The excitatory influence on heart rate is generally considered by beta-adrenergic neuroreceptors of Ahlquist's classificantion. Blockade of the beta adrenergic system would therefore be expected to alter heart rate and consequently to have an effect of patients with a variety of cardiac arrhythmias. In 1964 a clinically useable agent was produced by the name of propranolol which would effectively block beta action of adrenergic system and safe from side effects. The purpose of this study is to determine and estimate the immediate therapeutic effects of propranolol on 29 cases with various cardiac arrhythmias, administered intravenously. The following results were obtained: 1. It is apparent that propranolol by the intravenous route offers a rapid means of inducing A-V block and hence a reduction of the ventricular response in atrial fibrillation and atrial flutter. 2. Propranolol may be of value in improving digitalis-resistant atrial tachyarrhythmias with the therapeutic supplement. 3. Propranolol diminishes the automaticity of ectopic pacemakers because this is evident in the slowing of atrial rate or conversion of paroxysmal atrial tachycardia to sinus rhythm and the abolition or diminution of ventricular extrasystoles. 4. Digitalis-induced ventricular arrhythmias respond to propranolol well, and propranolol may well be the drug of choice in treating digitalis-induced ventricular arrhythmias. 5. Ventricular arrhythmias not related to digitalis were not satisfactorily treated with propranolol in our series. 6. Side effects associated with propranolol treatment were not remarkable except for development of transient hypertension in 2 cases.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Flutter ; Digitalis ; Heart Rate ; Humans ; Hypertension ; Propranolol* ; Sensory Receptor Cells ; Tachycardia ; Ventricular Premature Complexes

No abstract available.
Hodgkin Disease* ; Radiotherapy*

From May 1979 through December 1981 a total of 524 patients with carcinoma of the uterine cervix were treated by radiation therapy with curative intent. Among the 524 patients, 356 were treated with a high-dose-rate (HDR), remote-controlled, afterloading intracavitary irradiation (ICR) system using a cobalt source (Ralstron), and 168 patients received a low-dose-rate (LER) ICR using a radium source. External beam irradiation with a total dose of 40-50 gy to the whole pelvis followed by intracavitary irradiation with a total dose or 30-39 gy in 10-13 fractions to point A was the treatment protocol ICR was given three times a week with a dose of 3 gy per fraction. Five-year actuarial survival rates in the HER-ICR group were 77.6% in stage IB (N=20), 68.2% in stage II (N=182), and 50.9% in stage III (N=148). In LDR-ICR group, 5-year survival rates were 87.5% in stage IB (N=22), 66.3% in stage II (N=91), and 55.4% in stage III (N-52). Survival rates showed a statistically significant difference by stage, but there was no significant difference between the two ICR groups. Late bowel complications after radiotherapy were noted in 3.7% of the HDR-ICR group and 8.4% of the LDR-ICR group. There was no severe complication requiring surgical management. The incidence of bladder complications was 1.4% in the HDR-ICR group and 2.4% in the LDR-ICR group. The application of HDR-ICR was technically simple and easily performed on an outpatient basis without anesthesia, and the patients tolerated it very well. Radiation exposure to personnel was virtually nil in contrast to that of LDR-ICR. Within a given period of time, more patients can be treated with HDR-ICR because of the short treatment time. Therefore, the HDR-ICR system is highly recommended for a cancer center, particularly one with a large number of patients to be treated. In order to tachieve an improved outcome, however, the optimum dose-fractionation schedule of HDR-ICRand optimum combination of intracavitary irradiation with external beam irradiation should be determined through an extensive protocol study with different treatment regimens.
Anesthesia ; Appointments and Schedules ; Cervix Uteri* ; Clinical Protocols ; Cobalt ; Female ; Humans ; Incidence ; Outpatients ; Pelvis ; Radiotherapy ; Radium ; Survival Rate ; Urinary Bladder

