Locally advanced cancer of the uterine cervix is a major cause of death worldwide. Standard treatment with rdiolherepy for locally advanced cancer of the uterine cnvix has a response rate of less than 50%. Resently concurrent chcmoradirothcrpay has been introduced but with some contvovesy. Interferon and retinoic acid are inducible proteins which posses many hiologic activities such as, antiproliferative, immunomodulatory and antineoplastic properties. Combination of interferon and retinoic acid has produced high response rates especially for patients with squamous cell carcinoma . And they may potentiate the radiation cytotoxicity as adiosensitizer. This study was underaken to assess the clinical efficacy of combination regimen with interferon-alpha2a, 13-cis-retinoic acid and radiotherapy from Dec. 1988 to Dex. 1994 at Severance hospital Yonsei uniersity. Twenty seven patients of locally advanced squamous cell carcionma of the uterine cervix enrolled in this study are evaluated for response and toxicity. The results were as follow: 1. Preliminary results of interferon-alpha2a 13-cis-retinoic acid and radiotherapy are 46.7% of response rate(33.3% complete response)and those of concurrent chemoradiotherapy are 41.7% of response rate(46.7% complete response). 2. Major toxicity of interferon-alpha2a, 13-cis-retinoic acid and radiotherapy is fever(60.0%), and only case of grade 2 anemia and one case of grade 1 AST/ALT elevation was noted. There was no grade 3 or 4 toxicity. Systemic interferon-alpha2a, 13-cis-retinoc acid and radiotherapy is highly active, well tolerated therapy for locally advanced cervical cancer.
Anemia ; Carcinoma, Squamous Cell* ; Cause of Death ; Cervix Uteri* ; Chemoradiotherapy ; Female ; Humans ; Interferons ; Isotretinoin* ; Radiotherapy* ; Tretinoin ; Uterine Cervical Neoplasms

Locally advanced cancer of the uterine cervix is a major cause of death worldwide. Standard treatment with rdiolherepy for locally advanced cancer of the uterine cnvix has a response rate of less than 50%. Resently concurrent chcmoradirothcrpay has been introduced but with some contvovesy. Interferon and retinoic acid are inducible proteins which posses many hiologic activities such as, antiproliferative, immunomodulatory and antineoplastic properties. Combination of interferon and retinoic acid has produced high response rates especially for patients with squamous cell carcinoma . And they may potentiate the radiation cytotoxicity as adiosensitizer. This study was underaken to assess the clinical efficacy of combination regimen with interferon-alpha2a, 13-cis-retinoic acid and radiotherapy from Dec. 1988 to Dex. 1994 at Severance hospital Yonsei uniersity. Twenty seven patients of locally advanced squamous cell carcionma of the uterine cervix enrolled in this study are evaluated for response and toxicity. The results were as follow: 1. Preliminary results of interferon-alpha2a 13-cis-retinoic acid and radiotherapy are 46.7% of response rate(33.3% complete response)and those of concurrent chemoradiotherapy are 41.7% of response rate(46.7% complete response). 2. Major toxicity of interferon-alpha2a, 13-cis-retinoic acid and radiotherapy is fever(60.0%), and only case of grade 2 anemia and one case of grade 1 AST/ALT elevation was noted. There was no grade 3 or 4 toxicity. Systemic interferon-alpha2a, 13-cis-retinoc acid and radiotherapy is highly active, well tolerated therapy for locally advanced cervical cancer.
Anemia ; Carcinoma, Squamous Cell* ; Cause of Death ; Cervix Uteri* ; Chemoradiotherapy ; Female ; Humans ; Interferons ; Isotretinoin* ; Radiotherapy* ; Tretinoin ; Uterine Cervical Neoplasms

