Metastatic tumor of the epididymis is a rare tumor. There are around 31 cases in the literature until now. The primary tumor was from the prostate in 18 cases, large and small intestine in 6 cases, kidney in 4 cases, stomach in 2 cases and pancreas in 1 case. We recently experienced a case of metastatic carcinoma to the epididymis from a primary cancer in the sigmoid colon and the other case of metastatic carcinoma to the testis and the liver from a sigmoid adenocarcinoma.
Adenocarcinoma ; Colon, Sigmoid* ; Colonic Neoplasms ; Epididymis ; Intestine, Small ; Kidney ; Liver ; Male ; Neoplasm Metastasis ; Pancreas ; Prostate ; Stomach ; Testis

PURPOSE: The cisplatin and etoposide had been reported to be an effective anti-tumor drug for small cell lung cancer, ovarian cancer, breast cancer and so on. The aim of this study was to evaluate the stability of cisplatin and etoposide in aqueous solution. MATERIALS AND METHODS: Cisplatin 200 microgram/ml was prepared in 0.9% sodium chloride and stored in either glass bottle or polyvinyl chloride (pvc) bag and protected from light or exposed to fluorescent light. Etoposide solution was prepared in 0.9% sodium chloride, and contained in glass bottle. Precipitating concentration was achieved using 200 microgram/ml, 400microgram/ml, 600 microgram/ml, and 1000 microgram/ml of etoposide solution. Samples were stored at room temperature and visually inspected and assayed for etoposide and cisplatin content by high-performance liquid chromatography after 15 minutes, 2, 4, 8, 12, 16 and 24 hours of storage. RESULT: 1) Cisplatin concentration decreased less than 10% from initial concentration for 24 hours of storage, both in glass bottle and pvc bag. Stability of cisplatin 200 microgram/ml in both container were not different. and Condition of light exposure did not have significant effect on stability of cisplatin 200 microgram/ml in glass bottle. 2) The etoposide 200 microgram/ml was not precipitated and stable for 24 hours, but we could find the precipitates of etoposide with the concentration of 400 microgram/ml or higher for 24 hours. CONCLUSION: Cisplatin 200 microgram/ml and etoposide 200 microgram/ml in 0.9% sodium chloride were stable at room temperature under room fluorescent light for 24 hours.
Breast Neoplasms ; Chromatography, Liquid ; Cisplatin* ; Etoposide* ; Glass ; Ovarian Neoplasms ; Polyvinyl Chloride ; Small Cell Lung Carcinoma ; Sodium Chloride

BACKGROUND: Granisetron, a new 5-HT3 receptor antagonist, was reported as a highly effective antiemetics, especially in combination with dexamethasone, in the prevention of acute emesis induced by cisplatin. But there is lack of data about effectiveness in the prevention of delayed emesis. In this study, the efficacy of granisetron plus dexamethasone in the prevention of delayed emesis induced by cisplatin was evaluated. MATERIALS AND METHODS: Sixty-four patients who were to receive high-dose cisplatin containing chemotherapy regimen were enrolled in this study. They were received 20 mg of dexamethasone and 3 mg of granisetron at 30 min and 10 minutes prior to cisplatin infusion, respectively. They were monitored for 5 days, first 24 hours for acute nausea/ vomiting and the subsequent 4 days for delayed nausea/vomiting. Antiemetic effect of granisetron was evaluated according to the criteria of Italian Group of Antiemetic Research. RESULTS: Control of delayed nausea and vomiting was achieved in 58% and 84%, respectively. Eastern Cooperative Oncology Group performance status was a statistically significant prognostic factor for control of acute vomiting and delayed nausea/vomiting. There were no stastically significant differences between control of delayed nausea/ vomiting and other prognostic factors, including sex, age, and prior history of cisplatin therapy. The antiemetic effect was greater in the patients who had controled acute nausea/ vomiting than those who had not. CONCLUSION: Granisetron plus dexamethasone is an excellent regimen in the control of not only acute emesis but also delayed emesis induced by high-dose cisplatin chemotherapy.
Antiemetics ; Cisplatin ; Dexamethasone* ; Drug Therapy ; Granisetron* ; Humans ; Nausea* ; Receptors, Serotonin, 5-HT3 ; Serotonin ; Vomiting*

