No abstract available.
Child* ; Humans ; Hypercalciuria*

No abstract available.
Angioplasty*

PURPOSE: Peritoneal carcinomatosis is a dismal prognostic factor and is frequently encountered during initial exploration in gastric-cancer patients, but there are no effective therapeutic modalities. Thus, we investigated the prognostic factors in gastric-cancer patients with peritoneal carcinomatosis and evaluated the usefulness of intraperitoneal (IP) chemotherapy as a treatment modality in such patients. METHODS: From 1992 to 1997 in Korea University Guro Hospital, 105 patients revealed at initial exploration peritoneal carcinomatosis due to gastric cancer. We excluded two patients who died due to postoperative complications and 10 patients who were lost during follow up. Prognostic factors, including IP che motherapy, were analyzed by using univariate and multivariate methods for the remaining 93 cases. RESULTS: The median survival time of the 93 patients was 7.86 months, and the frequency of peritoneal carcinomatosis at initial exploration was 11.6%. On univariate analysis, sex, tumor depth, degree of peritoneal seeding, presence of hepatic metastasis, operative method, and systemic chemotherapy were significant prognostic factors. However, IP chemotherapy was not a significant prognostic factor. On multivariate analysis, only the degree of peritoneal seeding and the presence of hepatic metastasis were significant prognostic factors (p<0.05). CONCLUSIONS: The most important prognostic factors in peritoneal carcinomatosis in gastric-cancer patients are the degree of peritoneal seeding and the presence of hepatic metastasis. However, operative resection of the primary tumor may prolong survival and improve the quality of life. Thus, a resection is recommended when possible.
Carcinoma* ; Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Multivariate Analysis ; Neoplasm Metastasis ; Postoperative Complications ; Quality of Life ; Stomach Neoplasms*

A comparison was made of a new serological method, thin layer immunoassay (TIA), and an established method, enzyme-linked immunosorbent assay (ELISA), in the detection and quantification of antibodies in clonorchiasis. Saline extract of lyophilized Clonorchis sinensis adult worm was used as antigen, and TIA by the method of Elwing et al. (1976) and ELISA by Voller et al. (1974) were performed. Using sera from known clonorchiasis cases, 100 percent of the sera tested were positive by TIA and 88.3 percent by ELISA. TIA produced false positive results in 14 out of 36 cases, which were 10 amoebiasis cases, 16 paragonimiasis cases and 10 healthy controls. ELISA, however, produced a small number of false positives, 7 out of 55 cases. There was correlation between immunoglobulin G level in sera and ELISA value (correlation coefficient, 0.69), whereas no correlation between immunoglobulin G level and TIA result. The performance of TIA and ELISA was not correlated in the results using homologous antigen.
parasitology-helminth-trematoda ; Clonorchis sinensis ; clonorchiasis ; ELISA ; immunology ; diagnosis ; thin-layer immunoassay

PURPOSE: The gastrointestinal tract (GI) is the most common site of extranodal non-Hodgkin's lymphoma (NHL), which is increasing in incidence, but the staging and the histologic classification of GI-NHL are still in debate. Furthermore, there is no established optimal treatment modality. Thus, we investigated the clinicohistologic features, the therapeutic modalities, and the prognosis for GI-NHL, as well as the factors affecting it. We also give a review of the literature. METHODS: We retrospectively analyzed 67 patients who had been diagnosed as having GI-NHL and had been followed up from 1984 to 1999 at Korea University Medical Center Hospital. They were divided into groups according to the site of origin and to various other features, and the survivals of the various groups were compared. The modified Ann Arbor system and the international working formulation (IWF) were adopted for staging and histopathologic classification, respectively. RESULTS: GI-NHL of the stomach, the small bowel, and the colon and rectum occurred in 35 patients (52.2%), 20 patients (29.9%), and 10 patients (14.9%), respectively. In two patients, the entire gastrointestinal tract was diffusely involved. The mean age of patients was 49.7+/-16.2 years, and the male-to-female ratio was 4.2:1. There was an tendency for young and male to have GI-NHL involving the lower gastrointestinal tract. Twenty-three (34.3%) patients was in stage I, 28 (41.8%) in stage II, 7 (10.4%) in stage III, and 9 (13.4%) in stage IV. Eight (11.9%) patients had a low IWF grade, 47 (70.1%) an intermediate grade, and 12 (17.9%) a high grade. The stage and the histologic classification did not vary with the original site. Surgical resection was performed in 50 (74.6%) patients, and chemotherapy was performed in 53 (79.1%) patients. The overall 5-yearsurvival rate of 67 patients was 49.9%, and there was a significant survival difference between the stages (p=0.0023), but not between sites of origin (p=0.9043). The most important factors influencing the survival was the stage; other factors were not significant. CONCLUSION: The stomach was the most common site of GI-NHL. Most GI-NHLs were localized and of intermediate grade. Stage was the most important prognostic factor. However, prospective randomized studies are needed to approve the therapeutic modality.
Academic Medical Centers ; Classification ; Colon ; Drug Therapy ; Gastrointestinal Tract ; Humans ; Incidence ; Korea ; Lower Gastrointestinal Tract ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Male ; Prognosis ; Rectum ; Retrospective Studies ; Stomach

