Poland's syndrome which is associated with thoracic anomaly and ipsilateral syndactyly is not hereditary and is of unknown origin. It was described first Alfred Poland in 1841 year. This syndrome affects males more frequently than females. We have experienced two cases of Polands syndrome who were all male and each case revealed thoracic anomalies; abscent pectoral muscles and anterior axillary fold, pectus excavatum, and ipsilateral syndactyly with aplasia or hypoplasla of the middle phalanx.
Female ; Funnel Chest ; Humans ; Male ; Muscles ; Poland ; Syndactyly

PURPOSE: To evaluate the role of fractionated stereotactic radiotherapy (FSRT) in the management of benign brain tumors, we reviewed the clinical, and radiographic responses of patients treated. METHODS AND MATERIALS: Between March 1996 and March 2002, 36 patients with benign brain tumors were treated by FSRT. The pathological diagnoses consisted of pituitary adenomas (12 patients), craniopharyngiomas (5 patients), meningiomas (10 patients), and acoustic neurinomas (9 patients). Radiotherapy doses of 25 to 35 Gy (3~6 Gy/fraction, 5~10 fractions) were prescribed to the 85~90% isodose line, depending upon the location, size and volume of the tumors. The median clinical and radiographical follow- up periods were 31 (range, 2~74) and 21 (range, 4~56) months, respectively. RESULTS: In the 35 patients that could be evaluated for their clinical response, 13 (37.1%) were considered improved, 16 (45.7%) stable and 6 (17.2%) worse. Of the 33 patients who had radiographic studies, tumor shrinkage was noted in 17 (51.5%), tumor stabilization in 13 (39.4%), and tumor progression in 3 (9.1%). Of the 17 tumor shrinkage patients, 7 (21.2%) showed a complete response. Acute radiation-induced complications occurred in 11 (30.6%) patients. CONCLUSION: FSRT is considered a safe and effective treatment method for benign brain tumors, but large numbers of patients, with relatively long follow-up periods are needed to assess the exact role or effect of FSRT.
Brain Neoplasms* ; Brain* ; Craniopharyngioma ; Diagnosis ; Follow-Up Studies ; Humans ; Meningioma ; Neuroma, Acoustic ; Pituitary Neoplasms ; Radiotherapy*

A case of chondroma of soft tissue of right hand in 23-year old man was reported. The presenting symptom was a slow growing mass, causing mild tenderness. Radiologic examination revealed a well demarked and lobulated calcified mass, was located extraskeletally. Specimen exised from soft tisssue of the hypothenar area of the hand was 5×4×3.5cm sized mass, had gelatinous and gray-whitish appearance. On microscopical examination, the tumor was classified as a chondroma of soft tissue.
Chondroma ; Gelatin ; Hand

PURPOSE: This study was tried to evaluate the potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate, overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. MATERIAL AND METHODS: Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200cGy) radiation therapy alone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940 cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months. RESULTS: Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group (25% vs. 47%). The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting (22% vs. 6%) and bone marrow toxicities (25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. CONCLUSION: The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.
Bone Marrow ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin ; Follow-Up Studies ; Humans ; Incidence ; Nausea ; Neoplasm Metastasis ; Pulmonary Fibrosis ; Survival Rate ; Survivors ; Vomiting

Myasthenia gravis (MG) is relatively rare occuring as one of important autoimmune disease to affect neuromuscular junction. This study was clinically to evaluate total body irradiation (TBI) against two patients including 33-year and 39-year females for chronic MG with thymoma who hospitalized in the St. Mary's Hospital, Catholic University since 1994 as well as who showed no response by thymectomy, immunotherapy and hormonal therapy. TBI designed by the dose of 150~180 cGy consisting of 10 cGy per fraction, three times a week, for 5~6 weeks using linear accelerator of 6 MV. During the treatment of TBI, they did complain acute side effect such as vomiting and also appear improved physical condition from 4~6 weeks after TBI. Through the follow-up period of 18 or 42 months after TBI, they did not have any symptomatic recurrence. Consequently, the results suggest that TBI can be used as an alternative tool for the patients concurrently for MG with thymoma who had been refractory to various conventional therapies like thymectomy, immunotherapy and hormonal therapy.
Autoimmune Diseases ; Female ; Follow-Up Studies ; Humans ; Immunotherapy ; Myasthenia Gravis* ; Neuromuscular Junction ; Particle Accelerators ; Recurrence ; Thymectomy ; Thymoma* ; Vomiting ; Whole-Body Irradiation*

To determine the therapeutic effect of closed-needle irrigation of knee for pain from osteoarthritis(OA), we conducted a randomized, single blind, 8 week prospective trial study. A comparison was done between the closed-needle irrigation of knee and standard conservative treatment in 30 patients with non-end stage OA of the knee. Statistically significant differences (P<0.05) favoring closed-needle irrigation of knee over conservative treatment were noted by the Visual Analog Scale for pain in these patients. Overall assessments on effectiveness of therapy by patients(Patient's global assessment) and physician(Knee rating scale) were also statistically superior among closed-needle irrigation group. We conclude that the closed-needle irrigation of knee for the treatment of pain from osteoarthritis is an effective treatment and is superior than the traditional conservative treatment in therapeutic effect.
Humans ; Knee* ; Osteoarthritis* ; Prospective Studies ; Visual Analog Scale

