Carbon Monoxide poisoning is one of the most serious Public health problems in Korea. The incidence rate officially reported has been known to be the highest in the world. This high incidence is mainly due to the wide prevalence of anthracite coal briquette as the domestic fuel for unique Korean heating system called "ondol." The coal briquette gas contains around 3-5% of Carbon Monoxide. A nation-wide effort to eliminate or reduce this serious hazards has produced little effect and the most hospitals are offering very ineffective measures such as oxygen inhalation through nasal catheter. Author has believed that this preventable accident should be approached by the secondary preventive measure because of our socio-economic status do not allow us optimistic results from primary preventive measure as far as the problem of CO poisoning is concerned. Author has treated 466 patients during 30 months period by Hyperbaric Oxygenation at Seoul National University Hospital. The results found are as follows. 1. Female has a higher incidence rate than male and the age group between 15-29 years showed highest incidence. 2. The recovery time depends on the time when the patients arrived at hospital. Earlier the arrival time, shorter the recovery time. 3. Some objective signs are representing typical physiological response to tissue hypoxia. 4. Therapeutic effectiveness of Hyperbaric Oxypenation is confirmed by such indices as recovery rate, Admission rate and average stay in hospital. Futher, these results are cocordant with other reports on the clinical value of Hyperbaric Oxygenation in the treatment of CO poisoning.
Anoxia ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Catheters ; Coal ; Female ; Heating ; Hot Temperature ; Humans ; Hyperbaric Oxygenation* ; Incidence ; Inhalation ; Korea ; Male ; Oxygen ; Poisoning* ; Prevalence ; Public Health ; Seoul

Carbon Monoxide poisoning is one of the most serious Public health problems in Korea. The incidence rate officially reported has been known to be the highest in the world. This high incidence is mainly due to the wide prevalence of anthracite coal briquette as the domestic fuel for unique Korean heating system called "ondol." The coal briquette gas contains around 3-5% of Carbon Monoxide. A nation-wide effort to eliminate or reduce this serious hazards has produced little effect and the most hospitals are offering very ineffective measures such as oxygen inhalation through nasal catheter. Author has believed that this preventable accident should be approached by the secondary preventive measure because of our socio-economic status do not allow us optimistic results from primary preventive measure as far as the problem of CO poisoning is concerned. Author has treated 466 patients during 30 months period by Hyperbaric Oxygenation at Seoul National University Hospital. The results found are as follows. 1. Female has a higher incidence rate than male and the age group between 15-29 years showed highest incidence. 2. The recovery time depends on the time when the patients arrived at hospital. Earlier the arrival time, shorter the recovery time. 3. Some objective signs are representing typical physiological response to tissue hypoxia. 4. Therapeutic effectiveness of Hyperbaric Oxypenation is confirmed by such indices as recovery rate, Admission rate and average stay in hospital. Futher, these results are cocordant with other reports on the clinical value of Hyperbaric Oxygenation in the treatment of CO poisoning.
Anoxia ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Catheters ; Coal ; Female ; Heating ; Hot Temperature ; Humans ; Hyperbaric Oxygenation* ; Incidence ; Inhalation ; Korea ; Male ; Oxygen ; Poisoning* ; Prevalence ; Public Health ; Seoul

PURPOSE: This study was undertaken to establish a Peyronie's disease model by using local injection of fibrin into the tunica albuginea. MATERIALS AND METHODS: Four-month-old male Sprague-Dawley rats were divided into three groups (n=12 per group): Gr I, age-matched control; Gr II, a single injection of fibrin (50 microliter each of human fibrin and thrombin solutions); and Gr III, repeated injections of fibrin (50 microliter each of human fibrin and thrombin solutions, days 0, 3, and 6, respectively) into the tunica albuginea. We evaluated penile curvature by the use of an artificial erection test with intracavernous injection of saline and erectile function by cavernous nerve electrical stimulation 30, 45, and 60 days (n=4 per time point) after treatment. The penis was then harvested and stained with Masson trichrome, hematoxylin-eosin, and antibody to phospho-Smad2. RESULTS: Whereas a single intratunical injection of fibrin induced fibrous scar in the tunica, which lasted up to 45 days and disappeared 60 days after injection, repeated injections of fibrin induced more pronounced tunical fibrosis, which lasted up to 60 days after injection. However, a single or repeated intratunical injection of fibrin did not induce significant penile curvature. The peculiar histological findings in group receiving a single or repeated intratunical injection of fibrin were infiltration of inflammatory cells, and increase of transnuclear expression of phospho-Smad2. CONCLUSIONS: Although a single or repeated administration of fibrin did not induce penile curvature, this model may contribute to further investigation of pathogenesis and development of potential therapeutics in Peyronie's disease.
Animals ; Caves ; Cicatrix ; Electric Stimulation ; Fibrin ; Fibrosis ; Humans ; Male ; Models, Animal ; Penile Induration ; Penis ; Rats ; Rats, Sprague-Dawley ; Thrombin

