BACKGROUND AND OBJECTIVES: The incidence of nasopharyngeal carcinoma (NPC) is reported to be high in South China and Hong-Kong. For that reason, the Ho's staging system has been used in the Hong-Kong area, while the American Joint Committee on Cancer (AJCC) staging system has been commonly used in western countries. The fifth-edition staging system defines new rules for classifying NPC. The purpose of this study was to find out whether the fifth-edition of the AJCC staging system is better than Ho's and the fourth-edition AJCC staging system in predicting the prognosis of NPC. MATERIALS AND METHOD: Fifty NPC patients of World Health Organization type II and type III were restaged according to the Ho's staging system, the fourth-edition AJCC and the fifth-edition AJCC staging systems. The disease specific survival rate was calculated by T category, N category and stage grouping for each staging system. RESULTS: The fifth-edition of AJCC showed good distribution compared with other systems in stage classification and also showed statistical significance in the disease specific survival rate between early carcinoma (stage I-II) and advanced carcinoma (stage III-IV). On the survival curve of T and N categories, the fifth-edition of AJCC showed statistical significance in the disease specific survival rate between T1-2 and T3-4 group, and also between N0-1 and N2-3 group. But Ho's staging system showed similar statistical results to the fifth-edition of AJCC, except for higher concentration of patients at stage III. The fourth-edition of AJCC didn't show any statistical significance among categories of T, N and the stage groups. CONCLUSION: In considering the poorer survival rates resulting from the cranial nerve or intracranial invasion and bilateral, or lower neck lymph node metastasis, the extensive invasion to adjacent regions and lymph node metastasis may have an influence on the prognosis. As far as prognostic categories are concerned, the fifth-edition of AJCC appears to be an improvement over other system. So, we concluded that the fifth-edition of AJCC staging system is better than the fourth-edition of AJCC and Ho's staging system to predict the prognosis of NPC.
China ; Classification ; Cranial Nerves ; Humans ; Incidence ; Joints* ; Lymph Nodes ; Nasopharyngeal Neoplasms ; Neck ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Survival Rate ; World Health Organization

PURPOSE: Glehnia littoralis has been used to treat ischemic stroke, phlegm, cough, systemic paralysis, antipyretics and neuralgia. The pharmacological mechanisms of Glehnia littoralis include calcium channel block, coumarin derivatives, anticoagulation, anti-convulsive effect, as well as anti-oxidant and anti-inflammatory effects. Alpha-amanitin (α-amanitin) is a major toxin from extremely poisonous Amanita fungi. Oxidative stress, which may contribute to severe hepatotoxicity was induced by α-amanitin. The aim of this study was to investigate whether Glehnia littoralis ethyl acetate extract (GLEA) has the protective antioxidant effects on α-amanitin -induced hepatotoxicity. METHODS: Human hepatoma cell line HepG2 cells were pretreated in the presence or absence of GLEA (50, 100 and 200µg/ml) for 4 hours, then exposed to 60µmol/L of α-amanitin for an additional 4 hours. Cell viability was evaluated using the MTT method. AST, ALT, and LDH production in a culture medium and intracellular MDA, GSH, and SOD levels were determined. RESULTS: GLEA (50, 100 and 200µg/ml) significantly increased the relative cell viability by 7.11, 9.87, and 14.39%, respectively, and reduced the level of ALT by 10.39%, 34.27%, and 52.14%, AST by 9.89%, 15.16%, and 32.84%, as well as LDH by 15.86%, 22.98%, and 24.32% in culture medium, respectively. GLEA could also remarkably decrease the level of MDA and increase the content of GSH and SOD in the HepG2 cells. CONCLUSION: In the in vitro model, Glehnia littoralis was effective in limiting hepatic injury after α-amanitin poisoning. Its antioxidant effect is attenuated by antidotal therapy.
Alpha-Amanitin* ; Amanita ; Antioxidants ; Antipyretics ; Apiaceae* ; Calcium Channels ; Carcinoma, Hepatocellular ; Cell Line ; Cell Survival ; Cough ; Coumarins ; Fungi ; Hep G2 Cells ; Humans ; In Vitro Techniques* ; Methods ; Neuralgia ; Oxidative Stress ; Paralysis ; Poisoning ; Stroke

A cystic mass of the neck causing neonatal respiratory distress is usually cystic hygroma. A branchial cleft cyst, however, also can cause respiratory distress on rare cases. The fourth branchial cleft cyst is very rare entity and, until now, only 35 cases have been reported worldwide. There have been some controversial attempts to prove its anatomical route through embryological background. Some reports, however, even suggested that it might be impossible to prove its entity anatomically. Recently, reports are coming out on the diagnostic approaches using not only anatomical pathway but also pathological impression. Authors experienced in neonates two cases of lateral cystic neck mass which were pathologically presumed to be fourth branchial cleft cyst. We are reporting these two cases with their diagnostic basis and the related literature.
Branchial Region* ; Branchioma* ; Humans ; Infant, Newborn* ; Lymphangioma, Cystic ; Neck ; Periodontal Cyst

