To investigate recovery, growth, and activity of hepatocyte in primary culture after cell separation, the authors followed up the marker enzyme activities of golgi complex, mitochondria and biologic membrane. Thiamine pyrophosphatase, the marker enzyme of golgi complex, activity approached the level of long term culture at 4th day. Succinate dehydrogenase, the marker enzyme of mitochondria, activity decreased with time, then it maintained constant level after 4th day. Alkaline phosphatase, the marker enzyme of biological membrane, activity increased from 3rd day, and after 5th day it showed strong reaction. These data suggested that hepatocytes were stabilized and recovered normal activity 4 day after cell separation. But the main secretory function was speculated to be reduced in culture.
Alkaline Phosphatase ; Animals ; Cell Separation ; Golgi Apparatus ; Hepatocytes* ; Membranes ; Mitochondria ; Organelles* ; Rats* ; Succinate Dehydrogenase ; Thiamine Pyrophosphatase

PURPOSE: To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. MATERIALS AND METHODS: From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients ere managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A: minimal < about 5cc, B: mouthful 5-50 cc, C: Large > 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using C0-60 teletherapy machine. A total of 10Gy(2Gy/fr. X 5 days)was delivered without correction of lung density. RESULTS: In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due o multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group B, six of 7 patients(86%) with no RT were died due to respiratory failure, but 4 of 8 patients with RT were alive and 4 of 5 patients who received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion wre died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity. CONCLUSION: It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggressive supportive treatment appears to decrease pulmonary toxicity and contribute survival in patients with mouthful ingestion of paraquat who are destined to have reversible renal and hepatic damage but irreversible pulmonary toxicity.
Diuresis ; Eating ; Gastric Lavage ; Humans ; Lung ; Mouth ; Paraquat* ; Plasma ; Poisoning* ; Pulmonary Fibrosis ; Respiratory Insufficiency

Tamoxifen and radiotherapy are used in breast cancer treatment worldwide. Radiation recall dermatitis (RRD), induced by tamoxifen, has been rarely reported. Herein, we report a RRD case induced by tamoxifen. A 47-year-old woman had a right quadrantectomy and an axillary lymph node dissection due to breast cancer. The tumor was staged pT2N0; it was hormone receptor positive, and human epidermal growth factor receptor 2 negative. The patient received adjuvant chemotherapy followed by tamoxifen and radiotherapy. After 22 months of tamoxifen, the patient developed a localized heating sensation, tenderness, edema, and redness at the irradiated area of the right breast. The symptoms improved within 1 week without treatment. Three weeks later, however, the patient developed similar symptoms in the same area of the breast. She continued tamoxifen before and during dermatitis, and symptoms resolved within 1 week.
Breast ; Breast Neoplasms* ; Chemotherapy, Adjuvant ; Dermatitis ; Edema ; Female ; Heating ; Hot Temperature ; Humans ; Lymph Node Excision ; Middle Aged ; Radiodermatitis* ; Radiotherapy ; Receptor, Epidermal Growth Factor ; Sensation ; Tamoxifen*

The skin sparing effect associated with high energy x-ray or gamma ray beams may be reduce or lost under certain conditions of treatment. Current trends in using large fields. Shield carrying trays, compensating filters, and isocentric methods of treatment have posed problems of increased skin dose which sometimes become a limiting factor in giving adquate tumor doses. We used the shallow ion chamber to measure the phantom surface dose and the physical treatment variables for Co-60 gamma ray, 4MV and 10 MV x-ray beam. The dependence of percent surface dose on field sizes, atomic number of the shielding tray materials and its distance from the surface for 4, 10MV x-rays and Co-60 gamma ray is qualitatively similar. The use of 2 mm thick tin filter is recommended for situations where a low atomic number tray is introduced into the beam at distances less than 15 cm from the surface and with the large field sized for 4 MV x-ray beam. In case of Co-50 gamma ray, the lead glass tray is suitable for enhancement of skin sparing. Also, the filter distance should be as large as possible to achieve substantial skin sparing.
Gamma Rays ; Glass ; Skin* ; Tin

