No abstract available.
Antifungal Agents* ; Candida albicans* ; Candida*

No abstract available.

The management of ipsilateral fractures of the femoral neck and shaft has proved to be a challenge to the orthopedist. Most major institutions have treatment protocols that emphasize early rigid stabilization of the femoral neck fracture to minimize the incidence of avascular necrosis of the femoral head and the shaft fractures were fixed prior to definitive neck stabilization. Whenever possible, patients should be followed for a minimum of three years to rule out aseptic necrosis of the femoral head. These dual fractures are usually encountered in the young, associated with high-velocity accidents and usually accompanied by multiple system trauma. At the department of orthopedic surgery, Eul Gi General Hospital, from June, 1986 to August, 1993, 21 cases of the concomitant ipsilateral femoral neck and shaft fractures had been treated. The mean follow-up was 2.8 years(ranging from 1.6 to 5.8 years). The diagnosis of femoral neck fracture was delayed in two patients. Seventeen of the 21 cases underwent surgery had a relatively satisfactory functional outcome without complication of femoral head. In two patient, a symptomatic varus nonunion and varus malunion developed. In two cases, osteonecrosis of femoral head developed and one case of these patients was treated with Meyer techniqe of muscle pedicle graft. Our series emphasize that the recommended treatment consists of a closed intramedullary fixation of the femoral shaft fracture followed by ASNI screw fixation of the femoral neck fracture, with good long term functional results and minimum complication. And approaches to the treatment of concomitant femoral neck and femoral shaft fractures should be selected according to the skill and experience of the surgeon and the availability of equipment.
Clinical Protocols ; Diagnosis ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hospitals, General ; Humans ; Incidence ; Neck ; Necrosis ; Orthopedics ; Osteonecrosis ; Transplants

PURPOSE: We tried to evaluate the role of conventional radiotherapy alone or with neoadjuvant chemotherapy in the hypopharyngeal cncer by retrospective analysis. MATERIALS AND METHODS: Between Jul. 1985 and Sep. 1992, 42 patinets of hypopharyngeal cancer were treated by conventional radiotherapy alone or combined with neoadjuvant chemotherapy. The male to female ration was 20:1 with a median age of 58 years. Twelve patients were treated by conventional radiotherapy alone and 30 patients were treated by neoadjuvant chemotherapy and radiotherapy. RESULTS: Seven patients were stage I, II and the patients with stage III and IV were 10 and 25, respectively at the time of presentation. The overall survival and disease-specific survival rates at 24 month were 12.9% and 15.5%, respectively. Two-year survival rates of stage I+II and III+IV patients were 50% and 6.3%, respectively(p<0.05). Sixteen patients (38%) revealed CR and 26 patients(62%) revealed less that CR at the end of radiotherapy and their 2-year survival rates were 31.3% and 0%, respectively(p<0.05). On univariate anaysis, stage, T-stage, N-stage and treatment response were the significant prognositc factors, but only stage an dtreatment response were significant on multivariate analysis. CONCLUSION: This conventional radiotherapy alone or with neoadjuvant chemotherapy does not seem to be sufficient in the treatment of most advanced hypopharyngeal cancer. Therefore other treatment modalities such as hyperfractionation or concurrent chemoradiotherapy should be considered.
Chemoradiotherapy ; Drug Therapy ; Female ; Humans ; Hypopharyngeal Neoplasms* ; Male ; Multivariate Analysis ; Radiotherapy* ; Retrospective Studies ; Survival Rate

PURPOSE: This study was performed to verify dose distribution with the tissue compensator which is used for uniform dose distribution in total body irradiation (TBI). MATERIALS AND METHODS: The compensators were made of lead (0.8mm thickness) and aluminum(1mm or 5mm thickness) plates. The humanoid phantom of adult size was made of paraffin as a real treatment position for bilateral total body technique. The humanoid phantom was set at 360cm of source-axis distance(SAD) and irradiated with geographical field size(FS) 144cm' 144cm2(40 40 cm2 at SAD 100cm) which covered the entire phantom. Irradiation was done with 10MV X-ray(CLINAC 1800, Varian Co., USA) of linear accelerator set at Department of Therapeutic Radiology, Chonnam University Hospital. The midline absorbed dose was checked at the various regions such as head, mouth, mid-neck, sternal notch, mid-mediastinum, xiphoid, umbilicus, pelvis, knee and ankle with or without compensator, respectively. We used exposure/exposure rate meter (model 192, Capintec Inc., USA) with ionization chamber(PR 05) for dosimetry. For the dosimetry of thorax region TLD rods of lxlx6mm3 in volume(LiF, Harshaw Co., Nethrland) was used at the commercially available humanoid phantom. RESULTS: The absorbed dose of each point without tissue compensator revealed significant difference(from -11.8% to 21.1%) compared with the umbilicus dose which is a dose prescription point in TBI. The absorbed dose without compensator at sternal notch including shoulder was 11.8% less than the dose of umbilicus. With lead compensator the absorbed doses ranged form +1.3% to -5.3% except midneck which revealed over-compensation (-7.9%). In case of aluminum compensator the absorbed doses were measured with less difference (from -2.6% to 5.3%) compared with umbilicus dose. CONCLUSION: Both of lead and aluminum compensators applied to the skull or lower leg revealed a good compensation effect. It was recognized that boost irradiation or choosing reference point of dose prescription at sternal notch according to the lateral thickness of patient in TBI should be considered.
Adult ; Aluminum ; Ankle ; Compensation and Redress ; Head ; Humans ; Jeollanam-do ; Knee ; Leg ; Mouth ; Paraffin ; Particle Accelerators ; Pelvis ; Prescriptions ; Radiation Oncology ; Shoulder ; Skull ; Thorax ; Umbilicus ; Whole-Body Irradiation*

