PURPOSE: This study tried to evaluate the effectiveness of combined treatment using radiation therapy and concurrent cisplatin as a radiosensitizer in the management of locally advanced head and neck cancer. MATERIALS AND METHODS: From January 1995 to August 1998, 29 evaluable patients with locally advanced head & neck cancers (AJCC stage II-IV) were received curative radiation therapy (total 70-75.6 Gy/35 -42 fractions , 1.8-2 Gy/fraction) and concurrent cisplatin chemotherapy (100 mg/m2, D1, D22, D43). The neck dissections were performed for residual lymphadenopathy. Follow- up ranged from 5 to 55 months (median 24 months). RESULTS: Twenty- one (72.4%) patients achieved clinical complete responses. The partial response and minimal response rates were 17.2% and 10.4%, respectively. Locoregional failure rate was 27.6%, and included 6 patients with local failures , 4 patients with regional failures, and 2 patients with combined local and regional failures. Four of 29 patients (13.8%) developed distant metastasis. The disease free survival rate at 3 years was 60%. Nasopharyngeal primary tumors or complete responders showed significantly higher disease free survival rate. The grade 3 mucositis and nausea/vomiting was noted in 34.5%, respectively. Major prolongation of radiation therapy duration was inevitable in three patients. Twenty- one patients (72.4%) completed 3 courses of cisplatin and 5 patients received 2 courses of cisplatin. Three patients received only one course of cisplatin due to nephrotoxicity and neurotoxicity, and then changed to 5- FU regimen. CONCLUSIONS: Concurrent cisplatin- radiation therapy in locally advanced head and neck cancer showed high response rate, reasonable locoregional control, and survival rate. As expected, acute toxicities were increased, but compliance to treatment was acceptable. Assess ment of the effect of the combination in this setting requires further accrual and follow- up.
Cisplatin* ; Compliance ; Disease-Free Survival ; Drug Therapy ; Head and Neck Neoplasms ; Head* ; Humans ; Lymphatic Diseases ; Mucositis ; Neck Dissection ; Neck* ; Neoplasm Metastasis ; Survival Rate

No abstract available.
Osteoarthritis*

Defecography evaluates in real time the morphology of rectum and anal canal in a physiologic setting by injection of a thick barium paste into the rectum and its subsequent evacuation. Because of its ability of structural and functional evaluation, defecography is primarily performed for work up of patients with longstanding constipation, unexplained anal or rectal pain, residual sensation after defecation or suspected prolapse. Technique and interpretation of this examination are outlined in this review.
Anal Canal ; Barium ; Constipation ; Defecation ; Defecography ; Humans ; Pelvic Floor ; Prolapse ; Rectum ; Sensation

OBJECTIVE: To examine the relationship of the amniotic, and maternal infiammatory responses and decreased amniotic fluid in patients with preterm PROM. METHODS: Fifty three patients with preterm PROM in singleton pregnancy who delivered preterm neonates (gestational age<35 weeks) within 3 days of amniocentesis were included. Amniotic fluid index(AFI) was measured by transabdominal ultrasonography at amniocentesis. Amniotic fluid was cultured far aerobic and anaerobic bacteria and mycoplasma. The intensity of the inflammatory response was evaluated by clinical and histologic chorioamnionitis. The intensity of fetal hypoxia was evaluated by 1 min Apgar score, 5 min Apgar score, and pH of cord blood at birth. RESULTS: The prevalence of oligohydramnios, which was defined when measured AFI was equal or less than 5.0, was 34% (18/53). The prevalence of positive amniotic fluid culture was 45% (24/53) and that of patients with was significantly higher than that of patients without oligohydramnios (78% [14/l8] vs 29% [10/35], p<0.01). Intrauterine inflammatory response was significantly stronger in patients with oligohydratnnios than in patients with adequate amniotic fluid (pathologic chorioamnionitis 100% [l6/16] vs 63% [19/30], clinical chorioamnionitis 39% [7/18] vs 6% [2/35]; p<0.01 for each). However, no significant difference was found in the intensity of fetal hypoxia (I min Apgar score <7 67% [12/18] vs 66% [23/35], 5 min Apgar score <7 39% [7/l8] vs 26% [9/35], pH of cord artery blood at birth 7.27+0.13 vs 7.22+0.13; p>O.I, for each). CONCLUSION: Oligohydramnios in patients with preterm PROM is strongly pedictive for positive amniotic fluid culture, and is associated with a robust host response in amniotic, and maternal cornpartments, but not with fetal hypoxia.
Amniocentesis ; Amniotic Fluid ; Apgar Score ; Arteries ; Bacteria, Anaerobic ; Chorioamnionitis ; Female ; Fetal Blood ; Fetal Hypoxia* ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Mycoplasma ; Oligohydramnios* ; Parturition ; Pregnancy ; Prevalence ; Ultrasonography