PURPOSE: Early gastric cancer is now considered to be a curable disease, and its traditional treatment is a D2 lymphadenectomy. However, the low rate of lymph node metastasis, the recent developments of endoscopic and laparoscopic surgery, and concerns for postoperative quality of life have led to less invasive therapeutic options. The D1 lymphadenectomy is one such option, so we investigated its adequacy as a substitute for a D2 lymphadenectomy as a treatment modality for early gastric cancer by comparing the prognoses of the two approaches. METHODS: A retrospective analysis of the case histories of 332 patients who had received an operation for early gastric cancer at Korea University Guro Hospital from 1984 to 1997 was performed. These cases were divided into D1 and D2 groups, and the groups were compared on the basis of clinicopathologic features, operative procedures, and 5-year survival rates. RESULTS: The D1 group included 160 cases, and the D2 group had 172 cases. The D2 group included more distal one-third cancer (66.3% vs 51.9%), more submucosal tumors (51.2% vs 38.7%), and more dissected lymph nodes (31.1+/-12.8 vs 23.0+/-11.3) than the D1 group (p<0.05). The overall 5-year survival rate for the early gastric-cancer patients was 95.5%. The 5-year survival rate of the D1 group was 96.6%, and that of the D2 group was 94.1%, but this difference was not significant (p>0.05). When the tumor depth was considered, the 5-year survival rates of the D1 and the D2 groups were not significantly different for mucosal and submucosal tumors (p>0.05). CONCLUSION: A D2 lymphadenec tomy for early gastric cancer can harvest more lymph nodes, but it has no survival benefit over a D1 lymphadenectomy. The result of this retrospective study suggests that a D1 lymphadenectomy may be used as a replacement for a D2 lymphadectomy in early gastric-cancer surgery, although prospective randomized studies are needed.
Humans ; Korea ; Laparoscopy ; Lymph Node Excision* ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis* ; Quality of Life ; Retrospective Studies ; Stomach Neoplasms* ; Surgical Procedures, Operative ; Survival Rate

PURPOSE: Retroperitoneal soft tissue sarcomas are frequently found in advanced state due to the abscent or nonspecific symptoms, and the only hope for cure is a radical resection. The differentiation between benign and malignant tumor is a prerequisite for preoperative preparation and deciding the extent of resection. for the purpose of determining the malignancy of retroperitoneal tumor, we evaluate the clinic oradiologic features of the patients. METHODS: Retrospective study was done on 37 eases who were oper ated Korea University Hospital from Jan. 1990 to Dec. 1998. Their clinicoradiologic characters were analyzed and compared between benign and malignant tumor pationts. RESULTS: Among the 37 cases, 27 cases (73%) were benign tumors and the remaining 10 cases (27%) were malignant tumors. There was no significant difference in age distribution between malignant and benigntumor group (p>0.05) Among 20 male patients, 10 eases had malignant tumor (50%) but all 17 female patients had benign tumor (p=0.001) Preoperative symptoms were present in 29 cases (78.4%). and mean duration of symp toms in malignant cases was 20 months and in benign cases was 18 months but had no significance in differentiating between malignant and benign tumors (p>0.05) All eases were porformed abdominal CT scanning and it had 100% of sensitivity and 74% of specificity. Among the radiologic characteristics, size of tumor, irregular margin, and abscence of calcification were correlated with malignancy (p<0.05). CONCLUSION: Preoperative clinical symptoms and duration are not helpful in differentiating the malig naney but CT scanning has a good results for such purpose. So when the retroperitoneal tumor shows large size, irregular margin and no visible calcification especially in male patients, the patient, we should prepare and treat the patients according to malignant tumor.
Age Distribution ; Diagnosis, Differential* ; Female ; Hope ; Humans ; Korea ; Male ; Retrospective Studies ; Sarcoma ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: Retroperitoneal soft tissue sarcomas are frequently found in advanced state due to the abscent or nonspecific symptoms, and the only hope for cure is a radical resection. The differentiation between benign and malignant tumor is a prerequisite for preoperative preparation and deciding the extent of resection. for the purpose of determining the malignancy of retroperitoneal tumor, we evaluate the clinic oradiologic features of the patients. METHODS: Retrospective study was done on 37 eases who were oper ated Korea University Hospital from Jan. 1990 to Dec. 1998. Their clinicoradiologic characters were analyzed and compared between benign and malignant tumor pationts. RESULTS: Among the 37 cases, 27 cases (73%) were benign tumors and the remaining 10 cases (27%) were malignant tumors. There was no significant difference in age distribution between malignant and benigntumor group (p>0.05) Among 20 male patients, 10 eases had malignant tumor (50%) but all 17 female patients had benign tumor (p=0.001) Preoperative symptoms were present in 29 cases (78.4%). and mean duration of symp toms in malignant cases was 20 months and in benign cases was 18 months but had no significance in differentiating between malignant and benign tumors (p>0.05) All eases were porformed abdominal CT scanning and it had 100% of sensitivity and 74% of specificity. Among the radiologic characteristics, size of tumor, irregular margin, and abscence of calcification were correlated with malignancy (p<0.05). CONCLUSION: Preoperative clinical symptoms and duration are not helpful in differentiating the malig naney but CT scanning has a good results for such purpose. So when the retroperitoneal tumor shows large size, irregular margin and no visible calcification especially in male patients, the patient, we should prepare and treat the patients according to malignant tumor.
Age Distribution ; Diagnosis, Differential* ; Female ; Hope ; Humans ; Korea ; Male ; Retrospective Studies ; Sarcoma ; Sensitivity and Specificity ; Tomography, X-Ray Computed

