PURPOSE: To analyze survival rate and late rectal and bladder complication for patients with stage with stage I and II carcinoma of uterine cervix treated by radiation alone or combined with chemotherapy. MATERIALS AND METHODS: Between November 1984 and December 1993, 127 patients with stage I and II carcinoma of uterine cervix treated by radiation alone or combined therapy of radiation and chemotherapy. Retrospective analysis for survival rate was carried out on eligible 107 patients and review for complication was possible in 91 patients. The median follow-up was 47 months (range 3-118) and the median age of patients was 56 years (range 31-76). 26 patients were stage IB by FIGO classification. 40 were stage IIA and 41 were stage IIB. 86 cases were treated by radiation alone and 21 were treated by radiation and chemotherapy. 101 patients were treated with intracavitary radiation therapy (ICRT), of these, 80 were received low dose rate (LDR) ICRT and 21 were received high dose rate (HDR) ICRT. Of the patients who received LDR ICRT, 63 were treated by 1 intracavitary insertion and 17 were underwent 2 insertions. And we evaluated the external radiation dose and midline shield. RESULTS: Acturial survival rate at 5 years was 92% for stage IB, 75% for stage IIA, 53% for stage IIB and 69% in all patients. Grade 1 rectal complications were developed in 20 cases(22%), grade 2 were in 22 cases (24%), 22 cases (24%) of grade 1 urineary complications and 17 cases (19%) of grade 2 urinary complications were observed But no patients had severe complications that needed surgical management or admission care. Maximum bladder dose for the group of patients with urinary complications was higher than that for the patients without urinary complications(7608cGy v 6960cGy, p<0.01). Maximum rectal dose for the group of patients with rectal complications was higher than that for the patients without urinary complications (7041cGy v 6269cGy, p<0.01). While there was no significant difference for survival rate or bladder complication incidence as a function of dose to whole pelvis, Grade 2 rectal complication incidence was significantly lower for the patients receiving less than 4500cGy(6.3% v 25.5%, p<0.05). There was no significant difference between HDR ICRT group and LDR ICRT group for survival rate according to stage, on the other hand complication incidence was higher in the HDR group than LDR group. This was maybe due to different prescription doses between HDR group and LDR group. Midline shield neither improved survival rate nor deceased complication rate. The number of insertion in LDR ICRT group did not affect on survival and complication rate. CONCLUSION: In stage I and II carcinoma of uterine cervix, there was no significant difference for 5 year survival rate by radiation therapy technique. Rectal complication incidence was as a function of dose to whole pelvis and there were positive correlations of maximum dose of rectum and bladder and each complication incidence. So we recommand whole pelvis dose less than 4500cGy and maximum dose of rectum and bladder as low as possible.
Cervix Uteri* ; Classification ; Drug Therapy ; Female ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Pelvis ; Prescriptions ; Rectum ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms

OBJECTIVES: The purpose of this study was to provide photodynamic bactericidal effect against Enterococcus faecalis by erythrosine concentrations and LED irradiation times. METHODS: Erythrosine was used as a photosensitizer and green LED (3 Watt, 520-530 nm) was used as light source. E. faecalis ATCC 1943 and E. faecalis ATCC 29212 were used in this study. Approximately 10(5) CFU of bacteria were added in wells of a 96-well microtitration plate. For examining the effects of concentrations of erythrosine, 0, 0.625, 1.25, 2.5, 5, and 10 microM of erythrosine were added in wells containing bacteria. The irradiation time with LED was 30 sec. In another set of experiment, the effect of irradiation time for killing of bacteria was investigated by increasing irradiation time from 0 to 30 s with 10 microM of erythrosine final concentration. After irradiation, each sample was serially diluted with PBS and 50 microl of diluents was spread on duplicate blood agar plates. The plates were incubated for 72 h at 37degrees C under aerobic conditions and the number of CFU was determined. The experiments were repeated four times. The results were analyzed using one-way ANOVA, and Tukey's multiple comparison at a significance level of 0.05. RESULTS: When the erythrosine concentrations were more than 2.5 microM, E. faecalis ATCC 29212 was significantly decreased (P<0.05). The more erythrosine concentrations increased, the more E. faecalis ATCC 1943 decreased statistically significantly (P<0.05). In another set of experiment, when LED irradiation time was more than 20 s, E. faecalis ATCC 1943 decreased significantly (P<0.05), and if the irradiation times was more than 5 s, E. faecalis ATCC 29212 decreased significantly (P<0.05). CONCLUSIONS: PDT using erythrosine and green LED was found to be an effective method in killing E. faecalis.
Agar ; Bacteria ; Enterococcus faecalis* ; Erythrosine* ; Homicide ; Photochemotherapy

