This study was designed to evaluate the worth of preoperative chemoradiation therapy in the management of locally advanced rectal cancer. Between march 1993 and January 1997, 64 patients with adenocarcinoma of the rectum were treated with preoperative irradiation followed by operation by one surgeon at department of surgery, Chungnam national university hospital. Cancers were treated with high-dose radiation (45 to 54 Gy) with (group 2) or without (group 1) chemotherapy Preoperatively 64 Patients were analysed prospectively, of these, 15 cases were preoperative radiotherapy alone arm and 49 cases were preoperative radiotherapy plus chemotherapy arm. The average age of the patients were 56 years (range 38~67) in group 1 and 57 years (range 27~80) in group 2. Male to female ratio was 8 : 7 in group 1 and 30 : 19 in group 2. Most clinical stage of the primary tumor mass were 73 (80% in Group 1,96% in group 2), being palpated slightly fixed (40% in group 1, 43% in group 2) or fixed (13.3% in group 1, 24.5% in group 2). As to distance of tumor from anal verge, most patients ranged from 4 to 8 cm (53% in group 1, 63.3% in Group 2). Chemotherapy consisted of 2 cycles of 5-fluorouracil (500 mg/m2/day for S days) delivered as a continuous infusion or bolus therapy and low-dose leukovorin (20 mg/m2/day for 5 days). After six weeks resting period of radiation, definitive surgical approach was performed. Overall treatment related toxicity rate was similar in both group except erythema on perineal skin, which was more frequent in group 2 than in group 1. Most frequent postoperative complication was intestinal obstruction (7.8%) followed by wound infection (6.3%), but there was no significant difference between two groups. There was one case of postoperative mortality in group 2 patients at 44 days after operation due to pneumonia and sepsis combined with liver cirrhosis. Tumor depth was downstaged in 38.5% of group 1 and 70% of group 2 patients on preoperative CT staging, and nodal downstaging was more effective on the respect of postoperative pathological report. Overall recurrence rate was 38.5% in group 1 and 20.5% in group 2. Of these, failure occured first as a distant metastasis more frequently than as a local recurrence in both group. These data do suggest that the preoperative chemotherapy and radiotherapy used are as safe as preoperative radiotherapy alone. Futhermore, tumor and lymph node downstaging are more effective in combined arm. Preoperative chemotherapy will more promising in prevention of distant metastasis when treated in the period of least metastatic tumor burden. Whether combined arm will have greater or lesser survival awaits the completion of this relevant study.
Adenocarcinoma ; Arm ; Chungcheongnam-do ; Drug Therapy ; Erythema ; Female ; Fluorouracil ; Humans ; Intestinal Obstruction ; Leucovorin ; Liver Cirrhosis ; Lymph Nodes ; Male ; Mortality ; Neoplasm Metastasis ; Pneumonia ; Postoperative Complications ; Prospective Studies ; Radiotherapy ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sepsis ; Skin ; Tumor Burden ; Wound Infection

No Abstract Available.
Hepacivirus* ; Hepatitis C* ; Hepatitis*

A 43-year-old male patient showed well defined, irregular, dark eythematous, thick plaque and tumor with ulceration on the right chest, right axilla, pubis and scrotum, Histopathological findings rervealed atypical lymphocytes showing epidermotrophism and heavy infiltrations in the deep dermis and subcutaneous tissue. The infiltrative cells were positively stained with leukocyte common antigen and T-cell UCHL-1 antigen, but not with L26 antigen. This clinicohisto-pathological features were consstent with dermblade type of mycosis fungoides. The authors report clinicopathological findings of the case with its thrapeutic responses to systemic chemotherapy and radiation treatment.
Adult ; Antigens, CD45 ; Axilla ; Dermis ; Drug Therapy ; Humans ; Lymphocytes ; Male ; Mycosis Fungoides ; Scrotum ; Subcutaneous Tissue ; T-Lymphocytes ; Thorax ; Ulcer

Persistent burning and derythema were present for 10 months cin he lower lip of a 55-year-old woman, who had extreme melalignment of the anterior maxillary teeth. Candida albicans was identified not only from the surface material of the lower lip but also from tl.e malaigned dental cleft, which was thought to be the source of the organisms. We feel that the impor.ance of malaligned theeth as a source of candida albicans miist be kept in mind when we face persis ent cheilitis in a patient whose teeth arrangement is bad.
Burns ; Candida albicans ; Candida* ; Cheilitis ; Female ; Humans ; Lip ; Middle Aged ; Tooth*

