The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system (RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.
Cause of Death ; Humans ; Nasopharyngeal Neoplasms ; Nasopharynx ; Neck ; Radiotherapy ; Recurrence

No abstract available.
Carcinoma, Renal Cell* ; Colon, Descending* ; Neoplasm Metastasis*

PURPOSE: FP(5-FU, Cisplatin) combination is one of the most active regimen for the advanced gastric cancer with a response rate of 50~60%. In spite of this high response rate, there is little evidence that FP regimen results in survival benefit for patients with advanced gastric cancer. This study was performed to evaluate the efficacy and toxicity of this regimen with the addition of levamisole, an immunomodulatory agent, known as enhancing the antitumor effects of 5-FU in other cancer. MATERIALS AND METHODS: Previously untreated patients with metastatic or recurrent gastric cancer were treated with 5-FU(1000 mg/M2 civ, D1~5), cisplatin(60 mg/M2 iv, Dl) every 3 weeks, and levamisole(150 mg/day, Dl~3) every 2 weeks. The major endpoints were response rate, response duration, and toxicities. RESULTS: Between June 1992 and Aug. 1996, thirty three patients were included in this study. Patients received 2~18 cycles of chemotherapy(median 5). Among the evaluable 31 patients, 18 patients(58%, 95% C.I. 40.4~75.7) showed objective responses including one(3.2%) clinical complete response. The median response duration was 7.7 months(95% C.I. 3.6~11.8). During total of 189 cycles of chemotherapy, 79 episodes(41.7%) of leucopenia were observed. There was no death from concurrent infection. CONCLUSION: FPL combination therapy is at least as effective as conventional FP chemotherapy, but resulted in somewhat more myelosuppression.
Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Fluorouracil* ; Humans ; Levamisole* ; Stomach Neoplasms

PURPOSE: The clinical efficacy of extracorporeal shock wave lithotripsy (ESWL) monotherapy with EDAP LT-02 (LT-02) lithotriptor for staghorn stone was estimated. MATERIALS AND METHODS: Thirty eight patients (39 renal units) with staghorn stone had been treated by ESWL monotherapy with LT-02 lithotriptor that had piezoelectric system with mounted C-arm and ultrasound unit (dual localization system) between Jan. 1996 and Dec. 2000. Success rate (SR) and stone free rate (SFR) were evaluated according to the stone type, volume and associated hydronephrosis. RESULTS: Overall SR and SFR were 56% and 38%. SR (SFR) of complete and incomplete staghorn stone were 57 (36%) and 56 (40%). SR (SFR) of stone under and over 20ml of volume were 53 (40%) and 58 (38%). SR (SFR) according to the associated hydronephrosis were 78 (57%), 44 (27%), and 42 (27%) in patients with no (group 1), mild (group 2), and severe hydronephrosis (group 3). SR (SFR) were not different in terms of stone type and volume but significantly low in patients with hydronephrosis. Auxillary procedures (percutaneous nephrostomy: 4 renal units, ureteral stent: 1 renal unit) were required in 5 renal units due to complete ureteral obstruction. CONCLUSIONS: In spite of low SR and SFR and multiple treatment sessions, we consider ESWL monotherapy to be a minimally invasive alternative treatment in patients with staghorn stone as outpatient procedure without the fear of ureteral stent, percutaneous nephrostomy and other auxillary procedures. Associated hydronephrosis is considered to be poor outcome factor of ESWL monotherapy in patients with staghorn stone.
Humans ; Hydronephrosis ; Lithotripsy* ; Nephrostomy, Percutaneous ; Outpatients ; Shock* ; Stents ; Ultrasonography ; Ureter ; Ureteral Obstruction

