PURPOSE: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. MATERIALS AND METHODS: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). RESULTS: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. CONCLUSION: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.
Chondrosarcoma ; Curettage ; Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Tumor Burden

No abstract available.
Catheters* ; Heart Defects, Congenital*

Double outlet right ventricle, a complex of congenital cardiac anomalies in which both great arteries arise wholly or in large part from the morphologic right ventricle presents diverse clinical manifestations according to the morphological characteristics. Eighty cases with DORV were diagnosed and operated at Yonsei Cardiovascular Center from 1988 to 1992. The analysis of the morphological characteristics of this anomaly and comparative study of operative methods and mortality according to the morphological classification led to the following results: 1) The location of VSD varied to be subaortic in 40 cases, subpulmonic in 15, doubly committed in 6 and noncommitted in 19 cases. The great arteries were interrelated in D-malposition in 43 cases and L-malposition in 18 and 26 cases among above mentioned 61 cases revealed the side-by-side relationship. Ten of the cases showed normal position and the rest 9, A-malposition. 2) Pulmonary stenosis was found in 60 cases, and when associated with subpulmonic VSD, occurring less frequently. PDA and ASD secundum were associated in successional order and only 3 cases were verified to carry aortic arch anomalies such as coarctation and interruption, all with subpulmonic VSD. 3) Intraventricular tunnel repair was possible in every case associated with subaortic VSD and the postoperative prognosis was excellent. In comparison, most of the cases associated with other types of VSD in which only palliative surgery or various types of intraventricular repair were performed, the general outcome was poor. But total cavopulmonary connection, one of the physiological corrective methods, showing a better postoperative prognosis is being carefully considered for its broad adoptation in future. In conclusion, double outlet right ventricle, a pathophysiological complex of various anomalies, should be thoroughly evaluated for the morphological characteristics to decide the most appropriate types of operation and for consequent improvement of prognosis.
Aorta, Thoracic ; Arteries ; Classification ; Double Outlet Right Ventricle* ; Heart Ventricles ; Mortality ; Palliative Care ; Prognosis ; Pulmonary Valve Stenosis

No abstract available.

Trigeminal neurinomas are relatively rare tumors that arise from the sheath of Schwann and constitute 2.9% of intracranial neurinomas and 0.26% of all brain tumors. The most cases are confined to the middle fossa and arising from the Gasserian ganglion. In slight fewer cases the tumor occupy the cerebellopontine angle. In minority it is an hourglass form both situations. By reason of their rarity, the complex clinical problems which may present and the difficult technical aspects involved in their removal, neurinomas of the Gasserian ganglion are of extreme interest. We are reporting a case of trigeminal neurinoma which was arised from the right Gasserian ganglion and located in both situations of middle and posterior cranial fossas. A 37 year-old female was admitted to our department with characteristic symptoms and signs involving many cranial nerves, cerebellum and cerebral peduncle. We chose temporal craniotomy and approached to and exposed the mass by extradural and intradural techniques. Complete removal of the tumor occupying the middle and posterior cranial fossas are accomplished satisfactorily.
Adult ; Brain Neoplasms ; Cerebellopontine Angle ; Cerebellum ; Cranial Fossa, Posterior ; Cranial Nerves ; Craniotomy ; Female ; Humans ; Neurilemmoma* ; Tegmentum Mesencephali ; Trigeminal Ganglion

No abstract available.
Breast Neoplasms* ; Breast*

BACKGROUND: Hemodilution is known to increase cerebral blood flow, but it is not known why it is. We tried to investigate about these question like above. METHODS: Blood flow were checked on carotid artery after hemodilution by using electromagnetic blood flow-meter in 10 rabbits. Hemodilution was induced as 15 ml of lactated Ringers solution (LR) was infused after removing 5 ml of blood. Hemodilution was done 5 times in each rabbit. At 15 minutes after each hemodilution procedure, blood flow was checked and arterial blood gas analysis, and they compared with control data. The Sigma STAT and one way repeated measured ANOVA in Bonfferoni correction and regression analysis with DBSTAT PC application were used for statical analysis. RESULTS: Hemoglobin concentration and hematocrit in blood according to each hemodilution step decreased. At the same time, carotid blood flow increased following hemodilution. Though PaO2 level was not changed, CaO2 and pH, bicarbonate, and base excess in accordance with hemodilution were decreased. Also carotid blood flow calculated as increase 2.5 ml/min whenever hematocrit decreased 1%. CONCLUSIONS: We concluded as follow. Carotid blood flow increased to 2.5 ml/min (4.7%) whenever hematocrit decreased 1% by hemodilution. Whenever 15 ml of L/R solution was infused for acute hemodilution, carotid blood flow increased, on the contrary, hematocrit and arterial oxygen content decreased. Metabolic acidosis was induced by the large amount of L/R solution and it may be affected to carotid blood flows.
Acid-Base Equilibrium* ; Acidosis ; Blood Gas Analysis* ; Carotid Arteries ; Hematocrit ; Hemodilution* ; Hydrogen-Ion Concentration ; Magnets ; Oxygen ; Rabbits*

