No abstract available.
Transplants

PURPOSE: Although adjuvant chemotherapy after resection of gastric cancer is a popular practice in Korea, there are still controversies about the effectiveness of the treatment. The fact that the relatively less effective drugs have been used and the rarity of large-scaled controlled studies may be partially responsible for the controversies. FP(5-FU, Cisplatin) combination is one of the most active regimen against advanced gastric cancer, consistently showing a response rate of 50~60%. We tried the FP chemotherapy as an adjuvant treatment for high-risk patients after curative resection of gastric cancer. MATERIALS AND METHODS: Between February 1992 and June 1996, 35 patients with completely resected high-risk gastric cancer(postoperative stage III or IV except thase with M1) received six courses of FP chemotherapy. Endpoints were toxicities of treatment, relapse free survival, and overall survival. RESULTS: With a median follow-up time of 17.1 months, Kaplan-Meier estimates of 2-year overall survival was 63.3% and relapse free survival estimates was 49%. There were no differences between stage III and IV patients in terms of overall survival or relapse free survival. Hematologic and non-hematologic toxicities were tolerable for most of the patients. CONCLUSION: Postoperative FP combination chemotherapy was tolerable for patients with high-risk(stage III and IV) gastric cancer. It is too early to determine the long term survival rates for this patients, but 2-year overall and relapse free survival were comparable to that of historical non-cisplatin containing regimens. Randomized phase III studies are warranted.
Chemotherapy, Adjuvant ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil* ; Follow-Up Studies ; Humans ; Korea ; Recurrence ; Stomach Neoplasms* ; Survival Rate

About 40% of patients with diabetes mellitus develops to diabetic nephropathy, and these patients show increment of glomerular filtration rate and renal volume at early phase. 99mTc-DMSA SPECT (single photon emission computed tomography) can measure a functional renal volume because 99mTc- DMSA it is taken up by the viable proximal tubular cells located in the renal cortex. To evaluate the renal volume in early diabetic nephropathy, we compared functional renal volume between diabetic patients and control, renal transplantation donor. 99mTc-DMSA was injected intravenously and SPECT was done after 2 hours in 15 diabetic patients, 18 renal transplantation donors, and 2 patients with end stage renal disease due to chronic glomerulonephritis. In diabetic patients with creatinine clearance more than 30ml/min and proteinuria, right and left renal volume were 247+/-22ml/BSA(m2), 256+/-37ml/BSA (m2), which were greater than those of diabetic patients with normal renal function and without proteinuria, or renal transplantation donors(P<0.05). In conclusion, we measured the functional renal volume by 99mTc-DMSA SPECT. Renal volume of diabetic patients with proteinuria were larger than the volume of control group or diabetic patients with normal renal function and without proteinuria. 99mTc-DMSA SPECT was thought to be useful test a for the measurement of functioning renal volume.
Creatinine ; Diabetes Mellitus* ; Diabetic Nephropathies ; Glomerular Filtration Rate ; Glomerulonephritis ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Proteinuria ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tissue Donors ; Tomography, Emission-Computed, Single-Photon*

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

In 1929, Bailey first described an intracranial sarcomatous tumor as a term of perithelial sarcoma. The term of microgliomatosis was introduced by Benedek and Juba, 1941. In recent period, malignant lymphoma was widely used rather than many other terms such as reticulum cell sarcoma, malignant reticulosis, etc. An autopsy case of microgliomatosis was presented. She was a 33-year-old woman with headache, ataxia, memory disturbance, defecation and micturition difficulty. She was relatively well until 3 months earlier before admission. She visited first St. Vincent Hospital due to memory disturbance, and a tumor was found in her left frontal lobe by CT scanning of her brain. She was transferred to Kang Nam Sacred Heart Hospital for further evaluation of the tumor mass. She ws given steroid therapy and somewhat improved in her symptoms. By follow-up CT scannings, the tumor could not be found. Her general conditions were progressively deteriorated and died on 85th day of her admission. Brain limited autopsy was performed. The external features of her brain were grossly unremarkable. Cut surfaces revealed multiple ill-defined grayish white masses, especially on deep white matter of left frontal lobe, left cingulate gyrus and white matter together with medial side of basal ganglia. The definite size was not able to be measured, but the largest one in left frontal lobe was about 2.5cm in diameter. Microscopically, the tumors have many characteristics of microgliomatosis, such as perivascular arrangement of tumor cells and concentric reticulin condensation. These microscopic features were seen not only in grossly visible masses but also in other areas, almost all cerebral hemispheres. Literature review on microgliomatosis and a case report were done.
Female ; Humans

