Many articles concerning the accuracy of diagnosis of malignant tumor cells in body fluids have appeared in the literature, but few authors have attempted to describe the characteristics of these cells to determine the site of the primary tumor as they relate to tumors of specific primary sites. This paper presents the results of a retrospective study on malignant body cavity effusions of which the primary site was established on the basis of either biopsy or surgical resection of the primary neoplasm during the period of 6 years beginning from January 1983 to December 1988. The results obtained are summarized as follows: 1) The 143 fluid specimens from 129 patients were composed of 51 cases of pleural, 69 of peritoneal, and 9 of pericardial origin. 2) Adenocarcinoma was the most frequent type of malignant effusions (78.3%). The most common primary site was the lung (50%) in pleural fluid and stomach (55.2%) in ascites. 3) The results of this study show that the primary site of tumor cells can be identified in the body fluid of accurate cytomorphologic criteria are used. Identification of the primary site of an effusion would be improved by the consideration of clinical information
Adenocarcinoma ; Biopsy

BACKGROUND: With the increase of cigarette consumption by women and the young, the incidence of lung cancer is expected to increase during the next three or four decades in Korea. The purpose of this study was to analyze the smoking habits in patients with lung cancer and to identify the gender differences in terms of their susceptibility to cigarette related carcinogens. METHODS: This investigation was a hospital-based case control study, which included the data of 178 case subjects(72 females, 106 males) with lung cancer and 218 control subjects(97 females, 121 males) with diseases unrelated to smoking. The information was obtained through a direct personal interview and a questionnaire related to personal smoking history. RESULTS: The relative frequency of the squamous cell carcinoma was substantially higher in males than in females(61.3% in males, and 29.2% in females), while adenocarcinoma including bronchoalveolar cell carcinoma was higher in females(31.9% in females, 18.9% in males). Keryberg Ilung cancer was of relatively higher frequencies in males and smokers. while Kreyberg IIlung cancer was higher in females and never smokers. The odds ratios(ORs) at each exposure level were consistently higher in females than males. For all cell types, the risk of lung cancer was increased with the quantity of smoked cigarettes, duration of smoking, and depth of inhalation. Odds ratio was distinctly higher in Kreyberg Ilung cancer than in total lung cancer and a steeper gradient of risk with increased smoking was observed in females. CONCLUSION: The ralative risk for lung cancer was consistently higher in females than in males at every level of exposure to cigarette smoke. This is believed to be due to the higher susceptibility of females to tabacco carcinogens, such as gender associated differences of carcinogen activation and/or the elimination of smoking related metabolites.
Adenocarcinoma ; Carcinogens ; Carcinoma, Squamous Cell ; Case-Control Studies ; Female ; Humans ; Incidence ; Inhalation ; Korea ; Lung Neoplasms* ; Lung* ; Male ; Odds Ratio ; Smoke* ; Smoking* ; Tobacco Products

No abstract available.
Intestinal Obstruction*

The clinical applications of free have been extended tremendously in head and neck reconstruction. In a nine-year period, 92 microvascular free flaps were performed to repair the defects following major head and neck ablative surgery. Twenty-one transverse rectus abdominis myocutaneous flaps, 18 radial foream flaps, 15 latissimus dorsi muscle flaps, 12 jejunal flaps, 8 fibular osteocutaneous flaps, 6 rectus abdominis muscle flaps, 6 iliac osteomyocutaneous flaps, 2 groin fasciocutaneous flaps, 1 scapular fasciocutaneous flap, 1 parascapular osteocutaneous flap, 1 tensor fascia lata muscle flap and 1 serratus anterior muscle flap were used for reconstruction. Twenty-five maxillary defects including the orbit or skull base, 16 pharyngoesophageal defects, 15 intraoral defects, 15 mandibular defects, 13 scalp defects, 1 cervical region and 7 other facial region were covered with various free flaps. The overall success rate of the flaps was 95.6%. The complications included total flap loss (3 cases), partial flap loss (1 case), recurrence of primary tumors (15 cases), cerebrospinal fluid leakage (3 cases), fistula formation (3 cases) and infection (5 cases). Superficial temporal artery, facial artery, superior thyroidal artery, lingual artery, occipital artery, transverse cervical artery were commonly used recipient arteries and 7 cases of vein grafts were used if indicated. End to end anastomosis was performed in 84 cases and end to side anastomosis in 8 cases. The average follow-up period was 42 months, ranging from 6 months to 8 years. One patent died during postoperative intensive care due to sepsis and 19 patients died because of recurrence of tumors and underlying medical diseases during the follow-up period. Although free flaps may appear to be riskier than traditional forms of reconstruction, they offer the surgeon a greater spectrum of reconstructive options. Free flap reconstruction also improves the quality of life and minimizes the loss of function. Limitations of the use of free flaps result only from a lack of technical skills and specialized equipment.
Arteries ; Cerebrospinal Fluid ; Fascia Lata ; Fistula ; Follow-Up Studies ; Free Tissue Flaps* ; Groin ; Head* ; Humans ; Critical Care ; Myocutaneous Flap ; Neck* ; Orbit ; Quality of Life ; Rectus Abdominis ; Recurrence ; Scalp ; Sepsis ; Skull Base ; Superficial Back Muscles ; Temporal Arteries ; Thyroid Gland ; Transplants ; Veins

