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*

Calvarium protects the brain, the most important organ. The defect of calvarium results in not only deformity but also fatal injury from the trauma. The cranial bone defects result from 1) removal of bone flap for intracranial decompression or infection 2) fracture 3) excision of tumor 4) craniectomy for craniosynostosis. The goals of cranioplasty are to protect the brain from trauma and make the aesthetically acceptable contour. From 1990 to 1995, we experienced twelve cases of cranioplasty using autogenous bone graft; 5 cases with rib bone, 3 cases with iliac bone, 2 cases with calvarial bone, and 2 cases with rib and calvarial bones. The result was very excellent without any significant complications.
Brain ; Congenital Abnormalities ; Craniosynostoses ; Decompression ; Ribs ; Skull ; Transplants*

No abstract available.
Ductus Arteriosus* ; Indomethacin*

No abstract available.
Skin Neoplasms* ; Skin*

We compared the pain produced during different phases of phacoemulsification cataract surgery using a scleral pocket incision under pinpoint anesthesia with that under intracameral anesthesia. This prospective study comprised each 100 cataract patients who had no complications influencing the degree of pain during surgery. Patients were asked about pain immediately after each phase and pain occurring during each phase was measured using 4 step verbal scale(from 0 to 4). In both anesthesia,conjunctival reposition was the most painful.Pinpoint injection was statistically significantly more painful than induction of intracameral anesthesia.The pain score during conjunctival reposition and at 1hr after surgery were significantly higher under intracameral anesthesia than under pinpoint, but during most of phases under both anesthesia,the pain score was relatively low. Intracameral anesthesia is easy,safety and dose not require additional ocular damage during induction of anesthesia,so if combined with topical anesthesia,it is very effective during cataract surgery using scleral pocket incision.
Anesthesia* ; Cataract* ; Humans ; Phacoemulsification ; Prospective Studies

We investigated the effects of the oral administration of Korean red ginseng (KRG) on morphologic change and function of liver in dogs. Fifteen adult mongrel dogs (n=15) were divided into three groups: a control group (40% hepatectomy, untreated), a 250 group (40% hepatectomy, 250 mg/kg of KRG, PO), and a 500 group (40% hepatectomy, 500 mg/kg of KRG, PO). The liver regeneration, histologic findings, CBC (WBC, RBC, PCV, and PLT), and liver function tests (AST, ALT, GGT, ALP, LDH, and T-bil) were examined during experiment. The liver regeneration rates were higher in treated groups than in the control group. But, there were no significant differences. All hematological values were within normal ranges except leukocyte counts for 3 days postoperatively. The levels of AST and ALT in the treated groups were significantly decreased compared to that in the control group (p<0.05). The numbers of degenerative cells and area of connective tissue were significantly decreased in the liver of the dog with KRG administration (p<0.01). On the basis of these results, we could conclude that KRG accelerate the liver regeneration and ameliorate the liver injury after hepatectomy in dogs.
Animals ; Blood/drug effects ; Dogs ; Female ; Hepatectomy/*veterinary ; Liver/*drug effects/*surgery ; Liver Regeneration/*drug effects ; Male ; *Panax ; Plant Extracts/*pharmacology ; Plant Roots/chemistry

Cystitis glandularis is a benign metaplastic proliferative lesion of the urinary bladder which usually occurs in the setting of chronic irritation and infection or in some cases as a congenital process. Sometimes it presents as a tumor mass-like florid lesion, grossly mimicking malignancy. We report a case of 59-year-old man with multiple mass lesions around the trigone and the neck portion, which suggested the possibility of malignancy in clinical and radiological evaluations. Final diagnosis was confirmed by transurethral resection. The surface urothelial lining was intact. The submucosa showed von Brunn's nests, cystitis glandularis and cystitis cystica in the edematous lamina propria. There were numerous glands lined by tall columnar, mucin producing epithelium without atypia, conforming to the appearance of the intestinal variant of cystitis glandularis. The cystitis glandularis may mimic a neoplasm on gross evaluation. The intestinal variant of cystitis glandularis is particularly likely to be problematic when florid.
Cystitis* ; Diagnosis ; Epithelium ; Humans ; Middle Aged ; Mucins ; Mucous Membrane ; Neck ; Urinary Bladder Neoplasms* ; Urinary Bladder*

