PURPOSE: Although the gold standard treatment for muscle invasive bladder cancer, radical cystectomy does not guarantee a high survival rate even without the natural bladder. We evaluated the survival rate and prognostic factors in patients with muscle invasive transitional cell carcinoma of the bladder, performed with the combined modality of transurethral resection and chemotherapy. MATERIALS AND METHODS: A total of 72 patients with clinical stage T2-T4 N0M0 bladder cancer diagnosed/treated/admitted between 1991 and 2002 were included in the study. They were treated with transurethral resection followed by 6 cycles of methotrexate, vinblastine, epirubicin, and cisplatin chemotherapy. The patients were evaluated with cystoscopy, urine cytology, abdominal-pelvic CT scan, whole body bone scan, and chest radiography. The prognostic factors such as age, the presence of hydronephrosis, and tumor stage, size, grade, and morphology were analyzed using log-rank test, while the 5-year overall survival rate was estimated using Kaplan-Meier method. RESULTS: The 5-year overall survival rate was 48%(stage T2, 83%; stage T3, 60%; stage T4, 0%). Age, T stage, tumor grade and tumor size were significant predictors for an increased probability of bladder preservation. Tumor morphology and the presence of hydronephrosis were not associated with survival rate in bladder preservation management. CONCLUSIONS: Our RESULTS showed that bladder preservation managed with transurethral resection and chemotherapy for muscle invasive bladder cancer demonstrates a good response rate in selected patients. Therefore, muscle invasive bladder cancer with T2-3 stage, low grade, small size(less than 4 cm), and solitary in patients less than 65 years old may be considered as a candidate for bladder preservation management.
Aged ; Carcinoma, Transitional Cell ; Cisplatin ; Cystectomy ; Cystoscopy ; Drug Therapy ; Epirubicin ; Humans ; Hydronephrosis ; Methotrexate ; Organ Preservation ; Radiography ; Survival Rate ; Thorax ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vinblastine

BACKGROUND: In contrast to the relationship between UV exposure and nonmelanoma skin cancers, molecular evidence for the involvement of UV radiation in melanocytic tumorigenesis is quite limited. Mitogen-activated protein kinase (MAPK) is an important molecule in transducing extracellular signals from the cell surface to the nucleus. The MAPK family includes ERK (extracellular signal- regulated protein kinase), JNK (stress-activated c-Jun N-terminal kinase), and p38 kinases. Various growth factors and cytokines, as well as other signals such as UV light are able to activate MAPK, resulting in a variety of cellular responses including proliferation, differentiation and apoptosis. OBJECTIVE: The purpose of our study was to investigate the effect of UV irradiation on the expression of MAPK in melanocytic nevi. METHOD: Melanocytic nevi from ten healthy volunteers were partially covered, irradiated with a defined UV dose, and excised after 1 week. healthy The irradiated and non-irradiated area were examined separateted by immunohistochemistry using p-ERK, p-JNK, and p-p38 monoclonal antibodies. RESULTS: In the non-irradiated area of melanocytic nevus, p-ERK, p-JNK, and p-p38 were undetectable in nevus cells. After irradiation, p-ERK expression was observed in nevus cells in 7 cases, and p-p38 was stained diffusely in the cytoplasm of nevus cells in 6 cases, but there was no immunoreactivity of p-JNK. CONCLUSION: We suggest that a single UV irradiation of melanocytic nevi can stimulate both p-ERK and cytoplasmic p-p38 expression, but not p-JNK.
Antibodies, Monoclonal ; Apoptosis ; Carcinogenesis ; Cytokines ; Cytoplasm ; Healthy Volunteers ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Nevus ; Nevus, Pigmented* ; Phosphotransferases ; Protein Kinases ; Skin Neoplasms ; Ultraviolet Rays

Congential bile duct cysts, the so called "choledochal cysts" occur at all levels of the biliary tree and may be of saccular, diverticular, or fusiform configuration. There are 6 types of choledochal cysts proposed by todani et al based on roentgenologic and operative findings. This disease is usually diagnosed at the childhood or early adult life and predilection for orientals. Clinical manifestations are usually jaundice, right upper quadrant abdominal pain and abdominal mass. Here we are reporting a case of choledochal cyst, type IV-A diagnosed by abdominal ultrasonogram. 99mTc-DISIDA hepatobiliary scan and endoscopic retrograde cholangiopancreatogram.
Abdominal Pain ; Adult ; Biliary Tract ; Choledochal Cyst* ; Humans ; Jaundice ; Technetium Tc 99m Disofenin ; Ultrasonography

