PURPOSE: Malignant disease of the anus is rare. Abdominoperineal resection was formerly considered to be the treatment of choice. But, in recent, less ablative and more effective combined therapeutic modalities have been developed. METHODS: we analyzed 33 patients who were diagnosed and treated as anal cancers at the Department of Surgery, Gospel Hospital, Kosin Medical Collage, from July 1, 1988 to Nov. 30, 1997. RESULTS: The ratio of male to female was 1.4:1 and mean age was 56.7 years old. Twenty-two (84.8%) of these cancers were located in the anal canal and 5 (15.2%) in the anal margin. Three main histologic types of the anal cancers were identified: squamous cell carcinoma was the most common lesion, accounted for 17 cases (51.1%), adenocarcinoma accounted for 8 cases (24.2%), malignant melanoma accounted for 8 cases (24.2%). The overall 3-year survival rate and 5-year survival rate of anal cancer were 54.1%, 41.7%. Eleven patients with squamous cell carcinoma were treated curatively: 6 patients were treated with chemoradiotherapy, 3 patients with abdominoperineal resection, one patient with chemoradiotherapy and abdominoperineal resection, one patient with local excision. CONCLUSION: In survival rate, there were no significant differences between chemoradiotherapy group and surgical treatment group. In squamous cell carcinomas, chemoradiotherapy had anal sparing benefit without loss of survival. On univariate analysis, T, N, type of treatment, histologic type had no statistical significances on survival. On multivariate analysis, location of lesion and distant metastasis had statistical significances.
Adenocarcinoma ; Anal Canal ; Anus Neoplasms* ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Female ; Humans ; Male ; Melanoma ; Multivariate Analysis ; Neoplasm Metastasis ; Survival Rate

No abstract available.
Genitalia* ; Humans ; Male*

No abstract available.
Amino Acid Sequence* ; HIV* ; Phenotype*

PURPOSE: Retroperitoneoscopic nephroureterectomy (RNUx), with a bladder cuff excision, has only recently been used to treat patients with upper tract transitional cell carcinomas. We retrospectively evaluated our early experiences, and compared our results to those of a contemporary series of open nephroureterectomies (ONUx), in upper tract transitional cell carcinomas. MATERIALS AND METHODS: We reviewed the records of 7 patients who had undergone a RNUx, with a bladder cuff excision, for a suspicious upper tract transitional cell carcinoma, and 7 who had undergone an ONUx, with a bladder cuff excision. RESULTS: Comparing the results of the RNUx (7 patients) to the ONUx (7 patients) over the same period, we found no significant differences in the body mass index (25.1 versus 25.5kg/m2, p=0.22), specimen weights (155 versus 175gm, p=0.59) and operating time (266 versus 244 min., p=0.20). The RNUx group had significantly reduced estimated blood losses (350 versus 543mL, p=0.01), pain medication requirements (141 versus 232mg, p=0.03) and times to ambulate (21 versus 31 hours, p<0.01). CONCLUSIONS: Our early experiences show that RNUx takes a longer operation time, and is a harder operation compared to ONUx, but it is well tolerated by patients because we can remove the kidney and ureter from a smaller lower abdominal incision. With increased experience, the operating time decreased compared to an ONUx. Thus, a RNUx may be a viable alternative for managing localized transitional cell carcinomas of the upper urinary tract.
Body Mass Index ; Carcinoma, Transitional Cell* ; Humans ; Kidney ; Retrospective Studies ; Ureter ; Urinary Bladder ; Urinary Tract* ; Weights and Measures

