We have analysed 13 patients with malignant obstructive jaundice due to metastasis who were treated with local radiation therapy to the area of porta hepatis at the Radiation Therapy Department of Paik hospital attached to the Inje University between 1984 and 1988. A good response was observed in 6 out of 7 evaluable paitens receiving a total radiation dose ranging from 2600 to 5480 cgy in 2.6 to 6 weeks. A complete response was noted in 5 patients, a partial response in 1 patient, and no response in 1 patient. The overall median survival for 13 patients was 3 months. But two patients lived more than a year without recurrence of jaundice. Moderate dose, localized field radiation therapy appears to the beneficial in relieving obstructive jaundice and gives a good symptomatic relief.
Humans ; Jaundice ; Jaundice, Obstructive* ; Neoplasm Metastasis ; Recurrence

No abstract available.
Ethics

PURPOSE: According to the staging system for breast cancer by the 2003 revised American Joint Committee on Cancer (AJCC), the patients with 10 or more positive axillary nodes are classified as N3 and also as a new stage, i.e., stage IIIC. The aim of this study was to investigate the prognosis of patients with 10 or more positive nodes. METHODS: The database of 125 patients with 10 or more positive axillary nodes who underwent surgery at Korea Cancer Center Hospital between 1997 and 2001 were reviewed. The age of the patients, the T stage, the number and site of the positive nodes, the hormone receptor status, the HER-2 over-expression, and the treatment modalities were examined in reference to the disease-free survival (DFS). RESULTS: At the median follow-up time of 40 months, 16 cases (13%) of locoregonal recurrence and 57 cases (46%) of systemic relapse had developed in 67 patients (54%). The DFS and overall survival rates at 5 years were 46% and 55%, respectively. On univariate analysis, the T stage (p<0.001), hormone receptor status (p=0.001), and neoadjuvant chemotherapy (p=0.014) were predictive factors of recurrence. On multivariate analysis, the T stage (p=0.002) and hormone receptor status (p=0.02) were independent predictors of recurrence. The patients with hormone receptor positive tumor had a 58%, 5-year DFS rate. On the contrary, in 9 of 10 patients with T4 tumor, recurrence developed within 2 years after the initial treatment. CONCLUSIONS: This study showed that stage IIIC according to the revised AJCC staging system was not a prognostically homogeneous group. Some notably high survival rates were observed in a subgroup of patients, and especially for those patients with hormone receptor positive tumor. In contrast, the prognosis of patients with T4 tumor was significantly worse than that of the patients with the other stage IIIC disease. Thus, we suggest that the stage IIIC group in the new AJCC staging system needs to be refined to provide more reliable prognostic information for the patients with advanced breast cancer.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Joints ; Korea ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Staging ; Prognosis* ; Recurrence ; Survival Rate

PURPOSE: Many reliable articles on the effectiveness of alpha blockers have been published. Evidence-based diagnostic guidelines and therapeutic guidelines for benign prostatic hypertrophy (BPH), which is one of the most common urological diseases, have been proposed in many foreign countries. This paper examines the efficacy of alpha blocker, a common therapeutic drug for BPH, in Korean patients through meta-analysis. MATERIALS AND METHODS: From 1993 to 2001, the term 'BPH' and alpha blocker for BPH were used as key words to search for related articles in the Medical Research Information Center, the National Assembly Library of the Republic of Korea, the Korean Journal of Andrology and the Korean Journal of Urology. A total of 10 articles were selected as being suitable for evaluation and these articles were ranked with levels ranging from I to V, where level I indicated a large randomized controlled trial and level V indicated a non-controlled case accumulation study. RESULTS: There were improvements for the symptom score (45.3%), and for the maximum urinary flow rate (36.0%). The reasons for patient drop-outs were follow-up loss for 60%, drug side effects for 11%, and ineffectiveness of drug for 6.8%. The common side effects were dizziness (4.2%), orthostatic hypotension (2.2%), and headache (1.7%). The blood pressure was sustained in the normotensive patients, wheareas BP showed a tendency to be reduced in hypertensive patients. CONCLUSIONS: Treatment with alpha blocker resulted in the BPH patients in all the studies receiving sustained benefit. Yet most of these papers were short-term, non randomized case-accumulation studies. However, BPH is a chronic disease that may worsen over time. Therefore, evaluation of long term tolerability and efficacy of alpha blocker is necessary.
Adrenergic alpha-Antagonists ; Andrology ; Blood Pressure ; Chronic Disease ; Dizziness ; Follow-Up Studies ; Headache ; Humans ; Hypotension, Orthostatic ; Information Centers ; Korea* ; Prostatic Hyperplasia* ; Republic of Korea ; Urologic Diseases ; Urology

