In order to provide bases for the control of air pollutants in Korea, the author figured out the trend on the annual increase of air pollutants emitted in the process of combustions, and estimated the amounts of air pollutants of the future years from 1975 to 1981. 1) In 1973 the consumption rate of coal was 1.2 times of that of fuel oil. The consumption rate of them would be same in 1975 and 1977. However, the rate of fuel oil would exceed that of coal in 1979. In contrast with the rate in 1979. The one of coal would be increased faster and faster to show reverse trend of consumption in 1981. 2) The estimated amounts of air pollutants emissions in the years of 1973, 1975, 1977, 1979 and 1981 were 1,561,800, 1,921,700, 2,253,300, 20769,000, and 3,145,700 tons respectively. These indicated that the amount of air pollutants in 1981 would be about 2 times of that in 1973. 3) The amounts of sulfur oxides emissions in 1981 would be 2.3 times of that in 1973, nitrogen oxides 2.2 times, carbon monoxide 1.7 times, particulate 2.0 times and hydrocarbon 2.0 times. 4) The estimated amounts of air pollutants emissions per unit area(km) in the years of 1965, 1971, 1975 and 1980 were 5.2, 14.5, 19.5 and 28.7 tons respectively. These indicated that the amount of air pollutants emissions per unit area would increase 5.5 times in 1980 comparing the one in 1965.
Air Pollutants ; Carbon Monoxide ; Coal ; Fuel Oils ; Korea* ; Nitrogen Oxides ; Sulfur Oxides

Authors analysed 36 cases(33 patients) of Peroneal Buoy Flap to investigate branching pattern, course, length of vascular pedicle, and perforating level of the perforating cutaneous branches from Oct. 1985 to July 1988. The results were as follows. 1. The perforating cutaneous branchea were classified into four types, the Straight Branch (18 cases), the Proximal Oblique Branch (8 cases), the Branch from Muscular Artery (8 cases), the Distal Oblique Branch(2 cases) respectively. The most common patten was Straight Branch. 2. There were 3 pathways of these branches, the most common one passed between the Soleus and Peroneus muscles(23 cases, 64%), and second one passed through the snterior part of Soleus muscle(8 cases, 22%), the third one passed through the posterior part of Peroneus muscle(5 cases, 14%). 3. The length of vascular pedicle in Buoy Flap was variable from 3cm to 15cm, but 27 cases(75%) were distributed between 4cm and 6cm. 4. The perforating level of branches were 6.3cm in average from Fibular Neck, 88% of them were distributed within 10cm. 5. Peroneal Buoy Flap in possible to reconstruct both seperated bone and skin defect in some distance by One-Stage Operation.
Arteries ; Neck ; Skin

PURPOSE: To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. MATERIALS AND METHODS: Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. RESULTS: The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; p = 0.038), lymph node dissection extent (HR, 0.201; p = 0.002), and maintenance oral chemotherapy (HR, 2.964; p = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). CONCLUSION: The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.
Chemoradiotherapy ; Combined Modality Therapy ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Intestinal Obstruction ; Leucovorin ; Leukopenia ; Lymph Node Excision ; Multivariate Analysis ; Nausea ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Thrombocytopenia ; Vomiting

BACKGROUND AND OBJECTIVES: Stroke onset is known to vary by several factors. Although it has been known that stroke may develop most frequently in the morning, its association with the type of activity has quite rarely been described. METHODS: We prospectively investigated by interview the time of and the activity during or before the onset of stroke in patients with acute cerebral infarction from Aug. 1995 to Mar. 1996. The activities were subdivided into basal metabolic rate state, sedentary, light, moderate, and heavy movements based on the caloric expenditure. RESULTS: One hundred-twenty five patients were enrolled. The time of day when ischemic stroke most frequently occurred was from 8:00 AM to noon. The type of activity was significantly associated with stroke onset in that it developed most commonly during and just after sleep or resting. The relationship between the onset of stroke and such patterns of onset time and the activity was found only in the atherothrombotic infarction, but not in the other stroke types. CONCLUSION: We demonstrated that stroke has clear diurnal variation. Our observations also suggested that the activity may be significantly associated with stroke onset. These findings may be useful for better understanding of the pathogenesis and prevention of ischemic stroke.
Basal Metabolism ; Cerebral Infarction* ; Health Expenditures ; Humans ; Infarction ; Prospective Studies ; Stroke

BACKGROUND: A number of cytokines, growth factors and inflammatory mediators made by keratinocytes, fibroblasts and potentially other cells in the skin were shown to augment melanin production and/or melanin transfer to keratinocytes. A lot of studies were done to investigate the mechanisms. But there was no studies about sequential relationship between the suggestive factors. OBJECT: To measure the changes in expressions of ET-1, MITF, and PAR-2 after UV exposure on skin in Korean. MATERIAL AND METHOD: We established an immunohistochemical staining protocol for specimens which were obtained from UV-irradiated skin in four healthy Korean males on the 2nd, 4th, 7th days after UV irradiation. RESULT: This study reveals the sequential relationship between ET-1, MITF, and PAR-2. ET-1 was increased at day 2 and decreased at day 4 and 7. MITF increased gradually day 2, day 4, and day 7. PAR-2 increased at day 4 and increased once more at day 7.
Cytokines ; Endothelin-1* ; Fibroblasts ; Humans ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Male ; Melanins ; Melanocytes ; Microphthalmia-Associated Transcription Factor* ; Microphthalmos* ; Skin

