No abstract available.
Teratoma* ; Turner Syndrome*

This study was attempted to observe the rate of fall of arterial oxygen tension and the rate of rise of artetrial carbon dioxide tension after denitrogenation with 100%(Group I, n=10) or 50% oxygen(Group II, n=15) in 25 healthy ASA class I patients scheduled for ear, oromaxillary, head and orthopedic surgery that do not affect respiration or pulmonary function. After 30 minutes of denitrogenation under supine position, apnea was carried out by dis- connecting the endotracheal tube and rebreathing circuit until arterial oxygen saturation decreased to 90-95% by pulse oximetry which was placed at index finger. We calculated the mean rate of decrease of arterial oxygen tension (PaO2(tn)-PaO2(tn+1)) and the mean rate of increase of arterial carbon dioxide tension (PaCO2(tn+1)-PaCO2(tn)) minute by minute by arterial blood gas analysis. The results are as follows. 1) The mean rate of decrease of arterial oxygen tension after apnea was 40.96+/-11.02 in Group I and 43.22+/-5.49 mmHg/min. in Group II 2) The rate of increase of arterial carbon dioxide tension during the first one minute of apnea was 5.94+/-0.85 in Group I and 5.56+0.64 mmHg in Group II 3) The mean rate of increase of arterial carbon dioxide tension after first one minute was 2.46+/-0.78 in Group I and 2.47+/-0.71 mmHg/min. in Group II With the above results, we concluded that healthy human subject who was denitrogenated with 100% oxygen about 30 minutes can withstand apnea as far as 7 minutes, and those who denitrogenated with 50% oxygen can withstand apnea as far as 3 minutes without hypoxic insult.
Anesthesia* ; Anoxia ; Apnea* ; Blood Gas Analysis ; Carbon Dioxide* ; Carbon* ; Ear ; Fingers ; Head ; Humans ; Orthopedics ; Oximetry ; Oxygen* ; Respiration ; Supine Position

Sheehans syndrome is a known complication of pregnancy, It was described as a syndrome of hypopituitarysm due to acute ischemic necrosis of the anterior pituitary gland secondary to severe postpartum bleeding and shock. The neurophysis is usually preserved. But it can be involved in severe cases manifesting as diabetes insipidus. Because of its rare coexistence with Sheehans syndrome, diabetes insipidus is seldom recognized as a potential postpartum complication. The report describes a patient who developed Sheehans syndrome and diabetes insipidus immediately following delivery. Diabetes insipidus resolved spontaneously after 15 months, while panhypopituitarysm is persistent.
Diabetes Insipidus ; Hemorrhage ; Humans ; Hypopituitarism ; Necrosis ; Pituitary Gland, Anterior ; Postpartum Hemorrhage ; Postpartum Period ; Pregnancy ; Shock

OBJECTIVES: This retrospective study was conducted to analyze the hypothesis that with neoadjuvant chemotherapy of vinblastine, bleomycin, and cisplatin followed by radical hysterectomy or radiation therapy and concurrent chemoradiation with cisplatin based regimen would improve survival in patients with barrel-shaped or bulky-endophytic (Diameter > 4cm) cervical carcinomas than those of radiation alone or combined radiation and surgery. STUDY DESIGN: Eighty-eight patients with barrel-shaped or bulky-endophytic cervical carcinomas, treated at the Hanyang University Hospital from 1983 to 1997, were the subjects of this investigation. Fifty-six of these patients were treated by neoadjuvant chemotherapy followed by radical hysterectomy with bilateral pelvic lymphadenectomy ( Stage I b2, 8; IIa, 15; IIb, 20; III- IV, 13), twelve patients were treated by neoadjuvant chemotherapy followed by radiation therapy ( Stage Ilb, 4; IIJ-IV, 8), and twenty patients were treated by concurrent chemo-radiotherapy ( Stage IIb, 2; III-IV, 18). RESULTS: The incidence of parametrial extension and pelvic lymphnode metastases was higher in patients with barrel-shaped or bulky-endophytic cervical carcinomas than non-barrel-shaped cervix (p .025: .001). 5-years disease free survival rate was determined for patients treated by neoadjuvant chemotherapy followed by radical hysterectomy with bilateral pelvic lymphadenectomy was 73.3 %. For patients treated by neoadjuvant chemotherapy followed by radiation therapy it was 45.7%. For patients treated by concurrent chemo-radiotherapy it was 46.1%. CONCLUSION: These data support an improvement in survival of patients with barrel-shaped or bulky-endophytic cervical carcinomas treated by neoadjuvant chemotherapy followed by radical hysterectomy or radiation therapy and concurrent chemo-radiotherapy.
Bleomycin ; Cervix Uteri* ; Cisplatin ; Disease-Free Survival ; Drug Therapy* ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Node Excision ; Neoplasm Metastasis ; Retrospective Studies ; Vinblastine