The main objectives of this study were to assess the age related changes of biochemical indices of bone turnover in postmenopausal osteoporotic females, and to assess the correlations of these indices with bone mineral density(BMD) of lumbar spine measured by dual energy X-ray absorptiometry(DEXA). Subgects were 70 osteoporotic women in pre and postmenopausal periods. The results showed that Postmenopausal women had higher level of Osteocalcin(OS) and Deoxypyridinoline(DPYD) with lower level BMD of lumbar spine compared with premenopausal women. Age, height, and weight had significant correlations with BMD of lumbar spine. Also a significant correlation was observed between the OS and DPYD. Pre and postmenopausal osteoporotic women(5, 10, 15 year duration) were similar for the rate of bone turnover. These results indicate that the biochemical indices used in our study are the potential markers to predict an age related change of BMD, as well as bone turnover rate of the lower BMD subjects. The combination of BMD measurement and assessment of the bone turnover rate by measuring biochemical indices would be helpful for the screening and treatment of patients with risks of osteoporosis.
Bone Density ; Female ; Humans ; Mass Screening ; Osteocalcin ; Osteoporosis ; Postmenopause ; Spine

PURPOSE: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. MATERIALS AND METHODS: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. RESULTS: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. CONCLUSION: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.
Aged ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Disease-Free Survival ; Esophagitis ; Humans ; Lymph Nodes ; Pneumonia ; Retrospective Studies ; Survival Rate

PURPOSE: This report is the result of retrospective analysis for children who received prophyactic cranial irradiation combined with intrathecal chemotherapy. METHODS AND MATERIALS: Ninety children with ALL who had got bone marrow remission after induction chemotherapy received PCI. All but 3 children were treated with a dose of 1800 cGy as a standard regimen. While the PCI was given, all patients received intrathecal chemotherapy. RESULTS: Nine of 90 patients experienced CNS relapse during the duration of follow-up ranged from 36 to 96 months (median 60 months). Three children experienced BM relapse prior to CNS relapse. Therefore, CNS relapse rate as the first adverse event was 6.7%. Median time interval of CNS relapse was 16 months from the first day of hematologic complete remission. Eighty-nine percent of patients who had CNS relapse occurred during maintenance chemotherapy (on-therapy relapse). The CNS RFS at 2 and 5 years are 68 % and 42 %, respectively with median of 43 months. The prognostic factors affecting CNS RFS are initial WBC count (cut-off point of 50,000/mul), FAB subtype and CALGB risk WBC count (cut-off point of 50,000/mul), FAB subtype, POG and CALGB risk criteria. CONCLUSION: In our study, 6.7% of CNS relapse rate as a first adverse event was comparable with other studies. Various risk criteria was based on age at diagnosis and initial WBC count such as POG and CALGB criteria, had prognostic significance for CNS RFS and DFS. Prospective randomized trial according to prognostic subgroup based on risk criteria and systematic study about neuropsychologic function for long term survivors, are essential to determine the most effective and least toxic form of CNS prophylaxis.
Bone Marrow ; Child ; Cranial Irradiation* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Maintenance Chemotherapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Retrospective Studies ; Survivors

PURPOSE: We evaluated whether Cyberknife radiosurgery is an effective and safe method of therapy for medically intractable trigeminal neuralgia (TN). MATERIALS AND METHODS: We retrospectively analyzed the outcome of 26 patients, who failed to surgery or were not suitable candidates for invasive intervention and were treated by Cyberknife radiosurgery between March 2004 and May 2005. Radiosurgery doses of 60~64 Gy were delivered to the 80% isodose line prescribed to an 6 mm length of the nerve, sparing the most proximal 3 mm away from the trigeminal nerve root entry zone (median dose: 64 Gy). RESULTS: Follow-up period was 3~15 months (median follow-up period: 9 months) Preliminary results from a cohort of 26 patients undergoing Cyberknife radiosurgery for TN showed that pain relief was achieved in 50% (13/26) of patients within the first 24 hrs after treatment. At last follow-up, 96.2% (25/26) of patients reported early pain relief within 7 days. Treatment failure developed in 2 of 26. Poor response occurred in one patient and relapse was observed in the other patient. 3 patients had hypoesthesia (11.5%), which was the only complication observed with any of our patients. CONCLUSION: With these results, authors assumed that Cyberknife radiosurgery for TN could be one of safe and effective therapeutic methods.
Cohort Studies ; Follow-Up Studies ; Humans ; Hypesthesia ; Radiosurgery* ; Recurrence ; Retrospective Studies ; Treatment Failure ; Trigeminal Nerve ; Trigeminal Neuralgia*