The study was undertaken to detemine the effect of fractionated high-dose total lymphoid irradiation (TLI) onthe servival of skin allograft despite major histocompatibility difference. Total lymphoid irraditation is arelatively safe form of radiotherapy, has been used extensively to treat lymphoid malignancies in humans with fewside effects. A total of 90 rats, Sprague-Dawley rat as recipient and Wistar rat as donor, were used for theexperiment, of which 10 rats were used to determine mixed lymphocyte response (MLR) for antigenic difference andskin allografts was performed in 30 rats given total lymphoid irradiation to assess the immunosuppressive effectof total lymphoid irradiation despite major histocompatibility difference. In addition, the peripheral white bloodcell counts and the proportion of lymphocytes was studied in 10 rats given total lymphoid irradiation but no skingraft to determine the effects of bone marrow suppression. The results obtained are summerized as follows. 1. Theoptimum dose of total lymphoid irradiation was between 1800 rads to 2400 rads. 2. The survival of skin graft onrats given total lymphoid irradiation (23.2±6.0days) was prolonged about three folds as compared to unirradiated-control (8.7±1.3 days). 3. Total lymphoid irradiation resulted in a severe leukopneia with marked lymphopenia,but the count was normal by the end of 3rd week. 4. The study suggests that total lymphoid irradiation is anonlethal procedure that could be used successfully in animals to transplant allograft across major-histocompatibility barriers.
Allografts ; Animals ; Bone Marrow ; Histocompatibility ; Humans ; Lymphatic Irradiation ; Lymphocytes ; Radiotherapy ; Rats ; Rats, Sprague-Dawley ; Skin ; Tissue Donors ; Transplants

Forty-nine lobectomized hepatocellular carcinomas(HCC) were classified according to the gross anatomical features. Because the presence of cirrhosis in the remaining liver has a good clinico-pathological implication, cases of HCC were divided into non-cirrhotic(non-LC) and cirrhotic(LC) groups. In both groups, the tumors themselves belonged to either expanding, focal spreading, spreading or mixed type. Another special type, which has been called a "diffuse type" is added in the LC group with the name of "cirrhotomimetic type" Among 49 cases, 21 belonged to the non-LC group and 28 to the LC group. Most common was expanding type(20 cases, 40.8%), which was followed by spreading(32.7%), focal spreading(16.3%), mixed(6.1%) and cirrhotomimetic(4.1%) types. Expanding type of the LC group was the single most common type(13 cases, 26.5%). The accordance rate of gross typing was 0.94. Tumor masses of the LC group showed a greater tendency of having a fibrous capsule(60.7%) and a lobulated cut surface(82.1%), in contrast to those of the non-LC group (28.6% and 42.9% respectively). The patient's age and the HBsAg seropositivity were not different between the groups and between the types. Increased serum level of AFP was particularly frequent in the spreading type(81.3%) of both groups and in the cirrhotomimetic type(100%).
Carcinoma, Hepatocellular

A case of micronodular cirrhosis of the alcoholic type developed following an intestianl bypass surgery in a 47 year-old nonalcoholic male patient is presented. The patient denied any drug use of a long duration and had no diabetes mellitus. Five years before, a side to side ileo-transverse colon anastomosis had been performed for perforated intestinal tuberculosis at 1 m proximal to the ileocecal valve, bypassing a short segment of ileum (about 1.5 m) and transverse colon. The ileum distal to the perforated site had been found completely stenosed. He was severely lean with evidences of nutritional deficiency such as low serum levels of the albumin and vitamin B12. The liver biopsy showed a fatty change, Mallory bodies and perihepatocellular collagenosis within the cirrhotic nodules. The present case suggests that, when there are blind loop formation and nutritional deficiency, hepatic changes identical to those following jejunoileal bypass could develop even by reduction of a shore segment of the small intestine.
Male ; Humans ; Biopsy

Aneurysmal bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with blood. This case, a eighteen years old female, complained of pain and swelling in the right lateral aspect of thigh. Roentgenograms showed a ballooned-out distension of the shaft of the femur, eccentric buldging of the cortex and soap-bubble appearance of interior of the lesion. The case was treated with radical curettage and autogenous bone graft with bone chips which were taken from the iliac wing. Pathological examination grossly and microscopically revealed an aneurysmal bone cyst. Patient made an uneventful recovery, and 11 months later she had no complaints and no evidence of recurrence.
Aneurysm ; Bone Cysts ; Curettage ; Female ; Femur ; Humans ; Recurrence ; Thigh ; Transplants