No abstract available.
Apgar Score* ; Humans

BACKGROUND: The end-tidal carbon dioxide (ETCO2) is defined as a partial pressure of carbon dioxide at the end of an exhaled breath. And it has been found to correlate with cardiac output during cardiopulmonary resuscitation (CPR) in animal model. The purpose of this study is to determine that the assessment of ETCO2 could provide a highly sensitive predictor of return of spontaneous circulation (ROSC) during CPR. METHODS: Prospective, observational study was performed from Oct 1996 to Mar 1997 at the Severance hospital. All patients were endotracheally intubated and connected immediately to mainstream capnography sensor. We measured ETCO2 with Escort II model 20100 monitor(Medical Data Electronics, Inc, USA). It works on the principle of nondispersed infrared absorption with radiometric single beam optics. RESULTS: This study included 70 patients (52 were men) with a mean age of 54+/-15 years. ROSC was obtained in 43 patients. The initial ETCO2 averaged 15.5 +/-8.2 mmHg in survivors and 6.5+/-5.3 mmHg in nonsurvivors (p<0.01), and during the first 20 minutes of CPR, the maximal ETCO2 averaged 29.7+/-10.3 mmHg in survivors and 10.2+/-8.9 mmHg in nonsurvivors (p<0.01). ETCO2 was not significantly different in relation to initial rhythm, survival time after ROSC and possible cause of arrest. There is no cutoff value of ETCO2 satisfying greater than 90% of both sensitivity and specificity in predict ROSC. When maximal ETCO2 was less than 12 mmHg, we observed sensivity of 100% in predicting ROSC. CONCLUSION: Our results demonstrate that ETCO2 measurement represents a valuable, noninvasive, and clinical tool for monitoring patients during CPR.
Absorption ; Capnography ; Carbon Dioxide* ; Carbon* ; Cardiac Output ; Cardiopulmonary Resuscitation* ; Humans ; Models, Animal ; Observational Study ; Partial Pressure ; Prospective Studies ; Sensitivity and Specificity ; Survivors

To estimate the child and infant mortality rates among Korean children, a mortality survey was carried out in the province of Kyongsangnam,buk-do. The study population are the beneficiaries of Korea Medical Insurance Coorporation (KMIC), Kyongsangnam,buk-do area, among which the 3,867 and 1767 deaths occurred from January, 1989 to December, 1990 in Kyongsangnam-do area and from January, 1991 to December, 1991 in Kyongsangbuk-do area respectively. We reviewed the data to confirm the causes of death. These were based on the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey conducted along three steps. At first, the death certificates were examined, as a second step, medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 115 deaths were found under 20 years of age. Using them, age specific mortalities and causes of death were estimated. Mortality rate in this area was estimated 129 per 100,000 person-years during 1 month to 11 months of age, 67 during 1 year to 4 years of age, 23 during 5 years to 9 years of age, 10 during 10 years to 14 years of age, and 29 during 15 years to 19 years of age, respectively. And the frequent causes of death were congenital anomalies, central nervous system (CNS) diseases, certain condition originating from perinatal period during 1 months of age; accidents, congenital anomalies, malignancies, CNS diseases, and pneumonia or bronchiolitis during 1 to 4 years of age; accidents, malignancies, CNS diseases, and congenital anomalies during 5 to 14 years of age; and accidents, suicide, malignancies, and CNS diseases during 15 to 19 years of age.
Bronchiolitis ; Cause of Death ; Central Nervous System ; Central Nervous System Diseases ; Child ; Child Mortality* ; Child* ; Death Certificates ; Gyeongsangbuk-do ; Gyeongsangnam-do ; Humans ; Infant ; Infant Mortality ; Insurance ; Korea ; Mortality ; Pneumonia ; Suicide

BACKGROUND: Hyperkalemia is a common and potentially life-threatening metabolic disorder. The electrocardiogram(ECG) is known to be a relatively sensitive diagnostic tool hyperkalemia. However many exceptions, in which patients showed normal ECG findings even though hyperkalemic, have been reported. The purpose of this study was to determine the extent of correlation between the ECG findings and hyperkalemia and to determine when the ECG has value for diagnosing hyperkalemia. METHODS: Patients who had been diagnosed as having hyperkalemia at two university hospitals during three years were enrolled in this study. We reviewed the medical records of the patients and evaluated the following 6 ECG abnormalities: tall T waves, narrow T waves, QRS widening, atrioventricular block, loss of P waves, and sine waves. We defined tall T waves and narrow T waves as 20 percentiles of heights and widths of the T waves from the 100 patients with normokalemia. RESULTS: During the study period, there were 100 hyperkalemic patients, and we analyzed 69 available electrocardiograms. Abnormal ECG findings were revealed in 67% of 69 patients. The higher the serum potassium level, the more abnormal ECG findings. The common ECG abnormalities were tall T waves and loss of P waves. The patients with normal ECGs even though hyperkalemic had relatively low potassium levels. And whether chronic renal disease was not correlated to the ECG abnormality. CONCLUSION: The electrocardiogram is a good diagnostic tool for hyperkalemia if it is used with accurate diagnostic criteria. Thus, hyperkalemia should be considered when the ECG shows tall T waves or loss of P waves.
Atrioventricular Block ; Electrocardiography* ; Hospitals, University ; Humans ; Hyperkalemia* ; Medical Records ; Potassium ; Renal Insufficiency, Chronic