The development of multidrug-resistant tumor cell population is a major problem in the chemotherapy of human cancer. These cells are often cross resistant to unrelated drugs and the precise mechanisms of multidrug resistant phenotype of tumor cells has not been fully elucidated. Cisplatin resistant tumor cell (SNU-1/Cis₅) was induced from human stomach cancer cell line (SNU-1) in vitro. Growth profiles of survival cells were observed during 5 days by thiazolyl blue (MTT) assay. To investigate the cross resistance of various anticancer drugs in SNU-1 and SNU-1/Cis5, We compared the value of IC₅₀-drug concentration at 50% survival of control and gained relative resistances (RR). The RR for SNC-1/Cis₅ were as follows; vinblastine, > 43.0; epirubicin, 22.9; dactinomycin, 16.0; etoposide, 15.0; vincristine, 9.2; adriamycin, 5.7; aclarubicin, 5.3. But 5-fluorouracil, methotrexate, daunorubicin have not cross resistance with cisplatin. Resistant inhibition values of 10µM verapamil for SNU-1/Cis₅ were as follows; vincristine, 13.1; epirubicin, 10.0; etoposide, 6.3; vinblastine, 4.4; dactinomycin, 3.6; daunorubicin, 2.4. Membrane proteins of 51,400 and 81,300 daltons were identified by radioiodination with SDS-PAGE, which might represented the drug resistance.
Aclarubicin ; Cell Line ; Cisplatin* ; Dactinomycin ; Daunorubicin ; Doxorubicin ; Drug Resistance ; Drug Resistance, Multiple* ; Drug Therapy ; Electrophoresis, Polyacrylamide Gel ; Epirubicin ; Etoposide ; Fluorouracil ; Humans* ; In Vitro Techniques ; Membrane Proteins ; Methotrexate ; P-Glycoprotein ; Phenotype ; Stomach Neoplasms* ; Stomach* ; Verapamil* ; Vinblastine ; Vincristine

Intramural implantation is among the rarest forms of ectopic pregnancy.Since the first description by Perli, 21 cases were reported in worldwide literatures.The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament.The previous history of uterine injury or adenomyosis is known as possible etiology of intramural implantation. Because the early diagnosis is very difficult, most cases is found after onset of complication such as a uterine rupture or hemoperitoneum. We have recently experienced a case of intramural pregnancy diagnosed and treated by laparoscopy in a 9 weeks gestation nulliparous woman without previous history of uterine injury or disease, and report with a brief review of literatures.
Adenomyosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertilization ; Hemoperitoneum ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Uterine Rupture ; Round Ligaments

Multidrug resistance(MDR) phenotype is frequently observed in animal and human cancer cell lines selected for in vitro resistance to a single chemotherapeutic agent. It is characterized by the diminished j drug accumulation and is related to the drug efflux mechanism in resistant cells. In the present study, adriamycin resistant cells(L1210-AdR6 : 10-6M adriamycin, -AdR5: 10-5M) and vincristine resistant cells (L1210-VcR7: 10-7M vincristine, -VcR6: 10-6M) were produced from mouse lymphoblastic leukemia cell line L1210. Growth profiles of survived cells were observed for 5 days with MTT(thiazolyl blue) assay and resistance was compared with IWdrug concentration of 50% survival reduction in absorbance). Resisrant cells proliferated more slowly than sensitive cell. Doubling times were 29.7hr in L1210, 68.7hr in L1210-AdR5 and 58.2hr in -VcR6. MDRs expressed as resistance factor were as follows, L1210-AdR5 was 76.4 times for vincristine, L1210-VcR6 was 96.4 times for adriamycin. The cell membrane proteins with three different M.W. were recognized to be related resistance, 220, 158, and 88 kd in L1210-AdR5, 158, 140 and 88 kd in L1210-VcR6 by SDS-PAG electrophoresis. Cell surface membrane proteins were identified by radio-iodination and autoradiogram. their molecular! weights were 158, 72.8. and 42.4 Kd in L1210-VcR6.
Animals ; Cell Line ; Doxorubicin ; Drug Resistance* ; Electrophoresis ; Humans ; Membrane Proteins* ; Membranes* ; Mice* ; Phenotype ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Vincristine ; Weights and Measures