BACKGROUND: Care for prehospital cardiac arrest is one of the major concerns of emergency medical services. But, in Korea, prehospital emergency medical service systems are not yet well established. We tried to offer one of the fundamental data for development of these systems. METHODS: After application of exclusion criteria, 183 patients who transferred to emergency center of our hospital after cardiac arrest in consecutive 24 months from Jan,1,1994 to Dec,31,1995 were included in this study. Retrospective review of the hospital charts of these patients was done. For statistical analysis, we divided patients to some categories. t-test or chi-square analysis was used. RESULTS: 24 patients of the 183 patients were secondary visitors(cardiac arrest was occurred during transfer from other hospitals), 159 patients were primary visitors. In the primary visitor group, only one third was ambulance visitors, and there is no statistical differences between arrest time of ambulance visitors and non-ambulance visitors(35+/-27 vs 37+/-24 min, p=NS). No organized bystander CPR was done. After arrival, 131 patients received CPR and 87 patients(66.4%) were not responded, 31 patients(23.1%) experienced transient ROSC, 13 patients(10.0%) survived until discharge, and only 2 patients(1.5%) were returned to their lives. CONCLUSION: We failed to find significant statistical survival differences between ambulance visitors and non-ambulance visitors, between presumed cardiac etiology group and non-cardiac etiology group. Survival rate was high in witnessed arrest group than unwitnessed arrest group(14.5% vs 2.1%, p=0.015).
Ambulances ; Cardiopulmonary Resuscitation ; Emergencies ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Survival Rate

Three cases of orbital rhabomyosarcoma are reported here. Histological studies comfirmed the lesion 1:0 be the alveolar type in all cases. This tumor is a rare disease entity in Orient than Europe and America and accordingly, rarely encountered in our ophthalmologic practice, although it is the commonest primary malignant orbital tumor in children. Of the three cases reported here one occurred in adu1t and the other two in children. Case I. This 15 month old male showed a swelling of the left upper lid toward the medial side for 2 months and visited to our hospital on March 10, '69 with complaints of progressive swelling on the region with ptosis. The eye ball was slightly displaced toward the lower temporal side and ocular movement is limitted to upward. On palpation, the childthumb sized tumor was palpable in the upper nasal portion of the orbit. On excision of the tumor, the mass was found to be originated from the superior oblique muscle. The mass round measuring 2.5 X 2.5 X 1.5 cm in size. Histological diagnosis was alveolar rhabdomyosarcoma without cross-striation. No follow-up could be done. Case II. This patient of 15 month old male showed a swelling on the right lower lid existed 6 months and visited to our hospital on September 8, '69. The physical examination revealed that the left eye and the other routine examinations were within normal limits. The right eye showed the swelling of the lower lid, congestion of the palpebral conjunctiva, limitted movement of the eye ball toward the lower side and a palpable bean-sized mass on the region. The excision of tumor was performed under the general anesthesia. This mass was attached with the inferior oblique muscle with no other recognizable adhesion seemingly originating from that muscle. The mass was round and oval in shape, measuring 2 X 2 X 1 cm in size, diagnosis was alveolar rhabdomyosarcoma. The post-operative follow-up studies were unavailable. Case III. This case in one of adult alveolar rhabdomyosarcoma. At the age of 25 years, this man showed a proptosis of the right eye associated with migrain like headache, ocular pain and visual disturbance. This symptoms existed 6 months and gradually increased in intensity. On the physical examination, the left eye was found to be normal. The skull and orbit x-ray and c.b.c. were with in normal limits. The right eye revealed about 5mm proptosis compared with left eye and the adult thumb sized tumor was palpated on the inner side of the lower orbital rim. The visual acuity was in zero. The right optic disc was edematous and elevated about 4.0 D. The pupil showed marked dilatation and the light reflex was abscent and ocular movement was markedly limitted and eye ball is deviated toward the upper side. Under the general anesthesia, the exenteration of the orbit associated with the removal of tumor was carried out with no untoward complications. Origin of the mass was the inferior oblique muscle penetrating to the deeper part of the optic foraman and optic nerve was surrounded by the tumor completely Histology confirmed alveolar rhabdomyosarcoma. Follow-up study was impossible.
Adult ; Americas ; Anesthesia, General ; Child ; Conjunctiva ; Diagnosis ; Dilatation ; Estrogens, Conjugated (USP) ; Europe ; Exophthalmos ; Headache ; Humans ; Infant ; Male ; Optic Nerve ; Orbit* ; Palpation ; Physical Examination ; Pupil ; Rare Diseases ; Reflex ; Rhabdomyosarcoma* ; Rhabdomyosarcoma, Alveolar ; Skull ; Thumb ; Visual Acuity