PURPOSE: We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. MATERIALS AND METHODS: We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. RESULTS: Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). CONCLUSION: Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.
Carcinoma, Hepatocellular* ; Humans ; Palliative Care ; Portal Vein* ; Radiotherapy ; Radiotherapy, Conformal* ; Retrospective Studies ; Survival Rate ; Thrombosis*

PURPOSE: This study was performed to examine the neck failure patterns after a complete response (CR) to definitive radiotherapy for advanced head and neck cancer patients, as well as evaluate the clinical significance of the results of this study. MATERIALS AND METHODS: Between 1987 and 2008, the clinical data of patients who had been treated with radical radiotherapy for primary squamous cell carcinomas and enlarged cervical lymph nodes was analyzed retrospectively. Ultimately, the cases that showed CR of the cervical lymph node lesions to full-dose radiotherapy were included in this study. The recurrent rate and sites in the cervical lymphatic area were evaluated periodically by radiologic imaging studies, along with some factors which might have affected the rate of recurrence. RESULTS: A total of 73 patients who achieved CR in neck area after radiotherapy were included in this study. The rate of subsequent neck failure among those patients was 19.2%. There was only a 5.5% failure rate in the 55 patients who underwent radiotherapy in their primary site. Eighty percent of the recurrent cases were found within 3 years (median follow-up, 68 months). The majority of neck recurrent cases (47%) were accompanied with the failure of the primary lesions. The initial response of the primary site and the method of radiotherapy simulation were significant prognostic factors associated with the nodal recurrence rate. CONCLUSION: The recurrence rate of cervical nodes in patients with CR to radiotherapy in the primary site and neck area was about 5%. These patients could be followed up with close observation without a planned neck dissection.
Carcinoma, Squamous Cell ; Follow-Up Studies ; Head and Neck Neoplasms ; Humans ; Lymph Nodes ; Neck ; Neck Dissection ; Recurrence ; Retrospective Studies

PURPOSE: This study was performed to objectively evaluate the rate of tumor response to hypofractionated radiotherapy for advanced squamous cell carcinomas of the head and neck. MATERIALS AND METHODS: Thirty-one patients with advanced squamous cell carcinoma of the head and neck, who were treated by hypofractionated radiotherapy with 3 Gy per fraction for palliative purpose between 1998 and 2008, were reviewed retrospectively. Every tumor-volume was measured and evaluated from CT (computed tomography) images obtained before and 2~3 months after radiotherapy. The radiation toxicity was assessed during and after radiotherapy. A statistical analysis was performed to investigate overall survival, progression-free survival, and the prognostic factors for survival and response. RESULTS: The median age of the study patients was 70 years. In addition, 85% of the patients were in stage 4 cancer and 66.7% had an ECOG performance status of 1~2. The mean tumor-volume was 128.4 cc. Radiotherapy was administered with a total dose of 24~45 Gy (median: 36 Gy) over 10~25 days. Twenty-nine patients were treated with 30 Gy or more. The observed complete response rate was 12.9% and the partial response rate was 61.3%. Median survival time was 8.9 months and the 1-year progression-free survival rate was 12.9%. The treatment response rate was confirmed as a prognostic factor in the rate of survival. The primary site, stage, tumor-volume, radiotherapy field and overall radiation-dose showed a significant relationship with survival and treatment response. No grade 4 toxicity was observed during and after radiotherapy. CONCLUSION: There was an objective tumor-regression in about 74% of patients treated by hypofractionated radiotherapy. Further evaluation is needed to select the appropriate fraction-size and patient who may require the additional radiotherapy.
Carcinoma, Squamous Cell ; Disease-Free Survival ; Head ; Head and Neck Neoplasms ; Humans ; Neck ; Retrospective Studies

PURPOSE: Partial bladder outlet obstruction (PBOO) in rats leads to changes in bladder function, such as obstruction and detrusor overactivity (DO). The aim of our study was to observe factors essential for the objective descriptions of PBOO rats as an overactive bladder model as well as an obstruction model under awake cystometry. We also aimed to investigate the urodynamic effects of PBOO objectively in view of DO-related parameters as well as conventional pressure and volume-related parameters. MATERIALS AND METHODS: PBOO was produced in 10 female Sprague-Dawley rats by ligating the proximal urethra over a 0.9 mm metal rod; 10 sham-operated rats were used as controls. Intravesical pressure (IVP) was recorded via an open catheter in the bladder, and intraabdominal pressure (IAP) via an intraabdominal balloon catheter. Continuous cystometry was performed 2 weeks after the PBOO procedure. Conventional and newly developed DO-related urodynamic parameters were investigated. RESULTS: PBOO led to a significant increase in bladder weight. Three rats showed the picture of decompensated bladder and were excluded from the analysis. The obstructed group showed some increased pressure- and volume-related parameters. They showed a DO frequency of 1.5+/-0.3/min, but the sham group did not. CONCLUSIONS: Our results showed that bladder decompensation can happen after PBOO, and we need to describe those exclusions accurately in reports. In conscious PBOO rats, simultaneous registration of IAP and IVP is needed for accurate investigations of DO, because PBOO can lead to DO as well as bladder hypertrophy.
Animals ; Catheters ; Female ; Humans ; Hypertrophy ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Overactive ; Urodynamics

