CT scans obtained on 15 patients of head and neck malignant tumors were evaluated for their utility in ratiotherapy treatment planning. To evaluate the advantage of incorporating CT scans in radiotherapy treatment planning of head and neck malignant tumors, the dose distributions of treatment plan with and without CT scan were compared in 15 patients. And then the dose distributions of the first and second treatment plan were compared. 1. Tumor extend and localization were clearly delineated on CT scan in 12 of 15 cases (80%), suggestive in 2 (13.3%), and not seen in only one (6.7%) which had been in the postoperative state. 2. Tumor coverage after CT scan was adequate in 14 of 15 cases (93.3%) and not in only one. In one case of inadequate tumor coverage the target volume lay inside the field but reached within 0.5cm of the field margin (marginal miss). 3. The volume of normal tissue irradiated was reduced after CT scan in 12 of 15 cases (80%), increased in 1 (6.7%) and not changed in 2 (13.3%). 4. We could maximize the local control of disease and minimize unnecessary morbidity by delineating the location and extent of tumor and normal tissue with CT for treatment plannings.
Head* ; Humans ; Neck* ; Radiotherapy* ; Tomography, X-Ray Computed

Malignant glaucoma is a disease process in which entire anterior chamber becomes uniformly shallow and elevates intraocular pressure. Classically, this has been described as limited to cases occurring following glaucoma surgery. Subsequently, association with trauma, inflammation, and the use of miotic agents, as well as spontaneous occurrence have also been noted. We have experienced one case of bilateral malignant glaucoma associated with ciliochoroidal detachment which was detected by ultrasoundbiomi-croscopy in a 55-year-old male. The episode followed the use of a strong miotic(pilocarpine hydrochloride 4%) and laser iridotomy for acute angle closure glaucoma. We report this case with review of available literature.
Anterior Chamber ; Glaucoma* ; Glaucoma, Angle-Closure ; Humans ; Inflammation ; Intraocular Pressure ; Male ; Middle Aged

99mTc-DMSA is a new renal scanning agent that provides a good quality of renal image as a result of preferential cortical accumulation and also makes feasible a quantitative assessment of separate kidney functions. Using 99mTc-DMSA renal scan. we evaluated renal functions in 26 patients who had unilateral non-functioning obstructed kidneys on intravenous pyelogram (IVP) and normal contralateral kidneys for recent 2 years and decided whether to perform surgeries for relief of obstructions or nephrectomies. In the patients who undertook surgeries for relief of obstructions for the recovery of renal functions, we compared renal functions of preoperative and postoperative obstructed kidneys. The results were as follows: 1. Etiologic diseases in 26 patients were urinary stones in 13. ureteropelvic junction obstructions in 7 and renal tuberculosis in 6. 2. Nephrectomies were performed in 13 patients who showed less than 15% of the total renal functions as determined by a preoperative 99mTc-DMSA scans. 3. Surgeries for relief of obstructions were performed in the other 13 patients for the recovery of the renal functions. The functions of the obstructed kidneys as determined by preoperative 99m Tc-DMSA scans were from 23% to 42% (mean 29.3%) and by postoperative 99mTc-DMSA scans were from 24% to 47 % (mean 34.4 %). The functions of the obstructed kidneys were recovered from 1% to 12% (mean 43.5 %) after surgeries for relief of obstructions. The follow-up periods were from 1 to 13 months (mean 6.6 month).
Follow-Up Studies ; Humans ; Kidney ; Nephrectomy ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tuberculosis, Renal ; Urinary Calculi

No abstract available.
Perfusion* ; Stomach Neoplasms* ; Stomach*

PURPOSE: To evaluate the CT findings of histologically confirmed endobrnchial tuberculosis(EBTB) and to access their diagnostic value by comparing with the bronchoscopic findings. MATERIALS AND METHOD: We evaluated retrospectively the CT findings of 25 patients(male : female=5 : 20) with EBTB, and classified them into 3 types by their characteristic features, which are compared with the brochoscopic findings. The 3 types of CT features were as follows ; type 1 : central mass-like lesion with coarse calcific spots associated with atelectasis, type 2: caseous pneumonia with air-bronchogram associated with atelecatasis, type 3 : irregularly distorted and narrowed bronchovascular changes. RESULTS: Comparing the characteristic CT findings with the bronchoscopic findings, they were as follows ; type 1 showed completely occluded lumen by caseous or scar-like tissue with severely swollenmucosa, type 2 showed very thick tenacious mucous plug with anthracotic pigmentation of mucosa, type 3 showed chronic inflammatory change of mucosa with severely deviated or septated bronchial lumen by out-growing caseousgranulation tissue. A tracheal tuberculosis without parenchymal lesion was noted and the bronchoscopy showed caseous materials along the tracheal lumen to the carinal level. CONCLUSION: The characteristic CT findings ofthe bronchial wall and the changes of the adjacent tissues are related to the tracheobronchial tuberculous involvement. CT is useful for diagnosis of the endobronchial tuberculosis.
Adult* ; Bronchoscopy ; Diagnosis ; Humans ; Mucous Membrane ; Pigmentation ; Pneumonia ; Pulmonary Atelectasis ; Tuberculosis* ; Tuberculosis, Pulmonary

