No abstract available.
Antibodies, Anticardiolipin* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

PURPOSE: To characterize MRI findings of central nervous system(CNS) granulocytic sarcoma (chloroma) and to analyse the points which differentiate it from other CNS tumors. MATERIALS AND METHODS: We evaluated MRI in six patients with CNS granulocytic sarcoma proven by surgery or bone marrow biopsy (intracranical, one case and spine five cases). A 0.5T superconductive MR machine was used for diagnosis and, axial, coronal and sagittal T1- and T2-weighted spin echo images and Gd-DTPA enhanced T1-weighted images were obtained. We retrospectively analized the location, signal intensity, margin, contrast enhancement and homogeneity, and bony change around the tumor. RESULTS: MRI findings of CNS granulocytic sarcomas were as follows : one tumor was seen to be an extra-axial mass in the posterior fossa of the brain, four were epidural, and one was an epidural and presacral masses in the spine ; tumor magins were lobulated and three were smooth. On T1-weighted images, all tumors were of isoignal intensity; on T2-weighted images, four were of isosignal intersity and two were of high signal intensity. Contrast enhancement was inhomogeneous in five of six cases. Bony change around the tumor was seen in two cases. CONCLUSION: On T1-weighted images, CNS granulocytic sarcomas (chloromas) were of isosignal intensity, relative to brain parenchyma or spinal cord ; on T2-weighted images, they were of iso or high signal intensity, with relative contrast enhancement. These points could be useful in differentiating them from other CNS tumors.
Biopsy ; Bone Marrow ; Brain ; Central Nervous System* ; Diagnosis ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; Sarcoma, Myeloid* ; Spinal Cord ; Spine

PURPOSE: The clinical significance of preoperative serum levels of CEA and CA19-9, levels of CEA and CA19-9 in peritoneal washing fluid and free cancer cells in peritoneal washing fluid in gastric cancer patients were evaluated in this study. MATERIALS AND METHODS: Serum and peritoneal levels of CEA and CA19-9 and peritoneal washing cytology in 115 patients with gastric cancer were analyzed with respect to the prognostic factors using univariate and multivariate analysis. RESULTS: Positive rate of serum CEA and CA19-9 was 16.5%, 13.0%. And that of peritoneal washing CEA, CA19-9 and cytology was 15.7%, 7.8% and 9.6%. A univariate analysis showed that tumor markets in serum and peritoneal washing fluid and peritoneal washing cytology had significant correlations with the progression of the tumors, and patients with positive serum or peritoneal tumor markers had poorer survival after operation than did the patients with negative tumor markers. But in a multivariate analysis showed that only peritoneal CA19-9 was an independent risk factor. And combination of these five markers provided rnore predictable prognostic informations in a multivariate analysis. CONCLUSION: Combination of serum or peritoneal levels of CEA, CA19-9 and washing cytology appeared to be a useful marker for managing gastric cancer patients.
Humans ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Biomarkers, Tumor

BACKGROUND: Although regional lymph-ode metastasis from early gastric cancer (EGC) is rare, it is well known that EGC patients with lymph-ode metastasis constitute a high-isk group for recurrence. Thus, it is important to clarify the characteristics of patients having lymph-ode metastasis in order to ascertain the optimal therapy. METHODS: We analyzed the clinical aspects of 34 cases of node-ositive EGC and compared them to 197 cases of node-egative EGC. All patients were operated on from June 1994 to December 1997 at Ajou University Hospital. Also, by using immunohistochemical staining, we examined the expression of cathepsin D in the tumors to identify its significance in EGC. RESULTS: Lymph-ode involvement correlated significantly with deeper tumor invasion, severity of lymphatic invasion, and larger tumor size. Age, sex, histologic type, location, gross appearance, and serum carcinoembryonic antigen (CEA) level were unrelated to lymph-ode involvement. Positive cytoplasmic staining for cathepsin D was detected in 100% of the tumors, and strongly positive staining was found in 33.3%. Also, strong positivity was found more frequently in tumors with lymph-ode involvement. CONCLUSION: Prophylactic lymph-ode dissection may be necessary for patients with EGC with submucosal invasion, lymphatic invasion, and larger tumor size. Also, cathepsin D can be a useful tool for understanding the pathophysiology of early gastric cancer.
Carcinoembryonic Antigen ; Cathepsin D ; Cytoplasm ; Humans ; Neoplasm Metastasis* ; Recurrence ; Risk Factors* ; Stomach Neoplasms

