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*

Purpose: Neutropenia is a major factor contributing to morbidity and mortality in patients undergoing chemotherapy for cancer. The efficacy and complications of GM- CSF (Granulocyte-Macrophage colony stimulating factor) on the neutropenia induced by chemotherapy or immunotherapy were evaluated in patients with a urologic malignancy. Material and Methods: Twenty-nine patients with a histologically confirmed urologic malignancy, who presented with neutropenia during either chemotherapy or immunotherapy, were given a fixed dose (400microgram) of GM-CSF subcutaneously for three to fifteen days. Twenty-nine patients with neutropenia were given GM-CSF for 50 cycles. The patients were evaluated by means of a complete blood cell count, white cell and differential counts. The mean time to response was 2.3 days. The statistical significance of the differences was calculated using a paired t test. RESULTS: GM-CSF treatment in patients with neutropenia resulted in an increase in the mean neutrophil count, the eosinophil count, and the monocyte count. Complications of GM-CSF included fever (76%), GI problems (19%), headache (14%), bone pain (14%), arthralgia (10%), and urticaria (5%). CONCLUSIONS: GM-CSF may be useful in reducing the toxicity of chemotherapy. Therefore, GM-CSF can be used to increase the effect of chemotherapy without delaying or stopping treatment as a result of neutropenia.
Arthralgia ; Drug Therapy* ; Eosinophils ; Fever ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Headache ; Humans ; Immunotherapy* ; Leukocyte Count ; Monocytes ; Mortality ; Neutropenia* ; Neutrophils ; Urticaria

OBJECTIVE: We analyzed 200 cases of prenatal amniocentesis and compared them with other reported studies. Thus we propose the necessity of metanalysis for prenatal amniocentesis. METHOD: We analyzed 200 cases that have undergone amniocentesis at Masan Samsung hospital from January 1996 to December 1997. The results of our study was compared with other reported studies of amniocentesis by indication and maternal age. The proportion of age-class and indication are compared between previous study subjects and our 200 cases. RESULTS: Triple marker abnormality was the most common indication of amniocentesis(51%) and the most common age distribution was 25-29 years (43.5%). Chromosomal aberration was diagnosed in 20 cases (10%) of which the numerical aberration was 9 cases (4.5%) and the structural aberration was 11 cases (5.5%). 5 cases (2.5%) out of ll cases of the structural aberration were normal variant. There were 7 cases (trisomy 21) of autosomal aberration and 2 cases (Turner syndrome) of sex chromosome aberration. Arnong the structural aberration, there was only one reported case of 46, t(7:10) reciprocal translocation. There were no cases of fetal death except for a little self limited preterm labor. There were no neonatal complications. In the comparison of indication and maternal age with other studies, abnormal triple test was the most common indication of amniocentesis. The number of young pregnant women under 35 years old who underwent genetic amniocentesis was increased year by year. CONCLUSION: Triple maker screening test and genetic amniocentesis become popular method of antenatal diagnosis in Korea. Now, it is the proper time to establish standard indication of prenatal amniocentesis in this country by systemic and objective statistic examination. So we address the need for metanalysis in our country as comparing with other studies.
Adult ; Age Distribution ; Amniocentesis* ; Chromosome Aberrations ; Female ; Fetal Death ; Humans ; Korea ; Mass Screening ; Maternal Age ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women ; Prenatal Diagnosis ; Sex Chromosome Aberrations

Pigmented neurofibroma, a variant of neurofibroma, has rarely been observed in patients with or without neurofibromatosis. Pigmented neurofibroma is characterized histologically by the coexistence of scattered melanin-laden cells and benign spindle cells with neural differentiation. We report a case of pigmented neurofibroma in a 22-year-old female patient.
Female ; Humans ; Neurofibroma* ; Neurofibromatoses ; Young Adult

The congenital long-QT syndrome (LQTS) is characterized by recurrent syncope, prolonged QT intervals, QT interval lability, polymorphic ventricular tachycardia, and sudden death. We report a case of congenital long QT syndrome in a 28-day-old male infant who presented with syncope, bradycardia with 2: 1 pseudo-atrioventricular block and a markedly prolonged QT inteval. One episode occured after crying and degenerated into ventricular fibrillation and terminated after cardioversion. A VVI type cardiac pacemaker was implanted. Subsequently, the infant's heart rate was over 110/min and 2: 1 AV block and any other arrhythmia were absent. The infant recovered from the accompanied pneumonia and sepsis and was discharged 47 days after adrnission. However, 13 days after discharge, the infant returned to our hospital ER with syncope. Ventricular fibrillation ceased after cardioversion. Despite medication with propranolol, ventricular tachycardia persisted. The infant expired the day after he was discharged against medical advice.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Bradycardia ; Crying ; Death, Sudden ; Electric Countershock ; Heart Rate ; Hospitals ; Humans ; Infant ; Long QT Syndrome ; Male ; Pneumonia ; Propranolol ; Sepsis ; Syncope ; Tachycardia, Ventricular ; Ventricular Fibrillation

Papillary serous peritoneal carcinoma(PSPC) is a rare malignancy that arises in the peritoneum and histologically resembles papillary serous carcinoma of the ovary. If peritoneal carcinomatosis occurs in the absence of an obvious primary tumor site and is associated with a papillary serous pathology, we may be dealing with the distinct entity of PSPC of extraovarian origin. Radiological findings suggesting the diagnosis are diffuse microcalcifications in the peritoneum, which occur in relation to psammoma bodies. The Ca-125 is most often abnormal and, not uncommonly, markedly elevated. The diagnosis requires that the surgeon identify grossly normal ovaries or minimal surface involvement. If PSPC is confirmed, a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and aggressive debulking surgery should be carried out, followed by cisplatin-based chemotherapy. We report a case of PSPC arising from the rectum in a 41 year-old woman.
Adult ; Carcinoma ; Diagnosis ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Ovary ; Pathology ; Peritoneum ; Rectum*

A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*

No abstract available.
Histiocytoma, Malignant Fibrous*