BACKGROUND: Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and METHODS: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. RESULTS: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. CONCLUSIONS: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.
Ascites ; Carcinoma, Hepatocellular* ; Female ; Humans ; Liver Cirrhosis ; Male ; Radiotherapy* ; Survival Rate

The best confirming method of the endatracheal intubation was that the endotracheal tube was seen between the vocal cords. The rapid confirming method of the endotracheal intubation was to displace the tracheal tube toward the palate, and to see the endotracheal tube between the vocal cords under laryngoseopy. The purpose of this study was to examine the accuracy of conect endotracheal tube placerment performed by an unexperienced resident of first grade used by rapid confirming method. Two hundreds and nine patients were randomly examined Samson & Young grade firstly and confirmed the rapid method. The results were as follows; 1) Samson & Young grade I (104 patients): 100% confirmed 2) Samson & Young grade II (68 patients): male-91.3%,female-97.8% confirmed 3)Samson & Young grade III (36 patients): male-94.7%, female-88.2% confirmed 4) Samson & Young grade IV (1 patients): 100% confirmed 5) The total rate of success was 97.1% (203/209). With the above results, the authors concluded that first grade resident could confirm queekly the most endotracheal intubation used by the rapid confirming method and even though in the patients of Samson & Young grade III or IV.
Humans ; Intubation ; Intubation, Intratracheal* ; Palate ; Vocal Cords

For a treatment of advanced gastric cancer, the CHPP (Continuous Hyperthermic Peritoneal Perfusion) was often carried out with the surgical procedure. During the CHPP, many cardiovascular changes were occurred. In this case, ventricular fibrillation was suddenly happened at 21 minutes after the CHPP initiation, so we immediately stopped the CHPP. After we carried out the chest massage, heart rate and blood pressure was normalized. But ECG was revealed ST depression & T wave inversion. Therefore, we injected 1% lidocaine 60mg and infused nitroglycerin at a rate of 0.7 ug/kg/min. At the end of the surgery, the ECG was nearly normalized. After this case, we figured out many causes of ventricular fibrillation. First, the patient might had silent myocardial ischemia or coronary arterial disease, but he did not complain any symptoms. Second, peritoneal cavity expander and 8 liters of heated perfusate directly compressed his heart and facilitated the myocardial ischemia. So we planned routinely nitroglycerin infusion during the CHPP. The patient rarely complained chest pain at ward and discharged postoperatively 19 days later.
Blood Pressure ; Chest Pain ; Depression ; Electrocardiography ; Heart ; Heart Massage ; Hot Temperature ; Humans ; Lidocaine ; Myocardial Ischemia ; Nitroglycerin ; Peritoneal Cavity ; Stomach Neoplasms ; Thorax ; Ventricular Fibrillation*

BACKGROUND: It is well known that ischemic preconditioning protects the heart against infarction or arrhythmias from a subsequent ischemic injury. Recent laboratory data indicate that the adenosine during the ischemic period may trigger protection via A1 or A3 adenosine receptor and also protein kinase C(PKC) plays a central role. This study was designed to determine the role of adenosine receptor subtypes and PKC in the preconditioning protection. METHODS: All cat heart groups were subjected to 40min ischemia and 30min reperfusion. The preconditioning protocol consists of 4min ischemia and then 10min of reperfusion 4 times. The effects of ischemic preconditioning, nonselective adenosine receptor blocker(SPT), an A1 specific antagonist(DPCPX) and protein kinase C inhibitor(Polymyxin B), on ischemic preconditioning were determined by infarction size. There were 5 groups : (1) control group (Group 1, n=10)(2) Ischemic preconditioned group(Group 2, n=9)(3) DPCPX pretreatment group(Group 3, n=6)(4) SPT preteatment group(Group 3, n=6)(5) Polymyxin B pretreatment group(Group 5, n=6). SPT and DPCPX were given intravenously 5 min before ischemic preconditioning. Polymyxin B was administered to cats for 30min during ischemic preconditioning period. RESULTS: Ischemic preconditioning only or pretreatment with DPCPX prior to preconditioning demonstrated a significant reduction in infarct size(22.6+/-1.5, 25.4+/-0.9% infarction of the risk zone, respectively, p<0.05) with respect to control, SPT-pretreatment, and polymyxin B-pretreatment groups(44.0+/-1.7, 43.0+/-2.0 and 40.3+/-0.4% infarction of the risk zone, respectively). CONCLUSIONS: Ischemic preconditioning protects heart from subsequent ischemia. Protection was blocked by SPT and protein kinase C inhibitor(polymyxin B), but not by A1 antagonist DPCPX. The cardioprotective effects by ischemic preconditioning in the in vivo cat heart appear to be dependent on A3 adenosine receptors and activation of protein kinase C.
Adenosine* ; Animals ; Arrhythmias, Cardiac ; Cats* ; Heart* ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Polymyxin B ; Polymyxins ; Protein Kinase C* ; Protein Kinases* ; Receptors, Purinergic P1* ; Reperfusion