Gastric emptying in patients after several upper gastrointestinal surgeries was studied using the acetaminophen method. The subjects consisted of 23 gastric cancer patients, 2 duodenal ulcer patients, 5 periampullary cancer patients and 4 normal subjects. As an indicator of the gastric emptying rate, the serum acetaminophen concentration was measured by fluorescence polarization immunoassay, in units of g/ml, at 0, 30, 60, 120, and 180 minutes after ingestion of a liquid meal with 1.5 g of acetaminophen. In the normal subjects, the acetaminophen concentrations were 0, 16.35+/-5.06, 18.71+/-5.58, 16.38+/-4.82, and 11.09+/-3.62 g/ml at time 0, 30, 60, 120, and 180 min, respectively. The concentration peaked at 60 min after ingestion of the test meal in the normal subjects. We observed significant delayed gastric emptying after pancreas preserving pancreaticoduodenectomy (PPPD) and a standard Whipple's operation in the early postoperative period. In all patients with a subtotal gastrectomy, a truncal vagotomy was done. However, in patients with a pancreaticoduodenectomy, the vagus nerves were preserved. The gastric emptying pattern was different between the patients with a subtotal gastrectomy and the patients with a pancreaticoduodenectomy, despite similar reconstructions of the gastroenterostomy (Billroth I or Billroth II type reconstruction). There was more rapid gastric emptying in patients with a truncal vagotomy and pyloroplasty than in the normal subjects. Hence, we speculate that the truncal vagotomy was the main cause of the different gastric emptying between the patients with a pancreaticoduodenectomy and the patients with a subtotal gastrectomy.
Acetaminophen* ; Duodenal Ulcer ; Eating ; Fluorescence Polarization Immunoassay ; Gastrectomy ; Gastric Emptying* ; Gastroenterostomy ; Humans ; Meals ; Pancreas ; Pancreaticoduodenectomy ; Postoperative Period ; Stomach Neoplasms ; Vagotomy, Truncal ; Vagus Nerve

Recently much interest has been expressed for the use of biological response modifiers and growth factor antagonists in the treatment or radiation and chemotherapeutic drug-refractory renal cell carcinoma. Herein antiproliferative effects of Suramin, human recombinanl tumor necrosis factor alpha (TNF-alpha) and human recombinant interferon alpha (IFN-alpha) as a single and in combination were studied in vito on human renal carcinoma cell line (Caki-1). Antiproliferative effect was evaluated by trypan blue dye exclusion assay after 3 days exposure to Suramin at 10, 30, 100, 300, 1,000 mcg/ ml. TNF-alpha at 1, 10, 50, 100, 500, 1,000 units/ml and IFN-alpha at 10, 100, 1,000. 10,000 units/ml concentration, respectively. In addition, effects of combined administration in tolerable peak plasma level or suramin (300 mcg/ml). TNF-alpha (500 units/ml) and IFN-alpha (1000 units/ml) were comparatively analyzed to those of single drug administration. The results were as follows: 1. Significant dose dependent antiproliferative effects were shown by Suramin at above 100 mcg/ml. TNF-alpha at above 500 units/ml and IFN-alpha at above 10 units/ml, respectively (p<0.05). 2. At peak plasma level, suramin, TNF-alpha and IFN-alpha showed less than 50% inhibition of proliferation. 3. On combined administration, suramin plus TNF-alpha (61.0%), Suramin plus IFN-alpha(71.7%) and TNF-alpha plus IFN-alpha (57.2%) induced significantly greater inhibition of proliferation (p<0.005). These results suggest that further in vivo study using combination of Suramin plus TNF-alpha Suramin plus IFN-alpha and TNF-alpha plus IFN-alpha is necessary and that these combination trials may become one of the treatment options for renal cell carcinoma.
Carcinoma, Renal Cell ; Cell Line* ; Humans* ; Immunologic Factors ; Interferon-alpha ; Necrosis* ; Plasma ; Suramin* ; Trypan Blue ; Tumor Necrosis Factor-alpha

