No abstract available.
Humans

No abstract available.
Failed Back Surgery Syndrome*

No abstract available.

PURPOSE: Although adjuvant chemotherapy after resection of gastric cancer is a popular practice in Korea, there are still controversies about the effectiveness of the treatment. The fact that the relatively less effective drugs have been used and the rarity of large-scaled controlled studies may be partially responsible for the controversies. FP(5-FU, Cisplatin) combination is one of the most active regimen against advanced gastric cancer, consistently showing a response rate of 50~60%. We tried the FP chemotherapy as an adjuvant treatment for high-risk patients after curative resection of gastric cancer. MATERIALS AND METHODS: Between February 1992 and June 1996, 35 patients with completely resected high-risk gastric cancer(postoperative stage III or IV except thase with M1) received six courses of FP chemotherapy. Endpoints were toxicities of treatment, relapse free survival, and overall survival. RESULTS: With a median follow-up time of 17.1 months, Kaplan-Meier estimates of 2-year overall survival was 63.3% and relapse free survival estimates was 49%. There were no differences between stage III and IV patients in terms of overall survival or relapse free survival. Hematologic and non-hematologic toxicities were tolerable for most of the patients. CONCLUSION: Postoperative FP combination chemotherapy was tolerable for patients with high-risk(stage III and IV) gastric cancer. It is too early to determine the long term survival rates for this patients, but 2-year overall and relapse free survival were comparable to that of historical non-cisplatin containing regimens. Randomized phase III studies are warranted.
Chemotherapy, Adjuvant ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil* ; Follow-Up Studies ; Humans ; Korea ; Recurrence ; Stomach Neoplasms* ; Survival Rate

No abstract available.
Child* ; Humans ; Hydrocephalus*

BACKGROUND/AIMS: A single gene mutation alone cannot explain the poor prognosis of colorectal cancer. This study aimed to establish a correlation between the expression of six proteins and the prognosis of colorectal cancer patients. METHODS: Tissue samples were collected from 266 patients who underwent surgery for colorectal cancer at our institution from January 2006 to December 2007. The expression of six proteins were determined using immunohistochemical staining of specimens. RESULTS: Cathepsin D, p53, COX-2, epidermal growth factor receptor, c-erbB-2, and Ki-67 expression were detected in 38.7%, 60.9%, 37.6%, 35.7%, 30.1%, and 74.4% of the samples, respectively. The expression of cathepsin D was significantly correlated with reduced cancer-free survival (p=0.036) and colorectal cancer-specific survival (p=0.003), but the other expression levels were not. In a multivariate analysis, cathepsin D expression was found to be an independent prognostic factor for poorer colorectal cancer-specific survival (hazard ratio, 8.55; 95% confidence interval, 1.07 to 68.49). Furthermore, patients with tumors expressing four or more of the proteins had a significantly decreased cancer-free survival rate (p=0.006) and colorectal cancer-specific survival rate (p=0.002). CONCLUSIONS: Patients with cathepsin D positivity had a poorer outcome than patients who were cathepsin D-negative. Thus, cathepsin D may provide an indicator for appropriate intensive follow-up and adjuvant chemotherapy.
Adenocarcinoma/*pathology ; Adenocarcinoma, Mucinous/pathology ; Adult ; Aged ; Cathepsin D/analysis ; Colorectal Neoplasms/*pathology ; Cyclooxygenase 2/analysis ; Female ; Humans ; Ki-67 Antigen/analysis ; Male ; Middle Aged ; Prognosis ; Receptor, Epidermal Growth Factor/analysis ; Receptor, ErbB-2/analysis ; Survival Analysis ; Tumor Markers, Biological/*analysis ; Tumor Suppressor Protein p53/analysis

Although the incidence is very low, acute mechanical obstruction of the right coronary artery may occur as a cause of right ventricular failure during aortic surgery. In a 67-year-old woman with severe aortic regurgitation, acute right ventricular failure was noticed at the end of cardiopulmonary bypass weaning after an aortic valve replacement with a Hancock II 19 mm bioprosthesis. We suspected mechanical obstruction of the right coronary artery and consequent coronary artery bypass graft to the right coronary artery with right internal mammary artery was performed with success in weaning the bypass. On the postoperative 9th day, the right coronary angiogram revealed obstruction at proximal right coronary artery by plaque emboli. We herein report a clinical case in which the acute right ventricular failure occurred due to mechanical obstruction of the right coronary artery was recovered by coronary artery bypass graft to the right coronary artery.
Aged ; Aortic Valve Insufficiency ; Aortic Valve* ; Bioprosthesis ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Vessels* ; Female ; Humans ; Incidence ; Mammary Arteries ; Transplants ; Weaning