We reviewed 90 cases of popliteal cyst in 88 patients, managed at Department of Orthopedic Surgery, Severance Hospital from January 1976 to June 1985 and the following results were obtained. 1. The average age of the 88 patients was 42 years. There were 23 males and 65 females. Of the all patients, 47 were occured in right side and 39 the left. Two patients were both sides. 2. Of the all cysts, 62 were found to be bursa between the semimembranosus and the medial head of the gastrocnemius muscles(68.8%). 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 3. Associated adnormalities of the knee joint were apparent in 29(33%) and the most common abnormalities were osteoarthritis. 4. Communication of the cyst with the joint was apparent in 44 cases(49%). 5. Twelve patients were recurred and associated abnormality of the knee joint was osteoarthritis. Three patients were children and they had no abnormality of the knee joint. 6. Recurrence after primary operation was rare when the stalk of the cyst had been opened.
Child ; Clinical Study ; Female ; Head ; Humans ; Joints ; Knee Joint ; Male ; Orthopedics ; Osteoarthritis ; Popliteal Cyst ; Recurrence

It is well known that high energy X and r-ray have high penetration power in tussue, but have lower survacedose which is called the “skin sparing effect”. However, the surface dose can be increased significantly by excessive electron contamination and it is an important factor intreatment planning in the presence of a blocktray, especially in isocentric set-up. So relaltive surface doses for 10MV-X-ray and Co-60 r-ray were measuredwith various field sizes and SSD with or withoug 1/4" lucite shadow tray, present in the beams, using pancakechamber and polystylene phantom. The results obtained are as follows. 1. A rapid increase in surface dose isapparant with increasing field size in 10MV X-ray and Co-60 r-ray. 2. high surface dose is evident for smallerdistance from the tray, so at least 25cm of skin shadow tray distance for 10MV X-ray and 20cm for Co-60 are desirable. 3. Utilization of either bolus for treatment field or electron boost should be considered in treatmentof superificial nodal disease. 4. A tray using an intermediate or high z No. filter can be reduced the surfacedose significantly.
Polymethyl Methacrylate ; Silver Sulfadiazine ; Skin

NO abstract available.
Brain* ; Neoplasm Metastasis*

Benign epiepsy of childhood with centrotemporal spikes (BECCT) is an electroclinical syndrome characterized by noctural seizure that remit spontaneoully before adulthood, and belong to idiopathic age and location related epilepsies. We reviewed the medical records to analyse the seizure the seizure pattern, and also inspect the EEG recording to identify topography of the epileptiform discharge of 24 patient who met the following criteria: 1) presence of nocturnal seizure or partial seizure confined to the face, 2) normal intecual and development, 3) normal background EEG feature, 4) monomormhic spikes or sharp wave that increase in the frequency during sleep if those state were achieved. The result as follow: 1) The age of seizure onset were 3 to 11 years old (7.08 1.89) and male to female ratio was 1, 4:1. 2) Past history of birth trauma, CNS infection and other diseases involving CNS, were not found. There was past history of febrile convulsoin 33.3% of patient and epilepsy in 8.3%. One of paient's sister had childhood abscence epilepsy and never a nocturnal partial seizure, also and had centrotemporal spikes in EEG. 3) In 91.7% of Seizures occurred during sleep, especially short after sleep onset and the symptomatology of seizure was shown 66.7% of oropharyngeal sign, such as hypersalivation and gargle sound, and 54.2% of hemifacial involvement, 33.3% of speech arrest, 25.5% of upper limb involement, 18.3% of lower limb involvement, and 45.8% of general seizure. 4) In 91.5% of patients had on location of epileptiform discharge that located central (37.5%) midtemporal (33.3%), parietal and frontal. We could observe tangental dipole in 16.7% of patients.
Child ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Female ; Humans ; Lower Extremity ; Male ; Medical Records ; Parturition ; Rabeprazole ; Seizures ; Sialorrhea ; Siblings ; Upper Extremity