Cyclopia is rare congenital craniofacial anomaly, in which the eyes are fused together and located in a single orbit. It is consistently associated with severe holoprosencephaly, which is the failure of cleavage of the prosencephalon with a deficit in the midline facial development. chromosomal study revealed 47, X( ), +13 (Patau syndrome).
Holoprosencephaly ; Orbit ; Prosencephalon ; Trisomy*

BACKGROUND: Although blood is very important therapeutic agent in bleeding patients, it may transmit disease, cause an adverse reaction in the recipients, raise the cost of patient care. Since the misuse and inappropriate use of blood is common, we are to review the transfusion practice in our hospital and to reduce unnecessary blood transfusion. METHODS: During a 10-month period from June 1994 through March 1995, 347 patients received blood transfusion during the operation. Among them, we reviewed retrospectively the charts of 211 patients available. We analyzed the transfusion pattern of 47 patients whose postoperative hematocrit exceeded 32 percent to determine the magnitude and cause of unnecessary blood transfusion. RESULTS: The patients of postoperative hematocrit over 32 percent were 119 patients out of 211 patients(56.4%). The main cause of overtransfusion was no reevaluation of the patients hematocrit after the prior unit was given. CONCLUSIONS: Guidelines for transfusing patients must be constructed based on acceptable intraoperative hematocrits. Unnecessary transfusion can be decreased when the transfusion done according to the guidelines, insisting on each reevaluation of the hematocrit prior to the administration of unit of blood.
Blood Transfusion ; Hematocrit ; Hemorrhage ; Humans ; Patient Care ; Retrospective Studies

BACKGROUND: Rocuronium(ORG 9426) is a new steroid nondepolarizing neuromuscular blocking drug with fast onset and intermittent duration of action. Its effects on vital signs are controversial. We studied onset, clinical duration, recovery index of rocuronium and its effects on blood pressures and heart rates. METHODS: We selected thirty healthy children who would receive inguinal herniorrhaphy and allocated them to 2 groups(control and rocuronium group). Without premedication or with oral medication of PocralTM (20 mg/kg), they administrated propofol(2.5 mg/kg) intravenous for loss of consciousness and we maintained anesthetic states with 20 mg/kg/hr of propofol. After 2 minutes, we checked BP(SBP/ DBP/MBP) and HR at every minutes and checked TOF, T1 height compare to control, T4 to T1 at every twenty seconds. We injected intravenously rocuronium(0.8 mg/kg, 2ED95) to rocuronium group and nothing to control group. We determined intubation time(from injection to 90% depression of maximal block), onset time(to maximal depression or T1=0), clinical duration(to T1=25%) and recovery index(from T1=25% to T1=75%). RESULTS: In children, intubation time was 93.8sec, onset time was 146.2sec, clinical duration was 34.6min, recovery index was 15.4min. SBP, DBP, MBP and HR were not changed independent of injection of rocuronium. CONCLUSION: Rocuronium is a muscle relaxant with rapid onset and intermittent clinical duration in children. It does not affect BP and HR.
Anesthesia* ; Anesthetics ; Blood Pressure* ; Child* ; Depression ; Heart Rate* ; Heart* ; Herniorrhaphy ; Humans ; Intubation ; Neuromuscular Blockade ; Premedication ; Propofol* ; Unconsciousness ; Vital Signs