In dermatologic practice, acute urticaria showing leukocytosis and fever suggesting syatemic bacterial infection is often observed. The clinician in dealing with such patients is tempted to use antibiotics in addition to corticosteroids and antihistamines before the patient can be sure that there is no bacterial infection. Authors observed the degree of the leukocytosis with its differential counts in 106 cases of acute urticaria to evaluate what percentages of acute urticaria patients are showing similar data with the changes seen in leukocyte counts of patients of erysipelas, and evaluated the effect of aqtibiotics-administered group with non-administered group of acute urticaria patients. The results were as follows: 1. In 106 acute urticaria patients, 42% showed higher total leukocyte count ( >12, 500/cu mm) than the mean total leukocytes of 20 erysipelas patients(12, 412/cu mm) and 29% showed greater neutrophilia(>70%) than the mean neutrophil differential count of the erysipelas (69.1%). In the cases showing both leukocytosis (>12,500/cu mm) and fever (>37. 5C) there was no difference in the course of treatment between the antibiotics-administered group and non-administered group. 3. The corticosteroid hormone reduced the total WBC count toward normal level generally within a week.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Bacterial Infections ; Erysipelas ; Fever ; Histamine Antagonists ; Humans ; Leukocyte Count ; Leukocytes* ; Leukocytosis ; Neutrophils ; Urticaria*

About 20 or more cases of seminal vesicle cyst were reported up to nowadays, but CT findings are not yetdescribed. Seminal visicle cyst is often associated with ipsilateral renal agenesis, and the mechanism ofdevelopment is based on embryogenesis. A 26 year old male was confirmed as seminal vesicle cyst in S.N.U.H. inNov. 1981. CT of the seminal vesicle cyst revealed huge, globular and homogeneous mass with well-circumscribedsmooth margin between urinary bladder and rectum. Adilated tubular structure was also found lateral to the hugecystic mass. The ipsilateral kidney was not found in any level of abdomen from the diaphragmetic dome to thesymphisis pubis.
Abdomen ; Embryonic Development ; Female ; Humans ; Kidney ; Male ; Pregnancy ; Pubic Bone ; Rectum ; Seminal Vesicles ; Urinary Bladder

Parosteal lipoma is a rare and generally asymptomatic benign tumor of mature adipose tissue that is located in direct apposition to the external surface of the bone. These tumors are occasionally associated with reactive changes in the underlying bone. The reactive bone formation is generally restricted to the base of the tumor, that is, near the periosteum. We recently experienced a case of parosteal lipoma in the proximal femur, which displayed exuberant bone and cartilage formation, and this led us to a misdiagnosis of chondroblastic osteosarcoma on the initial biopsy. We report here on this case with a special emphasis on making the differential diagnosis from osteosarcoma.
Adipose Tissue ; Biopsy ; Cartilage ; Chondrocytes ; Diagnosis, Differential ; Diagnostic Errors ; Femur* ; Lipoma* ; Osteogenesis ; Osteosarcoma ; Osteosarcoma, Juxtacortical ; Periosteum

No abstract available.
Lipomatosis*

PURPOSE: To assess the spinal canal and neural foraminal stenosis associated with spondylolisthesis on MR imaging. MATERIALS AND METHODS: We retrospectively analysed MR findings of 63 cases of spondylolisthesis(degenerative type:23 cases, isthmic type:40 cases) regarding the type and grade of spondylolisthesis, prensence or absence of associated spinal canal stenosis, and the severity of associated neural foraminal stenosis. RESULTS: Central canal stenosis were more frequent in degenerative type(91%) than isthmic type(33%), and more frequent in grade II spondylolisthesis of degenerative type(100%) and isthmic type(89%) than in grade spondylolisthesis of degenerative type(45%) and isthmic type(20%). There was positive correlation between the severity of neural foraminal stenosis and the grade of spondylolisthesis, whereas there was no significant difference between degenerative and isthmic types. CONCLUSION: Degenerative spondylolisthesis were frequently associated with central canal stenosis more than isthmic type. When the grade of spondylolisthesis was higher, it was more frequently associated with central canal stenosis and severe neural foraminal stenosis.
Constriction, Pathologic* ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Canal ; Spondylolisthesis*

To evaluate the radiographic characteristics of osteochondritis dissecans (OCD) and useful parameter for predicting mechanical stability, we retrospectively analysed 26 plain radiographic examinations and seven MR imagings in 28 cases of OCD in 24 patients. Typical radiologic findings were osteochondral defect with sclerotic rim of variable thickeness and osteochondral fragment. Sites of osteochondral defect were medial (35.9%) or lateral (32%) femoral chondyle and medial (7.1%) or lateral (25%) side of talar dome. Sclerotic rim was seen in 24 cases (85%) and osteochondral fragments including nine loose bodies were seen in 21 cases (75%). The size of osteochondral defect with unstable fragment (average 2.05cm) and loose body (2.04cm) in the knee joint were similar to, but statistically larger than that with stable fragment (1.35cm). All osteochondral defects were well visualized on MR images. Abnormalities of articular cartilage and effusion in the interface between the parent bone and fragment were seem in five cases of which there were confirmed three unstable cases arthroscopically. We conclude that size of defect may be a good parameter for predicting mechanical stability and MRI may be useful in the diagnosis of OCD and determining the methods of treatment.
Cartilage, Articular ; Diagnosis ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Osteochondritis Dissecans* ; Osteochondritis* ; Parents ; Retrospective Studies