BACKGROUND AND OBJECTIVES: The kinds of offending allergens in our environment have changed in accordance with the changes wrought in the living environment. Thus, the study of offending allergens in allergic rhinitis is important. This study attempted to find out annual and seasonal distribution of offending allergens in patients of allergic rhinitis and to investigate the common offending allergens. MATERIALS AND METHODS: A series of allergic skin tests were performed for 3,159 allergic rhinitis patients from Jan. 1981 to Jun. 1990 at the allergic clinic, St.Benedict Hospital, Pusan, Korea, and the results were reviewed. The allergic study included 1) an allergic skin test, 2) a nasal smear for eosinophil. RESULTS: The following summary shows the results of this study: 1) The ratio between male and female of allergic rhinitis patients was 1.15:1 with the peak age being the teens and the twenties (60.6%). 2) The peak season of allergic rhinitis was winter (29.6%), followed by autumn, spring and summer. 3) The common offending allergens were dust and mites (35.9%), pollens (31.2%), epithelials (24.8%). 4) The most common offending allergen was D. farinae (52.5%), followed by D. pteronyssinus, cat fur, Alder pollens and Hazel pollens. 5) 29.6% of patients reacted positive to the skin tests for perennial types of allergens only and 5.2% of patients demonstrated pure pollinosis. CONCLUSION: The most common offending allergen was found to be the dust mite, and the most common pollen was from Alder trees. Perennial types of allergic rhinitis exceeded seasonal types in their occurence.
Adolescent ; Allergens* ; Alnus ; Animals ; Busan ; Cats ; Dust ; Eosinophils ; Female ; Humans ; Korea ; Male ; Mites ; Pollen ; Rhinitis* ; Rhinitis, Allergic, Seasonal ; Seasons ; Skin Tests ; Trees

The incidence of airway difficulty in the general surgical population varies greatly depending on the degree of airway difficulty. Much of the anesthesia related morbidity attributable to managing a difficult airway comes from an interurruption of gas exchange (hypoxia and hypercarbia) which may cause cardiovascular instability and brain damage. Most airway catastrophes ocurrs when possible difficulty with the airway was not recognized. Although fiberoptic intubation is reliable method in patients with difficult airways, there are many cases of difficulty in visualizing the structure of the larynx with conventional fiberoptic technique due to copious secretion, swelling and hemorrhage in the pharyngeal cavity. Recently, we experienced a success in difficult tracheal intubation with LMA in the 27 year old male patient diagnosed ankylosing spondylitis. We hope that using a #4 LMA as a conduit for 6.0 mm cuffed endotracheal tube with the aid of fiberscope attached to the video camera system would be an alternative method for difficult intubation.
Adult ; Anesthesia ; Anesthesia, General* ; Blood Pressure* ; Brain ; Clonidine* ; Epinephrine ; Heart Rate* ; Heart* ; Hemodynamics ; Hemorrhage ; Hope ; Humans ; Incidence ; Intubation* ; Larynx ; Male ; Norepinephrine ; Plasma* ; Skin ; Spondylitis, Ankylosing ; Succinylcholine ; Thiopental

Total 87 patients were divided into 4 different dosage and try to observe what was affected to cardiovascular system depends on the increasing the plasma ionized cakium concentration (3% calcium chloride; 4 mg/kg, as its double 8 mg/kg and 10% calcium gluconate; 14 mg/kg, as its double 28 mg/kg). The results were as follows;, 1) Though using double dosage of 3% calcium chloride and 10% calcium gluconate, could not get to increase as double of plasma ionized calcium concentration. 2) Plasma ionized calcium concentration was increased to the highest level on 1 minute after intravenous administration with each dosage and after increasing to highest level was show to be decreased gradually during 30 minutes after injection. 3) Heart rate was decreased until 30 minute after injection with each dosage of 10% calcium gluconate with statistically significancy (p<0.05) but when 3% calcium chloride were used, the change of heart rate following increase of calcium concentration have not any statistically signi- ficancy. 4) When 3% calcium chloride and 10% calcium gluconate were used, mean arterial pressure (MAP) and increasing of plasma ionized calcium concentration have not any statistically signi- ficancy. 5) Changing of cardiac index (CI) following plasma ionized calcium concentration, have only statistically significancy after each dosage of 10% calcium gluconate was injected but each dosage of 3% calcium chloride have not any statistically significancy respectively. With the above results, equivalent dosage of 3% calcium chloride and 10% calcium gluconate were increased as similar change of plasma ionized calcium concentration but 10% calcium gluconate 14 mg/kg, 28 mg/kg are only have statistically significany between the change of PR, CI and increasing plasma ionized calcium concentration (p<0.05).
Administration, Intravenous ; Arterial Pressure ; Calcium Chloride* ; Calcium Gluconate* ; Calcium* ; Cardiovascular System* ; Heart Rate ; Humans ; Injections, Intravenous* ; Plasma*