BACKGROUND: As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. METHODS: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological,and radiographic differences and scoring system. RESULTS: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). CONCLUSION: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.
Adolescent ; Bacteria ; Child ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin M ; Infant ; Korea ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Pneumonia, Viral ; Polymerase Chain Reaction ; Serologic Tests ; Sputum

Hemolytic disease in a newborn that causes early jaundice is common. It is often due to the Rh (D) and ABO incompatibility, but rarely due to unexpected antibodies. Among these unexpected antibodies, the anti-Di(a) antibody rarely occurs. The anti-Di(a) antibody was observed in the serum and red-cell eluate of an infant, and in the serum of his mother. The frequency of the appearance of the Di(a) antigen in the Korean population is estimated to be 6.4-14.5%. This paper reports a case of hemolytic disease in a newborn associated with the anti-Di(a) antibody. A full-term male infant was transferred to the authors' hospital due to hyperbilirubinemia the day after his birth. The laboratory data indicated a hemoglobin value of 11.6 g/dL, a reticulocyte count of 10.6%, a total bilirubin count of 14.4 mg/dL, a direct bilirubin count of 0.6 mg/dL, and a positive result in the direct Coombs' test. Due to the identification of an irregular antibody from the maternal serum, an anti-Di(a) antibody was detected, which was also found in the eluate made from the infant's blood. The infant had been treated with phototherapy and intravenous immunoglobulin since the second day after his birth and was discharged due to an improved condition without exchange transfusion. Therefore, in cases of iso-immune hemolytic disease in a newborn within 24 hours from birth who had a negative result in an antibody screening test, the conduct of an anti-Di(a) antibody identification test is recommended due to the suspicion of an anti-Di(a) antigen, followed by early administration of intravenous immunoglobulin.
Antibodies ; Bilirubin ; Coombs Test ; Hemoglobins ; Humans ; Hyperbilirubinemia ; Immunoglobulins ; Infant ; Infant, Newborn ; Jaundice ; Male ; Mass Screening ; Mothers ; Parturition ; Phototherapy ; Reticulocyte Count

OBJECTIVE: Long-term oral anticoagulation or antiplatelet therapy has been used with increasing frequency in the elderly. These patients are at increased risk of morbidity and mortality from expansion of intracranial hemorrhage. We conducted a single-center retrospective case control study to evaluate risk factors associated with outcomes and to identify the differences in outcome in traumatic brain injury between preinjury anticoagulation use and without anticoagulation. METHODS: A retrospective study of patients who underwent craniotomy or craniectomy for acute traumatic cerebral hemorrhage, between January 2005 and December 2014 was performed. RESULTS: A consecutive series of 50 patients were evaluated. The factors significantly differed between the two groups were initial Prothrombin Time-International Normalized Ratio, initial platelet count, initial Glasgow Coma Scale score, and postoperative intracranial bleeding. Mean Glasgow Outcome Scale (GOS) score were similar between the two groups. In the patient with low-energy trauma only, no significant differences in GOS score, postoperative bleeding and many other factors were observed. The contributing factors to postoperative bleeding was preinjury anticoagulation and its adjusted odds ratio was 12 [adjusted odds ratio (OR), 12.242; p=0.0070]. The contributing factors to low GOS scores, which mean unfavorable neurological outcomes, were age (adjusted OR, 1.073; p=0.039) and Rotterdam scale score for CT scans (adjusted OR, 3.123; p=0.0020). CONCLUSION: Preinjury anticoagulation therapy contributed significantly to the occurrence of postoperative bleeding. However, preinjury anticoagulation therapy in the patients with low-energy trauma did not contribute to the poor clinical outcomes or total hospital stay. Careful attention should be given to older patients and severity of hemorrhage on initial brain CT.
Aged ; Brain ; Brain Injuries* ; Case-Control Studies ; Cerebral Hemorrhage, Traumatic ; Craniotomy ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Length of Stay ; Mortality ; Odds Ratio ; Platelet Count ; Prothrombin ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed

