No abstract available.
Abdomen ; Syringoma

No abstract available.
Abdomen ; Syringoma

PURPOSE: To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. MATERIALS AND METHODS: From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients ere managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A: minimal < about 5cc, B: mouthful 5-50 cc, C: Large > 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using C0-60 teletherapy machine. A total of 10Gy(2Gy/fr. X 5 days)was delivered without correction of lung density. RESULTS: In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due o multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group B, six of 7 patients(86%) with no RT were died due to respiratory failure, but 4 of 8 patients with RT were alive and 4 of 5 patients who received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion wre died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity. CONCLUSION: It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggressive supportive treatment appears to decrease pulmonary toxicity and contribute survival in patients with mouthful ingestion of paraquat who are destined to have reversible renal and hepatic damage but irreversible pulmonary toxicity.
Diuresis ; Eating ; Gastric Lavage ; Humans ; Lung ; Mouth ; Paraquat* ; Plasma ; Poisoning* ; Pulmonary Fibrosis ; Respiratory Insufficiency

No abstract available.
Lung*

No abstract available.
Polymerase Chain Reaction*

PURPOSE: To evaluate our clinical experience with the combination of teletherapy and intraluminal brachytherapy in patients with unresectable or inoperable esophageal cancers. MATERIALS AND METHODS: From Nov. 1989 to Mar. 1993, twenty patients with esophageal cancer were treated with radical radiotherapy and intraluminal brachytherapy at Yonsei Cancer Center. All patients had squamous histology and stage distribution was as follows: stage II, 4(20%) patients; III, 15(75%) patients; IV, 1(5%) patients. A dose of 5-12 Gy/1-3 weeks with intraluminal brachytherapy (3-5 Gy/fraction) to 5mm from the outside of the esophageal tube using high dose rate iridium-192 reotely afterloading bracytherapy machine was given 2 weeks after a total dose of 59-64Gy with external radiotherapy. Induction chemotherapy using cisplatin and 5-FU was performed in 13 patients with median 3 cycles(1-6 cycles). Response rate, local control rate, survival and complications were analysed retrospectively. RESULTS: Two-year overall survival rate and median survival were 15.8% and 13.5 months. Resonse rates were as follows: complete remission(CR) 5(25%); partial remission a(Pra) 7(35%); partial remission b(PRb) 7(35%); no response(NR) 1(5%). Patterns of failure were as follows : local failure 13(65%), local and distant failure 3(15%), distant failure 0(0%). Ultimate local control rate was 20%. Treatment related complications included esophageal ulcer in two patients and esophageal stricture in one. CONCLUSION: Though poor local control rate, median survival was improved as compared with previous results of radiation therapy alone(8months) and chemo-radiation combined treatment(11months) in Yonsei Cancer Center. High-dose-rate intraluminal brachytherapy following external irradiation is an effective treatment modality with acceptable toxicity in esophageal cancer.
Brachytherapy* ; Cisplatin ; Esophageal Neoplasms* ; Esophageal Stenosis ; Fluorouracil ; Humans ; Induction Chemotherapy ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Ulcer

PURPOSE: To evaluate influences associated with radiation treatment planning obtained with the patient breathing freely. MATERIAL AND METHODS: We compared reduction or elimination of planning target volume (PTV) margins with 2-D conventional plan with inclusion of PTV margins associated with breathing with 3-D conformal therapy. The respiratory non gated 3-D conformal treatment plans were compared with respiratory gated conventional 2-D plans in 4 patients with hepatocellular carcinomas. Isodose distribution, dose statistics, and dose volume histogram (DVH) of PTVs were used to evaluate differences between respiratory gated conventional 2-D plans and respiratory non gated 3-D conformal treatment plans. In addition, the risk of radiation exposure of surrounding normal liver and organs are evaluated by means of DVH and normal tissue complication probabilities (NTCPs). RESULTS: The vertical movement of liver ranged 2-3 cm in all patients. We found no difference between respiratory gated 2-D plans and 3-D conformal treatment plans with the patients breathing freely. Treatment planning using DVH analysis of PTV and the normal liver was used for all patients. DVH and calculated NTCP showed no difference in respiratory gated 2-D plans and respiratory non gated 3-D conformal treatment plans. CONCLUSION: Respiratory gated radiation therapy was very important in hepatic tumors because radiation induced hepatitis was dependent on remaining normal liver volume. Further investigational studies for respiratory gated radiation treatment combined with 3-D conformal treatment are required.
Carcinoma, Hepatocellular ; Hepatitis* ; Humans ; Liver ; Respiration

