PURPOSE: The purpose of this retrospective study was to identify factors predictive of survival in rectal cancer patients who received surgery with curative intent after preoperative chemoradiotherapy (CRT). MATERIALS AND METHODS: Between July 1996 and June 2010, 104 patients underwent surgery for rectal cancer after preoperative CRT. The median dose of radiotherapy was 50.4 Gy (range, 43.2 to 54.4 Gy) for 6 weeks. Chemotherapy was a bolus injection of 5-fluorouracil and leucovorin for the first and last week of radiotherapy (n=84, 77.1%) or capecitabine administered daily during radiotherapy (n=17, 16.3%). Low anterior resection (n=86, 82.7%) or abdominoperineal resection (n=18, 17.3%) was performed at a median 47 days from the end of radiotherapy, and four cycles of adjuvant chemotherapy was administered. The serum carcinoembryonic antigen (CEA) level was checked at initial diagnosis and just before surgery. RESULTS: After a median follow-up of 48 months (range, 9 to 174 months), 5-year disease free survival (DFS) was 74.5% and 5-year overall survival (OS) was 86.4%. Down staging of T diagnoses occurred in 32 patients (30.8%) and of N diagnoses in 40 patients (38.5%). The CEA change from initial diagnosis to pre-surgery (high-high vs. high-normal vs. normal-normal) was a statistically significant prognostic factor for DFS (p=0.012), OS (p=0.002), and distant metastasis free survival (p=0.018) in a multivariate analysis. CONCLUSION: Patients who achieve normal CEA level by the time of surgery have a more favorable outcome than those who retain a high CEA level after preoperative CRT. The normalization of CEA levels can provide important information about the prognosis in rectal cancer treatment.
Carcinoembryonic Antigen ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Deoxycytidine ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Leucovorin ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Retrospective Studies ; Capecitabine

Over the past 30 years, there has been an increase in the incidence of multifetal pregna-ncies, primarily because of the introduction of ovarian stimulants for ovulation induction and assisted reproductive technology ( ART ) in infertile patients. It is well established that multifetal pregnancies are associated with an increased frequency of the maternal complications and gre-ater perinatal morbidity and mortyality. The adverse outcome of multifetal pregnancies is dire-ctly proportional to the number of fetuses, primarily as an consequence of prterm delivery. Re-duction in the number of fetuses in multifetal pregnancies has been proposed as a way to impr-ove the perinatal outcome in this situation. Therefore, selective fetal reduction ( SFR ) is sugges-ted as a therapeutic option for continuation of pregnancy with fetuses mature enough to survi-ve. In this paper, we report our infertility clinic experiences with 6 patients who carried mult- ifetal pregnancies including 1 quintuplet, 1 quadruplet, and 4 triplets. from January, 1991 to May, 1996, transabdominal SFR was accomplished by fetal intrathoracic KCl injection at 9~10 weeks of gestation. After the prcedure, 4 patients remained as twin pregnancies, and 2 patients as single pregnancy. There have been 3 sets of twin deliveries and the 2 sets of single delivery. One case was aborted. Two patients were delivered after 37 weeks of gestation, 2 patients were at 35 weeks, and 1 patient at 24 weeks. All babies have been healthy after birth in patients after 35 weeks gestation. There was no fetal anomaly related to the procedure in the 6 cases. We concluded that transabdominal SFR is a rather safe and useful procedure that may improve the outcome of multifetal pregnancies.
Fetus ; Humans ; Incidence ; Infertility ; Ovulation Induction ; Parturition ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted ; Triplets ; Twins

