BACKGROUND: Medical skin care is essential for the treatment of skin diseases all over the world. Medical skin care is also part of medical practice and this must be differentiated from the simple skin care that is given for normal healthy skin. OBJECTIVE: We wanted to discuss medical skin care and the related medical devices and legal issues. METHODS: We reviewed the related laws and regulations, we consulted experts and associations and we analyzed the result of the survey. RESULTS: Legally, medical skin care and simple skin care are well classified. However, many illegal procedures are still performed by non-medical personnel and many adverse effects have been reported as a result. Furthermore, there are no legal restrictions for the performer based on the grade of each medical skin care procedure. CONCLUSION: For the best results and safe procedures, medical skin care must be performed by approved medical equipment under the supervision of a physician or medical personnel. Continuous control and guidance by the government is strongly needed.
Jurisprudence ; Organization and Administration ; Skin ; Skin Care ; Skin Diseases ; Social Control, Formal

The prognostic significance of multidrug resistance (MDR) gene expression is controversial. We investigated whether multidrug resistance gene 1 (MDR1), multidrug resistance-related protein (MRP) and lung resistance protein (LRP) mRNA expression are associated with outcomes in acute leukemia patients. At diagnosis we examined MDR1, MRP and LRP mRNA expression in bone marrow samples from 71 acute leukemia patients (39 myeloid, 32 lymphoblastic) using nested RT-PCR. The expression of each of these genes was then expressed as a ratio in relation to beta-actin gene expression, and the three genes were categorized as being either 0, 1+, 2+ or 3+. MDR1, MRP and LRP mRNA expression was detected in 23.9%, 83.1% and 45.1 %, respectively. LRP mRNA expression was significantly associated with resistance to induction chemotherapy in acute leukemia patients, and in the AML proportion (p=0.02 and p=0.03, respectively). MRP and high MDR1 mRNA expression was associated with poorer 2-yr survival (p=0.049 and p=0.04, respectively). Patients expressing both MRP and LRP mRNA had poorer outcomes and had worse 2-yr survival. The present data suggest that MDR expression affects complete remission and survival rates in acute leukemia patients. Thus, determination of MDR gene expression at diagnosis appears likely to provide useful prognostic information for acute leukemia patients.
Vault Ribonucleoprotein Particles/*genetics ; Survival Rate ; RNA, Neoplasm/genetics ; RNA, Messenger/genetics ; Prognosis ; Neoplasm Proteins/*genetics ; Multidrug Resistance-Associated Proteins/*genetics ; Middle Aged ; Male ; Leukemia, Myelocytic, Acute/drug therapy/genetics/mortality ; Leukemia, Lymphocytic, Acute/drug therapy/genetics/mortality ; Leukemia/drug therapy/*genetics/mortality ; Infant ; Humans ; *Genes, MDR ; Gene Expression ; Female ; Child, Preschool ; Child ; Base Sequence ; Aged ; Adult ; Adolescent

BACKGROUND: The Wilms' tumor gene (WT1) is located on chromosome 11p13. Several authors have shown that the expression of WT1 gene is associated with prognosis of acute leukemia. It was the aim of this study to investigate the relationship between WT1 positivity and the response to treatment in terms of rate of complete remissions (CR), and survival and to evaluate the prognostic value of WT1 expression in patients with acute leukemia. METHODS: We examined the presence of WT1 specific mRNA in bone marrow samples of 71 patients with acute leukemia at diagnosis (AML 39, ALL 32) by nested RT-PCR. The integrity and the amount of RNA were analyzed by amplification of the -actin gene as an internal control. The relative ratio of WT1 gene expression/ -actin was calculated and classified as not amplified (0), weakly amplified (1+), moderately amplified (2+), or strongly amplified (3+). RESULTS: Thirty-four (47.9%) of the patients with acute leukemia at diagnosis were WT1 PCR positive. Among the WT1 positive patients, 10 patients (14.1%) showed 1+, 20 patients (28.2%) 2+, and 4 patients (5.6%) 3+. The patients with WT1 mRNA expression were younger than those without it in AML. There was a tendency of a higher CR rates in WT1 negative patients than in WT1 positive ones (AML 61.9% vs. 50%, ALL 75.0% vs. 68.8%). The probability of 5 year survival was 62.2% for WT1 negative group and 44.1% for WT1 positive group in all patients. The median survival days accord-ing to levels of WT1 expression was 709 days for negative group, 310 days for 1+ or 2+ groups and 294 days for 3+ group. CONCLUSIONS: The present data suggest a clinical relevance of WT1 expression for the achieve-ment of CR and long term survival in acute leukemia. Analysis of WT1 expression with bone mar-row aspirates at the diagnosis of acute leukemia may be useful to predict prognosis.
Bone Marrow ; Diagnosis ; Gene Expression* ; Humans ; Leukemia* ; Polymerase Chain Reaction ; Prognosis ; RNA ; RNA, Messenger ; Wilms Tumor