PURPOSE: Taurolidine is an antimicrobial agent that was originally used in the local treatment of peritonitis. The aim of this study was to evaluate the efficacy of taurolidine irrigation in primary total knee arthroplasty (TKA). MATERIALS AND METHODS: All patients who underwent TKA at our institute from January 2015 to March 2017 were eligible. There were 300 patients in the taurolidine irrigation group and 300 patients in the control group. The patients in the taurolidine irrigation group were irrigated after implantation with a mix of 250 mL of taurolidine and 750 mL of normal saline. The patients in the control group were not irrigated after implantation. We compared postoperative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and infection rate between groups. RESULTS: The taurolidine irrigation group had a significantly lower CRP (5.39 mg/dL vs. 7.55 mg/dL; p<0.001) and ESR (53.21 mm/hr vs. 58.74 mm/hr; p=0.003) on postoperative day 3 after TKA, as compared with the control group. However, there was no difference between the two groups on postoperative days 6, 13, and 20. Periprosthetic joint infection occurred in one patient in the taurolidine irrigation group. CONCLUSIONS: We believe that it is not necessary to use taurolidine for patients who undergo primary TKA.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Blood Sedimentation ; C-Reactive Protein ; Humans ; Joints ; Knee ; Peritonitis

PURPOSE: A randomized prospective study was conducted to compare the efficacy of early or late alternating schedules of radiotherapy, and carboplatin and ifosfamide chemotherapy in patients with limited-disease small cell lung cancer. MATERIALS AND METHODS: From August 1993 to August 1996, a total of 44 patients with newly diagnosed, limited-disease small cell lung cancer, PS H0~2, wt loss<10% were enrolled in a randomized trial which compared early alternating radiotherapy (RT)/chemotherapy (CT) and late alternating RT/CT. The CT regimen included ifosfamide 1.5 g/m(2) IV, d1-5 and carboplatin AUC 5/d IV, d2 performed at 4 week intervals for a total of 6 cycles. RT (54 Gy/30 fr) was started after the first cycle of CT (early arm, N=22) or after the third cycle of CT (late arm, N=22) with a split course of treatment. RESULTS: The pretreatment characteristics between the two arms were well balanced. The response rates in the early (86%) and late (85%) arm were similar. The median survival durations and 2-year survival rates were 15 months and 22.7% in the early arm, and 17 months and 14.9% in the late arm ( p=0.47 by the log-rank test). The two-year progression free survival rates were 19.1% in the early arm and 19.6% in the late arm ( p=0.52 by the log-rank test). Acute grade 3 or 4 hematologic and nonhematologic toxicities were similar between the two arms. Eighteen patients (82%) completed 6 cycles of CT in the early arm and 17 (77%) in the late arm. Four patients received less than 45 Gy of RT in the early arm and two in the late arm. There was no significant difference in the failure patterns. The local failure rate was 43% in the early arm and 45% in the late arm. The first site of failure was the brain in 24% of the early arm patients compared to 35% in the late arm (p=0.51). CONCLUSION: There were no statistical differences in the overall survival rate and the pattern of failure between the early and late alternating RT/CT in patients with limited-disease small cell lung cancer.
Appointments and Schedules ; Area Under Curve ; Arm ; Brain ; Carboplatin ; Disease-Free Survival ; Drug Therapy* ; Humans ; Ifosfamide ; Prospective Studies ; Radiotherapy ; Small Cell Lung Carcinoma* ; Survival Rate

No abstract available.
Breast Neoplasms* ; Breast*