PURPOSE: Retroperitoneoscopic nephroureterectomy (RNUx), with a bladder cuff excision, has only recently been used to treat patients with upper tract transitional cell carcinomas. We retrospectively evaluated our early experiences, and compared our results to those of a contemporary series of open nephroureterectomies (ONUx), in upper tract transitional cell carcinomas. MATERIALS AND METHODS: We reviewed the records of 7 patients who had undergone a RNUx, with a bladder cuff excision, for a suspicious upper tract transitional cell carcinoma, and 7 who had undergone an ONUx, with a bladder cuff excision. RESULTS: Comparing the results of the RNUx (7 patients) to the ONUx (7 patients) over the same period, we found no significant differences in the body mass index (25.1 versus 25.5kg/m2, p=0.22), specimen weights (155 versus 175gm, p=0.59) and operating time (266 versus 244 min., p=0.20). The RNUx group had significantly reduced estimated blood losses (350 versus 543mL, p=0.01), pain medication requirements (141 versus 232mg, p=0.03) and times to ambulate (21 versus 31 hours, p<0.01). CONCLUSIONS: Our early experiences show that RNUx takes a longer operation time, and is a harder operation compared to ONUx, but it is well tolerated by patients because we can remove the kidney and ureter from a smaller lower abdominal incision. With increased experience, the operating time decreased compared to an ONUx. Thus, a RNUx may be a viable alternative for managing localized transitional cell carcinomas of the upper urinary tract.
Body Mass Index ; Carcinoma, Transitional Cell* ; Humans ; Kidney ; Retrospective Studies ; Ureter ; Urinary Bladder ; Urinary Tract* ; Weights and Measures

No abstract available.
Humans ; Kidney Transplantation*

OBJECTIVE: Several psychological characteristics of medical students were investigated, the relationhip between these characteristics and academic achievement was identified, and futhermore some significant predictors of their academic achievement were explored. METHOD: Subjects were a total of 489 medical students, 1st, 2nd, 3rd year in Chosun university as of in 1998. We administered self-report questionnaires including age, sex, grade failure, and transfer experience. And Beck Depression Inventory, Achievement Self-Discrepancy Scale, Self-Efficacy Scale, State-Trait Anxiety Inventory(state) Test Anxiety Scale, and the Inventory of Performance Anxiety were handed out to them on April 1998. After the semester, we examined the academic achievement according to grade point average. Pearson's correlations were calculated to explore the relationships between grade failure and other psychological variables, as well as the relationships between academic achievement and other psychological variables. The amount that academic achievement was explained by the psychological variables was obtained using multiple regression analysis. RESULT: 1)In 489 students, grade failure was 168(34.3%) non-failure was 321(65.7%) and transfer was 33(6.7%) 2)While G.P.A., performance anxiety, and self-efficacy, respectively, were negatively correlated with the failure, test anxiety was positively correlated with the grade failure. There were no statistically significant correlations between grade failure and depression, self-discrepancy, or state anxiety. 3)Academic achievement was positively correlated with both gender and self-efficacy, whereas it was negatively correlated with depression, self-discrepancy, test anxiety, and state anxiety, respectively. Female students were better than males in academic achievement. 4)The amount that age, gender, grade failure, transfer, depression, self-discrepancy, test anxiety, state anxiety, performance anxiety, and self-efficacy accounted for academic achievement was 10.86% totally. CONCLUSION: Gender, grade failure, and depression in medical students affected their academic achievement significantly.
Anxiety ; Depression ; Female ; Hand ; Humans ; Male ; Performance Anxiety ; Surveys and Questionnaires ; Students, Medical* ; Test Anxiety Scale

No abstract available.
Cause of Death* ; Kidney Transplantation* ; Kidney*

No abstract available.
Staphylococcus aureus* ; Staphylococcus*

Peritonitis is a major cause of morbidity in peritoneal dialysis patients; however, Aeromonas caviae rarely causes peritonitis in these patients. We report peritonitis due to A. caviae in a 72-year-old male with end-stage renal failure who had been undergoing automated peritoneal dialysis for 1 year. The white blood cell (WBC) count in the peritoneal fluid was 2,722/mm3 with 85% neutrophils. Gram staining of the peritoneal fluid yielded Gram-negative rods. Empirical antibiotic therapy with ceftriaxone was initiated intraperitoneally. However, drug sensitivity testing revealed that the organism was resistant. On the third hospital day, A. caviae was cultured from the peritoneal effluent, and the antibiotic regimen was switched to ciprofloxacin. The patient recovered rapidly and the WBC count of the peritoneal effluent decreased. He was discharged and the intraperitoneal ciprofloxacin therapy was continued for 14 days. The peritoneal catheter was not removed.
Aeromonas ; Aeromonas caviae ; Animals ; Ascitic Fluid ; Catheters ; Ceftriaxone ; Ciprofloxacin ; Guinea Pigs ; Humans ; Kidney Failure, Chronic ; Leukocytes ; Male ; Neutrophils ; Peritoneal Dialysis ; Peritonitis