No abstract available.
Humans ; Hypercholesterolemia*

PURPOSE: Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. METHODS AND MATERIALS: Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcioma in situ (38 cases), severe dysplasia(2), myoma(6), uterine bleeding (4), uterine prolapse (2), and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy form August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients reveived ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. RESULTS: Overall 5-year survival rate and relapse-free survival rate were 83.8%, 86.9% respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were 90.9%, 88.8%, 38.4%, and 100% respectively. There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cncer (stage IA) had no treatment related failure. Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. CONCLUSION: Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy. Survivals for patients with gross disease remained after inappropriate hysterectomy was poor. So, early cancer detection and proper management with precise pretreatment staging is necessary to avoid inadherent hysterectomy especially in the cases of gross residual disease.
Carcinoma in Situ ; Cervix Uteri ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Node Excision ; Myoma ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms ; Uterine Hemorrhage ; Uterine Prolapse

rcinoma (SCC) is the second most common skin cancer. In particular, invasive SCC has a high risk of metastasis and sometimes, this can be fatal. At present, the treatment of choice for invasive SCC is complete excision with a proper surgical margin, but most cases of SCC develop on cosmetically-sensitive areas, so sometimes significant scarring or deformities can lead to an unhappy result. An 80 year-old female presented with a 4x1.5cm sized SCC on her lower lip. Although surgery was the first line therapy for this invasive SCC, a cosmetically poor outcome was expected. Thus the patient did not want to undergo a surgical operation, so we had to explore other treatment options. Recently there have been many reports that show imiquimod 5% cream is effective in the treatment of invasive SCC. Therefore we started topical therapy with imiquimod 5% cream five times a week. After 6 months, the lesion size was reduced to 2x1.5cm and we could remove the remnant tumor by wedge resection with cosmetically acceptable result. We suggest this neo-adjuvant immunotherapy can be an alternative for the treatment of cosmetically-critical SCC and present this case as a good example that has shown successful size-reductive neoadjuvant immunotherapy using imiquimod in invasive SCC.
Aged, 80 and over ; Carcinoma, Squamous Cell* ; Cicatrix ; Congenital Abnormalities ; Female ; Humans ; Immunotherapy* ; Lip* ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Skin Neoplasms

Fourty-seven patients with non-aneurysmal spontaneous subarachnoid hemorrhage were reviewed retrospectively. Attention was directed to the distribution and amount of subarachnoid hemorrhage on computerized tomography scans. Though the hemorrhage could be distributed in all cisterns, the frequency and amount of hemorrhage were higher in infratentorial cisterns than in supratentorial cisterns. Among infratentorial cisterns, the hemorrhage was distributed to cisterns around the brain-stem mainly and it had a predilection for interpeduncular cistern. Also the telangiectasia of thalamoperforating artery might be one of the causes of non-aneurysmal spontaneous subarachnoid hemorrhage.
Arteries ; Hemorrhage ; Humans ; Retrospective Studies ; Subarachnoid Hemorrhage* ; Telangiectasis

PURPOSE: Treatment of choice for uterine cervix cancer stage IIB is radiotherapy. We analyzed survivals, prognostic factors, patterns of failure and complications. MATERIALS AND METHODS: This is a retrospective analysis of 167 patients with stage IIB carcinoma of uterine cervix treated with curative external pelvic and high dose rate intracavitary radiotherapy at the Department of Therapeutic Radiology, Soonchunhyang University Hospital from August 1985 to August 1994. All the patients followed up from 3 to 141 months (mean 60 months) and age of patients ranged from 31 to 78 years at presentation (mean : 55 years). RESULTS: Overall complete response rate was 84%. The response rate for squamous cell carcimoma and adenocarcinoma were 86% and 60%, respectively. Overall 5-years survival rate and disease free survival rate was 62 and 59%, respectively. Mass size and treatment response were significant prognostic factors for survival. Pathologic type and parametrial involvement were marginally significants prognostic factors. Local failure was 43 cases, distant metastasis was 14 cases and local failure plus distant metastasis was 3 cases, and most of local failures occurred within 24 months, distant metastasis within 12 months after treatment. Twenty eight (16.8%) patients developed late rectal and urinary complications. There were tendency to increasing severity and frequency according to increased fractional dose and total (rectal and bladder) dose. CONCLUSIONS: Survival rate was significantly related to tumor size and radiotherapy response. Tumor size should be considered in the clinical staging. To increased survival and local control, clinical trials such as decreasing duration of radiotherapy or addition of chemotherapy is needed. To detect early recurrence, regular follow up after RT is important. Because total rectal and bladder doseaffected late complications, meticulous vaginal packing is needed to optimize dose of normal tissues and to decrease late complications.
Adenocarcinoma ; Cervix Uteri* ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms

No abstract available.
Genes, ras* ; Humans

BACKGROUND AND OBJECTIVES: Compared to other target cells examined for gene therapy, vascular smooth muscle cells (VSMCs) have the unique advantages including proximity to blood stream and relative abundance in vasculature. With an ultimate goal of developing VSMC-based therapies for cardiovascular disorders, we explored the utility of VSMC as a target cell for ex vivo gene therapy using a set of retroviral vectors. MATERIALS AND METHODS: Cultured VSMCs were transduced with replication-defective recombinant retroviruses harboring LacZ, nlsLacZ, mVEGF, mGM-CSF or bacterial CAT reporter. The VSMCs were examined for G418-selection, transduction efficiency, the level of transgene expression, and longevity of gene expression. ResultsVSMCs were readily transduced with different kinds of retroviral vectors. The bacterial neo r gene-transduced VSMCs were successfully selected with G418. The G418-selected VSMCs could express the transduced genes at a level comparable to NIH3T3. The level of transgene expression did not appear to be affected by the increasing number of passages. CONCLUSION: The results demonstrate an efficient transduction of VSMCs by retroviral vectors in vitro and an sustained expression of retrovirally transduced genes in VSMCs. VSMCs could be one of the ideal target cells for ex vivo cardiovascular gene therapy employing retroviral vector.
Animals ; Cats ; Gene Expression ; Genetic Therapy* ; Longevity ; Muscle, Smooth, Vascular* ; Retroviridae ; Rivers ; Transgenes ; Zidovudine

PURPOSE: The purpose of this study was to investigate the positional change of the uterus during radiotherapy MATERIALS AND METHODS: Between 1997 and 2001, 47 patients received definitive radiotherapy for cervical cancer at the Samsung Medical Center. For each patient, two MRI scans were taken; one before and the other 3~4 weeks after the radiotherapy treatment. In T2 weighted MRI images, the positional change of the uterine was quantified by measuring six quantities; the distance from the cervix os to the isthmus of the uterus (Dcx), the maximum length from the isthmus of the uterus to the uterine fundus (Dco), the maximum vertical distance of the uterine body (Dco-per), the angle between the vertical line and the cervical canal in the sagittal images (Acx), the angle of the uterine corpus from the vertical line in the sagittal plan (Aco-ap), and the relative angle of the uterine corpus from a fixed anatomical landmark in the axial images (Aco-axi). RESULTS: The mean Dcx values, before and during the treatment, were 36.7 and 27.8 mm, respectively. The Dco deviated by more than 10 mm in 14 cases (29.8%). The change in the Acx ranged from 0.1 to 67.8degrees (mean 13.2degrees). The Aco-ap changed by a maximum of 84.8degrees (mean 16.9degrees). The differences in the Dcx plus the Dco in the smaller (<4 cm) and larger (>or= 4 cm) tumors were 5.3 and 19.4 mm, respectively. With patients less than 60 years old, or with a tumor size larger than 4 cm, the difference in the Acx was statistically significant. CONCLUSION: The positional changes of the uterus, during radiation treatment, should be considered in the 3DCRT or IMRT treatment planning, particularly in patients under 60 years of age or in those with a tumor size greater than 4 cm in maximum diameter.
Cervix Uteri* ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Radiotherapy* ; Uterine Cervical Neoplasms* ; Uterus*

OBJECTIVES: The purpose of this study was to compare two subtypes of attention-deficit hyperactivity disorder (ADHD) and controls in their attention using ADHD diagnostic system(ADS), a kind of continuous performance test. METHODS: Subjects of this study were 8 children with ADHD-predominantly inattentive type, 28 children with ADHDcombined type and 20 control children. Ages ranged from 5 to 14 years. The Korean Educational Development Institute version of the Wechsler Intelligence Scale for Children(KEDI-WISC) and the ADS were administered to all subjects to provide measures of intelligence and attention. RESULTS: Significant differences were found in the ADS variables for the three groups. When compared with controls, the ADHD-predominantly inattentive type children scored significantly higher on the omission error at middle stage and later stage and ADHD-combined type children scored significantly higher on the omission error and reaction time at later stage. When compared with the other two groups, the ADHD-combined type children scored significantly higher on the commission error at all three stages. CONCLUSION: Our results suggest that the two subtypes of ADHD have different features in attention deficit. And there was a possibility that commission error is available variable to show cognitive characteristics of ADHD-combined type than any other ADS variables. Further studies are needed to evaluate this finding.
Child ; Humans ; Intelligence ; Reaction Time

OBJECTIVES: To determine whether there is an association between the characteristics of pain in endometriosis and chronic stress. METHODS AND MATERIALS: Fifteen women were diagnosed as endometriosis by diagnostic laparoscopy and 14 asymptomatic volunteers were enrolled. Case group was divided into two groups with their pain duration and severity. Saliva was collected four times a day with commercial collector, Salivette. Salivary cortisol was analyzed by enzyme immunoassay. Statistical association was assessed with Kruskal-Wallis test, Mann-Whitney U test, and repeated measures ANOVA test. RESULTS: In the curve showing diurnal changes of cortisol level, morning rise in cortisol level was significantly blunted among patients compared with control group (p<0.05). Among two patient groups, there was no significant correlation with disease severity, but with duration (p<0.05). CA 125 level, pain scaling score, and age showed no significant correlation. CONCLUSION: Morning rise in salivary cortisol level is blunted in women especially with chronic endometriosis. These is findings might be a small clues that the changes in the salivary cortisol level can be a sign of chronic stress state.
Endometriosis* ; Female ; Humans ; Hydrocortisone ; Immunoenzyme Techniques ; Laparoscopy ; Saliva ; Volunteers