No abstract available.
Animals ; Hantavirus* ; Korea* ; Murinae*

The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system (RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.
Cause of Death ; Humans ; Nasopharyngeal Neoplasms ; Nasopharynx ; Neck ; Radiotherapy ; Recurrence

PURPOSE: To understand the MR findings of extraabdominal desmold tumors by correlation with histopathologic findings. MATERIALS AND METHODS: MR images of histologically proved 12 patients with extraabdominal desmold tumor were retrospectively reviewed. Three types of MR features were defined; type I had signal changes on T1 and T2 weighted images and relatively homogeneous nature, type II had homogeneously low signal intensities on T1 and T2 weighted images and type III was a mixed form of type I and type II. Signal intensity, enhancement pattern and margin of the lesions were analyzed on MR images. Pathologic features were analyzed by three aspects, which were cellularity, amount of collagen and vascularity, and were correlated with MR images. RESULTS: The signal intensities of type I desmolds were intermediate on T1 weighted image and higher on T2 weighted image with localized margin and gadolinium enhancement. Pathologically this type showed predominant cellularity and vascularity. The signal intensities of type II desmold were homogenous low signal intensities on both T1 and T2 weighted images without enhancement. Pathologically this type showed predominant collagen components and hypovascularity. Type III desmolds were mixed form of type I and type II on MR images as well as on pathologic features. Type I and type II desmold tumors had localized margins, however type III had both localized and infiltrative margins. CONCLUSION: The MR findings of extraabdominal desmold tumors would reflect the pathologic background of the tumor.
Collagen ; Gadolinium ; Humans ; Retrospective Studies

From April 1986 to Dec. 1988, fifty one patients with carcinoma of lung were treated by radiation therapy in Department of Therapeutic Radiology, Yeungnam University Hospial. Of the 51 patients, 31(61%) were squamous cell ca, 8(15.7%) were small cell ca, and remained 4(7.9%) were other cell types. Total radiation dose was average 64 Gy (60~75 Gy) for group A and 45 Gy (40~59 Gy) for group B. The mass regression and the response of airway obstruction to radiation therapy was established on the basis of follow up chest X-ray. The mass regression above 50% of total volume was noted in 23 patients (74.2%) among 31 patients and the difference between two groups was not seen. In squamous cell ca, however, the mass regression rate(above 50% of total volume) was 83.3%(10/12) in group A compared to 50%(3/6) in group B(p<0.05). The alleviation of airway obstruction was noted as follows. In group A, CR 42.9%, PR 35.7%, no response 21.4% and in group B, CR 55.6%, PR 33.3%, no response 11.1%. But, in squamous cell ca, responsiveness is higher than group B. The study indicates that the importance of higher radiation dose in the management of primary tumor mass and airway obstruction caused by lung cancer especially squamous cell ca. So, meticulous treatment plaining and multimodality combination therapy without increasing side effect or complication is recommended in management of inoperable bronchogenic carcinoma.
Airway Obstruction* ; Carcinoma, Bronchogenic ; Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Radiation Oncology ; Radiotherapy ; Thorax

To evaluate the reliability of MR imaging in tissue characterization and depiction of tumor boundaries, we performed MR-pathologic correlation using parosteally implanted VX-2 carcinoma in 17 rabbit thighs. T1-weighted, T2-weighted and Gd-DTPA enhanced T1-weighted axial images were obtained 10-30 days after tumor implantation. After the animals were killed, frozen and sectioned along the MR imaging planes, and histopathologic examinaton were done. For accurate MR-pathologic correlation, rabbits were fixed on the cardboard plate to minimize position change during the procedures. Tumor boundaries depicted on MR images were larger than those depicted on the specimen. Small tumors were surrounded by capsule-like loose connective tissue. Loose connective tissue became compact with tumor growth. This connective tissue showed high signal intensity on both T2-weighted and Gd-DTPA enhanced T1-weighted images. Muscle atrophy with fatty tissue accumulation around the tumor also contributed to the high signal intensity on MR images. Peritumoral edema and inflammatory reaction were not remarkable. Six of 8 cases with bone marrow fibrosis were detected on MR images. We concluded that peritumoral loose connective tissue and muscle atrophy exaggerated the size of experimentally induced malignant musculoskeletal tumors on MR images.
Adipose Tissue ; Animals ; Connective Tissue ; Edema ; Gadolinium DTPA ; Magnetic Resonance Imaging ; Muscular Atrophy ; Primary Myelofibrosis ; Rabbits ; Thigh

