To avoid residual cancer in resection lines, some authors have recommended routine frozen section study of both resection margins during gastric cancer surgery. Therefore, to evaluate the significance of the routine frozen section study of resection margins in radical gastric cancer surgery, the authors analysed frozen resection margins of 2107 consecutive curative gastrectomy cases from Jan. 1988 to Jun. 1994. The following results were obtained. We experienced 117 cases of true positive resection margin by frozen section examination. In 65 cases, proximal resection margin was positive. In 52 cases distal resection margin was positive. True positive frozen resection rate was 5.6%(117/2107) total, 3.1% in proximal resection margin, 2.5% in distal resection margin. In 19 cases, frozen section study was false negative. The false negative rate was 14.0%. In 4 cases, frozen section study was false positive. The false positive rate was 0.2%. The results of diagnostic accuracy of frozen section study was as follows.: accuracy was 98.9%, sensitivity 86.0%, specificity 99.8%, positive predictive value 96.7%, negative predictive value 99.0%. Among the cancer located at antrum and body, the proximal margin was positive in 43 cases (EGC: 10 cases, AGC: 33 cases). The distance from tumor border to the proximal margin was greater than 2 cm in 2 EGC cases and greater than 6 cm in 8 AGC cases. Among the cancer located at cardia, the proximal margin was positive in 22 cases (EGC: 1, AGC: 21). The distance from the esophagogastric junction to the proximal margin was greater than 3 cm in 3 cases. Among the cancer located at pylorus, the distal margin was positive in 23 cases (AGC: 23). The distance from the pyloric ring to the distal margin was greater than 2 cm in 6 cases. Among the cancer located in antrum and body, the distal margin was positive in 29 cases (EGC: 3, AGC: 26). The distance from the tumor border to the distal margin was greater than 6 cm in 1 case. In conclusion, the present study indicates that resection margin can be infiltrated by the cancer cell though the distance to resection margin is greater than the recommended distance and frozen section study offers acceptable diagnostic accuracy, so we recommend the routine frozen section study of resection margins during gastric cancer surgery.
Cardia ; Esophagogastric Junction ; Frozen Sections* ; Gastrectomy ; Neoplasm, Residual ; Pylorus ; Sensitivity and Specificity ; Stomach Neoplasms

PURPOSE: To compare the antimicrobial effects of various kinds of multi-purpose solutions, study effective ways of washing contact lens (CLs), and suggest the most effective lens care system using P. aeruginosa-contaminated CLs. METHODS: Each disposable soft CL was incubated in 0.1 ml of diluted solution of P. aeruginosa standardstrain (10(8)CFU / mm(3)) and 0.9 ml tryptic soy broth in cell culture wells for 24 hours. In the first experimental group, to find the most antimicrobial solution, 40 CLs contaminated by P. aeruginosa were divided into four subgroups washed with four different kinds of multi-purpose solutions. Ten CLs were used in each subgroup and in the control group; Ten CLs contaminated by P. aeruginosa were washed with phosphate buffered saline (PBS) instead of cleaning solution. In the second experiment groups to find the most effective way of washing, using only Renu Multiplus multi-purpose solutionR we compared the antimicrobial effect of four different ways of washing including 30 seconds rubbing, 30 minutes soaking, 4 hours soaking, 30 seconds rubbing and 4 hours soaking. RESULTS: There was no significant difference of antimicrobial effect between four kinds of multi-purpose solutions. All methods have a significant antimicrobial effect over control group (P<0.001) and the most effective method of washing CLs was 4 hours soaking. CONCLUSIONS: we should advise all the soft CL users that they should have their CLs soaked over 4 hours everyday after wearing it.
Cell Culture Techniques ; Contact Lens Solutions* ; Contact Lenses, Hydrophilic ; Pseudomonas aeruginosa

In order to evaluate the comparison of corneal astigmatism after keratoplasty with 3 kinds of suture techniques, penetrating keratoplasty was performed in 25 patients(25 eyes) with different suture techniques, single continuous(group I, N=7), interrupted(II, N=7), and combined sutures(III, N=11) with 10-0 nylon. In group I, suture control was made from postoperative 1 month and selective suture removal was done in group II and III. The corneal astimatism was analyzed prospectively with corneal topography more than 1 year in all except 2 patients. The amout of corneal astigmatism in group I, II and III at postoperatie 1 month was 2.12D, 3.14D and 3.08D respectively (P>0.05, Kruskal-Willis test) and showed marked reduction upon postoperative 3 months. At postoperative 1 year, corneal astigmatism of each group was 2,62D, 1.49D and 2,18D respectively(P>0.05). The corneal astigmatism between keratoconus and other corneal disorders was not statistically ignificant. Interrupted suture induced least corneal astigmatism after keratoplasty compared to other suture methods even if there was no statistical significance.
Astigmatism* ; Corneal Topography ; Corneal Transplantation ; Humans ; Keratoconus ; Keratoplasty, Penetrating ; Nylons ; Prospective Studies ; Suture Techniques* ; Sutures*