Objective: A suicide attempt by self-poisoning is a common cause of admissions to the emergency department (ED). Management of such intentiona poisoning often requires complicated medical procedures, resulting in a longer length of stay (LOS) as compared to other cases that require treatment in the ED. This study aimed to determine the factors affecting a longer LOS in self-poisoning patients. Methods: This was a retrospective study wherein all the medical charts of patients who visited the ED of one hospital, from August 2016 to July 2019, because of intentional self-poisoning, were reviewed. Results: Most of the patients visited the ED involuntarily and there were almost twice as many female patients as males. Almost half of the patients were referred to the psychiatry department. A comparison of various factors within the LOS groups revealed significant differences in mental status, guardian co-visitation, patient gender, psychiatric referral, and poisoning substance. Moreover, the LOS had a stronger association with the pre-consultation period than the consultation to decision-making period. Conclusion To reduce the LOS, it seems important to make a rapid decision on whether to observe the patient in the ED and wait until the workup is completed or to admit and then evaluate the patient in the ward. If the clinicians cannot obtain enough information to evaluate the patient for appropriate management, short-term admission may be an option to reduce the LOS and to provide a stable evaluation.

BACKGROUND AND OBJECTIVES: For the treatment of glottic T1 cancer, several methods such as laser cordectomy, conservative laryngeal surgery and radiation therapy are possible. This study was performed to investigate the utility of laser cordectomy in the oncological and phonetic aspects. MATERIALS AND METHOD: Eighteen patients with glottic T1 cancer, who had undergone laser cordectomy at Kosin Medical Center from March, 1997 to July, 2001, were retrospectively investigated. The method of the operation was classified according to European Laryngological Society Classification. We analysed intraoperative complication, the duration of admission, postoperative complication, and tumor recurrence. Twelve patients were phonetically analysed using MATLAB and have undergone perceptual analysis. Videostroboscopy was performed for every patient to analyze the mechanism of phonation. As a control group, six normal persons were used. RESULTS: Intraoperative complications were not found in any of the 18 patients, but 5 patients who had suspicious lesions during following up after operation, have undergone biopsy which gave negative results. Among 4 patients who had granulation tissues, 2 patients were spontaneously regressed, and the other 2 patients have undergone removal of tissue with no recurrences. The vocal parameters such as Fo, S.D.Fo, jitter, shimmer and NHR differed significantly between the surgery group and the control group. The parameters maximum phonation time, speech rate and speech intelligiblity did not differ between two groups. CONCLUSION: Laser cordectomy for glottic T1 cancer provides time-and cost-effectiveness, a low level of morbidity, excellent local control rate, and acceptable voice quality.
Biopsy ; Classification ; Glottis ; Granulation Tissue ; Humans ; Intraoperative Complications ; Laser Therapy ; Phonation ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Voice Quality ; Voice*

OBJECTIVE: Recently, the atypical antipsychotics such as quetiapine, olanzapine, risperidone, aripiprazole and ziprasidone are increasingly used in the management of acute manic patients as the monotherapy. But there are only a few reports on the use of these drugs in the treatment of bipolar disorder in Korea. The aim of this study was to evaluate the efficacy and tolerability of quetiapine monotherapy in patients with acute mania. METHOD: This study is multi-center, open-label, 6-week evaluation of the efficacy of quetiapine in bipolar mania. In this study, patients with a DSM-IV diagnosis of bipolar I disorder (manic or mixed episodes) were included to treatment with quetiapine (flexibly dosed up to 800 mg/day). Clinical improvements were rated by Young Mania Rating Scale (YMRS), Clinical Global Impression-Bipolar Version (CGI-BP), Brief Psychiatric Rating Scale (BPRS) and Montgomery-Asberg Depression Rating Scale (MADRS). Adverse events were measured using Simpson-Angus Rating Scale (SARS) and Barnes Akathisia Rating Scale (BARS), and subjective reports of patients were evaluated. Global Assessment Scale (GAS) was used to evaluate the general functioning of patients. All assessments were done at baseline and at days 7, 14, 21, and 42 except GAS (at days 21 and 42). Analyses were focused on change from baseline to day 42. RESULTS: Total 78 (male=30, female=48) patients were included and 59 patients (75.6%) completed the study. The mean initial dose of quetiapine was 268.0+/-223.2 mg/day and mean daily dose at day 42 was 585.3+/-244.5 mg/day. YMRS and CGI-BP were significantly improved at day 7, 14, 21, and 42 as compared to baseline. Mean scores of BPRS and MADRS were also significantly decreased at the each assessment points. Fifty-two patients (66.7%) showed response (more than 50% of decrease in YMRS score from baseline) and 35 patients (44.6%) reached remission (YMRS score < or =12) at day 21. GAS showed the improvements of patient's global functioning at days 21 and 42 of quetiapine monotherapy compared to baseline. There was no significant difference between baseline and any assessment points on SARS and BARS scores. CONCLUSIONS: The data showed that quetiapine monotherapy has favorable effects across a broad range of mood symptoms with minimal adverse events in addition to functional improvement in acute manic patients. This result suggests that quetiapine may be preferred for patients with acute mania as one of the first-line agents.
Antipsychotic Agents ; Bipolar Disorder* ; Brief Psychiatric Rating Scale ; Depression ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Psychomotor Agitation ; Risperidone ; Aripiprazole ; Quetiapine Fumarate