BACKGROUND: Fosinopril is a new phosphorous containing angiotensin converting enzyme inhibitor. To assess the antihypertensive efficacy and safety of fosinopril, the clinical trial was done in patients with mild to moderate hypertension. METHODS: In 30 patients with mild to moderate essential hypertension, we administered fosinopril 10-20mg once daily for 10 weeks and checked their blood pressure every 2 weeks. RESULTS: The blood pressure decreased from 158+/-12.3/103.4+/-4.2mmHg to 139+/-7.5/88.4+/-5.9mmHg at the end of treatment(p<0.05). Heart rate did not change significantly during therapeutic period. Of 30 patients, the efficacy of fosinopril therapy disclosed 25 patients(83.7%) with normal diastolic pressure of more than 10mmHg decline of diastolic blood pressure. But two patients had no effects and three patients were not followed up. The adverse reactions due to fosinopril were reported in 3 patients(10%) with dry cough, 2 patients with palpitation(6.7%) and 1 patient with weakness(3.3%), but there were no patients who discontinued fosinopril due to adverse effect. CONCLUSION: Fosinopril has an excellent antihypertensive effect at low dosage as a first line antihypertensive agent or as a substituting agent for other antihypertensives in patients with mild to moderate essential hypertension.
Antihypertensive Agents ; Blood Pressure ; Cough ; Fosinopril* ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A

The common sites of esophageal diverticula are the pharyngoesophageal junction, midesophagus and epiphrenic. The pathophysiological mechanisms of acquired esophageal diverticula are traction and pulsion forces. Traction diverticula of the midesophagus are usually asymptomatic, and found incidentally on an esophagogastroduodenoscopy or barium contrast esophagogram. Midesophageal traction diverticula are caused by inflammatory processes between the external wall of the esophagus and the adjacent structure. Pneumonia, bronchoesophageal fistula and gastrointestinal bleeding can occur due to an extension of inflammatory process into the lung or blood vessels. There are a few reports of midesophageal diverticular bleeding. We present a case of massive upper gastrointestinal bleeding from a traction diverticulum of the midesophagus that was successfully managed by endoscopic treatment.
Barium ; Blood Vessels ; Diverticulum* ; Diverticulum, Esophageal ; Endoscopy ; Endoscopy, Digestive System ; Esophagus ; Fistula ; Hemorrhage* ; Lung ; Pneumonia ; Traction*

BACKGROUND: Reports on the relationship between osteoporosis and osteoarthritis (OA) have tended to disagree, especially in non-weight bearing joints such as the hand joints. We aimed to investigate the relationship between bone mineral density (BMD) and hand and knee OA in a general Korean elderly population. METHODS: We evaluated femur neck BMD and the hand and knee radiographs of 143 men and 123 women over 65 years of age who participated in a population-based cohort study. The Kellgren-Lawrence criteria for grading OA were implemented, and grade 2 or higher were categorized as radiographic OA. BMD was compared according to the existence of radiographic OA in the hand and knee using analysis of covariance, and correlation analyses were performed to explore the relationship between BMD and radiographic OA grade. RESULTS: After controlling for age and body mass index, there was no significant difference in BMD between participants with and without hand OA (p = 0.717 in male and p = 0.862 in female), between those with and without knee OA (p = 0.974 in male and p = 0.563 in female), and between those with only hand OA and those with only knee OA (p = 0.920 in male and p = 0.961 in female). Furthermore, there was no significant correlation between BMD and the radiographic OA grade of the hands (p = 0.182 in male and p = 0.897 in female) and knees (p = 0.245 in male and p = 0.098 in female). CONCLUSIONS: In our cohort of the general Korean elderly population, no association was found between osteoporosis and OA, regardless of the weight bearing status of the joints.
Aged ; *Bone Density ; Female ; Femur Neck/*radiography ; Hand/*radiography ; Humans ; Male ; Osteoarthritis, Knee/complications/*radiography ; Osteoporosis/complications/*radiography ; Republic of Korea ; Sex Factors