Between December 1983 and December 1989, twenty-five breast carcinoma patients were treated with surgical resection and postoperative radiotherapy at Inje University Seoul Paik Hospital. Twenty-three of 25 were evaluable and there were 7 patients with stageII, 14 patients with stageIII, and 2 patients with stageIV. Twenty-one patients were treated with modified radical mastectomy and the remained 2 patients with simple mastectomy. The follow-up period ranged from 2 to 8 years. The local control rate was 83c13 for the entire group. The local control rates for each stage were 100%(6/6) for stage II, 73%(l1/15) for stageIII, and 100%(2/2) for stageIV. The number of metastatic axillary nodes was a good predictor of locoregional cotrol. It was 100% for the patients with 0-3 metastatic nodes and 72% for more than 4 nodes, respectively. The 5-year overall survival rate for the entire group was 59%, and the disease-free survival rate was 32%. The 5-year survival rates for each stageII,III and IV was 83%, 59% and 50%, respectively. The distant metastasis occurred in 10 out of 23 patients and the most common site was bone. The results indicate that postoperative radiotherapy continues to play an important role in the primary mangement of the high-risk breast cancer patients.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Simple ; Neoplasm Metastasis ; Radiotherapy* ; Seoul ; Survival Rate

45,X/47,XYY mosaicism is a rare sex chromosomal disorder with clinical information limited to 25 cases in the literature. We report an unusual mosaic Turner syndrome case in a 35-year old Korean woman with a phenotypic female, primary amenorrhea, short stature, immature secondary sexual characteristics. Cytogenetic analysis including G- and Q-banding revealed 45,X/47,XYY mosaicism, and SRY gene was demonstrated by polymerase chain reaction(PCR). Prophylactic bilateral gonadectomy was performed because the presence of Y-chromosomal sequences in Turner stigmata may predispose this patient to gonadoblastoma formation.
Adult ; Amenorrhea ; Christianity ; Chromosome Disorders ; Cytogenetic Analysis ; Female ; Genes, sry ; Gonadoblastoma ; Humans ; Mosaicism ; Turner Syndrome*

PURPOSE: There are many reports on penile prosthesis implantation, but few on the natural history of prosthesis. We investigated the failure rate and causes for revision. MATERIALS AND METHODS: We reviewed 518 cases of penile prosthesis implantation performed by the same surgeon from December, 1983 to March, 2005 at the department of urology in Yongdong Severance Hospital. The mean follow up duration was 92 months, and average age was 49.1 years. A penile prosthesis survival is defined as a prosthesis that does not need revision due to infection, mechanical dysfunction or dissatisfaction, and a patient who is able to have intercourse. Analysis was performed by Kaplan-Meier formula and Log rank test. Significance was defined as p below 0.05. RESULTS: The survival rate of AMS 600 was significantly higher than that of the inflatable prosthesis. The survival failure rate was 22.2% in the inflatable prosthesis. Mechanical failure was the most common cause of survival failure in the inflatable prosthesis. Especially, the cylinder survival rate was lower than that of the other compartment of AMS (American medical system) 700 CXM . The AMS 700 CXM survival rate was lower in the neurogenic erectile dysfunction than the other causes of erectile dysfunction. The survival rate was reliable in the original and revised cylinder. CONCLUSIONS: The overall survival failure rate was 16.4%. Neurogenic erectile dysfunction was the most prevalent risk factor of survival failure in AMS 700 CXM . The survival rate must be considered in neurogenic patients who want to be implanted with the inflatable prosthesis. The infection rate was not increased in AMS 700 CXM revision cases. However, further research is warranted for the development of a failure- free prosthesis.
Erectile Dysfunction ; Follow-Up Studies* ; Humans ; Male ; Natural History ; Penile Implantation ; Penile Prosthesis* ; Prostheses and Implants ; Reoperation ; Risk Factors ; Survival Rate* ; Urology

No abstract available.
Child* ; Humans

No abstract available.
Radiation Oncology*

'Pubic atrichosis or hypotrichosis' is defined as the agenesis or the insufficient amount of pubic hair nevertheless the presence of other secondary sexual characteristics are normal. Such females may suffer from low self-esteem and psychological problem in addition to the aesthetic problem. In past, the treatment of atrichosis or hypotrichosis was done mainly with such medical therapeutics as hormonal drug therapy, but treatment tends toward the single hair transplantation in these days. Therefore, the importance of preoperative design have been emphasized to obtain more natural appearances and satisfactory results. We have studied for the pattern, hair line, distribution, density, direction, and angle to skin surface of pubic hair in 50 adult females. In pattern of pubic hair, the most common type was the horizontal type(64%) and the acuminate, the dispersed, the few type followed in order. But, the sagittal type was not observed. In the horizontal type, the upper border of line of pubic hair was located at 3/6-4/6(53%) or 4/6-5/6(47%) point of the distance from junctional point of both inguinal ligaments to the horizontal line passing both anterior superior iliac spines. In the acuminate type, most of them(75%) were located at 4/6-5/6 point of the distance from junctional point of both inguinal ligaments. In the horizontal and the acuminate type, the most lateral points of pubic hair were located, between right and left symmetrically, at 2/6-3/6 point of distance between both anterior superior iliac spines. The density of pubic hair at mons pubis, superior and lateral region of labium major didn't have no statistical difference and the central region had higher density than peripheral region. The direction of pubic hair was equal to Langer's line, angle of hair shaft to skin surface was about 60 degrees at central region and it was more acute angle at the peripheral region. In transplantation of pubic hair, it is important to know anatomical shape of pubic hair in normal adult female. If a surgeon considers the pattern, hair line, distribution, density, direction, and angle of hair shaft to skin in preoperative design and hair transplantation, one can obtain more natural-appearing and satisfactory results.
Adult* ; Drug Therapy ; Female* ; Hair* ; Humans ; Hypotrichosis ; Ligaments ; Skin ; Spine