Our experience with 150 patients with congestive heart failure has been reviewed with particular reference to physical and laboratory findings on admission, precipitating factors and diagnostic clues. Congestive heart failure has been defined as that heart failure due to myocardial failure (primary or secondary). (1) Congestive heart failure was found in 3.65% of total medical admissions and in 24.0% of total cardiovascular patients. There was no difference between two sexes and incidence was peak in the 6th decade. (2) Rheumatic heart disease was the most common cause of congestive heart failure (41.0%). Hypertensive and/or atherosclerotic heart disease (36.5%), cor pulmonary (6.6%), postpartum heart failure (5.3%), pericardial disease (3.6%), thyrotoxic heart disease (2.0%) and congenital heart disease (0.6%) were the etiologies of the remainder. In male hypertensive and/or atherosclerotic heart disease was most common cause of congestive heart failure. (3) The precipitating factors of congestive heart failure were found in 31% and infection, pregnancy, discontinuation of digitalis and physical exertion were major causes. (4) Dyspnea, cervical vein distension, pulmonary rale, hepatomegaly and cardiac murmur were important symptoms and signs on admission. (5) Peripheral venous pressure was elevated in 883.2% and circulation time was prolonged in 90.9%. (6) Leucocytosis (39.8%) albuminuria (60.2%), elevated GOT (serum glntamin oxaloacetic transaminase) (12.0%) and azotemia (50%) were observed. (7) Chest X-ray on admission revealed increased vascularity including pulmonary edema (88.8%), cardiomegaly (83.3%) and hydrothorax (27.1%). (8) Electrocardiographic findings was abnormal in 99.4% and left ventricular hypertnophy (45.7%), atrial fibrillation (27.3%), Right ventricular hypertrophy and low voltage were frequently observed.
Albuminuria ; Atrial Fibrillation ; Azotemia ; Cardiomegaly ; Digitalis ; Dyspnea ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart Defects, Congenital ; Heart Diseases ; Heart Failure* ; Heart Murmurs ; Hepatomegaly ; Humans ; Hydrothorax ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Physical Exertion ; Postpartum Period ; Precipitating Factors ; Pregnancy ; Pulmonary Edema ; Respiratory Sounds ; Rheumatic Heart Disease ; Thorax ; Veins ; Venous Pressure

A clinical observation of 30 cases of pyogenic abscess and 18 cases of tuberculous abscess in the metaphysis of long bones during the past 15 years was carried out and following results were obtained. 1. The highest age incidence was the second decade (53.3%) in pyogenic abscess and the first decade (44.4%) in tuberculous abscess. 2. Average duration of symptoms were 1.6 years in pyogenic abscess and 2.3 years in tuberculous abscess. 3. Chief complaint on admission was pain both in pyogenic abscess (56.7%) and in tuberculous abscess (27.8%). 4. The tibia was the most common site in pyogenic abscess and the femur in tuberculous abscess. 5. Leucocyte count was increased more than 15, 000/mm in 23.3% of pyogenic abscess and 22. 2% of tuberculous abscess. 6. Erythrocyte sedimentation rate was increased more than 21mm/hr in 60.0% of pyogenic abscess and in 44.4% of tuberculous abecess. 7. Epiphysis was involved in 23.3% of pyogenic abscess and 38.9% of tuberculous abscess. 8. The positive result on bacteriologic culture was 46.7% in pyogenic abscess and 22.2% in tuberculous abscess. Coagulase positive staphylococcus aureus was cultured in 12 cases and other organisms were cultured in 2 cases. 9. Differential diagnosis between pyogenic, tuberculous abscess, and cystic tumors was not easy in many cases. Preoperatively, 5 cases of pyogenic abscess were misdiagnosed as tuberculosis and 2 cases as osteod osteoid osteoma. 3 cases of tuberculous abscess were misdiagnosed as pyogenics and 1 case as giant cell tumor. 10. Various methods of surgery including saucerization, curettage and bone graft, resection of bony focus, and arthrodesis were carried out. There was no difference in the end result between them. 11. Shortening or deformity due to epiphyseal plate damage was occurred in 3 cases (10.0%) in pyogenic abscess and 4 cases (22.2%) in tuberculous abscess. Those complications could be minimized with meticulous surgery not damaging the epiphyseal plate.
Abscess ; Arthrodesis ; Blood Sedimentation ; Coagulase ; Congenital Abnormalities ; Curettage ; Diagnosis, Differential ; Epiphyses ; Femur ; Giant Cell Tumors ; Growth Plate ; Incidence ; Osteoma, Osteoid ; Staphylococcus aureus ; Tibia ; Transplants ; Tuberculosis

