Mass casualty disasters have complex communication requirement. The involvement of many different communication systems and agencies and the difficulty of exchanging information between them is a perplexing problem. This may be compounded by telecommunication systems overload or failure, and electric service disruptions in the disaster area. In addition, emergencies are characterized by a sudden need for an increased information flow, an explosion in the topographical complexity of the information network, and a feeling of intense psychological pressure among the participants. The rescue, treatment, evacuation of a lot of patients from a natural disaster or mass casualties must be performed in accordance to several national agencies. Without an effective communication system, morbidity and mortality will needlessly rise. The stabilization and evacuation off lot of patients in a disaster is a serious and complex medical problem that must be resolved expeditiously. The potential far maximizing care depends on an well-organized rescue. However, without adequate communications, the patient may experience needless delays into the health care system an6 thus compromise prognosis. Established communication systems in most communities consist of private services, provincial and national agencies, and military and amateur radio operator. A disaster situation can severely disrupt routine telephone and radio communication. Customary frequencies may be incompatible with military and emergency civilian frequencies or become overloaded and useless because of intense activity. In a disaster, local telephone communication resources may be destroyed: qualified staffing of communications networks may be inadequate or unavailable to cope with the demands of the emergency. So, we recommend, that Amateur Radio should be provide as a effective emergency communication in a disaster.
Delivery of Health Care ; Disasters* ; Emergencies* ; Explosions ; Humans ; Information Services ; Mass Casualty Incidents ; Military Personnel ; Mortality ; Prognosis ; Telecommunications ; Telephone

No abstract available.
Plasminogen Activators* ; Plasminogen* ; Pulmonary Embolism*

No abstract available.
Hypophysectomy*

BACKGROUND: It is difficult to treat patients with hepatolithiasis because of recurrent or residual stones and serious postoperative complications. This study was done to compare the operation method and postoperative progression related to location of the hepatolithiasis. METHODS: Retrospective analysis was done in 234 patients who underwent operation due to hepatolithiasis from Jan. 1989 to Dec. 1998 in Chonnam University Hospital. RESULTS: The patients with left intrahepatic duct stones were 135, with right intrahepatic duct stones were 30 and with both intrahepatic duct stones were 69. In cases of resection of the liver, left lobectomy, left lateral segmentectomy, right posterior segmentectomy or right lobectomy was done. In a patient with stone in caudate lobe, caudate lobectomy was done. In non-resected group choledocholithotomy was done. Of 135 patients with left intrahepatic stones, 117 patients(86.7%) underwent hepatic resection and 18 patients(13.3%) underwent choledocholithotomy. Of 30 patients with right intrahepatic stones, 6 patients(20.0%) underwent hepatic resection and 24 patients(80.0%) underwent choledocholithotomy. Of 69 patients with both intrahepatic stones, 36 patients(52.2%) underwent resection and 33 patients(47.8%) underwent choledcholithotomy. Overall incidence of remnant stone was 28.2%. In resected group of left intrahepatic stones, the incidence of remnant stones was 8.5% and in non-resected group 33.3%. In resected group of right intrahepatic stones, the incidence of remnant stones was 0% and in non-resected group 37.5%. In resected group of both intrahepatic stones, the incidence of remnant stones was 55.6% and in non-resected group 63.6%. Incidence of postopertive complications was 22.6% and wound complication was most common. There was no postoperative mortality. CONCLUSIONS: Hepatic resection for hepatolithiasis confined to one lobe has an advantage of low incidence of remnant stone without increasing the morbidity and mortality rate. In both intrahepatic stones, the treatment is difficult, but if operation is performed with proper selection of extent of hepatic resection, favorable result would be expected.
Humans ; Incidence ; Jeollanam-do ; Liver ; Mastectomy, Segmental ; Mortality ; Postoperative Complications ; Retrospective Studies ; Wounds and Injuries