PURPOSE: This study was designed to evaluate the role and the value as progression markers, of type IV collagen and E-cadherin in the pathogenesis of progressive uterine cervical epithelial lesions. MATERIALS AND METHODS: Materials examined were 4 cases of normal exocervical squamous epithelium, 9 of endocervical squamous metaplasias, 2 of mild dysplasias, 8 of moderate dysplasias, 15 of severe dysplasias, 12 of carcinoma in situ, 7 of microinvasive squamous cell carcinomas, and 4 cases of invasive squamous cell carcinomas. All of them were biopsied ones and products of conization and hysterectomy. The expression of type IV collagen and E-cadherin in uterine cervical epithelial lesions were studied by immunohistochemical method using monoclonal antibodies to type IV collagen and E-cadherin. RESULTS: The expression of type IV collagen decreased relatively stepwise from squamous metaplasias to cervical intraepithelial neoplasias (CIN) and subsequently to invasive carcinomas. The expression of type IV collagen in normal uterine exocervical squamous epithelium was within normal range in contrast to variable expression in squamous metaplasia. There was no definite difference in expression pattern between early invasive carcinoma and advanced invasive carcinomas. Normal and squamous metaplastic epithelium of uterine cervix revealed membranous expression of E-cadherin and cervical intraepithelial lesions showed cytoplasmic expression or negative expression instead of membranous expression. There was clearcut difference in E-cadherin expression between normal or metaplastic epithelium and neoplastic lesions. CONCLUSION: The change of type IV collagen expression could be an early marker in the progression of uterine cervical epithelial lesions from normal epithelium. And the loss of differentiaton and polarity and the deranged expression of E-cadherin are closely correlated on the basis of the result that the changed expression of E-cadherin was evident in the stage of transition from normal to neoplastic lesions.
Antibodies, Monoclonal ; Cadherins* ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Collagen Type IV* ; Conization ; Cytoplasm ; Epithelium ; Female ; Hysterectomy ; Metaplasia ; Reference Values

PURPOSE: The identification of genetic traits that predispose individuals to environmentally induced cancers is one of the challanges in the assessment of individual cancer risk. The genetically determined differences in metabolism, related to glutathione S-transferases (GSTs) have been reported to be associated with various cancer susceptibility. The present study was set up to establish the frequencies of the polymorphic genotypes of two GST (GST- mu and GST-theta) isozymes in Korea, to evaluate a possible increased incidence of the genotypes associated with higher cervical cancer risks among Korean cervical cancer patients. MATERIALS AND METHODS: In this study, extracted DNAs from cervical cancer patients (228 for GST-mu and 241 for GST-theta genotypes) and normal controls (360 for GST-mu and 353 for GST-theta genotypes) were analysed with the polymerase chain reaction (PCR). RESULTS: The overall genotype distribution of the GST-theta polymorphisms was not statistically different between the patients and control groups. But, in the GST-mu null genotypes, there were remarkable differences between patients and control groups when the cervical cancer patients were devided into subgroups with respect to the age. The frequency of GST-mu null polymorphisms in the cervical cancer patients under the 40 years old was significantly higher compared to the patients above the 40 years old (0.01cancer which develops before 40 years of age and GST-mu null genotype may play a some role in cervical cancer progression.
Adult ; Alleles ; DNA ; Genetic Predisposition to Disease* ; Genotype ; Glutathione Transferase* ; Glutathione* ; Humans ; Incidence ; Isoenzymes ; Korea ; Metabolism ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms*