Enterobacter cloacae is isolated from 10 newborns in the neonatal Intensive care unit(NICU) of Seoul Red Cross Hospital from April, 1997 to June, 1997. Their gestational age is from 195-299 days(mean 244.3 days), and their birth weight was from 980-4,100g(mean 2,287g). We obtained 16 E, cloacae strains form their blood, urine, endotracheal tube, umbilical catheter and 4 of them were isolated from the same patient at different culture sites. We also obtained another 3 strains of E. cloacae from 14 persons who worked in NICU and 26 places of NICU. We analysed the molecular types of 19 isolates by using rep-PCR method. We get 6 different types of PCR-products from the patients and NICU workers, and NICU environments. We observed that the incidence of E. cloacae was decreased by handwashing and wearing personal plastic gloves during the care of NICU patients.
Birth Weight ; Catheters ; Cloaca ; Cross Infection ; Enterobacter cloacae* ; Enterobacter* ; Epidemiologic Studies* ; Gestational Age ; Hand Disinfection ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal* ; Plastics ; Red Cross ; Seoul

The purpose of this study was to investigate weight control practices and cardiovascular risk in middle-aged women. 304 middle-aged women were selected as subjects from thirties to fifthies living at J city in Chung-Buk Do. Data were collected using a questionnaire, anthropometric measurements, BP & total cholesterol level in serum from April 1, to June 30, 2003. The results of this study were as follows: The middle-aged woman's age is average 43.95+/-7.09yr and mean BMI(body mass index) was 23.54+/-3.09 kg/m2. Underweight, normal weight, overweight, obese women were 3.0%, 39.5%, 27.9% and 29.6%respectively. Subjects perceived own as 'Slim' 5.9%, 'ordinary' 45.7%, 'Fat' 48.4%. Their weight perception coincide their own actual body weight but as many as 41.8% of overweight and 9.0% of obese perceived themselves as being 'ordinary'. Middle age women with past weight control experience were 55.6%, and only 35.5% was doing weight control at present. Of these subjects, 71.4% reported wanting to lose weight and the primary reason of weight control was to improve their appearance(39.53%). The most frequently reported weight control behavior was 'exercise' followed 'dieting', but 39.6% reported using 'diet food', 12.4% 'behavior modification', 12.4% 'fasting', and 'diet-drug'(3.6%) or 'smoking'(3.6%). Effective weight control methods were thought regular exercise(97.1%) & dieting (79.3%). And behavior modification(71.4%) or diet camp(60%) were effective, too. An average waist circumference was 79.80+/-9.47cm, waist/hip ratio was 86.63+/-6.78, waist/ height ratio was 50.43+/-6.10. In the index of abdominal obesity, 79.7 % of middle-aged women was waist/height ratio over 0.46, 65.3% was waist/hip ratio over 0.85, 28.4% was waist circumference over 85cm. There were significant differences in the degree of abdominal obesity according to age and BMI. In the index of cardiovascualr risk, 10.9% of middle aged women was systolic hypertension over 140mmHg, 18.7% was diastolic hypertension over 90mmHg and 10.6% was hypercholesterolemia over 200mg/dl. There was significant difference in systolic hypertension ratio according to age. There was significant difference in diastolic hypertension ratio according to age and obesity. There were significant differences in hypercholesterolemia accorting to obesity. The abdominal obesity indices and the levels of T-cholesterol in the serum, systolic and diastolic BP increased significantly according to age. T-cholesterol in serum was predicted 2.6% by waist/height ratio. And systolic BP was predicted 15.2% by waist/height, add BMI to 16.8%. Subject's diastolic BP was predicted 12.1% by BMI. Therefore waist/height ratio and BMI were significant factors for the predictors of cardiovascular risk. There was significant correlation between index of obesity and cardiovascular risk. T-cholesterol in serum had correlation with waist/eight ratio(r=0.174) and waist circumference(r=0.48). Systolic BP had correlation with waist/height ratio(r=0.387), and BMI(=0.371). diastolic BP correlation had correlation with BMI(r=0.343) and waist/height ratio(r=0.327). In conclusion, The prevalence of obesity was 29.6% in 304 cases, and increased as age after menopause increased. Middle-aged women's weight perception and actual BMI coincide but some of them did not. Trial to reduce weight was attempted. But most of them did not actually. Undesirable weight control method such as using drugs, fasting, smoking was used by some women. It is important to educate about health weight control methods and raise their awareness of exact body figures. High frequency of abdominal obesity in middle-aged women had correlation with hypertension and hypercholesterolemia. Abdominal index such as waist/height ratio, waist circumference, waist/ hip ratio was used. Women's hypertension, hypercholesterolemia significantly related to body mass index and abdominal obesity.
Body Mass Index ; Body Weight ; Cholesterol ; Diet ; Fasting ; Female ; Hip ; Humans ; Hypercholesterolemia ; Hypertension ; Menopause ; Middle Aged ; Obesity ; Obesity, Abdominal ; Overweight ; Prevalence ; Surveys and Questionnaires ; Smoke ; Smoking ; Thinness ; Waist Circumference ; Weight Perception