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.
Adult ; Aneurysm* ; Aorta, Thoracic* ; Aortic Valve ; Brain Ischemia ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Male ; Middle Aged ; Perfusion ; Sternotomy ; Thoracotomy ; Transplants

Clonidine, an 2 agonist, has been shown to be effective as preanesthetic medication in adults. To evaluate the effects of clonidine on the sedation and cardiovascular changes induced by intubation, we administered clonidine (2.0-2.5g/kg, 4.5-5.0g/kg, peros) 90-120min before induction of anesthesia. We measured heart rate, systolic pressure and diastolic pressure before premedication, before induction, after intubation and 5, 10, 15, 20 and 30 min after intubation and evaiuated sedative sction before induction. The results are as follows: 1) Before intubation heart rate decreased significantly in both clonidine groups compared with diazepam group (P<0.05). 2) Before intubation clonidine 4.5-5.0g/kg group produced a significant reduction in systolic pressure compared with diazepam group (P<0.05). 3) After intubation systolic and diastolic blood pressure increased in all group but the increasing rate was significently less then in clonidine 4.5-5.0g/kg group (P<0.05). 4) After intubstion the increase in heart rate in both clonidine groups were significsntly less than in diazepam group (P<0.005). 5) Sedative actions were not significantly different in all groups.
Adult ; Anesthesia ; Blood Pressure ; Cardiovascular System* ; Clonidine* ; Diazepam ; Heart Rate ; Humans ; Intubation ; Preanesthetic Medication ; Premedication

A case of neurogenic pulmonary edema (NPE) occured during operation of brain tumor in the sit- ting position is reported. NPE is a common complication of brain insults. It is characterized clinically by an acute fulminant course, marked pulmonary vascular congestion, protein rich edema fluid, and intra alveolar hemorrhage. The mechanisms involved in the development of NPE are briefly discussed.
Brain Neoplasms* ; Brain* ; Edema ; Estrogens, Conjugated (USP) ; Hemorrhage ; Neurosurgery ; Pulmonary Edema* ; Tolnaftate

From August 1976 to February 1997, we have experienced 29 cases of rapidly destructive coxarthrosis in 23 patients who represented severe hip pain and destruction of the femoral head more than 50% within one year. The retrospective analyses of clinical, radiographic and operative findings of 2090 hips in 1534 patients, who have been diagnosed as ischemic necrosis of femoral head were performed to investigate the correlation between ischemic necrosis of the femoral head and rapidly destructive coxarthrosis. The incidence of rapidly destructive coxarthrosis was 1 % of the overall ischemic necrosis of the femoral head. The average duration of hip pain was 9 months. The average age of the patients was 56 years old and most of them were male. The cultures of synovial fluid for bacteria were negative in all cases except one case of non-pathogenic organism. But, the erythrocyte sedimentation rate and C-reactive protein were elevated. The pathologic findings were not different from the ischemic necrosis except the destruction of articular cartilage. Therefore, we concluded that rapidly destructive coxarthrosis is a subtype of ischemic necrosis of the femoral head.
Bacteria ; Blood Sedimentation ; C-Reactive Protein ; Cartilage, Articular ; Femur Head Necrosis ; Head ; Hip ; Humans ; Incidence ; Male ; Middle Aged ; Necrosis ; Osteoarthritis, Hip* ; Retrospective Studies ; Synovial Fluid

Antimicrobial resistance has become one of the most serious public health concerns worldwide. Although circumstances may vary by region or country, it is clear that some Asian countries are epicenters of resistance, having seen rapid increases in the prevalence of antimicrobial resistance of major bacterial pathogens. In these locations, however, the public health infrastructure to combat this problem is very poor. The prevalence rates of methicillin-resistant Staphylococcus aureus (MRSA), macrolide-resistant Streptococcus pneumoniae, and multidrug-resistant enteric pathogens are very high due to the recent emergence of extremely drug-resistant gram-negative bacilli in Asia. Because antimicrobial options for these pathogens are extremely limited, infections caused by antimicrobial-resistant bacteria are often associated with inappropriate antimicrobial therapy and poor clinical outcomes. Physicians should be aware of the current epidemiological status of resistance and understand the appropriate use of antimicrobial agents in clinical practice. This review focuses on describing the epidemiology and clinical implications of antimicrobial-resistant bacterial infections in Asian countries.
Anti-Infective Agents ; Asia ; Asian Continental Ancestry Group ; Bacteria ; Bacterial Infections ; Drug Resistance, Microbial* ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Public Health ; Streptococcus pneumoniae