PURPOSE: We evaluated the correlation between the clinical outcome and the expression of p53 protein and EGFR mRNA in bladder cancer. MATERIALS AND METHODS: Sixty seven patients with transitional cell carcinoma of the bladder (40 patients with superficial cancer and 27 patients with invasive cancer) and 10 persons with normal urothelium were included in our study. We examined the overexpression of p53 protein by immunohistochemical analysis and EGFR by in situ mRNA hybridization. Both expression were compared with the known factors of prognosis. RESULTS: Mutant p53 protein was overexpressed in 43.3% of transitional cell carcinoma cases and undetectable in normal urothelium. The positive staining of EGFR mRNA was observed in 30% of normal urothelium and 100% of transitional cell carcinoma of bladder. p53 overexpression was related to the degree of differentiation, but not with the stage and the recurrence of superficial cancers. Progression to invasive cancer occurred in 4 patients with superficial cancer and all of them showed p53 protein overexpression, which had statistical significance (P<0.05). p53 positivity in invasive cancer was not related to the poor survival and strong expression of EGFR mRNA. The positive staining of EGFR mRNA was also not related to stage, grade, recurrence and survival. When we combined positivity of p53 and EGFR mRNA, we observed that the subset of patients with strong expression of EGFR mRNA and positive expression of p53 also had no different survival. CONCLUSIONS: These results suggest that mutant p53 protein does not seem to be a prognostic marker for the recurrence of superficial cancer and survival but may be a marker for progression of superficial cancer to invasive cancer.
Carcinoma, Transitional Cell* ; Humans ; Prognosis ; Receptor, Epidermal Growth Factor ; Recurrence ; RNA, Messenger* ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urothelium

PURPOSE: It is known that heat production in breast cancer is caused by hypermetabolism, hypervascularization and hyperperfusion in the affected regions of the breast. The object of this study is to detect the heat production in breast cancer of Korean women. MATERIALS AND METHODS: 240 patients with breast cancer and benign mass were examined by digital infrared thermographic system from January 1991 through December 1995. The heat production was detected when there was a hot spot on clinically palpable breast mass area on the breast thermogram. RESULTS: Of the 240 patients, 130 with breast cancer and 110 with benign mass, as control group. 118 (90.8%) of 130 patients with breast cancer had the heat production, but only 12 (10.9%) of 110 patients with benign mass had the heat production (p<0.0001). The sensitivity of breast thermogram was 90.8% and the specificity was 89.1%. 16 (64%) of 25 breast cancer of which size was smaller than 2 cm had the heat production. But all of 45 breast cancer of which size was larger than 4 cm had the heat production (p<0.0001). 103 (79.2%) of breast cancer had greater than 2degrees C in thermal difference (delta T), and 120 (92.3%) had greater than 1degrees C. CONCLUSION: We conclude that there is heat production in breast cancer. And also the heat production in breast cancer could be detected by the breast thermography. We suggest that further studies of mechanism about heat production in breast cancer is necessary.
Breast Neoplasms* ; Breast* ; Female ; Hot Temperature* ; Humans ; Sensitivity and Specificity ; Thermogenesis* ; Thermography

PURPOSE: Paclitaxel has not been used widely in gastrointestinal cancers. However, a recent phase II report of paclitaxel in patients with esophageal adenocarcinoma has suggested a possible role of paclitaxel for the treatment of advanced gastric carcinoma. A phase II trial was initiated to determine the clinical utility of a 3 drug combination (paclitaxel, cisplatin, and 5-fluorouracil) in patients with advanced gastric carcinoma. MATERIALS AND METHODS: Eligibility included biopsy-proven inoperable or relapsed adenocarcinoma of the stomach with adequate bone marrow, hepatic, and renal function. Patients received paclitaxel at 175 mg/m2 (3 hour infusion) on day 1 followed by cisplatin at 20 mg/m2/day infusion and 5-fluorouracil at 750 mg/m2/day continuous infusion for 5 days. Treatment has been repeated in every 4 weeks. Total 31 patients were enrolled; 7 had relapsed disease after resection and 5-fluorouracil based adjuvant chemotherapy, 5 had previous chemotherapy. Twenty-one patients had measurable disease and 9 were evaluable. Demographics included; median age, 47 years (range, 27~64 years); male: female, 21: 10; median performance status 2 (range, 0~4). RESULTS: Major responses occurred in 16/30 (53%; 95% confidence interval, 35~71%) patients (2 complete responses, 14 partial responses); 13 of 21 (61.9%) patients with measurable disease and 3 of 9 (33%) evaluable patients. Median response duration was 17 weeks (range, 8~44+ weeks) and median time to progression was 20 weeks (range, 8~51+ weeks). Median survival was 27 weeks (range, 8~72+ weeks). WHO grade 3~4 toxicities included: neutropenia (61.9%), nausea/vomiting (23.8%), mucositis (19%), and diarrhea (9.5%). Grade 2~3 neurotoxicity, fluid retention syndrome, hypersensitive reaction had occurred in 6, 2, and 1 patients, respectively. There was 1 instance of treatment-related death due to sepsis. CONCLUSION: This regimen was highly active in advanced gastric carcinoma and had moderate toxicity. However, the response duration was short like other regimens. Considering poor performance status of our patients, this regimen may have strong potential in the neoadjuvant setting.
Adenocarcinoma ; Bone Marrow ; Chemotherapy, Adjuvant ; Cisplatin* ; Demography ; Diarrhea ; Drug Therapy* ; Female ; Fluorouracil ; Gastrointestinal Neoplasms ; Humans ; Male ; Mucositis ; Neutropenia ; Paclitaxel ; Sepsis ; Stomach Neoplasms* ; Stomach*

