No abstract available.
Anniversaries and Special Events* ; Korea*

Actinomycosis is a subacute or chronic suppurative infection caused by Actinomyces species, which are anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and urogenital tracts. Cervicofacial actinomycosis is the most frequent clinical form of actinomycosis, and is associated with odontogenic infection. Characterized by an abscess and mandibular involvement with or without fistula, but the cervicofacial form of actinomycosis is often misdiagnosed because the presentation is not specific and because it can mimic numerous infectious and non-infectious diseases, including malignant tumors. We report a rare case of actinomycosis infection with coexisting submandibular sialolithiasis. The patient presented with a 1x1 cm abscess-like lesion below the lower lip. Punch biopsy of the lesion revealed atypical squamous cell proliferation with infiltrative growth, suggestive of squamous cell carcinoma. The patient underwent wide excision of this lesion, where the lesion was found to be an abscess formation with multiple submandibular sialolithiases. The surgical specimen was found to contain Actinomyces without any evidence of a malignant process. We assumed that associated predisposing factors such as poor oral hygiene may have caused a dehydrated condition of the oral cavity, leading to coexistence of actinomycosis and sialolithiasis.
Abscess ; Actinomyces ; Actinomycosis* ; Actinomycosis, Cervicofacial ; Biopsy ; Carcinoma, Squamous Cell ; Causality ; Cell Proliferation ; Colon ; Fistula ; Gram-Positive Bacteria ; Humans ; Lip ; Mouth ; Oral Hygiene ; Salivary Gland Calculi* ; Submandibular Gland*

To evaluate the differences between current and past surgical treatment of intussusception, the medical records of 48 intussusception patients who underwent surgical treatment over 4 years (1975-1978, Group A) were reviewed and compared to the medical records of 75 intussusception patients who underwent surgical treatment over 4 years (1995-1998, Group B). Sex ratio is male predominant in both group (2.7:1 vs 1.6:1) and mean age of operation is 6.7+/-5.0 month (Group A) and 8.1+/-7.0 month (Group B). Major symptoms and signs of both groups are vomiting, hematochezia and irritability. White blood cell count of peripheral blood in both groups had no significant difference (12,417+/-4,446/mm3 vs 12,297+/-4,531/mm3). In operation methods, group A had significantly higher bowel resection rate over group B (31.3% vs 14.7%, p<0.05). In group A, 2 patients were died after operation, but group B have no operative mortality. Admission period after operation is significantly short in Group B (7.5+/-2.7 day vs 5.4+/-2.1 day, p<0.01). These results suggest there were no significant difference in characters of patients between Group A and B. But surgical treatment of intussusception in 1990s was more conservative than that in 1970s. We expect that recent surgical treatment lead early recovery from operation and early discharge from hospital.
Gastrointestinal Hemorrhage ; Humans ; Intussusception* ; Leukocyte Count ; Male ; Medical Records ; Mortality ; Sex Ratio ; Vomiting

PURPOSE: We performed a clinical study and a matched-set radiographic analysis to determine the factors that contribute to dislocation after total hip arthroplasty. MATERIALS AND METHODS: We reviewed 346 total hip arthroplasties (46 were revision procedure) followed by more than 1 year from January, 1992 to June, 1998. A clinical study was performed for dislocated group (16 cases) and non-dislocated group as to disease and patient's factors and prosthesis type. A radiographic analysis was performed for dislocated group and matched control group (32 cases) to evaluate operative factors. RESULT: Dislocation occurred in sixteen cases (4.6%) of the 346 total hip arthroplasties. There was no statistical correlation between age, gender, preoperative diagnosis or prior hip surgery in disease and patient's factor and dislocation. The patients who had a history of alcoholism (more than 0.8 bottle of Soju a day) had the significant difference in dislocation rate in comparison with the patients who did not have such a history. Operative factors were studied by radiographic analysis for sixteen hips that had dislocated and thirty-two that had not. We detected no relationships between the angle of the anteversion and inclination of the cup, leg length difference or the rate of horizontal offset and the risk of dislocation. The prosthesis type and acetabular liner also had no relationships with the dislocation. CONCLUSION: Although the causative factors for dislocation after total hip arthroplasty were not related to operative factor and prosthesis type, alcoholism in patient related factors was important.
Acetabulum ; Alcoholism ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations* ; Hip ; Humans ; Leg ; Prostheses and Implants

