OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

We report a case of sarcoidosis which developed in the skin, lung and eyes in a 50-year-old woman. The skin lesions showed two types of cutaneous manifestations which were subcutaneous nodules on her back and erytrematous papules on the face for several months. Our patient's seurm angiotensin converting enzyme (ACE) level was elevated at 33.5 IU/L(reference range, 8.3-21.4 IU/L) and the purified protein derivative(PPD) skin test had a negative result. On her roentgenographic examinations, we could find multiple nodular densities with hazziness on both her lungs and radionuclides(Gallium 67) uptakes in right lower lung field. The ratio of helper to suppressor T cells was 9 in bronchial lavage. Diagnosis of sarcoidosis was made on the basis of histologic findings of non-caseating granulomas from skin and lung tissue. Treatment was initiated with oral alternate-day prednisone 40mg. The cutaneous lesions and dyspnea improved in 2 and 4 weeks respectively, and serum ACE level returned to normal in 2 months.
Bronchoalveolar Lavage ; Diagnosis ; Dyspnea ; Female ; Granuloma ; Humans ; Lung ; Middle Aged ; Peptidyl-Dipeptidase A ; Prednisone ; Sarcoidosis* ; Skin ; Skin Tests ; T-Lymphocytes

BACKGROUND: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. METHODS: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg + lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. RESULTS: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of 2.4 +/- 2.1 points, which was lower, with statistical significance, than the VAS score of group 2, which was 4.4 +/- 3.1 points (p<0.001). CONCLUSIONS: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.
Bursitis* ; Follow-Up Studies ; Humans ; Joints ; Lidocaine ; Motion Therapy, Continuous Passive ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation ; Shoulder ; Visual Analog Scale

PURPOSE: We evaluated the clinical and radiological results of arthroscopic ankle fusion using 2 medial screws which had advantages of less morbidity, early weight-bearing and high union rate. MATERIAL AND METHODS: From April, 2002 to March, 2004, 8 patients who had ankle osteoarthritis were treated by ankle fusion using 2 medial screws under arthroscopy; five patients with post-traumatic osteoarthritis, two with post-infectious arthritis and one with paralytic foot. There were 5 male and 3 female. Average age was 67 years old ranging from 57 to 71 years. We evaluated them clinically preoperative and postoperative using AOFAS score, VAS pain scale and patient's satisfaction. In regard to radiological fusion, we checked them by simple AP, lateral and mortise view. Follow up period was average 11 months (range, 6~24 months). RESULTS: All ankles were successfully fused with 2 medial screws under arthroscopy. The mean time of fusion was 10.5 weeks (range, 8~14 weeks). Patient's satisfaction checked at 6 months after operation had favorable results (excellent and good 75%). One case had pain on medial malleolar area because of screw's protrusion. CONCLUSION: Arthroscopic ankle fusion using 2 medial screws was good modality of ankle fusion with less morbidity and early weight-bearing in some cases of ankle arthritis.
Aged ; Ankle* ; Arthritis ; Arthritis, Reactive ; Arthroscopy ; Female ; Follow-Up Studies ; Foot ; Humans ; Male ; Osteoarthritis ; Weight-Bearing

BACKGROUND AND OBJECTIVE: T cells play a pivotal role in initiating and orchestrating bronchial inflammation in asthma. However, little is known about changes in T cell subset in the airways. Our objective was to study whether the proportion of CD4+ or CD8+ T cells in the bronchoa1veolar lavage fluid (BALF) of bronchial asthma is different from normal subjects, and whether it is associated with clinical characteristics. METHODS: We examined the percentage of CD4+ and CD8+ cells in the BALF of 37 patients with bronchial asthma and 14 normal controls by flow cytometry. Bronchial asthma was classified as mild, moderate and severe according to bronchial hyperresponsiveness. Skin prick test and pulmonary function tests were performed. RESULTS: The percentage of CD4+ cells in BALF did not differ between asthmatics and controls, however, the percentage of CD8+ cells was significantly higher in asthmatics than contro1s, In asthmatics, the percentage of CD4+ cells and CD8+ cells did not differ between atopic and nonatopic asthmatics. The percentage of CD8+ cells in addition to CD4+ cells was correlated with the percentage of eosinophils in BALF, and the percentage of CD8+ cells also showed negative correlation with FEV, and FEF25-75% CONCLUSION: These results suggest that CD8+ cells as well as CD4+ cells are associated with airway inflammation in bronchial asthma.
Asthma* ; Eosinophils ; Flow Cytometry ; Humans ; Inflammation ; Respiratory Function Tests ; Skin ; T-Lymphocytes ; Therapeutic Irrigation

