PURPOSE: To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. MATERIALS AND METHODS: Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. RESULTS: The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. CONCLUSION: Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.
Anus Neoplasms ; Chemoradiotherapy ; Dermatitis ; Electrons ; Follow-Up Studies ; Humans ; Incidence ; Neoplasm Metastasis ; Pelvis ; Retrospective Studies ; Skin

PURPOSE: We reviewed the treatment outcomes and prognostic factors for patients with anal canal carcinoma who were treated with curative intent chemoradiotherapy (CRT) at Severance Hospital from 2005 to 2011. MATERIALS AND METHODS: Data for 38 eligible patients treated during this period were reviewed. All patients were treated with curative intent using radiotherapy (RT) with (n = 35) or without concomitant chemotherapy (n = 3). Among 35 patients who received CRT, most of the chemotherapeutic regimens were either 5-fluorouracil (5-FU) plus mitomycin C (23 patients) or 5-FU plus cisplatin (10 patients). Recurrence-free survival (RFS), colostomy-free survival (CFS), overall survival (OS), and locoregional control (LRC) rates were calculated using the Kaplan-Meier method and survival between subgroups were compared using the log-rank test. Cox's proportional hazard model was used for multivariate analysis. RESULTS: Over a median follow-up period of 44 months (range, 11 to 96 months), 3-year RFS, CFS, OS, and LRC were 80%, 79%, 85%, and 92%, respectively. In multivariate analysis, tumor size >4 cm was an independent predicting factor for poorer RFS (hazard ratio [HR], 6.35; 95% confidence interval [CI], 1.42 to 28.5; p = 0.006) and CFS (HR, 6.25; 95% CI, 1.39-28.0; p = 0.017), while the presence of external iliac lymph node metastasis was an independent prognosticator for poorer OS (HR, 9.32; 95% CI, 1.24 to 70.3; p = 0.030). No treatment-related colostomies or deaths occurred during or after treatment. CONCLUSION: Curative intent CRT resulted in excellent outcomes that were comparable to outcomes in previous randomized trials. No severe treatment-related toxicities were observed.
Anal Canal ; Anus Neoplasms ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Cisplatin ; Colostomy ; Fluorouracil ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mitomycin ; Multivariate Analysis ; Neoplasm Metastasis ; Proportional Hazards Models

Gastric tuberculosis is a rare disease and the diagnoeis of gastric tuberculosis is based on either positive histological or bacteriological study. We experienced a case of gastric tuberculosis with pleural effuaion in 59 year-old woman, diagnosed by the histological study of the endoscopic biopsy specimen. Follow up endoscopic finding revealed marked improvement of gastric lesion after anti-tubercadoua medication. We reported the case with review of literature.
Biopsy ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Rare Diseases ; Tuberculosis*

Higenamine is known to possess stimulatory activity on beta-receptor of the heart. Chronotropic actions of higenamic were studied in spontaneously beating right atrial muscle isolated from rabbits. The frequency of spontaneous beating and the relative threshold voltage of the right atrium were examined. The relative threshold voltage was defined as the minimal voltage of the given impulse above which the right atrium could be paced at the frequency of 20% of higenamine was also observed. Higenamine caused the postive chronotropic effect. This response became prominent as the ca2+ concentration in the bathing solution lowered. When tetrodotoxin was added to the bathing solution, the effect of higenemine altered and became similar to that of epinephrine. Higenamine reduced the relative threshold voltage of the right atrium in the bathing solution with [ca2+] of 0.5mM. Such effect was abolished by tetrodotoxin. The effects of verapamill on the spontaneous rate and the relativel threshold voltage were inhibited by higenemine. The above results suggest that, aithough the main action og higenamine is on the Ca channel, higenamine also have a minor effect of augmenting the Na channel.
Baths ; Epinephrine ; Heart ; Heart Atria* ; Heart Rate ; Rabbits ; Tetrodotoxin ; Verapamil

The possibility for cyclooxygenase (COX) inhibitors in colorectal cancer prevention and theraphy is evident from epidemiologic data (reduction of colorectal cancer in nonsteroidal anti-inflammatory drugs (NSAIDs) users), animal experiments (nude mouse xenograft tumor reduced by NSAIDs or reduction of colorectal cancer in APCmin mouse and azoxymethane treated rat by using NSAIDs), and molecular genetics. Among two variant COX, inducible COX-2 enzyme is more involved in tumorigenesis than constitutive COX-1 enzyme and molecular method have given us insight into the mechanism of colorectal cancer development by COX-2 such as, apoptosis, angiogenesis, invasiveness, and immune modulation. Based on that COX-2 is involved in tumor promotion during colorectal cancer progress, a large number of prevention and treatment trials of colorectal cancer have been started. And many trials to elucidate the function of prostaglandin produced by COX-2 are now in progress.
Animal Experimentation ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; Apoptosis ; Azoxymethane ; Carcinogenesis ; Colorectal Neoplasms* ; Cyclooxygenase 2 ; Heterografts ; Mice ; Molecular Biology ; Prostaglandin-Endoperoxide Synthases ; Rats