PURPOSE: Little attention has been paid to predictive the factors for recurrence and survival after relapse in patients with breast cancer in Korea. The purpose of this study was to identify the survival and potential prognostic factors associated with survival from the time of a distant relapse. METHODS: Between 1989 and 2000, 2355 patients were treated by surgery for breast cancer at the Breast Clinic of the Asan Medical Center. We retrospectively analyzed 247 women who developed a distant relapse among that. RESULTS: The median follow-up duration from the first distant relapse was 10.5 months (0.5-101 months) and the median age at the time of relapse was 46.8 years, retrospectively. The median survival was 19.2 months with a 41.5% and 19.5%, two and five year overall survivals. The dominant sites for the spread were bone (32.0%), lung (29.3%), soft tissue (20.0%) and other visceral organs (18.7%). The median survivals along the site of the relapse were as follows: bone, 26.6; soft tissue, 19.5; lung, 15.8; and other visceral organs, 9.0 months. The location of recurrence, number of metastatic site (both visceral and multiple), the axillary lymph node status (above 4), and operation methods (breast conserving operation) were significantly associated with shorter survivals from the first distant relapse. Conversely, the estrogen receptor status, adjuvant chemotherapy and disease free interval, all failed to reach statistical significance. CONCLUSION: We confirmed that our results for survival of the distant relapsed patients were similar, when comparing to those of Western countries. In this study, the site of the initial recurrence and the axillary lymph node status were important factors for predicting survival after distant recurrence and should help in designing new therapeutic strategies for this group of patients.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Korea ; Lung ; Lymph Nodes ; Recurrence* ; Retrospective Studies ; Survival Analysis*

OBJECTIVE: To compare the multiplex-PCR and hybrid capture methods for detection of Human papillomavirus (HPV) in uterine cervical swab samples. METHODS: This study determined the HPV infection and its risk group (subtype) in uterine cervical swab samples of 91 Korean women by HPV hybrid capture I and multiplex-PCR method. RESULTS: The prevalence of HPV infection determined by muliplex-PCR was more higher than by hybrid capture method I. Of 65 women with nonspecific uterine cervical lesions, the frequence of HPV-positivity was 14/65 (12 low-risk and 2 high-risk HPV) by hybrid capture method I and was 37/65 (34 low-risk and 3 high- risk HPV) by multiplex-PCR method, respectively. The frequence of high-risk HPV was 2/6 in LSIL, 7/14 in HSIL, 4/6 in uterine cervical cancer by hybrid capture method I, and was 2/6 in LSIL, 8/14 in HSIL, 4/6 in uterine cervical cancer by multiplex-PCR method. CONCLUSION: These results suggest that multiplex-PCR is more sensitive, simple and cost-effective technique than Hybrid-capture I in the detection of HPV infection in the uterine cervix.
Cervix Uteri* ; Female ; Humans* ; Multiplex Polymerase Chain Reaction* ; Prevalence ; Uterine Cervical Neoplasms

Obesity and its related factors are known to suppress the secretion of growth hormone (GH). We aimed to evaluate the influence of body mass index (BMI) on the peak GH response to provocative testing in short children without GH deficiency. We conducted a retrospective review of medical records of 88 children (2-15 yr old) whose height was less than 3 percentile for one's age and sex, with normal results (peak GH level > 10 ng/mL) of GH provocative testing with clonidine and dopamine. Peak stimulated GH level, height, weight, pubertal status and serum IGF-1 level were measured. Univariate analysis showed that the BMI standard deviation score (SDS) correlated negatively with the natural log (ln) of the peak stimulated GH level (ln peak GH). BMI SDS did not correlate significantly with sex, age, pubertal status, or ln IGF-1 level. BMI SDS correlated negatively with ln peak GH level induced by clonidine but not by dopamine. In stepwise multivariate regression analysis, BMI SDS was the only significant predictor of ln peak GH level in the combination of tests and the clonidine test, but not in the dopamine test. In children without GH deficiency, BMI SDS correlates negatively with the peak GH level. BMI SDS should be included in the analysis of the results of GH provocation tests, especially tests with clonidine.
Adolescent ; Body Height ; *Body Mass Index ; Body Weight ; Child ; Child, Preschool ; Clonidine/therapeutic use ; Dopamine/therapeutic use ; Dwarfism/drug therapy ; Female ; Human Growth Hormone/*analysis ; Humans ; Insulin-Like Growth Factor I/analysis ; Male ; Regression Analysis ; Retrospective Studies