Midtrimester genetic amniocentesis has been a gold standard for prenatal diagnosis in antenatal care since last 25 years. After the triple serum marker test was introduced as a prenatal screening method for Down syndrome, the frequency of genetic amniocentesis was increased. OBJECTIVE: To determine the complication, risk of amniocentesis and detection rate of chromosomal abnormality. MATERIAL AND METHODS: A retrospective clinical analysis of 1,064 midtrimester genetic amnicentesis in IL Sin Christian Hospital antenatal clinic from Jan 1995 to Dec 1997. Chi square test was used for the statistical analysis and p value < 0.05 was considered significant. RESULTS: Amnicentesis were significantly increased in the age of 35-39 yrs and 40yrs over. And also the incidence of chromosomal abnormality was higher than younger age group. The indications of amnicentesis were screen positive of triple marker test(43%), advanced maternal age(20.8%), abnormal beta-hCG level, past history of chromosome abnormality or malformed baby and abnormal alpha-FP level in order. Total number of chromosomal abnormalities was 30 and the incidence of chromosomal abnormalities was 2.8%(30/1,064). The complications were developed in 13 cases and fetal loss rate was 0.78%(9/1,064). CONCLUSION: The detection rate of chromosomal abnormality in midtrimester amnicentesis for prenatal diagnosis was high and relatively safe procedure but, we should be attention to more careful manipulation.
Amniocentesis ; Biomarkers ; Chromosome Aberrations ; Down Syndrome ; Female ; Humans ; Incidence ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Retrospective Studies

The analgesic effect of epidural pentazocine for the postoperative pain relief was studied. In our previous report, we used the pentazocine diluted to normal saline, however in this study, pentazocine was diluted with distilled water and made to 10ml mixture. Fourty patients were divided into four groups (n=10) as follows: Group I: control, distilled water of 10 ml, Group II: pentazocine 0.2 mg/kg, Group III: pentazocine 0. 3mg/kg, Group IV: pentazocine 0.4mg/kg, all pentazocine groups were diluted to 10ml of distilled water. We have carried out the study to see the effects on the time of peak analgesia, the duration of analgesia, the degree of analgesia and the side effects. The results are as follows: 1) Seven cases (70%) in the control group showed rapid but short duration of analgesia. 2) The pentazocine 0.3 and 0.4 mg/kg groups were significantly different from the control group (p< 0.05). 3) In the pentazocine 0.3 and 0.4 mg/kg groups, the time of peak analgesia occured 8-9 minutes, the duration of analgesia was 10 hours and the degree of analgesia showed moderate to good degree. 4) Nine cases (90%) in the control group complained of back pain during epidural injection and 16 cases (53%) in the pentazocine group conplained of drowsiness.
Analgesia ; Back Pain ; Humans ; Injections, Epidural ; Pain, Postoperative* ; Pentazocine* ; Sleep Stages ; Water

Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Myasthenia Gravis* ; Neck ; Thymectomy* ; Thymus Hyperplasia ; Thyroid Gland ; Thyroidectomy*

There exists a need to develop strategies that promote neovascularization in virtually all tissue engineering and regenerative medicine efforts. While research typically focuses on understanding and exploiting the role of angiogenic factors and vascular cells on new blood vessel formation, the activity of the immune system is being recognized to impact vascular formation and adaptation. This review will provide both an overview of the relationship of angiogenesis and the immune system, and how biomaterials may be designed to promote favorable angiogenesis by interaction between these 2 systems to promote effective vascularization.
Angiogenesis Inducing Agents ; Biocompatible Materials ; Blood Vessels ; Immune System ; Inflammation* ; Regenerative Medicine ; Tissue Engineering

Coagulants have been used for a long time to promote the hemostasis during operation. We have carried out the study to see the effect of the thromboplastin preparation. Thrombokinase, on the coagulation mechanism, thrombin time, partial thromboplastin time, Ca++, and operation time and amount of bleeding in the twenty patients undergoing laminectomy or femur fracture operation. The patients were divided into two groups, in the control group(n=10), disllied water 20ml, and in the Thrombokinase group(n=10), 20ml of Thrombokinase(4 amles) was administered intravenously during 5 minutes. The results were as follows: 1) Prothrombin time and partial thromboplastin time were significantly prolonged in the control group compared to the Thrombokinase group(p<0.05). 2) In the Thrombokinase group, the duration of operation was shorter and the amount of blood loss was less than in the control group, but there was no significant statistical difference(p>0.05).3) There was no change in either blood pressure or pulse rate and also no side reaction during or after the Thromobkinase injection.
Blood Coagulation* ; Blood Pressure ; Coagulants ; Factor Xa* ; Femur ; Heart Rate ; Hemorrhage ; Hemostasis ; Humans ; Laminectomy ; Partial Thromboplastin Time ; Prothrombin Time ; Thrombin Time ; Thromboplastin* ; Water

