No abstract available.
Pierre Robin Syndrome*

PURPOSE: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. MATERIALS AND METHODS: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. RESULTS: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. CONCLUSION: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.
Aged ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Disease-Free Survival ; Esophagitis ; Humans ; Lymph Nodes ; Pneumonia ; Retrospective Studies ; Survival Rate

No abstract available.
Echocardiography, Doppler, Color* ; Mitral Valve Insufficiency*

Pheochromocytomas can arise wherever chromaffin cells are found, and most of them(90%) are in one or both adrenal glands. But they may be located anywhere along the sympathetic chain and rarely in aberrant sites. One of the common extra-adrenal sites from which these tumors can arise is a collection of para-aortic and para-ganglion cells around the origin of the inferior mesenteric artery. We experienced a case of extra-adrenal pheochromocytoma located at the organ of Zukerkandl in a 21-year-old female patient with abdominal colic and paroxysmal hypertension, whose symptoms and blood pressure returned to normal after successful surgical excision of the tumor.
Adrenal Glands ; Blood Pressure ; Chromaffin Cells ; Colic* ; Female ; Humans ; Hypertension* ; Mesenteric Artery, Inferior ; Pheochromocytoma* ; Young Adult

PURPOSE: In the Spring 1995, there was an outbreak of adenoviral infection, which caused four death out of ten patients with adenoviral pneumonia in our hospital. Clinical courses of ten patients with severe pneumonia were similar each other, and two were confirmed as adenoviral pneumonia by postmortem autopsy. Although not proven, we believe eight patients had adenoviral pneumonia. Therefore, we report clinical features in ten cases of severe adenoviral pneumonia. METHODS: Two cases with adenoviral pneumonia and eight cases with presumed adenoviral pneumonia were admitted in this hospital from March to June, 1995. Age and sex distribution, clinical manifestations, laboratory data, chest X-ray findings were reviewed. RESULTS: They were young children between 4 to 25 months of age(mean 12.7+/-6.1 months), and male to female ratio was 9:1. They presented with abrupt fever, cough, tachypnea, and dyspnea. Mean duration of fever were 12.7+/-6.1 days. Crackles on auscultation were heard in all patients. Studies for Mycoplasma and Tuberculosis were all negative. Cultures of bacteria and fungi were negative, and they did not respond to the antibiotics. The chest X-ray revealed the diffuse lobar consolidation with varying amount of pleural effusions. The findings of pleural fluid showed characteristics of transudate with predominant monocyte. Eight of our severe adenoviral pneumonia patients were enjoying normal health previously. Only two patients had previous medical problems, one with chronic cytomegalovirus pneumonia and the other with neutropenia induced by phenobarbital. The course of illness suggests that the infection was hospital acquired and the final outcome was fatal. Three of them developed seizure with fever, five change of consciousness, four conjunctivitis, three otitis media, and two gastro-intestinal symptoms. Autopsy was done in two of four patients. Grossly, the lungs were heavy and dark- red in color. There were bilateral pneumonic consolidation with patchy areas of hemorrhage. Microscopically, severe necrotizing bronchitis and bronchiolitis with numerous intranuclear inclusion of Cowdry type A and B were found. Alveoli were edematous and filled with fibrinous exudate, and covered with hyaline membrane. Ultrastructurally, typical adenoviral particles showing hexagonal shape in paracrystalline array symmetry were found in the nucleus of aleveolar lining cells. CONCLUSIONS: Yet, occasionally, adenoviral infection becomes most aggressive form of pneumonia. We should consider adenoviral pneumonia when clinical findings of pneumonia are very similar with baterial pneumonia except poor response to broad spectrum antibiotics. There is no specific treatment for adenoviral infection. So, for prevention of adenoviral pneumonia, we recommend isolation in suspicious adenoviral infection.
Adenoviridae ; Anti-Bacterial Agents ; Auscultation ; Autopsy ; Bacteria ; Bronchiolitis ; Bronchitis ; Child ; Conjunctivitis ; Consciousness ; Cough ; Cytomegalovirus ; Dyspnea ; Exudates and Transudates ; Female ; Fever ; Fibrin ; Fungi ; Hemorrhage ; Humans ; Hyalin ; Intranuclear Inclusion Bodies ; Lung ; Male ; Membranes ; Monocytes ; Mycoplasma ; Neutropenia ; Otitis Media ; Phenobarbital ; Pleural Effusion ; Pneumonia* ; Respiratory Sounds ; Seizures ; Sex Distribution ; Tachypnea ; Thorax ; Tuberculosis

During surgical procedures, unexpected material, including surgical instruments and tissue segments, may get lost in the surgical field. Most of these should be immediately removed to prevent further complications, such as vital organ irritation, infection, and inflammatory pseudo-tumor formation. However, it is not always easy to define the exact location of the foreign body, especially if the item is very small and/or it is embedded in the soft tissue of the head and neck region. Intraoperative real-time radiological imaging with C-arm fluoroscopy can be useful to trace the three-dimensional location of small and embedded foreign bodies in the oral and maxillofacial area. We describe an unusual case of an embedded micro-screw in the intrinsic tongue muscle that had been dropped into the sublingual space during a lower alveolar bone graft procedure. The lost foreign body was accurately identified with C-arm fluoroscopy and safely removed without any further complications.
Fluoroscopy* ; Foreign Bodies* ; Head ; Mouth Floor ; Neck ; Surgical Instruments ; Tongue ; Transplants