BACKGROUND: Hepatitis C virus(HCV) is well known major cause of posttransfusion hepatitis. There were a lot of studies about the prevalence of anti-HCV. But, most of these focused on healthy blood donors or patients with liver diseases in urban areas. So they may not represent the prevalence of anti-HCV in the entire Korean population. This study focused on people of a rural area which consisted of six towns near Reservoir Juam in the Chonnam province in Korea. METHODS: Nine hundred and sixty three persons were selected by multi-stage cluster sampling method from January to February in 19%, Anti-HCV and HBsAg were examined by microparticle enzyme immunoassy(MELA; Abbott Co., USA). Alanine aminotransferase(ALT) was examined by enzyme kinetic method. RESULTS: 1) The positivity of anti-HCV in all subjects was 0.9%. 2) The positivity of anti-HCV in male(1.1%) was not significantly higher than in female(0.9%). 3) The positivity of anti-HCV was 0% below the 5th decade, 0.7% in the 6th decade, 1.4% in the 7th decade, 1.7% in 8th decade, 0% above the 9th decade. There was no significant relationship between the positivity of anti-HCV and age. 4) The positivity of anti-HCV was 0.8% in normal ALT(35U/L) subjects. There was no statistical relationship between the positivity of anti-HCV and ALT level. 5) HBsAg was serologically negative in all of nine anti-HCV positive subjects. CONCLUSION: The positivity of anti-HCV was 0.9% in rural area of Korea and was similar to the prevalence of anti-HCV in urban areas.
Alanine ; Blood Donors ; Enzyme-Linked Immunosorbent Assay* ; Hepatitis ; Hepatitis B Surface Antigens ; Hepatitis C ; Humans ; Jeollanam-do* ; Korea ; Liver Diseases ; Prevalence

PURPOSE: Standardization quality assurance (QA) program of CyberKnife for suitable circumstances in Korea has not been established. In this research, we investigated the development of QA program for CyberKnife and evaluation of the feasibility under applications. MATERIALS AND METHODS: Considering the feature of constitution for systems and the therapeutic methodology of CyberKnife, the list of quality control (QC) was established and divided dependent on the each period of operations. And then all these developed QC lists were categorized into three groups such as basic QC, delivery specific QC, and patient specific QC based on the each purpose of QA. In order to verify the validity of the established QA program, this QC lists was applied to two CyberKnife centers. The acceptable tolerance was based on the undertaking inspection list from the CyberKnife manufacturer and the QC results during last three years of two CyberKnife centers in Korea. The acquired measurement results were evaluated for the analysis of the current QA status and the verification of the propriety for the developed QA program. RESULTS: The current QA status of two CyberKnife centers was evaluated from the accuracy of all measurements in relation with application of the established QA program. Each measurement result was verified having a good agreement within the acceptable tolerance limit of the developed QA program. CONCLUSION: It is considered that the developed QA program in this research could be established the standardization of QC methods for CyberKnife and confirmed the accuracy and stability for the image-guided stereotactic radiotherapy.
Constitution and Bylaws ; Humans ; Korea ; Mortuary Practice ; Quality Control ; Radiotherapy

PURPOSE: NOS2 induce NO production and NO activate TGF-beta. The TGF-beta is a inhibitor of NOS2. If this negative feedback mechanism operating in radiation pneumonitis model, NOS2 inhibitor may play a role in TGF-beta suppression. We planned this study to evaluate the expression patterns of NO, NOS2 and TGF-beta in vivo radiation pneumonitis model. MATERIALS AND METHODS: Sixty sprague-Dawley rat were irradiated 5 Gy or 20 Gy. They were sacrificed 3, 7, 14, 28 and 56 days after irradiation. During sacrifice, we performed broncho-alveolar lavage (BAL). The BAL fluids were centrifuged and supernatents were used for measure NO and TGF-beta, and the cells were used for RT-PCR. RESULTS: After 5 Gy of radiation, NO in BAL fluid increased at 28 days in both lung and TGF-beta in left lung at 56 days. NO increased in BAL fluid at 28 days in both lung after irradiation and TGF-beta in right lung at 28-56 days after 20 Gy of radiation. After 5 Gy of radiation, NOS2 expression was increased in right lung at 14 days, in both lung at 28 days and in left lung at 56 days. TGF-beta expression was reduced in both lung at 28 days and increased in left lung at 56 days. CONCLUSIONS: The proposed feedback mechanism of NO, NOS2 and TGF-beta was operated in vivo radiation pneumonitis model. At 56 days, however, NOS2 and TGF-beta expressed concurrently in left lung after 5 Gy and in both lung after 20 Gy of radiation.
Animals ; Lung* ; Radiation Effects* ; Radiation Pneumonitis ; Rats* ; Rats, Sprague-Dawley ; Therapeutic Irrigation ; Transforming Growth Factor beta*