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*

No abstract available.
Meningitis*

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.
Fluconazole* ; Humans

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: This study investigates the effect of 60° semi-squat exercises according to three different types of support surfaces. The effects were examined on joint position sense and balancing ability using stable and unstable surfaces in patients afflicted with post-stroke hemiplegia. Methods: Subjects were instructed to perform three sets of 60° semi-squat exercises according to the characteristics of the support surface conditions. The three ground states were bilateral stable surface (BSS), nonaffected side unstable surface (NUS), and bilateral unstable surface (BUS). The joint position sense, characteristics of body sway, and dynamic balance were analyzed according to floor conditions before and after the experiment. A balance-pad (50 cm W × 41 cm L × 6 cm H; Alcan Airex AG, Sins, Switzerland) was used for the unstable floor. Results: The 60° semi-squat exercises applied to hemiplegic patients showed the highest statistical significance in joint position sense in the NUS group, and Timed Up and Go test (TUG) in the BUS group (p < 0.05). Conclusion Functional training using an unstable surface can be applied as a meaningful intervention method for improving the balance and joint position sense of stroke patients.

Purpose: This study describes the effects of kicking a ball training on balance and upper limb function in chronic hemiplegia. Methods: Thirty chronic stroke patients were randomly selected; Kicking a ball (n = 10), Treadmill gait (n = 10), Stepping on the ground group (n = 10). The Short Physical Performance Battery (SPPB) for balance and Foot Scan for weight distribution. Upper limb function was measured by the Manal Function Test (MFT). This treatment was performed five times a week for a total of 4 weeks. Results: Kicking group was significantly increased in SPPB (p < 0.05) and MFT (p < 0.05) between pretest vs post test and pretest vs follow-up. Conclusion Kicking a ball was effective for improving weight acceptance on the paretic leg, balance and upper limb function. However, In terms of balance, the core stabilization that affected the upper extremity function was not evaluated. Thus, additional research may help determine correlation between core stability and upper limb function to improve balance.

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

No abstract available.
Humans ; Teicoplanin*

Cerebral rete mirabile is an entity of particular disease which showed the specific angiographic findings. Many authors have been reported this disease with various discussion in opinion. It's exact pathogenesis and etiology were however unable to establish. Authors had experienced a total of 10 cases with cerebral rete mirabile from 3 period of 1973 to 1977, which were confirmed by cerebral angiography. We attempted to analyze it clinically and discussed with the review of literature. The result were summarized as following; 1) In age and sex distribution, 8 patients were over 20 years old age and 2 cases were below 20. 7 cases were female and 3 male. 2) Majority of cases(8 of 10 cases) were accompanied with subarachnoid hemorrhage and only 2 cases were non-hemorrhagic which all were over 20 years. 3) In 8 cases with subarachnoid hemorrhage initial symptoms were mainly impairment of consciousness and signs of meningeal irritation such as headache and vomiting etc. Other common initial symptoms in both non-hemorrhagic and hemorrhagic cases were hemiparesis, speech disturbance and seizure. 4) All cases disclosed the characteristic angiographic findings of cerebral rete mirabile. A patient showed nonfilling of left carotid system and anomaly of left vertebral artery. Aneurysm of anterior communicating artery was combined in other case. It is our consideration that vertebral angiography must be helpful in this disease to demonstrate the collateral circulation and an abnormal findings of vertebrobasilar system.
Aneurysm ; Angiography ; Arteries ; Cerebral Angiography ; Collateral Circulation ; Consciousness ; Female ; Headache ; Humans ; Male ; Paresis ; Seizures ; Sex Distribution ; Subarachnoid Hemorrhage ; Vertebral Artery ; Vomiting ; Young Adult