The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system (RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.
Cause of Death ; Humans ; Nasopharyngeal Neoplasms ; Nasopharynx ; Neck ; Radiotherapy ; Recurrence

From April 1986 to Dec. 1988, fifty one patients with carcinoma of lung were treated by radiation therapy in Department of Therapeutic Radiology, Yeungnam University Hospial. Of the 51 patients, 31(61%) were squamous cell ca, 8(15.7%) were small cell ca, and remained 4(7.9%) were other cell types. Total radiation dose was average 64 Gy (60~75 Gy) for group A and 45 Gy (40~59 Gy) for group B. The mass regression and the response of airway obstruction to radiation therapy was established on the basis of follow up chest X-ray. The mass regression above 50% of total volume was noted in 23 patients (74.2%) among 31 patients and the difference between two groups was not seen. In squamous cell ca, however, the mass regression rate(above 50% of total volume) was 83.3%(10/12) in group A compared to 50%(3/6) in group B(p<0.05). The alleviation of airway obstruction was noted as follows. In group A, CR 42.9%, PR 35.7%, no response 21.4% and in group B, CR 55.6%, PR 33.3%, no response 11.1%. But, in squamous cell ca, responsiveness is higher than group B. The study indicates that the importance of higher radiation dose in the management of primary tumor mass and airway obstruction caused by lung cancer especially squamous cell ca. So, meticulous treatment plaining and multimodality combination therapy without increasing side effect or complication is recommended in management of inoperable bronchogenic carcinoma.
Airway Obstruction* ; Carcinoma, Bronchogenic ; Follow-Up Studies ; Humans ; Lung Neoplasms* ; Lung* ; Radiation Oncology ; Radiotherapy ; Thorax

BACKGROUND: Although the pro-convulsant or anticonvulsant properties of propofol remain a matter of controversy, it is evident that propofol can produce involuntary movement. Such movement is a relatively common side effect, especially in children, and may be dose-related or injection rate-related. The goal of this study was to evaluate the effect of injection rate upon involuntary movement during propofol induction in children. METHODS: Children (age 3-14 yr) undergoing elective Eye and ENT surgery were randomly allocated to one of 4 groups based on the propofol injection rate (A, manual/15 s; B, 360 ml/hr; C, 200 ml/hr, D, 100 ml/hr) using a manual injection method and syringe pumps. No premedication was used. The induction dosage of propofol was 3 mg/kg in all groups. Fentanyl 1mcg/kg and 1% lidocaine 1-2ml were given I.V. before propofol. Involuntary movement was graded 0-2 on severity. The infused dose of propofol at movement was measured. Movement due to pain or mask fitting was not regarded as an involuntary movement. All results were analyzed using the Chi-Square Test and ANOVA. RESULTS: 595 children were studied. Age, gender, and weight were similar in the 4 groups. Involuntary movements were apparent in 179 (30.1%) of the 595 subjects. Movements were significantly less in group A (12.4%) and B (16.4%) compared to group C (46.6%) and D (45.3%). The grades of movement were not different among the 4 groups. The durations of movement in group A and B were significantly short compared to group C and D. The infused dose of propofol (mg/kg) at movement was higher in group C (2.65+/-0.62) than in A (1.99+/-0.62) and B (2.43+/-0.78). There were no significant hemodynamic and SPO2 changes during and after the propofol injection. CONCLUSIONS: We concluded that slow injection may increase the incidence of involuntary movement during propofol induction in children. Since the bolus injection rates are usually slow in most syringe pumps, manual injection for 10 15 s may be a better choice for smoother induction, as it requires fewer interventions to prevent venous catheter displacement in children.
Catheters ; Child* ; Dyskinesias* ; Fentanyl ; Hemodynamics ; Humans ; Incidence ; Lidocaine ; Masks ; Premedication ; Propofol* ; Syringes

The acute effects of variable dos rates to total body irradiation (TBI) were investigated with 600 cgy of single exposure in the mice as a preclinical model. Total 80 mice (ICR) were used. Twenty of which served as controls, receiving no irradiation. All irradiated mice showed a universal decline in their weight and white blood cell count. The degree of weight loss and leukopenia were similar at 3 different dos rate but slightly prominent with 15 cgy/minute group. The degree of recovery among the groups showed no dose rate dependence. Our results suggest that TBI with 15 cgy/minute may be applicable for clinical therapy with careful evaluation of patient's condition.
Animals ; Leukocyte Count ; Leukopenia ; Mice* ; Weight Loss ; Whole-Body Irradiation*

Verrucous carcinoma is a rare, low-grade, well-differentiated variant of squamous cell carcinoma. It occurs mainly on the soles, but has also been reported in other locations, including the buttocks, hand, anus, and genitalia. A 38-year-old woman presented with an asymptomatic skin lesion of the nipple. She first noticed the lesion three months prior. A solitary, cauliflower-shaped, black polypoid mass was observed on her right nipple.Histopathological examination revealed a superficial lesion resembling verruca vulgaris. It was composed of relatively well-differentiated cells with severe epidermal proliferation, and some tumor cells were observed in the dermis. The final diagnosis was verrucous carcinoma. Complete excision of all the lesions was performed. The patient had no recurrence. We report an interesting case of verrucous carcinoma that occurred at a relatively rare site; only one previous report of verrucous carcinoma associated with the breast or nipple was found.