No abstract available.
Hearing* ; Polychondritis, Relapsing* ; Vertigo*

In humans, echinococcal species produce cystic lesions primarily involving the liver and lung. Echinococcal infection is caused far more commonly by Echinococcus granulosa than by E. multilocularis, which accounts for less than 5 percent of all cases of hydatid liver disease. Hydatid disease occurs principally in sheep grazing areas, particularly in the Australia, New Zealand, Greece, Yugoslavia, Middle East, and South American countries, but with increasing migration and traveling, this disease now has a worldwide distribution. This disease is rare in Korea and only few cases have been reported. This is a clinical case report of hydatid cyst of liver caused by Echinococcus granulosus in a 52-year-old man who had been dispatched in the Vietnam from 1966 to 1968.
Australia ; Echinococcosis* ; Echinococcus ; Echinococcus granulosus ; Greece ; Humans ; Korea ; Liver Diseases ; Liver* ; Lung ; Middle Aged ; Middle East ; New Zealand ; Sheep ; Vietnam ; Yugoslavia

Superior mesenteric vein (SMV) thrombosis caused by acute appendicitis is a very rare entity nowadays. We report a successfully treated case of a 21-year-old man with SMV thrombosis associated with severe acute appendicitis. Intravenous heparin was administered, and it was later substituted with warfarin. Systemic antibiotic therapy was continued for 1 week, and it was substituted with oral antibiotics, which were administered for 3 weeks. On the 45th postoperative day, follow-up computed tomography scan demonstrated dissolution of SMV thrombosis. Anticoagulation therapy was maintained for 3 months. He was discharged without any complications. SMV thrombosis can be treated successfully with emergency appendectomy, broad-spectrum antibiotics, and anticoagulation therapy.
Anti-Bacterial Agents ; Appendectomy ; Appendicitis* ; Emergencies ; Follow-Up Studies ; Heparin ; Humans ; Mesenteric Veins* ; Thrombosis* ; Warfarin ; Young Adult

Pacemaker malfunctions are secondary to alterations of the preset pacing rate, irregular pacing failure of sensing, failure of cardiac capture or depolarization, and various combinations of these events. A 76 years old male patients was admitted due to pacemaker malfunction. 2 years ago, he was diagnosed as complete atrioventricular block. And then bipolar permanent pacemaker was implanted. Since then syncopal attack developed repetitivly. 12 lead ECG and 24 hour holter moniter monitoring, revealed pacing and sensing failure, thus we converted bipolar system into unipolar system. since then syncopal attack did not developed again.
Atrioventricular Block* ; Electrocardiography ; Humans ; Male

Optokinetic nystagmus(OKN) is commonly employed in the assessment of central vestibular lesion. Asymmetry in the OKN has been found in lesions ipsilateral to the direction of the slow phase in parietal lobe, in brain stem, and in the cerebellum. Asymmetry of the OKN may also occur in peripheral vestibular lesions due to spontaneous nystagmus, and this may explain why even enhanced velocities of OKN are sometimes met in these patients. The ocular abnormality as congenital strabismus, extraocular paresis, and congenital nystagmus can cause abnormalities of optokinetic nystagmus. We investigated the clinical significance of OKN test and spontaneous nystagmus for differentiation of peripheral and central vestibular disorder. In this study, we recorded the optokinetic nystagmus by the electronystagmography. We divided the optokinetic response from normal to type III according to direction of the nystagmus and difference of(Rt-Lt) Vmean. At the result, all of the vestibuloneuronitis who had the optokinetic abnormality showed type I OKN abnormality with spontaneous nystagmus. Type II and type III OKN abnormality always appeared in central vertigo patients. Type I OKN abnormality could be seen in peripheral and central vertigo patient. But half of the central vertigo patients who had type I OKN abnormality did not have spontaneous nystagmus. We could not correlated OKN abnormality with specific location of central nervous system.
Brain Stem ; Central Nervous System ; Cerebellum ; Electronystagmography ; Humans ; Nystagmus, Congenital ; Nystagmus, Optokinetic* ; Paresis ; Parietal Lobe ; Strabismus ; Vertigo

The ductus arteriosus is a normal and essential structure in fetal circulation. Since the introduction of fetal echocardiography, there have been reports of ductal constriction, many of which were related to maternal use of some medications. However, there have been some reports of idiopathic ductal constriction, which usually present in later gestation. Recently we experienced a case, which initially showed an S-shaped ductus with mild narrowing at 23 weeks and 27 weeks gestation and developed severe ductal constriction at 33 weeks. Soon after birth, ductus was searched for but no ductus was found in 2-D and color images. The neonate required mechanical ventilation with supplemental oxygen for 3 days. All echocardiographic abnormalities were normalized in 7 months. We report progressive ductal constriction in an S-shaped ductus and emphasize the importance of continuous follow up extending to the third trimester and even immediately after birth.
Constriction* ; Ductus Arteriosus ; Echocardiography ; Female ; Fetus* ; Follow-Up Studies ; Humans ; Infant, Newborn ; Oxygen ; Parturition ; Pregnancy ; Pregnancy Trimester, Third ; Prenatal Diagnosis ; Respiration, Artificial ; Ultrasonography, Prenatal