PURPOSE: To assess the combined effectiveness of angioinfarction and immunotherapy for improving survival in patients with stage IV renal cell carcinoma. MATERIALS AND METHODS:During the past 3 years, 13 patients of stage IV renal cell carcinoma were treated with angioinfarction and immunotherapy. Angioinfarction was performed on these 13 patients using absolute ethanol and occlusive baloon catheter. After angioinfarction, Interferon alpha was used for immunotherapy. For our analysis, 12 control patients of stage IV renal cell carcinoma without treatment were included in the study. Survival has been calculated according to the Kaplan and Meier method. RESULTS: The 1 year survival rate and median survival time in patients treated with angioinfarction and immunotherapy, were 46% and 13 months and in patients without treatment, 16% and 4 months, respectively. CONCLUSION:The combined treatment of angioinfarction and immunotherapy is of considerable value for improving survival in patients with stage IV renal cell carcinoma
Carcinoma, Renal Cell* ; Catheters ; Ethanol ; Humans ; Immunotherapy* ; Interferon-alpha ; Survival Rate

No abstract available.
Emergencies* ; Humans ; Prospective Studies*

No abstract available.
Autonomic Pathways* ; Rectal Neoplasms* ; Urodynamics*

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants

No abstract available.
Wernicke Encephalopathy*

Among 73 patients with possible and definite tuberculous meningitis, 14 cases showed a sudden unexpected polymorphonuclear (PMN) CSF pleocytosis during treatment. Patients with superimposed bacterial meningitis were excluded. Eleven patients(15. 1%) matched inclusion criteria. The intervals between the onset of the treatment and the onset of the PMN CSF pleocytosis were 7-54 days(mean 17.2+ 14.4 days). The mean duration of PMN CSF pleocytosis was 14.2+12.4 days. A PMN CSF pleocytosis may develop occasionally weeks or months after the start of the treatment for tuberculous meningitis. Though the cause is uncertain, we suggest that probably its cause is superimposed acute meningeal inflanunation by the release of Mycobacterium from tuberculomas or.delayed Jarisch-Herxheimer reaction.
Humans ; Leukocytosis* ; Meningitis, Bacterial ; Mycobacterium ; Tuberculoma ; Tuberculosis, Meningeal*

PURPOSE: We evaluate the efficacy of bimodality therapy for organ preservation in locally advanced bladder tumors. MATERIALS AND METHODS: A total of 23 patients with a clinical stage T2- T4aN0M0 bladder tumor were included in our study and treated with transurethral resection or partial cystectomy by chemotherapy. They are composed of T2: 6, T3: 11, T4a: 6 cases in stage, W.H.O. LMP (low malignant potencial): 1, low grade: 9, high grade: 13 cases in pathologic grade. The followed chemotherapy regimens were composed of M-VAC (methotrexate 30mg/m2, vinblastine 3mg/m2, adriamycin 30mg/m2, cisplatin 70mg/m2), S-MEC (methotrexate 30mg/m2, epirubicin 50mg/m2, cisplatin 100mg/ m2), and gemcitabine (100mg/m2)-cisplatin (70mg/m2) in 10, 8, and 5 cases, respectively. The evaluation of response was performed by transurethral biopsy, urine cytology, CT, and MRI after more than 4 cycles of postoperative chemotherapy. RESULTS: A complete response was achieved in 10 patients (43.5%), and a partial response occurred in 3 patients (13.0%) to give an overall response rate of 56.5%. The mean duration of complete responses was 35.5 months. Eight of 23 patients are still alive. The mean duration of the follow-up was 41.6 months, and their 5-year survival rate was 33.3%. Low stage, initial response to therapy, and no evidence of hydronephrosis were all significant predictors for an increased probability of organ preservation. CONCLUSIONS: Transurethral resection or partial cystectomy followed by chemotherapy result in long-term bladder preservation in a significant proportion of responding patients, and may be a comparable therapy to trimodality therapy in select patients in locally advanced bladder tumors.
Biopsy ; Cisplatin ; Cystectomy ; Doxorubicin ; Drug Therapy ; Epirubicin ; Follow-Up Studies ; Humans ; Hydronephrosis ; Magnetic Resonance Imaging ; Organ Preservation* ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vinblastine

The Dandy-Walker syndrome is a developmental disorder of the brain characterized by cystic dilatation of the fourth ventricle and agenesis or hypoplasia of the cerebellar vermis. We experinced a case of Dandy-Walker syndrome with complex cardiac anomaly in female newborn who presented with apnea at birth. Physical examination showed coloboma on left eye, low estting malformed ear, and high arched palate. Autopsy revealed cystic dilatation of the fourth ventricle with secondary loss of cerebellar vermis. The floor of the fourth ventricle is exposed through this defect. Heart showed aortic atresia and univentricular heart. The case is reported with the review of the literatures.
Apnea ; Autopsy ; Brain ; Coloboma ; Dandy-Walker Syndrome* ; Dilatation ; Ear ; Female ; Fourth Ventricle ; Heart ; Humans ; Infant, Newborn ; Palate ; Parturition ; Physical Examination

