No abstract available.
Gastrointestinal Stromal Tumors* ; Hemorrhage*

No abstract available.

It has long been an accepted policy to employ radiation therapy as initial treatement of choice for most casesof invasive carcinoma of cervix uteri. But, complications following radiotherapy were troublesome problem fot thepatients cured by radiation therapy. The aim of the present study is to present the types and rate of complicationsand to evalute the contributing facors induced the radiation complications. The aim of the present study is topresent the types and rate of complications and to evalute the contributing factors induced the radiationcomplications. 957 cases of invasive carcinoma of cervix uteri receiving radiation therapy were analyzed. Theconclusions are as follows; 1. Bowel complications developed in 96 cases (10.03%). 2. 86% of all bowelcomplications appeared during the first 18 months and most frequently seen after 6 to 12 months(40.03%). 3. Thefrequency of complicaiton was higher in older age and larger irradiation dose, but there is no apparentcorrelation between stage and the occurrence of complications. 4. Portal combination was also a contributingfactor. Highest frequency was noted in AP & PA parallel opposing portals followed by 4 oblique portals and boxtechnique.
Cervix Uteri ; Female ; Radiotherapy

BACKGROUND: Recent studies suggest the hypothesis that blockade of nociceptive input with local anesthetics before surgery can decrease pain beyond the immediate postoperative period. The purpose of this study was to determine if the preincisional infiltration with local anesthetics affected postoperative pain relief. METHOD: Among 30 patients having tonsillectomy, 15 patients(group 1) given peritonsillar infiltration using lidocaine with epinephrine(1 : 200,000) were compared with 15 patients(group 2)given peritonsillar infiltration using saline with epinephrine(1 : 200,000). Following general anesthesia with a mixture of O2-N2O(50%) and enflurane(1-2vol.%), peritonsillar infiltration were performed 5 minutes before surgery. Constant incisional pain and pain on swallowing were assessed using a visual analogue scale at 4 hour, 1, 2, 3 and 4 days postoperatively. The time to emergence and behaviour of patient at 0.5, 1 and 4 hour were recorded postoperatively. RESULT: Preincisional infiltration with lidocaine resulted in a significant decrease in postoperative pain during 4 days after surgery and smoother emergence. CONCLUSION: There were significant difference in pain scores between lidocaine group and saline group during 4 days after surgery. Preincisional lidocaine infiltration seemed to have analgesic activity beyond the residual anesthetic period. The results of this study support the theory of pre-emptive analgesia.
Analgesia ; Anesthesia, General ; Anesthetics ; Anesthetics, Local ; Child* ; Deglutition ; Humans ; Lidocaine* ; Pain, Postoperative ; Postoperative Period ; Tonsillectomy

Narcotic analgesics may be added to spinal anesthetics solution to improve the quality of sensorimotor blockade and to produce postoperative pain relief. The opioid-related side effects of respiratory depression, pruritus, nausea, and urinary retension also occur with intrathecal administration and the effects are dose-related. It is difficult to select morphine with spinal anesthetic solution due to fatal side-effect, respiratory depression. Intrathecal morphine dose used for our study was less than 1mg, thereby the risk of respiratory depression was decreased. There was no report that the addition of morphine affected the motor block produced by the local anesthetics in spinal anesthesia. But in our study, we found that 0.9 mg of intrathecal morphine produced prolongation of optimal condition for operation(more than 3 hours duration), and sufficient postoperative pain relief(for about 20 hours) without respiratory depression in 28 out of 30 spinal anesthesia cases. On the other hand, 0.5 mg or 0.7 mg of intrathecal morphine produced sufficient postoperative pain relief without respiratory depression(for about 20 hours), but insufficient prolongation of optimal condition for operation in each 30 cases of spinal anesthesia.
Anesthesia, Spinal* ; Anesthetics ; Anesthetics, Local ; Hand ; Morphine* ; Narcotics ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Tetracaine*

