Newborns with ileal atresia frequently present with abdominal distension, bilious vomiting, and failure to pass meconium. Diagnosis is usually established on plain x-ray of the abdomen by the findings of distended small bowel loops and air-fluid levels. In the period of October 1988 to February 1994, 8 patients with congenital ileal atresia were operated and the following results were obtained. 1. Eight patients were comprise of 4 males and 4 females, the ratio of male and female was 1 : 1. 2. Six patients(75%) had been admitted to our hospital during three days of life. 3. Congenital ileal atresia was in 8 cases : Type I in two(25%), Type II in two(25%), Type III a in three(37.5%), Type III b in one(12.5%). 4. There was one premature patient who was small for gestational age. 5. Overall, abdominal distension and bilious vomiting occurring in seven patients, were frequent presenting complaints. 6. Diagnosis was possible with clinical symptom and simple abdomen. 7. Operative treatment was undertaken as soon as the diagnosis was made. In seven cases a primary end-to-end anastomosis was performed after resection of dilated proximal loop. 8. A total of four associated congenital anomalies were found in one patient. 9. Postoperative complications occurred in three cases(37.5%).
Abdomen ; Diagnosis ; Female ; Gestational Age ; Humans ; Infant, Newborn* ; Male ; Meconium ; Postoperative Complications ; Vomiting

331 patients of stage IIb uterine cervix cancer treated by radiation alone at Kosin Medical Center between June 1980 and Dec. 1985 were analysed to determine parameters of radiotherapy associated to disease states. Survival rate was highest among the reported (82.8% for crude and 82.4% for disease free survival). Pelvic control rate in 6 weeks after the end of radiotherapy was 93.6% in the patients treated with ICR following total pelvic radiation and 71.6% with small field additional external irradiation. 5 year survival rate in those who achieved pelvic control was 98. 9% and 12.9% in those who had pelvic failure and/or metastasis after radiation. The survival rate figured maximal 88.5% with dosage of 7500~8500 cgy to point A with acceptable incidence of complications (4.9%) but without increasing survival above it and minimal 74.1% with dosage of less than 6500 cgy. The treatment failure was counted 18.7% (62 of 331 patients): Local failure 72. 6% ( 45 of 62 patients), locoregional failure 3.2% (2 of 62 patients) and distant failure 24% (15 of 62 patients). Late complications were found In 50 patients (15.1%) and 42% of them was rectal bleeding and stenosis. The dose of 8500 cgy to point A was found to be critical for complication and 70% of complications occurred above it and was more serious one such as fistula. Rectal complications were developed above rectal dose 6500 cgy and bladder complication above bladder dose 7500 cgy. Major cause of death was cachexia due to locoregional failure (73.7% of death), next was due to metastasis to lung, liver and bone, and only 3 patients died of complication of intestinal perforations and obstruction. In conclusion higher external radiation dose for a bulky uterine cervix and barrel shaped uterus was essential for local control.
Cachexia ; Cause of Death ; Cervix Uteri* ; Constriction, Pathologic ; Female ; Fistula ; Hemorrhage ; Humans ; Incidence ; Intestinal Perforation ; Liver ; Lung ; Neoplasm Metastasis ; Radiotherapy* ; Survival Rate ; Treatment Failure ; Urinary Bladder ; Uterus

Seventy-nine patients with carcinoma of maxillary antrum treated at the department of therapeutic radiology, Kosin Medical Center, between June 1980 and December 1986 were analyzed retrospectively for survival rate and treatment failure. Forty-three patients were treated with radiotherapy alone and thirty-six patients were treated with combination of surgery and radiotherapy. The overall 5 year survival rate was 32%, patients that were treated with radiotherapy alone had a 5-year survival rate of 23%, and patients who were treated with combination of surgery and radiotherapy had a 5-year survival rate of 42%. 54 patients(68.4%) failed to be cured. Among these 54 patients, 37 patients(68.5%) had only locoregional failure, 16 patients(29.6%) had locoregional failure and distant metastases and 1 patient had only distant metastasis. From above study combination of surgery and radiotherapy might be a better treatment modality for carcinoma of the maxillary antrum.
Humans ; Maxillary Sinus* ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Treatment Failure