A collision tumor is defined by the presence of two separate masses in one organ, which are pathologically distinct. We described a 70-yr-old patient who complained of abnormal vaginal bleeding with a collision tumor of the uterine corpus. The patient received total hysterectomy, bilateral salphingo-oophorectomy, bilateral pelvic-paraaortic lymphadenectomy, omentectomy, and intraperitoneal chemotherapy. The uterine corpus revealed three separate masses, which were located at the fundus, anterior and posterior wall. Each tumor revealed three pathologically different components, which were malignant mixed mullerian tumor, papillary serous carcinoma, and endometrioid adenocarcinoma. Among these components, only the papillary serous carcinoma component invaded the underlying myometrium and metastasized to the regional lymph node. Adjuvant chemotherapy and radiation therapy were performed. The patient is still alive and has been healthy for the last 8 yr. We have reviewed previously reported cases of collision tumors which have occurred in the uterine corpus.
Aged ; Aromatase Inhibitors/therapeutic use ; Carcinoma, Endometrioid/drug therapy/*pathology/surgery ; Chemotherapy, Adjuvant ; Cystadenocarcinoma, Papillary/drug therapy/*pathology/surgery ; Endometrial Neoplasms/drug therapy/*pathology/surgery ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Keratins/metabolism ; Lymphatic Metastasis ; Mixed Tumor, Mullerian/drug therapy/*pathology/surgery ; Nitriles/therapeutic use ; Triazoles/therapeutic use ; Tumor Suppressor Protein p53/metabolism

Carcinosarcoma of the stomach is a rarely occurring malignant biphasic tumor that consists of both carcinomatous and sarcomatous components simultaneously in a single tumor. The common carcinoma component is tubular or papillary adenocarcinoma and the mesenchymal sarcomatous components are variable and these include leiomyosarcoma, rhabdomyosarcoma, osteosarcoma and chondrosarcoma. However, neuroendocrine carcinomatous differentiation in the carcinomatous component is extremely rare. We present here a rare gastric carcinosarcoma that demonstrated neuroendocrine carcinomatous and leiomyosarcomatous differentiation in a 47-year-old man.
Adenocarcinoma, Papillary ; Carcinosarcoma ; Chondrosarcoma ; Humans ; Leiomyosarcoma ; Middle Aged ; Muscle, Smooth ; Neurosecretory Systems ; Osteosarcoma ; Rhabdomyosarcoma ; Stomach

Castleman's disease is a rare benign lymphoproliferative disorder that frequently affects lymph nodes of the mediastinal thorax and the neck. It very rarely affects the renal sinus. We report a case of Castleman's disease arising in the renal sinus in a 64-year-old man. The patient visited the hospital with the chief complaint of hematuria. Abdominal computed tomography revealed a homogeneous mass in the sinus of the left kidney, radiologically interpreted as a malignant urothelial tumor. Subsequently, nephroureterectomy was performed, after which microscopic examination of the specimen revealed a diffuse lymphoproliferative lesion with reactive lymphoid follicles of various sizes and prominent plasma cell infiltration of interfollicular spaces, highlighted by immunohistochemical staining for CD138. The lesion was diagnosed as Castleman's disease of the plasma cell type. Although preoperative diagnosis of Castleman's disease is difficult and the incidence is exceedingly rare, it should be considered in the differential diagnosis of renal sinus tumors.
Diagnosis, Differential ; Giant Lymph Node Hyperplasia ; Hematuria ; Humans ; Incidence ; Kidney ; Lymph Nodes ; Lymphoproliferative Disorders ; Middle Aged ; Neck ; Plasma Cells ; Thorax