PURPOSE: Most malignant peritoneal or pleural effusions caused by advanced malignancy are unresponsive to systemic chemotherapy except for chemotherapy sensitive tumors, and they are equally ineffective to regional therapy or radiotherapy. Thus, for the purpose of palliating the symptoms related to malignant effusion and to reduce fluid reaccumulations, we evaluated the therapeutic feasibility and efficacy of intracavitary ' Ho-CHICO (chito- san complex) instillation for intractable malignant effusions. MATERIALS AND METHODS: Thirty one patients with cytologically or pathologically proven malignant effusions underwent intracavitary 166Ho-CHICO therapy from May 1996 to March 1998 at Ajou University Hospital. The subjective and objective responses were evaluated 4 weeks after the treatment, including the changes of symptoms, weight, abdominal girth, doses of diuretics, frequencies and amounts of repeat aspirations for fluid reaccumulations, and imaging studies of chest radiograph and ultrasounds. RESULTS: The response rates treated with Ho-CHICO were 50% in patients with peritoneal effusion and 46% in patients with pleural effusion (overall 49%). The response rates between 166Ho-CHICO doses of 50-80 mCi and 90-100 mCi were similar (50% vs 47%). Response rate of 70% was noted in patients with even distribution of radioisotope on the post-therapy scan, but, the response rate was lower in cases with focal (44%) and uneven (29%) distribution pattern. There was no difference in response by the effusion sites. All patients tolerated intracavitary 166Ho-CHICO instillation well, although the majority of patients experienced Grade I/II side effects such as pain, fever, weakness and dyspnea. But, no serious complications of Grade lII or IV degree were observed with 166Ho-CHICO therapy. CONCLUSION: Intracavitary 166Ho-CHICO instillation was clinically efficacious in controlling malignant effusions without a significant toxicity seen with conventional sclerotic therapy. The therapeutic modality appeared to offer similar benefits obtained with the conventional intracavitary therapy.
Ascitic Fluid ; Aspirations (Psychology) ; Chitosan* ; Diuretics ; Drug Therapy ; Dyspnea ; Fever ; Holmium* ; Humans ; Pleural Effusion* ; Radiography, Thoracic ; Radiotherapy ; Ultrasonography

Extraskeletal Ewing's sarcomas (EES) are rare. Recently, Ewing's sarcoma of the bone, primitive neuroectodermal tumor (PNET), Askin tumor and EES have been included into the family of Ewing's tumors, due to the overlapping features relating to their clinico-pathological and cytogenetic appearance. We experienced a case of an EES arising from the duodenum in a 14-year-old girl who presented with hematemesis and epigastric discomfort. A duodenal biopsy specimen revealed the infiltration of small round cells and rich vasculatures, with immunohistochemical finding of MIC-2 (CD99) (+), vimentin (+), CD56 (NCAM) (+), LCA (-), T-cell (-), B-cell (-), CD43 (-) and CD68 (-). She was treated with several cycles of multiagent chemotherapy, and achieved an initial partial response, but rapid progression of tumor followed, so she was treated with surgical excision. This is the first case report of an EES arising from the duodenum in the literature.
Adolescent ; B-Lymphocytes ; Biopsy ; Cytogenetics ; Drug Therapy ; Duodenum* ; Female ; Hematemesis ; Humans ; Neuroectodermal Tumors, Primitive ; Sarcoma ; Sarcoma, Ewing* ; T-Lymphocytes ; Vimentin

PURPOSE: The purpose of our study was to evaluate the outcome of intensified induction therapy using the Vanderbilt regimen in patients with a poor prognosis non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: We retrospectively analyzed the results of two pilot studies, which enrolled the patients aged 60 years or less, with a previously untreated NHL of intermediate grade on the Working formulation, having 2 or 3 adverse prognostic factors on the age- adjusted International Prognostic Index. Patients received an intensified induction, with the regimen described by the Vanderbilt group. RESULTS: Thirty-five patients were analyzed. After induction, 29 patients (83%) achieved more than partial response (PR): 22 (63%) complete response (CR) and 7 (20%) PR. Three of the PRs were subsequently converted to CR following consolidation therapy. The overall CR rate, following the completion of treatment, was 71%. The 3-year overall survival (OS) rate of all patients was 53%. In the univariate analysis, age (50 years) was the only factor affecting the OS. The 3-year disease-free survival (DFS) rate of patients with CR was 68%. In the univariate analysis, age and bone marrow involvement were the factors affecting the DFS. Two patients died from the treatment-related toxicity of the induction therapy: one due to sepsis and the other due to congestive heart failure. CONCLUSION: Although the CR rate was relatively high, the OS or DFS of patients with a poor prognosis NHL, who had received the intensified induction using the Vanderbilt regimen, were no different from those that had received the conventional chemotherapy, as reported by the International Prognostic Index Project. However, the OS or DFS in the young patient groups were encouraging. To test the hypothesized benefits of our approach in the young patient groups, a larger cohort of patients aged 50 years or less should be studied.
Bone Marrow ; Cohort Studies ; Disease-Free Survival ; Drug Therapy ; Heart Failure ; Humans ; Lymphoma, Non-Hodgkin* ; Pilot Projects ; Prognosis ; Retrospective Studies ; Sepsis