The mesenteric lipoma is rare in chilcren. A 2 years and 8 months old female child was admitted to department of Pediatrics in Inchon Christian Hospital on the 17 th Dec., 1974, because of abdominal distention and dyspnea. Operation revealed a soft yellowish mass, measuring 25x23x19cm. In size and 4,000gm. In weight. The pathologic diagnosis confirmed lipoma of the mesentery. The patient was discharged without any complications on the 8 th postoperative day. A brief review of literatures was made.
Child ; Diagnosis ; Dyspnea ; Female ; Humans ; Incheon ; Infant ; Lipoma* ; Mesentery ; Pediatrics

Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae from crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection, but several ectopic paragonimiasis cases have also been reported. Among them, cases of subcutaneous paragonimiasis are rare, especially in children. We report a case of subcutaneous paragonimiasis of the right abdominal wall with pleural effusion with hepatic involvement and without abnormal pulmonary infiltration in a boy aged 2 years and 5 months. He had eaten soybean sauce-soaked freshwater crabs (kejang) 6 months prior to complaining of right abdominal wall distension. On evaluation, right pleural effusion without abnormal pulmonary infiltration was detected, as well as blood eosinophilia, an elevated serum IgE level, pleural fluid eosinophilia and a positive enzyme-linked immunosorbent assay that detected P. westermani antibody in the serum. Thoracentesis, praziquantel administration, and excision of subcutaneous lesions were performed. After treatment, the eosinophil count and serum IgE level were decreased, and the subcutaneous lesions did not recur. The frequency of paragonimiasis has decreased recently, but it is still prevalent in Korea. Paragonimiasis should be suspected if pleural fluid eosinophilia is associated with blood hypereosinophilia and a high level of serum IgE; however clinicians should obtain a thorough history of travel and food habits.
Abdominal Wall ; Aged ; Astacoidea ; Child ; Eating ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Food Habits ; Fresh Water ; Humans ; Immunoglobulin E ; Korea ; Metacercariae ; Paragonimiasis ; Paragonimus ; Paragonimus westermani ; Pleural Effusion ; Praziquantel ; Soybeans

A lung hernia, defined as the protrusion of pulmonary tissue and pleural membranes through a defect in the thoracic wall, is a rare event. It can be congenital or acquired, and cervical, thoracic, or diaphragmatic in location. We report the rare occurrence of a congenital atraumatic lung herniation through the azygoesophageal recess. An 8 -month-old male infant, who was born at 3 5 weeks gestation, had a chronic cough. Chest radiography showed haziness at the right lower lobe of the lung (RLL). Chest computed tomography (CT) revealed herniation of the RLL through the azygoesophageal recess. If persistent unilateral haziness is observed on chest radiography, the possibility of lung herniation should be considered.
Child ; Cough ; Hernia ; Humans ; Infant ; Lung ; Male ; Membranes ; Pregnancy ; Thoracic Wall ; Thorax

BACKGROUND: Frailty is considered to be a clinical syndrome characterized by decreased physiological reserves associated with a greater risk of health-related problems, hospitalization, and death. The current study examined hospitalization, falls, cognitive decline and disability between robust, prefrail and frail elderly in one year. METHODS: 110 participants aged 65 or more who visited two senior welfare centers in Seoul from February 2008 to June 2008 were surveyed again from March 2009 to June 2009 with demographic characteristics, number of chronic diseases and medication, study of osteoporotic fractures (SOF) frailty index, instrumental activity of daily living (IADL), depression, mini-mental state examination-Korean version (MMSE-K), falling history and admission history within one year. These results were compared with participants' previous survey done one year ago. RESULTS: Among total 110 subjects, 48 (44%) robust, 30 (27%) prefrail, and 32 (29%) frail subjects changed to 26 (24%), 54 (49%), and 30 (27%) respectively over the year. There were statistical significances in age, number of chronic disease, depressive mood, MMSE, falls, hospitalization, IADL disability contributing to frailty (P < 0.05). Frailty defined by SOF frailty index was associated with greater risk of adverse outcomes. Frail subjects had a higher age-adjusted risk of cognitive function decline (odds ratio [OR], 3.57), disability (OR, 9.64), fall (OR, 5.42), and hospitalization (OR, 4.45; P < 0.005). CONCLUSION: The frailty index like SOF frailty index might predict risk of falls, disability, hospitalization, and cognitive decline in the elderly, emphasizing special attention to the individuals showing frailty in outpatient examination.
Aged ; Chronic Disease ; Depression ; Frail Elderly ; Hospitalization ; Humans ; Osteoporotic Fractures ; Outpatients ; Retrospective Studies

