Modern medical oncology has introduced various anti-cancer drugs since the World War I and II. Unlike for the solid tumors, hematological malignancies had been documented some limitations for curing it with chemotherapeutic agents only. In 1960, Dr. Nowell and Dr. Hungerford had discovered elongated chromosome (Philadelphia chromosome) which has documented as a product of translocation between 9th and 22nd chromosome in the patients with chronic myeloid leukemia. In 1970s, immunochemistry technique using monoclonal antibody has spread world widely and from 1990s, flow cytometry method has been available. In appreciation of these evolutions in basic science, the treatment strategy ofhematological malignancies has changed from the chemotherapeutic agents to targeted agents. Among the targeted agents, some drugs are newly developed and others are recreated as anti-cancer drugs after long-time of discard because of their toxicities or teratogenic effects. Nowadays, we are in the middle of flood of targeted agents, for example, tyrosinekinase inhibitors, epidermal growth factor receptor blockers, farnesyl transferase inhibitors, histone deacetylase inhibitors, and etc. In 21st century, the optimal treatment of hematological malignancies should follow a tailor- made strategy according to the patient and disease itself. In the present article, some representative agents will be introduced in accordance with target diseases.
Flow Cytometry ; Hematologic Neoplasms ; Histone Deacetylase Inhibitors ; Humans ; Immunochemistry ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Medical Oncology ; Receptor, Epidermal Growth Factor ; Transferases ; World War I

BACKGROUND: Epidural and intravenous (IV) administration of opioids are commonly used for postoperative pain management. However, studies that compare the epidural and IV routes of opiate administration show conflicting results. The purpose of this study was to determine the superior route of analgesics by comparing the effect of epidural fentanyl-bupivacaine with IV morphine using patient-controlled analgesia (PCA) system in the management of posterior thoracic surgery pain. METHODS: Sixty patients undergoing elective thoracic surgery were randomly assigned to receive either Epiural-PCA (Epi-PCA, n=30) or IV-PCA (n=30) when postoperative pain first increased to 40/100 mm (by visual analogue scale; VAS). Epi-PCA group received epidural bolus of 0.1% bupivacaine 10 ml containing fentanyl 100 microgram and then followed by Epi-PCA with 0.1% bupivacaine 100 ml containing fentanyl 800 microgram (basal infusion 2 ml/hr, PCA dose 1 ml, lock-out interval 30 min), IV-PCA group received repeated IV boluses of 3 mg of morphine until postoperative pain decreased to 40/100 mm and then followed by a IV-PCA with morphine (basal infusion 0.005 mg/kg/hr, PCA dose 0.02 mg/kg, lock-out interval 8 min). Analgesic efficacy, degree of patient satisfaction and pain, analgesics consumptions, forced vital capacity (FVC), forced expired volume in one second (FEV1) and side effects were evaluated. RESULTS: There were no significant differences in analgesic efficacy and degree of patient satisfaction and pain in both group. But the PHS were significantly lower (p<.05), and FEV1 higher (p<.05) in Epi-PCA group, signifying better analgesia during movement (cough and deep breaths). CONCLUSIONS: We concluded that an epidural PCA with mixture of fentanyl and bupivacaine administration is superior to that of intravenous PCA with morphine in the management of pain after thoracic surgery.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics ; Analgesics, Opioid ; Bupivacaine ; Fentanyl ; Humans ; Hydrogen-Ion Concentration ; Morphine* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Thoracic Surgery* ; Vital Capacity

Since introduction of venous flap in 1980, many experimental studies and clinical applications of various kinds of venous flaps were reported. Venous flap has the following advantages : (1) nonbulky and goo-quality of flap (2) long & large vascular pedicle (3) easy & rapid elevation of flap (4) no sacrifice of major arteries (5) a single operative field. But, we also have some disadvantages of difficult handling of the pliable veins and the tmcertainty of flap survival. For the better result we had to design the size of the flap larger than that of defect and increase the number of draining vein to reduce the postoperative edema of the flap. We have treated the defects of soft tissue of the hand using free arterialized venous flap from the flexor aspect of the forearm & had an excellent results.
Arteries ; Edema ; Forearm ; Hand* ; Veins ; Wounds and Injuries*

OBJECTIVES: Chronic pain is one of the most common experiences of humans and a typical psychophysiological disorder. The aim of this study was to measure the psychophysiological responses in chronic pain patients using a biofeedback system, and to compare them with the results from normal healthy subjects. METHODS: Forty two patients with chronic pain (17 males and 25 females, average age 44.67+/-11.10 years) and 42 normal healthy controls (17 males and 25 females, average age 45.17+/-10.46 years) participated in this study. Electromyography (EMG), skin conductance (SC), and skin temperature (ST) were recorded using biofeedback system during the 3 phases (baseline, stress, and recovery) of stress reactivity test, and average values of them were calculated. Difference of values between two groups in each corresponding phase was analyzed with independent t-test, and change of values across phases of stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). RESULTS: Compared to normal controls, chronic pain patients had higher value of EMG (baseline : 8.10+/-5.97 micronV vs 4.72+/-1.52 micronV, t=-3.56, p<0.01 ; stress : 11.25+/-6.89 micronV vs 8.49+/-4.78 micronV, t=-2.13, p<0.05 ; recovery : 7.12+/-3.77 micronV vs 4.78+/-1.59 micronV, t= -3.70, p<0.01) and SC (baseline : 1.06+/-1.0 micronS vs 0.42+/-0.29 micronS, t=-4.0. p<0.01 ; stress : 1.87+/-2.05 micronS vs 1.03+/-0.86 micronS, t=-2.47, p<0.05 ; recovery : 1.74+/-1.77 micronS vs 0.64+/-0.59 micronS, t=-3.8, p<0.01) in all the 3 phases. But, skin temperature comparison did not reveal significant differences in all the 3 phases between two groups. CONCLUSION: Psychophysiological responses of chronic pain patients in stress reactivity test were different from those of normal healthy controls. These results suggest that sympathetic nervous system is more activated in chronic pain patients.
Biofeedback, Psychology ; Chronic Pain ; Electromyography ; Female ; Humans ; Male ; Psychophysiologic Disorders ; Psychophysiology ; Skin ; Skin Temperature ; Sympathetic Nervous System

