No abstract available.
Liver Diseases* ; Liver*

OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

PURPOSE: The prevalance rate of chronic hepatitis B viral infection in children is high in our contry. We performed a prospective study to evaluate the effectiveness of and the factors predictive of response to interferon-alpha therapy in children with chronic hepatitis B. METHODS: Thirty-two children with chronic hepatitis B werew admitted to the Department of Pediatrics, Yonsei University College of Medicine from Oct. 1992 to Apr. 1994, and liver biopsies were performed. They recieved interferon-alpha (Intermax-alpha: 3 million IU intramuscularly three times a week) for from 4 to 6 months and were followed for 19+/-7.5 months after treatment. The control group comprised forty children with chronic hepatitis B who had conservative or no treatment. The therapeutic effectiveness of IFN-alpha was evaluated, and factors predictive of response to treatment were analyzed. RESULTS: 1) Thirty two children in the treatment group comprised 22 males and 10 females. The mean age was 11.7+/-3.5 years at entry. The pathologic types were chronic lobular hepatitis in 4, chronic persistant hepatitis in 12 and chronic active hepatitis in 16 cases. The mean age of 40 children in the control group was 8.2+/-4.4 years. There were no differences in the clinical and laboratory data between the two group. 2) The serum ALT and AST levels normalized in 29 (91%) of 32 treated cases and 33 (88%) of 40 controls. The normalization of serum aminotransferases in control group, however, was thought to be meaningful because most controls were in healthy chronic carrier state with normal aminotransferases levels. The serum HBV-DNA was cleared in 25 (78%) of 32 treated cases and 7 (41%) of 40 controls, which showed statistically significant difference (P<0.005) between two groups. HBeAg was cleared in 24 (75%) of the treated cases and 10 (25%) of 40 controls (P<0.05). The positive seroconversion of anti-HBe was noted in 18 (56%) of 32 treated cases and 7 (18%) of 40 controls (P<0.05). 3) Normalization rate of AST and ALT levels, the clearance rate of HBV-DNA andHBeAg, and the seropositive rate to anti-HBe were 100%, 50%, 75% and 50% in CLH; 83%, 75%, 58% and 42% in CPH; 94%, 88%, 88% and 69% in CAH, respectively. 4) Children with higher pretreatment peak ALT level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 6 (55%) and 5 (45%) of 11 children with pretreatment peak ALT level of less than 100IU/L; 6 (75%) and 7 (88%) of 8 children with pretreatment peak ALT level of 100-200IU/L; 12 (92%) and 13 (100%) of 13 children with pretreatment peak ALT level of greater than 200IU/L. 5) Children with lower pretreatment HBV-DNA level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 13 (72%) and 14 (78%) of 18 children with pretreatment HBV-DNA level less than 100pg/ml; 2 (40%) and 2 (40%) of 5 children with pretreatment HBV-DNA level greater than 100pg/ml. 6) Children with higher post-treatment peak ALT level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 8 (73%) and 7 (64%) of 11 children with posttreatment peak ALT level less than 100IU/L; 9 (69%) and 10 (77%) of 13 children with post-treatment peak ALT level of 100-200IU/L; 7 (88%) and 8 (100%) of 8 children with post-treatment peak ALT level greater than 200IU/L. 7) Normalization of serum ALT and AST level took 7.1+/-6.8 months. The clearance of HBV-DNA and HBeAg took 12.9+/-8.3 and 10.1+/-7.3 months, respectively. positive seroconversion to antiHBe was obserbed at 10.6+/-6.3 months after IFN-alpha treatment. CONCLUSION: These results suggest that interferon-alpha therapy can induce an increased clearance of HBV-DNA and HBeAg with an increased positive seroconversion to anti-HBe in children with chronic type B hepatitis. Factors that may help in in identifying those children with a better chance of responding, were higher pre- and post-treatment peak ALT levels and lower pretreatment peak HBV-DNA levels.
Biopsy ; Carrier State ; Child* ; Female ; Hepatitis ; Hepatitis B e Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Liver ; Male ; Pediatrics ; Prospective Studies ; Transaminases

No abstract available.
Hand* ; Regional Blood Flow*

No abstract available.

