It is well established that the CT is an essential part not only in screening primary brain tumors, but alsoin staging known malignancy. This paper reports various CT findings demonstrated in 12 cases of choriocarciomawith brain metastasis. The CT findings such as the number, location and density of the metastatic lesions, thedegree of brain edema, mass effect and effect of contrast enhancement are reviewed as well as the episode ofstroke syndrome and survival duration after neurologic symptoms attacks. The results were as follows; 1. Ten ofthese cases showed solitary metastatic lesion and remaining 2 cases were multiple lesions. 2. One was isodensedensity and the others were hemorrhagic increased denstiy by CT. 3. All of these showed mass effect to thesurrounding structures along with moderate to marked brain edema. 4. The position of the metastatic lesion werelocated at the supratentorially in all cases. Most of them were at the unilateral frontal or parietal area of bothof them. One which noted multiple metastatic foci showed at the bilateral occipital regions. 5. Nine cases showedring enhancement after contrast infusion. One which noted isodense density on the noninfusion scan showed alsoring enhancement after contrast infusion. 6. Nine cases showed positive stroke syndrom. One of them was perforemdemergency craniotomy. The remainging 3 cases noted progressive neurologic symptoms. 7. Two cases were noted onlybrain metastasis but the others also had various degree of pulmonary metastasis and 2 of latter had hepaticmetastasis, too. 8. Most of the cases were treated with CHAMOCA regimen, and one of them was taken whole brainirradiation (3000 rads/2 weeks). Another one case revealed marked regression of not only metastatic brain lesionbut the pulmonary lesion after the 8th course of CHAMOCA regimen and still alive for over 460 days.
Brain Edema ; Brain Neoplasms ; Brain ; Choriocarcinoma ; Craniotomy ; Female ; Mass Screening ; Neoplasm Metastasis ; Neurologic Manifestations ; Occipital Lobe ; Pregnancy ; Rabeprazole ; Stroke

PURPOSE: In order to understand in vivo radiation damage modifying effect of bFGF on jejunal mucosa, bone marrow and the effect of bFGF on the growth of transplanted mouse sarcoma 180 tumor in mice. MATERIALS AND METHODS: Mice were treated with 6 microgram of bFGF at 24 hours and 4 hours before exposing to 600 cGy, 800 cGy and 1,000 cGy total body irradiation (TBI), and then exposed to 3,000 cGy local radiation therapy on the tumor bearing thigh. Survival and tumor growth curve were plotted in radiation alone group and combined group of bFGF and irradiation (RT). Histologic examination was performed in another experimental group. Experimental groups consisted of normal control, tumor control, RT (radiation therapy) alone, 6 microgram bFGF alone, combined group of 3 microgram bFGF and irradiation (RT), combined group of 6 microgram bFGF and irradiation (RT). Histologic examination was performed with H-E staining in marrow, jejunal mucosa, lung and sarcoma 180 bearing tumor. Radiation induced apoptosis was determined in each group with the DNA terminal transferase nick-end labeling method (ApopTag S7100-kit, Intergen Co.) RESULTS: The results were as follows 1) 6 microgram bFGF given before TBI significantly improved the survival of lethally irradiated mice. bFGF would protect against lethal bone marrow syndrome. 2) 6 microgram bFGF treated group showed a significant higher crypt depth and microvilli length than RT alone group (p<0.05). 3) The bone marrow of bFGF treated group showed less hypocellularity than radiation alone group on day 7 and 14 after TBI (p<0.05), and this protective effect was more evident in 6 microgram bFGF treated group than that of 3 microgram bFGF treated group. 4) bFGF protected against early radiation induced apoptosis in intestinal crypt cell but might have had no antiapoptotic effect in bone marrow stem cell and pulmonary endothelial cells. 5) There was no significant differences in tumor growth rate between tumor control and bFGF alone groups (p>0.05). 6) There were no significant differences in histopathologic findings of lung and mouse sarcoma 180 tumor between radiation alone group and bFGF treated group. CONCLUSIONS: Our results suggest that bFGF protects small bowel and bone marrow from acute radiation damage without promoting the inoculated tumor growth in C3H mice. Improved recovery of early responding normal tissue and reduced number of radiation induced apoptosis may be possible mechanism of radioprotective effect of bFGF.
Animals ; Apoptosis ; Bone Marrow ; DNA ; Endothelial Cells ; Fibroblast Growth Factor 2* ; Lung ; Mice ; Mice, Inbred C3H* ; Microvilli ; Mucous Membrane ; Sarcoma 180 ; Stem Cells ; Thigh ; Transferases ; Whole-Body Irradiation