Diaphragm injuries are very important because, if both thoracic and abdominal viscera are damaged, a combination of shock and acute respiratory distress may develop. It can be highly lethal. This evaluation was based on the reviews of 17 cases of traumatic diaphragm injuries treated at the Department of Cardiovascular Surgery, Seoul Adventist Hospital during 5 years from March 1993 to February 1997. The mean age of the patients was 37.2 years and sex ratio was 3.2:1 with male dominance. Blunt trauma(N=5, Rt.=4, Lt.=1) was 29.5%, penetrating trauma(N=12, Rt.=5, Lt.=7) was 70.5%. Dyspnea(76%) was the most common symptom. Blunt trauma(9.8 3.7 Cm) was larger than the penetrating trauma(3.2 1.3 Cm)(P<0.05) in the size(mean SD) of the injury. All of the patients had associated injuries and repaired immediatley with thoracic approach 11 cases(64%), abdominal approach 3 cases(18%) and thoracoabdominal approach 3 cases(18%). 5 cases of penetrating diaphragmatic trauma was diagnosed on the operation of other organ injury. Now we suggest that diaphragmatic injury should be suspected in all patients with penetrating as well as blunt injury of the chest and abdomen to protect the patient from its late complications.
Abdomen ; Diaphragm ; Humans ; Male ; Seoul ; Sex Ratio ; Shock ; Thorax ; Viscera ; Wounds, Nonpenetrating

PURPOSE: This study was designed to describe clinical differences between symptomatic and asymptomatic group in varicose vein. METHOD: We reviewed 59 cases of varicose vein managed in our hospital. The retrospective review of clinical records was done from March, 1999 to October, 1999. All patients were put into two groups:those were symptomatic and asymptomatic. RESULT: Analysis showed that varicose vein was more frequent in women than in men. 27.1% were asymptomatic and 72.9% were symptomatic. The mean age was 39.1 years in asymptomatic group and 52.1 years in symptomatic group. In asymptomatic group, the mean age of the male patients was 45.2 years and that of the female patients was 35.4 years. In symptomatic group, the mean age of the male patients was 49.6 years, that of the female patients was 54.2 years. The age difference between the two groups were 5.4 years in male in comparison with 19.8 years in female. In the symptomatic group, the frequency of association with deep vein thrombosis (DVT) was 21% (male:28% vs female:8.3%). CONCLUSION: The varicose vein appears to be a gradually progressive disease. In female patients, aging factor may be more important for the development of symptom. DVT is one of major causes of development of symptom.
Aging ; Female ; Humans ; Male ; Retrospective Studies ; Varicose Veins* ; Venous Thrombosis

The expectoration of blood is always a fearful experience for the patient and a matter of grave concern to the attending physician, because it may be the warning sign of serious diseases. When such bleeding occurs, the possibility of its being due to pulmonary tuberculosis, bronchiectasis or carcinoma of the lung is promptly suggested. Nowadays, with the advance of modern diagnostic studies, differential diagnosis has become possible for the hemoptysis patients to have appropriate treatment. This evaluation is based on the review of 75 cases of patients whom we performed emergency open thoracotomies for 6 years from March 1992 to February 1997 in the Department of Thoracic and Cardiovascular Surgery, Seoul Adventist Hospital. The mean age of the patients was 36.6 years old with a range from 19 to 68, and most prevalent age group was thirties. The most common underlying lung disease causing hemoptysis was tuberculosis(44%). Most accurate diagnostic study was bronchoscopy during hemoptysis(95%) and right middle and lower lobe(17.3%) was the most common site of lesion. Lobectomy(50%) was the most frequent operative method and recurrent hemoptysis(31.6%) was the most common postoperative complication. But most of the patients(82.6%) were completely recovered by surgical treatment. Now we concluded that the proper management of hemoptysis was completed by surgical approach with definite diagnosis and supportive medication.
Bronchiectasis ; Bronchoscopy ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Hemoptysis* ; Hemorrhage ; Humans ; Lung ; Lung Diseases ; Postoperative Complications ; Seoul ; Thoracotomy ; Tuberculosis, Pulmonary