No abstract available.
Glycogen Storage Disease Type I*

Neonatal hepatitis(NH) and congenital extrahepatic biliary atresia(BA) are two major causes of neonatal cholestasis. The method of therapeutic trials for each disease is essentially different. Nonetheless it is very difficult to differentiate these diseases histologically, since most of the hepatic changes are mutual in both of them. This study is to aimed to find out major differences between the two by scoring various histological parameters. A total of 63 consecutive liver biopsies taken from 54 patients with suggested NH and BA were examined by applying morphometric scoring system. The detailed clinical histories, laboratory data including serology for HBsAg and TORCH infection and radiologic operative findings were reviewed. Among 54 patients, 27 were diagnosed as NH and 20 as BA. In two cases, features of both diseases were coexistent. The pathological diagnosis was not compatible with the final diagnosis in 5 cases(10.7%). In all of these 5 cases, biopsy had been performed at the age of one to two months. The seropositivity for TORCH was 59.3%(16.27) in NH, but 25.0%(5/20) in BA. Serum AST, ALT and alpha-fetoprotein values were higher in NH, and total bilirubin in BA. Of various histological parameters, scores of portal fibrosis, bile duct and ductular proliferation and bile thrombi were much higher in BA, and at the age of less than 2 months, extramedullary hemopoiesis(EMH) was found much more frequently in NH. Giant cell transformation of hepatocytes(GCT) was more commonly observed in NH. The numbers of GCT and EMH were particulary plentiful when the patients' sera were positive for HBsAg or TORCH. These results indicate that portal fibrosis, biliary proliferation and bile thrombi are the three major histologic features of BA, and therefore erroneous histological diagnosis may ensue when scores of those features are low as in some early BA.
Infant, Newborn ; Humans ; Biopsy

PURPOSE: To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. MATERIALS AND METHODS: Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. RESULTS: The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; p = 0.038), lymph node dissection extent (HR, 0.201; p = 0.002), and maintenance oral chemotherapy (HR, 2.964; p = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). CONCLUSION: The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.
Chemoradiotherapy ; Combined Modality Therapy ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Intestinal Obstruction ; Leucovorin ; Leukopenia ; Lymph Node Excision ; Multivariate Analysis ; Nausea ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Thrombocytopenia ; Vomiting

For young children with scoliosis before growth spurt, suhcutaneous lengthening without fusion was designed by Harrington and modified by Moe and Luque. However, many problems including spontaneous fusion, rod breakage, and hook disloclgement have been ohserved. CotrelDubousset(CD) instrumentation was sometimes used, but it usually resulted in failure due to soft tissue adhesion around the rough surface of ordinary CD rod. We tried to use the smooth CD rod, transvcrse-pedicle clawing on the upper part, and pedicle screw inscrtion on upper and lower part of the curve to reduce the hardware failures. Among 8 patients in whom suhcutaneous lengthening with smooth CD rod was carried out hetween October l992 and Suly 1996. 4 cases perfomed with final spinal fusion were analysed. There were I central core disease, 1 multicore disease and 2 idiopathic scoliosis(infantile and juvenile type). Mean age at the first operation was l0.0(8.8-11.8) years, and the Risser sign was all grade 0 except one with grade 1. Suhcutaneous lengthening was performed every 5 or 6 months Mean lengthening duration was 22(9-39) months and mean age at spinal fusion was 11.7(9.6-13.8) years. Mean Cobb angle decreased from 7ldegrees (55degrees-88degrees) at preoperative stage to 32 (10degrees-59degrees) at the last follow-up. There were 5 complications during 21 operations, and three hardware failures comprised 2 hook dislodgcment and 1 screw pull-out. Crankshaft phenomenon happened in I case who had had a posterior fusion in young age(9.6 years) due to laminar fracture. The suhcutaneous lengthening with smooth CD rod can he another option of treatment for young children with severe scoliosis. prescrving the powth potential of involved vertebrae with few complications.
Animals ; Child* ; Follow-Up Studies ; Hoof and Claw ; Humans ; Myopathy, Central Core ; Scoliosis* ; Spinal Fusion ; Spine ; Tissue Adhesions

Tamoxifen citrate is a non-steroidal agent that has demonstrated estrogen agonist and antagonist properties and has found successful application for all stages, as adjuvant therapy, in the treatment of primary breast cancer. The drug was originally introduced for the treatment of high risk postmenopausal women or for postmenopausal patients with advanced disease. Since then, it was reported that long term treatment schedules could provide maximal benefit in preventing recurrences. Recent analyses of clinical trials have demonstrated an increase of disease-free survival in breast cancer among patients with positive estrogen receptor tumor. Tamoxifen is now recommended for chemoprevention of breast cancer in healthy high risk women. An agonist estrogenic effect upon the endometrium, the so called "paradoxical" effect, is suggested when proliferative changes, such as endometrial hyperplasia, adenocarcinoma, polyps. We report a case of endometrial cancer which developed in premenopausal patients with breast cancer under tamoxifen therapy.
Adenocarcinoma* ; Appointments and Schedules ; Breast Neoplasms ; Chemoprevention ; Disease-Free Survival ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometrium ; Estrogens ; Female ; Humans ; Polyps ; Recurrence ; Tamoxifen*