PURPOSE: This study investigated the influence of irradiation and cisplatin on PrxI & PrxII expression and on their survival rates (SR) in SK-N-BE2C and Rat2 cell lines. MATERIALS AND METHODS: The amount of PrxI & PrxII production with or without N-acetyl-L-cysteine (NAC) pretreatment was studied using a western blot after 20 Gy irradiation to determine the degree of inhibition of ROS accumulation. In addition, the amount of PrxI & PrxII production after cisplatin and after combination with cisplatin and 20 Gy irradiation was studied. The SRs of the cell lines in SK-N-BE2C and Rat 2 cells, applied with 20 Gy irradiation only, with various concentrations of cisplatin and with the combination of both, were studied. The 20 Gy irradiation-only group and the combination group were each subdivided according to NAC pretreatment, and corresponding SRs were observed at 2, 6, 12 and 48 hours after treatment. RESULTS: Compared with the control group, the amount of PrxI in SK-N-BE2C increased up to 60 minutes after irradiation and slightly increased after irradiation with NAC pretreatment 60 minutes. It did not increase in Rat2 after irradiation regardless of NAC pretreatment. PrxII in SK-N-BE2C and Rat2 was not increased after irradiation regardless of NAC pretreatment. The amounts of PrxI and PrxII in SK-N-BE2C and Rat2 were not increased either with the cisplatin-only treatment or the combination treatment with cisplatin and irradiation. SRs of irradiation group with or without NAC pretreatment and the combination group with or without NAC pretreatment were compared with each other in SK-N-BE2C and Rat2. SR was significantly high for the group with increased amount of PrxI, NAC pretreatment and lower the cisplatin concentration. SR of the group in SK-N-BE2C which had irradiation with NAC pretreatment tended to be slightly higher than the group who had irradiation without NAC pretreatment. SR of the group in Rat2 which had irradiation with NAC pretreatment was significantly higher than that the group which had irradiation without NAC pretreatment. Compared to the combination group, the irradiation-only group revealed statistically significant SR decrease with the maximal difference at 12 hours. However, at 48 hours the SR of the combination group was significantly lower than the irradiation-only group. CONCLUSION: PrxI is suggested to be an antioxidant enzyme because the amount of PrxI was increased by irradiation but decreased pretreatment NAC, a known antioxidants. Furthermore, cisplatin may inhibit PrxI production which may lead to increase cytotoxicity of irradiation. The expression of PrxI may play an important role in cytotoxicity mechanism caused by irradiation and cisplatin.
Acetylcysteine ; Animals ; Antioxidants ; Blotting, Western ; Cell Line ; Cisplatin* ; Fibroblasts* ; Humans* ; Neuroblastoma* ; Peroxiredoxins* ; Radiation, Ionizing* ; Rats* ; Survival Rate*

The cranial CT is a new radiological technique with which, for the first time, minimal differences anattenuation by intracranial soft tissue can be measured exactly. Th basic physical principles of CT have beenextensively presented by Hounsfield (1973). It is well established that the attenuation of extravasated blood measures between 35 and 45 houns field units. Therefore no difficulty should be encoutered in the recognition anddiagnosis of extra-axial hematoma and cerebral contusion since the density of the brain parenchyma never measures more than 25 units. As the constant increase in high velocity accidents and violence, the problem of acute headinjury is one of the matters of great importance in today's medical practice. Therfore it is very important to figure out the method that would allow us to diagnose easily and precisely the effects of trauma upon the brain inorder to institute the proper treatment at the earliest possible moment . CT allows us to make a diagnosis quickly and in a non-invasive manner. The CT scan was carried out on 310 head trauma cases in the department of radiology, St. Mary's and Kang Nam St. Mary's Hospital, Catholic Medical College, for 16 months from June 1979 to Oct. 1980.All the scans were obtained with the Hitachi CT-H2 scanner and the scans were repeated following intravenous injection of high dose of contrast media(roughly 1.8cc per kg body weight of 60% Conray). We have reviewed the CTscans of 310 patients got acute head injury in order to assess the location of brain lesions, the relationshipbetween the CT scans of 310 patients got acute head injury in order to assess the location of brain lesions, the relationship between the CT densities of hematomas and their stage, the shape mass effect of the extra-axialhematomas, and the effect of contrast enhancement. The resuls were as follows; 1. Of all 310 cases of the headinjuries, epidural hematoma was 13.5%, subdural hematoma was 8.7%, subdural hygroma was 10%, cerebral contusion was 39%. hydrocephalus and atrophy was 3.9% and negative finding was 24.9%. 2. The extra-axial hematoma waslocated on the right side in 49.3% and the left side in 39.1% and bilaterally in 11.6%. Therfore unilateral lesion was much more than bilateral one. 3. The extra-axial hematoma was getting decreased in density as time gone by. 4. The shape of epidural hematoma was biconvex in 88.1% and planoconvex in 11.9%. 5. The shape of subdural hematoma was crescent in 88.9% and biconvex in 11.9% in chronic stage. 6. The mass effect of extra-axial hematoma was getting slowly decreased as time gone by. 7. The extra-axial hematoma was enhanced by the contrast media in allacute, subacute and chronic stages as well as in the cerebral contusion, but there was a tedency that the contrast enhancement of hematoma was getting increased as time gone by.
Atrophy ; Body Weight ; Brain ; Contrast Media ; Contusions ; Craniocerebral Trauma ; Diagnosis ; Hematoma ; Hematoma, Subdural ; Humans ; Hydrocephalus ; Injections, Intravenous ; Methods ; Subdural Effusion ; Tomography, X-Ray Computed ; Violence