BACKGROUND: We evaluated the clinical and radiologic results of impacted femoral neck fractures treated with multiple pinning and determined the influence of the progression of impaction at the fracture site on clinical outcome. METHODS: There were 34 patients with a mean age of 65.5 years. The mean follow-up period was 3.4 years. Progression of fracture site impaction was measured using an articulo-trochanteric distance index and the percentage decrease in the articulo-trochanteric distance index between follow-up intervals. The failure of treatment was clarified as non-union and avascular necrosis. Other characteristics of the patients, including mean waiting time for surgery, preoperative Singh index score, and body mass index, were also measured to evaluate the influence on the clinical outcome of surgery. RESULTS: There were 6 fractures which were not treated successfully (3 non-union, 8.8% and 3 avascular necrosis, 8.8%). The mean percentage decrease of the articulo-trochanteric distance index within the first 6 weeks after surgery was 4.5% in the successful group and 25.1% in the failure group (p < 0.001). There was also a significant mean percentage decrease in the articulo-trochanteric distance index between 6 weeks and 3 months (p < 0.001). CONCLUSIONS: Primary stabilization with Knowles pins for impacted femoral neck fractures had a reasonable clinical outcome with low morbidity. Despite a significant difference of a mean percentage decrease in the articulo-trochanteric distance index between the successful group and the failure group, we could not verify it as a risk factor for failure of treatment because the odds ratio was not statistically significant.
Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Neck Fractures/complications/radiography/*surgery ; Femur Head Necrosis/etiology/radiography ; Follow-Up Studies ; *Fracture Fixation, Internal ; Fractures, Ununited/radiography ; Hip Joint/*pathology/radiography ; Humans ; Male ; Middle Aged ; Odds Ratio ; Treatment Outcome

BACKGROUND: We evaluated the clinical and radiologic results of impacted femoral neck fractures treated with multiple pinning and determined the influence of the progression of impaction at the fracture site on clinical outcome. METHODS: There were 34 patients with a mean age of 65.5 years. The mean follow-up period was 3.4 years. Progression of fracture site impaction was measured using an articulo-trochanteric distance index and the percentage decrease in the articulo-trochanteric distance index between follow-up intervals. The failure of treatment was clarified as non-union and avascular necrosis. Other characteristics of the patients, including mean waiting time for surgery, preoperative Singh index score, and body mass index, were also measured to evaluate the influence on the clinical outcome of surgery. RESULTS: There were 6 fractures which were not treated successfully (3 non-union, 8.8% and 3 avascular necrosis, 8.8%). The mean percentage decrease of the articulo-trochanteric distance index within the first 6 weeks after surgery was 4.5% in the successful group and 25.1% in the failure group (p < 0.001). There was also a significant mean percentage decrease in the articulo-trochanteric distance index between 6 weeks and 3 months (p < 0.001). CONCLUSIONS: Primary stabilization with Knowles pins for impacted femoral neck fractures had a reasonable clinical outcome with low morbidity. Despite a significant difference of a mean percentage decrease in the articulo-trochanteric distance index between the successful group and the failure group, we could not verify it as a risk factor for failure of treatment because the odds ratio was not statistically significant.
Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Neck Fractures/complications/radiography/*surgery ; Femur Head Necrosis/etiology/radiography ; Follow-Up Studies ; *Fracture Fixation, Internal ; Fractures, Ununited/radiography ; Hip Joint/*pathology/radiography ; Humans ; Male ; Middle Aged ; Odds Ratio ; Treatment Outcome

