Congenital syphilis is transmitted throuth the placenta by the infected mother after 16 weeks of gestation.Since the incidence of syphilis is again on the increase, syphilis remanis at the present time a public problem ofmajor and increasing proportions. Recently, congenital syphilis has different formas of presentation. The authorsobserved clinically and radiologically 27 cases of congenital syphilis in the neonates and infants treated at thepediatric ward of Chonnam National University Hsopital from Jan. 1977 to Mar. 1982. The results are as follows; 1.The number of observed patients was 27 cases, 22 cases in male, 5 cases in female. 2. Onset of first clinicalsymptoms and signs was within the 4th week life in 14 cases (52%), 1-2 months in 6 cases (22%), 2-3 months in 4cases (15%), 3-4 months in 3 cases (11%). All cases was within 6 months. 3. The order of the frequency of commonclinical manifestations was hepatomegaly (96%). splenomegaly (78%), skin lesions(63%), anemia(63%), nasalsnuffle(56%). 4. Of 11 cases with known birth weight, 10 cases were low birth weight. 5. The serologic test (VDRLslide test) of 27 tested cases revealed reactive response in 26 cases, nonreactive response in 1 case, and that ofsyphilitic mothers except one revealed reactive in 23 cases, non-reactive in 3 cases. 6. Roentgenographicsyphilitic bonychanges were detected in 26 cases (96%), of 27 studied cases, Osteochondritis was present in 24cases (89%), periostitis in 21 cases (78%), osteomyelitis in 11 cases(41%). 7. The most common sites affected wereas follows. Radius and ulna were the most frequently affected, the next were in order of tibia and fibula.Considering osteochondiritis only, the distal end of radius and ulna(78% respectively) and proximal end of tibia(67%) were the most frequently affected sites, the proximal en of femur (33%) was least frequently affected site.8. On chest films of 27 cases, osseous chanages(Mainly periostitis) of clavicle were noted in 14 cases and thoseof rib in 2 cases.
Birth Weight ; Clavicle ; Female ; Femur ; Hepatomegaly ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Jeollanam-do ; Male ; Mothers ; Osteochondritis ; Osteomyelitis ; Periostitis ; Placenta ; Radius ; Ribs ; Serologic Tests ; Skin ; Splenomegaly ; Syphilis ; Syphilis, Congenital ; Thorax ; Tibia ; Ulna

PURPOSE: To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. MATERIALS AND METHODS: From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coller stage B2-C3. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was performed in the range of 39.6-55.8 Gy (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by 5.4-10 Gy. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was performed by Cox proportional hazards model. RESULTS: 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were 53% and 49%, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were 63% vs 45%, respectively ( p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups ( p<0.05 by x2-test) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were 68% vs 55% ( p=0.09), 100% vs 100%, 40% vs 33% ( p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were 65% vs 49% ( p=0.14), 100% vs 100%, 33% vs 31% ( p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was 72.5%. 5YPCRs of surgery alone and adjuvant radiotherapy group were 71% vs 74%, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were 79% vs 75% ( p= 0.88), 100% vs 100%, 44% vs 68% ( p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. CONCLUSION: Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, along with radiotherapy should be considered.
Disease-Free Survival ; Fluorouracil ; Humans ; Multivariate Analysis ; Pelvis ; Proportional Hazards Models ; Radiotherapy ; Radiotherapy, Adjuvant* ; Rectal Neoplasms* ; Retrospective Studies ; Survival Rate

PURPOSE: We performed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. METHODS AND MATERIALS: One hundred and six patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (9 4%) and ranged from 1 month to 92 months (median; 6 months). RESULTS: The median age was 62 years old and male to female ratio was 104:2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was performed in 83%. Mean tumor dose delivered with curative aim was 58.6 Gy (55-70.8 Gy) and median duration o f the radiation therapy was 53 days. The median survival of all patients was 6 months and 1-year and 2-year overall survival rte was 27% and 12%, respectively. Improvement of dysphagia was obtained in most patients except fo 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32% (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30% respectively, while those of the nonresponder was 4 months and 0% respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 rnonths and 16% while those of the patients who could not tolerate regular diet was 3 months and 0%, respectively (p=0.004). The survival difference between the patients with 5 cm or less turnor length and those with more than 5 cm tumor length was rnarginally statistically significant (p=0.06). However, the survival difference according to the periesophageal invasion or mediastinal lymphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor length, and initial degree of dysphagia in a decreasing order. The complication was observed in 10 patients (9%). CONCLUSION: The survival outcome for advanced esophageal cancer patients treated by external be am radiotherapy alone was very poor, In the treatment of these patients, the brachytherapy and chemotherapy should be added to improve the treatment outcome.
Brachytherapy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Diet ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Female ; Follow-Up Studies ; Gastrostomy ; Humans ; Lymphatic Diseases ; Male ; Middle Aged ; Multivariate Analysis ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Thorax ; Tomography, X-Ray Computed ; Treatment Outcome

