This study was designed to evaluate the worth of preoperative chemoradiation therapy in the management of locally advanced rectal cancer. Between march 1993 and January 1997, 64 patients with adenocarcinoma of the rectum were treated with preoperative irradiation followed by operation by one surgeon at department of surgery, Chungnam national university hospital. Cancers were treated with high-dose radiation (45 to 54 Gy) with (group 2) or without (group 1) chemotherapy Preoperatively 64 Patients were analysed prospectively, of these, 15 cases were preoperative radiotherapy alone arm and 49 cases were preoperative radiotherapy plus chemotherapy arm. The average age of the patients were 56 years (range 38~67) in group 1 and 57 years (range 27~80) in group 2. Male to female ratio was 8 : 7 in group 1 and 30 : 19 in group 2. Most clinical stage of the primary tumor mass were 73 (80% in Group 1,96% in group 2), being palpated slightly fixed (40% in group 1, 43% in group 2) or fixed (13.3% in group 1, 24.5% in group 2). As to distance of tumor from anal verge, most patients ranged from 4 to 8 cm (53% in group 1, 63.3% in Group 2). Chemotherapy consisted of 2 cycles of 5-fluorouracil (500 mg/m2/day for S days) delivered as a continuous infusion or bolus therapy and low-dose leukovorin (20 mg/m2/day for 5 days). After six weeks resting period of radiation, definitive surgical approach was performed. Overall treatment related toxicity rate was similar in both group except erythema on perineal skin, which was more frequent in group 2 than in group 1. Most frequent postoperative complication was intestinal obstruction (7.8%) followed by wound infection (6.3%), but there was no significant difference between two groups. There was one case of postoperative mortality in group 2 patients at 44 days after operation due to pneumonia and sepsis combined with liver cirrhosis. Tumor depth was downstaged in 38.5% of group 1 and 70% of group 2 patients on preoperative CT staging, and nodal downstaging was more effective on the respect of postoperative pathological report. Overall recurrence rate was 38.5% in group 1 and 20.5% in group 2. Of these, failure occured first as a distant metastasis more frequently than as a local recurrence in both group. These data do suggest that the preoperative chemotherapy and radiotherapy used are as safe as preoperative radiotherapy alone. Futhermore, tumor and lymph node downstaging are more effective in combined arm. Preoperative chemotherapy will more promising in prevention of distant metastasis when treated in the period of least metastatic tumor burden. Whether combined arm will have greater or lesser survival awaits the completion of this relevant study.
Adenocarcinoma ; Arm ; Chungcheongnam-do ; Drug Therapy ; Erythema ; Female ; Fluorouracil ; Humans ; Intestinal Obstruction ; Leucovorin ; Liver Cirrhosis ; Lymph Nodes ; Male ; Mortality ; Neoplasm Metastasis ; Pneumonia ; Postoperative Complications ; Prospective Studies ; Radiotherapy ; Rectal Neoplasms* ; Rectum ; Recurrence ; Sepsis ; Skin ; Tumor Burden ; Wound Infection

No abstract available.
Diagnosis* ; Foreign Bodies*

No abstract available.
Femoral Neck Fractures* ; Femur Neck* ; Humans ; Young Adult*

PURPOSE: The inhibitory effect of TGFbeta1 on survivals of L1210 and anticancer drug- resistant L1210 sublines was investigated and the gene expression of TGFbeta1 in these cells was examined. MATERIALS AND METHODS: The survivals of L1210, adriamycin-resistant(L1210AdR), vincristine-resistant(L1210VcR) or cisplatin-resistant(L1210Cis) cells were measured by MTT assay after treatment of TGFbeta1. Northern analysis was performed for TGFbeta1 gene expression in L1210, L1210AdR, L1210VcR or L1210Cis. RESULTS: There was no different survival ratio between two groups, control and TGFbeta1(10 ng/ml) treated groups in L1210 cells. However, the survival ratio of L1210AdR was 59% in TGFbeta1 treated group for 96 hours. The survival ratio of L1210VcR was 61% for 96 hours in TGFbeta1 treated group. The survival ratio of L1210Cis was 40% for 96 hours in TGFbeta1 treated group. Expressions of TGFbeta1 gene in drug-resistant sublines were significantly decreased than that of L1210 cells. CONCLUSION: Growth of anticancer drug-resistant L1210 sublines were inhibited by TGFbeta1 but not in L1210 cells. So, it is suggested that TGFbeta1 gene expression may have a part in anticancer drug-resistance.
Control Groups ; Gene Expression

