PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*

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

The present study has been undertaken to pursue the cytotoxic effects of cis-Platin on the osteoid formation in metaphysis of rat tibia. By using the immunohistological staining method for type I collagen in rat tibial osteoid, the author detected the deposition of type I collagen, which is the collagenous constituent of endochondral osteoid, after administration of cis-Platin in experimental animals. For the immunological reactions of type I collagen, we used the rabbit anti-rat collagen type I polyclonal antibody as primary antibody and biotinylated goat anti-rabbit IgG as secondary antibody. The distributions of immunohistological reactions in the each of metaphyseal osteoids were analyzed with an image analyzer, and we studied the variances of type I collagens by statistical probabilities. In 12 hours after cis-Platin injection, immunoreactive area in the osteoid of metaphysis was distinctly decreased. Immunoreactive area of type I collagen in osteoids of 1 day and 3 days group metaphysis was increased more than that of 12 hours group and the type I collagen in the metaphysis showed weak immunoreactions of type I collagens with an image analyzer. In the osteoids of 7 days group after cis-Platin injection, the immunoreactive area was similar to that of control group. It is consequently suggested that cis-Platin would induce the decrease of type I collagen in the osteoid. But the type I collagen in tibial osteoid shows the increase from a few days after cis-Platin injection.
Animals ; Collagen ; Collagen Type I* ; Goats ; Immunoglobulin G ; Rats* ; Tibia*

For the morphological analysis of DMBA (9,10-diemethyl-1,2-benzanthracene) induced tumor, thirty Sprague-Dawley rats were received 0.1 ml of a 2% paraffin solution of DMBA into the knee joint cavity, which was repeated three times at an interval of 4 weeks. The induced tumor masses were removed at the 12th week after the first injection. Histological and histochemical examinations (H & E, PAS, alcian blue, Van Gieson, prussian blue, reticulin, PTAH stain) and enzyme histochemical examinations (acid phosphatase, alkaline phosphatase, alpha-naphthyl acetate esterase) were performed. The results were as follows: 1) By the 12th week after the first injection of DMBA, the tumor incidence rate was 20 percent. 2) On histological and histochemical examination, most of the induced tumor disclosed the features of the fibrous histiocytoma originating from mesenchymal cells, and the remains sweat gland adenoma and adenocarcinoma originating from epithelial cells. 3) On enzyme histochemical examination, most of the mesenchymal cell-derived tumor cells showed positive reactions for acid phosphatase and alpha-naphthyl acetate esterase, which were similar characteristic features of enzyme stains as shown in the component cells of fibrous histiocytoma.
Rats ; Animals ; Incidence ; Adenocarcinoma ; Adenoma

We evaluated the renal function could be estimated by the visual analysis of the perfusion images of Tc-99m DTPA renal scan. Renal scan, creatinine clearance(CCr) and serum creatinine(s-Cr) were obtained in 105 patients. Intensity of renal activity(RA) at 6 sec perfusion image after the first visualization of abdominal aortic activity(A or A) was considered as the parameter for estimating renal function. Intensity of RA was scored from grade(Gr.) 1 to 3(Gr. 1: RAsplenic activity(SA), Gr. 2: RA A or A, Gr. 3: RA60 mL/min. The P.P.V. of Gr. 2 RA was 92% for s-Cr from 1.5 to less than 3.5mg/dL and 83% for CCr value from 20 to less than 60mL/min. The P.P.V. of Gr. 3 RA was 95% for s-Cr3.5mg/dL and 95% for CCr<20mL/min. As the intensity of RA of perfusion images decreased, renal function more decreased. We could detect renal dysfunction by visual analysis of perfusion images of renal scan.
Creatinine ; Humans ; Pentetic Acid* ; Perfusion*

No abstract available.
Mitral Valve Insufficiency*

We compared the pain produced during different phases of phacoemulsification cataract surgery using a scleral pocket incision under pinpoint anesthesia with that under intracameral anesthesia. This prospective study comprised each 100 cataract patients who had no complications influencing the degree of pain during surgery. Patients were asked about pain immediately after each phase and pain occurring during each phase was measured using 4 step verbal scale(from 0 to 4). In both anesthesia,conjunctival reposition was the most painful.Pinpoint injection was statistically significantly more painful than induction of intracameral anesthesia.The pain score during conjunctival reposition and at 1hr after surgery were significantly higher under intracameral anesthesia than under pinpoint, but during most of phases under both anesthesia,the pain score was relatively low. Intracameral anesthesia is easy,safety and dose not require additional ocular damage during induction of anesthesia,so if combined with topical anesthesia,it is very effective during cataract surgery using scleral pocket incision.
Anesthesia* ; Cataract* ; Humans ; Phacoemulsification ; Prospective Studies

