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

In electron therapy, low melting point alloy is used for shaping of the field. Electron field shaping material affect the output factor as well as the collimator system. The output factors of electron beams for shaped fields from NELAC-1018 were measured using ionization chamber of Farmer type in water phantom. The output factors of electron beams depend on the incident energy, inherent collimator system and the size of shaped field. Obtained results were followings. 1. In the smaller applicator, output varied extremely according to extent of collimator opening. 2. The higher energy, the output is less varied according to treatment field at small field.
Alloys ; Farmers ; Freezing ; Water

The stereotactic radiosurgery using ionizing radiation of high energy is a technique for exadicating intracranial small tumors, which are inaccessible or unsuitable for open surgical technique. For such a small field radiosurgery, TLD or film dosimetry is essential. The three dimensional dose planning of radiosurgery was performed with dose planning computer system (Therac 2300). The target dose distribution and its error according to patient position were discussed. And were measured of circular cone which specially designed in our Hospital. The position error of Rando Phantom compared with CT were 0.4 mm in the AP-LAT section and in the AP-VERT section, 1.0 mm in the AP-VERT 45°section. The ratio of accuracy of the gantry and couch rotation were 1.5 mm diameter for central axis of 18MeV linear accelerator. Our study suggested that radiosurgery of small field in out department will be appropriate for clinical application.
Computer Systems ; Film Dosimetry ; Humans ; Particle Accelerators ; Radiation, Ionizing ; Radiosurgery*

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*

Total 21 patients with airway obstruction from lung cancer treated with radiotherapy at Department of Therapeuctic Radiology, Yeungnam University College of Medicine, between April 1986 and December 1988 are retrospectively analyzed by means of roentgenologic findings. Obtained results are as follows. 1. 15 out of 21 patients (71%) showed complete or partial response. 2. Patients with small cell lung cancer showed 100% response in spite of low dose (30 GY/10 fractions.) 3. Patients with non-small cell lung cancer treated with 50 GY or over showed better response than below 45 GY or below. 4. There is no relationship between the response and site of airway obstruction. These date suggested that high dose irradiation is more effective in the management of airway obstruction from lung cancer and meticulous radiotherapy planning with appropriate protection of normal lung and critical organs should be investigated in order to maximize radiation effect and minimize side effect, complication or sequelae.
Airway Obstruction* ; Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Neoplasms* ; Lung* ; Radiation Effects* ; Radiotherapy ; Retrospective Studies ; Small Cell Lung Carcinoma

In recent years there has been a growing interest in total body, hemibody, total lymphoid irradiation. For refractory leukemia or lymphoma patients, various techniques and dose regimens were introduced, including high dose total body irradiation for destruction of leukemic or bone marrow cells and immunosuppression prior to bone marrow transplantation, and low dose total body irradiation for treatment of lymphocytic leukemias or lymphomas. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. Purposes of this paper are to discuss calibrating Cobalt Unit in 3m distance using Rando Phantom, to compare calculated dose, calibrated dose, and compensating filters for homogeneous dose distribution in the head and neck, the lung and the pelvis. Results were following. 1. Measured dose on the lung was 6% higher than on the abdomen. Measured dose on the head (10%) and neck (18%) were higher than the abdomen because of thinness. Pelvic dose was measured 12% less than the abdomen. Those date suggest that compensating filter was essential. 2. Measured dose according to distance was 3% less than calculated dose which suggest that all doses in clinical use should be compared with calculated dose for minimizing error.
Abdomen ; Bone Marrow Cells ; Bone Marrow Transplantation ; Cobalt ; Head ; Humans ; Immunosuppression ; Leukemia ; Leukemia, Lymphoid ; Lung ; Lymphatic Irradiation ; Lymphoma ; Neck ; Pelvis ; Thinness ; Whole-Body Irradiation*

No abstract available.

We observed the motion of left ventricular posterior wall aortic root posterior wall in 20 normal persons and 20 patients with left ventricular hypertrophy during the period from March 1985 to Agust 1985. The results were as followings; 1) The percentage of rapid filling time to one cycle of heart beat obtained from the ventriculat posterior wall motion was significantly prolonged in patients with left ventricular hypertrophy(24.1+/-5.44%) than in normal persons(13.5+/-3.69%)(p<0.05) and that of slow filling time was significantly shortend in patients with left ventricular hypertrophy(27.4+/-6.10%) than in normal persons(38.7+/-9.06%)(P<0.005). 2) The rapid filling slop obtained from left ventricular postrior wall motion was significantly reduced in patients with left ventricular hypertrophy(44.0+/-12.45mm/sec)than in normal persons(91.7+/-53.16mm/sec)(P>0.005) but the slow were not signigficantly different between the two groups. 3) The left artial emptying index calculated from the aortic root posterior wall motion was significantly lower in patients with left ventricular hypertrophy(0.6+/-0.18) than in normal persons(1.1+/-0.26)(P<0.005).
Echocardiography* ; Heart ; Humans ; Hypertrophy, Left Ventricular*