CT scans of 23 patients with gallbladder carcinoma were retropectively reviewed to determine the incidence of lymphatic spread and to access the pattern of regional lymph node metastases. The lymphatic spread were noted in 74%(17/23). The involved patterns of regional lymph node metastases were nodes of porta hepatis 65%, portocaval nodes 41%, superior pancreaticoduodenal nodes 47%, posterior pancreaticoduodenal nodes 59%, nodes around the celiac trunk 35%, nodes around the superior mesenteric artery 29% and paraaortic nodes 35%. The findings suggested that the pattern of regional lumph node metastases in gallbladder carcinoma occurred along the normal lymphatic pathway of the gallbladder.
Gallbladder* ; Humans ; Incidence ; Lymph Nodes* ; Mesenteric Artery, Superior ; Neoplasm Metastasis* ; Tomography, X-Ray Computed*

CT scans of 23 patients with gallbladder carcinoma were retropectively reviewed to determine the incidence of lymphatic spread and to access the pattern of regional lymph node metastases. The lymphatic spread were noted in 74%(17/23). The involved patterns of regional lymph node metastases were nodes of porta hepatis 65%, portocaval nodes 41%, superior pancreaticoduodenal nodes 47%, posterior pancreaticoduodenal nodes 59%, nodes around the celiac trunk 35%, nodes around the superior mesenteric artery 29% and paraaortic nodes 35%. The findings suggested that the pattern of regional lumph node metastases in gallbladder carcinoma occurred along the normal lymphatic pathway of the gallbladder.
Gallbladder* ; Humans ; Incidence ; Lymph Nodes* ; Mesenteric Artery, Superior ; Neoplasm Metastasis* ; Tomography, X-Ray Computed*

A case of intracerebral tension pneumatocele as a complication of an Osteoma in the Fronto-ethmoid sinus is reported. The commonest causes of intracranial air are head trauma and neurosurgical procedures. Less common etiologies include infection due to gas-forming organisms, mucoceles, tumors(e.g. osteomas carcinomas pituitary adenomas peripheral nerue tumors) and congenital neurenteric cysts or dural defects. Computed tomography permitted rapid diagnosis including localization of the air thus facilitating prompt treatment.
Craniocerebral Trauma ; Diagnosis ; Mucocele ; Neural Tube Defects ; Neurosurgical Procedures ; Osteoma* ; Pituitary Neoplasms

We have studied 1927 cases of primary tumor patients, who were admitted, managed and registered at Cancer Center of Maryknoll Hospital from Nov. 1985 to Jun. 1988. Of these, 50 cases were metastasized to central nervous systems, and the cases of brain metastases were 31 cases. This report presents an analysis of 31 cases of metastatic brain tumors. The results are as followings: 1) The sexes were represented with 20 males and 11 females. In 20 cases(65%), the metastases occurred between the 6th decade and 7th decade. 2) The most frequent anatomical site of brain metastases was brain parenchyme(67.7%). 3) The most frequent site of primary malignancy was lung(45.2%), and the next order was choriocarcinoma of the uterus. 4) The clinical symptoms and signs of metastatic brain tumors were headache(87%), nausea, vomiting(35.5%) orderly. 5) In C-T scan findings, the metastatic brain tumors presented hyperdense area at 50% of cases before contrast enhancement, and were enhanced nearly almost of cases. 6) In cases which could be treated surgical procedure, radiation and chemotherapy seemed to improve the prognosis.
Brain Neoplasms* ; Brain* ; Central Nervous System ; Choriocarcinoma ; Drug Therapy ; Female ; Humans ; Male ; Nausea ; Neoplasm Metastasis ; Pregnancy ; Prognosis ; Uterus

This study was performed to evaluate the semiquantitative food frequency questionnaire used to obtain information about. dietary patterns of adults in a rural county, Yang-pyeung Gun. The study population was 1311 adults aged 17~85 years. And well-trained interviewers interviewed subjects in 1990, 1992, 1993. The results are as follows. 1) Nutrients intake calculated from each questionnaire showed significant difference, because the number of question was not same(fifty questions in 1990, eighty questions in 1992, 1993). 2) Estimated nutrients intake from separate food items was significantly different when food items are combined in one question. 3) The agreement of nutrients intake level except vit C were high when the subjects are cross-classified by their ranks on the nutrients intake level from items in both questionnaires and on the nutrient intake level from items in each questionnaire. 4) And analysing this study data by multiple stepwise regression, we selected twenty seven food items whic could explained over 85% of inter-individual variation of nutrients(energy, carbohydrate, fat, protein, vit A, vit B1, vit B2, vit C, Ca). From above results, we suggested that it is neccessary to standardize questionnaire and perform validity studies.
Adult ; Humans ; Korea* ; Rural Population* ; Surveys and Questionnaires