PURPOSE: This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. MATERIAL AND METHODS: The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. RESULTS: The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2% over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6% with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. CONCLUSION: This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning, but prospective studies are required to define the true clinical benefit.
Brain Stem ; Humans ; Nasopharynx* ; Parotid Gland ; Temporal Lobe ; Temporomandibular Joint

PURPOSE: To find the more effective treatment methods that improving thesurvival of patients with glioblastoma multiforme(GBM), we analyze the prognostic factors and the outcome of therapy in patients with GBM. METHODS AND MATERIALS: One hundred twenty-one patients with a diagnosis of GBM treated at Severance Hospital between 1973 and 1993 were analyzed for survival with respect to patients characteristics, that is, duration of symptom, age, and Karnofsky performance status, as well as treatment related variables such as extent of surgery and radiotherapy. RESULTS: The median survival time(MST) and 2-year overall survival rate (OSR) of the patients with GBM were 13 months and 20.8%, respectively. Duration of symptom, age, Karnofsky performance status(KPS), radiotherapy, and extent of surgical resection were associated with improved survival in a univariate analysis. Patients whose duration of symptom was longer than 3 months, had the 2-year OSR of 47.2%(p=0.0082), who were younger than age 50, 32.9%(p=0.0003). In patients with a KPS of 80 or higher, the 2 year OSR was 36.9%(p=0.0422). Patients undergoing radiotherapy had the 2-year OSR of 22.9%(p=0.030), and surgical resection of 23.3%(p<0.000). A cox regression model confirmed a significant correlation of duration of symptom, age, radiotherapy,and extent of surgical resection with survival, excluding KPS(p=0.8823). The 2-year OSR were 22.3% and 19.4%, combined with chemotherapy or without, respectively(p=0.06028). The duration of symptom of 3 months or shorter. 50 years of age or older, and undergoing stereotactic biopsy only were considered as risk factors. then patients without any risk factors had the MST of 29 months and 2-year OSR of 53.9% compared to 4 months and 0% for patients who had all 3 risk factors. Most of all treatment failure occurred in the primary tumor site(86.4%) CONCLUSION: The duration of symptom, age, radiotherapy, and extent of surgical resection were a prognostically significant independent variables. To get a better survival, it seems to be reasonable that the study design which improves the local control rates is warranted.
Biopsy ; Diagnosis ; Drug Therapy ; Glioblastoma* ; Humans ; Karnofsky Performance Status ; Radiotherapy ; Risk Factors ; Survival Rate ; Treatment Failure

PURPOSE: To evaluate influences associated with radiation treatment planning obtained with the patient breathing freely. MATERIAL AND METHODS: We compared reduction or elimination of planning target volume (PTV) margins with 2-D conventional plan with inclusion of PTV margins associated with breathing with 3-D conformal therapy. The respiratory non gated 3-D conformal treatment plans were compared with respiratory gated conventional 2-D plans in 4 patients with hepatocellular carcinomas. Isodose distribution, dose statistics, and dose volume histogram (DVH) of PTVs were used to evaluate differences between respiratory gated conventional 2-D plans and respiratory non gated 3-D conformal treatment plans. In addition, the risk of radiation exposure of surrounding normal liver and organs are evaluated by means of DVH and normal tissue complication probabilities (NTCPs). RESULTS: The vertical movement of liver ranged 2-3 cm in all patients. We found no difference between respiratory gated 2-D plans and 3-D conformal treatment plans with the patients breathing freely. Treatment planning using DVH analysis of PTV and the normal liver was used for all patients. DVH and calculated NTCP showed no difference in respiratory gated 2-D plans and respiratory non gated 3-D conformal treatment plans. CONCLUSION: Respiratory gated radiation therapy was very important in hepatic tumors because radiation induced hepatitis was dependent on remaining normal liver volume. Further investigational studies for respiratory gated radiation treatment combined with 3-D conformal treatment are required.
Carcinoma, Hepatocellular ; Hepatitis* ; Humans ; Liver ; Respiration