BACKGROUND: Endoscopic Ultrasonography(EUS), a combination of endoscopy and ultrasonography is one of the most useful tools for diagnosis of digestive system diseases. EUS is useful in staging the primary tumor invasion and regional lymph node metastasis because of its ability to image the gut wall and adjacent structures in unique detail. We performed a study preoperatively for assessing the accuracy and limitation of EUS in gastric carcinoma. METHODS: In 75 patients(Male 54, Female 21, Mean age 62.3 years) with a gastric carcinoma confirmed by endoscopic biopsy, we performed EUS preoperatively. The results were compared with the postoperative histopathologic staging. RESULTS: 1) In assessing the depth of tumor invasion, EUS accuracy on depth of invasion was 76.0% and overstaging and understaging were 14.7% and 9.3%, respectively. 2) In assessing the lymph node metastasis, the accuracy rate of EUS was 65.3%. A rate of false-positive diagnosis was 27.3%, and a rate of false-negative diagnosis was 24.5%.3) In assessing the incidence of lymph node metastasis for each T stage, the involve rate was 10.5% in pT1, 36.4% in pT2, 95.7% in pT3, 100% in pT4. CONCLUSIONS: EUS is the most accurate diagnostic methods presently available to determine tumor infiltration depth and lymph node metastasis.
Biopsy ; Diagnosis ; Digestive System Diseases ; Endoscopy ; Endosonography* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Lymph Nodes ; Neoplasm Metastasis ; Stomach* ; Ultrasonography

No abstract available.
Tetralogy of Fallot*

No abstract available.
Heart* ; Thoracic Surgery*

BACKGROUND/AIMS: Electrohydraulic lithotrypsy(EHL) under cholangioscopic control has been performed for difficult bile duct stones. The percutaneous transhepatic approach is technically easy and useful in diagnosis and treatment of bile duct obstruction and stones. Biliary stenting with self expanding metal stent is gaining increasingly wider acceptance as a palliative treatment of bile duct obstruction. METHODS: Between Sep. 1994 and Sep. 1996, EHL under choledochoscopy by percutaneous transhepatic approach was performed in 30 cases(Male: 13, Female: 17). After PTBD with 7F pig tail catheter, the percutaneous transhepatic passage was dilated over guide wire with dilaters of increasing size up to 16Fr in 3-Sdays. In one week, after fistula had been estabilished, choledochoscopy was performed. RESULTS: (1) Mean age was 61.3 years. Mean stone number was 2.5. And mean stone size was 1.6 X 2.3 cm. (2) Com.plete removal of the stone was achieved in all patients(100%). (3) There were no serious complications. (4) In six cases, Endocoils were implanted with successful decompression of obstructions and simultaneous removal of biliary stones located at both side of stricutre. CONCLUSIONS: Percutaneous transhepatic choledochoscopy is easy and safe and assists in the diagnosis and treatment of biliary stricture and the management of difficult CBD stone.
Bile Ducts ; Catheters ; Cholestasis ; Common Bile Duct* ; Constriction, Pathologic ; Decompression ; Diagnosis ; Female ; Fistula ; Humans ; Palliative Care ; Stents