BACKGROUND: Measurement of the FEV1 and PEFR in COPD patients is a significant indicator of the disease severity , the response to treatment and the acute exacerbation. However, it is not known if PEFR can be used to determine the severity of COPD because the agreement between PEFR and FEV1 in COPD patients is not well known. METHODS: From September, 2003 to August, 2004, 125 out patients with COPD who were treated at the pulmonary clinic in KonKuk University Hospital were enrolled in this study. The FEV1 and PEFR of each patient were measured and all the data was analyzed using SPSS. RESULTS: The average predicted FEV1 % and PEFR % was 56.98 +/- 18.21% and 70 +/- 27.60%, respectively. There was linear correlation between the predicted FEV1 % and predicted PEFR %. There was no correlation between age of the COPD patients and the predicted PEFR %. There was correlation between dyspnea, which is a subjective symptom of the patients, and the predicted PEFR %. CONCLUSION: In COPD patients, the classification of the severity by PEFR tends to underestimate the state of the disease compared with the classification of the severity by the FEV1. Therefore, the classification of the severity by PEFR should be interpreted carefully in patients with severe symptoms. Once the classification of the severity has made, the follow-up examination may use the PEFR instead of the FEV1.
Classification* ; Dyspnea ; Follow-Up Studies ; Humans ; Outpatients ; Peak Expiratory Flow Rate* ; Pulmonary Disease, Chronic Obstructive*

BACKGROUND: The p53 and retinoblastoma(Rb) tumor suppressor genes are associated with the pathogenesis of several types of human cancer. Substantial. proportion of the primary lung cancers or cell lines have been reported to have the p53 and/or the Rb gene mutations. But so far there is no report on the analysis of the Rb gene polymorphism as one of the genetic susceptibility marker. This study was undertaken to establish the gene frequencies of the polymorphic genotypes of the p53 and Rb genes in Koreans to evaluate the possible involvement of these genotypes as a risk factor of lung cancer. METHODS: In this study 145 controls without previous and present tumor history and 128 lung cancer patients were subjected to analysis The two intragenic polymorphisms of the p53 gene(exon 4/AccII, intron 6/MspI) and one intron 17/XbaI polymorphism of the Rb gene were analysed by the method of polymersae chain react lion-restriction fragment length polymorphisms(PCR-RFLPS). The genotype of the intron 3/16 bp repeat polymorphism of p53 was determined by PCR and direct gel electrophoresis. RESULTS: There were no significant differences in the genotype distributions of the p53 gene between lung cart cert patients and controls. But heterozygotes(Arg/Pro) of the exon 4/AcclII polymorphisms were slightly over-represented than controls, especially in the Kreyberg type I cancer, which was known 13 be associated with smoking. The intron 3/16 bp duplication and the intron 6/MspI polymorphisms were in complete linkage disequilibrium. About 95% of the individuals were homozygotes of the common alleles both in the 16 duplication and MspI polymorphisms, and no differences were deteced in the genotype distributions between lung cancer patients and controls. Overall genotype distributions of the Rb gene polymorphisms between lung cancer patients and controls were not significantly different However, the genotype distributions in the Kreyberg type I cancer were significantly different from those of controls(p=0.0297) or adenocarcinomas(p=0.0008). It was noticeable that 73.4% of the patients with adenocarcinomas were heterozygotes(r1/r2) whereas 39.2% of the Kreyberg type I cancer were heterozygous at this polymorphisms. In the lung cancer patients, significant differences were a]so noted between the high dose smokers and low dose smokers including non-smokers(p=0.0258). The relative risk to Kreyberg type I cancer was significantly reduced in the individuals with the genotype of r1/r2(odds ratio=0.46, 95%C.I.=0.25-0.86, p=0.0124). The combined genotype distribution of the exon 4/AccII of the p53 and the intron 17 Rb gene polymorphisms in Kreyberg type I cancers were significantly different from dose of controls or adenocarcinomas. The highest odds ratio were observed in the individuals with the genotypes of Arg/pro and r2/r2(odds ratio=1.97, 95%C.I.=0.84-4.59) and lowest one was in the patients with Arg/Arg, r1/r2 genotype(odds ratio=0.54, 95%C.I.=0.25-1.14). CONCLUSION: The p53 and the Rb gene polymorphisms modulate the risk of smoking induced lung cancer development in Koreans. However, the exact mechanism of risk modulation by these polymorphism remains to be determined. For more discrete clarification of associations between specific genotypes and lung cancer risk, the evaluations of these polymorphisms in other ethnics and more number of patients will be needed.
Adenocarcinoma ; Alleles ; Cell Line ; Electrophoresis ; Exons ; Gene Frequency ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Genetic Predisposition to Disease ; Genotype ; Homozygote ; Humans ; Introns ; Linkage Disequilibrium ; Lung Neoplasms* ; Lung* ; Odds Ratio ; Polymerase Chain Reaction ; Risk Factors ; Smoke ; Smoking