BACKGROUND: The aim of this study was to determine whether the conventional subcostal approach is suitable for emergency pericardiocentesis in patients with cardiac tamponade or impending cardiac tamponade. METHODS: This study was a prospective, observational study conducted at the emergency department of a tertiary hospital. Patients who had symptomatic pericardial effusion and who needed emergency pericardiocentesis in the emergency department were included in this study. We measured the epicardium-to-pericardium distance at the subcostal, parasternal, and apical area with two-dimensional echocardiography to determine the appropriate puncture site for pericardiocentesis. An epicardium-to-pericardium distance of more than 1.0cm was considered as the primary safety factor in determining the puncture site for pericardiocentesis. The skin-to-pericardium distance was considered as secondary safety factor. RESULTS: Ninety-five consecutive patients(55 males and 40 females; total mean age: 53 year old) with cardiac tamponade or impending cardiac tamponade were enrolled in this study. The puncture site for pericardiocentesis, as determined by echocardiography, was the subcostal area in 43 patients(45%), the apical area in 40 patients(42%), the left parasternal area in 11 patients(12%), and the right parasternal area in one patient(1%). Pericardiocentesis failed in 2 patients(2%) with the subcostal approach and in one patient(1%) with the apical approach. The average epicardium-to-pericardium distance was 31+/-21mm in patients with the subcostal approach and 21+/-8mm in patients with other approaches. There were no differences in the amount of pericardial fluid and in the intrapericardial pressure among patients groups according to puncture site. There were two procedure related complications: a puncture of the right ventricle with the subcostal approach and a ventricular tachycardia with the apical approach. CONCLUSION: The puncture site for emergency pericardiocentesis should be determined by using two-dimensional echocardiography because approaches from other areas can be safer than the subcostal approach.
Cardiac Tamponade ; Echocardiography ; Emergencies* ; Emergency Service, Hospital ; Female ; Heart Ventricles ; Humans ; Male ; Observational Study ; Pericardial Effusion ; Pericardiocentesis* ; Prospective Studies ; Punctures ; Tachycardia, Ventricular ; Tertiary Care Centers

PURPOSE: A retrospective study was performed to evaluate the efficiency and feasibility of twice daily radiation therapy plus concurrent chemotherapy for limited-stage small cell lung cancer in terms of treatment response, survival, patterns of failure, and acute toxicities. MATERIALS AND METHODS: Between February 1993 and October 2002, 76 patients of histologically proven limited-stage small cell lung cancer (LS-SCLC) were treated with twice daily radiation therapy and concurrent chemotherapy. Male was in 84% (64/76), and median age was 57 years (range, 32~75 years). Thoracic radiation therapy consisted of 120 or 150 cGy per fraction, twice a day at least 6 hours apart, 5 days a week. Median total dose was 50.4 Gy (range, 45~51 Gy). Concurrent chemotherapy consisted of CAV (cytoxan 1000 mg/m2, adriamycin 40 mg/m2, vincristine 1 mg/m2) alternating with PE (cisplatin 60 mg/m2, etoposide 100 mg/m2) or PE alone, every 3 weeks. The median cycle of chemotherapy was six (range, 1~9 cycle). Prophylactic cranial irradiation (PCI) was recommended to the patients who achieved a complete response (CR). PCI scheme was 25 Gy/ 10 fractions. Median follow up was 18 months (range, 1~136 months). RESULTS: Overall response rate was 86%; complete response in 39 (52%) and partial response in 26 (34%) patients. The median overall survival was 23 months. One, two, and three year overall survival rate was 72%, 50% and 30%, respectively. In univariate analysis, the treatment response was revealed as a significant favorable prognostic factor for survival (p<0.001). Grade 3 or worse acute toxicities were leukopenia in 46 (61%), anemia in 5 (6%), thrombocytopenia in 10 (13%), esophagitis in 5 (6%), and pulmonary toxicity in 2 (2%) patients. Of 73 evaluable patients, 40 (55%) patients subsequently had disease progression. The most frequent first site of distant metastasis was brain. CONCLUSION: Twice daily radiation therapy plus concurrent chemotherapy produced favorable response and survival for LS-SCLC patients with tolerable toxicities. To improve the treatment response, which proved as a significant prognostic factor for survival, there should be further investigations about fractionation scheme, chemotherapy regimens and compatible chemoradiotherapy schedule.
Anemia ; Appointments and Schedules ; Brain ; Chemoradiotherapy ; Cranial Irradiation ; Disease Progression ; Doxorubicin ; Drug Therapy* ; Esophagitis ; Etoposide ; Follow-Up Studies ; Humans ; Leukopenia ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Survival Rate ; Thrombocytopenia ; Vincristine