The Marfan syndrome is classified as a heritable disorder of connective tissue with clinical and pathological alterations involving supporting elements. In its classic form, the Marfan syndrome is associated with abnormalities of the eye(ectopia lentis), aorta(aortic dilatation and aortic regurgitation) and skeleton(dolichostenomelia, arachnodactyly and pectus deformity). The authers have experienced a case of marfan syndrome recently. The patient was 30-years-old male complaining of anterior chest pain radiating to upper back. Physical examination showed tall status, increased length of the limbs as compared with the trunk and arachnodactyly. On auscultation, heart sound was normal without murmur. He wore glasses because of moderate myopia. Roentgenogram of the chest P-A revealed normal cardiac and aortic contours and lung fields. Left lateral view of chest X-ray revealed concave depression of sternum showing mild pectus excavatum, fusiform dilatation of aorta from aortic root to mid portion of thoracic aorta and resulting in obliteration of retrosternal clear space. Echocardiogram demonstrated moderate dilatation of aortic root A-P diameter(4.5cm) without aortic or mitral valvular abnormalities and normal size of left ventricular cavity(EDD:5.3cm). These data coupled with a distinct family history could permit the diagnosis of Marfan syndrome.
Aorta ; Aorta, Thoracic ; Arachnodactyly ; Chest Pain ; Connective Tissue ; Depression ; Diagnosis ; Dilatation ; Extremities ; Eyeglasses ; Funnel Chest ; Glass ; Heart Auscultation ; Humans ; Lung ; Male ; Marfan Syndrome* ; Myopia ; Physical Examination ; Sternum ; Thorax

Recently the clinical estimation of gestational age has been of increasing concern particularly in premature babies because of its great aid in treament and expectation of future health. The clinical distinction between small-for-dates infants and premature babies offers great difficulty, but can be made readily if the gestational age is known. The author has investigated the clinical estimation of gestational age in 100 premature infants who were born at the Seoul National University Hospital, the Eul Ji Hospital and the So Wha Hospital from March to August in 1977, in order to evaluate the correlation between the gestationl age calculated from LMP and the clinically estimated gestaionl age using two charts designed by Brazie and Lubchenco, which were based on 16 physical criteria and 20 neurologic criteria with the following results. 1) The sex and age distribution of the 100 premature infants showed predominance in male and in the 34th336th weeks of gestional age. 2) The numbers of babies whose weight was appropriate, small and large for gestational age were 89, 9 and 2 respectively according to University of Colorado Medical Center Example, while they were 91, 4 and 5 according to the chart based on Rha's report in 1976 in Korea. 3) The correlation percentages between the gestational age determined by each of the 16 physical criteria and those calculated from LMP were as following; vernix (88%), skin and nail plates(88%), recoil-leg(75%), skin thickness appearance(73%), sole creases(68%), genitalia, testes and scrotum(67.5%) and so forth. 4) The correlation percentages between the gestational ages determined by each of the 20 neurologic criteria and those calculated from LMP were as following, pupillary reflex(94%), grasp reflex(90%), vertical positions(87%), head lag (83%), glabellar tap(81%), body extensors(80%), horizontal positions(80%), rooting reflex(80%), and so forth. 5) The correlation coefficiency between the clinically estimated gestational age using the above described two charts and that calculated from LMP was 0.98. And the regression formula for the latter (X) against the former (Y) was Y=0.786X+7.753. With the above results, the author could conclude that clinical estimation of the gestational age with the two charts of Brazie and Lubchenco was highly correlated and it deserves to be recommended for clinical purpose.
Age Distribution ; Colorado ; Genitalia ; Gestational Age* ; Hand Strength ; Head ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Korea ; Male ; Seoul ; Skin ; Testis