We recently encountered two cases of emphysematous pyelonephritis with abscess formation, which have recovered by only conservative treatment and percutaneous abscess drainage(PAD). Two patients had diabetes mellitus. in the first case, initial CT showed left intrarenal abscess with air-fluid level. In the second case, CT showed right perirenal abscess with air-fluid level. PAD was performed under CT and US guidances, respectively. Both patients were successfully treated with PAD and conservative treatment. Follow up after confirmation of abscess resolution by CT scan and contrast study through the catheter, we removed catheters two months and 40 days after PAD respectively.
Abscess* ; Catheters ; Diabetes Mellitus ; Drainage* ; Follow-Up Studies ; Humans ; Pyelonephritis* ; Tomography, X-Ray Computed

PURPOSE: The aim of this study was to identify the level of Human papillomavirus (HPV) knowledge, intention of HPV vaccination, and barriers on HPV vaccination among male undergraduate students of Health department and Non-health department. METHODS: A total of 149 male undergraduate students responded to self-administered questionnaires about their HPV knowledge, HPV vaccination intention, and their barriers on HPV vaccination. ANOVA, t-test and χ2 test (Fisher's exact test) were used for data analysis. RESULTS: Mean score of HPV knowledge was 3.39±3.05, and there was significant difference between Health department (4.15±3.08) and Non-health department (2.58±2.82) in HPV knowledge (t=3.241, p=.001). There was no significant difference in HPV vaccination acceptance between the two groups. The barriers on HPV vaccination were 'lack of information about HPV vaccine efficacy' and 'lack of information about HPV vaccination time and strategy', and there were significant differences in barriers on HPV vaccination between the two groups. CONCLUSION: The knowledge on HPV was low, and HPV vaccination was hindered due to lack of information about HPV vaccine despite their intention to obtain HPV vaccine. HPV education to promote HPV vaccination should be targeted among male students.
Education ; Humans ; Intention* ; Male* ; Papillomaviridae ; Statistics as Topic ; Vaccination*

PURPOSE: To find the effects of semi-Fowler's position on the post-operative recovery for patients with laparoscopic abdominal surgery in recovery room. METHOD: The research was performed by nonequivalent control group non-synchronized quasi-experimental design. The subjects are forty patients who had laparoscopic abdominal surgery in a hospital from Aug. thru Nov. of 2003. Post-recovery scores and O2 saturation degree were measured. The experimental group was place in semi fowler's position while the control group was placed in supine position. The homogeneity between the control group and experimental group was analyzed using the Chi-square, and the hypothesis were tested using t-test. RESULT: 1. The patients in the experimental group placed in semi fowler's position showed significant higher post-recovery scores than those in the control group who were in a supine position. 2. The patients in the experimental group who were in semi Fowler's position showed no significant higher O2 saturation degree than those in the control group who were in supine position. CONCLUSION: Based on the results described above, it is considered that the semi-Fowler's position might be effective in enhancing the post-operative recovery score of the patients with laparoscopic abdominal surgery in recovery room.
Humans ; Laparoscopy ; Postoperative Care ; Recovery Room* ; Supine Position

OBJECTIVE: Neonatal blood pressure is one of the vital signs used to assess the general health of a newborn infant. But, it is difficult to measure and varies according to the model of sphygmomanometer, the used method, the postconceptional age, birth weight, asphyxia, postnatal age and activity. We have assessed the rnean value of blood pressure(BP) according to postconceptional age. Variations caused by the postconceptional age, birth weight, body surface area(BSA), postnatal age, and sex were analyzed to determine the rnost important factor influencing the neonatal BP. METHODS: This study included 448 normal fullterm infants and healthy preterm infants born from Jan. 1995 to Aug. 1997 at Ewha Dongdaemoon and Mokdong Hospital. The BP was taken on day 1, 3, 5 with the oscillometric device(Dinamap 1846 critikon Inc.), for premature infants BP was followed up every week afterward. RESULTS: The neonatal BP was related to the postconceptional age(R=0.204, P<0.05), BSA(R =0.191, P<0.05), birth weight(R=0.183, P<0.05) and the postnatal age in fullterm infants(R=0.022, P<0.05) but not with the sex of the infant. The postconceptional age was the most significant variable among those influencing the BP. The normal value of the systolic and the diastolic BP was expressed as mean+/-2SD according to the postconceptional age, less than 28 weeks(n=27) systolic/diastolic pressure 50.4+/-23.1mmHg/26.2+/-12.8mmHg, 28-32weeks(n= 63) 60.1+/- 30.6mmHg/33.6+/-16.7mmHg, 32-36weeks(n = 139) 63.2+/- 20.4mmHg/37.7+/- 19.8 mmHg, 36- 40weeks(n=543) 65.6+/-18.5mmHg/38.6+/-17.3mmHg, more than 40weeks(n= 136) 67.7+/-16,9mmHg/39.3+/- 15.8mmHg. The increase in blood prssure with the postconceptional age was statistically significant. CONCLUSION: The normal range of neonatal BP, especially preterm infants, was presented, and it would be much valuable for the evaluation of BP in neonate if standardized by postconceptional age.
Asphyxia ; Birth Weight ; Blood Pressure* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Parturition ; Reference Values* ; Sphygmomanometers ; Vital Signs