In man the epiglottis is a thin lamella of yellow elastic cartilage. The upper part is free and is known asleaf and lower part participates in the formation of the anterior wall of the vestibule of the larynx. Theipithelial covering extends forwards onto the base of the tongue over the medial glossoepiglottic folds. The sidesof epiglottis are connected with the cartilages of Wrisberg and arytenoid cartilage by the aryepiglottic fold. Inview of these anatomical complexities, the function and physiology of the epiglottis have been debated sinceMagendi(1815), who proposed the theory that the epiglottis acts as a flap valve to prevent food entering thewindpipe, and who found that he could remove the free part of the epiglottis in dog without spoiling the dog.Follwoing the introduction of laryngoscopy(Garcia, 1815; Liston, 1840; Czermark, 1861) and modern cineradiographicequipments in 1950's, the anatomy and physiology of epiglottis has become much clearrer. Age as it is seen on thelateral x-ray of the neck. In the present study we have made an attempt to systematically analyze aging changes ofthe epiglottis in the lateral x-ray of the neck in 245 healthy adults. The age ranged from 16 to 65 years old.Based on our observation the epiglottis was classified into type A, B, and C according to their curvatures. Thus,type A represented those with posterior curvature, type B those with straight epiglottis and type C anteriorcurvature. Type C was sudivided into I, II and III according to the degree of curvature. Thus, type C-I, C-II andC-III represented mild, moderated and marked anterior curvature, respectively. Type A epiglottis was found in thesecond, third and fourth decades and type C-III in the older age group. Type A was least comon and type C mostprevalent. It seems that the epiglottis inclines anteriorly with backward curvature with age (p<0.0001).
Adult ; Aging ; Animals ; Arytenoid Cartilage ; Cartilage ; Dogs ; Elastic Cartilage ; Epiglottis ; Humans ; Larynx ; Neck ; Physiology ; Tongue

Epilepsy can be defined as a paroxysmal, neuronal discharge within the brain originating from either corticalor sugcortical regions. The incidence of epilepsy is increasing possibly due to the survival of persons who shouldhave died of brain injuries or other cerebral abnormalities acquired in earlylife. the use of abtibiotics andimprovement in the medical care have saved many children who might have died of meningitis, brain abscess,encephalitis, severe head injuries, etc. CCT scan is new radiologic procedure for defining cranial andintracranial structures and also an useful procedure for evaluation and follow-up(FU) of patient with focalseizure disorder. Recently we experienced nodules which were isodense or hypodense on initial noncontrasted CT(NECT) and scans became hyperdense of the enhancement in 4 cases of focal epileptic seizures. Nearly completedisappearance or regression of the epileptic foci occurred on the FU CT scans in 2 cases. Operation was performedin 2 cases. The tissue specimen obtianed from the CT nodule revealed cerebral edema in one case and localizedgliosis and congestion in the other. All the patients showed marked clinical improvement when the CT noduleimporved. Review of literature failed to disclose any previous report on such observation.
Brain ; Brain Edema ; Brain Injuries ; Child ; Craniocerebral Trauma ; Epilepsy ; Estrogens, Conjugated (USP) ; Humans ; Incidence ; Meningitis ; Neurons ; Tomography, X-Ray Computed

PURPOSE: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. MATERIALS AND METHODS: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. RESULTS: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. CONCLUSION: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymphedema ; Pelvis ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Treatment Outcome ; Vulvar Neoplasms

The authors have intended to measure intrinsic dose distribution by Farmer dosimeter in irregularly shaped fields such as L.M. and T shape models in order to determine dose in homogeneity in those models. We made 2 off-xis points in each model and measured the depth dose at 1.5, 5 and 9cm below surface. The results showed 1~3% dose discrepancy between 2 points. We also measured the depth dose by geometric approximation and computer calculation in those models, and came to the conclusion that computer calculation using Clarkson's principle is simpler and the measurements are closer to the ideal data obtained by the experiment in three models of irregularly shaped fields than those of geometric approximation method.

Radiation therapy was the treatment of choice for CML in the past, in the form of Sl or radioactive phosphorus. Its use has been replaced to a large extent by various chemotherapeutic agents. Recently Sl in CML has been used, both to relieve painful splenomegaly and to take advantage of an indirect effect of Sl on unirradiated bone marrow. We have treated 15 CML cases who had a huge spleen during chemotherapy or even after chemotherapy by 6 MV linear accelerator during the past two years at the Division of Radiation Therapy, Kang Nam St. Mar's Hospital, Catholic College. Response to Sl has been rated according to the scoring system of Roger W. Byhardt, et al. which evaluated the splenic and hematologic response as well as the response of disease-elated systems. According to this scoring system, most patients demonstrated a significant relief of splenomegaly along with improvement of hemogram. And we observed the change of Karnofsky Performance Status after Sl, and survival after a confirmative diagnosis and Sl.
Bone Marrow ; Diagnosis ; Drug Therapy ; Humans ; Karnofsky Performance Status ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Particle Accelerators ; Phosphorus ; Spleen ; Splenomegaly

No abstract available.
Meningioma* ; Radiosurgery*