No abstract available.
Tuberculosis, Pulmonary*

OBJECTIVE: To evaluate the efficacy and safety of concurrent chemotherapy of paclitaxel and carboplatin with standard pelvic radiotherapy as adjuvant therapy after primary surgery in high-risk cervical cancer. METHODS: Twenty-eight patients with FIGO stage IB1-IIB cervical cancer who received adjuvant concurrent chemoradiotherapy with paclitaxel and carboplatin from February 2000 to November 2001 were analyzed retrospectively in this study. Adjuvant chemoradiotherapy was done if there were lymph node involvement or at least 2 positive findings among following risk factors; lymphovascular space invasion, full- thickness involvement of cervix and tumor size larger than 4 cm in diameter. Two cycles of paclitaxel 135 mg/m2, followed by carboplatin with AUC of 4.5 were administered intravenously with an interval of at least 4 weeks. The radiotherapy was initiated concurrently at the first day of chemotherapy. The therapeutic results were evaluated by pelvic examination, Pap smear, SCCA (Squamous cell carcinoma antigen) and computed tomography (CT). The toxicities of the treatment were evaluated and graded by NCI-CTC version 2.0. RESULTS: Total 56 cycles of paclitaxel/carboplatin chemotherapy with concomitant pelvic radiotherapy was delivered. None of the patients had a progressive or recurrent disease during the follow-up period ranging from 6 to 33 months (median: 12.5 months). Neutropenia was the most common and concerned toxicity. Fifteen cases of grade 3 and 4 neutropenia (26.8%) were observed. Non-hematologic toxicities were mild and mainly related to neurologic or gastrointestinal symptoms. Eight cases of grade 1 and 2 neurotoxicity were observed (14.3%). CONCLUSION: The adjuvant chemoradiotherapy with paclitaxel and carboplatin seems to be effective and well-tolerated for the treatment of high risk group cervical cancer after primary surgical therapy. But a large randomized study with longer duration of follow-up is needed to justify this conclusion.
Area Under Curve ; Carboplatin* ; Cervix Uteri ; Chemoradiotherapy* ; Chemoradiotherapy, Adjuvant ; Drug Therapy ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Lymph Nodes ; Neutropenia ; Paclitaxel* ; Radiotherapy ; Retrospective Studies ; Risk Factors ; Uterine Cervical Neoplasms*

No abstract available.
Humans ; Polyamines*

PURPOSE: To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. MATERIALS AND METHODS: Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. RESULTS: The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. CONCLUSION: HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.
Brachytherapy* ; Humans ; Mouth Neoplasms ; Mouth* ; Radiotherapy ; Recurrence ; Retrospective Studies

BACKGROUND: Disseminated intravascular coagulation (DIC) is a syndrome characterized by a systemic activation of coagulation leading to the intravascular deposition of fibrin and the simultaneous consumption of coagulation factors and platelets. Inflammatory cytokines can activate the coagulation system. This study investigated the diagnostic and prognostic usefulness of the plasma level of interleukin-6 (IL-6) and interleukin-10 (IL-10) for predicting DIC. METHODS: The study populations were 15 healthy controls and 81 patients who were clinically suspected of having DIC and were requested to perform DIC battery tests. The presence of overt DIC was defined by the International Society on Thrombosis and Haemostasis Subcommittee cumulative score of 5 or above. The 28 day mortality was used to assess the prognostic outcome. The plasma levels of the cytokines were measured by ELISA. RESULTS: The plasma levels of IL-6 and IL-10 in patients (N=81) were higher than those of control (N=15). IL-6 and IL-10 levels of overt DIC group (N=31) were 3 times and 1.5 times higher than those, respectively, of non-overt DIC group (N=50). In infection group (N=48), IL-6 and IL-10 levels of overt DIC group (N=18) were 5 times and 3 times higher than those, respectively, of non-overt DIC group (N=30). The diagnostic efficiency of IL-6 (optimal cut off >40.4 pg/mL) and IL-10 (>9.7 pg/mL) for the diagnosis of overt DIC were 67% and 69%, respectively, which were similar to that of D-dimer. Plasma levels of IL-6 and IL-10 were also higher in non-survivors than in survivors. The patients with higher levels of IL-6 and IL-10 showed a poorer prognosis. CONCLUSIONS: The proinflammatory cytokine, IL-6 and anti-inflammatory cytokine, IL-10 were useful for the diagnosis of overt DIC and the prediction of its prognosis. These results also showed the evidence of a close interaction between coagulation and inflammation.
Adult ; Aged ; Blood Coagulation Tests ; Disseminated Intravascular Coagulation/blood/*diagnosis/mortality ; Female ; Humans ; Infection/blood ; Interleukin-10/*blood ; Interleukin-6/*blood ; Male ; Middle Aged ; Prognosis ; Survival Analysis

No abstract available.
Humans ; Nephritis, Interstitial* ; Nephrotic Syndrome*