No abstract available.
Circumcision, Male* ; Female ; Male ; Sensation*

BACKGROUND: Extended radical dissection of gastric cancer offers a more accurate stage, and complete removal of the metastatic lymph nodes raises the rate of curability. It has been thought for a long time that gastric cancer with paraaortic lymph-node metastasis is impossible to cure. However, with several reports of long-term survival of cases with paraaortic lymph-node metastasis, recently the procedure of paraaortic node dissection has become prevalent in Japan. METHODS: The study group was comprised with 348 patients of stage IV gastric cancer from among total of 2,015 patients with gastric cancer who had undergone gastric resection between 1979 and 1997 at the Department of Surgery, Chonnam University Hospital. Thirty-eight (38) of the 348 patients were paraaortic lymph-node positive (group I), 233 presented peritoneal metastasis (group II), and the remaining 77 presented liver metastasis (group III). The following factors were taken into consideration: age, sex, size of tumor, histopathologic classification, Borrmann type, location of tumor, DNA ploidy pattern, and survival rate. RESULTS: 1) In sex distribution, the third group (III) showed a statistically significant male predominence compared with the other groups (I=63.2%, II=67.4%, III=87.0%) (p<0.01). 2) In histopathologic classifications, well-differentiated tubular adenocarcinomas were more common in group III (I=10.5%, II=6.4%, III=22.0%). Poorly differentiated tubular adenocarcinomas were more common in group II (I=44.7%, II=59.2%, III=27.3%) (p<0.01). 3) In Borrmann types, type IV was more common in group II (I=7.9%, II=27.8%, III=9.1%) (p<0.01). 4) In tumor location, antral involvement of the tumor was presented in 55.3% of group I, 54.7% of group II, and 67.5% of group III whereas whole involvement of stomach was presented in 5.3% of group I, 15.0% of group II, and 5.2% of group III (p<0.01). 5)Group I had a significantly higher (37.9%) two-year survival rate than the other groups (II=10.9%, III=12.8%) (p<0.01). CONCLUSIONS: This study suggests a greater prognostic benefit for radical surgery in cases of paraaortic lymph-node metastsis than in cases involving other stage IV gastric cancers.
Adenocarcinoma ; Classification ; DNA ; Humans ; Japan ; Jeollanam-do ; Liver ; Lymph Nodes ; Male ; Neoplasm Metastasis* ; Ploidies ; Sex Distribution ; Stomach ; Stomach Neoplasms* ; Survival Rate

Breast conserving surgery is increasingly performed in early stage breast cancer patients. A certain propotion of these patients are at substantial risk for systemic metastasis. However, there is no valid consensus about optimal sequencing of chemotherapy and radiation therapy. We conducted a randomized prospective study to investigate whether concurrent chemotherapy and radiation therapy after breast conservation surgery are associated with increased toxicity. Fifty-seven patients with stage I or II breast cancer were randomly assigned to receive CMF chemotherapy either simultaneously (n=37) or before (n=20) radiation therapy. Moist desquamation was the most common adverse effect which occurred in 46% (16/37) treated with concurrent chemotherapy and radiation therapy while 8 patients (38%) treated with sequential regimen had the finding. Difference between two groups was not statistically significant. Incidence of severe neutropenia (WBC>1,800) or abnormal elevation of liver enzymes was also not influenced by sequencing of adjuvant therapies. Arm edema was observed in 2 patients of concurrent group and was observed in 2 patients treated with sequential regimen. Two patients treated with concurrent regimen did not complete 6 cycles of chemotherapy while one patient with sequential regimen did not complete. Incidence of toxicity during chemotherapy was not altered by timing of radiation therapy. In conclusion, chemotherapy and radiation therapy can be given concurrently after breast conservation surgery in stage I or II breast cancer patients without increase of serious toxicity.
Arm ; Breast Neoplasms* ; Breast* ; Consensus ; Drug Therapy* ; Edema ; Humans ; Incidence ; Liver ; Mastectomy, Segmental ; Neoplasm Metastasis ; Neutropenia ; Prospective Studies

The majority of ptients with ischemic heart disease such as angina pectoris and myocardial infarction have coronary atherosclerosis as a underlying cause. However, in unusual conditions such as variant angina, aortic valvular heart disease, hypertrophic cardiomyopathy, vasculitis, hypercoagulable states, coronary atherosclerosis is not the cause. Polycythemia vesa is a myeloproliferative disease characterized by infrequent thromboembolic complications such as ischemic heart disease. We report a case of polycythemia vera presenting with angina pectoris without coronary artery stenosis with the review of the literature.
Angina Pectoris* ; Cardiomyopathy, Hypertrophic ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Heart Valve Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Polycythemia Vera* ; Polycythemia* ; Vasculitis