Sixty patients, treated with postoperative radiation therapy following radical hysterectomy and pelvic lymphadenectomy for stage lb carcinoma of the uterine cervix between Jan. 1980 and Dec. 1984 at Department of Radiation Oncology, Yonsei University College of Medicine, were retrospectively analysed. The minimum follow-up period was 5 years. The indications for postoperative radiotherapy were positive pelvic lymph node (34 pts), a large tumor size more than 3 cm in longest diameter (18 pts), positive surgical margin (10 pts), deep stromal invasion (10 pts), and lymphatic permeation (9 pts). The overall 5-year survival rate was 81.8%. The univariate analysis of prognostic factors disclosed tumor size (less than 3cm, greater than or equal to 3cm) and the status of the surgical margin (positive, negative) as significant factors (tumor size; 88.1% vs 6.3%, surgical margin; 85.5% vs 60%, p less than 0.05). Age (less than or equal to 40, greater than 40 yrs) was marginally significant (90.2% vs 73.1%, p less than 0.1). Multivariate analysis clarified two independent prognostic factors; tumor size (p = 0.010) and surgical margin (p = 0.004). Analysis of the tumor factors with the radiation dose disclosed a better survival rate for patients with a positive surgical margin who were given over 50 Gy than for those who were given below 50 Gy in patients (4/4, 100% vs 2/6, 33.4%; p = 0.06). Significant complications requiring surgical correction were not observed. In conclusion, it is believed that the status of the surgical margin and tumor size both have important prognostic significance, and that a radiation dose over 50 Gy is advisable for patients with a positive surgical margin.
Adult ; Carcinoma/mortality/*radiotherapy/surgery ; Cervix Neoplasms/mortality/*radiotherapy/surgery ; Combined Modality Therapy ; Female ; Human ; Hysterectomy ; Lymph Node Excision ; Lymphatic Metastasis ; Prognosis ; Retrospective Studies ; Support, Non-U.S. Gov't

Fourty nine patients with squamous cell carcinoma of oral tongue were reviewed retrospectively for the evaluation of clinical manifestation and for the comparison between therapeutic modalites. The gross shape of the tumor was infiltrative in 22, ulcerative in 12, and ulceroinfiltrative type in 10 patients. Direct extension of the tumor was most commonly to the floor of the mouth. The incidence of nodal metastasis generally increased with tumor stage. 55% of the patients showed neck nodal metastasis at the time of diagnosis. Ipsilateral subdigastric node were most commonly involved, followed by submandibular nodes. The 5-year survival rate of patients treated with surgery and radiotherapy was 58.7% in contrast to 21.6% in radiation alone group. Overall 5-year survival rate was 31%. In radiation alone group, half of the patients in stage I, II were locally controlled. But the local control in stage III, IV was much inferior to early lesions. Especially, of 4 patients combined with implantation tecnhnique, 3 were completely controlled. 5-year survival rate of these implanted patients was 50%, 49.4% of patients treated over 7,000 cGy survived 5 years. This was significant in contrast to 6.4% of the group treated below 7,000 cGy. The most common sites of failures were primary sites. In early lesions primary radiotherapy with implantation would be an appropriate treatment in cancer of oral tongue, operation reserved for radiation failure. Operation and adjuvant radiotherapy is recommended in cases of advanced disease.
Carcinoma, Squamous Cell* ; Diagnosis ; Humans ; Incidence ; Mouth ; Neck ; Neoplasm Metastasis ; Radiotherapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Rate ; Tongue* ; Ulcer