Chordoid glioma is an uncommon low-grade tumor of the third ventricle with histologic features of a chordoma and immunolabeling for glial fibrillary acid protein. We present a rare case of a patient with a chordoid glioma of the third ventricle and review the literature regarding this tumor's clinical, radiological and pathologic aspects.
Chordoma ; Glial Fibrillary Acidic Protein ; Glioma* ; Humans ; Third Ventricle*

Inguinoscrotal bladder hernia is relatively common in obese males over 50 years old, especially patients with benign prostate hyperplasia. Various imaging modalities are used for diagnosis of inguinoscrotal bladder hernia. In particular, ultrasonography has many benefits, including non-invasiveness, and the fact that it does not require exposure to radiation; however, no domestic cases of ultrasonographic diagnosis of inguinoscrotal bladder hernia have been reported. The authors report on a case of a 67-year-old male patient with right scrotal swelling diagnosed as inguinoscrotal bladder hernia by ultrasonography, including three-dimensional imaging. Findings on ultrasonography showed a sacular lesion in the scrotum, which was connected to the urinary bladder through the inguinal canal; additional findings on CT, PET, and cystography showed that the entire lesion had a dumbbell shape.
Hernia ; Hernia, Inguinal ; Humans ; Hyperplasia ; Imaging, Three-Dimensional ; Male ; Prostate ; Scrotum ; Urinary Bladder

No abstract available.
Genitalia* ; Poroma*

Duplex ultrasonography (USG) is an accepted method to assess noninvasively arterial inflow to the penis. Optimal pharmacological agents as well as timing of the scan and stimulation during the scan continue to be debated. Between August 1994 and May 1996, 24 normal males (control group) and 45 impotent patients (impotence group) underwent penile doppler sonography, and their records were reviewed. Scans were performed at 1, 3, 5, 10, 15, 20 and 30 minutes after intracavernous injection of PGE1 (10 pg) in all subjects. Any subject not having a full erection at 15 minutes performed private self-stimulation for at least 5 minutes before the 30 minute scan. If we define normal arterial inflow as a peak systolic velocity (PSV) of 30 cm. per second or greater in the best artery, 46% of control group and 55% of impotence group achieved this velocity until 5 minutes. One (4%) of control group and three (6%) of impotence group achieved maximum velocity at 1 or 3 minutes but continually PSV of 30 cm. per second or greater after 5 minutes, so any subject may not have had an incorrect diagnosis. When we calculated maximum velocity in the best artery in relation to percentage tumescence, maximum velocity were recorded most often at 10% tumescence (46% of control group and 51% of impotence group). If we define normal arterial inflow as PSV of 30 cm. per second or greater in best artery, the cumulative percentage of patients who achieved this velocity at 1, 3, 5, 10, 15, 20 and 30 minutes were 4, 34, 46, 88, 96, 96 and 100% in control group and 6, 28, 55, 90, 92, 94 and 96% in impotence group. In conclusion, we support delaying the initial scan until 5 minutes, performing the additional scans until 30 minutes and self-stimulation when necessary. We believe all efforts should be made to have studies performed in the setting of least anxiety to the patient.
Alprostadil* ; Anxiety ; Arteries ; Diagnosis ; Erectile Dysfunction ; Humans ; Male ; Penis ; Ultrasonography*

No abstract available.
Hemangioma, Cavernous*

PURPOSE: To investigate the efficacy of age, International Prostate Symptom Score(I-PSS), quality of life(QOL) score, various parameters obtained by transrectal ultrasonography(TRUS) as predictors of the onset of acute urinary retention in patients with benign prostatic hyperplasia(BPH). MATERIALS AND METHODS: From January 1996 to December 1997, 101 men(mean age 70years, range 52-92) with symptoms of BPH were enrolled in this study. Among them, 36 patients had suffered from acute urinary retention. TRUS was used to calculate the total prostate(TP) volume, the transitional zone(TZ) volume, the transitional zone index(TZ index=TZ volume/TP volume). To compare the usefulness of various indices, the area under the receiver-operator characteristic(ROC) curve was calculated for each index. RESULTS: There were significant differences in age, TP volume, TZ volume, TZ index between patients with and without acute urinary retention, but no significant differences in I-PSS and QOL score. In patients with acute urinary retention, the area under the ROC curve was 0.911 for the TZ index, 0.892 for the TZ volume, 0.769 for the TP volume and 0.660 for the age. CONCLUSIONS: The TZ index is a useful predictor of acute urinary retention in patients with BPH and may be a useful parameter for decision of surgical intervention.
Humans ; Prostate ; Prostatic Hyperplasia* ; ROC Curve ; Urinary Retention*