PURPOSE: It is well known that the incidence of cholelithiasis and cholecystitis increases after a gastrectomy and vagotomy for peptic ulcer disease, but operations for ulcers have decreased due to improved medical therapy. However, there are not so many studies about cholelithiasis and cholecystitis after a gastric resection due to gastric cancer. Therefore, we investigated its incidence, the factors affecting it, and its natural course. METHODS: Six hundred eighty-four gastric patients who had received a gastric resection at the Korea University Guro Hospital from January 1992 to October 1999 and who had been followed regularly with abdominal ultrasonography or computed tomography were enrolled in this study. The incidence of gallstones and sludge was investigated according to age group (< OR =60 vs >60), sex, extent of gastric resection (subtotal vs total), anastomotic methods (duodenal bypass vs duodenal passage of food), and degree of lymph node dissection (< OR =D2 vs > or =D2+alpha). The clinical course of cholelithiasis was also followed up. RESULTS: Gallstones were discovered in 38 patients (5.6%) with a mean duration of 26.4+/-20.7 months, and sludge was found in 17 patients (2.5%) with a mean duration of 25.1+/-20.5 months. There were no significant differences of incidence of gallstones and sludge according to sex, age group, and other surgical options (p>0.05). Twenty- eight cases of gallstones (73.7%) were detected within 36 months, and 11 cases of sludge (64.7%) within 24 months. Among the 38 gallstones patient, only 7 patients (18.4%) developed acute cholecystitis; they received cholecystectomy during the follow-up period, and all removed stones were pigment stones. CONCLUSION: The incidences of cholelithiasis and chole-cystitis do not increased very much after a gastric resection with lymph-node dissection due to gastric cancer, and there are no specific factors affecting those incidences. A prophylactic cholecystectomy during the gastric cancer operation should be performed with caution.
Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute ; Cholelithiasis* ; Follow-Up Studies ; Gallstones ; Gastrectomy ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Peptic Ulcer ; Sewage ; Stomach Neoplasms* ; Ulcer ; Ultrasonography ; Vagotomy

OBJECTIVES: The symptoms of attention-deficit/hyperactivity disorder (ADHD) can be treated with methylphenidate, a potent blocker of the dopamine transporter (DAT). The homozygosity of the 10-repeat allele at dopamine transporter gene (DAT1) seems to be associated with a poor response to methylphenidate (MPH) in children with ADHD. In present study, we investigated association between DAT density using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl)tropane ([123I]IPT SPECT) and the homozygosity for 10-repeat allele at DAT1, and response to MPH in children with ADHD. METHODS: Eleven drug-naive children with ADHD were included in the study and treated with MPH for about 8 weeks. After the genotyping and SPECT were performed, we compared DAT density between ADHD children with and without the homozygosity for the 10-repeat allele at DAT1 and investigated correlation between the homozygosity for the 10-repeat allele and response to MPH. RESULTS: ADHD children with 10/10 genotype (n=7) had a significantly higher DAT density in basal ganglia than the children without 10/10 genotype (n=4)(Right: z=-2.65, p=0.008; Left: z=-2.65, p=0.008). We found that while only 28.6% (2/7) of the subject with 10/10 genotype showed good response (> or =50% improvement) to MPH treatment, 100% (4/4) of the subjects without 10/10 genotype showed good response to MPH treatment (chi2 test: F=5.238, df=1, p=0.022). CONCLUSION: Our findings support an association between homozygosity for the 10-repeat allele at DAT1 and the DAT density assessed in vivo and correlation between the homozygosity for the 10-repeat allele and poor response to MPH.
Alleles* ; Attention Deficit Disorder with Hyperactivity* ; Basal Ganglia ; Child ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Genotype ; Humans ; Methylphenidate* ; Tomography, Emission-Computed, Single-Photon*