A 30 years old female patient was diagnosed valvular heart disease and double valve replacement was ndertaken. After operation, mediastinitis developed and we had done continuous mediastinal irrigation and had used IV antibiotics for 3 weeks. During outpatient follow-up, infection signs developed, so she readmitted and was reoperated because CT revealed mediastinal abscess. No infected material was observed at the operation. Infection signs continued for 3 weeks. Chest CT revealed giant pseudoaneurysm of ascending aorta. We resected the pseudoaneurysm and performed an aortoplasty with bovine pericardium under deep hypothermia and total circulatroy arrest. She recovered well and was discharged without any complication.
Abscess ; Adult ; Aneurysm, False ; Anti-Bacterial Agents ; Aorta* ; Female ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Hypothermia ; Mediastinitis* ; Outpatients ; Pericardium ; Thoracic Surgery* ; Tomography, X-Ray Computed

PURPOSE: Combination chemotherapy with cisplatin and etoposide have been considered as one of the chemotherpy regimen for non small cell lung cacer(NSCLC) with the response rate of 20~40%. Ifosfamide is one of the most active agent against NSCLC. And so, we initiated a phase II trial for advanced NSCLC to determine the effect of PIE(cisplatin, ifosfamide, etoposide) regimen. MATERIALS AND METHODS: 36 patients with inoperable non-small cell lung cancer who had no prior systemic chemotherapy were treated with combined ifosfamide (1,800 mg/m2 plus mesna 1,100 mg/m2 by intravenous continuous infusion daily for 3 days) with cisplatin (20 mg/m2 intravenous for 3 days) and etoposide (80 mg/m2 intravenous for 3 days). We evaluated the response rate, survival and toxicities of these patients. RESULTS: The objective response rate was 28%(CR; 2/36, 6%, PR; 8/36, 22%). Among 10 responders, 7 patients were in good ECOG performance status(0~1). The mean survival of all these patients were 43 weeks(8~141 weeks); the responding patients survived longer than the non-responders(median survival; 59 weeks vs 28 weeks, p<0.05). The toxicities of this regimen were acceptable without treatment related toxic death. CONCLUSION: We concluded that PIE regimen is effective in the treatment of advanced non-small cell lung cancer with acceptable toxicities and long-term follow up is warranted.
Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Follow-Up Studies ; Humans ; Ifosfamide* ; Lung ; Mesna ; Small Cell Lung Carcinoma* ; Survival Rate

PURPOSE: A prolonged administration of etoposide increases its effectiveness on the suggestion that pralonged maintenance of low levels is an important factor in determining its activity. Many studies have been tried to define the efficacy of combination of oral etoposide with other chemotherapeutic drugs such as cisplatin, 5-FU, and ifosfamide in patients with advanced non-small cell lung cancer (NSCLC). In this study, we evaluated the effectiveness and toxicities of combination chemotherapy of oral etoposide with intravenous cisplatin and ifosfamide in advanced NSCLC patients. MATERIALS AND METHODS: Thirty-three patients with inoperable NSCLC who had measurable diseases and had not been treated with chemotherapeutic drug, were enrolled in this study (from May 1995 to April 1998). Treatment consisted of intravenous cisplatin (20 mg/m(2)/day, Day 1-3) and ifosfamide (1,800 mg/m(2)/day, Days 1-3) with Mesna (1,100 mg/m(2)/day, Days 1-3), and oral etoposide (50 mg/m(2)/day, Days 4-17). This treatment was repeated every 4 weeks. Patients showing stable disease or a better response were continued on treatment with the range of one to nine cycles (medium: 3 cycles). All patients were evaluated for the response, survival, and toxicity of this combination chemotherapy. RESULTS: Eleven patients showed either complete responses [CR, 3 (9%)] or partial responses [PR, 8 (24%)]. The median number of treatment cycles were 5 (range, 3-9) for responders and 2 (range, 1-7) for non-responders. The responders had median response duration of 10 months and the overall survival of 12 months. The overall survival of responders were longer than that of non-responders (median 19 vs 5 months, p 0.0232). The toxicities of this treatment were tolerable without treatment related death. Limiting toxicities were myelosuppression and oral mucbsities, Grade 3 or 4 leukopenia and oral mucosities were observed in 34% and 9%, respectively. CONCLUSION: The combination of cisplatin, ifosfamide, and oral etoposide produced encouraging response rates and median survival duration in patients with response. Further study of this combination is warranted in comparison with standard cisplatin+etoposide regimen or intravenous etoposide, cisplatin and ifosfamide regimen.
Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide* ; Fluorouracil ; Humans ; Ifosfamide* ; Leukopenia ; Mesna ; Small Cell Lung Carcinoma*

