ; Humans ; Immunohistochemistry ; Lung ; Lung Neoplasms ; Matrix Metalloproteinases* ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2

Prevalence of splenic infarction developed during acute pancreatitis is extremely rare. However, we recently experienced a case of 42-year-old woman who developed splenic infarction during acute alcoholic pancreatitis. There were sustained subjective symptoms and no resolution of image despite of conservative management, so we performed angiography to confirm whether vascular lesion existed or not. We found the significant celiac artery stenosis due to compression by median arcuate ligament and no visible thrombus. We report an unusual case of splenic infarction developed during acute recurrent pancreatitis possibly related with celiac artery stenosis.
Adult ; Angiography ; Celiac Artery* ; Constriction, Pathologic* ; Female ; Humans ; Ligaments ; Pancreatitis* ; Pancreatitis, Alcoholic ; Prevalence ; Splenic Infarction* ; Thrombosis

BACKGROUND: PM10(Particulate matter with a diameter < 10micrometer), which is characterized by different environmental conditions, is a complex mixture of organic and inorganic compounds. The Asian dust event caused by meteorological phenomena can also produce unique particulate matter in affected areas. This study investigated the cytokine produced by A549 epithelial cells exposed to particles collected during both the Asian dust pfenomenon and ambient air particles in a non-dusty period. METHOD: Air samples were collected using a high volume air sampler(Sibata Model HV500F) with an air flow at 500l/min for at least 6 hours. The cytokine messenger RNA(mRNA) was measured using a reverse transcriptase polymerase chain reaction(RT-PCR). The A549 cells were exposed to 10 to 500microgram/microliter of a suspension containing PM10 for 24 hours. Each was compared with those in the non-exposed control cells. RESULT: The mRNA levels of interleukin(IL)-1alpha, IL-Ibeta , IL-8, and the granulocyte macrophage colony stimulating factor(GM-CSF) increased after veing exposed to PM10 in the ambient air particles, compared with those in the non-exposed control cells. The increase in IL-1alpha and IL-8 were dose dependent at a PM10 concentration between 100microgram/microliter and 500microgram/microliter. The mRNA level of IL-8 in the A549 epithelial cells was higher during the in the Asian dust period(500microgram/microliter) than during the non dust period. CONCLUSION: A549 cells exposed to the PM10 collected during the Asian dust period produce more proinflammatory cytokine than during non-dusty period. This cytokine enhances the local inflammatory response in the airways and can also contribute to the systemic component of this inflammatory process.
Asian Continental Ancestry Group* ; Dust* ; Epithelial Cells* ; Granulocytes ; Humans ; Interleukin-8 ; Macrophages ; Particulate Matter* ; RNA, Messenger ; RNA-Directed DNA Polymerase

Alpha-fetoprotein(AFP) is a plasma protein produced in the fetal liver, yolk sac and gastrointestinal tract. The plasma level of AFP decreases markedly 1 year after birth. The AFP level is usually increased in hepatocellular carcinoma and yolk sac tumor but is rare in a primary lung cancer. We report a case of primary adenocarcinoma of lung producing high levels of AFP.
Adenocarcinoma* ; alpha-Fetoproteins* ; Carcinoma, Hepatocellular ; Endodermal Sinus Tumor ; Gastrointestinal Tract ; Liver ; Lung Neoplasms ; Lung* ; Parturition ; Plasma ; Yolk Sac

OBJECTIVE: To evaluate the differences in the surgical and chemotherapeutic outcomes of elderly versus younger patients with epithelial ovarian cancer. METHODS: We compared clinical characteristics, operative factors and outcomes of chemotherapy of elderly patients 65 years old or over (n=26) with those of younger patients aged 41-49 years (n=47). All subjects underwent their primary surgical therapy and following adjuvant chemotherapy at Seoul National University Hospital, from January 1996 to June 2003. RESULTS: As for tumor characteristics (tumor stage, histology etc.), there were no differences between two groups. Medical comorbidities were more frequent in the elderly group, primarily due to hypertension (50.0% vs. 28.3%; p=0.02). Optimal surgical treatment and adjuvant chemotherapy were performed less frequently in the elderly group (54.2% vs. 78.3; p=0.012). Perioperative and postoperative variables (operation time, intraoperative bleeding, postoperational complications and duration of hospitalization etc.) showed no differences except episode of transfusion in the elderly group. Residual mass, diameter less than 2 cm, showed difference between two groups with marginal significance (30.4% vs 55.6%, p=0.072). Chemotherapeutic dosage reduction was more frequent in elderly group (23.1% vs. 8.5%; p=0.003), but the occurrences of the chemotherapeutic cycle delay and toxicity profiles, were similar in the two groups. Response rate to adjuvant chemotherapy and the number of recurrence were not different between two groups (p=0.119 and p=0.587). CONCLUSION: Elderly women who present the same distribution of stages as their younger counterparts are likely to be treated more conservatively than younger ovarian cancer patients.
Aged* ; Chemotherapy, Adjuvant ; Comorbidity ; Drug Therapy ; Female ; Hemorrhage ; Hospitalization ; Humans ; Hypertension ; Ovarian Neoplasms* ; Recurrence ; Seoul

BACKGROUND: According to the 2002 consensus report of the American Thoracic Society/European Respiratory Society (ATS/ERS), idiopathic pulmonary fibrosis (IPF) was classified as biopsy proven or probable IPF. Probable IPF is defined as those with distinctive features that allow for a confident diagnosis of IPF/usual interstitial pneumonia (UIP) within an appropriate clinical setting. The determination of the clinical course of probable IPF, as diagnosed by the ATS/ERS criteria, was studied. METHODS: Between March 1995 and August 2002, 36 patients with probable IPF, from two tertiary referral hospitals, were enrolled in this study. The clinical characteristics, prognostic factors and treatment efficacy of these patients were retrospectively evaluated. RESULTS: The mean age of the subjects was 65 +/- 6 years. The one and 3 year survival rates were 82.4 and 50.3%, respectively, and a median survival period of 42.0 months. The total cell count of bronchoalveolar lavage was higher in the death than the survival group (p<0.05). No survival benefits were found in the cytoxan and steroid treatment groups compared with other treatment groups. CONCLUSION: These results suggest that the clinical course of probable IPF may be similar to that of biopsy-proven UIP. However, atypical patients must undergo an open lung biopsy for confirmation of the diagnosis.
Biopsy ; Bronchoalveolar Lavage ; Cell Count ; Consensus ; Cyclophosphamide ; Diagnosis ; Humans ; Idiopathic Pulmonary Fibrosis* ; Lung ; Lung Diseases, Interstitial ; Retrospective Studies ; Survival Rate ; Tertiary Care Centers ; Treatment Outcome