PURPOSE: This study was to obtain the basic dosimetric data using the 10 MV X-ray for the total body irradiation. MATERIALS AND METHODS: A linear accelerator photon beam is planned to be used as a radiation source for total body irradiation (TBI) in Chonnam University Hospital. The planned distance from the target to the midplane of a patient is 360cm and the maximum geometric field size is 144cm' 144cm. Polystyrene phantom sized 30 30 30.2cm3 and consisted of several sheets with various thickness, and a parallel plate ionization chamber were used to measure surface dose and percent depth dose (PDD) at 345cm SSD, and dose profiles. To evaluate whether a beam modifier is necessary for TBI, dosimetry in build up region was made first with no modifier and next with an 1cm thick acryl plate 20cm far from the polystyrene phantom surface. For a fixed source-chamber distance, output factors were measured for various depth. RESULTS: As any beam modifier was not on the way of radiation of 10MV X-ray the dmax and surface dose was 1.8cm and 61%, respectively, for 345cm SSD. When an 1cm thick acryl plate was put 20cm far from polystyrene phantom for the SSD, the dmax and surface dose were 0.8cm and 94%, respectively. With acryl as a beam spoiler, the PDD at 10cm depth was 78.4% and exit dose was a little higher than expected dose at interface of exit surface. For two-opposing fields for a 30cm phantom thick phantom, the surface dose and maximum dose relative to mid-depth dose in our experiments were 102.5% and 106.3%, respectively. The off-axis distance of that point of 95% of beam axis dose were 70cm on principal axis and 80cm on diagonal axis. CONCLUSION: 1. To increase surface dose for TBI by 10MV X-ray at 360cm SAD, 1cm thick acrylic spoiler was sufficient when distance from phantom surface to spoiler was 20 cm. 2. At 345cm SSD, 10MV X-ray beam of full field produced a satisfiable dose uniformity for TBI within 7% in the phantom of 30cm thickness by two-opposing irradiation technique. 3. The uniform dose distribution region was 67cm on principal axis of the bean and 80cm on diagonal axis from beam axis. 4. The output factors at mid-point of various thickness revealed linear relation with depth, and it could be applicable to practical TBI.
Axis, Cervical Vertebra ; Humans ; Jeollanam-do ; Particle Accelerators* ; Polystyrenes ; Silver Sulfadiazine ; Whole-Body Irradiation*

A retrospective analysis was performed on 102 patients with non-small cell lung cancer who received the curative radiotherapy from August 1985 to October 1988 at the Department of Therapeutic Radiology of Chonnam University Hospital. The follow-up period was ranged from 1 to 37 months and the median follow-up time was 15 months. The acturial 1 and 2 year survival rate of all the patients was 28% and 5%, respectively. The median survival was 10 months for stage II, 6 months for stage IIIA, and 9 for IIIB and the actuarial 2 year survival tate was 12.5%, 12.1%, and 0% respectively. The treatment failure was identified in 32 patients and the locoregional failure was seem in 9 patients (28%) and the distant failure in 23 patients (72%). The initial performance status was related to the survival with statistical significance (p<0.01), but the survival difference by the radiation dose was not statistically significant (p>0.05).
Carcinoma, Non-Small-Cell Lung* ; Follow-Up Studies ; Humans ; Jeollanam-do ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Treatment Failure