BACKGROUND: This study aims to obtain basic data regarding the proper maintenance and potential role of humidifiers in the development of nosocomial pneumonia. We investigated into a spectrum of bacteria that grew after disinfection in humidifiers that were used in intensive care units (ICUs). The bacteria were isolated at different time points after disinfection. METHODS: We randomly selected 6 humidifiers that were used in an ICU and conducted a series of bacterial culture studies at 24 hr, 48 hr, 72 hr and 168 hr after disinfecting the six humidifiers. The fluid from the humidifider was cultured in the same manner as the dialysate. RESULTS: No bacteria were isolated in most of the 6 humidifiers 24 hr after the disinfection of the instruments. Gram-negative bacilli such as Acinetobacter baumannii, Burkholderia cepacia, and Stenotrophomonas maltophilia were cultured at 48 hr after disinfection. CONCLUSION: Regular and thorough disinfection of humidifiers is necessary to prevent possible spread of infection via humidifiers in the ICU.
Acinetobacter baumannii ; Bacteria ; Burkholderia cepacia ; Disinfection ; Critical Care ; Intensive Care Units ; Pneumonia ; Stenotrophomonas maltophilia

Venous thromboembolic disease is a frequent complication after total hip arthroplasty. However, in Korea, the low incidence of deep vein thrombosis after total hip arthroplasty was reported. In this study, we present the results of 82 consecutive patients(90 hips) who had a cementless total hip replacement with a Anatomic Medullary Locking Component(AML: Depuy, Warsaw, Indiana, USA) between August 1995 and September 1996 at Inha University Hospital, Korea. Postoperatively, none of the patients were treated with any known prophylatic method for deep vein thrombosis except elastic stockings. Both preoperatively and six weeks after surgery, all patients were studied by an radiologist using a portable Doppler ultrasonic velocity detector with a transmission frequency of 5 megahertz. Contrast phlebography was also done in all patients at the same time as the Doppler ultrasound. In addition, coagulation assays, a complete blood count, blood typing, and serum chemical-profile tests were done for all patients. In comparing the results of these laboratory tests from the DVT group and from the non-DVT group, we found that only eight patients(9.8%) out of eighty-two patients had DVT after total hip arthroplasty. Thrombi were found in the superficial femoral vein in five cases and in the common femoral vein in three cases. Though two(2.4%) patients showed suspicious symptoms of pulmonary embolim, their perfusion lung scans were negative. The DVT group show a significantly shorter activated partial thromboplastin time than did the non-DVT group(P<0.05). In addition, the DVT group showed significantly higher serum total protein than the total protein level of the non-DVT group(P<0.01). In this two groups, there was no difference between the results of Doppler ultrasound and the results of contrast phlebography. Consequently, the incidence of deep vein thrombosis after total hip replacement arthroplasty in Korean patients is significantly lower than incidence in patients from countries other than Korea. Doppler ultrasound was a non-invasive and the most reliable diagnostic technique for deep vein thrombosis.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Blood Cell Count ; Blood Grouping and Crossmatching ; Femoral Vein ; Humans ; Incidence ; Indiana ; Korea ; Lung ; Partial Thromboplastin Time ; Perfusion ; Phlebography ; Stockings, Compression ; Ultrasonics ; Ultrasonography* ; Venous Thromboembolism ; Venous Thrombosis*

