No abstract available.
Anal Canal* ; Carcinoma, Squamous Cell* ; Chemoradiotherapy*

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

A case of gouty polyarthropathy accompanied with carpal tunnel syndrom is reporte, in a 70 year old man. The patient was treated by removal of tophaceous materials surgically in both knee and right wrist joints for the relief of pain. There was a relatively good result postoperatively in the aspect of pain free motion of joints, but he was died of the complication of gouty nephropathy 4 months later after discharge.
Arthritis ; Gout ; Humans ; Joints ; Knee ; Wrist ; Wrist Joint

No abstract available.
Decompression* ; Facial Nerve* ; Melkersson-Rosenthal Syndrome*

Recently many domestic hospitals computerize and automatize the process to manage their own medical data. These medical data should be shared among the departments in the hospital and be held in common in case of patients transfers or references to the remote hospitals. However, there is no simple method to share data among the management systems to be shared due to their heterogeneous platforms. Schema sharing with systems and standard format data transfer could be a solution. In this paper, we propose HIES(Hospital Information Exchange System), which uses XML as a standard medical data transfer method. HIES uses XML, which is currently recognized as the standard of electronic documents, for integrating and managing heterogeneous and distributed medical data. Information Sharing Manager to maintain consistent schema information for heterogeneous database systems in hospital systems as well as Image Compression/Partition Manager for efficient image data transfer and reemergence among the systems are implemented.
Data Compression ; Humans ; Information Dissemination

Differential surgical procedures have been described on the treatment of patients with obstructing carcinoma of the left colon and rectum, and these vary from classical three stage approach to primary resection and anastomosis using intraoperative colonic irrigation or subtotal colectomy. Staged colonic prcedures are associated with significant morbidity and mortality eventhough its initial easy performance, and many patients, unfit for further surgery, are left with a permanent colostomy. We have already reported the initial results of intraoperative antegrade colonic irrigation for one-stage operation in obstructing left colorectal cancers. In this investigation, we evaluated the results of prospective trials of primary resection and anastomosis using intraoperative colon irrigation and subtotal colectomy in obstructing left colon and rectal carcinomas. During recent five years, 19 cases of obstructing left colon and rectal carcinomas which could not received regular colon preparation due to marked abdominal distension were enrolled to this study. There were 12 men and 7 women, and mean age was 61. 14 of the 19 patients which tumors located below mid-descending colon were subjected to primary resection and anastomosis using intraoperative antegrade colonic irrigation, 4 patients which tumors located above the mid-descending colon were treated with subtotal colectomy, and remaining one patient which tumor located upper rectum was performed subtotal coloectomy because of underlying colonic ischemia. There was no mortality and significant postoperative complications such as anastomotic lealrage, pelvic abscess or intraabdominal sepsis which seemed to be related with anastomotic dehiscence. Therefore, primary resection and anastomosis using intraoperative colonic irrigation or subtotal colectomy depending on tumor locations in cases of obstructing left colon and rectal carcinomas might be useful methods to obtain safe one-stage restorative colorectal resections.
Abscess ; Colectomy ; Colon* ; Colorectal Neoplasms ; Colostomy ; Female ; Humans ; Intestinal Obstruction ; Ischemia ; Male ; Mortality ; Postoperative Complications ; Prospective Studies ; Rectum ; Sepsis

PURPOSE: Anal canal carcinoma is a rare clinical entity accounting for 1 to 3 percent of all gastrointestinal malignancies. Prevoiously, abdominoperineal resection was the primary modality of treatment. However, a recurrence rate of 20 to 40 percent has been observed following this procedure. In recent years, multimodal therapy with radiation and chemotherapy has been shown to at least equal the results obtained through surgery with the ability to preserve sphincter function. The objective of this study is to evaluate the survival, recurrence pattern, acute and late morbidity rates of a widely used combined chemotherapy and radiation therapy regimen given to patients with carcinoma of the anal canal. METHODS: Ten patients received radiation therapy (5,000~5,400 cGy) and chemotherapy (mitomycin-C plus 5-fluorouracil) as a primary treatment between 1988 and 1998. RESULTS: Patients with primary tumors had a complete response rate of 60 percent and a 10-year corrected survival rate and disease-free survival rate of 77.14 percent and 60 percent, respectively. There was a significant difference in survival rates and disease-free survival rates according to AJCC stage. Acute complications (grade III~IV, ECOG toxicity criteria) such as leukopenia, anemia, thrombocytopenia and radiation dermatitis were seen in 10 to 50 percent of cases. Furthermore, 20 percent of patients experienced late treatment-related symptoms including perineal fibrosis and incontinence due to sphincter dysfunction. CONCLUSION: The current treatment regimen is effective but carries a considerable risk of complications. Therefore, new chemotherapeutic modalities that may reduce such complications, but still potent, are needed.
Anal Canal* ; Anemia ; Anus Neoplasms ; Carcinoma, Squamous Cell* ; Dermatitis ; Disease-Free Survival ; Drug Therapy ; Fibrosis ; Humans ; Leukopenia ; Recurrence ; Survival Rate ; Thrombocytopenia

As advanced sequencing technologies continue to uncover an increasing number of variants in genes associated with human genetic diseases, there is a growing demand for systematic approaches to assess the impact of these variants on human development, health, and disease. While in silico analyses have provided valuable insights, it is essential to complement these findings with model organism studies to determine the functional consequences of genetic variants in vivo. Drosophila melanogaster is an excellent genetic model for such functional studies due to its efficient genetic technologies, high gene conservation with humans, accessibility to mutant fly resources, short life cycles, and cost-effectiveness. The traditional GAL4-UAS system, allowing precise control of gene expression through binary regulation, is frequently employed to assess the effects of monoallelic variants. Recombinase medicated cassette exchange or CRISPR-Cas9-mediated GAL4 insertion within coding introns or substitution of gene body with Kozak-Gal4 result in the loss-of-function of the target gene. This GAL4 insertion strategy also enables the expression of reference complementary DNA (cDNA) or cDNA carrying genetic variants under the control of endogenous regulatory cis elements. Furthermore, the CRISPR-Cas9-directed tissue-specific knockout and cDNA rescue system provides the flexibility to investigate candidate variants in a tissue-specific and/or developmental-timing dependent manner. In this review, we will delve into the diverse genetic techniques available in Drosophila and their applications in diagnosing and studying numerous undiagnosed diseases over the past decade.

Papillary serous carcinoma of the peritoneum (PSCP) is a primary tumor of peritoneal lining (mesothelioma) of the abdomen and is histologically difficult to differentiate from papillary serous carcinoma of the ovary. It is very rare tumor that involves the surface of the pelvic and/or abdominal peritoneum. Most patients with this tumor have been treated with optimally surgical cytoreduction and postoperative chemotherapy. However, long term survival has not been achieved in many studies. In recent years, platinum-paclitaxel combination therapy was reported as a effective initial therapy for recurrent PSCP. We have experienced one case of recurrent PSCP which was successfully treated with heptaplatin and paclitaxel. We report the toxicity and long term result of the patient.
Abdomen ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Ovary ; Paclitaxel ; Peritoneum

No abstract available.
Cochlear Implants*