PURPOSE: In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data. MATERIALS AND METHODS: The authors analyzed retrospectively pathological features of 95 patients who underwent paraacntic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation Bom May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unlmown causes of death in survival analysis. RESULTS: The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSRs) in relation to the paraaortic lymph node (No16) status was 0.096 in No16+, and 57.8Po in Nol6 with D4 of advanced gastric cancer. The 5 YSRs were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, nl, n2 and n.3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively. CONCLUSION: The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Bonmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p < 0.05).
Cardia ; Causality ; Cause of Death ; Drug Therapy* ; Granisetron* ; Hospitals, General ; Humans ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Nausea* ; Neoplasm Metastasis ; Platinum* ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate ; Vomiting*

PURPOSE: We conducted a phase II study in previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer to evaluate the response rate and toxicity of the combination chemotherapy regimen of etoposide, ifosfamide and cisplatin. MATERIALS AND METHODS: From September 1993 to December 1996, twenty patients with advanced non-small cell lung cancer (stage IIIB 5 and IV 15) (squamous cell 8, adeno- carcinoma 12), were enrolled in this study. There were 13 (65%) males and 7 (35%) females, and median age of patients were 56 years (range: 34~66). Eighteen patients had performance status (ECOG) 0~1, two patients had performance status 2. Treatment was consisted of cisplatin (20 mg/m2 i.v., day 1~4), VP-16 (etoposide) (75 mg/m2 i.v., day 1~4), ifosfamide (1000 mg/m2 i.v., day 1~4) with mesna. This treatment was repeated every four weeks. RESULTS: The overall response rate was 25%. Complete response rate was 5% (1/20) and partial response rate was 20% (4/20). The median cycle of response was 4 (2~6) cycles. The median overall survival time was 28 weeks (9~98 weeks). The median time to progression was 10 weeks (3~50 weeks). Toxicities were evaluated by WHO criteria. Toxicity > GradeIII included: leukopenia 1.6%, thrombocytopenia 3.2%, nausea and vomiting 15%, alopecia 30%, stomatitis 10%. These toxicities were tolerable and reversible. CONCLUSION: VIP regimen was not superior to previous regimens for advanced non-small all lung cancer, and the toxicities were tolerable.
Alopecia ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide ; Female ; Humans ; Ifosfamide* ; Leukopenia ; Lung Neoplasms ; Male ; Mesna ; Nausea ; Small Cell Lung Carcinoma* ; Stomatitis ; Thrombocytopenia ; Vomiting

PURPOSE: Alteration of p53 and telomerase activity may be responsible for gastric carcino- genesis. In this study, we tried to observe modulation of telomerase activity by wild type p53 in gastric cancer cell lines. MATERIALS AND METHODS: We used five gastric cancer cell lines (KATO-III, AGS, SNU-1, SNU-5, SNU-16). In order to find p53 mutation, we used western blot and PCR-SSCP. The TRAP-eze kit which supplied by Oncor (Gaithersburg, MD) was used to detect telomerase activity of the five gastric carcinoma cell lines. The wild type p53 gene was transfected by electroporation method. RESULTS: The expression of p53 protein was increased in four gastric carcinoma cell lines and one cell line (KATO-III) did not express. We found p53 point mutation in exon 5 and 8, and the p53 gene was deleted in KATO-III. The telomerase activity were observed in all five gastric carcinoma cell lines and there were no difference in telomere repeat length among five cell lines. After transfection with wild type p53, we could not find the change of telomerase activity in KATO-III. CONCLUSION: Although activation of telomerase activity and mutation of p53 gene may be needed in gastric carcinogenesis, the telomerase activity was not affected by restoration of p53 function in gastric carcinoma cell lines.
Blotting, Western ; Carcinogenesis ; Cell Line* ; Electroporation ; Exons ; Genes, p53* ; Point Mutation ; Stomach Neoplasms ; Telomerase* ; Telomere ; Transfection

No abstract available.
Disseminated Intravascular Coagulation*

No abstract available.
Fluconazole* ; Humans

The management of hemophilia patients includes the treatment of acute bleeding, prevention of bleeding, and the treatment of complications. Bleeding can be minimized by prophylactic factor maintenance, education, and lifestyle modifications. The complications in hemophilia include hemophilic arthropathy, inhibitor development, liver disease due to transfusion-transmitted infections, etc. Patients can be managed ideally in comprehensive hemophilia care centers. The management of bleeding is most important. Treatment should be given early with an appropriate amount of drugs, according to the extent and site of bleeding. This early treatment is possible by home therapy. Life-threatening bleedings such as bleeding of the central nervous system, throat, or neck should be treated as emergency, immediately before evaluation. Recently, the World Federation of Hemophilia published a guideline for the management of hemophilia, which also suggested a good standard for the care of bleeding patients. In this article, the author introduce coagulation factors available in Korea for the treatment of hemophilia patients, including bypassing agents for inhibitor patients, and discuss practical points for the treatment of hemophilia patients in Korea.
Blood Coagulation Factors ; Central Nervous System ; Education ; Emergencies ; Hemophilia A* ; Hemorrhage* ; Humans ; Korea ; Life Style ; Liver Diseases ; Neck ; Pharynx

No abstract available.
Stem Cells*

No abstract available.
Humans ; Teicoplanin*

No abstract available.
Doxorubicin* ; Drug Therapy, Combination* ; Etoposide* ; Stomach Neoplasms*

Multiple myeloma is a hematologic malignancy characterized by the proliferation of monoclonal plasma cells that produce monoclonal immunoglobulins. Cutaneous involvement is very uncommon in patients with multiple myeloma. It usually appears late in the course of the disease. Bortezomib is a potent proteasome inhibitor, recently introduced in the treatment of multiple myeloma. It has proven to be safe and effective in the treatment of refractory or relapsed multiple myeloma. In this study, we show the high efficacy of a concurrent therapeutic approach with bortezomib and radiation in a patient with a cutaneous plasmacytoma.
Boronic Acids ; Hematologic Neoplasms ; Humans ; Immunoglobulins ; Multiple Myeloma ; Plasma Cells ; Plasmacytoma ; Proteasome Inhibitors ; Pyrazines ; Bortezomib