BACKGROUND: Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. METHODS: Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. RESULTS: The forces vital capacity(FVC), forced expiratory volume in 1 second(FEV1)and maximal voluntary ventilation(MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity(DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption(VO2max), carbon dioxide production(VCO2), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. CONCLUSION: Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.
Carbon Dioxide ; Carcinoma, Non-Small-Cell Lung* ; Drug Therapy ; Exercise Test ; Follow-Up Studies ; Forced Expiratory Volume ; Humans ; Lung Neoplasms ; Male ; Oxygen ; Prospective Studies ; Radiotherapy ; Respiratory Function Tests

BACKGROUND: With the increase of cigarette consumption by women and the young, the incidence of lung cancer is expected to increase during the next three or four decades in Korea. The purpose of this study was to analyze the smoking habits in patients with lung cancer and to identify the gender differences in terms of their susceptibility to cigarette related carcinogens. METHODS: This investigation was a hospital-based case control study, which included the data of 178 case subjects(72 females, 106 males) with lung cancer and 218 control subjects(97 females, 121 males) with diseases unrelated to smoking. The information was obtained through a direct personal interview and a questionnaire related to personal smoking history. RESULTS: The relative frequency of the squamous cell carcinoma was substantially higher in males than in females(61.3% in males, and 29.2% in females), while adenocarcinoma including bronchoalveolar cell carcinoma was higher in females(31.9% in females, 18.9% in males). Keryberg Ilung cancer was of relatively higher frequencies in males and smokers. while Kreyberg IIlung cancer was higher in females and never smokers. The odds ratios(ORs) at each exposure level were consistently higher in females than males. For all cell types, the risk of lung cancer was increased with the quantity of smoked cigarettes, duration of smoking, and depth of inhalation. Odds ratio was distinctly higher in Kreyberg Ilung cancer than in total lung cancer and a steeper gradient of risk with increased smoking was observed in females. CONCLUSION: The ralative risk for lung cancer was consistently higher in females than in males at every level of exposure to cigarette smoke. This is believed to be due to the higher susceptibility of females to tabacco carcinogens, such as gender associated differences of carcinogen activation and/or the elimination of smoking related metabolites.
Adenocarcinoma ; Carcinogens ; Carcinoma, Squamous Cell ; Case-Control Studies ; Female ; Humans ; Incidence ; Inhalation ; Korea ; Lung Neoplasms* ; Lung* ; Male ; Odds Ratio ; Smoke* ; Smoking* ; Tobacco Products

Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders. characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold : correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been. used corticosteroid for persisting polyarthritis.
Adrenal Cortex Hormones ; Arthritis ; Coma ; Diagnosis ; Diarrhea ; Drug Therapy ; Feces ; Helminths ; Humans ; Immunity, Cellular ; Intestines ; Opportunistic Infections ; Sepsis ; Sputum ; Strongyloides stercoralis* ; Strongyloides* ; Strongyloidiasis ; Thiabendazole ; Tropical Climate ; Tuberculosis, Pulmonary

A 25-year-old woman transferred to pain clinic complaining of severe throbbing eye ball pain, eyelid edema and severe tearing in her left eye under the diagnosis of herpes zoster ophthalmicus that was developed 3months ago. In addtion to conventional medication, she had been taken stellate ganglion block, supraorbital and supratrochlear nerve block to contol of pain, but the response was poor. So we tried to administer ketamine subcutaneously, because not only ketamine, NMDA receptor antagonist, played a significant role to reduce neuropathic pain and pain caused by nerve injury, but also she wanted to work in her office during the treatment. We used subcutaneous ketamine 3 mg/hr (0.06 mg/kg/hr) in patient with postherpetic neuralgia of the ophthalmic nerve, and accomplished almost complete pain relief without any sign of side effect.
Adult ; Diagnosis ; Edema ; Eyelids ; Female ; Herpes Zoster Ophthalmicus ; Humans ; Infusions, Subcutaneous* ; Ketamine* ; N-Methylaspartate ; Nerve Block ; Neuralgia ; Neuralgia, Postherpetic* ; Ophthalmic Nerve* ; Pain Clinics ; Pain Management* ; Stellate Ganglion

