PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*

No abstract available.
Humans ; Korea* ; Multiple Birth Offspring*

PURPOSE: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. MATERIALS AND METHODS: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were an lysed with non-parameteric statistics method. RESULTS: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced . In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. CONCLUSION: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.
Blood Platelets* ; Bone Density ; Bone Resorption ; Bone Transplantation ; Dental Enamel ; Dental Implantation ; Dental Implants ; Humans ; Inlays ; Maxillary Sinus ; Osteogenesis ; Platelet-Rich Plasma ; Tooth ; Transplants

No abstract available.
Extremities* ; Sarcoma*

The combination of the various diagnostic methods of palpable breast mass has improved the diagnosticaccuracy. From Sep.1983 to Aug. 1985 pathologically proven 85 patients with palpable breast masses examined withX-ray mammography, ultrasonography, penumomammography and aspiration cytology at Korea Cancer Center Hospital wereanalyzed. The diagnostic accuracies of each methods were 77.6% of mammogram, 74.1% of ultrasonomgram, 90.5% ofpenumommaogram and 92.4% of aspiration cytology. Pneumommamograms was accomplished without difficulty orcomplication and depicted more clearly delineated mass with various pathognomonic findings; air-ductal pattern infibroadenoma(90.4%) and cystosarcoma phylloides(100%), air-halo in fibrocystic disease(14.2%), fibroadenoma(100%),cystosarcoma phylloides (100%), air-cystogram in cystic type of fibrocystic disease(100%) and vaculoar pattern orirregular air collection without retained peripheral gas in carcinoma.
Breast ; Humans ; Korea ; Mammography ; Ultrasonography

From Jan. of 1990 to Dec. of 1992, we have experienced three cases of multiple primary malignant neoplasms originated from different histogenesis, in the Department of Orthopedic Surgery of Korea Cancer Center Hospital. Liposarcomas, malignant fibrous histiocytoma were combined with renal cell carcinoma, mucinous cystadenocarcinoma of ovary or prostatic cancer. With Moertel's classification, synchronous tumors were found in 2 cases and metachronous in 1 case. Synchronous tumors were 2 liposarcomas-renal cell carcinoma or mucinous cystadenocarcinoma of ovary. Metachronous tumors were malignant fibrous histiocytoma-prostate cancer. We couldn t find any family history among them. The causes of these multiple malignancies were considered as the individual predilrection to tumors.
Carcinoma, Renal Cell ; Classification ; Cystadenocarcinoma, Mucinous ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Liposarcoma ; Orthopedics ; Ovary ; Prostatic Neoplasms

BACKGROUND/AIMS: Imrnortalized human fetal liver cell lines established by transfecting simian virus 40 T gene wae found to lose differentiated liver cell functions in successive long-term culture. Butyrate, known as a differentiation-promoting agent for a variety of cancer cell lines, is produced in the colon by bacterial flora and selectively transported into the liver though the portal blood flow. Therefe, butyrate might play a role in the maintenance of differentiation in hepatocytes in vivo. In thepresent study, the effects of butyrate on cell growth and differentiation in human fetal liver cell lines was investigated. METHODS: Human fetal liver cell lines imrnortalized by SV 40 T antigen were treated with sodium butyrate (1mM), and cell growth rate after butyrate treatment were nmsured by the number of viable cells, determined by trypan blue dye exclusice method. The effects of sodium butyrate on the hepatocyte-specific differentiatian were assessed by albumin and alfa-fetoprotein (AFP) mRNA expression, analyzed using reverse-transcription polymerase chain reaction, and were also by the increment of albumin secretion into culture media, determined by a competitive inhibition ELISA. RESULTS: Treatment with sodium butyrate resulted in a cessation of cellular proliferation and alterations in cellular morphology (increased cell size and polygonal change in shape). The level of albumin mRNA after sodium butyrate treatment was elevated by about two times as compared to that of control. In contrast, AFP mRNA expression were dennstrated neither before nor after sodium butyrate treatment. The average amount of albumin released in the medium was less than 6pghnl/10'cells/2days in the absence of sodium butyrate, and increased to 17 p g/ml/10'cells/2days at day 2, 21ugfml 10'cells/2days at day 4 in the presence of sodium butyrate, and these levels thereafter were over 10 times higher than that in the absence of sodium butyrate until day 10. CONCLUSION: These mults indicate that treatment of immcetalized fetal liver cell lines with butyrate leads to inhibition of cellular proliferation and promotion of adult hepatocyte-specific differentiation.
Adult ; Antigens, Viral, Tumor ; Butyrates ; Butyric Acid* ; Cell Line* ; Cell Proliferation ; Cell Size ; Colon ; Culture Media ; Enzyme-Linked Immunosorbent Assay ; Hepatocytes ; Humans* ; Liver* ; Polymerase Chain Reaction ; RNA, Messenger ; Simian virus 40 ; Sodium* ; Trypan Blue

