We reviewed 80 cases of hemorrhagic radiation cystitis(HRC) treated in the Department of Urology, Korea Cancer Center Hospital from March, 1985 to July, 1990. The results were obtained as follows. 1. Primary underlying diseases were 1 bladder tumor and 79 cervix cancers. Main presenting symptoms and signs on hospitalization were gross hematuria, passage of blood clots and vesical irritability symptoms. 2. The range of radiation doses to the bladder was from 5,000 to 11,086 cGy and the ratio of cases receiving irradiation over 7,000 cGy was 56.3 %(45 among 80 cases). Time elapsing between termination of radiation therapy and occurrence of HRC was ranged from 1 month to 14.5 years. 3. We performed histopathologic examination in 22 cases. Microscopically, diffuse mucosal edema and ulceration, vascular telangiectasia, submucosal hemorrhage were observed. The areas of ulceration contained acute inflammatory cells at their base and the lamina propria was hyalinized with enlarged atypical fibroblasts and endothelial cells. Of 22 cases, 4 cases of the secondary neoplasia (1 case of transitional cell papilloma, 2 cases of transitional cell carcinoma(TCC) and 1 case of adenocarcinoma), 1 case of TCC of recurrent bladder tumor and 1 case of recurrent cervix cancer invading bladder were observed. 4. Hematuria was controlled in 57 cases receiving transurethral fulguration(TUF), but repeated TUF (2-4 times) was performed for recurrent severe gross hematuria in 7 cases and the ratio of cases requiring re-hospitalization due to recurrent severe gross hematuria after TUF was 16.4%. Of complications due to treatment of HRC, no significant complication was found after TUF, but incontinence due to contracted bladder was occurred in 1 case of 3% formalin instillation.
Cervix Uteri ; Cystitis* ; Edema ; Endothelial Cells ; Female ; Fibroblasts ; Formaldehyde ; Hematuria ; Hemorrhage ; Hospitalization ; Hyalin ; Korea ; Mucous Membrane ; Papilloma ; Telangiectasis ; Ulcer ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urology ; Uterine Cervical Neoplasms

By using Factor analysis on the variables relating to the subjective symptoms of total 56 workers, who have exposed to mixture of organic solvents at the musical instrument manufacturing plant, as experimental group, and 70 workers, who worked in noisy working environment as control group, the study was performed. It was confirmed that the variables found in hematological figures, age specification, occupational history and physical examination have a influential factor on the subjective symptoms of both groups. It was explicated that the ratio of these to total Eigen Values showed 31.1 percent in experimental group and the control group revealed 37.7 percent.
Factor Analysis, Statistical* ; Music ; Occupations* ; Physical Examination ; Plants ; Solvents*

PURPOSE: The purpose of this study was to evaluate the morphologic changes of the injured hepatic acini following ligation of common bile duct and to investigate the pathophysiologic process of hepatic failure and biliary liver cirrhosis in the extrahepatic cholestasis. MATERIALS AND METHODS: The common bile ducts of 18 rabbits were ligated partially. The rabbits were killed and selective microangiography was carried out with infusion of barium suspension via portal vein 4 to 24 weeks after ligation. Selective microangiography was also carried out in two normal rabbits. The microangiographic findings were evaluated and correlated with histopathologic features. RESULTS: The sinusolds of the liver acinus showed distortion, varying degrees of luminal widening, and irregularities in architecture. Terminal branches of the portal vein (TPV) showed increased number of branches, luminal narrowing, tortuosity, distortion, and beaded appearance. Peribiliary plexi were found as thin curvilinear, barium-filled structures along the wall of the dilated bile duct. The microangiographic findings were well correlated with histopathologic findings. The grades of microangiographic and histopathologic findings were poorly correlated with the duration of the ligation of CBD. CONCLUSION: Changes in microvasculature of the liver acinus following partial ligation of common bile duct were demonstrated by microangiography. Although the microvascular changes were evoked secondary to the injury, they might have some active roles in the pathophysiologic process in the liver.
Barium ; Bile Ducts ; Cholestasis, Extrahepatic ; Common Bile Duct* ; Ligation* ; Liver Cirrhosis ; Liver Failure ; Liver* ; Microvessels ; Phenobarbital ; Portal Vein ; Rabbits

