Epidemiology and Clinical Outcomes of Childhood Wilms Tumor in Korea / 대한소아혈액종양학회지

PURPOSE: Wilms tumor is the most common malignant renal tumor in children. We investigated the epidemiology, clinical features and treatment outcome of the children with Wilms tumor in Korea during the recent 10 years. METHODS: Two hundred forty six patients were enrolled between January 1991 and December 2000 from 26 major hospitals in Korea. The data regarding the clinical features including sex, age, pathologic type, prognostic factor and treatment outcome of patients were analyzed retrospectively by review of patient's medical records. Kaplan-Meier survival curves were constructed, The differences between groups were analyzed by log-rank test. RESULTS: There were 130 males and 116 females. The incidence between the age of 1~4 years was the highest with 66.2%. The annual incidence rate per 1, 000, 000 population varied from 1.9 to 2.1. The 10 years overall survival rate according to sex, clinical stage, pathologic type and relapse were as follows: 88.6% in male, 90.9% in female, 100% in stage I, 94.7% in stage II, 92.1% in stage III, 63.4% in stage IV, 85.7% in stage V, 95.3% in favorable histology, 64.1% in unfavorable histology, 94.8% in non-relapse, and 40.9% in relapse. The relapse rate was 12%. The 10 years overall survival rate of 246 patients were 89.1%. CONCLUSION: Our results could provide the most recent and important clinical information on Wilms tumor of children in Korea.

Polymorphism of Angiotensin Converting Enzyme in Hypertensive Intracerebral Hemorrhage Patients

Polymorphism in the angiotensin-converting enzyme(ACE) gene may confer an increased risk of vascular disease. DD type of ACE polymorphism predispose a person to myocardial infarction and IgA nephropathy. The roles of the ACE insertion/deletion polymorphism are unknown in the patients with hypertensive intracerebral hemorrhage (HICH). Our objective is to test and to identify whether genotype distribution of the insertion/deletion polymorphism in ACE gene is different in HICH patients from control subjects. Fifty six HICH patients and sixty one control subjects were studied. Genotypes were determined by the polymerase chain reaction(PCR) with specific oligonucleotide primers flanking the polymorphic region in intron 16 of ACE gene to amplify genomic DNA isolated from patients blood PCR products were separated in 2% agarose gels and bands were visualized by ethidium bromide staining. The PCR reaction amplified a 490bp DNA fragment(II type) from genomic DNA if the subjects had an intact intron 16, and amplified a both 490bp and 190bp DNA fragments(ID type) if subjects had heterozygous polymorphism. While the distribution of ACE polymorphism in control subjects was 26.2%:57.4%:6.4%(II:ID:DD), and the distribution of it in patients with HICH was 37.5%:35.7%:26.8%. Thus, the pattern of distribution was no significant different between control subjects and patients with HICH. The factors of age and sex did not influence on the ratio of distribution in both control and HICH subjects. From these results, we conclude that there is no significant association between I/D polymorphism and HICH.

One Stage Operation of Triple Aneurysms: Case Report

In the multiple aneurysm cases of the conservatively treated patients in the cooperative study and in Suzuki's personal series, three aneurysm comprised 15 percent in the multiple aneurysm. Posterior circulation aneurysms is about 15 percent of all intracranial aneurysm. When an aneurysm on the anterior circulation is found, the chance of a secondary aneurysm on the posterior circulation is between 3 and 5 percent. Authors experienced a case of large basilar tip aneurysm projected superiorly and posteriorly accompanied with right middle cerebral artery and right anterior choroidal artery aneurysm. This case was difficult one because of the importance of the perforating vessels in large aneurysm at the basilar fiburcation and the existence of the perforating vessels in large aneurysm at the basilar fiburcation and the existence of another two aneurysms. Through the right pterional approach, three aneurysm were clipped in one stage operation successfully, but the large basilar tip aneurysm was clipped partially because both PCA arose from the aneurysm.

A clinical analysis of T-tube choledochostomy

No abstract available.

Clinical Analysis of Outcome for Ruptured Intracerebral Aneurysm with Hematoma

This author analysed 34 cases of aneurysmal rupture which had a hematoma in ventricle, intracerebral and subdural space except subarachnoid space. All the patient had been treated in Chonbuk National University Hospital from Aug. 1. 1984 to Aug. 30. 1990. Among the 34 cases, 24 cases were treated with surgery and 10 cases conservatively. The result of operation showed favorable outcome(Good recovery, Moderately disabled);8 cases(33.3%) and unfavorable(severely disabled, vegetative state);5 cases(20.8%). Mortality rates were 70%(7/10) in nonoperative cases and 45.8%(11/24) in operative cases. The data for 34 cases were correlated with outcome by using Chi-square test and t-test. Mortality and morbidity were increased in patients with hypertension, poorer clinical grades at the time of admission or surgery, larger amounts of intracranial hematoma, and older age. From the overall results, the removal of hematoma and simultaneous clipping aneurysmal neck is necessary to obtain a good outcome.

Clinical Analysis of Outcome for Ruptured Intracerebral Aneurysm with Hematoma

This author analysed 34 cases of aneurysmal rupture which had a hematoma in ventricle, intracerebral and subdural space except subarachnoid space. All the patient had been treated in Chonbuk National University Hospital from Aug. 1. 1984 to Aug. 30. 1990. Among the 34 cases, 24 cases were treated with surgery and 10 cases conservatively. The result of operation showed favorable outcome(Good recovery, Moderately disabled);8 cases(33.3%) and unfavorable(severely disabled, vegetative state);5 cases(20.8%). Mortality rates were 70%(7/10) in nonoperative cases and 45.8%(11/24) in operative cases. The data for 34 cases were correlated with outcome by using Chi-square test and t-test. Mortality and morbidity were increased in patients with hypertension, poorer clinical grades at the time of admission or surgery, larger amounts of intracranial hematoma, and older age. From the overall results, the removal of hematoma and simultaneous clipping aneurysmal neck is necessary to obtain a good outcome.