The clinical review was done on 15 cases with the foreign body in the upper gastrointestinal tract who visited and underwent endoscopic removal of foreign body at department of lnternal Medicine of Chonnam University Hospital and Namkwang Hospital from June 1982 to August 1987. The results are as follows: 1) The age distribution varied from 32 yeara to 83 years of age, being most prevalent at 6th decade, The ratio between male and femaie was 4:1, more prevelant in male. 2} Among 15 eases, 8 cases were lodged in the esophagus and 7 cases in the stomach. The foreign bodies in the esophagus were meat, pressure-through package, food materials and bone in order of frequency and those in the stomach were bezoar, persimmon seed, brown seaweed, tooth brush and suture materials. 3) Cambined diseases of upper gastrointetinal passage disturbance were 1 case of esophageal cancer and 3 cases of gastric outlet obstruction caueed by duodenal ulcers and gastric malignancy. Other combined diseases were schizophrenia, chronic alcoholism, diabetes mellitus and gastrie polyp. 4) Complications by foreign body were retropharyngeal abscess and phlegmonous esophagitis with esophageal ulcer.
Age Distribution ; Alcoholism ; Bezoars ; Cellulitis ; Diabetes Mellitus ; Diospyros ; Duodenal Ulcer ; Esophageal Neoplasms ; Esophagitis ; Esophagus ; Foreign Bodies* ; Gastric Outlet Obstruction ; Humans ; Jeollanam-do ; Male ; Meat ; Polyps ; Retropharyngeal Abscess ; Schizophrenia ; Seaweed ; Stomach ; Sutures ; Tooth ; Ulcer ; Upper Gastrointestinal Tract*

The records of 34 patients with histologically proven pm-gastric cancer were reviewed from Chonnam University Hospital during the recent 6 year period, 1981, to 1986. The male outnumbered female in a ratio of 2.4:1.0. The peak incidence was 6th decade and mean age were 53.8 years in male, 48.7 years in female respectively. pm-gastric cancer was most often seen on the lesser curvature side, eapecially in the lower 1/3 of the stomach. Macroscopically, it can be divided into early-cancer-like type and Borrmann type. Early-cancer-like type was more frequent than Borrmann type. Early-cancer-like type IIc+III was most often seen with a rate of 20.6%, followed in the order of frequency by Borrman type II, early-cancer-like type IIc, IIa+IIc, and Ile+ IIa. The incidence of lymph node involvement was 26.4% and were related to the macroscopic types and/or histologic differentiation degrees. 5 cases out of 34 pm-gastric cancer expired during the follow up period, and their mean survival time was 32.8 months. The type of operation and the extent of resection were closely related to survival. Five year survival rate was 54.0%. These results shows the significance of the pm-gastrie cancer as a early simulating advanced cancer.
Female ; Follow-Up Studies ; Humans ; Incidence ; Jeollanam-do ; Lymph Nodes ; Male ; Stomach ; Stomach Neoplasms* ; Survival Rate

OBJECTIVES: Recently, the studies for oncogene and tumor marker have been actively performed to investigate the carcinogenesis of gastric carcinoma, but it is not clearly understood. We investigated the expression of tumor suppressor gene and proliferation activity in gastric carcinoma. METHODS: Immunohistochemistry for p53 protein (wild and mutant type), retinoblastoma protein(wild type), and PCNA was performed in 131 cases of formalin fixed paraffin embedded tissue sections of gastric carcinoma. We compared that expression with tissue invasiveness, lymph node metastasis, staging and, Lauren classification, and that expression with each other. RESULTS: 1) The positive ratio of p53 protein, Rb protein, also PCNA in gastric carcinoma was 64.9%, 98.5%, 99.2%, 2) The expression of p53 protein was related to invasiveness, lymph node metastasis, staging, and Lauren classification(p<0.05). 3) The positive reaction for Rb gene was identified in tumor cells as well as proliferating cells. 4) There was a close relationship between Rb gene expression and PCNA in gastric carcinoma (p<0.05). CONCLUSION: Theses results suggested that the expression of p53 gene is related to invasiveness, lymph node metastasis, staging and Lauren classification in gastric carcinoma. Expression of retinoblastoma gene is a closely related to proliferating activity.
Carcinogenesis ; Classification ; Dronabinol* ; Formaldehyde ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Paraffin ; Proliferating Cell Nuclear Antigen* ; Retinoblastoma ; Retinoblastoma Protein