Chemotherapy offers palliative treatment to patient with advanced nonresectable hepatoma. The usefulness of systemic chemotherapy is limited becaused of serious side reaction and low concentration of drug at tumor. Butthis problem may be overcome by intraarterial infusion. Nonsurgical percutaneous hepatic arteiral catheterizationwas done in 21 patients with primary hepatoma, and infusion chemotherapy was done in 19 patients who were successful in catherization. The results were as follows; 1. Selective catheterization of hepatic artery proper,common hepatic artery, and celiac artery were seccessful in 4, 9 and 4 patients, respectively. The success rate ofselective catheterization is 80.9% including celiac artery among 21 patients with hepatoma. 2. Simple catherization method was applied in 14 patients, and catheter exchange and Loop methods were applied in 2 and 1patient respectively. 3. Complications related to catheterization, such as infection and bleeding on punctured site, intimal injury and dislodgement of catheter were not serious. 4. Drugs were well tolerated without serioustoxicity or complication. 5. 3 patients showed objective response and median survival time of treated patients is 2.5 months.
Carcinoma, Hepatocellular ; Catheterization ; Catheters ; Celiac Artery ; Drug Therapy ; Hemorrhage ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Methods ; Palliative Care

In the personalized medicine era, utilizing paraffin blocks in pathology archives for investigating human diseases has come into the limelight. This archived material with clinical data will reduce the research time and could prevent new patient recruitment to obtain tissue for research. However, the clause indicating the necessity of consent from human material providers in the Korean Bioethics and Safety Act has made the Institutional Review Board (IRB) deny permission to use paraffin blocks for research without consent, and alternatively to get the same before starting an experiment. Written consent may be waived off in studies using paraffin blocks with anonymous status or conditions not linked to personal information by applying the paragraph 3, article 16 of the current Bioethics and Safety Act. Also, the IRB should recommend researchers to preserve the blocks as medical records of patients in long-term archives.
Anonyms and Pseudonyms ; Bioethics ; Ethics Committees, Research ; Humans ; Medical Records ; Paraffin ; Pathology ; Patient Selection ; Precision Medicine

In the personalized medicine era, utilizing paraffin blocks in pathology archives for investigating human diseases has come into the limelight. This archived material with clinical data will reduce the research time and could prevent new patient recruitment to obtain tissue for research. However, the clause indicating the necessity of consent from human material providers in the Korean Bioethics and Safety Act has made the Institutional Review Board (IRB) deny permission to use paraffin blocks for research without consent, and alternatively to get the same before starting an experiment. Written consent may be waived off in studies using paraffin blocks with anonymous status or conditions not linked to personal information by applying the paragraph 3, article 16 of the current Bioethics and Safety Act. Also, the IRB should recommend researchers to preserve the blocks as medical records of patients in long-term archives.

No abstract available.
Blood Volume* ; Hypotension* ; Nitric Oxide* ; Plasma* ; Renal Dialysis*

Angiosarcoma is a very rare neoplasm, and even more so in the gastrointestinal tract where its distinction from adenocarcinoma may be extremely difficult. We report a case of multifocal epithelioid angiosarcoma of the stomach in a 65-year-old woman. Histologically, the tumor foci were composed of haphazard, anastomosing channels lined by malignant endothelial cells with epithelioid features. Those neoplastic cells stained positive for CD31, CD34, and factor VIII-related antigen.
Adenocarcinoma ; Aged ; Endothelial Cells ; Female ; Gastrointestinal Tract ; Hemangiosarcoma* ; Humans ; Stomach* ; von Willebrand Factor

Recently vesicovaginal fistula is rare, but infrequently is found after pelvic surgery especially total hysterectomy for benign gynecologic diseases. In general, the correction of vesicovaginal fistula has been performed 3-4 months after the diagnosis. Recently, earlier correction of fistula was challenged. It has been reported that Latzko operation is a simple effective method for easy correction of vesicovaginal fistula in early correction. We experienced two successful cases of Latzko operation, which were performed as early as day 25 and 31 postoperatively.
Diagnosis ; Female ; Fistula ; Genital Diseases, Female ; Hysterectomy* ; Vesicovaginal Fistula*