To report cases of metastasectomy for metastatic gynecologic malignancies, we reviewed the medical records of all patients who have undergone metastasectomy for metastatic gynecologic malignancies in Center for Uterine Cancer from June 2001 to October 2002. Six patients were identified with median age of 55 years (range 52-66 years). The metastatic sites and primary sites were as follows: 3 liver metastasis from ovary; 1 abdominal wall metastasis from uterus (endometrial cancer), 1 brain metastasis from ovary, 1 lung metastasis from uterus (sarcoma). The median disease free interval was 48 months (range 10 months-13 years). There was no perioperative mortality. Postoperative morbidity was tolerable with 1 case of bile leakage. In three patients with hepatectomy, one patient was dead of disease after 15 months, one patient is alive with disease at 20 months of follow up, one patient have no evidence of recurrence at 7 months follow up. The patient with brain metastasis was dead due to lung metastsis after 9 months later postoperatively. Remaining two patients with abdominal wall and lung metastasis have no evidence of tumor recurrence at 4, 7 months follow up respectively. Metastasectomy for metastatic gynecologic malignancies can be performed safely and may help prolong survival in carefully selected patients.
Abdominal Wall ; Bile ; Brain ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver ; Lung ; Medical Records ; Metastasectomy ; Mortality ; Neoplasm Metastasis ; Ovary ; Recurrence ; Uterine Neoplasms ; Uterus

OBJECTIVE: To characterize the clinical features of platinum compounds (cisplatin plus carboplatin) associated hypersensitivity reactions. METHODS: Medical records of 102 patients with gynecologic malignancy who received chemotherapy based on platinum at Center for Uterine Cancer from Jun. 2001 to Nov. 2002 were analyzed. Platinum hypersensitivity reaction was classified as acute and delayed reaction according to the time of onset, also mild and severe reaction according to the severity of symptoms and signs. RESULTS: Among the 102 patients treated with platinum compounds during this period, 20 (20%) developed hypersensitivity reaction. The median number of platinum courses for the first episode was 7 (range 4-9) and it concentrated at 7, 8, 9th cycles. Fourteen patients developed acute reaction and six patients experienced delayed reaction. Ten patients experienced severe symptoms including dyspnea. Acute reaction developed from a few minutes to 30 minutes after the initiation of the platinum infusion. Delayed reaction developed after discharge of patients with mild intensity. CONCLUSION: Platinum hypersensitivity reactions develop in patients who have been extensively pre- treated with these agents. As platinum compounds are increasingly used as neoadjuvant, initial, second-line chemotherapy of ovarian cancer and concurrent chemoradiation, palliative setting of cervical cancer, it can be anticipated that hypersensitivity reactions to these drugs will happen more frequently, at the same time it might be a important issue for clinicians engaged in chemotherapy.
Carboplatin* ; Cisplatin* ; Drug Therapy ; Dyspnea ; Humans ; Hypersensitivity* ; Medical Records ; Ovarian Neoplasms ; Platinum ; Platinum Compounds ; Uterine Cervical Neoplasms ; Uterine Neoplasms

OBJECTIVE: The purpose of this study was to investigate the clinical feasibility of FDG-PET scan in selection of patients with pelvic recurrence of cervical cancer for surgical treatment. METHODS: From Jun. 2001 to Oct. 2002, whole body FDG-PET scan findings were compared with findings of CT, MRI, and pathologic reports in 24 patients with pelvic recurrence of cervical cancer. PET scan was obtained with a GE Advance PET scanner, beginning at 60 minutes after injection of 370-555 MBq (10- 15 mCi) of 18F FDG. Regional scan was also obtained if needed. Uptake exceeding 2.5 SUV was determined as a positive finding. RESULTS: Among these 24 patients, 10 patients had metastatic lesions at pelvic lymphnodes (4), para- aortic lymphnodes (3), mediastinal lympnnodes (1), lung (4), and bone (1). Among 14 patients with no metastasis, 10 patients underwent surgical treatment but the operations were abandoned in 2 patients due to lymphnodes metastasis and pelvic peritoneal spreads that confused as normal FDG uptake of the intestines pre- operatively. Among 8 patients whom the operation was completed, 3 patients received pelvic exenteration, 2 patients received CORT, and 3 patients received LEER. CONCLUSION: FDG-PET is clinically feasible in selection of patients with pelvic recurrence of cervical cancer for surgical treatment.
Humans ; Intestines ; Lung ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pelvic Exenteration ; Positron-Emission Tomography ; Recurrence* ; Uterine Cervical Neoplasms*