PURPOSE: More effective diagnosis and treatment through a survey on clinical aspect for the last 5 years and interrelation between cold agglutinin titer and mycoplasma antibody titer of Mycoplasma pneumoniae pneumonia. METHODS: 369 patients hospitalized in the department of pediatrics of Chung Goo Sung Shim Hospital for the 5 years from January 1990 to December 1994 have been surveyed, which diagnosed to be Mycoplasma pneumoniae pneumoniaby physical findings or chest x-ray findings with the titer of 1:64 in cold agglutinin test or the titer of 1:80 in Mycoplasma antibody test or forefold increase of any one or both of 2 titers in follow-up tes RESULTS: 1) More cases were found in 1990(76 cases, 20.6%) and 1994(181 cases, 49%) and the monthly distribution showed irregular fluctuations. Male to female ratio was 1:1.2 and high incidence was in the age of 3 to 5 years(27.9%), but 46 cases(12.5%) affected the infants below 1 year old. 2) Cough, fever, sputum were the most chief complaints. More moist rales, pharyngial injection, wheezing were found in physical examination. 86.7% of pneumonic infiltration were found in x-ray findings, 35.8% of which were both lung infiltration. The most common affected site was Rt. lower lobe and then Lt lower lobe and then followed by Rt. upper lobe. 71.8% of the whole cases were hospitalized for 5-8 days. 3) EM administration started 10-12 days after the onset in 29.3%. Mean duration of hospitalization of the cases administrated within 6 days from onset was 7.5+/-2 days, which was shorter than 8.4+/-3.5-that of the cases administrated after 6days from onset. The observation on those duration meant little atatistically(p>0.1) 4) The measure of Mycoplasma antibody titer in 142 cases among 245 positive cold agglutinin test case showed 61.3% of positive ratio. Positive ratio of cold agglutinin test peaked from 13th to 15th day after onset(89%) and went down(33%) after 19th day. Positive ratio of Mycoplasma antibody titer was at its summit(91%) from 7th to 9th day and went down(63%) after 16th day. decreased to 63% after 16 days. 264 cases tested simultaneously for cold agglutinin titer and Mycoplasma antibody titer. Titers of each simultaneous test for cold agglutinin and Mycoplasma antibody were in proportion each other(p<0.005, N=264, r=0.51). CONCLUSIONS: Mycoplasma pneumoniae pneumonia prevailed every 4 years(1990, 1994) and monthly distribution had been irregular. The most cases were found at age of 4 and 5. Mycoplasma antibody titer seems more effective for early diagnosis for Mycoplasma antibody titer showed high positive rate earlier and the rate went down earlier than cold agglutinin titer. The earlier diagnosis and treatment are required because of tendency of later erythromycin administration.
Child* ; Cough ; Diagnosis ; Early Diagnosis ; Erythromycin ; Female ; Fever ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Infant ; Lung ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pediatrics ; Physical Examination ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Sounds ; Sputum ; Thorax

PURPOSE: To evaluate the response and toxicity of gemcitabine and cisplatin combination chemotherapy in advanced transitional cell carcinomas. MATERIALS AND METHODS: Twenty two patients with advanced transitional cell carcinoma received gemcitabine combined chemotherapy. Nineteen of them were scheduled to receive 1,000mg/m2 gemcitabine intravenously for 30 minutes on days 1, 8, and 15 and 70mg/m2 cisplatin for 1 hour on day 1 of a 28-day cycle. In addition, 3 patients with decreased renal function were scheduled to receive 1,200mg/m2 gemcitabine on day 1, 8, and 15. The toxicity of each cycle and the response after more than 4 cycles were evaluated. RESULTS: There were 5 complete responses and 4 partial responses in the 15 assessable patients, giving an overall response rate 60%. The toxicity was primarily hematologic, with 3 out of 22 patients (14%) with grade 3 thrombocytopenia, 10 out of 22 patients (45%) with grade 1 & 2 leukopenia and 10 out of 22 patients (45%) having grade 1 & 2 anemia. The most common non-hematologic toxic response was nausea and vomiting. CONCLUSIONS: Gemcitabine based chemotherapy for advanced transitional cell carcinoma has larger response rate compared to M-VAC. Furthermore, it has much less systemic toxicity than M-VAC combination chemotherapy.
Anemia ; Carcinoma, Transitional Cell ; Cisplatin ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Leukopenia ; Nausea ; Thrombocytopenia ; Vomiting