In gastric cancer, the significance of lymphatic invasion as a prognostic factor is controversial. This study was performed to investigate the significance of lymphatic invasion as a prognostic factor in early results of gastric cancer after gastrectomy. We had been prospectively analyzed 362 consecutive patients resected from June 1994 to June 1996 in the Department of Surgery, Ajou University Hospital. Grading of the lymphatic invasion was determined by pathologists according to the JRSGC classification. The difference in the survival rate between the ly0 group and the ly1 group was statistically insignificant, so we only used ly2 and ly3 as the risk group. The prognostic values of lymphatic invasion as a single parameter for survival and early recurrence were determined by using univariate and multivariate analyses. Lymphatic invasion was observed in 90 (24.9%) of the 362 gastric cancer cases, and ly2 or ly3 were 66 (18.3%)cases. The incidence of ly> or =2 steadily increased with advancing TNM stage : stageI, 9/124 (7.3%); stageII, 5/50 (10.0%); stageIII, 24/111 (21.6%); stageIV, 28/78 (35.9%). The incidence of ly> or =2 was significantly correlated with other prognostic factors such as lymph node metastasis, the depth of the primary tumor, and the stage (p<0.05). The cummulative 2-year-survival rate determined by the Kaplan-Meirer method was 56.4% in patients with ly> or =2 and 90.9% in patients with ly<2. The log-rank test showed significant differences between the ly<2 group and the ly> or =2 group (p<0.05). Multivariate analysis of the survival function showed that the depth of the primary tumor had the highest prognostic value followed by lymphatic invasion (ly> or =2) as an independent prognostic factor (p=0.0008, Exp(B)=3.55). The cummulative recurrence free rate determined by the Kaplan-Meirer method was 78.7% in the ly> or =2 group and 90.54% in the ly<2 group. There was statistically significant difference (p<0.05). Univariate analysis for recurrence after radical resection showed that lymphatic invasion had a prognostic impact in the ly> or =2 group (p=0.0055). Therefore lymphatic invasion with ly2 or ly3 grade is an independent prognostic factor that is associated with poor prognosis for early results after gastrectomy. In grading of lymphatic invasion by gastric cancer, simple differentiation of whether lymphatic invasion is present or not was insignificant in the results of our study. In the future, the grade of lymphatic invasion in gastric cancer should be carefully classified by pathologists.
Classification ; Fibrinogen ; Gastrectomy ; Humans ; Incidence ; Lymph Nodes ; Lymphatic Vessels* ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Prospective Studies ; Recurrence ; Stomach Neoplasms* ; Survival Rate

PURPOSE: This study was aimed to identify whether total mesorectal excision (TME) is a valid prognostic factor for recurrence following curative surgery for rectal carcinoma. METHODS: For 110 high-risk rectal carcinoma patients, recurrence rate and patterns of recurrence were compared between patients undergoing TME and those with classical dissection. RESULTS: Both local recurrence and distant metastasis were significantly lower in TME group than those in classical dissection group. Time interval from operation to the initial recurrence was also significantly delayed in TME group. By comaparing with other prognostic variables, TME was found to be a significant prognostic factor for the recurrence. CONCLUSIONS: We think TME is an important prognostic factor for the recurrence following curative resection in rectal carcinoma.
Humans ; Neoplasm Metastasis ; Recurrence*

PURPOSE: To investigate the in vivo proton MRS features of various focal hepatic lesions and to distinguish these features according to the involved. MATERIALS AND METHODS: Twenty-five hepatic lesions [hepatocellular carcinoma (n=7), cholangiocarcinoma(n=3), metastatic tumor (n=9), hemangioma (n=3), hepatic abscess (n=2), lymphoma (n=1)] underwent proton MR spectroscopy using a 1.5T unit and a localized proton STEAM sequence, without respiratory interruption, The findings of this in-vivo sequence were then reviewed, with particular attention to the presence and location of dominant peaks. RESULTS: In-vivo proton MR spectra were successfully acquired in all cases. A dominant lipid peak appeared in the MR spectra of the hepatocellular carcinomas, metastatic tumors, hepatic abscesses, lymphoma, one hemangioma and one cholangiocarcinoma(88%) at 1.3ppm, but not in two cholangiocarcinomas and one hemangioma. The spectral peaks of other metabolites appeared very irregular and even different in the same disease. CONCLUSION: In focal hepatic lesions, the spectra obtained during in-vivo proton MRS were useful, and a lipid peak was most frequent and dominant. Among the various neoplasms there were, however, no specific MR spectral features, and nor did such features vary according to the specific pathologic entity.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Hemangioma ; Liver Abscess ; Lymphoma ; Magnetic Resonance Spectroscopy ; Protons* ; Steam

PURPOSE: To compare breath-hold gadolinium enhanced MR angiography(MRA) with digital subtraction angiography. MATERIALS AND METHODS: Ten patients underwent angiography and breath-hold gadolinium enhanced MRA;the latterperformed at 1.5T with 3D FSPGR after a bolus injection of gadopentetate dimeglumine(0.4mmol/kg) RESULTS: Sevenof ten pathologic conditions(70%) evaluated by both techniques had a similar appearance. The conditions examinedwere as follows : the artery feeding renal cell carcinoma(n=2): renal artery stenosis(n=2); pulmonaryAVM(n=2);abdominal aortic aneurysm(n=1); atheromatous plaque in the lower abdominal aorta(n=1);an enlargedbronchial artery(n=1); and an aberrant renal artery(n=1). For evaluating an anatomic relationship, a reconstructed3D image obtained by MRA is more advantageous. CONCLUSION: Breath hold contrast enhanced MRA is a potentiallyuseful noninvasive screening method for detecting vascular abnormality of the aorta and its branches.
Angiography ; Angiography, Digital Subtraction ; Aorta ; Arteries ; Gadolinium ; Humans ; Mass Screening ; Renal Artery