Spinal muscular atrophy(SMA) is the second most common fatal disease of childhood with autosomal dominant mode of inheritance, and in its less severe form the third most common neuromuscular disease of childhood after Duchenne muscular dystrophy. The genetic defect was found to be on the long arm of chromosome 5(5q11.2-q13.3) where many genes and microsatellite markers were missing. One of the most important genes is the Survival Motor Neuron(SMN) gene which is homozygously missing in 90% of SMA patients. Another important gene, the Neuronal Apoptosis Inhibitory Protein(NAIP) gene was found to be defective in 67% of SMA type I patients. Studies so far suggest SMA occurs when the genes on the long arm of chromosome 5 are mutated or deleted. Recently our hospital encountered 2 SMA patients of type I and II respectively. These patients both had homozygously defective SMN genes but intact NAIP genes. We are reporting these cases with bibliographic review and discussion. Korean SMA patients presumably have defects in SMN genes similar to those found in European patients, although the siginificance of NAIP genes remains to be established. SMN gene defects can be easily diagnosed using PCR and restriction enzymes, and this method could be applied towards convenient prenatal diagnosis and towards screening for family members at risk.
Apoptosis ; Arm ; Chromosomes, Human, Pair 5 ; Diagnosis* ; Humans ; Mass Screening ; Microsatellite Repeats ; Muscular Atrophy, Spinal* ; Muscular Dystrophy, Duchenne ; Neuromuscular Diseases ; Neurons ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Wills

PURPOSE: To evaluate the diagnosis and treatment of the carpal tunnel syndrome (CTS) due to space occupying lesions (SOL). MATERIALS AND METHODS: Eleven patients and 12 cases that underwent surgery for CTS due to SOL were studied retrospectively. We excluded SOL caused by bony lesions, such as malunion of distal radius fracture, volar lunate dislocation, etc. The average age was 51 years. There were 3 men and 8 women. Follow-up period was 12 to 40 months with an average of 18 months. The diagnosis of CTS was made clinically and electrophysiologically. In patients with swelling or tenderness on the area of wrist flexion creases, magnetic resonance imaging (MRI) and/or computed tomogram (CT) were additionally taken as well as the carpal tunnel view. We performed conventional open transverse carpal ligament release and removal of SOL. RESULTS: The types of lesion confirmed by pathologic examination were; tuberculosis tenosynovitis in 3 cases, nonspecific tenosynovitis in 2 cases, and gout in one case. Other SOLs were tumorous condition in five cases, and abnormal palmaris longus hypertrophy in 1 case. Tumorous conditions were due to calcifying mass in 4 cases and ganglion in 1 case. Following surgery, all cases showed alleviation of symptom without recurrence or complications. CONCLUSION: In cases with swelling or tenderness on the area of wrist flexion creases, it is important to obtain a carpal tunnel view, and MRI and/or CT should be supplemented in order to rule out SOLs around the carpal tunnel, if necessary.
Adult ; Aged ; Carpal Tunnel Syndrome/*diagnosis/*etiology/pathology ; Female ; Gout ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tenosynovitis ; Tomography, X-Ray Computed ; Wrist/pathology/surgery

No abstract available.
Leukemia, Myeloid, Acute* ; Mucormycosis*

OBJECTIVE: The purpose of this study was to compare the in vivo anti-tumor efficacy of a mucoadhesive, lipid-based, oral paclitaxel formulation (DHP107) with traditional, intraperitoneal (IP) paclitaxel using an orthotopic mouse model of chemotherapy-sensitive SKOV3ip1 ovarian cancer. METHODS: To determine the optimal therapeutic dose of oral paclitaxel, DHP107 was administered per os to female athymic nude mice at 0, 25, or 50 mg/kg twice per week. Control mice received 100 microL saline once per week. IP injections of paclitaxel at 5 mg/kg once per week were used for comparison. To evaluate the potential therapeutic effect of metronomic DHP107 chemotherapy, mice received DHP107 50 mg/kg once per week per os, which was compared with 25 mg/kg twice per week and with vehicle-treated controls. RESULTS: Low-dose DHP107 (25 mg/kg) twice per week was as effective as IP paclitaxel (5 mg/kg once a week) but high-dose DHP107 (50 mg/kg once per week) was less effective at inhibiting tumor growth in an orthotopic mouse model (88%, 82%, and 36% decrease in tumor weight, respectively). Mice that received 25 mg/kg DHP107 twice per week or 50 mg/kg DHP107 once per week per os had a significant decrease in tumor weight compared with vehicle-treated controls (p<0.01, both doses). CONCLUSION: Metronomic oral chemotherapy with DHP107 showed anti-tumor efficacy in vivo similar to IP paclitaxel in an orthotopic mouse model.
Animals ; Drug Therapy ; Female ; Humans ; Mice* ; Mice, Nude ; Ovarian Neoplasms* ; Paclitaxel* ; Tumor Burden