Verrucous carcinoma is a rare, low-grade, well-differentiated variant of squamous cell carcinoma. It occurs mainly on the soles, but has also been reported in other locations, including the buttocks, hand, anus, and genitalia. A 38-year-old woman presented with an asymptomatic skin lesion of the nipple. She first noticed the lesion three months prior. A solitary, cauliflower-shaped, black polypoid mass was observed on her right nipple.Histopathological examination revealed a superficial lesion resembling verruca vulgaris. It was composed of relatively well-differentiated cells with severe epidermal proliferation, and some tumor cells were observed in the dermis. The final diagnosis was verrucous carcinoma. Complete excision of all the lesions was performed. The patient had no recurrence. We report an interesting case of verrucous carcinoma that occurred at a relatively rare site; only one previous report of verrucous carcinoma associated with the breast or nipple was found.

Erythema multiforme (EM) is an acute, self-limited mucocutaneous disease with diverse triggering factors, and the recurrences are quite common. A 24-year old male presented with multiple erythematous, itchy papules and plaques on multiple sites. He has worked in a lithium battery factory and experienced the chemical burn 2 weeks ago. A histopathologic examination on right wrist showed a scattered lymphocytic infiltration, vacuolar degeneration, and necrotic keratinocyte. The final diagnosis was EM after occupational lithium exposure. He was treated by oral methylprednisolone and experienced recurrences after returning to the same workplace after remission. Although the precise pathogenesis is unknown, the pathogenesis of EM by lithium is related to the effect of lithium on immune system, different from other etiologies. To our knowledge, our case is the first report of EM following the chemical burn and occupational lithium exposure. We report this as an interesting case of EM.

Lichen nitidus is an uncommon, asymptomatic cutaneous eruption. There are many reports of variable subtype of lichen nitidus including of spinous, follicular, vesicular, hemorrhagic, actinic, purpuric, and perforating lichen nitidus. We report a 7-year-old boy who presented with multiple generalized papular eruption that was composed of discrete, flesh colored, 1-2mm sized, glistening, and round shaped papules. The histopathology of the biopsied specimen showed a well-circumscribed dermal infiltrate mainly composed of histiocytes. The overlying epidermis showed atrophy, thinning of granular layer and liquifaction degeneration of basal layer. Transepidermal perforation was observed and eosinophilic amorphous debris was in the channel of the perforation.
Actins ; Atrophy ; Child ; Eosinophils ; Epidermis ; Histiocytes ; Humans ; Lichen Nitidus* ; Lichens* ; Male

BACKGROUND: It has been reported that the phototherapy with blue light (415 nm) or a mixed blue and red light (415 nm and 660 nm) is effective in the treatment of acne vulgaris. however, the effects of red light on acne vulgaris have not been investigated. OBJECT: To examine the effects of red light (680 nm) on patients with moderate acne vulgaris. METHODS: Patients treated their skin by themselves, using portable light source (680 nm), and irradiation was performed for 7 minute twice daily. Each patient was evaluated every 2 weeks with Burton scale and the numbers of papules and pustules. After 6 weeks, the degrees of satisfaction of patients and physicians were assessed. RESULT: Therapy with red light significantly decreased the numbers of papules and pustules (p<0.01). The numbers of satisfied patients and physicians at the end of treatment were 59 (83.1%) and 56 (78.9%) respectively. Side effect was not reported, except only one patient complained of headache. CONCLUSION: Phototherapy with red light (680 nm) was effective and safe treatment for patients with acne vulgaris.
Acne Vulgaris* ; Headache ; Humans ; Phototherapy* ; Skin

Chronic neutrophilic leukemia(CNL) is a rare disorder characterized by persistent neutrophilia of mature cell type without evidence of infection, hepatosplenomegaly, elevated neutrophil alkaline phosphatase score and the absence of Philadelphia chromosome We report a typical case of CNL with multiple myeloma(IgG-lambda type) in 68 years old female. Many neutrophils had toxic granule and vacuole. The peripheral blood smear showed neutrophlic leukocytosis(50,940/microliter, neutrophil 94%) with rare immature form. The cytogenetic study showed normal karyotype without Philadelphia chromosome. She was diagnosed as multiple myeloma with paraproteinemia, lytic bone lesion of skull, and immature plasma cells in bone marrow.
Aged ; Alkaline Phosphatase ; Bone Marrow ; Cytogenetics ; Female ; Humans ; Karyotype ; Leukemia, Neutrophilic, Chronic* ; Multiple Myeloma* ; Neutrophils ; Paraproteinemias ; Philadelphia Chromosome ; Plasma Cells ; Skull ; Vacuoles