We evaluated the clinical course of subchondral insufficiency fracture of the femoral head (SIFFH) and its characteristic findings with special regard to joint space narrowing (JSN). Thirty-one cases of SIFFH of mean age 68.9 yr initially underwent limited weight-bearing conservative treatment. During the follow-up period, the patients with intractable pain underwent total hip arthroplasty (THA). For radiographic evaluation, lateral center-edge angle, JSN and femoral head collapse (FHC) were documented, and the extent of FHC was classified as mild (<2 mm), moderate (2-4 mm), and severe (>4 mm). The progression or new development of FHC more than 2 mm was evaluated on sequential plain radiographs. The relationship between radiographic parameters and clinical outcomes were evaluated. THAs were performed in 15 cases (48.4%). There was no significant correlation between clinical outcomes and the extent of initial FHC. However, a significantly larger proportion of patients that underwent THA showed JSN and FHC progression compared to the symptom improvement group. The risk factor significantly associated with failed conservative treatment was JSN (P=0.038; OR, 11.8; 95% CI, 1.15-122.26). Clinical results of conservative treatment for SIFFH in elderly patients are relatively poor. The patients with JSN are at higher risk of failed conservative treatment.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Body Mass Index ; Disease Progression ; Female ; Femur Head/pathology/*radiography ; Hip Fractures/pathology/*radiography ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Odds Ratio ; Risk Factors

PURPOSE: Dysregulated cysteinyl leukotriene (CysLT) synthesis is prominent in exercise-induced bronchoconstriction (EIB). Secreted phospholipase A2 (sPLA2) plays a key regulatory role in the biosynthesis of CysLTs. We previously found that serum leptin levels correlate with (EIB) in children with asthma. The aim of this study was to address the relationship between plasma sPLA2/leptin levels and EIB. METHODS: Sixty-seven prepubertal children between the ages of 6 and 10 years were included in the study. They were asthmatics with EIB (n=25), asthmatics without EIB (n=21), and healthy subjects (n=21). We measured the plasma sPLA2 and leptin levels. We also performed pulmonary function tests at baseline, after bronchodilator inhalation, and after exercise. RESULTS: The sPLA2 and leptin levels were significantly higher in asthmatics with EIB than in those without and control subjects. In addition, sPLA2 levels were significantly correlated with body mass index (Speraman correlation coefficient r=0.343, P=0.023) and leptin levels (partial correlation coefficient r=318, P=0.033). The maximum decrease in % forced expiratory volume in 1 second after exercise was significantly correlated with both PLA2 levels (r=0.301, P=0.041) and leptin levels (r=0.346, P=0.018). CONCLUSION: The sPLA2 and leptin levels were significantly higher in asthmatics with EIB than in asthmatics without EIB and control subjects. In addition, sPLA2 levels were significantly correlated with leptin levels and EIB in asthmatic children.
Asthma ; Body Mass Index ; Bronchoconstriction* ; Child* ; Forced Expiratory Volume ; Humans ; Inhalation ; Leptin* ; Phospholipases A2* ; Plasma* ; Respiratory Function Tests

PURPOSE: Recently, component-resolved diagnosis (CRD) using microarray technology has been introduced to the field of clinical allergy. This study was aimed to investigate the clinical usefulness of microarray-based IgE detection for diagnosing clinical raw fruit allergy in birch pollen-sensitized children. METHODS: Thirty-one children with allergic disease who had been sensitized to pollen were studied. A pollen-sensitized patient was defined as having an allergen-specific history with concomitant positive skin-prick tests (SPTs) to natural allergen extracts or positive allergen-specific IgE. All subjects underwent SPTs for pollen and fruit. In all subjects, specific IgE to pollen and fruit were measured by ImmunoCAP. Specific IgE antibodies to allergen components were determined by a customized allergen microarray (ISAC). RESULTS: Thirteen of the 31 patients (41.9%) had a history of fruit hypersensitivity with positive SPTs. Measuring IgE to allergen components by ISAC, all the 13 patients with fruit hypersensitivity were positive to at least one of Mal d 1, Pru p 1, Pru p 3, Act d 8, and Act d 2 compared to 12 of the 13 patients (92.3%) who had at least 1 positive IgE to fruits (apple, peach, and kiwi) using ImmunoCAP. The sensitivity of ISAC microarray was 100.0% for the diagnosis of fruit hypersensitivity, but its specificity was 27.7% (5/18). The sensitivity of ImmunoCAP was 92.3%, and its specificity was 83.3%. CONCLUSION: The sensitivity of allergen components tested using microarray for the diagnosis of clinical fruit hypersensitivity in children with pollen allergy was high; however, its specificity was low.
Antibodies ; Betula* ; Child* ; Diagnosis* ; Fruit* ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Pollen* ; Prunus persica ; Rhinitis, Allergic, Seasonal