PURPOSE: Angiogenesis is an essential component of tumor growth and proven to be a prognostic factor in breast, cervix, prostate carcinoma and melanoma. This study was designed to define the relationship of microvessel density with overall survival, clinicopathologic data and with other reported prognostic factors in gastric carcinoma. METHODS: We studied resected tumor specimens from thirty-two patients with gastric carcinoma who underwent gastrectomy at Ewha Women's University Hospital from January, 1989 to December, 1991. Specimens were investigated by staining with a monoclonal antibody aganist factor VIII-related antigen, which was localized to vascular endothelium. Correlation between the microvessel count (X200), various clinicopathologic factors, EGFR and p53 were studied. RESULTS: The microvessel count was increased with higher histologic staging. The microvessel count was significantly higher in group with lymph node metastasis than in those without lymph node metastasis (60.7 vs 27.4, p=0.02). In patients with high microvessel count (> or =30), overall survival time was shorter than in those with low count (<30), but insignificant statistically (p>0.05). The microvessel count was higher in group with recurrence than in those without recurrence (48.1 vs 33.2, p=0.05). CONCLUSION: Microvessel count may be a prognostic indicator in gastric carcinoma but larger scale study should be followed.
Breast ; Cervix Uteri ; Endothelium, Vascular ; Female ; Gastrectomy ; Humans ; Lymph Nodes ; Melanoma ; Microvessels ; Neoplasm Metastasis ; Prognosis* ; Prostate ; Recurrence ; von Willebrand Factor

PURPOSE: This study was carried out to evaluate the impact of combined splenectomy with total gastrectomy on survival and postoperative morbidity in advanced gastric cancer. PATIENTS AND METHODS: We performed a retrospective analysis of 193 patients who underwent curative resection among 289 patients with total gastrectomy during the period of Sep. 1983 through Dec. 1995 at the Department of Surgery, Korea University Hospital. RESULTS: Out of 11 clinicopathologic factors, 5 were associated with splenectomy through univariate analysis. The incidence of splenectomy increased when the patients with advanced gastric cancer had Borrmann type III, Gross T3 & T4 stage, greater than 4 cm of tumor size, Serosal invasion, or UICC stage IIIb, IV (p<0.05). Postoperative complication occurred more commonly in splenectomy group than in non-splenectomy group (20.2% vs 16.9%). The 5-year survival rate of Stage II was lower in splenectomy group than in non-splenectomy group (63.5% vs 83.5%) but that of Stage III was higher in splenectomy group than in non-splenectomy group (22.8% vs 17.3%), there was no significant difference between the survival rates across different stages. CONCLUSION: We could not find any beneficial effect of splenectomy in gastric cancer patients who underwent curative total gastrectomy in this retrospective analysis. There was no clinical evidence to support splenectomy as a general policy in patients with total gastrectomy. We conclude that the randomized prospective clinical trials using more precise criteria for the indication of splenectomy are needed in order to assess the beneficial effect of splenectomy.
Gastrectomy* ; Humans ; Incidence ; Korea ; Postoperative Complications ; Prognosis* ; Retrospective Studies ; Splenectomy* ; Stomach Neoplasms* ; Survival Rate