No abstract available.
Classification* ; Humans ; Stomach Neoplasms* ; Survival Rate*

No abstract available.
Gallbladder Neoplasms* ; Gallbladder*

No abstract available.
Gastrectomy* ; Stomach Neoplasms*

Peritoneal tuberculosis is a disease rarely seen nowadays. Its symptoms are easy fatigue, abdominal distension, intermittent abdominal pain and ascites. Its onset is insidious, which si-mulates symptoms of peritonitis or carcinomatosis. Peritoneal tuberculosis should be considered in the differential diagnosis when a Patient's symptoms and signs are ascites, ovarian tumor, vague abdominal pain and abdominal distension with high serum level of CA 125, an antigenic determinant of epithelial ovarian cancers. We have recently experienced a case of peritoneal tuberculosis with markedly elevated serum level of CA 125 in 54 year-old woman and report our case with a brief review of the literature.
Abdominal Pain ; Ascites ; Carcinoma ; Diagnosis, Differential ; Fatigue ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; Peritonitis ; Peritonitis, Tuberculous*

No abstract available.
Pancreatic Neoplasms*

BACKGROUND: Although it is known that patients wth peripheral vascular disease are at high risk for coronary arterial disease, however, it has not been determined that patients with coronary artery disease(CAD) correlates with peripheral vascular disease(PVD). This study was designed to determine the prevalence and clinical characteristics of peripheral vascular disease(PVD) in patients with coronary artery disease(CAD). METHODS: A total of one hundred seventy-eight patients with CAD confirmed by coronary angiogram(145 male, age 58.5+/-10.1) were included in this study from February 1992 to May 1994. Coronary and peripheral angiograms were performed in all patients and the patients were divided into two groups; patients with PVD dand patients without PVD. Clinical characteristics were compared between two groups. RESULTS: Peripheral vascular disease was present in 49 patients(27.5%) among 178 CAD patients. The mean age of patients with PVD was significantly older than that of patients without PVD. The hypertension was statistically significant difference between two groups(P<0.05). There were no major differences in the number of risk factors or number of stenotic coronary arteries in patients with and without PVD. CONCLUSION: The prevalence of PVD in patients with CAD was high and it is reasonable to state that most common risk factors for coronary and peripheral atherosclerosis were age, hypertension and obesity.
Atherosclerosis ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Hypertension ; Male ; Obesity ; Peripheral Vascular Diseases* ; Prevalence ; Risk Factors

No abstract available.
Follow-Up Studies* ; Prognosis* ; Stomach Neoplasms* ; Stomach*

[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.
[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.
[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.
[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.
[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

PURPOSE: Although local recurrence rates of stomach cancer after radical surgery have been eported in the range of 30-70%, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. MATERIALS AND METHODS: From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiomyosarcoma. The numbers of patients with stage IB, II, IIIA, IIIB, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion. Minimum and median follow-up periods were 12 months and 18 months, respectively. RESULTS: Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than 15% of their pretreatment weight. But hematemesis, melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/ remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient. Peritoneal seeding occurred in 6, liver metastases in 2, and distant nodes in 2 patients. Four year disease specific survival rate was 40% and disease free survival was 48%. Median survival was 35 months and median disease free survival time was 26 months. Stages and radiation dose were not significant prognostic factors for locoregional failures. CONCLUSION: Although all patients in this study had positive surgical margins, locoregional failure rate was 28%, and 4 year disease specific survival rate was 40%. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences, but we could find a possibility of the role of postoperative radiotherapy in patients with high risk factors.
Adenocarcinoma ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Gastrectomy ; Gastric Stump ; Hematemesis ; Humans ; Intestinal Obstruction ; Leiomyosarcoma ; Liver ; Lymph Nodes ; Melena ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Risk Factors ; Stomach ; Stomach Neoplasms* ; Survival Rate ; Weight Loss

PURPOSE: Small uterine cervical tumors are often undetected on MRI, and undetectable tumors are usually regarded as being in their early stages. The purpose of this study was to evaluate morphological factors determining MRI detectability of uterine cervical tumors by comparing detected and undetected tumors using high resolution MRI units. MATERIALS AND METHODS: Sixty-six surgically-proven uterine cervical cancer patients were included in this study. Using a GE Signa 1.5T magnet (GE, U.S.A.) axial T1-weighted MR images and axial, sagittal, and coronal T2-weighted fast spin echo MR images were obtained with a 5 mm thickness/2 mm gap and a 512x256 matrix size. The patients were divided into two groups, tumor-detected and tumor-undetected. Maximal tumor dimension, depth of stromal invasion, and horizontal tumor spread, measured during histopathological examinations, as well as pathological stages, were compared between the two groups. RESULTS: In the tumor-detected group, the pathological stages were IB1 in 25, IB2 in 3, IIA in 10, and IIB in 5 patients; in the tumor-undetected group, the stages were IA1 in 8, IA2 in 2, and IB1 in 13 patients. Maximal tumor dimension, depth of stromal invasion and horizontal tumor spread for tumor-detected and -undetected groups were 27.4 (10-60) mm vs. 10.4 (3-40) mm (p=0.077), 11.1 (3-20) mm vs. 2.3 (0-5) mm (p<0.001), and 26.6 (8-60) mm vs. 10.4 (3-40) mm (p=0.057), respectively. CONCLUSION: Of the criteria studied, depth of stromal invasion is the most important factor in determining tumor detectability on MRI. All tumors in which this depth was more than 5 mm were thus detected; which are undetected on high resolution MRI can be regarded as early-stage tumors (stage IB1).
Humans ; Magnetic Resonance Imaging* ; Uterine Cervical Neoplasms