We have analysed 13 patients with malignant obstructive jaundice due to metastasis who were treated with local radiation therapy to the area of porta hepatis at the Radiation Therapy Department of Paik hospital attached to the Inje University between 1984 and 1988. A good response was observed in 6 out of 7 evaluable paitens receiving a total radiation dose ranging from 2600 to 5480 cgy in 2.6 to 6 weeks. A complete response was noted in 5 patients, a partial response in 1 patient, and no response in 1 patient. The overall median survival for 13 patients was 3 months. But two patients lived more than a year without recurrence of jaundice. Moderate dose, localized field radiation therapy appears to the beneficial in relieving obstructive jaundice and gives a good symptomatic relief.
Humans ; Jaundice ; Jaundice, Obstructive* ; Neoplasm Metastasis ; Recurrence

We performed a reoperation of failed tricuspid mechanical valve in a 63-year-old female patient because the overgrown endothelial pannus had entrapped the prosthetic leaflets. Four years ago, the patient underwent mitral and tricuspid valve replacements with 31 and 33 mm Carbomedics, respectively. The patient showed symptoms of neck vein distention, abdominal distention and peripheral edema. The chest film, echocardiography and cineangiography confirmed the diagnosis of tricuspid valve. During the operation, we found the entrapped leaflets of the tricuspid valve in a partially closed state and the endothelial pannus had overgrown into the leaflets. Carpentier-Edward bovine pericardial valve was inserted and the patient was discharged with no significant events.
Cineangiography ; Diagnosis ; Echocardiography ; Edema ; Female ; Humans ; Middle Aged ; Neck ; Reoperation* ; Thorax ; Tricuspid Valve ; Veins

BACKGROUND: Mutations in the human Cu, Zn-superoxide dismutase (SOD1) gene have been identified in some cases of familial amyotrophic lateral sclerosis (ALS). Neuronal cells with mutant SOD1 gene promoted cell death during differentiation by dibutyryl cAMP and aphidicolin. The aim of this study is to delineate if there is an impairment of the neural differentiation process in mutant SOD1 cells. METHODS: We studied the motoneuron-neuroblastoma hybrid cells (VSC 4.1) expressing wild-type or mutant SOD1 (G93A) during the differentiation by dibutyryl cAMP and aphidicolin. RESULTS: Mutant SOD1 cell (G93A) showed an impairment in the neurite formation. Western blot analysis revealed that the amount of neurofilament decreased before differentiation. A decrease in the amount of MAP-2 is observed during differentiation. CONCLUSIONS: Our results suggest that the impairment in the neurite formation of mutant SOD1 cell (G93A) is a differentiation failure and is associated with neuronal cell death.
Amyotrophic Lateral Sclerosis ; Aphidicolin ; Blotting, Western ; Cell Death ; Humans ; Hybrid Cells ; Neurites* ; Neurons

Between December 1983 and December 1989, twenty-five breast carcinoma patients were treated with surgical resection and postoperative radiotherapy at Inje University Seoul Paik Hospital. Twenty-three of 25 were evaluable and there were 7 patients with stageII, 14 patients with stageIII, and 2 patients with stageIV. Twenty-one patients were treated with modified radical mastectomy and the remained 2 patients with simple mastectomy. The follow-up period ranged from 2 to 8 years. The local control rate was 83c13 for the entire group. The local control rates for each stage were 100%(6/6) for stage II, 73%(l1/15) for stageIII, and 100%(2/2) for stageIV. The number of metastatic axillary nodes was a good predictor of locoregional cotrol. It was 100% for the patients with 0-3 metastatic nodes and 72% for more than 4 nodes, respectively. The 5-year overall survival rate for the entire group was 59%, and the disease-free survival rate was 32%. The 5-year survival rates for each stageII,III and IV was 83%, 59% and 50%, respectively. The distant metastasis occurred in 10 out of 23 patients and the most common site was bone. The results indicate that postoperative radiotherapy continues to play an important role in the primary mangement of the high-risk breast cancer patients.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Simple ; Neoplasm Metastasis ; Radiotherapy* ; Seoul ; Survival Rate