OBJECTIVE: An adjustable Ghajar guide is presented to improve the accuracy of the original Ghajar guide technique. The accuracy of the adjustable Ghajar guide technique is also investigated. METHODS: The coronal adjustment angle from the orthogonal catheter trajectory at Kocher's point is determined based on coronal head images using an electronic picture archiving and communication system. For the adjustable Ghajar guide, a protractor is mounted on a C-shaped basal plate that is placed in contact with the margin of a burrhole, keeping the central 0° line of the protractor orthogonal to the calvarial surface. A catheter guide, which is moved along the protractor and fixed at the pre-determined adjustment angle, is then used to guide the ventricular catheter into the frontal horn adjacent to the foramen of Monro. The adjustable Ghajar guide technique was applied to 20 patients, while a freehand technique based on the surface anatomy of the head was applied to another 47 patients. The accuracy of the ventricular catheter placement was then evaluated using postoperative computed tomography scans. RESULTS: For the adjustable Ghajar guide technique (AGT) patients, the bicaudate index ranged from 0.23 to 0.33 (mean±standard deviation [SD]: 0.27±0.03) and the adjustment angle ranged from 0° to 10° (mean±SD: 5.2°±3.2°). All the AGT patients experienced successful cerebrospinal fluid diversion with only one pass of the catheter. Optimal placement of the ventricular catheter in the ipsilateral frontal horn approximating the foramen of Monro (grade 1) was achieved in 19 patients (95.0%), while a suboptimal trajectory into a lateral corner of the frontal horn passing along a lateral wall of the frontal horn (grade 3) occurred in 1 patient (5.0%). Thus, the AGT patients experienced a significantly higher incidence of optimal catheter placement than the freehand catheterized patients (95.0% vs. 68.3%, p=0.024). Moreover, none of the AGT patients experienced any tract hemorrhages along the catheter or procedure-related complications. CONCLUSION: The proposed adjustable Ghajar guide technique, using angular adjustment in the coronal plane from the orthogonal trajectory at Kocher’s point, facilitates accurate freehand placement of a ventricular catheter for hydrocephalic patients.
Animals ; Catheterization ; Catheters* ; Cerebral Ventricles ; Cerebrospinal Fluid ; Head ; Hemorrhage ; Horns ; Humans ; Hydrocephalus ; Incidence ; Pilot Projects* ; Ventriculoperitoneal Shunt

OBJECTIVES: To find differences in Framingham risk scores which predict the probable risk of future cardiovascular disease, among three different occupational categories. METHODS: Subjects were selected from respondents of the 3rd Korean National Health and Nutrition Examination Survey. A total of 2,059 employed people between 20 to 59 years old were selected. The occupational categories were professional and office workers, salespeople and service workers and technicians and elementary occupations. The Framingham risk score was calculated to find the risk of cardiovascular disease within the next 10 years. In addition socio-demographic characteristics, life-styles, the prevalence of chronic disease, and cardiovascular disease were compared among the occupational categories. RESULTS: The average Framingham risk score was 2.77+/-6.44 for professional and office workers (n=771), 5.95+/-6.10 for salespeople and service workers (n=603) and 7.07+/-5.87 for technician and elementary occupations (n=685) Statistically significant multiple regression equations were derived (p<0.001). CONCLUSIONS: Framingham risk scores of technicians and elementary occupations were highest which suggests that this occupational group has the highest risk of cardiovascular disease.
Cardiovascular Diseases ; Chronic Disease ; Data Collection ; Humans ; Nutrition Surveys ; Occupational Groups ; Occupations ; Prevalence