BACKGROUND/AIMS: Portal hypertension in cirrhosis is associated with a hyperdynamic circulation, which is characterized by hypervolemia, high cardiac output, arterial hypotension and low peripheral vascular resistance. These circulatory abnormalities are thought to be secondary to a splanchnic arteriolar vasodilation related to the increase in portal pressure. Studies assessing regional hemodynamics in patients of cirrhosis with ascites have shown vasoconstriction in the renal circulation and in peripheral vascular territory. This study was designed to assess the cerebral vascular resistance in cirrhotic patients with ascites. METHODS: The resistive index in the middle cerebral artery and in a renal interlobar artery were measured by Doppler ultrasonography in 12 cirrhotic subjects without ascites, 23 cirrhotic subjects with ascites, and 8 healthy subjects. The arterial blood pressure and plasma renin and norepinephrine concentration, which reflect the activity of the renin-ngiotensin and sympathetic nervous systems respectively, were also measured. RESULTS: The resistive index in the middle cerebral artery were significantly higher in cirrhotic patients with ascites (0.58 +/- 0.04, mean +/- standard deviation) than in cirrhotic patients without ascites (0.53 +/- 0.02, p<0.01) and in control subjects (0.50 +/- 0.05, p<0.01). The resistive index in the middle cerebral artery showed direct correlation with renal resistive index (r = 0.52, p<0.01), plasma renin activity (r = 0.44, p<0.01) and norepinephrine (r = 0.33, p<0.05). The resistive index in the middle cerebral artery showed an inverse correlation with mean arterial pressure (r = -.59, p<0.01). CONCLUSION: The results suggest that in patients of cirrhosis with ascites, independent of the amount of ascites, there is a cerebral vasoconstriction which is related with the arterial hypotension and the overactivity of vasoconstrictor systems.
Arterial Pressure ; Arteries ; Ascites* ; Cardiac Output, High ; Fibrosis ; Hemodynamics ; Humans ; Hypertension, Portal ; Hypotension ; Liver Cirrhosis* ; Liver* ; Middle Cerebral Artery ; Norepinephrine ; Plasma ; Portal Pressure ; Renal Circulation ; Renin ; Sympathetic Nervous System ; Ultrasonography, Doppler ; Vascular Resistance ; Vasoconstriction ; Vasodilation

DNA immunization induces B and T cell responses to various pathogens and tumors. However, these responses are known to be relatively weak and often transient. Thus, novel strategies are necessary for enhancing immune responses induced by DNA immunization. Here, we demonstrated that co-immunization of influenza virus nucleoprotein (NP) gene significantly enhances humoral and cell-mediated responses to codelivered antigens in mice. We also found that NP DNA coimmunization augments in vivo proliferation of adoptively transferred antigen-specific CD4 and CD8 T cells, which enhanced protective immunity against tumor challenge. Our results suggest that NP DNA can serve as a novel genetic adjuvant in cocktail DNA vaccination.
Animals ; DNA ; Immunization ; Influenza, Human ; Mice ; Nucleoproteins ; Orthomyxoviridae ; T-Lymphocytes ; Vaccination

The number of cases of extracorporeal membrane oxygenation (ECMO) has rapidly increased all over Korea since the introduction of peripheral cannulation catheters. However, the application of ECMO to children has been limited due to the shortage of pediatric equipment and difficulty in maintaining an ECMO system with peripheral cannulation. For this reason, there have been only few reports of pediatric ECMO in Korea, and most of them pertained to the veno-arterial type ECMO for supporting the cardiac system in postcardiotomy patients. We report here on the successfully performing veno-venous ECMO, with using a double lumen percutaneous catheter, in a child with acute respiratory distress syndrome.
Catheterization ; Catheters ; Child ; Extracorporeal Membrane Oxygenation ; Humans ; Korea ; Respiratory Distress Syndrome, Adult