Gastric adenocarcinoma in childhood is an extremely rare disease with poor prognosis. We experienced a case in which a 14 year old female patient who was admitted with complaints of abdominal pain, indigestion and obstipation. Her physical examination revealed positive Blumer's rectal shelf, positive ascitic fluid cytology and typical radiologic and endoscopic findings suggesting gatric adenocarcinoma. She showed symptomatic improvement with combination chemotherapy. Thus we report a case of gastric adenocarcinoma with a brief review of literatures.
Abdominal Pain ; Adenocarcinoma* ; Adolescent ; Ascitic Fluid ; Drug Therapy, Combination ; Dyspepsia ; Female ; Humans ; Physical Examination ; Prognosis ; Rare Diseases

This study was carried out to evaluate the effects of stevia (Stevia rebaudiana Bertoni) leaf powder on soybean milk quality. Soybean milk was prepared with the addition of 0.1 g (SP1), 0.2 g (SP2), 0.3 g (SP3), 0.4 g (SP4) of stevia leaf powder. The pH of soybean milk added with stevia leaf powders ranged from 7.90 to 7.98, whereas that of control was 7.88. The viscosity of soybean milk added with stevia leaf powder was 11.13~12.71 cp while that of control was 11.09 cp. Soymilk added with stevia leaf powder yielded values of Hunter L (59.40~64.94), a (-7.63~-6.45), and b (18.71~19.63), whereas that of control were 67.45, -4.74 and 20.13, respectively. There was decrease upon addition of stevia leaf powder. During storage, the pH, viscosity, L, and b values were decreased continuously. According to sensory evaluation, taste, and flavor of SP3 were better than the other groups. Quality characteristics between control and SP3 showed no significant differences. Therefore, this study showed the possibility of substituting 0.3 g of stevia leaf powder instead of sugar for creating a standard quality soybean milk with low calories. Upon the results of this study, it may be assumed that there are consequences positive responses to health-oriented consumers when using stevia leaf powder.
Hydrogen-Ion Concentration ; Milk* ; Powders ; Soybeans* ; Stevia* ; Viscosity

IgE-dependent activation of mast cells and basophils through the high-affinity IgE receptor (FcepsilonRI) is involved in the pathogenesis of allergen-induced immune responsiveness in atopic diseases like atopic dermatitis (AD). We sought to determine FcepsilonRI gene polymorphisms are associated with AD in Korean patients, and analyzed the relevance of FcepsilonRI gene polymorphisms and serum IgE levels. We conducted a case-control association analysis (175 patients and 56 controls) of Korean subjects. Genotyping was performed using the TaqMan fluorogenic 5' nuclease assay, and serum levels of IgE were measured using a fluorescence enzyme immunoassay. We found that there were no significant relationships between FcepsilonRI and AD, although there were trends towards an association between the 66T>C (rs2251746) polymorphism and total serum IgE levels in the Korean AD patients. In conclusion, while the 66T>C (rs2251746) of the FcepsilonRIalpha polymorphism may be linked to AD and higher serum IgE levels, polymorphisms in the FcepsilonRIbeta gene did not confer susceptibility to AD in our patient sample.
Adolescent ; Alleles ; Asian Continental Ancestry Group/*genetics ; Case-Control Studies ; Child ; Child, Preschool ; Dermatitis, Atopic/*genetics/immunology ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Immunoglobulin E/*blood ; Male ; *Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Receptors, IgE/*genetics ; Republic of Korea