OBJECTIVE: We wanted to describe the retrospective CT features of subtle pleural metastasis without large effusion that would suggest inoperable lung cancer. MATERIALS AND METHODS: We enrolled 14 patients who had open thoracotomy attempted for lung cancer, but they were proven to be inoperable due to pleural metastasis. Our study also included 20 control patients who were proven as having no pleural metastasis. We retrospectively evaluated the nodularity and thickening of the pleura and the associated pleural effusion on the preoperative chest CT scans. We reviewed the histologic cancer types, the size, shape and location of the lung cancer and the associated mediastinal lymphadenopathy. RESULTS: Subtle pleural nodularity or focal thickening was noted in seven patients (50%) having pleural metastasis and also in three patients (15%) of control group who were without pleural metastasis. More than one of the pleural changes such as subtle pleural nodularity, focal thickening or effusion was identified in eight (57%) patients having pleural metastasis and also in three patients (15%) of the control group, and these findings were significantly less frequent in the control group patients than for the patients with pleural metastasis (p = 0.02). The histologic types of primary lung cancer in patients with pleural metastasis revealed as adenocarcinoma in 10 patients (71%) and squamous cell carcinoma in four patients (29%). The location, size and shape of the primary lung cancer and the associated mediastinal lymphadenopathy showed no significant correlation with pleural metastasis. CONCLUSION: If any subtle pleural nodularity or thickening is found on preoperative chest CT scans of patients with lung cancer, the possibility of pleural metastasis should be considered.
Adenocarcinoma/radiography/secondary ; Adult ; Aged ; Carcinoma, Squamous Cell/radiography/secondary ; Female ; Humans ; Lung Neoplasms/*pathology ; Male ; Middle Aged ; Pleural Effusion, Malignant/pathology ; Pleural Neoplasms/*radiography/*secondary ; Preoperative Care ; Retrospective Studies ; *Tomography, X-Ray Computed

PURPOSE: To assess the relative frequency of benign and metastatic nodules in patients in whom nodules were resected due to suspected metastasis, and to compare the CT features of these nodules with pathologic findings in resected specimens. MATERIALS AND METHODS: Ninety-four pulmonary nodules resected by pulmonary metastasectomy in 31 patients with extrathoracic malignancies were included in our study. We retrospectively analyzed the CT features of each nodule with regard to size, shape, margin characteristics, the presence or absence of cavity, location and distance from the pleura. RESULTS: Among 94 resected nodules, 67 (71 %) were metastatic, and 27 (29 %), were benign. Among the pathologically benign nodules, involvement was as follows : fibrosis (n=14), intrapulmonary lymph node (n=7), necrosis (n=3), organizing pneumonia (n=2) and xanthogranulomatous inflammation (n=1). The mean diameter of metastatic nodules was 10.9 (range, 1-30) mm, and that of benign nodules 6.0 (range, 1-30) mm. Statistically significant differences in nodule size were found between the two groups (p<0.05), though CT revealed no significant differences in terms of shape, margin, the presence or absence of cavity, location and distance from the pleura. CONCLUSIONS: Twenty-nine percent of surgically resected nodules in patients with extrathoracic malignancies were benign. Although the possibility of metastatic nodule increases with larger nodule size, the correct diagnosis of pulmonary nodules requires histopathologic confirmation or monitoring of serial changes in nodule size.
Diagnosis ; Fibrosis ; Humans ; Inflammation ; Lymph Nodes ; Metastasectomy ; Necrosis ; Neoplasm Metastasis ; Pleura ; Pneumonia ; Retrospective Studies