OBJECTIVE: The purpose of this study was to review the incidence, types, chemotherapy regimens, operation methods, pregnancy rate and propiosis of the ov#arian malignancy under the age of twenty years old. METHODS: Retrospective reviews of the medical recordings for 22 patients with ovarian malignancy under the age of twenty years old in the Department of Obstetrics and Gynecology, Hanyang University from 1986 to 1997 were done. RESULTS: Gerin cell tumor accounts for the majority of cases (77%), whereas 5 patients(23%) belong to the common epithelial poup which were all mucinous type. Our experiences with 22 cases are as followings: 5 mucinous cystadenocarcinoma, 8 immature teratoma, 4 endodermal sinus tumor, 3 dysgernma and 2 mixed germ cell tumor. The incidence of this group was 8.2% (22/266) in all ovarian malignancy. Fourteen of them are stage I, each one is, stage II and IV, and six patients are stage III. The average age was 14.9 years old in germ cell tumor and 18.4 yems old in mucinous cystadenoearcinoma. Malignant ovarian cancer under the age of twenty can be treated with conservative surgery, followed by adjuvant chemotherapy. Commonly used chemotherapeutic regimens were VAC(Vincristine, Actinomycin-D; Cyclophosphamide), VBP(Vinblastine, Bleomycin, Cisplatin) and BEP(Bleomycin, Etoposide, Cisplatin). Second look operations were done in 11 patienth and histologic positive findings were detected in 4 of them. The length of follow-up ranged ftom 3 months to 137 months and median value was 44 rnonths. CONCLUSIONS: It is concluded that for young women who wish to preserve child-bearing capacity, regardless of the stage of the tumor, fertility preserving surgery with complete surgical staging, if necessary followed by combination chemotherapy is an appropriate treatment.
Bleomycin ; Chemotherapy, Adjuvant ; Cystadenocarcinoma, Mucinous ; Drug Therapy ; Drug Therapy, Combination ; Endodermal Sinus Tumor ; Etoposide ; Female ; Fertility ; Follow-Up Studies ; Gynecology ; Humans ; Incidence ; Medical Records ; Mucins ; Neoplasms, Germ Cell and Embryonal ; Obstetrics ; Ovarian Neoplasms ; Pregnancy Rate ; Retrospective Studies ; Teratoma

A retrospective review was performed of 33 patients aged under 30 with intracranial aneurysms; seven were between ten and nineteen years old, and 26 were in their twenties. Aneurysms were much more common in men, with a male to female ratio of 2.3:1. Among the younger age group, the most frequent location was the internal carotid artery(71.4%), and in those in their twenties, the anterior communicating artery(61.5%). Compared with the overall patients with intracranial aneurysms, aneurysms of anterior communicating artery, internal carotid artery and anterior cerebral artery were more common among the younger patients, but middle cerebral artery and multiple aneurysms were rare in this age group. Angiographic vasospasms were observed in 8 patients, but symptomatic vasospasms were seen in only three, none of whom were in the younger age group. All patients underwent direct clipping of the aneurysmal neck. The surgical outcome was favorable in 91% of cases, and the mortality rate was 6.1%; the outcome was influenced by the patient's preoperative clinical status, but did not depend on their age or the timing of the operation.
Aneurysm ; Anterior Cerebral Artery ; Arteries ; Carotid Artery, Internal ; Female ; Humans ; Intracranial Aneurysm* ; Male ; Middle Cerebral Artery ; Mortality ; Neck ; Retrospective Studies

Tricyclic antidepressant (TCA) is a useful drug for treating neuropathic pain. However, tremors are one of the relatively frequent side effects of TCA. A female patient, who was suffering from postherpetic neuralgia, was treated with amitriptyline starting with 10 mg/day. She developed resting tremors on the second day after increasing the dose to 30 mg/day. This case highlights the need for the careful use of amitriptyline in the treatment of neuropathic pain in elderly patients.
Aged ; Amitriptyline ; Female ; Humans ; Neuralgia ; Neuralgia, Postherpetic ; Tremor*