PURPOSE: To determine the perturbation effect in the tissue downstream from surface layers of lesions located in the air/tumor-tissue interface of larynx using 6MV photon beam. MATERIALS AND METHODS: Thermoluminescent dosimeters(TLDs). Were embedded at 3 measurement locations in slab no.7 of a humanoid phantom and exposed to forward and backward direction using various field sizes(4X4cm2 - 15X15 cm2). RESULTS: At the air/tissue interface, forward dose perturbation factor(FDPF) is about 1.085 with 4X4 cm2, 1.05 with 7X7 cm2, 1.048 with 10X10cm2, and 1.041 with 15X15cm2. Backscatter dose perturbation factor(BDPF) is about 0.99 with 4X4cm2, 0.981 with 7X7cm2, 0.956 with 10X10cm2 and 0.97 with 15X15cm2 . CONCLUSION: FDPF is greater as field size is smaller. And FDPF is smaller as the distance is further from the air/tissue interface.
Larynx

PURPOSE: To determine the perturbation effect in the tissue downstream from surface layers of lesions located in the air/tumor-tissue interface of larynx using 6MV photon beam. MATERIALS AND METHODS: Thermoluminescent dosimeters(TLDs). Were embedded at 3 measurement locations in slab no.7 of a humanoid phantom and exposed to forward and backward direction using various field sizes(4X4cm2 - 15X15 cm2). RESULTS: At the air/tissue interface, forward dose perturbation factor(FDPF) is about 1.085 with 4X4 cm2, 1.05 with 7X7 cm2, 1.048 with 10X10cm2, and 1.041 with 15X15cm2. Backscatter dose perturbation factor(BDPF) is about 0.99 with 4X4cm2, 0.981 with 7X7cm2, 0.956 with 10X10cm2 and 0.97 with 15X15cm2 . CONCLUSION: FDPF is greater as field size is smaller. And FDPF is smaller as the distance is further from the air/tissue interface.
Larynx

PURPOSE: The aim of this study is to analyze the survival rate, treatment failure and complication of radiation therapy alone in stage III uterine cervical cancer. MATERIALS AND METHODS: From January 1980 through December 1985, 227 patients with stage II uterine cervical cancer treated with radiation therapy at Kosin Medical Center were retrospectively studied. Among 227 patients, 72 patients(31.7%) were stage IIIa, and 155 patients(68.3%) were stage IIIb according to FIGO classification. Age distribution was 32-71 years(median: 62 years). Sixty nine patients(95.8%) in stage IIIa and 150 patients(96.8%) in stage IIIb were squamous cell carcinoma. Pelvic lymphnode metastasis at initial diagnosis was 8 patients (11.1%) in stage IIIa and 29 patients(18.7%) in stage IIIb. Among 72 patients with stage IIIa, 36 patients(50%) were treated with external radiation therapy alone by conventional technique (180-200 cGy/fr). And 36 patients(50%) were treated with external radiation therapy with intracavitary radiotherapy(ICR) with Cs137 sources, and among 155 patients with stage IIIb, 80 patients(51.6%) were treated with external radiation therapy alone and 75 patients(48.4%) were treated with external radiation therapy with ICR. Total radiation doses of stage IIIa and IIIb were 65-105 Gy(median : 78.5 Gy) and 65-125.5 Gy (median :83.5 Gy). Survival rate was calculated by life-table method. RESULTS: Complete response rates were 58.3% (42 patients) in state IIIa and 56.1%(87 patients) in stage Iiib. Overall 5 year survival rates were 57% in stage IIIa and 40% in stage IIIb. Five year survival rates by radiation technique in stage IIIa and IIIb were 64%, 40% in group treated in combination of external radiation and ICR, and 50%, 40% in the group of external radiation therapy alone(P=NS). Five year survival rates by response of radiation therapy in stage IIIa and IIIb were 90%, 66% in responder group, and 10%, 7% in non-responder group (p<0.01). There were statistically no significances of 5 year survival rate by total radiation doses and external radiation doses (40 Gy vs 50 Gy) of whole or true pelvis in stage IIIa and IIIb(P=NS). Treatement failures rates were 40.3%(29 patients) in stage IIIa and 57.4%(89 patients) in stage IIIb, 17 patients (23.6%) in stage IIIa and 46 patients (29.7%) in stage IIIb experienced complications. Total radiation doses more than 85 Gy produced serious complication in both stage IIIa(50%) and Iib(50%), Serious complicaton rates were higher in group received externl radiaton doses of 50 Gy than 40 Gy to whole or true pelvis in stage IIIa and IIIb. Seious rectal complication developed in rectal doses more than 65 Gy, and serious bladder complication developed in bladder doses more than 75 Gy. Major cause of deah was cachexia due to locoregional failure in both stage IIIa(34.7%) and IIIb(43.9%). CONCLUSION: From this study, we found that external radiation therapy with ICR was found to have a tendency to be superior to external radiation therapy alone in survival rate, local control rate and complication rate but not different in statistics, and external radiation doses of 50 Gy than 40 Gy tho whole or true pelvis produced serious rectal and bladder complications in stage III uterine cervical cancer.
Age Distribution ; Cachexia ; Carcinoma, Squamous Cell ; Classification ; Diagnosis ; Humans ; Lesser Pelvis ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Urinary Bladder ; Uterine Cervical Neoplasms