PURPOSE: To evaluate the efficacy of a modified small bowel follow-through (SBFT) and to optimize this technique. MATERIALS AND METHODS: Ninety-nine subjects without small bowel pathology underwent modified SBFT using oral administration of methylcellulose after taking 100ml of 120% or 100, 150, or 200ml of 70% barium. Thirty-three and 39 normal subjects undergoing enteroclysis or conventional SBFT, respectively, were also evaluated for comparison of image qualities and transit time. RESULTS: Enteroclysis was the most successful ofthree types of small bowel examination for obtaining the best quality of bowel transradiency and distension. Modified SBFT was, however much superior to the conventional series for obtaining good bowel transradiency and rapid transity time (mean, 37-49 minutes). The use of 150ml of 70% barium was better than the other three modified techniques in achieving good bowel transradiency, rapid transit time, and less flocculation. CONCLUSION: Our modified SBFT is a simple and safe method for easily improving bowel transradiency and transit time.
Administration, Oral ; Barium ; Flocculation ; Methylcellulose* ; Pathology

PURPOSE: Infection is a major complication in patients with malignant disease. This study was performed to identify the causes and the etiologic agents of febrile infections and to characterize the clinical courses including the response to antimicrobial agents inpediatric cancer patients. METHODS: This study reviewed 274 febrile episodes occurring in 163 children with neoplastic disease which were indentified prospectively at Seoul National University Children's Hospital from January, 1991 to June, 1993. Neutropenia was defined as [granulocyte+band from] < or = 500mm(3). Each febrile episode was classified as a microbiologically documented infection(MDI), a clinically documented infection(CDI), and a probale infection(PI). The responses to initial antimicrobial atents were categorized into improvement, temporary improvement, failure, and not evaluable according to period to defervescence. RESULTS: Seventy seven percent of the febrile epidodes developed in neutropenic state. MDI were 98(36%), CDI 92(34%), and PI 84(30%) episodes. Bacteria were isolated in 75%, viruses in 13% and fungi in 11% of MDI. Fifty two episodes(19% of all) were associated with a bacteremia, and focal infections were indentified in 63% of bacteremia. The most frequent organisms causing MDI were E. coli(22%), K. pneumoniae(15%), S.epidermidis(7%). The great majority of infections other than bacteremia ocurred in the lung(32%), oral cavity(17%), skin and soft tissue(13%), and urinary tract(11%). The frequency of antimicrobial resistance of causative organisms was high. The responses to initial antimicrobial agents were improvement in 49%, temporary improvement in 13%, and failure in 38%. Patients with bacteremia responded less well than those with other categories. Mortality was 7% of total episodes. All of the fatal cases occurred in neutropenia and all but one had hematologic malignancies. CONCLUSIONS: This study documents the etiology and the type of infections and the responses to antimicrobial therapy in children with neoplastic diseases. The changes of causative agents and antimicrobial resistance should be considered in therapeutic strategies of cancer infection.
Anti-Infective Agents ; Bacteremia ; Bacteria ; Child* ; Focal Infection ; Fungi ; Hematologic Neoplasms ; Humans ; Mortality ; Neutropenia ; Prospective Studies ; Seoul ; Skin

BACKGROUND: Patients with COPD generally complain of very different degrees of dyspnea regardless of their pulmonary function. The study, we assessed the right ventricular ejection fraction in relation to dyspnea in COPD patient. METHODS: The pulmonary function including the diffusion capacity was measured. The right ventricle ejection fraction (RVEF) was measured using a first-pass radionuclide scan by multigated acquisition (MUGA). Forty patients with chronic obstructive pulmonary disease (COPD) were stratified for dyspnea according to the Medical Research Council (MRC) scale. Moderate dyspnea and severe dyspnea is defined as MRC 2/3 (n = 16) and MRC 4/5 (n = 24) respectively. RESULTS: The baseline pulmonary function tests including DLCO and the resting arterial blood gas were similar in the moderate and severe dyspnea group, with the exception of the residual volume (% predicted) (moderate 160 +/- 27, severe 210 +/- 87, p < 0.03). The right ventricle ejection fraction was significantly (p < 0.001) lower in the severe dyspnea group (25 +/- 8) than in the moderate group (35 +/- 6). The independent factor assessed by multiple logistic regression revealed only the severity of dyspnea to be significantly associated with RVEF (p < 0.02). CONCLUSION: This study showed that the right ventricle ejection fraction would contributes to severity of dyspnea in patients with a similar pulmonary function.
Diffusion ; Dyspnea* ; Heart Ventricles* ; Humans ; Logistic Models ; Pulmonary Disease, Chronic Obstructive* ; Residual Volume ; Respiratory Function Tests ; Stroke Volume

No abstract available.
Interleukin-6* ; Myxoma*