Multidrug resistance(MDR) phenotype is frequently observed in animal and human cancer cell lines selected for in vitro resistance to a single chemotherapeutic agent. It is characterized by the diminished j drug accumulation and is related to the drug efflux mechanism in resistant cells. In the present study, adriamycin resistant cells(L1210-AdR6 : 10-6M adriamycin, -AdR5: 10-5M) and vincristine resistant cells (L1210-VcR7: 10-7M vincristine, -VcR6: 10-6M) were produced from mouse lymphoblastic leukemia cell line L1210. Growth profiles of survived cells were observed for 5 days with MTT(thiazolyl blue) assay and resistance was compared with IWdrug concentration of 50% survival reduction in absorbance). Resisrant cells proliferated more slowly than sensitive cell. Doubling times were 29.7hr in L1210, 68.7hr in L1210-AdR5 and 58.2hr in -VcR6. MDRs expressed as resistance factor were as follows, L1210-AdR5 was 76.4 times for vincristine, L1210-VcR6 was 96.4 times for adriamycin. The cell membrane proteins with three different M.W. were recognized to be related resistance, 220, 158, and 88 kd in L1210-AdR5, 158, 140 and 88 kd in L1210-VcR6 by SDS-PAG electrophoresis. Cell surface membrane proteins were identified by radio-iodination and autoradiogram. their molecular! weights were 158, 72.8. and 42.4 Kd in L1210-VcR6.
Animals ; Cell Line ; Doxorubicin ; Drug Resistance* ; Electrophoresis ; Humans ; Membrane Proteins* ; Membranes* ; Mice* ; Phenotype ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Vincristine ; Weights and Measures

PURPOSE: Adrenalectomy has traditionally been included as a component of the radical nephrectomy. However, its role remains controversial. We assessed the ipsilateral adrenal involvement in renal cell carcinoma to determine whether ipsilateral adrenalectomy during radical nephrectomy is essential. MATERIALS AND METHODS: The records of 77 patients undergoing radical nephrectomy with ipsilateral adrenalectomy for renal cell carcinoma were reviewed. Radiographic findings were subsequently compared to postoperative histopathological findings to assess the predictive value of tumor characteristics and imaging in determining adrenal involvement. RESULTS: Three patients (3.9%) had ipsilateral adrenal involvement. In one of these 3 patients, adrenal involvement was documented in preoperative CT scan. The other two, in whom there were no adrenal abnormalities in CT scan, showed renal vein thrombosis. All 3 patients had advanced stage (T3b or T4). Mean renal tumor size in patients with adrenal involvement was 13.7cm (8-24) compared to 5.9cm (1.5-18) in those without adrenal involvement. Two of 3 patients with adrenal involvement had the adrenal invasion by direct extension of tumor from the upper pole of the kidney and 1 patient by hematogenous metastasis. CONCLUSIONS: Adrenalectomy may not be needed to perform routinely in localized, early stage renal cell carcinoma (T1-2), particularly when CT is negative for adrenal involvement. In renal cell carcinoma with risk factors, such as high stage (T3-4), large tumor involving the upper pole and renal vein thrombus, adrenalectomy should be performed.
Adrenalectomy* ; Carcinoma, Renal Cell* ; Humans ; Kidney ; Neoplasm Metastasis ; Nephrectomy* ; Renal Veins ; Risk Factors ; Thrombosis ; Tomography, X-Ray Computed

PURPOSE: Nodal involvement has long been known to represent the single most reliable indicator of the prognosis for early-stage breast cancer. In common parlance, high-risk node-positive breast cancer has generally been used to describe patients who have involvement of ten or more axillary lymph nodes (10+LN). Breast cancer patients who had 10+LN clearly have a strikingly high risk of tumor recurrence and death. Thus we tried to evaluate the clinical courses of breast cancer patients who had more than 10 positive axillary lymph nodes. METHODS: Of the 587 breast cancer patients who were operated on at Chungnam National University Hospital from February 1992 to November 1999, 31 cases (5.3%) showed involvement of more than 10 axillary lymph nodes. We evaluated the clinical courses of these patients and the differences in survival according to the clinical and pathologic vaiables. Survival was calculated using the Kaplan-Meier method. RESULTS: The mean age of the patients was 50+/-4 years. A mastectomy was done in 28 cases (90.3%), and a breast conserving operation was done in 3 cases (9.7%). The mean tumor size was 4.8+/-.5 cm. The mean number of removed axillary Lymph Nodes was 23.5+/-0.2 (range:10-52), and the mean number of positive axillary LNs was 20.0+/-10.1 (10-51). At a median follow-up of 30.5 months, 23 cases (74.2%) of recurrence were noted. Among these 23 cases (69.6%) showed distant metastases as the first recurrence. The 3-year and 5-year disease-free survivals were 28.6% and 22.9%, respectively. The 3-year and 5-year expected overall survivals were 53.7% and 41.8%, respectively. There were significantly more recurrences in patients who had given up taking their adjuvant chemotherapy than for those patients who had completed 6 cycles of FEC or MMM. Also, significant survival benefits were noted in those patients who were treated using a combination chemotherapy with taxane plus cisplatin after their tumor recurrence. CONCLUSION: Breast cancer patients with 10+LNs have a strikingly high risk of tumor recurrence. Six cycles of adjuvant chemotherapy with FEC or MMM was a controllable variable for lowering the risk of tumor recurrence. A combination chemotherapy with taxane and cisplatin was also a controllable variable for increasing survival after tumor recurrence.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Cisplatin ; Disease-Free Survival ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Mastectomy ; Neoplasm Metastasis ; Prognosis ; Recurrence