Plasma cell cheilitis is a rare inflammatory disorder which shows a dense, band-like infiltrate of plasma cells in the upper dermis. Although the histological picture is shared with other diseases of the lips, plasma cell cheilitis is not associated with any known dermatoses. Some authors have shown the effectiveness of topical or intralesional corticosteroids; however, there have been many reports describing poor therapeutic response to topical steroids. We de-scribe two patients with plasma cell chielitis whose clinical condition responded rapidly to the intralesional injection of corticosteroids.
Adrenal Cortex Hormones* ; Cheilitis* ; Dermis ; Humans ; Injections, Intralesional* ; Lip ; Plasma Cells* ; Plasma* ; Skin Diseases ; Steroids

Tuberculous infections of the nasal cavity and paranasal sinuses are rare, as are descriptions of their radiologic findings, including those of CT. The authors recently encountered two cases of tuberculosis which developed in the paranasal sinus and the nasal cavity. Both were diagnosed by means of tissue biopsies taken from the mucosa of the maxillary sinus during endoscopic sinus surgery and Caldwell-Luc 's operation, respectively. In one case biopsy revealed caseous epitheloid granuloma, shown on histopathological examination to be consistent with tuberculosis. The other case involved a patient with pulmonary tuberculosis, in which nasal biopsy showed the presence of chronic granulomatous inflammation. In both cases CT scanning revealed a heterogeneous enhanced soft tissue mass in the paranasal sinus and nasal cavity, and associated findings consisting of surrounding bony thickening of the maxillary sinus and focal bony erosion or destruction were noted. CT findings of the latter showed prominent mass extension to the skull base, which was difficult to differentiate from the tumorous condition of the sinonasal cavity. After taking antituberculous medication for about two months, both patients showed substantial improvement.
Biopsy ; Cytomegalovirus* ; Granuloma ; Humans ; Inflammation ; Maxillary Sinus ; Mucous Membrane ; Nasal Cavity ; Paranasal Sinuses ; Pneumonia* ; Skull Base ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: This study is to evaluate the visual prognosis according to the ocular morbidity of the fellow eye in a national university hospital located in rural area. METHODS: We retrospectively reviewed the medical records of 390 eyes of 315 patients who had undergone cataract surgery. We assessed the change of postoperative visual acuity and the state of preoperative fellow eye. RESULTS: The age at cataract surgery was the highest in the sixties (29.2%) and seventies (27.7%). The patients older than 80 of age were 10.0%. Preoperative ocular co morbidities (23.3%) were diabetic retinopathy, glaucoma, corneal opacity, uveitis, etc. Preoperatively, 91.3% of all cases had a visual acuity of 0.4 or lower, but 3 months after surgery, 72.1% of all had 0.5 or better. At postoperative 3 months, 27.9% showed visual acuity of 0.4 or less and the ocular co morbidities were found in 67.0%. Preoperative visual acuity of less than 0.1 in the fellow eye was 10.2%. Preoperatively, 97.5% of these cases had a visual acuity of 0.4 or lower, but only 40% had 0.5 or better postoperatively. Preoperative and postoperative visual acuity were poor in patients whose preoperative visual acuity was less than 0.1 in the fellow eye. CONCLUSIONS: The age at cataract surgery was the highest in the sixties (29.2%) and seventies (27.7%). The patients older than 80 of age were 10.0%. Preoperative ocular co morbidities (23.3%) were diabetic retinopathy, glaucoma, corneal opacity, uveitis, etc. Preoperatively, 91.3% of all cases had a visual acuity of 0.4 or lower, but 3 months after surgery, 72.1% of all had 0.5 or better. At postoperative 3 months, 27.9% showed visual acuity of 0.4 or less and the ocular co morbidities were found in 67.0%. Preoperative visual acuity of less than 0.1 in the fellow eye was 10.2%. Preoperatively, 97.5% of these cases had a visual acuity of 0.4 or lower, but only 40% had 0.5 or better postoperatively. Preoperative and postoperative visual acuity were poor in patients whose preoperative visual acuity was less than 0.1 in the fellow eye.
Cataract Extraction* ; Cataract* ; Corneal Opacity ; Diabetic Retinopathy ; Glaucoma ; Humans ; Medical Records ; Prognosis* ; Retrospective Studies ; Uveitis ; Visual Acuity

PURPOSE: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children upper urinary tract. MATERIALS AND METHODS: We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. RESULTS: Six patients required pyeloplasty and eight were managed conservatively. All 6 patients requiring pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans at 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonobstructive patterns in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth., nonobstructive patterns of initial scan were coverted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. CONCLUSION: Tc-99m DTPA diuretic renal scan with standarized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan RESULTS in the neonatal period requires follow-up scan to monitor development of the obstructive pattern.
Child* ; Follow-Up Studies ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney Pelvis ; Parturition ; Pentetic Acid* ; Radioisotope Renography* ; Ultrasonography ; Urinary Tract*

No abstract available.
Femur* ; Hip*