During pregnancy profound immunologic, metabolic, endocrine, and vascular changes occur. Because of these changes, some diseases are affected by pregnancy. These diseases can aggravate or improve during pregnancy. Lymphomatoid papulosis is a continuing self-healing eruption whose lesions are clinically benign but histologically contain malignant-appearing cells. We report a case of lymphomatoid papulosis which developed in 30-year-old pregnant woman. And we discussed the possible association between lymphomatoid papulosis and pregnancy.
Pregnancy ; Female ; Humans

BACKGROUND: Cancer of the esophagus is one of the most malignant tumors with poor prognosis. The p53 gene alteration, over expression of Cyclin D1, and Ki67 index were thought to be the prognostic factors. However, their clinical significances in esophageal squamous cell carcinoma are controversial and p53 accumulation may not correlate with genetic mutation. The current study investigates their prognostic significance in squamous cell carcinoma of the esophagus. MATERIAL AND METHOD: The Subjects studied were 124 esophageal squamous cell carcinoma patients who underwent esophagectomy. The mutation of p53, over expression of Cyclin D1, Ki67 labelling index, mitotic index were examined by using an immunohistochemical staining. We compared the results and investigated the correlation with the mutation of p53, overexpression of Cyclin D1, Ki67 labelling index, mitotic index and tumor size, and duration of survival. RESULT: There was no correlation between the results in immunohistochemical staining according to age, sex, tumor size, lymph node status, and clinical stage of the disease. Mutant p53 protein was found in 69 cases (55.6%). Median survival time was 21 months in cases with negative for mutant p53 protein and 22 months in positive cases. There was no significant difference in survival (p=0.46). Median survival time was 22 months in cases with negative for Cyclin D1 and 16 months in positive cases (p=0.18). Median and mean survival time was 22 months and 36 months when Ki67 labeling index was 40 or less (102 cases). Median and mean survival was 16 months and 23 months, when Ki67 labeling index was more than 40 (22 cases). There was significant difference in survival rate (p=0.011). CONCLUSION: Positivity of p53 and cyclin D1 was not useful in predicting the prognosis in our study. There was no significant correlation among mutant p53 protein accumulation, Cyclin D1 over expression, and Ki67 labeling index. However, in several studies, PCR single strand conformational polymorphism analysis of p53 showed a correlation to the prognosis. We thought that there was a significant discordance between p53 gene mutation and mutant p53 protein accumulation. When Ki67 labeling index was more than 40, prognosis was poorer. Ki67 seems to be a prognostic factor in our study. Therefore, we confirmed the possibility of using molecular markers as prognostic factors.
Carcinoma, Squamous Cell* ; Cyclin D1* ; Cyclins* ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Genes, p53 ; Humans ; Lymph Nodes ; Mitotic Index* ; Polymerase Chain Reaction ; Prognosis* ; Survival Rate

The authors report the surgical results of thalamotomy and pallidotomy, performed at our hospital between 1983 and 1993 for the treatment of Parkinson's disease. The series included a retrospective analysis of 156 patients with this condition by stereotactic ventrolateral(VL) thalamotomy(126 patients, 138 thalamotomies) and posterolateral pallidotomy(30 patients, 30 pallidotomies). Each patient was followed up postoperatively, for one year. Among those who underwent the stereotactic VL thalamotomy, 136/138 procedures(99%) led to improvement of tremor, and 83/138(60%) resulted in reduced rigidity. Stereotactic posterolateral pallidotomy, led to improvement of bradykinesia after 27/30 procedures(90%), of rigidity after 22/30(73%) and of tremor after 13/30(43%). Drug-induced dyskinesia showed a 42% improvement in the thalamotomy series and a 93% improvement in the pallidotomy series; the difference between the two series was significant(p<0.001). The patients themselves and their relatives used the Hoehn & Yahr staging scale to assess postoperative improvement in disability, and according to the results, 91/126 patients(72%) in the thalamotomy series and 26/30(87%) in the pallidotomy series showed improvement. In the thalamotomy series, there was a significantly higher improvement in disability for preoperative groups I and II(Hoehn & Yahr staging scale) than for groups III and IV(p<0.029), while in the pallidotomy series, there was no statistically significant difference in postoperative improvement between these same groups(p>0.557). In addition, for groups with greater preoperative disability(Hoehn & Yahr staging, groups III and IV), improvement was more likely after pallidotomy than after thalamotomy. In the pallidotomy series, dysphasia was the only serious complication and this was seen after 20% of procedures. In the thalamotomy series, however, complications included hypotonia(24%), transient confusion(19%), transient dysphasia(11%), permanent dysarthria(7%), subjective numbness(4%) and epileptic seizure(3%). The authors believe that posterolateral pallidotomy is much more effective than VL thalamotomy for the control of Parkinsonian bradykinesia and rigidity, but that thalamotomy is still a useful surgical option for the control of Parkinsonian tremor.
Aphasia ; Dyskinesia, Drug-Induced ; Humans ; Hypokinesia ; Pallidotomy* ; Parkinson Disease* ; Retrospective Studies ; Tremor