The treatment planning and dosimetry of small fields for stereotactic radiosurgery with 10 MV x-ray isocentrically mounted linear accelerator is presented. Special consideration in this study was given to the variation of absorbed dose with field size, the central axis percent depth doses and the combined moving beam dose distributon. The collimator scatter correction factors of small fields (1x1~3x3 cm2) were measured with ion chamber at a target chamber distance of 300cm where the projected fields were larger than the polystyrene buildup caps and it was calibrated with the tissue equivalent solid state detectors of small size (TLD, PLD, ESR and semiconductors). The central axis percent depth doses for 1x1 and 3x3 cm2 fields could be derived with the same acuracy by interpolating between measured values for larger fields and calcu1ated zero area data, and it was also calibrated with semiconductor detectors. The agreement between experimental and calculated data was found to be under +/-2% within the fields. The three dimensional dose planning of stereotactic focusing irradiation on small size tumor regions was performed with dose planning computer system (Therac 2300) and was verified with film dosimetry. The more the number of strips and the wider the angle of arc rotation, the larger were the dose delivered on tumor and the less the dose to surrounding the normal tissues. The circular cone, we designed, improves the alignment, minimizes the penumbra of the beam and formats ball shape of treatment area without stellate patterns. These dosimetric techniques can provide adequate physics background for stereotactic radiosurgery with small radiation fields and 10 MV x-ray beam.
Axis, Cervical Vertebra ; Computer Systems ; Film Dosimetry ; Particle Accelerators ; Polystyrenes ; Radiosurgery* ; Semiconductors

From March 1970 to December 1984, treatment results of 21 patients treated initially with curative surgery for adenoarcinoma of the colon and referred to the Department of Radiation Oncology, College of Medicine, Yonsei University, were analyzed retrospectively. Thirteen of 21 patients who were considered to be at high risk (i.e, stage B2 or above), received postoperative adjuvant radiation therapy. However, 2 of 13 patients did not complete their courses of radiotherapy as planned because of poor tolerance to radiotherapy or patient's refusal and were excluded from this study. Remaining 8 of 21 patients who did not receive postoperative radiotherapy, presented with recurrence at the time of referral and treated for palliation. In 11 patients who finished postoperativc radiotherapy, overall local failure rate was 9%(1/11) and the 5 year actuarial survival rate was 55%. Local failure rates by stage were 0(0/4), 14%(1/7) for stage B2+B3, C1+C2+C3 respectively and 0(0/2), 17%(1/6), 0(0/3) for stage C1, B2+C2, B3+C3 respectively.
Adenocarcinoma* ; Colon* ; Disulfiram ; Humans ; Radiation Oncology ; Radiotherapy ; Recurrence ; Referral and Consultation ; Retrospective Studies ; Survival Rate

PURPOSE: This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. MATERIAL AND METHODS: The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. RESULTS: The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2% over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6% with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. CONCLUSION: This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning, but prospective studies are required to define the true clinical benefit.
Brain Stem ; Humans ; Nasopharynx* ; Parotid Gland ; Temporal Lobe ; Temporomandibular Joint

A total of 20 patients(male : female=10:10, adult : children=8:12) with brainstem tumors had been received radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between 1980 and 1990. Thirteen of 20 patients were treated with conventional radiation therapy (before 1989, 180~200 cGy per fraction, 5 days a week, total dose 4680~5400 cGy), and seven patients were treated with hypefractionated radiation therapy(in 1990, 100 cGy per fraction, twice daily 10 fractions a week, total dose 7200 cGy). Median follow up periods for conventional radiation therapy group and hyperfractionated radiation therapy group were 39 months and 10 months, respectively. Four of 20 Patients had histopathologic diagnosis prior to treatment ; 3 cases were low grade astrocytoma and 1 case was high grade astrocytoma. Overall 2-year actuarial survival rate was 30%. The prognosis of patients with a longer duration of symptom and sign was better(60% vs 12%), and the adult(52%) was better than children(14%). There was no significant difference between the focal(29%) and diffuse(20%) type. The initial clinical response was better in the hyperfractionated radiation therapy group. Because of the relatively small number of Patients and short follow up Period in hyPerFractionated radiation therapy group, there was no comparison between two group.
Adult ; Astrocytoma ; Brain Stem Neoplasms* ; Brain Stem* ; Diagnosis ; Follow-Up Studies ; Humans ; Prognosis ; Radiation Oncology ; Survival Rate

No abstract available.
Breast Neoplasms* ; Breast* ; Drug Therapy*