Emphysematous pyelonephritis is rare but freuently fatal complication of renal parenchymal infection, mostcommonly occurs in diabetic patients and is often associated with urinary obstruction, prior urologicalabnormality or infection. From 1898 to 1984 , about 50 cases of empysematous pyelonephritis have been reporteduniversally. The diaignosis of emphysematous pyelonephritis can be made only roentgenographically. In the last 2years, we have had two cases of emphysematous pyelonephritis at our hospital. It is our purpose to report twopatients who have survived wtih a brief review of the previous literature.
Humans ; Pyelonephritis

Ninety patients of esophageal cancer treated with radiation since November 1985 to June 1990 at the Deprtment of Therapeutic Radiology, Chonnam University Hospital, were analysed retrospectively regarding survival. Seventy five patients (94.9%) revealed squamous cell carcinoma in its histologic type, and most ofpatients were in advanced stage with 25 patients (27.8%) of T2 and 64 patients (71.1%) of T3 Minimum follow up period was 12 months and median was 5 months. Overall actuarial 2 year survival rate was 11.6%. Two year survival rates according to the parameters such as treatment aim, T stage, site, length, radiation dose and response were compared and resulted that survival by tumor length only had statistically significant impact on survival of esophageal carcinoma.
Carcinoma, Squamous Cell ; Esophageal Neoplasms* ; Follow-Up Studies ; Humans ; Jeollanam-do ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate

PURPOSE: Before we report the results of curative radiotherapy in cervix cancer patients, we review the significance and safety of our dose specification methods in the brachytherapy system to have the insight of the potential predictive value of doses at specified points. MATERIALS AND METHODS: We analyze the 45 cases of cervix cancer patients treated with intracavitary brachytherapy. In the lateral simulation film we draw the isodose curve and observe the absorbed dose rate of point A, the reference point of bladder(SBD) and rectum(SRD). In the sagittal view of pelvic MRI film we demarcate the tumor volume(TV) and determine whether the prescription dose curve of point A covers the tumor volume adequately by drawing the isodose curve as correctly as possible. Also we estimate the maximum point dose of bladder(MBD) and rectum(MRD) and calculate the inclusion area where the absorbed dose rate is higher than that of point A in the bladder(HBV) and rectum(HRV), respectively. RESULTS: Of forty-five cases, the isodose curve of point A seems to cover tumor volume optimally in only 24(53%). The optimal tumor coverage seems to be associated not with the stage of the disease but with the tumor volume. There is no statistically significant association between SBD/SRD and MBD/MRD, respectively. SRD has statistically marginally significant association with HRV, while TV has statistically significant association with HBV and HRV. CONCLUSION: Our current treatment calculation methods seem to have the defect in the aspects of the nonoptimal coverage of the bulky tumor and the inappropriate estimation of bladder dose. We therefore need to modify the applicator geometry to optimize the dose distribution at the position of lower tandem source. Also it appears that the position of the bladder in relation to the applicators needs to be defined individually to define "hot spots".
Brachytherapy* ; Cervix Uteri* ; Female ; Humans ; Magnetic Resonance Imaging* ; Prescriptions ; Radiotherapy ; Tumor Burden ; Urinary Bladder ; Uterine Cervical Neoplasms

Percutaneous antegrade pyelography guided by ultrasonography and fluoroscopy was attempted in 25 patients with supravesical obstructive hydronephrosis and suctessful in 23 patients to evaluate the site and nature of urinary obstruction. The etiology of the obstructive uropathies were urinary stricture in 11 cases,urinary Tbc. in 5 cases, urinary stone in 3 cases, uterine prolapse with cystocele, pyonephrosis, ureteral metastatic testicular carcinoma in 1 case respectively. No significant complication of the percutaneous antegrade pyelography was observed. Percutaneous antegrade pyelography provides significant diagnostic informations on the obstructive lesion and can be accomplished with ease and safe in patients with obstructiv hydronephnosis as a diagnostic procedure of choice in infants and children or as an alternative to a retrograde pyelography.
Child ; Constriction, Pathologic ; Cystocele ; Fluoroscopy ; Humans ; Hydronephrosis ; Infant ; Pyonephrosis ; Ultrasonography ; Ureter ; Urinary Calculi ; Urography ; Uterine Prolapse