PURPOSE: The prognosis of stage III non-small cell lung cancer (NSCLC) treated with radiotherapy alone has been disappointing. Combined therapy including chemotherapy and radiotherapy has potential of improving both local and distant metastatic control. Paclitaxel and cisplatin have demonstrated activity as radiation sensitizers. The aim of this study was to evaluate the efficacy of paclitaxel and cisplatin with concurrent radiotherapy for stage III NSCLC. MATERIALS AND METHODS: Between April 2000 and July 2002, twenty-four previously untreated patients with unresectable stage III NSCLC received paclitaxel (60 mg/m2) and cisplatin (20 mg/m2) with concurrent radiotherapy. Chemotherapy was given on the first day of each week during radiotherapy. Concurrent radiotherapy was performed in 1.8 Gy daily fractions to a total dose of 54~59.4 Gy in 6~7 weeks (median: 59.4 Gy). RESULTS: Among 24 evaluable patients, the overall response was 83.3%, with four complete responses and 16 partial responses. Median survival was 16 months, with survival rates of 62.5% at 1 year and 28.7% at 2 years. Serious side effect was generally limited to grade 3 pulmonary toxicity in 37.5% of patients. CONCLUSION: Paclitaxel and cisplatin with concurrent radiotherapy has acceptable response with manageable toxicity in patients with stage III NSCLC. More randomized studies with a larger group of patients are required to improve the true efficacy
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy ; Humans ; Paclitaxel* ; Prognosis ; Radiation-Sensitizing Agents ; Radiotherapy* ; Survival Rate

No abstract available.
Leukemia, Monocytic, Acute* ; Leukemic Infiltration* ; Lymphatic Diseases* ; Skin*

The purpose of this study was to compare the shaping ability of three Ni-Ti file systems used by dental students or the experts and consequently to aid in choosing a proper systems for educational courses of dental students and beginners. Fifty students and ten dentists who have clinical experience over two years prepared 180 simulated root canals in resin blocks with three Ni-Ti systems; ProFile(R) (PF), HeroShaper(R) (HS), K3TM (K3). After preparation, the Ni-Ti files were evaluated for distortion and canal preparation time was recorded. The images of pre- and post-instrumented canals were scanned and superimposed. Amounts of increased canal widths, deviation, and centering ratio were calculated at apical 1, 3 and 5 mm levels and statistical analysis was performed. The results were as follows: 1. HS showed the shortest preparation time and instrumented canal width in K3 was significantly larger than other groups (P < 0.05). 2. At 1 and 3 mm levels, all groups had outward deviation. In student group, at the 1 mm level, PF had the least deviation (P < 0.05). 3. In the centering ratio, the PF had the best centering ability compared to the others at 5 mm level. At 1 and 3 mm levels, HS and PF had better abilities than K3. Student group had better ratio than the expert at 3 mm level with PF (P < 0.05). Based on the results, it is surmised that the ProFile(R) is the safest and most ideal instrument for students and beginners.
Dental Pulp Cavity ; Dentists ; Humans ; Students, Dental

BACKGROUND: Laparoscopic surgery is replacing conventional surgical techniques due to its many advantages. However the possibility of respiratory complications during CO2-induced pneumoperitoneum remain. Tracheal gas insufflation (TGI) has been shown to be a useful adjunct to mechanical ventilation in hypercapneic patients. This study investigated the effectiveness of TGI in reducing the PaCO2 level in hypercapneic patients during laparoscopic surgery without increasing the peak inspiratory pressure (PIP) and usefulness of a Univent tube(R) as a device for TGI. METHODS:Twenty-four patients who were scheduled to undergo gynecological laparoscopic surgery, were enrolled in this study. Anesthesia was induced and maintained with propofol, rocuronium and N2O-O2-sevoflurane. The suction port of the endobronchial blocker of the Univent tube(R) was used for the path of TGI. Data including the ABGA and respiratory parameters were measured three times, the pre-CO2 peritoneum (pre-CO2 pneumoperitoneum point, PCP), 15 min after CO2 peritoneum (after-CO2 pneumoperitoneum point, ACP) and after 15 min TGI (TGI point, TGIP). RESULTS: At ACP, the PaCO2 and PIP had increased more significantly than PCP. After TGI, the PaCO2 was decreased more significantly than ACP, but the PIP did not increased. CONCLUSIONS: TGI is a useful adjunct to mechanical ventilation in hypercapneic patients during laparoscopic surgery, and a univent tube(R) is an economic and convenient device for TGI.
Anesthesia ; Humans ; Insufflation* ; Laparoscopy* ; Peritoneum ; Pneumoperitoneum ; Propofol ; Respiration, Artificial ; Suction