A clinical comparison of the urine acid-fast bacilli culture results with 82 cases of renal tuberculosis patients was made who were admitted to the Department of Urology, Wonju Christian Hospital during the period from January, 1982 to December, 1989. The urine acid-fast bacilli culture positive rate was 37.8%. The glucose and protein contents in urine of culture positive group were 47.6 mg% and 56. 8mg% and they were higher than those of culture negative group's 29.4 mg% and 27.7 mg%. The most frequent symptom in the urine acid-fast bacilli culture positive group was voiding symptoms (48%), and flank pain was the most frequent symptom(48%) in the urine acid-fast bacilli culture negative group. Non visualized kidney or delayed visualization was the main excretory urography findings in 41% of the culture positive and 74% of the culture negative group. In early renal tuberculosis the radiologic changes are minimaland the culture positive rate is high and the main complaints of patients are bladder irritation symptoms, later the disease progresses and the obstructive symptom appear more frequently and the culture positive rate is low. We concluded that the culture positive rate, excretory urography findings and main symptoms are related with the drainage of urine.
Drainage ; Flank Pain ; Gangwon-do ; Glucose ; Humans ; Kidney ; Tuberculosis, Renal* ; Urinary Bladder ; Urography ; Urology

PURPOSE: The purpose of this study was to investigate the diametral tensile strength of polymer-based temporary crown and fixed partial denture (FPD) materials, and the change of the diametral tensile strength with time. MATERIAL AND METHODS: One monomethacrylate-based temporary crown and FPD material (Trim) and three dimethacrylate-based ones (Protemp 3 Garant, Temphase, Luxtemp) were investigated. 20 specimens (the empty set 4 mm x 6 mm) were fabricated and randomly divided into two groups (Group I: Immediately, Group II: 1 hour) according to the measurement time after completion of mixing. Universal Testing Machine was used to load the specimens at a cross-head speed of 0.5 mm/min. The data were analyzed using one-way ANOVA, the multiple comparison Scheffe test and independent sample t test (alpha = 0.05). RESULTS: Trim showed severe permanent deformation without an obvious fracture during loading at both times. There were statistically significant differences among the dimethacrylate-based materials. The dimethacrylate-based materials presented an increase in strength from 5 minutes to 1 hour and were as follows: Protemp 3 Garant (23.16 - 37.6 MPa), Temphase (22.27 - 28.08 MPa), Luxatemp (14.46 - 20.59 MPa). Protemp 3 Garant showed the highest value. CONCLUSION: The dimethacrylate-based temporary materials tested were stronger in diametral tensile strength than the monomethacrylate-based one. The diametral tensile strength of the materials investigated increased with time.
Acrylic Resins ; Bisphenol A-Glycidyl Methacrylate ; Collodion ; Composite Resins ; Crowns ; Denture, Partial, Fixed ; Methacrylates ; Polymethacrylic Acids ; Tensile Strength

PURPOSE: Nodal involvement has long been known to represent the single most reliable indicator of the prognosis in early-stage breast cancer. In common parlance, high-risk node-positive breast cancer has generally been used to describe patients who have involvement of ten or more axillary lymph nodes (10 LN). Patients with 10 LN clearly have a strikingly high risk of recurrence and death. Thus we tried to evaluate the clinical courses of breast cancer patients with more than 10 positive axillary lymph nodes. METHODS: Of 587 breast cancer patients operated on at Chungnam National University Hospital from Feb. 1992 to Nob. 1999, 31 cases (5.3%) showed involvement of more than 10 axillary lymph nodes. We evaluated the clinical courses of these patients and differences in survival related to clinical and pathologic vaiables. Survival was calculated using the Kaplan-Meier method. RESULTS: The mean age of the patients was 50 14 years. A mastectomy was performed in 28 cases (90.3%), and a breast conserving operation in 3 cases (9.7%). The mean tumor size was 4.8 2.5 cm. The mean number of removed axillary LN was 23.5 10.2 (10-52), and the mean number of positive axillary LN was 20.0 10.1 (10-51). At a median follow-up of 30.5 months, 23 cases (74.2%) of recurrence were noted. Among these 69.6% (16/23) showed distant metastases as a first recurrence. The 3-year and 5-year disease-free survivals were 28.6% and 22.9%, respectively. The 3-year and 5-year expected overall survivals were 53.7% and 41.8%, respectively. There were significantly more recurrences in patients who had given up adjuvant chemotherapy than patients who had completed 6 cycles of FEC or MMM. Also, significant survival benefits were noted in patients who were treated using combination chemotherapy with taxane plus cisplatin after recurrence. CONCLUSION: Breast cancer patients with 10 LN have a strikingly high risk of recurrence. Six (6) cycles of adjuvant chemotherapy with FEC or MMM was a controllable variable for lowering the risk of recurrence. Also, combination chemotherapy with taxane and cisplatin was a controllable variable for increasing survival after recurrence.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Cisplatin ; Disease-Free Survival ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Mastectomy ; Neoplasm Metastasis ; Prognosis ; Recurrence