BACKGROUND: The prognosis for a hepatocellular carcinoma (HCC) is very poor because of delayed diagnosis caused by the absence of specific clinical manifestations in the early stage, the limitation of the extent of resection, the high postoperative complication rate due to associated liver cirrhosis, and the high recurrence rate due to multifocal tumorigenesis. Among the various kinds of treatment modalities for HCC, surgical resection is still recognized as the first treatment method. However, it is true that surgical resection has many problems, such as a high operative risk and a high postoperative recurrence rate. Therefore, an evaluation of the factors associated with the overall survival rate and with the recurrence rate is very important for improving the results of operative therapy for HCC. METHODS: We retrospectively analyzed the clinical and the pathological results of 44 curative hepatic resections for HCC performed at Chonnam University Hospital from 1991 to 1997. We evaluated 19 clinical and pathological factors by univariate and multivariate analysis, and we calculated the survival rate by using the Kaplan-Meier method. RESULTS: The cumulative 1-, 3-, and 5-year survival rates were 81%, 66%, and 28%, respectively. In 25 of the 44 cases, recurrences developed, and the 1-, 3-, and 5-year recurrence rates were 38%, 60%, and 65%, respectively. Factors with an independent effect on the overall survival rates were multiplicity of tumors, HBs Ag status, and Child classification. However, liver cirrhosis, ascites, prothrombin time, AFP level, and portal vein invasion were not statistically significant. CONCLUSIONS: The significant prognostic factors detected by multivariate analysis were multiplicity of tumors, HBs Ag status and Child classification. A preoperative evaluation for these factors should be done. If early diagnosis and multidisciplinary therapies are done through frequent postoperative follow-up surveys in these high risk groups, we can anticipate better long-term survival rates after a hepatectomy.
Ascites ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Child ; Classification ; Delayed Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Hepatectomy ; Humans ; Jeollanam-do ; Liver Cirrhosis ; Multivariate Analysis ; Portal Vein ; Postoperative Complications ; Prognosis ; Prothrombin Time ; Recurrence ; Retrospective Studies ; Survival Rate*

No abstract available.
Animals ; Macrophages ; Macrophages, Peritoneal* ; Mice* ; Signal Transduction*

No abstract available.
Constriction, Pathologic* ; Stents*

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

Xanthogranulomatous cholecystitis (XGC) is an uncommon, focal or diffuse destructive inflammatory process of the gallbladder that is assumed to be a variant of chronic cholecystitis. XGC is characterized grossly by irregular thickening of the gallbladder wall with the formation of a yellow mass (xanthogranuloma). Histologically the xanthogranuloma appears as yellow nodules or streaks in a thickened gallbladder wall and is composed of predominantly lipid-laden macrophages, inflammatory cells, and fibroblasts. These xanthogranulomatous foci may extend into adjacent structures, adhesions or ulcerations are often present, and fistula formation may occur. Although the pathogenesis of XGC is unclear, recurrent inflammation in the presence of calculi and biliary stasis are thought to be the main etiological factors because of the histologic evidence of chronic inflammation and the presence of gallstones in a majority of cases. XGC may lead to associated complications such as perforation, abscess, and fistula, and sometimes closely mimics a gallbladder carcinoma. During an operation for XGC, careful surgical technique is required to dissect the gallbladder and to excise the adjacent xanthogranulomatous tissue. Also a careful investigation to find the coincident gallbladder carcinoma is necessary. We report a case with XGC in a hemophilia A patient and a review of the clinical literatures.
Abscess ; Calculi ; Cholecystectomy ; Cholecystitis* ; Cholestasis ; Fibroblasts ; Fistula ; Gallbladder ; Gallstones ; Hemophilia A* ; Humans ; Inflammation ; Macrophages ; Ulcer

Liposarcoma is one of the most common soft tissue sarcomas in adults and its incidence rate is above 10% of all soft tissue sarcoma. The two common sites of liposarcoma are the extremities, particularly the thigh, and the retroperitoneum, but it developes rarely in spermatic cord, testis, chest wall and breast, mediastinum, omentum and mesentery. Primary solid tumors of omentum are exceedingly rare. Most of them are of mesenchymal origin and about one-half of them are malignant. Primary liposarcoma occurring in the omentum has been reported rarely, and especially round cell type liposarcoma, one of the histologic subtype of liposarcoma, has been known to be extremely rare. Recently, we experienced a patient with round cell liposarcoma arising primarily in the omentum. Herein, we report the clinical case with a consideration of the cytopathologic and ultrastructural features and a review of the literature.
Adult ; Breast ; Extremities ; Humans ; Incidence ; Liposarcoma* ; Mediastinum ; Mesentery ; Omentum* ; Sarcoma ; Spermatic Cord ; Testis ; Thigh ; Thoracic Wall