BACKGROUND: The authors studied factors that affected operative mortality and clinical course by analysis of 98 patients who had underwent total correction of TOF at department of thoracic surgery, Pusan Paik hospital from Sept, 1985 to Aug, 1996 to predict the outcome of operation and improve the result of total correction. MATERIALS AND METHODS: To analyse the factors that affect operative mortality, patients were divided into two groups, non-survivor (group I) and survivor (group II), compared body surface area (BSA), aortic clamping time (ACT), total bypass time (TBT), preoperative PRV/LV, postoperative PRV/LV, operation method between them. These same patients were also divided into two groups, group A (non-survivor or severe complication group) and B (survivor and only mild complication group), comparing the same items. RESULTS: There were statistical differences between group I and II about postoperative PRV/LV as 0.67+/-0.13, 0.46+/-0.15. There were statistical differences between group A and B about postoperative PRV/LV as 0.62+/-0.12, 0.44+/-0.15. Transventricular cases were predominant in group A, transatrial cases in group B (p<0.01). CONCLUSIONS: We suggested that the operative results of TOF were better in cases of lower postoperative PRV/LV and transatrial approach.
Body Surface Area ; Busan ; Constriction ; Humans ; Mortality ; Survivors ; Tetralogy of Fallot* ; Thoracic Surgery

No abstract available.
Laser Therapy*

BACKGROUND: For AVR using conventional prosthetic valves in adult patients with a narrow aortic root, aortic root enlargement is necessary to reduce postoperative pressure gradient across the aortic valve (deltaP). An evaluation of early and mid-term results of aortic root enlargement with AVR and echocardiographic follow up of deltaP and left ventricular function was performed. METHOD: From Aug. 1991 to Feb. 1998, eighteen patients aged 17 to 59 years(mean, 38+/-12 years) underwent Manouguian procedure with AVR. Aortic annular circumstance was enlarged 10.0mm to 18.0mm(mean, 12.6+/-6.3mm). Eight patients(44.0%) had NYHA class III status before operation, and seven cases of them underwent concomitant MVR. Valve pathology was ASr in 6 cases, AS in 4 cases, nd ASr+MSr in 8 cases. Replaced valve size was 21mm in 8 cases and 23 mm in 10 cases, and St. Jude Medical mechanical valve was used in 10 cases and Carbomedics in 8 cases. RESULT: Follow-up duration was 6 to 57 months (mean, 26+/-18 months), and total follow-up was 287 patient-year. There were one hospital death and one late death, therefore, actuarial survival rate was 85.7% at 56 months. Peak deltaP wad decreased significantly at postoperative mid-term period as 13+/-5mmHg, compared with thepreoperative one (42+/-8mmHg) (p<0.01). LVM(gm/m(2)) was also diminished as 35.8%(115+/-36gm/m(2))at postoperative mid-term period, compared with preoperative one (179+/-56gm/m(2))(p<0.05). CONCLUSIONS: There were no specific complications related to the procedure. And we could have adequate enlargement of aortic annulus to suitable prosthetic valve that have no effect of patient-prosthese mismatch.
Adult ; Aortic Valve ; Echocardiography ; Follow-Up Studies ; Humans ; Pathology ; Survival Rate ; Ventricular Function, Left

BACKGROUND: It is very important to obtain vascular access that resists repeated punctures and maintains an adequate blood flow for performing hemodialysis in patients with ESRD. This study was designed to identify the risk factors that may influence the patency rate of arteriovenous fistula (AVF) using perforating vein on antecubital fossa. MATERIAL AND METHOD: We analyzed 205 cases of AVF in 195 patients who underwent hemodialysis access surgery on antecubital fossa in our hospital from May 2006 to December 2009. RESULT: The patency rate of AVF from 6 months after surgery using perforating vein was 75.91%. The risk factors that influence the patency rate was age. There was no statistic difference between used vessels. CONCLUSION: The patency of the AVF using perforating vein on antecubital fossa was comparable. The condition of sex and location and presence or absence of diabetes and hypertension and other cardio-neurovascular disease did not make statistically significant effect on the AVF patency rate. The age was an independent risk factor for patency rate.
Arteriovenous Fistula ; Humans ; Hypertension ; Kidney Failure, Chronic ; Punctures ; Renal Dialysis ; Risk Factors ; Veins

Melanocytic nevi are subject to change with age in both clinical and histopathologic findings. In 1991, Cho et al. first reported three cases of lobulated intradermal nevi and suggested their cases represented an unusual form of regressing melanocytic nevus. Herein we report four cases of lobulated intradermal nevus and review previous literature.
Aging ; Nevus, Intradermal ; Nevus, Pigmented

Internal jugular vein (IJV) thrombosis is a form of deep vein thrombosis that has a potentially fatal outcome associated with its intracranial propagation. Computed tomography and ultrasonography are useful diagnostic tools. We report a case of IJV thrombosis associated with lymphoma that was detected by carotid ultrasonography and had disappeared in follow up ultrasonography.
Fatal Outcome ; Follow-Up Studies* ; Jugular Veins* ; Lymphoma* ; Thrombosis* ; Ultrasonography* ; Venous Thrombosis