BACKGROUND: PUVA has been used effectively in the treat,ment of vitiligo, but the mechanism by which PUVA stimulat.es melanocyte proliferation in vitiligo is not known. Several mechanisms have been suggested to be involved in the process of repigmentation of vitiligo. First, UV light, with or without psoralen, directly stimulates the proliferation of melanocytes. Secondly, PUVA may act. on epidermal keratinocytes or dermal components to stimulate t,hem to release certain melanocyte growth st,inulation factors that enhance the proliferation of melanocytes in depigmented lesions. Thirdly, PUVA irnmunologically leads to the impairment of epidermal Langerhans cell function and alteration of circulating T and B cell function, which results in the suppression of the stimuli is for rnelanocyte destruction during the therapy. OBJECTIVE: To test, th hypothesis that PUVA induced repigmentation in vitiligo results from the stimulation of growth factors that induce melanocyte proliferation, and that PUVA may suppress the immune reacticin to melanocytes, especially in autoantibody synt,hesis, we examined the effects of sera on the growth of epidermal melanocytes and control cells, and t,he incidence of antibodies to melanocyte and melanoma cells(SK-Mel 2~3) in the sera of patients with vitiligo. We also had normal control individuals and studied the changes of the antibody titer in the sera of patients with vitiligo. METHODS: The rate of H thymidine uptake was estimat,ed in cultured melanocytes and fibroblasts t,reated by patients sera before and after PUVA treatment. SDS-PAGE and immunoblotting analysis were used to idcntify anti pigment cell autoantibodies and were compared to the titers of autoantibodies after PUVA. RESULTS: 1. Melanocyte and fibrablast proliferation was increased by PUVA treated sera. Their proliferation was in proportion to the duration of the PUVA treatment. Melanocytes proliferated more than fibroblasts. 2. Significant differences between vitiligo patients and normal controls were found in the inci dence of anti-pigment cell antibodies. The antibodies were predominantly directed to melanocyte antigens of 110 kD, 65 kD, 45 kD and melanoma cell antigens of 110 kD, 103 kD, 88kD, 70 kD, 56 kD, 41 kD. 3. The titer of anti piment cell antibodies showed a tendency to decrease after PUVA treat- ment in most patients regardless of clinical improvement. Conclusion ; PUVA treated sera induced proliferation of melanocytes and fibroblasts and the production of aut,oantibodies was suppressed against pigment cell antigens through irnmunosuppression, which might help in the repigmentation of vitiligo.
Antibodies ; Autoantibodies* ; Electrophoresis, Polyacrylamide Gel ; Fibroblasts ; Ficusin ; Humans ; Immunoblotting ; Incidence ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Melanocytes* ; Melanoma ; Thymidine ; Ultraviolet Rays ; Vitiligo*

BACKGROUND: PUVA has been used effectively in the treat,ment of vitiligo, but the mechanism by which PUVA stimulat.es melanocyte proliferation in vitiligo is not known. Several mechanisms have been suggested to be involved in the process of repigmentation of vitiligo. First, UV light, with or without psoralen, directly stimulates the proliferation of melanocytes. Secondly, PUVA may act. on epidermal keratinocytes or dermal components to stimulate t,hem to release certain melanocyte growth st,inulation factors that enhance the proliferation of melanocytes in depigmented lesions. Thirdly, PUVA irnmunologically leads to the impairment of epidermal Langerhans cell function and alteration of circulating T and B cell function, which results in the suppression of the stimuli is for rnelanocyte destruction during the therapy. OBJECTIVE: To test, th hypothesis that PUVA induced repigmentation in vitiligo results from the stimulation of growth factors that induce melanocyte proliferation, and that PUVA may suppress the immune reacticin to melanocytes, especially in autoantibody synt,hesis, we examined the effects of sera on the growth of epidermal melanocytes and control cells, and t,he incidence of antibodies to melanocyte and melanoma cells(SK-Mel 2~3) in the sera of patients with vitiligo. We also had normal control individuals and studied the changes of the antibody titer in the sera of patients with vitiligo. METHODS: The rate of H thymidine uptake was estimat,ed in cultured melanocytes and fibroblasts t,reated by patients sera before and after PUVA treatment. SDS-PAGE and immunoblotting analysis were used to idcntify anti pigment cell autoantibodies and were compared to the titers of autoantibodies after PUVA. RESULTS: 1. Melanocyte and fibrablast proliferation was increased by PUVA treated sera. Their proliferation was in proportion to the duration of the PUVA treatment. Melanocytes proliferated more than fibroblasts. 2. Significant differences between vitiligo patients and normal controls were found in the inci dence of anti-pigment cell antibodies. The antibodies were predominantly directed to melanocyte antigens of 110 kD, 65 kD, 45 kD and melanoma cell antigens of 110 kD, 103 kD, 88kD, 70 kD, 56 kD, 41 kD. 3. The titer of anti piment cell antibodies showed a tendency to decrease after PUVA treat- ment in most patients regardless of clinical improvement. Conclusion ; PUVA treated sera induced proliferation of melanocytes and fibroblasts and the production of aut,oantibodies was suppressed against pigment cell antigens through irnmunosuppression, which might help in the repigmentation of vitiligo.
Antibodies ; Autoantibodies* ; Electrophoresis, Polyacrylamide Gel ; Fibroblasts ; Ficusin ; Humans ; Immunoblotting ; Incidence ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Melanocytes* ; Melanoma ; Thymidine ; Ultraviolet Rays ; Vitiligo*

No abstract available.
Appendicitis* ; Child* ; Humans