BACKGROUND: Although influenza has been a leading cause of global morbidity and mortality, we have few data regarding the epidemiological and clinical characteristics of influenza activity in Korea. Since an outbreak of influenza was recognized during winter of 1996-1997, we analyzed the epidemiological and clinical features of influenza activity in the hospital setting. METHODS: All clinical specimens requested for isolation of influenza virus at Samsung Medical Center from October 1996 to April 1997 were included. Mardin- Darby canine kidney (MDCK) cell line was used for virus culture. Isolated viruses were confirmed with immunostain followed by subtyping. The demographic and clinical characteristics of the patients were reviewed retrospectively. RESULTS: Ninety-eight influenza viruses were isolated from 461 patients (21.3%). Influenza A and B virus was isolated from 58 (54 children and 4 adults) and 40 pediatric patients, respectively. One of 31 influenza A viruses were confirmed as A/Wuhan/359/95-like strain and 5 of 12 influenza B viruses were confirmed as B/Guangdong/8/97-like strains. Two distinctive peaks of influenza activity were recognized and the most common age of patients was less than 1 year for influenza A, and 3 to 5 years for influenza B. Common lower respiratory infections were pneumonia followed by croup, bronchiolitis and laryngitis. CONCLUSION: We analyzed the epidemiological and clinical features of influenza activity during winter of 1996-1997. Although this study was performed not in the community but in the hospital setting, the morbidity caused by influenza may not be low in Korea. Therefore, nationwide surveillance for influenza activity is warranted.
Bronchiolitis ; Cell Line ; Child ; Croup ; Epidemiology ; Herpesvirus 1, Cercopithecine ; Humans ; Influenza A virus ; Influenza B virus ; Influenza, Human* ; Kidney ; Korea ; Laryngitis ; Mortality ; Orthomyxoviridae ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies

OBJECTIVES: Endoscopic Ultrasonography (EUS) is widely used to diagnose upper gastrointestinal tract disease. In recent, it is reported that EUS is also goood diagnostic method to assess depth of invasion through rectal wall and lymph node involvement of rectal cancer. We performed EUS in preoperative rectal cancer patients and compared to post operative histologic findings to evaluate EUS diagnostic accuracy for rectal cancer staging system METHODS: 51 patients with rectal cancer were performed with EUS. They were diagnosed by endoscopic biopsy from August 1994 to June 1996 at Kangbuk Samsung Hospital. Their ages were 28 to 78 (mean: 55 years) and the male to female ratio was 2 : 1 (34/17). Olympus GF-UM3, EU-M3 EUS and 7.5/12 MHz transducer were utilized. EUS was performed by the deaerated water filling method. We have analyzed between preoperative EUS findings and postoperative biopsy findings in order to evaluate the accuracy of EUS. The accuracy of EUS was signified by percentage. RESULTS: 1) Endoscopic ultrasonographic accuracy for assessment of wall invasion of rectal cancer was as follows ; The accuracy of mucosal cancer was 50% (patient numbers of EUS diagnosis/patient numbers of histologic diagnosis: 2/4). Submucosal cancer was 100% (1/1). Muscularis propria cancer was 44% (4/9). The accuracy with penetration to subserosa (or perirectal fat tissue) was 97% (33/34). The accuracy with invasion to adjacent organ was 33% (1/3). The overall accuracy rate was 80% (41/51). 2) EUS accuracy of lymph node metastasis in rectal cancer was ; The sensitivity was 90% (patient numbers of EUS diagnosis/patient numbers of histologic diagnosis: 28/31). The specificity was 60% (12/20). 3) EUS diagnosis of modified Duke classification was ; The accuracy of A stage was 80% (patient numbers of EUS diagnosis/patient numbers of histologic dagnosis: 4/5). B1 stage was 60% (4/8). B2 stage was 33% (1/3). C1 stage was 0% (0/3). C2 stage was 86%(25/28). D stage was 33% (1/3). The overall accuracy rate was 69% (35/51). CONCLUSION: EUS is useful method to assess rectal cancer invasion through rectal wall and lymph node involvement. However, further refinements in instruments and the techniques is required for more improving diagnostic accuracy.
Biopsy ; Classification ; Diagnosis* ; Endosonography* ; Female ; Humans ; Lymph Nodes* ; Male ; Neoplasm Metastasis* ; Rectal Neoplasms* ; Sensitivity and Specificity ; Transducers ; Upper Gastrointestinal Tract ; Water