The resistance to recombinant human erythropoietin (r-HuEPO) in patients with chronic renal failure can develop in conditions such as iron deficiency, chronic bleeding, or chronic inflammatory disease. Recently, there have been several case reports of pure red cell aplasia due to antibody production to r-HuEPO in chronic hemodialysis patients. A 59-year old female undergoing chronic hemodialysis responded well to r-HuEPO for 6 years. But, a rapidly progressive anemia was then noted which was unresponsive to maximal doses of r-HuEPO and the patient became transfusion-dependent. Bone marrow examination showed absence of red cell precursors. A detailed search for the cause of this pure red cell aplasia was unrevealing. We conclude that although very rare, pure red cell aplasia should be considered in evaluating chronic hemodialysis patients with erythropoietin-resistant anemia.
Anemia* ; Antibody Formation ; Bone Marrow Examination ; Erythropoietin ; Female ; Hemorrhage ; Humans ; Iron ; Kidney Failure, Chronic ; Middle Aged ; Red-Cell Aplasia, Pure* ; Renal Dialysis*

Tyrosinemia type 1 is an autosomal recessive disorder caused by deficiency of the enzyme fumarylacetoacetate hydrolase(FAH). The disease is characterized by hepatic dysfuntion, hepatocellular carcinomas, renal tubular dysfunction, rickets, and neurologic crises. Two forms of the disease, acute and chronic, are thought to be from the residual enzyme activity in the liver. The diagnosis of the tyrosinemia type 1 is suggested by elevated plasma tyrosine, supported by increased urinary succinylacetone, and confirmed by reduced FAH activity in cultured fibroblasts. We had a 5 month old Korean boy with acute tyrosinemia type 1 who presented with recurrent sepsis-like episodes since 2 months of age, progressive liver dysfunction, and rickets. Plasma amino acid analysis showed markedly elevated tyrosine, methionine and urine amino acid analysis was suggestive of Fanconi syndrome showing generalized aminoaciduria. Organic acid analysis by Gas Chromatography/Mass Spectrometry detected large amount of succinylacetone excreted in the urine. Delta-aminolevulinic acid was elevated as well. X-ray findings were characteristics of rickets and abdominal sonogram, CT and MRI revealed cirrhotic liver with varying size of multiple nodules. Liver transplantation was strongly recommended throughout his clinical course but refused by parents, and he died of hepatic failure at the age of 8 months. Autospy was perfomed showing macro and micronodular liver cirrhosis. Kidney was markedly enlarged, however, glomeruli and tubules were relatively unaltered. Mutation analysis is under the study.
Acute Disease ; Aminolevulinic Acid ; Carcinoma, Hepatocellular ; Diagnosis ; Fanconi Syndrome ; Fibroblasts ; Humans ; Infant* ; Kidney ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Failure ; Liver Transplantation ; Magnetic Resonance Imaging ; Male* ; Methionine ; Parents ; Plasma ; Rickets ; Spectrum Analysis ; Tyrosine ; Tyrosinemias*

Pulmonary tuberculosis is still endemic in Korea, but esophageal tuberculosis, especially primary esophageal tuberculosis, is very rarely seen. A 76-year-old male is presented dysphagia. The clinical presentation, barium swallow study, and chest CT were suggestive of carcinoma of the esophagus. Findings that can suggest the diagnosis are enlarged lymph nodes, ulceration, and luminal narrowing. The major differential diagnosis was primary esophageal tuberculosis. This was not excluded on biopsy obtained at endoscopy. Operation was done for severe dysphagia and exclusion of malignancy. The patient was finally diagnosed as primary esophageal tuberculosis.
Aged ; Barium ; Biopsy ; Deglutition Disorders ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Esophagus ; Humans ; Korea ; Lymph Nodes ; Male ; Phenobarbital ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer