PURPOSE: Recently in light of the development in immunology, interferon- e and inter- leukin-2 or combination therapy with anticancer drugs have been performed. This study aims to verify and compare the efficacy of therapies using interferon- a alone, interferon- a plus vinblastine, and interferon- a plus interleukin-2 plus 5-fluorouracil (5-FU) plus 13-cis retinoic acid (13cRA) in patients with advanced renal cell carcinoma. MATERIALS AND METHODS: A total of 29 patients were randomly assigned to receive treatment with either interferon- a alone or interferon- a plus vinblastine or interferon- a plus interleukin-2 plus 5-FU plus 13cRA from December 1989 to May 1998. The most frequent metastatic sites were the lung, lymph nodes, bone, liver, and brain. We studied the response rates, survival period, and complications of each regimen. RESULTS: Responses were achieved in 1 out of 1~5 patients (6.73?o) on interferon- a alone (partial responses lasting 13 months), 1 out of 9 patients (11.1%) on interferon- e plus vinblastine (partial responses lasting 25 months) and 1 out of 5 patients (20.0%) on interferon-a plus IL-2 plus 5-FU plus 13cRA regimen (partial responses lasting 14 months). The median durations of survival were 18, 33, and 23 months respectively. The overall response rate was 10.3% and overall median duration of survival was 19 months. The most common side effects were flu-like symptom such as fever, chills (93.1%), skin symptom such as erythema, pruritus (31.0%), G-I symptom such as nausea, vomiting (17.2%), netropenia (10.3%), abnormal LFT (10.3%), and thrombocytopenia (3.4%). CONCLUSIONS: This study confirms the manageability and tolerability of several regimen used. There is no significant differences in response rates and survival duration among the regimens used in this study. The effective immunotherapy in patients with metastatic RCC should be evaluated by further studies of larger patients groups even though a minority of patients responded.
Allergy and Immunology ; Brain ; Carcinoma, Renal Cell* ; Chills ; Erythema ; Fever ; Fluorouracil ; Humans ; Immunotherapy* ; Interferon-alpha ; Interferons* ; Interleukin-2 ; Liver ; Lung ; Lymph Nodes ; Nausea ; Pruritus ; Skin ; Survival Rate ; Thrombocytopenia ; Tretinoin ; Vinblastine ; Vomiting

PURPOSE: We investigated the effects of radical cystectomy and the prognostic factors that affect the survival of bladder cancer patients. MATERIALS AND METHODS: From 1979 to 2002, 59 patients with long-term follow up results of at least 2 years were enrolled in this study. Indications for surgery included muscle invasive bladder cancer and high-risk superficial bladder cancer. The cancer specific and recurrence free survival rates with respect to the possible prognostic factors were determined using Kaplan-Meier statistics. RESULTS: The mean patient age was 62.8 years (M: 48, F: 11), and the estimated 5- and 10-year survival rates were 62% and 39.4%, respectively. The median time to local or systemic recurrence was 16 months (range: 5~100), and the average survival durations after local and systemic recurrence were 14.4 months and 12.7 months, respectively. Pathologic stage, tumor grade, mean nuclear area, sex and lymphatic invasion were significant factors by univariate analysis (p<0.05). The disease related survival rate in patients having progression from an initial superficial tumor was lower than for those patients who displayed muscle invasive disease at the initial treatment. Multivariate analysis identified pathologic stage and lymphatic invasion as independent prognostic factors. CONCLUSIONS: Radical cystectomy for organ-confined cancer showed favorable 5- and 10-year survival rates. The survival rate for patients with progression from an initial superficial tumor was worse than for those patients with invasive tumor at the initial presentation. The most significant independent prognostic factors were the pathologic stage and the presence of lymphatic invasion, which were highly correlated with all the investigated disease endpoints.
Cystectomy* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

The Epstein-Barr virus(EBV) is known to play a causal role in oncogenesis and to be associated with endemic Burkitt's lymphomas, B cell lymphomas in immunocompromised patients, and nasopharyngeal carcinomas. More recently, EBV has also associated with Hodgkin's disease, B cell lymphomas in non-immunocompromised patients, and T-cell lymphomas. Twenty eight cases of a non-Hodgkin's lymphoma of gastrointestinal tract were investigated to determine both the immunophenotype by using immunohistochemical staining and the incidence of the EBV nuclear antigen by using the polymerase chain reaction. Twenty-four of the 28 cases(85.7%) were B-cell type, and 4 of the 28 cases(14.3%) are of T-cell type. The EBV nuclear antigen was detected in three of the 28 cases(10.7%), including two cases of B-cell lymphoma of the stomach and one case of T-cell lymphoma of the small bowel. The EBV nuclear antigen was more frequently found in malignant lymphomas arising in the intestine(1/4) than in stomach(2/16). EBV positivity (25%) in T-cell NHLs was rather higher than EBV positivity (8.3%) in B-cell NHLs. Further expanded evaluations on the role of EBV in the tumorigenesis of a gastrointestinal malignant lymphomas are necessary because the cases of gastrointestinal lymphomas examined were very limited.
B-Lymphocytes ; Burkitt Lymphoma ; Carcinogenesis ; Gastrointestinal Tract* ; Herpesvirus 4, Human* ; Hodgkin Disease ; Humans ; Immunocompromised Host ; Incidence* ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin* ; Lymphoma, T-Cell ; Polymerase Chain Reaction ; Stomach ; T-Lymphocytes

No abstract available.

No abstract available.
Humans ; Laparoscopy/methods ; Minimally Invasive Surgical Procedures/*methods ; Periodicals as Topic ; Robotic Surgical Procedures/*methods ; Urolithiasis/diagnosis/therapy ; Urologic Surgical Procedures/*methods ; Urology/trends

Cystic teratoma on the floor of the mouth is infrequent disease and known as congenital origin. Teratoma has no sex distribution. Treatrnent of the cystic teratoma is completely surgical excision and recurrence is rare. The authors have experienced a case of cystic teratoma on the floor of the mouth in neonate. We reported this case with review of literatures.
Humans ; Infant, Newborn* ; Mouth* ; Recurrence ; Sex Distribution ; Teratoma*

No abstract available.
Hemangioma, Cavernous*

PURPOSE: This study was performed to evaluate the results of surgical treatment of Nirschl procedure for intractable lateral epicondylitis of the elbow. MATERIALS AND METHODS: We retrospectively reviewed the functional records of surgically treated 21 cases from the 196 cases of lateral epicondylitis, which had been followed up at least 12 months from March 2000 to May 2003. Surgery was generally considered to be indicated if six months of conservative treatments since the first diagnosis had led to no improvement of the symptoms. The patients were evaluated by assessing of Pain Analog Scales (PAS) score. The objective outcomes of all patient after surgery were investigated according to the criteria by Roles and Maudsley. RESULTS: The mean PAS score followed up for 12 months postoperatively, had indicated significant improvements (p<0.001): 0.31 points (range, 0-2) at rest, 1.22 points (range, 0-3) at daily activities, and 2.25 points (range, 0-5) at sports and occupational activities. According to the Roles and Maudsley scores, there were 12 excellent, 7 good, 2 fair from the total of 21 cases; therefore, 19 (90%) cases showed the satisfactory results. CONCLUSION: The surgical treatment using the Nirschl procedure for intractable lateral epicondylitis of the elbow is considered as one of recommendable methods for the cases of no response at the conservative treatment.
Diagnosis ; Elbow ; Humans ; Retrospective Studies ; Sports ; Weights and Measures

PURPOSE: To identify the characteristic quadriphasic (unenhanced, corticomedullary, nephrographic, and excretory phase) helical multidetector computed tomography (MDCT) features of renal masses less than 4 cm to distinguish benign from malignant renal masses. MATERIALS AND METHODS: In total, 84 patients were retrospectively analyzed to determine the characteristic features for the prediction of subtypes of small renal masses. The patients' age, gender, and tumor size and CT features, including the presence of intra-tumor degenerative changes, septation, calcification, and wall irregularity, were evaluated. In addition, the degree and pattern of enhancement obtained during four phases were analyzed. The relationship between the subtype of the small renal masses and the gender, morphological features, and pattern of contrast enhancement on the CT was analyzed by using the chi-square test. Tumor size and degree of contrast enhancement were compared by the Mann-Whitney U test. The predictive value of each of the CT features was determined by multivariate logistic regression analysis. RESULTS: Of the 84 small renal masses, 17 (20%) were benign and 67 (80%) were malignant. Univariate analysis revealed that renal cell carcinoma lesions showed heterogeneous enhancement (p=0.002) and higher mean attenuation value on the corticomedullary and nephrographic phases (135.1+/-53.9, p=0.000, and 132.4+/-43.6, p=0.006). The multivariate analysis with logistic regression model showed that only the mean attenuation value on the corticomedullary phase had a statistically significant correlation (p=0.021). CONCLUSIONS: For the characterization of small renal masses, the degree of enhancement on the corticomedullary phase is a valuable parameter. Furthermore, the heterogeneous enhancement pattern and degree of enhancement on the nephrographic phase can provide information for differentiating small renal masses.
Carcinoma, Renal Cell ; Humans ; Logistic Models ; Multidetector Computed Tomography ; Multivariate Analysis ; Retrospective Studies