One hundred patients with 119 curves with idiopathic scoliosis, age ranged from 2 to 32 years, were-treated at Seoul National University Hospital from 1968 to 1979. Of 100 patients, 63 were adolescent type, 20 juvenile, and 17 infantile. The distribution of curve-patterns was 49 right thoracic, 19 double major (Rt. thoracic & Lt. lumbar), 18 left thoracic, 12 thoracolumbar, and 2 left lumbar. Of these patients, 67 with 83 curves were treated with Milwaukee-brace for one to seven years with an average of three and one-half years. Seven patients were treated surgically because of a poor response to the brace or progression of the curve.Sixteen patients with 20 curves followed for average 4. 6 years after the completion of brace treatment showed some loss of correction: 2.8 degrees for thoracolumbar, 3.1 degrees for thoracic, 4.2 degrees for lumbar segments and 4, 9 degrees for thoracic segments of double major curves. The brace was more effective for curves with 6 to 9 involved vertebrae and of less than 40 degrees. Thirty three patients with 36 curves were treated with Harrington instrumentation and posterior spinal fusion and followed from 1 to 12 years with an average of six and one-half years. The initial preoperative curves ranged from 50 to 120 degrees with an average of 75.3 degrees. Immediate postoperative correction ranged from 30 to 70 degrees with an average of 36. 2 degrees (48.1%). The average loss of correction at follow-up was 1.5 degrees (2.8%) for curves of less than 60degrees and 1.4 degrees (1.3%) for those of more than 101 degrees. Varioua methods of preoperative correction were applied. Halofemoral traction was applied for rigid and severe curve in 9 patients, Cotrel traction for less rigid one in 11 patients, Risser localizer cast for flexible one in 9 patients, and no preoperative correction for mild and flexible one in 4 patients.
Adolescent ; Braces ; Follow-Up Studies ; Humans ; Scoliosis ; Seoul ; Spinal Fusion ; Spine ; Traction

Uterine cervical cancer is the most common malignancy in Korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications cannot be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analyzed to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that out treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.
Adenocarcinoma ; Drug Therapy ; Female ; Humans ; Radiotherapy* ; Rectovaginal Fistula ; Recurrence ; Uterine Cervical Neoplasms*

Scatter-air ratios are used for the purpose of calculating scattered dose in the medium. The computation of the primary and the scattered dose separately is particularly useful in the dosimetry of irregular fields with shielding block in radiation field, dose distribution of scattered radiation using 18MeV Linear accelerator and Co-60 teletherapy measured. The effect of scattered radiation dose by protecting block was been ignored in radiation therapy, 2-3% of scattered radiation may be 90-200cGy which could be influence vital complication such as cataract, oligospermia or sterility. So that exact calculate scattered radiation by protecting block exactly for irregular field c small protection of vital organ is very important. The purpose of this article is to calculate scattered radiation by protecting block exactly for irregular field c Linac or Co-60 irradiation and to applicate these data in clinical radiation field. Authors could obtain following results. 1. The lesser angle between shielding block showed more scattered radiation. 2. With decreasing distance between shielding blocks, the dependent of scattered radiation were increased. 3. Output of 18 MeV Linear accelerator and Co-60 was related linear proportion on field size, but independent according to the size of shielding block in 18 MeV Linear accelerator.
Cataract ; Infertility ; Male ; Oligospermia ; Particle Accelerators