PURPOSE: The aim of this study was to assess the effectiveness, survival rate and complication of radiation therapy in nasopharyngeal cancer. MATERIALS AND METHODS: From January 1980 to May 1989, Fifty Patients who had nasopharyngeal carcinoma treated with curative radiation therapy at Kosin Medical Center were retrospectively studied. Thirty seven patients(74%) were treated with radiation therapy alone(Group I) and 13 patients (26%) treated with combination fo chemotherapy and radiation(Group II). Age distribution was 16-75 years(median:45.8 years). In histologic type, squamous cell carcinoma was in 30 patients(60%), undifferentiated carcinoma in 17 patinets(34%), and lymphoepithelioma in 3 patients(6%). According to AJCC staging system, 4 patinets(8%) were in T1, 13 patients(2%) in T2, 20 patients(40%) in T3, 13 patients(26%) in T4 and 7 patients(14%) in N0, 6 patients(12%) in N1, 23 patients(46%) in N2, 14 patients (28%) in N3. Total radiaton dose ranges were 5250-9200 cGy(median : 7355 cGy) in Group I and 5360-8400 cGy(median :6758cGy) in Group II. Radiotherapy on 4-6MV linear accelerator and/or 6-12MeV electron in boost radiation was given with conventional thechnique to 26 patinets(52%), with hyperfractionation(115-120cGy/fr., 2times/day) to 16 patients(32%), with accelerated fractionation(160cGy/fr., 2 times/day) to 8 patients(16%). In Chemotherapy, 5 FU 1000mg daily for 5 consecutive days, pepleomycin 10mg on days 1 and 3, and cisplatin 100mg on day 1 were administered with 3 weeks interval, total 1 to 3 cycles(average 1.8cycles) prior to radiation therapy. Follow up duration was 6-140 months(mean:58 months). Statistics was calculated with Chi-square and Fisher's exact test. RESULTS: Complete local control rates in Group I and II were 75.7%, 69.2%. Overall 5 year survival rates in Group I and II were 56.8%, 30.8%. Five year survival rates by histologic type in Group I and II were 52.2, 14.3% in squamous cell carcinoma an d 54.5%, 50% in undifferentiated carcinoma. Survival rates in Group I were superior to those of Group II though there were not statistically significant. In both group, survival rates seem to be increased according to increasing total dose of radiation up to 7500cGy, but not increased beyond it. There were not statistically significant differences in survival rates by age, , stage, and radiation tehchniques in both group. Twenty four patients (48%) experienced treatment failures. Complications were found in 12 patients(24%). The most common one was osteomyelitis(4 patients, 33.3%) involving mandible (3 patients) and maxilla(1patient). CONCLUSION: Chemotherapy in combination with radiotherapy was found to be not effective to nasopharyngeal cancer and the survival rate was also inferior to that of radiation alone group though it was statistically not significant due to small population in chemotherapy combined group.
Age Distribution ; Carcinoma ; Carcinoma, Squamous Cell ; Cisplatin ; Drug Therapy ; Follow-Up Studies ; Humans ; Mandible ; Nasopharyngeal Neoplasms* ; Particle Accelerators ; Peplomycin ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Treatment Failure