Although well-differentiated papillary mesothelioma (WDPM) is usually classified as benign, the natural history of this lesion has not been clearly established. We present a case of WDPM in 60-year old woman developing malignant mesothelioma with seeding mass on the trocar insertion site over a period of 2 years. The initial symptom exhibited by the patient was abdominal distension from massive ascitic fluid. With an impression of peritoneal carcinomatosis, we performed a diagnostic laparoscopy. On the laparoscopic finding, a small whitish nodule was found on the liver surface and the pathologic result revealed reactive mesothelial hyperplasia. At exploro-laparotomy, multiple small nodules were found on the omentum and a biopsy revealed well-differentiated papillary mesothelioma of the peritoneum. The patient underwent pelvic lymphadenectomy and omentectomy of the colon and was followed for 2 years without any further treatment. Subsequently, she presented with abdominal distention with massive ascites and palpable abdominal wall mass at the previous trocar insertion site. Malignant mesothelioma was confirmed histologically via re- exploration. The rare transformation of well-differentiated papillary mesothelioma into a typically malignant diffuse mesothelioma and the unusual seeding on trocar insertion site prompted us to report this case.
Abdominal Wall ; Ascites ; Ascitic Fluid ; Biopsy ; Carcinoma ; Colon ; Female ; Humans ; Hyperplasia ; Laparoscopy* ; Liver ; Lymph Node Excision ; Mesothelioma* ; Middle Aged ; Natural History ; Omentum ; Peritoneum ; Surgical Instruments*

Mixed endometrial stromal and smooth-muscle tumor is one of the uncommon forms of uterine sarcoma. Only a few cases of endometrial stromal tumors showing smooth muscle differentiation have been reported in the literature. We experienced a case of low grade endometrial stromal sarcoma with smooth muscle differentiation in a 44-year-old woman, so we report this case with brief review of literatures.
Adult ; Endometrial Stromal Tumors ; Female ; Humans ; Muscle, Smooth* ; Sarcoma ; Sarcoma, Endometrial Stromal*

Habitual abortion or recurrent pregnancy loss has been defined as the occurrence of three or more clinically recognized pregnancy loss before 20 gestational weeks. A recognized cause of habitual abortion is a genetic abnormality, and karyotyping of couples will reveal that about 5% have some abnormality, most frequently a balanced translocation. However, it has been reported that duplication of chromosome is a rare condition associated with habitual abortion. We have experienced a case of chromosomal duplication 9q as polymorphism found in fetus of the patient with habitual abortion. Father of the fetus also has the same chromosomal duplication on 9q. This represents familial polymorphism and it is very rare variant. We presented with brief review of literatures.
Abortion, Habitual* ; Chromosome Duplication ; Family Characteristics ; Fathers ; Female ; Fetus* ; Humans ; Karyotyping ; Pregnancy

PURPOSE: We studied the E2A-PBX1 positivity in t(1;19)-positive childhood acute lymphoblastic leukemia (ALL) patients during chemotherapy and follow-up period to evaluate the clinical implications of minimal residual disease (MRD) and the effect of delayed intensification chemotherapy on long-term survival. METHOD: Fifty-six bone marrow or peripheral blood samples collected retrospectively or prospectively before or during chemotherapy from 14 childhood ALL patients who had t(1;19) or E2A-PBX1 transcript at initial diagnosis were studied for the presence of E2A-PBX1 by RT- PCR. All patients received delayed intensification chemotherapy regardless of standard prognostic grouping for childhood ALL to evaluate its effect on the improvement of long-term survival. RESULTS: There were 11 t(1;19)-positive cases documented by karyotyping and 3 E2A-PBX1 transcript-positive cases amplified by PCR from the initial bone marrow samples. There were 11 cases of FAB L1 and 3 cases of L2. Immunophenotypic classification revealed 10 cases of group V, 2 cases of group IV, and 1 case of group III. Among 11 cases with documented karyotype, 9 cases (81.8%) had der(19)t(1;19) and the other 2 had balanced t(1;19). Fifty-six samples collected at 2 to 7 different time points of 14 patients revealed 4 cases of MRD immediately after completion of induction chemotherapy despite hematologic complete remission. Three of these cases relapsed eventually, and 1 was lost to follow-up. Among 12 cases who received adequate delayed intensificiation chemotherapy, 10 are alive in complete remission. CONCLUSION: MRD detection by RT-PCR amplification of E2A-PBX1 transcript was feasible, and the sample after completion of induction chemotherapy was most informative for the prediction of long-term survival and relapse. The presence of MRD after completion of induction chemotherapy conferred poor prognosis. The addition of delayed intensification chemotherapy to standard chemotherapy regimen could abolish the adverse effect of t(1;19) in childhood ALL patients.
Bone Marrow ; Classification ; Diagnosis ; Drug Therapy* ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Karyotype ; Karyotyping ; Lost to Follow-Up ; Neoplasm, Residual ; Polymerase Chain Reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Prospective Studies ; Recurrence ; Retrospective Studies