PURPOSE: A retrospective analysis was performed to investigate the proper management of maxillary sinus carcinoma. MATERIALS AND METHODS: Authors analysed 33 patients of squamous cell carcinoma of maxillary sinus treated at Chonnam University Hospital from January 1986 to December 1992. There were 24 men and 9 women with median age of 55 years. According to AJCC TNM system of 1988, a patient of T2, 10 patients of T3 and 22 patients of T4 were available, respectively. Cervical lymph node metastases was observed in 5 patients(N1;4/33, N2b;1/33). Patients were classified as 3 groups according to management method. The first group, named as "FAR" (16 patients), was consisted of preoperative intra-arterial chemotherapy with5-fluorouracil(5-FU;mean of total dosage;3078mg) through the superficial temporal artery with concurrent radiation(mean dose delivered;3433cGy, daily 180-200cGy) and vitamin A(50,000 IU daily), and followed by total maxillectomy and postoperative radiation therapy(mean dose;2351cGy). The second group, named as "SR"(7 patients), was consisted of total maxillectomy followed by postoperative radiation therapy(mean dose 5920 cGy). Her third group, named as "R"(6 patients), was treated with radiation alone(mean dose;7164cGy). Kaplan-Meier product limit method was used for survival analysis and Mantel-Cox test was performed for significance of survival difference between two groups. RESULTS: Local recurrence free survival rate in the end of 2 year was 100%, 5-% and 0% in FAR, SR and R group, repectively. Disease free survival rate in 2 years was 88.9%, 40% and 50% in Far, SR and R group, respectively. There were statistically significant difference between FAR and SR or FAR and R group in their local recurrence free, disease free and overall survival rates. But diffeence of each survival rate between SR and R group was not significant. CONCLUSION: In this study FAR group revealed better results that SR or R group. In the future prospective randomized study is in need.
Carcinoma, Squamous Cell ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Jeollanam-do ; Kaplan-Meier Estimate ; Lymph Nodes ; Male ; Maxillary Sinus* ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Temporal Arteries ; Vitamins

BACKGROUND: Although the net atrioventricular compliance can be obtained by invasive catheterization (Ccath) in mitral stenosis (MS), feasibility of noninvasive echocardiographic calculation of the compliance (Cecho) and its hemodynamic significance were not tested. METHODS: Using valve area by 2D planimetry (A2D) and deceleration slope (dv/dt) of transmitral velocity decay in continuous wave Doppler echocardiographic tracing, Cecho was defined as -A2D/(gamma dv/dt), which was compared with Ccath obtained directly during the catheterization in 30 MS patients with sinus rhythm. Exercise Doppler echocardiography with symptom-limited treadmill was performed in 66 patients with moderate to tight MS: mean mitral gradient (MG) and peak pressure gradient of tricuspid regurgitation (PGTR) at baseline and immediately after exercise were obtained using continuous wave Doppler echocardiographic tracing. Hemodynamic variables including Cecho, MG, PGTR and mitral valve area were analyzed to determine the association with patients' exercise tolerance. RESULTS: Cecho in 30 patients with tight MS (valve area 0.9+/-0.2 cm 2) was 4+/-1 ml/mmHg (2-7 mmHg), which showed a significant correlation with Ccath (r=0.48, p=0.01). Exercise time in 66 patients with moderate to tight MS showed significant negative correlation with resting MG, resting and postexercise PGTR, and positive correlation with Cecho: exercise time in those patients did not show any significant correlation with resting valve area. In multivariate analysis, Cecho and postexercise PGTR were independent factors determining exercise time in MS. CONCLUSIONS: The net atrioventricular compliance in MS can be calculated by noninvasive echocardiography, and it is an important hemodynamic factor determining exercise tolerance in MS.
Catheterization ; Catheters ; Compliance* ; Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Exercise Tolerance ; Heart* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Multivariate Analysis ; Tricuspid Valve Insufficiency

BACKGROUND AND OBJECTIVES: The GFX stent is a flexible, balloon-expansible stent made of sinusoidal element of stainless steel. The adjunct high-pressure balloon dilatations after stenting were usually recommended in routine stenting procedure. The aim of this study was 1) to evaluate the immediate and long-term clinical and angiographic outcomes and 2) to investigate the necessity of high-pressure balloon during GFX stenting. MATERIAL AND METHODS: One hundred seventy two consecutive patients underwent single 12 or 18 mm GFX stent implantation in 188 native coronary lesions. Two types of stenting technique were used: 1) stent size of a final stent-to-artery ratio of 1:1 (inflation pressure > 10 atm, usually 12-14 atm: high pressure group) and 2) stent size of 0.5 mm bigger than reference vessel (inflation pressure 10 atm, usually 9 atm: low pressure group). The adjunct high-pressure balloon dilatations were done only in cases of suboptimal results. RESULTS: The adjunct high-pressure balloon dilatation were required under angiographic guidance in 11 of 83 lesions (13%) in high pressure group and 7 of 105 lesions (7%) in low pressure group (p=0.203). Procedural success rate was 100%. There were no significant differences of in-hospital and long-term clinical events between 2 group. The overall angiographic restenosis rate was 17.7%: 18.4% in high pressure group and 17.1% in low pressure group (p=0.991). CONCLUSION: GFX stent is a safe and effective device with high procedural success rate and favorable late clinical outcome for treatment of native coronary artery disease. Further randomized trials may be needed to compare stenting techniques in GFX stent implantations.
Angioplasty ; Coronary Artery Disease ; Dilatation* ; Humans ; Stainless Steel ; Stents*