MIN GLASSES is specially manufactured in order to enhance satisfaction of wearer and therefore increase the effectiveness of treatment of an amblyopia and a diplopia. One of the lens is specially grounded and coated to blur vision. Cosmetically, the eye appears to wear regular glasses through the blur lens. We prospectively studied 58 amblyopic children and 10 diplopic adults. Each patient was treated with MIN GLASSES for cosmetic problems. We checked linear visual acuity of pre- and post-treatment. Questionnaires were given to the patients and parents regarding cosmetic satisfaction with treatment. In amblyopic children. 44 patients(75.9%) showed visual acuity improvement of 1.61 +/- 1.50 lines by Han's visual acuity chart. Patient compliance was 87.9%(51 patients) with patient satisfaction based on a questionnaire response. Parents were 87.9%(51 parents) positive response. In diplopic adults, 10 patients(100%) were positive response with satisfaction and demonstrated to be free of symptom of diplopia. MIN GLASSES is effective in high compliance satisfaction of amblyopia and diplopia, and improvement of visual acuity of amblyopia.
Adult ; Amblyopia* ; Child ; Compliance ; Diplopia* ; Eyeglasses* ; Glass* ; Humans ; Parents ; Patient Compliance ; Patient Satisfaction ; Prospective Studies ; Surveys and Questionnaires ; Visual Acuity

PURPOSE: Important advances in the treatment of acute myelogenous leukemia have been made with the introduction of cytosine arabinoside (ara-C) and anthracyclines (daunorubicin) over the past 20 years. Currently, 60 to 80% of patients with acute myelogenous leukemia achieve complete remission with induction chemotherapy consisting of ara-C and daunorubicin (adriamycin) AD ("7+3"). The one-fourth of complete responders will have extended long-term survival and may be cured. Therefore wetreated patients with acute myelogenous leukemia admitted to our hospital with AD ("7+3") regimen. METHODS: Induction therapy; Thirty four patients with previously untreated acute myelogenous leukemia received AD ("7+3") regimen (ara-C, 200 mg/m2/d by continuous infusion for seven days, and daunorubicin, 45 mg/m2/d for 3 days). The second course of therapy was AD ("5+2"), if the patients failed to enter remission. Consolidation therapy; three cycles of consolidation chemotherapy were administered with at least 4 week interval following remission. Course 1; ara-C at 100 mg/m2 by subcutaneous injection every 12 hour for seven days, 6-thioguanine at every 12 hour 100 mg/m2 orally every 12 hour for 7 days). Course 2; ara-C (same as course 1) at 100 mg/m2 by subcutaneous injection every 12 hour for seven days, vincristine at 1.5 mg/m2 (maximum 2 mg) by bolus injection for 1 day, prednisolone at 40 mg/m2 (maximum 60 mg) orally for 7 days. Course 3; ara-C (same as course 1) daunorubicin at 45 mg/m2 by 1 hour infusion for 3 dyas. RESULTS: Sixty-eight percent of the 34 patients entered complete remission. The remission duration for all patients in complete remission ranged from 4 weeks to 3122+ weeks, with the median of 50 weeks. The median duration of survival in complete responder group was 62 weeks. Twenty-Six percent of patients with complete remission are alive at 5 years. Cases with extramedullary leukemic involvement were found in four patients; M2 with orbital mass, M3 and M4 with CNS leukemia, M5a with subcutaneous nodules. Among the potential prognostic variables including age, initial WBC count, percent of blast in peripheral blood,none was statistically related to prognosis. CONCLUSION: Combination chemotherapy with cytosine arabinoside and daunorubicin is a effective regimen for acute myelogenous leukemia as much as other regimen. Futher clinical trials for effective treatment regimen and method are necessary to raise the complete remission rate.
Anthracyclines ; Consolidation Chemotherapy ; Cytarabine* ; Cytosine* ; Daunorubicin* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Induction Chemotherapy ; Injections, Subcutaneous ; Leukemia ; Leukemia, Myeloid, Acute* ; Orbit ; Prednisolone ; Prognosis ; Thioguanine ; Vincristine

BACKGROUND AND OBJECTIVE: Assessment of quality of life (QOL) of patients with chronic illness requires reasonable tools which reflect the patients' cultural and behavioral properties. We developed the quality of life questionnaire for adult Korean asthmatics (QLQAKA) on the basis of the Korean life style and evaluated its reliability and validity. METHODS: The QLQAKA consisted of four domains; symptoms (six items), daily activity (five items), emotion (three items) and reaction to environmental stimuli (three items). Patients answered each item according to a five-response scale. The reproducibility and validity of the questionnaire was estimated from the responses of 244 patients who visited the clinics in 15 institutes within a 2-week interval. RESULTS: Items with the most frequent complaints were dyspnea (87%), difficulty in sputum discharge or throat clearing (87%), limitation in strenuous activity (84%) and coughing (82.4%). The QLQAKA reflected the changes of patients' status very well. The value of minimal important differences, such as the clinically significant minimal change in the QOL score, was 0.5. The questionnaire was also highly reproducible with the value of intraclass correlation coefficiency and intraclass standard deviation as 0.940 (p<0.001) and 0.180, respectively. The changes of mean total QLQAKA score correlated weakly with the changes of FEV1 and PEFR values. CONCLUSION: The adult version of QLQAKA was valid and may be a reproducible tool for evaluating and monitoring Korean adult asthma patients.
Academies and Institutes ; Adult* ; Asthma ; Chronic Disease ; Cough ; Dyspnea ; Humans ; Life Style ; Peak Expiratory Flow Rate ; Pharynx ; Quality of Life* ; Reproducibility of Results ; Sputum ; Surveys and Questionnaires