BACKGROUNDS: Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional (PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometirc data and polysomnographic recordings between the two types of sleep apnea syndrome. MATERIALS: Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometirc data and polysomnographic data were analyzed, statistically. RESULTS: Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6±46.0min, p<0.05). Sleep efficiency was high in the PP group(89.6± 6.4%, 85.6±9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower(17.0±10.6, 28.5±13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7 ±1.8%, p<0.05) than in the NPP group. CONCLUSION: Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.
Apnea ; Humans ; Obesity ; Oxygen ; Polysomnography ; Respiration ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep, REM

Intracranial dermoid cyst is a rare congenital benign disease, representing less than 0.5% of primary brain tumors. Nevertheless, if ruptured spontaneously or during surgery, it has a poor prognosis due to chemical meningitis. Therefore, it is essential to perform accurate diagnosis and proper treatment. We report an intracranial subdural dermoid cyst that may be misdiagnosed as extracranial or epidural lesion because of extension into the right foramen ovale, and describe the CT and MR imaging findings.
Brain Neoplasms ; Dermoid Cyst* ; Diagnosis ; Foramen Ovale* ; Magnetic Resonance Imaging* ; Meningitis ; Prognosis

No abstract available.
Carcinoma, Squamous Cell* ; Lung Neoplasms* ; Lung* ; Small Cell Lung Carcinoma*

PURPOSE: We tried to evaluate the safety, feasibility and the clinical usefulness of the retroperitoneoscopic surgery for the treatment of variable renal diseases. MATERIALS AND METHODS: Between June 1998 and March 1999, a total of 18 patients (9 nonfunctioning kidneys, 1 ureter tumor, 3 simple renal cysts, 1 polycystic kidney, 3 ureter stones, 1 UPJ obstruction) underwent retroperitoneoscopic surgery (9 nephrectomies, 1 nephroureterectomy, 4 cyst marsupialization, 3 ureterolithotomy, 1 pyeloplasty) in our hospital. We analyzed the results of each operations. RESULTS: Out of total 18 cases, 15 retroperitoneoscopic surgeries were performed successfully as planed. Mean operative time was 194 minutes(ranged from 100 to 355 minutes) and mean postoperative hospital stay was 4.1 days(2-7 days). There was no significant intraoperative or postoperative complication in successfully completed cases. Open conversion was needed in three patients, all of them were not in an emergent condition, and there was no significant complication. Transfusion was not required in all cases. CONCLUSIONS: Retroperitoneoscopic surgery is a safe and feasible procedure for benign renal diseases, and there seems to be enough rooms for malignant diseases also.
Humans ; Kidney ; Length of Stay ; Nephrectomy ; Operative Time ; Polycystic Kidney Diseases ; Postoperative Complications ; Ureter

Laparoscopic ureterolithotomy has been attempted in the management of the large, long-standing, impacted ureter stone. However it was not commonly used because of difficulties in technique. So we report 2 cases of laparoscopic ureterolithotomy using the gasless technique. We performed the laparoscopic ureterolithotomy in two patients with ureter stones by transperitoneal approach. We used the laparolift system which was connected by laparofan retractor. The abdominal wall was elevated effectively, and the ureters were exposed with ease. The stone was successfully removed in all two cases. The operative time was 120 and 140 miniutes respectively. There was no intraoperative or postoperative complication including urinary leak in all cases. Postoperative pain was minimal. This gasless technique is convenient and safe because an operator can use the conventional surgical instruments and avoid the complications directly associated with pneumoperitoneum.
Abdominal Wall ; Humans ; Operative Time ; Pain, Postoperative ; Pneumoperitoneum ; Postoperative Complications ; Surgical Instruments ; Ureter

BACKGROUND: Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyoud just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD accordint to patient's smoking habits. METHOD: To evaluate the differences in the smoking patterens of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). RESULT: The patients with emphysema smoked earlier and had a higher smoking history(ie, more pachyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of ingalation was also significantly higher in the emphysema patients after taking into account age, cumulative cagarette consumption and the type of cigarette smoked. CONCLUSION: Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.
Bronchitis, Chronic* ; Emphysema* ; Humans ; Inhalation ; Male ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Risk Factors ; Smoke* ; Smoking* ; Tobacco Products