PURPOSE: To assess the relative frequency of benign and metastatic nodules in patients in whom nodules were resected due to suspected metastasis, and to compare the CT features of these nodules with pathologic findings in resected specimens. MATERIALS AND METHODS: Ninety-four pulmonary nodules resected by pulmonary metastasectomy in 31 patients with extrathoracic malignancies were included in our study. We retrospectively analyzed the CT features of each nodule with regard to size, shape, margin characteristics, the presence or absence of cavity, location and distance from the pleura. RESULTS: Among 94 resected nodules, 67 (71 %) were metastatic, and 27 (29 %), were benign. Among the pathologically benign nodules, involvement was as follows : fibrosis (n=14), intrapulmonary lymph node (n=7), necrosis (n=3), organizing pneumonia (n=2) and xanthogranulomatous inflammation (n=1). The mean diameter of metastatic nodules was 10.9 (range, 1-30) mm, and that of benign nodules 6.0 (range, 1-30) mm. Statistically significant differences in nodule size were found between the two groups (p<0.05), though CT revealed no significant differences in terms of shape, margin, the presence or absence of cavity, location and distance from the pleura. CONCLUSIONS: Twenty-nine percent of surgically resected nodules in patients with extrathoracic malignancies were benign. Although the possibility of metastatic nodule increases with larger nodule size, the correct diagnosis of pulmonary nodules requires histopathologic confirmation or monitoring of serial changes in nodule size.
Diagnosis ; Fibrosis ; Humans ; Inflammation ; Lymph Nodes ; Metastasectomy ; Necrosis ; Neoplasm Metastasis ; Pleura ; Pneumonia ; Retrospective Studies

Mongolian gerbil has been as an model animal for studing the neurological diseases such as stroke and epilepsy because of the congenital incompleteries in Willis circle, as well as the investigation of water metabolism because of the long time-survival in the condition of water-deprived desert condition, compared with other animal species. In order to accomplish this research, first of all another divided the laboratory animals 5 groups of which each group include the 5 animals. In this study of the long term water deprived condition author investigatied the vasopressinergic and oxytocinergic magnocellular neurons of the hypothalamus by using a quantitative immunohistochemistry, measured the plasma osmolalities at the time of sacrifice of indivisual animals, and the body weights every day during water-deprived. The results obtained in this study were summarized as followings: 1. The body weights and decreasing rates of the body weight in water-deprived animal groups were continuosly decreased. 2. The plasma osmolalities were increased from the 5th water-deprived day, after then the gradually increase reached nearly its equilibrium state at the 10th water-deprived day. 3. Vasopressin and oxytocin immunoreactive cells were mainly observed in PVN, SON and a few in the lateral magnocellular area of hypothalamus. 4. The number of VP immunoreactive cells in paraventricular and supraoptic nucleus were abruptly decreas-ed until the 5th day in the supraoptic nucleus in number and until the 10th day in the paraventricular nucleus of water-deprived. 5. The OT secreting cells were severely decreased on the 5th water deprived day in paraventricular and supraoptic nucleus, after than these cells were very slowly decreased until to the 38th water deprived day.
Animals ; Animals, Laboratory ; Body Weight ; Circle of Willis ; Epilepsy ; Gerbillinae* ; Hypothalamus* ; Immunohistochemistry ; Metabolism ; Neurons* ; Osmolar Concentration ; Oxytocin ; Paraventricular Hypothalamic Nucleus ; Plasma ; Stroke ; Supraoptic Nucleus ; Vasopressins

OBJECTIVES: Plasma lipid profiles and Apolipoprotein E (ApoE) are established risk factors for cardiovascular disease (CVD). The knowledge of lipid profile may estimate the potential victims of cardiovascular disease before its initiation and progression and offers the opportunity for primary prevention. The most common ApoE polymorphism has been found to influence plasma lipid concentrations and its correlation with CVD has been extensively investigated in the last decade. METHODS: The ApoE polymorphism and its influence on plasma lipid were investigated in healthy woman workers. The information on confounding factors was obtained through a self-administered questionnaire and ApoE polymorphism was investigated using PCR. RESULTS: The relative frequencies of alleles E2, E3 and E4 for the study population (n=305) were 0.127, 0.750 and 0.121, respectively. ApoE polymorphism was associated with variations in plasma HDL-cholesterol lipid profile. In order to estimate the independent effects of alleles E2 and E4, as compared with E3, on lipid profile, multiple regression was performed after adjustment for confounding variables such as age, BMI, blood pressure, education status, insulin, fasting glucose, HOMA-IR, menopause. ApoE2 had a negative association with HDL cholesterol and ApoE4 had a positive association with LDL cholesterol. CONCLUSIONS: This study identified that the ApoE and CVD risk factors contribute to the lipid profiles, similar to other studies. The analysis including dietary intake and other gene in further studies may help to identify clear effects on lipid profiles as risk factor for CVD.
Adult ; Apolipoproteins E/blood/*genetics/metabolism ; Cardiovascular Diseases/epidemiology/prevention & control ; Cholesterol, HDL/genetics ; Female ; *Genotype ; Humans ; Lipid Metabolism/*genetics ; Polymerase Chain Reaction ; Primary Prevention