Radiation therapy (RT) has improved patient outcomes, but treatment-related complicationrates remain high. In the conventional 2-dimensional and 3-dimensional conformalRT (3D-CRT) era, there was little room for toxicity reduction because of the need to balancethe estimated toxicity to organs at risk (OARs), derived from dose-volume histogramdata for organs including the lung, heart, spinal cord, and liver, with the planning targetvolume (PTV) dose. Intensity-modulated RT (IMRT) is an advanced form of conformal RTthat utilizes computer-controlled linear accelerators to deliver precise radiation doses tothe PTV. The dosimetric advantages of IMRT enable better sparing of normal tissues andOARs than is possible with 3D-CRT. A major breakthrough in the treatment of esophagealcancer (EC), whether early or locally advanced, is the use of proton beam therapy (PBT).Protons deposit their highest dose of radiation at the tumor, while leaving none behind;the resulting effective dose reduction to healthy tissues and OARs considerably reducesacute and delayed RT-related toxicity. In recent studies, PBT has been found to alleviatesevere lymphopenia resulting from combined chemo-radiation, opening up the possibilityof reducing immune suppression, which might be associated with a poor prognosis incases of locally advanced EC.

Extragonadal germ cell tumors are rare. accounting for approximately 38 of all germ cell tumors. Debate continues over whether these lesions originate from extragonadal site or are metastatic disease from an undetected testis primary tumor. Recently. we experienced a case of extragonadal mixed germ cell tumor in a 26-year-old male who showed complete response by combination chemotherapy with cisplatin. etoposide. and bleomycin(PVpB) and have remained disease tree for about 14 months since diagnosis. Herein we report the case with brief review of the literature.
Adult ; Cisplatin ; Diagnosis ; Drug Therapy, Combination ; Etoposide ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Testis

Spontaneous rupture of the kidney with subcapsular or perinephric hemorrhage usually occurs secondary to various kinds of underlying diseases such as benign malignant tumor. vascular disease and infection etc. We experienced 2 cases of spontaneous rupture of the kidney secondary to renal cell carcinoma in a 44-year-old female and adult Wilms' tumor in a 17-year-old male.
Adolescent ; Adult ; Carcinoma, Renal Cell ; Female ; Hemorrhage ; Humans ; Kidney* ; Male ; Rupture, Spontaneous* ; Vascular Diseases ; Wilms Tumor

The sensitivity and specificity of ST segment change on ECG for detection of coronary artery disease(CAD) by pacing stress test were assessed. Among 28 cases with chest pain(mean age 52, M/F : 21/7), 10 patients had normal coronary angiographic finding(Group I), and 18 had coronary artery disease(Group II). Pacing stress test showed high specificity(100%), but low sensitivity(61%) for the diagnosis of CAD. Especially in patients with 1 vessel disease, the sensitivity was only 50%, and positive results were not attained unless there was at least 90% or more stenosis in any of the major branches(LAD, RCA or LCX). But in patients with multivessel disease, the sensitivity was much higher(83%). Lateral(V4-6) or inferior leads(2, 3, aVF) showed ischemic ST segment depression most commonly. Therefore one of the inferior lead and V5 may be a minimum requirement for monitoring pacing-induced ST segment changes. Time constant during isovolumic relaxation showed statistically significant prolongation after pacing only in CAD patient group, suggesting pacing-induced impairment of early left ventricular relaxation.
Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Depression ; Diagnosis* ; Electrocardiography ; Exercise Test ; Humans ; Relaxation ; Sensitivity and Specificity ; Thorax