The basic strategy of irradiation is to deliver a dose to the cancer that is high enough to make cancer cells incapable of reproduction, while keeping the doses to the various healthy tissues below tolerable levels. In order to improve local control and survival, as a boost therapy after external radiotherapy, high dose rate transcatheteric irradiation using remote control after loading system (RALSTRON-20B) was used for twelve patients with head and neck cancers. Present results showed complete remission of cancer in 9 out of 112 patients without treatment related complications. Although this procedure is easy to operate, well trained skillful hand in essential for good results. Furthermore out experience suggested that meticulous treatment planning should be developed for better results.
Hand ; Head and Neck Neoplasms* ; Head* ; Humans ; Neck ; Radiotherapy ; Reproduction

Bone metastases represent an important and frequent clinical problem in patients with advanced cancers. Especially, painful bone metastases are common features in these patients. Radiotherapy is an effective tool for palliative aim of painful metastatic osseous lesions. Various treatment results have been previously reported. The present retrospective study was aimed to evaluate the efficacy of palliative irradiation on pain relief, with the goal of selecting appropriate irradiation dose schedule. Radiotherapy consisted of 5 times a week with a various fractional dose between 180 and 400cGy. The response of pain relief and the survival time after completion of radiotherapy are related to total dose and most of the patients have shown a similar response by the end of radiotherapy. The higher dose and the more aggressive multimodality treatment, the better pain control and the longer survival time.
Appointments and Schedules ; Humans ; Neoplasm Metastasis* ; Radiotherapy ; Retrospective Studies

We experienced a case of pedunculated left atrial primary fibrosarcoma, which obstructed the mitral orifice and produced symptoms and manifestations of mitral stenosis clinically. There was no evidence of metastasis to adjacent tissue or distant organs. It was treated by open heart surgery.
Fibrosarcoma* ; Heart Atria* ; Mitral Valve Stenosis ; Neoplasm Metastasis ; Thoracic Surgery

The object of this study was to determine the difference of radiation effect in different fractional does and to establish optimal fractionation schedule on the whole-abdominal X-ray irradiation. Total 160 mice were irradiated with 150 KVP, 15 mA orthovoltage x-ray machine and two different fractionation (100 cGy/Fr. and 200 cGy/Fr.) were used. Body weight, hemoglobin and WBC count with differential count were analyzed according to the same amount of total dose, same field size and two different fractionation schedules. The results of this study were summarized s follows: There was no significant difference in body weight and hemoglobin concentration by sex or fractional dose. Leukopenic change was prominent in the 3,000 cGy irradiation group and the proportion of decrease was remarkable in the 200 cGy/Fr. Group than 100 cGy/Fr. Group. Progressive decrease of lymphocyte count and reciprocal increase of neutrophil count were noted as dose increment. The effect of the fractional does on WBC count and proportion of lymphocyte were significant. This suggests that judicious selection of fractional dose may be important in clinical radiotherapeutic practice.
Animals ; Appointments and Schedules ; Body Weight* ; Lymphocyte Count ; Lymphocytes ; Mice* ; Neutrophils ; Radiation Effects*

Since discovery of X-rays, radiotherapy has evolved into one of the most scientific branches of medicine and has established its role as the primary line or the secondary line of attack, after surgery,. in the treatment of malignant cancers. Nowadays its importance is illustrated by the fact that as many as 70 per cent of all pastients with cancer will receive radiation therapy at sometime during their disease process. Biologic effects-of X-rays began to be apparant soon after the discovery by Roentgen in 1895. In clinical radiotherapy, the biologic endpoint of most importance is loss of cellular reproductive ability or clonogenicity. One of the commonest ;nays to assess cell survival is to use an in vitro plating assay. We analyzed radiation effect on colony formation of HaLa. S3(SC) cell line and obtained results are as follows The plating efficiency is 0.464. The shape of cell survival curve is similar to multi-target plus single hit component model. Estimated values of Do, Dq, and extrapolation number are 150 cGy, 80 cGy and 1.7 respectively. We reported these experimental data with review of literature.
Cell Line* ; Cell Survival ; Radiation Effects ; Radiotherapy