PURPOSE: To compare the accuracy of thick-and thin-section spiral CT and to determine whether, in diagnosing mediastinal lymph node metastasis from non-small cell lung cancer, the latter is superior to the former. MATERIALS AND METHODS: Between March 1997 and March 1998, 51 patients with pathologically proven non-s-mall cell lung cancer underwent thoracotomy with full nodal dissection. Thick- and thin-section spiral CT were performed in all patients, with a mean interval of 14 days. The former was performed with 10 mm thick-ness and 10 mm interval, and the latter with 3 mm thickness and 3 mm interval. Mediastinal lymph nodes were localized according to the lymph node mapping scheme of the American Thoracic Society and were considered positive for metastasis if they exceeded 10 mm in short-axis diameter. RESULTS: A total of 227 mediastinal nodal stations in 51 patients were obtained. Of these, 188 stations included in thin-section spiral CT were analyzed and the prevalence of ediastinal nodal metastasis was found to be 10%. On a station-by-station basis, and for thick-and thin-section spiral CT, respectively, the overall sensitivi-ties of mediastinal lymph node metastasis were 32% and 53% (p < .05), while specificities were 91% and 92% (p> .05). Although there were no statistically significant differences in sensitivity and specificity according to nodal station, thin-section spiral CT tended to be superior to the thick-section type for stations 7 and 10R in terms of sensitivity, and for stations 4L and 5 in terms of specificity. CONCLUSION: Thin-section spiral CT was more sensitive than thick-section spiral CT is the evaluation of medi-astinal lymph node metastasis from non-small cell lung cancer. This may be due to the higher resolution of the former and its ability to discriminate between lymph node and vessel.
Carcinoma, Non-Small-Cell Lung* ; Humans ; Lung Neoplasms ; Lymph Nodes* ; Neoplasm Metastasis* ; Prevalence ; Sensitivity and Specificity ; Thoracotomy ; Tomography, Spiral Computed*

Lung cancer study group at Asan Medical Center has conducted the second prospective study to determine the efficacy and feasibility of MVP chemotherapy with concurrent hyperfractionated radiotherapy for patients with stage III unresectable non-small cell lung cancer(NSCLC). All eligible patients with stage III unresectable NSCLC were treated with hyperfractionated radiotherapy( 120 cGy/fx BID, 6480 cGY/54fx) and concurrent 2 cycles of MVP(Motomycin C 6 mg/m2 , d2 & d29, Vinblastin 6 mg/m2, d2 & d29, Cisplatin 6 mg/m2 , d1 & d28) chemotherapy. Between Aug. 1993 and Nov. 1994, 62 patients entered this study ; 6(10%) had advanced stage IIIa and 56(90%) had IIIb disease including 1 with pleural effusion and 10 with supraclavicular metastases. Among 62 Ptients, 48(77%) completed planned therapy. Fourteen patients refused further treatment during chemoradiotherapy. Of 46 patients evaluable for response, 34(74%) showed major response including 10(22%) with complete and 24(52%) with partial responses. Of 48 patients evaluable for toxicity, 13(27%) showed grade IV hematologic toxicity but treatment delay did not exceed 5 days. Two patients died of sepsis during chemoradiotherapy. Server weight(more than 10%) occurred in 9 patients(19%) during treatment. Nine patients(19%) developed radiation pneumonitis. Six of these patients had grad I(mild) pneumonitis with radiographic changes within the treatment fields. Three other patients had grade II pneumonitis, but none of theses patients had continuous symptoms after steroid treatment. Concurrent chemoradiotherapy for patients with advanced NSCLC was well tolerated with acceptable toxicity and achieved higher response rates than the first study, but rather low compliance rate(7%) in this study is worrisome. We need to improve nutritional suppoert during treatment and to use G-CSF to improve leukopenia and if necessary, supportive care will given as in patients. Longer follow-up and larger sample size is needed to observe survival advantage.
Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Chungcheongnam-do ; Cisplatin ; Compliance ; Drug Therapy* ; Follow-Up Studies ; Granulocyte Colony-Stimulating Factor ; Humans ; Leukopenia ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Pleural Effusion ; Pneumonia ; Prospective Studies ; Radiation Pneumonitis ; Radiotherapy* ; Sample Size ; Sepsis ; Small Cell Lung Carcinoma*