BACKGROUND/AIMS: Lens culinaris agglutinin-A reactive alpha-fetoprotein (AFP L3) has been reported to be highly specific for the diagnosis of hepatocellular carcinoma (HCC). The present study was to evaluate the clinical usefulness of AFP-L3 for the diagnosis of HCC in the patients either with chronic liver disease or with HCC in complete remission who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. METHODS: A total numer of 34 patients (24 with chronic liver disease, 10 with HCC in complete remission) were enrolled, who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. Serum AFP L3 levels were analysed by AFP differentiation kit L. Abdominal spiral CT or ultrasonogram was performed at 1-3 month intervals and all of the patients were followed up for more than 6 months. RESULTS: Among 24 patients with chronic liver disease, two were positive (higher than 15%) for AFP L3; however, HCC was not detected in these patients, while HCCs were detected in two of 22 patients negative for AFP L3 during followe-up. Eight of the 10 patients with HCC in complete remission were positive for AFP L3; recurrent HCCs were detected in 7 of those 8 patients as well as in the rest 2 patients negative for AFP L3 during follow-up. The overall sensitivity and specificity of AFP L3 measurement for the detection of HCC within 6 months of follow-up were 63.6% and 87.0%, respectively. The positive and negative predictive value for HCC in patients with chronic liver disease were O% and 90.9% and for recurrent HCC in HCC patients in remission were 87.5% and ON, respectively. CONCLUSION: The measurement of AFP L3 is suggested to be useful for the diagnostic strategy in patients either with chronic liver disease or hepatocellular carcinoma in complete remission, who showed progressive increment of serum AFP level and no mass lesion in liver on ultrasonogram.
alpha-Fetoproteins* ; Carcinoma, Hepatocellular ; Diagnosis* ; Follow-Up Studies ; Humans ; Lens Plant* ; Liver Diseases* ; Liver* ; Recurrence ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Ultrasonography*

Gastritis cystica profunda (GCP) is an uncommom hyperplastic lesion, which is located within the submucosa. GCP may occur several years after previous gastric surgery. In some reported cases, it was a premalignant condition and may lead to carcinoma of the stomach. We report a case of a 54-year-old man with epigastric pain and dyspepsia. He had undergone peritoneal dialysis for end stage renal disease about 13 years prior. An Upper gastrointestinal endoscopy showed elevated lesion at the gastric antrum, looking like an advanced gastric cancer or gastrointestinal stromal tumor. Endoscopic biopsy results were tubular adenoma with low-grade dysplasia. When followed up 9 months later, the lesion had increased in size and symptoms remained. We therefore performed a subtotal gastrectomy. The final biopsy was adenocarcinoma arising in GCP.
Adenocarcinoma ; Adenoma ; Biopsy ; Dyspepsia ; Endoscopy, Gastrointestinal ; Gastrectomy ; Gastritis ; Gastrointestinal Stromal Tumors ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Peritoneal Dialysis ; Pyloric Antrum ; Stomach ; Stomach Neoplasms

Glutathione S-Transferase (GST) is a conjugation enzyme in the metabolism of exogenous and endogenous lipophilic compounds for their excretion and detoxification. Acidic isozyme of GST, GST-Pi, has been recognized as a preneoplastic marker in the experimental hyperplastic nodules of liver in rats, and GST-Pi is abundant in the squamous cells of the skin, also. This histochemical study was carried out to evaluate the distribution and the relationship between the differentiation status of squamous cells in dysplastic or neoplastic epithelium in various organs. The human placental form of glutathione S-transferase (GST-Pi) were stained immunohistochemically with specific anti GST-Pi rabbit antibody in 23 cases of human squamous cell carcinomas. The patients consisted of 14 cases from the uterine cervix, 3 cases from the esopahgus, 3 cases from the lung and 3 cases from the larynx. The results obtained were as follows; 1. Basal cells in normal mucosa were stained negative for GST-Pi while superficial keratinocytes were stained moderately positive. Basal dysplastic cells were stained negatively or weakly positive. Carcinoma cells especially large cells either keratinizing or nonkeratinizing were stained moderately to strongly. Carcinoma cells surrounding keratin pearl were strongly reacted with GST-Pi than other carcinoma cells. 2. Differentiated cells of squamous cell carcinoma showed moderate to strong positive reaction to GST-Pi staining irrespective of its site of origin. 3. Therefore, Immunohistochemical staining pattern of GST-Pi in various squamous carcinoma cells showed similar immunohistochemical reaction to the GST-pi, which is closely correlated to the degree of differentiation, keratinigation and also suggested that squamous carcinoma cells had abundant GST-Pi related detoxifying system.
Humans ; Rabbits ; Animals