PURPOSE: A retrospective analysis was performed to investigate the proper management of maxillary sinus carcinoma. MATERIALS AND METHODS: Authors analysed 33 patients of squamous cell carcinoma of maxillary sinus treated at Chonnam University Hospital from January 1986 to December 1992. There were 24 men and 9 women with median age of 55 years. According to AJCC TNM system of 1988, a patient of T2, 10 patients of T3 and 22 patients of T4 were available, respectively. Cervical lymph node metastases was observed in 5 patients(N1;4/33, N2b;1/33). Patients were classified as 3 groups according to management method. The first group, named as "FAR" (16 patients), was consisted of preoperative intra-arterial chemotherapy with5-fluorouracil(5-FU;mean of total dosage;3078mg) through the superficial temporal artery with concurrent radiation(mean dose delivered;3433cGy, daily 180-200cGy) and vitamin A(50,000 IU daily), and followed by total maxillectomy and postoperative radiation therapy(mean dose;2351cGy). The second group, named as "SR"(7 patients), was consisted of total maxillectomy followed by postoperative radiation therapy(mean dose 5920 cGy). Her third group, named as "R"(6 patients), was treated with radiation alone(mean dose;7164cGy). Kaplan-Meier product limit method was used for survival analysis and Mantel-Cox test was performed for significance of survival difference between two groups. RESULTS: Local recurrence free survival rate in the end of 2 year was 100%, 5-% and 0% in FAR, SR and R group, repectively. Disease free survival rate in 2 years was 88.9%, 40% and 50% in Far, SR and R group, respectively. There were statistically significant difference between FAR and SR or FAR and R group in their local recurrence free, disease free and overall survival rates. But diffeence of each survival rate between SR and R group was not significant. CONCLUSION: In this study FAR group revealed better results that SR or R group. In the future prospective randomized study is in need.
Carcinoma, Squamous Cell ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Jeollanam-do ; Kaplan-Meier Estimate ; Lymph Nodes ; Male ; Maxillary Sinus* ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Temporal Arteries ; Vitamins

PURPOSE: To evaluate the efficacies and toxicities of concurrent chemoradiotherapy (CCRT), with or without intraluminal brachytherapy (ILB), using a retrospective analysis in esophageal carcinomas with respect to survival. MATERIALS AND METHODS: From April 1995 to July 2001, a total of 65 patients, diagnosed with an esophageal carcinoma, were treated by CCRT, with 21 also treated by ILB after CCRT. External radiotherapy was performed using 6 or 10 MV X-rays, with a dose range of 46.8~69.6 Gy (median; 59.4). The ILB was performed using high-dose-rate brachytherapy with Ir-192. The fractionation of ILB was 3 Gy by 4, or 5 Gy by 2 fractions. Cisplatin (75 mg/m2) was given on each first day of weeks 1, 5, 9 and 13, and 5-FU (1,000 mg/m2) as a continuous infusion for the first 4 days of each course. RESULTS: The median survival time of all patients was 15 months, and the 1, 2 and 3-year survival rates were 55.4, 29.2 and 20.7%, respectively. The 2-year survival rates of the patients with and without ILB were 33.3 and 27.3%, respectively (p=0.80). The 2-year survival rates of the patients with a complete, partial and no response were 44.1, 13.8 and 0%, respectively (p=0.02). The response to treatment was the only significant factor affecting the overall survival from a multivariate analysis. CONCLUSIONS: This study has shown that the survival outcomes of CCRT were much better than previous results with radiotherapy alone. However, the addition of ILB after CCRT showed no advantage over that of CCRT alone.
Brachytherapy* ; Chemoradiotherapy* ; Cisplatin ; Drug Therapy ; Esophageal Neoplasms ; Fluorouracil ; Humans ; Multivariate Analysis ; Radiotherapy ; Retrospective Studies* ; Survival Rate

The cone-beam CT (CBCT) which is acquired using on-board imager (OBI) attached to a linear accelerator is widely used for the image guided radiation therapy. In this study, the effect of respiratory motion on the quality of CBCT image was evaluated. A phantom system was constructed in order to simulate respiratory motion. One part of the system is composed of a moving plate and a motor driving component which can control the motional cycle and motional range. The other part is solid water phantom containing a small cubic phantom (2 x 2 x 2 cm3) surrounded by air which simulate a small tumor volume in the lung air cavity. CBCT images of the phantom were acquired in 20 different cases and compared with the image in the static status. The 20 different cases are constituted with 4 different motional ranges (0.7 cm, 1.6 cm, 2.4 cm, 3.1 cm) and 5 different motional cycles (2, 3, 4, 5, 6 sec). The difference of CT number in the coronal image was evaluated as a deformation degree of image quality. The relative average pixel intensity values as a compared CT number of static CBCT image were 71.07% at 0.7 cm motional range, 48.88% at 1.6 cm motional range, 30.60% at 2.4 cm motional range, 17.38% at 3.1 cm motional range. The tumor phantom sizes which were defined as the length with different CT number compared with air were increased as the increase of motional range (2.1 cm: no motion, 2.66 cm: 0.7 cm motion, 3.06 cm: 1.6 cm motion, 3.62 cm: 2.4 cm motion, 4.04 cm: 3.1 cm motion). This study shows that respiratory motion in the region of inhomogeneous structures can degrade the image quality of CBCT and it must be considered in the process of setup error correction using CBCT images.
Cone-Beam Computed Tomography* ; Lung ; Particle Accelerators ; Radiotherapy, Image-Guided ; Tumor Burden ; Water