The authors analyzed 11 cases of pineal region tumor in young male patients who had been treated at the Capital Armed General Hospital. So, the following results were obtained. 1) Due to the army distinctiveness, all cases were young male patients. 2) An unusual large proportion of pineal region tumor(26.2%) was noted. 3) Headache and vomiting were main presenting symptoms and the duration of symptoms was short. 4) The tumors were mainly presented as a round well-enchancing masses with calcification. Also, nearly all were associated with hydrocephalus. 5) MRI was very useful for the demonstration of tumor extent. 6) Based on the classification of pineal tumor, the tumors of germ cell origin were predominant(81.9%). 7) The extrapineal metastasis was frequent. 8) The tumor marker(alpha-FP and HCG) was postive in 4 cases(36.4%). 9) Germinoma showed excellent prognosis for the irradiation following a drainage procedure.
Arm ; Classification ; Drainage ; Germ Cells ; Germinoma ; Headache ; Hospitals, General ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Pinealoma ; Prognosis ; Radiotherapy ; Vomiting

PURPOSE: We have previously demonstrated that increased urethral resistance was more prominent in diabetic rats than in controls. This may result from a compressive obstruction such as damage of the urethral nerve containing nitric oxide. Another possible cause for urethral obstruction could be a constrictive obstruction such as a periurethral fibrosis. In the present study, we investigated the changes in the expression of nitric oxide synthase(NOS) isoforms(compressive obstruction) and collagen subtypes (constrictive obstruction) in the urethral tissues of non-insulin dependent diabetic rats. MATERIALS AND METHODS: Thirty-six male Sprague-Dawley rats(18 diabetic rats and 18 control rats), bred from birth, were included in this study. Diabetes mellitus was induced by intraperitoneal administration of streptozotocin(90mg/kg) on the second day after birth. Urethral tissues were harvested at 12, 24 and 36 weeks after induction of diabetes and were stained for neuronal NOS(nNOS) and Masson trichrome. We also performed reverse transcriptase-polymerase chain reaction or Western blot analysis to evaluate mRNA or protein expression of NOS isoforms and collagen subtypes in the urethral tissues. RESULTS: Immunohistochemical staining and Western blot analysis of nNOS revealed that the immunoreactivity and nNOS expression in the urethra was lower in the diabetic rats than in the controls. The Masson trichrome staining showed that there was urethral fibrosis in the diabetic rats. The mRNA or protein expression of collagen subtypes, especially type I collagen, were higher in the diabetic rat urethra than in the controls. CONCLUSIONS: These data suggest that the increased urethral resistance in diabetic rats may be attributable to a decrease in the urethral nNOS expression and an increase in collagen content. Urethral dysfunction as well as a cystopathy may play an important role in the pathogenesis of diabetes- induced voiding dysfunction. (Korean J Urol 2007;48:1050-1057)
Animals ; Blotting, Western ; Collagen ; Collagen Type I ; Diabetes Mellitus ; Fibrosis* ; Humans ; Male ; Neurons ; Nitric Oxide Synthase* ; Nitric Oxide* ; Parturition ; Protein Isoforms ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Urethra* ; Urethral Obstruction

PURPOSE: To examine the feasibility of the treatment planning for minimizing carotid artery dose in the radiotherapy of early glottic cancer. MATERIALS AND METHODS: From 2007 to 2010, computed tomography simulation images of 31 patients treated by radiotherapy for early glottic cancer were analyzed. The virtual planning was used to compare the parallel-opposing fields (POF) with the modified oblique fields (MOF) placed at angles to exclude the ipsilateral carotid arteries. Planning target volume (PTV), irradiated volume, carotid artery, and spinal cord were analyzed at a mean dose, V35, V40, V50 and with a percent dose-volume. RESULTS: The beam angles were arranged 25 degrees anteriorly in 23 patients and 30 degrees anteriorly in 8 patients. The percent dose-volume of PTV shows no statistical difference. Conversely, the cumulative percent dose-volume of carotid artery shows the significant difference (p<0.001). The mean doses of carotid artery were 38.5 Gy for POF and 26.3 Gy for MOF and the difference was statistically significant (p=0.012). Similarly, V35, V40, and V50 also showed significant differences between POF and MOF. CONCLUSION: The modified oblique field was respected to prevent a carotid artery stenosis and reduce the incidence of a stroke based on these results.
Carotid Arteries ; Carotid Stenosis ; Humans ; Incidence ; Spinal Cord ; Stroke