PURPOSE: To describe the early experience of analyzing variations and time trends in bladder volume of the rectal cancer patients who received bladder ultrasound scan. MATERIALS AND METHODS: We identified 20 consecutive rectal cancer patients who received whole pelvic radiotherapy (RT) and bladder ultrasound scan between February and April 2012. Before simulation and during the entire course of treatment, patients were scanned with portable automated ultrasonic bladder scanner, 5 times consecutively, and the median value was reported. Then a radiation oncologist contoured the bladder inner wall shown on simulation computed tomography (CT) and calculated its volume. RESULTS: Before simulation, the median bladder volume measured using simulation CT and bladder ultrasound scan was 427 mL (range, 74 to 1,172 mL) and 417 mL (range, 147 to 1,245 mL), respectively. There was strong linear correlation (R = 0.93, p < 0.001) between the two results. During the course of treatment, there were wide variations in the bladder volume and every time, measurements were below the baseline with statistical significance (12/16). At 6 weeks after RT, the median volume was reduced by 59.3% to 175 mL. Compared to the baseline, bladder volume was reduced by 38% or 161 mL on average every week for 6 weeks. CONCLUSION: To our knowledge, this study is the first to prove that there are bladder volume variations and a reduction in bladder volume in rectal cancer patients. Moreover, our results will serve as the basis for implementation of bladder training to patients receiving RT with full bladder.
Humans ; Observer Variation ; Rectal Neoplasms ; Ultrasonics ; Urinary Bladder

PURPOSE: To investigate the patterns of locoregional recurrence of pathologic T3N0 (pT3N0) lower rectal cancer omitting postoperative radiotherapy (RT) and explore the potential of modification of a RT field. MATERIALS AND METHODS: From Jan 2003 to Nov 2011, 35 patients omitting preoperative or postoperative RT for pT3N0 lower rectal cancer were included. We defined the lower rectal cancer as the tumor with the inferior margin located below the virtual line-a convergent level between rectal wall and levator ani muscle. All patients had radiologic examinations for recurrence evaluation during the follow-up duration. RESULTS: The median follow-up duration was 66.4 months (range, 1.4 to 126.1 months). Eight (22.9%) of the 35 patients had recurrence. Three (8.6%) was local recurrence (LR) only, 3 (8.6%) was distant metastasis (DM) only, and 2 (5.7%) was LR with DM. All LR were located at primary tumor sites. The overall survival rate, LR-free survival rate, and DM-free survival rate at 5 years was 79.8%, 83%, and 87%, respectively. All LR developed from tumors over 5 cm. However, there was no statistical significance (p = 0.065). There was no other risk factor for LR. CONCLUSION: Even though the patients included in this study had pathologically favorable pT3N0 rectal cancer, LR developed in 14.3% of patients. Most of the LR was located at primary tumor sites prior to surgery. Based on these findings, it might seem reasonable to consider postoperative RT with a smaller radiation field to the primary tumor site rather than the conventional whole pelvic irradiation.
Follow-Up Studies ; Humans ; Muscles ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; Recurrence ; Risk Factors ; Survival Rate

Myxoma is a relatively rare tumor of mesenchymal origin that can be found in numerous sites throughout the body including heart, skin, and subcutaneous tissue along with various sites in the head and neck. It is presumed to be originated from dental malformation or missing teeth, but occasionally myxoma without dental abnormalities is found giving arguments for its embryogenesis. Myxoma in the head and neck is usually managed by radical operation in order to prevent the possible recurrence. A case of recurrent myxoma of maxilla is described, which was treated with en-bloc removal via lateral rhinotomy incision. The purpose of this article is to present a case of myxoma of maxilla with a review of the literature and is to give a special emphasis on the proper modalities of treatment which minimizes recurrence and functional deficit.
Embryonic Development ; Female ; Head ; Heart ; Maxilla* ; Myxoma* ; Neck ; Pregnancy ; Recurrence ; Skin ; Subcutaneous Tissue ; Tooth

PURPOSE: To report a patient with multiple subretinal and intraretinal hemorrhages in the absence of retinal/choroidal lesions, diagnosed with infective endocarditis (IE). CASE SUMMARY: We describe the case of a 44-year-old male with an acute decrease of vision in his right eye. Ophthalmic evaluation revealed multiple subretinal and intraretinal hemorrhages, but no choroidal or other retinal lesions. A systemic examination revealed a pansystolic murmur and blood cultures with echocardiography were suggestive of IE. CONCLUSIONS: Thorough systemic evaluations are important when patients present with subretinal and intraretinal hemorrhages in the absence of other retinal/choroidal lesions.
Adult ; Choroid ; Echocardiography ; Endocarditis* ; Hemorrhage* ; Humans ; Male ; Retinal Hemorrhage ; Retinaldehyde

Midline lesion at the base of skull have been considered in the past to be inoperable, partially respectable, and even when respectable, unpleasant difficult. According for the above has been the poor visulization of minimal surgical exposure, copious bleeding and lack of adequate fluoroscopic depth monitoring. These built-in difficulties may prove to be a fertile ground for microsurgery. Presently the use of the surgical dissecting microscope, portable image intensifiers and specifically designed microinstruments has enabled to permit approach of clival area for removal of the clival tumor. Authors had experience of transoral approach for removal of lower third of clival meningioma, and reviewed surgical approachs to midline lesion at the base of the skull.
Hemorrhage ; Meningioma* ; Microsurgery ; Skull ; Skull Base