No abstract available.
Arthritis* ; Rabbits*

PURPOSE: Thyroid hormone is essential for normal growth and development. The aim of this study was to evaluate the factors affecting final adult height in patients with congenital hypothyroidism. METHODS: The study group was comprised of 42 patients who were diagnosed as congenital hypothyroidism and attained final adult height. Retrospectively, we reviewed medical records as to clinical and laboratory data. We analyzed the influence of various factors on final adult height(FAH) in patients with congenital hypothyroidism. RESULTS: The mean chronologic age at initiation of treatment was 5.85+/-4.32 years and the FAH deviation score(SDS) was -1.21+/-1.14. The age at initiation of treatment, the chronologic age, the mean dose of L-thyroxine of current treatment, and the bone age delay at initiation of treatment were negatively related to the FAH SDS(P<0.05). The height SDS at initiation of treatment and the height SDS at initiation of puberty were positively related to the FAH SDS(P<0.05). Analyzing according to etiology, the FAH SDS of dyshormonogenesis, thyroid aplasia, thyroid ectopia, and thyroid hypoplasia were 0.16+/-0.27, -1.15+/-0.97, -1.45+/-1.07, and -2.70+/-1.70 respectively(P<0.05). CONCLUSION: The younger the age at initiation of treatment and the chronologic age, and the more the mean dose of L-thyroxine of current treatment and the bone age delay at initiation of treatment, The higher the final adult height SDS. The higher the height SDS at initiation of treatment and the height SDS at initiation of puberty, the final adult height SDS were the higher.
Adolescent ; Adult* ; Congenital Hypothyroidism* ; Growth and Development ; Humans ; Medical Records ; Puberty ; Retrospective Studies ; Thyroid Dysgenesis ; Thyroid Gland ; Thyroxine

The purpose of this paper is to study the effects of anti-inflammatory agents on the blood-aqueous-berrier in experimentally induced uveitis. 10% solution of sodium fluorescein was injection intravenously in the ear vein of rabbits (0.25 ml/kg) and fluorescein curve was drawn after the method of Amsler and Huber. Experimental uveitis was induced by the injection of 0.2 ml of human serwn into the vitreous body. After uveitis had been induced. three kinds of anti-inflammatory agents-Prednisolone, Benzyron and Methotrexate-were Biven oralIy. In control animals in which no uveitis was induced, no changes in fluorescein curve were demonstrated before and after the administrations of drugs. In animals with uveitis, maked increases of the blood-aqueous barrier were noted. When Benoyron and Prednisolone were given to these animals, normaliration of the fluorescein curves were demonstrated. Methotrexate had no effects on the fluorescein curves in uveitis animals, showing no improvements in the permeability of uveal vessela. This ineffectiveness seemed to be due to the resistance of rabbits to methotrexate.
Animals ; Anti-Inflammatory Agents ; Blood-Aqueous Barrier ; Ear ; Fluorescein ; Humans ; Methotrexate ; Permeability ; Prednisolone ; Rabbits ; Uveitis* ; Veins ; Vitreous Body

The mortality and morbidity in tricyclic antidepressants (TCAs) overdose still remained high due to fatal cardiac toxicities despite their decreased prescriptions. Also, monoamine oxidase inhibitors (MAOIs) may show relatively high cardiac toxicities in excess or mixed overdoses. Selective serotonin reuptake inhibitors (SSRIs) and newer antidepressants have been known to be safe in overdose until recently. However, many researchers have found that SSRIs and newer antidepressants also showed serious and fatal toxicities in case of excess or mixed overdoses. Citalopram or escitalopram overdoses showed a relatively high incidence of cardiac toxicity with a dose-dependent manner. Also, venlafaxine, bupropion and trazodone overdoses showed significant cardiac toxicities, although degrees of the toxicities are different each other. Especially, venlafaxine's pattern and incidence of cardiac toxicities are the similar to those of TCAs. Mirtazapine and reboxetine show no significant toxicities in overdose although the present toxicological data are insufficient. To conclude, assessment of compliance, pharmacology education for patients and effective treatment may reduce the incidence and severity of toxicities in overdose.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Bupropion ; Citalopram ; Compliance ; Cyclohexanols ; Humans ; Incidence ; Mianserin ; Monoamine Oxidase Inhibitors ; Morpholines ; Prescriptions ; Serotonin Uptake Inhibitors ; Trazodone ; Venlafaxine Hydrochloride