Paratesticular rhabdomyosarcoma is a rare tumor arising from the mesenchymal tissues of the spermatic cord, epididymis, testis, and testicular tunics, and represents 7% of all rhabdomyosarcomas. This tumor occurs predominantly in children and adolescent, but rarely in adult. We report a case of a paratesticular embryonal rhabdomyosarcoma occurring in a 27-year-old man.
Adolescent ; Adult* ; Child ; Epididymis ; Humans ; Male ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Embryonal ; Spermatic Cord ; Testis

When hydrocephalus develops, excessive cerebrospinal fluid accumulation usually occurs within the ventricular system, leading to a ventriculomegaly caused by increased intracranial pressure. Shunt malfunction, a common complication after a shunt operation, usually occurs, together with recurring ventricular dilatation. The authors report a case of shunt malfunction which manifested as a porencephalic cyst along the proximal catheter. The cyst subsided after the replacement of the shunt system, and this led to the patient's clinical improvement. We postulate that although the region around a catheter is an unusual site for cerebrospinal fluid collection, this finding should be considered as a shunt obstruction. The possible mechanism of reversible porencephaly is discussed and the literature is briefly reviewed.
Catheters ; Cerebrospinal Fluid ; Dilatation ; Hydrocephalus ; Intracranial Pressure

The objectives of this study were to evaluate the effect of surface roughness on the surface color and translucency of the composite resins. Two composite resins (Esthet-X, Dentsply, Milford, USA and Charisma, Kulzer, Domagen, Germany) were used to investigate the surface color. Charisma was used to investigate the translucency. 40 disc samples (diameter: 8 mm, thickness: 5 mm) were made by each product to measure the surface color. Polymerized each sample's one side was treated by Sof-Lex finishing and polishing system (Group C, M, F, SF). 40 disc samples (diameter: 6 mm, thickness: 1 mm) were prepared to measure the opacity. 1 mm samples were ground one side with #600, #1000, #1500 and #2000 sandpapers. CIE L*a*b* values of each 5 mm thickness samples, and XYZ values of 1 mm thickness samples on the white and black background were measured with spectrophotometer (Spectrolino, GretagMacbeth, Regensdorf, Switzerland). Mean surface roughness (Ra) of all samples before and after surface treatment was measured using the Surface Roughness Tester SJ-301 (Mytutoyo, Tokyo, Japan). Regardless of type and shade of the composite resin, L* values measured in group C were higher than others (p < 0.05), and L* value decreased as the Ra value decreased except B3 shade of Esthet-X. But there were no significant difference in a* values among groups. In control group and SF, highest b* values were measured (p < 0.05), except B1 shade of Esthet-X. Contrast ratio decreased as the Ra value decreased (p < 0.05). With the above results, difference of surface roughness has influence on surface color and translucency of dental composite resins.
Composite Resins* ; Polymers

Methyl bromide is a commonly used fumigant to disinfect soil, grains, and warehouses. The accumulation of danger-ous concentrations can produce various neurotoxic effects in humans. A 45-year-old man, who had worked in the fumi-gation business, presented with polyneuropathy, optic neuropathy, and cerebellar sign, and serially sampled blood, urine and cerebrospinal fluid showed significant elevation of methyl bromide concentration. Regular education to workers and strict adherence to the safety precautions are needed to avoid the risk of toxicity associated with methyl bromide fumigation.
Edible Grain ; Cerebellar Ataxia* ; Cerebrospinal Fluid ; Commerce ; Education ; Fumigation ; Humans ; Middle Aged ; Optic Nerve Diseases* ; Poisoning* ; Polyneuropathies* ; Soil