We evaluated the overall setup accuracy for the On-Board Imager (OBI, Varian Medical Systems Inc., Palo Alto, CA, USA), with attention to the laser, the gantry, and operator performance. We let experienced technicians place the marker block on the couch using a lock bar system, with alignment to the isocenter of the laser, every morning. A pair of radiographic images of the marker block was acquired at 0degrees and 270degrees angles to the kV arm to correct the position using a 2D/2D matching technique. Once the desired match was achieved, the couch was moved remotely to correct the setup error and the parameters were saved. The average for the vertical and the longitudinal displacements were 0.65 mm and 0.66 mm, and 0.01 mm for the lateral displacement. The average for the vertical and longitudinal displacements were statistically significant at the 0.05 level (p value=0.000 for both), while the p value for the lateral direction was 0.829. These results show that the tendencies to displacement in vertical and longitudinal directions occur through systematic error, while systematic error was not found in the lateral displacement. This daily overall evaluation is practical and easy to find the systematic and random errors in the setup system; however, a daily QA for laser and OBI alignment is still needed to minimize the systematic error in aligning patients.
Arm ; Displacement (Psychology) ; Humans ; Hypogonadism ; Linear Energy Transfer ; Mitochondrial Diseases ; Ophthalmoplegia

PURPOSE: To compare audio-only biofeedback to conventional audiovisual biofeedback for regulating patients' respiration during four-dimensional radiotherapy, limiting damage to healthy surrounding tissues caused by organ movement. MATERIALS AND METHODS: Six healthy volunteers were assisted by audiovisual or audio-only biofeedback systems to regulate their respirations. Volunteers breathed through a mask developed for this study by following computer-generated guiding curves displayed on a screen, combined with instructional sounds. They then performed breathing following instructional sounds only. The guiding signals and the volunteers' respiratory signals were logged at 20 samples per second. RESULTS: The standard deviations between the guiding and respiratory curves for the audiovisual and audio-only biofeedback systems were 21.55% and 23.19%, respectively; the average correlation coefficients were 0.9778 and 0.9756, respectively. The regularities between audiovisual and audio-only biofeedback for six volunteers' respirations were same statistically from the paired t-test. CONCLUSION: The difference between the audiovisual and audio-only biofeedback methods was not significant. Audio-only biofeedback has many advantages, as patients do not require a mask and can quickly adapt to this method in the clinic.
Biofeedback, Psychology* ; Feedback, Sensory ; Healthy Volunteers ; Humans ; Masks ; Radiotherapy* ; Respiration* ; Volunteers

PURPOSE: The aim of this study was to analyze the results and contributing factors of catch-up growth in very low birth weight infants(VLBWI) at the corrected age of 2 years. In addition, we looked for a relationship between the catch-up growth and the development by the bayley scales of infant development II(BSID II). METHODS: A retrospective analysis by evaluating medical records was done for the 76 VLBWI whose follow-up was possible up to a corrected age of 2 years, out of the 114 who had been treated in the neonatal intensive care unit during the January of 2000 to December of 2001 at Samsung Cheil Hospital. Based on the Standard Korean Infant's Growth Curve, the catch-up growth group was defined over the 10th percentile of weight at 2 years as the corrected age and the failed catch-up growth group was defined under the 10th percentile. We investigated the clinical factors and courses of each group and compared the scores of the BSID II. RESULTS: The catch-up growth group of the VLBWI was 51 infants and the failed catch-up growth group was 25 infants. In comparison with maternal clinical factors, use of antenatal steroids was significantly higher in the catch-up growth group. In comparisn with clinical factors and courses of VLBWI, two clinical factors were significantly different between the two groups: birth weight and intrauterine growth retardation(IUGR). Numbers of delayed development were increased in the failed catch-up growth group but statistically significant differences could not be observed. CONCLUSION: The catch-up growth of the VLBWI was affected by the use of antenatal steroids, birth weight and IUGR. No significant differences regarding neurodevelopmental outcome were observed between the catch-up and failed catch-up growth groups.
Birth Weight ; Child ; Child Development ; Fetal Growth Retardation ; Follow-Up Studies ; Growth and Development* ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Medical Records ; Retrospective Studies ; Steroids ; Weights and Measures

PURPOSE: To see the gross tumor volume (GTV) dependency according to the phase selection and reconstruction methods, we measured and analyzed the changes of tumor volume and motion at each phase in 20 cases with lung cancer patients who underwent image-guided radiotherapy. MATERIALS AND METHODS: We retrospectively analyzed four-dimensional computed tomography (4D-CT) images in 20 cases of 19 patients who underwent image-guided radiotherapy. The 4D-CT images were reconstructed by the maximum intensity projection (MIP) and the minimum intensity projection (Min-IP) method after sorting phase as 40%–60%, 30%–70%, and 0%–90%. We analyzed the relationship between the range of motion and the change of GTV according to the reconstruction method. RESULTS: The motion ranges of GTVs are statistically significant only for the tumor motion in craniocaudal direction. The discrepancies of GTV volume and motion between MIP and Min-IP increased rapidly as the wider ranges of duty cycles are selected. CONCLUSION: As narrow as possible duty cycle such as 40%–60% and MIP reconstruction was suitable for lung cancer if the respiration was stable. Selecting the reconstruction methods and duty cycle is important for small size and for large motion range tumors.
Four-Dimensional Computed Tomography* ; Humans ; Lung Neoplasms* ; Lung* ; Methods* ; Radiotherapy, Image-Guided ; Range of Motion, Articular ; Respiration ; Retrospective Studies ; Tumor Burden*