BACKGROUND: External ventricular drainage (EVD) is an important procedure for draining excessive cerebrospinal fluid (CSF) and monitoring intracranial pressure. Generally, EVD is performed in the operating room (OR) under aseptic conditions. However, in emergency circumstances, the operation may be performed in the intensive care unit (ICU) to save neuro-critical time and to avoid the unnecessary transfer of patients. In this study, we retrospectively analyzed the risk of EVD-induced CNS infections and their outcomes according to the operating place (ICU versus OR). In addition, we compared mortalities as well as hospital and ICU days between the CNS infection and non-CNS infection groups. METHODS: We reviewed medical records, laboratory data and radiographic images of patients who had received EVD operations between January, 2013 and March, 2015. RESULTS: A total of 75 patients (45 men and 30 women, mean age: 58.7 +/- 15.6 years) were enrolled in this study. An average of 1.4 catheters were used for each patient and the mean period of the indwelling catheter was 7.5 +/- 5.0 days. Twenty-six patients were included in the ICU group, and EVD-induced CNS infection had occurred in 3 (11.5%) patients. For the OR group, forty-nine patients were included and EVD-induced CNS infection had occurred in 7 (14.3%) patients. The EVD-induced CNS infection of the ICU group did not increase above that of the OR group. The ICU days and mortality rate were higher in the CNS infection group compared to the non-CNS infection group. The period of the indwelling EVD catheter and the number of inserted EVD catheters were both higher in the CNS infection group. CONCLUSIONS: If the aseptic protocols and barrier precautions are strictly kept, EVD in the ICU does not have a higher risk of CNS infections compared to the OR. In addition, EVD in the ICU can decrease the hospital and ICU days by saving neuro-critical time and avoiding the unnecessary transfer of patients. Therefore, when neurosurgeons decide upon the operating place for EVD, they should consider the benefits of ICU operation and be cautious of EVD-induced CNS infection.
Catheter-Related Infections ; Catheters ; Catheters, Indwelling ; Cerebrospinal Fluid ; Drainage* ; Emergencies ; Female ; Humans ; Intensive Care Units* ; Critical Care* ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Operating Rooms* ; Retrospective Studies ; Ventriculostomy

No abstract available.
Animals ; Embryonic Structures* ; Female ; Follicular Fluid* ; Humans* ; Mice*

Epilepsy can be divided into idiopathic epilepsy and symptomatic epilepsy according to the existence ofunderlying organic disease. It has been said that the incidence of the symptomatic epilepsy caused by underlyingorgainic brain disease is higher in late-onset epilepsy after the age of 20 than in childhood-onset epoilepsy. CTis very sensitive and non-invasive method for detection of organic brain disease. 168 cases of late-onset epilepsyafter the age of 20 were studied by CT in recent 2 years were analyzed. The results were as follows; 1. The 3rddecade was the most frequent age group, and the ratio of male to female was 2.5;1. 2. Structural abnormality onbrain CT was demonstrated in 51.8% of hte patient. 3. The older the onset of age was, the higher the rate of theabnormal CT finding, except 5th decade which showed less CT abnormality than 4th decade. 4. The most frequenthistory related to epilepsy was trauma. 63.1% of the patients had no relevant history; and they showed CT findingsof brain tumor, atrophy and infarction in decreasing order of frequency. 5. Abnormal CT finding was demonstratedin 49.2% of normal neurologic examination and in 46.4% of normal EEG study. 6. The most frequent lesion ofabnormal CT scan in late-onset epilepsy was 30 cases(18.4% )of brain atrophy. The next frequent lesion was 18cases (10.7%) of brain tumor. Infarction, parasites and calcification were other frequnet lesions.
Atrophy ; Brain ; Brain Diseases ; Brain Neoplasms ; Electroencephalography ; Epilepsy ; Female ; Humans ; Incidence ; Infarction ; Male ; Methods ; Neurologic Examination ; Parasites ; Tomography, X-Ray Computed