BACKGROUND: Osteoporosis after menopause is known as a disease that needs preventive measures before medical treatment. Many patients, however, do not undergo hormone therapy to prevent it. This paper investigates some obstacles to hormone replacement therapy (HRT). METHOD: A total of 85 menopausal women who under went bone-mineralodensitometry (BMD) examination at Chuncheon Sungshim Hospital Health Care Clinic from May, 1995 to April, 1997 were the subjects of our study. We interviewed them by telephone, examined their medical records including their BMD results. We also examined what the obstacles were for them to receive HRT for osteoporosis. RESULTS: The average age of the subjects was 55.8years. Only 40 women (47%) replied that they knew beforehand the purpose of the BMD examination. The rest of the subjects replied that they simply went through the examination because it was inclusive to health items. Those who had heard of HRT for osteoporosis were only 43 people because(50.1%), and those who did not currently receive HRT amounted to 32 (74.4%). The reasons why they do not undergo the therapy were fear of cancer, no symptoms related to osteoporosis, financial difficulty, and weight gain. Among the 32 subjects, only 1 person replied that she would not receive the HRT even if the above obstacles were removed. Therefore, it seems that most of our subjects would receive HRT if such obstacles removed. Those who were currently receiving HRT were 11 people(12.9%). According to the open questionnaire, many of them replied that they do not feel any inconvenience while receiving the HRT, but some of them complained of epigastric pain, dysmenorrhea, or mastalgia. They replied that after the HRT they felt no arthralgia and felt far better in body and mind than before treatment. All the 11 people replied that they will continue to receive the HRT. CONCLUSION: The main reason why so few people received HRT for osteoporosis proved to be the lack of knowledge of the therapy. Even those who had heard of HRT complained about the negative aspects, which in fact can be overcome, and as a result a considerable number of them do not receive HRT. Therefore we conclude that in order to increase the number of patients who will undergo HRT for osteoporosis after menopause we need to strengthen education about the merits of this therapy rather than just performing BMD examination.
Arthralgia ; Delivery of Health Care ; Dysmenorrhea ; Education ; Female ; Gangwon-do ; Hormone Replacement Therapy* ; Humans ; Mastodynia ; Medical Records ; Menopause ; Osteoporosis ; Osteoporosis, Postmenopausal* ; Telephone ; Weight Gain ; Surveys and Questionnaires

Recurrent peritonitis is the major complication of continuous ambulatory peritoneal dialysis (CAPD) and a common reason for discontinuation of this form of therapy. Polymicrobial peritonitis by gram- negative organisms suggests intraabdominal pathology not directly associated with CAPD, necessitating early removal of catheter and/or abdominal exploration. The source of infection may still be gastrointestinal, especially in light of the polymicrobial gram-negative peritonitis and rarely be gastrointestinal malignancy. We recently experienced a case of 64-year-old woman with recurrent CAPD peritonitis by polymicrobial gram-negative organisms, originated from colon cancer. Colon cancer was confirmed by barium enema, abdominal CT and colonoscopic biopsy. She underwent right hemicolectomy and removal of catheter simultaneously. The biopsy revealed a moderately to poorly differentiated adenocarcinoma with abundant mucin production.
Adenocarcinoma ; Barium ; Biopsy ; Catheters ; Colon* ; Colonic Neoplasms* ; Enema ; Female ; Humans ; Middle Aged ; Mucins ; Pathology ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tomography, X-Ray Computed

Gastric volvulus is an uncommon condition which is difficult to diagnose and treat. It designates abnormal rotation of the stomach along its longitudinal (organoaxial) or transverse (mesenteroaxial) axis. When the rotation exceeds 180 degrees, gastric obstruction or strangulation may occur. The classical presentation of acute gastric volvulus is the triad of severe epigastric pain, vomiting followed by retching without the ability to vomit, and difficulty or inability to pass a nasogastric tube. Delay in diagnosis and treatment of gastric volvulus can lead to fatal complications such as gastric ischemia, perforation, and hemorrhage. Gastric volvulus is a true emergency which should be treated immediately either surgically or by upper endoscopy. We report a case of an acute incarcerated gastric volvulus due to a left-sided diaphragmatic hernia in an adult male patient, which was treated successfully by operation.
Acute Disease ; Hernia, Diaphragmatic/*complications ; Humans ; Male ; Middle Aged ; Stomach Volvulus/diagnosis/*etiology