No abstract available.
Accidents, Traffic* ; Fistula*

This study aimed to assess the potential usefulness of optical coherence tomography[OCT]for the diagnosis of central serous chorioretinopathy. OCT was used to examine 50 patients[50 eyes]whose initial examination disclosed the clinical diagnosis of central serous chorioretinopathy. Optical coherence tomographic section acquired directly through the fovea showed an increase of the neurosensory retina above an optically clear space corresponding to a fluid-filled cavity. Serial OCT were able to demonstrate a decrease in the sensory retina elevation from[900~120]micrometer t o [130~0]micrometer for 3 months of period. This resolution correlated with an improvement in the patient's visual acuity. OCT is potentially useful as a new, noninvasive diagnostic technique for quantitative examination by objectively monitoring the degree of serous retinal detachment in patients with central serous chorioretinopathy.
Central Serous Chorioretinopathy ; Diagnosis* ; Humans ; Retina ; Retinal Detachment ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: The dose calculation program for the Buchler type remote afterloading system was developed. This program also can be used to calculate dose for various sealed sources. METHODS AND MATERIALS: We determined the source length and distribution by dividing the program disk to 72 points. The dose rate for the each program disk and source was calculated. The dose rate table for the xy coordinate was established. The dose rate for the interesting points of the patient were calculated by using this table. We also made isodose curve from this calculations. RESULTS: The storage size for the dose rate table were increased.But the calculation of the dose rate for the patient were carried out rapidly. So we could get real time calculation. CONCLUSION: By using this program, we could calculate the dose rate for the various oints of the patient quickly and accurately. This program will be useful for the treatment with various linear sources.
Brachytherapy ; Humans

PURPOSE: To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer. MATERIALS AND METHODS: One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients(95%) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus, and concurrent esophageal irradiation to 30 Gy. After that patients received 5-Fu continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000 mg/m2 administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100 mg/m2 bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrent chemoradiation, twenty-six patients underwent radical esophagectomy. RESULTS: ninety-three patients could be examined for response assessment. By treatment modality, response rates were 85.1% for radiation alone group and 86.3% for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was 61.9%. Ther pathologic complete response were 15.4% in operation group. Overall median survival was 11 months and actuarial 5-year survival rate was 8%. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognositc factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, siginificantly better survival was associated with clinical stage, tumor response, radiation dose, and peration. CONCLUSION: Compared with radiotherapy alone, combined mulimodlity may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.
Bleomycin ; Chemoradiotherapy ; Cisplatin ; Drug Therapy ; Esophageal Neoplasms* ; Esophagectomy ; Esophagus ; Fluorouracil ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Methotrexate ; Mitomycin ; Protestantism ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Vinblastine

Among the 63 patients with histopathologically proven primary squamous cell anal cancer who were managed in Presbyterian Medical Center and Yonsei University Cancer from Jan. 1971 to Dec. 1991, 34 patients, who were managed with surgery alone (abdominoperineal resection) or post-operative radiotherapy and concurrent chemoradiotherapy were analyzed. With mean follow up time of 81.3 months, 30 patients (88%) were followed up from 17 to 243 months. In methods, 10 patients were treated with surgery alone. 9 patients were treated with combined surgery and postoperative radiotherapy (59~60 Gy in 28~30 fractions). 15 patients were treated with concurrent chemoradiotherapy. Chemotherapy (Mitomycin C 15 mg/squ, bolus injection day 1;5-FU, 750 mg/squ, 24hr infusion, day 1 to 5) and radiotherapy started the same day. A dose of 30 Gy was given to the tumor and to the pelvis including inguinal nodes, in 15 fractions. After 2 weeks a boost of radiotherapy (20 Gy) to the ano-perineal area and second cycle of chemotherapy completed the treatment. The overall 50year survival rate was 56.2%. concurrent chemoradiotherapy group was 70% and surgery alone group was 16.7%. According to the cox proportional harzard model, there was significant different between survival with concurrent chemoradiotherapy and surgery alone (p=0.0129), but post-operative radiotherapy was 64.8%, which was not stastically significant (p=0.1412). In concurrent chemoradiotherapy group, the anal function preservation rate was 87% and the severe complication rate (grade 3 stenosis and incontinence) was 13.3%. In conclusion, we conclude that the concurrent chemoradiotherapy may be effective treatment modality in patients with anal cancer
Anus Neoplasms* ; Chemoradiotherapy* ; Constriction, Pathologic ; Drug Therapy ; Follow-Up Studies ; Humans ; Pelvis ; Protestantism ; Radiotherapy ; Survival Rate

The elevation and fusion of palatine are essential processes in the completion of the palatal development. It is believed that the mesenchyme plays a major role in the ascent of the palatal process, and that the palatal epithelium is involved in its fusion. The mechanism of fusion requires several different morphologic and molecular changes prior to the completion of the mesenchymal continuity between different palatine processes. The mechanism of removing the epithelial cells from the fusion zone could include either programmed cell death, epithelial-mesenchymal transformation or migration to adjacent epithelia. Retinoic acid has been known to induce cleft palate by disturbing mesenchymal growth and/or epithelial fusion. The effect of retinoic acid on the epithelium of the palatine process was studied in the fetus of the Sprague- Dawley rat with feeding 100 mg/kg of retinoic acid mixed in olive oil on the 10th day of fetal age and controlled with feeding pure olive oil. The epithelium of the palatine process was examined by PAS reaction and electron- microscopy on the 14th, 15th, 16th and 18th day of fetal age. The obtained results were as follows: 1. In the control group, glycogen was plentiful at the entire epithelium of the palatine process during the pre-fusion period(14th and 15th day), but it diminished in contact epithelium at the fusion stage(16th day). On the contrary, in the experimental group treated with retinoic acid, glycogen was plentiful and did not change from the 14th to 18th day of gestation. 2. In the control group at fusion stage(16th and 18th day), PAS-positive cells increased in the nasal and oral epithelium adjacent to the fusion site, and in the mesenchyme around the fusion site. 3. As a result of electronmicroscopic findings, the epithelium in the experimental group with retinoic acid seemed to be injured by retinoic acid; RER was composed of flattened cisternas and ribosomes were detached, mitochondrial crista and membrane were destructed and sacculated, and Golgi complex was extremely atrophied. According to the results, it seems that apoptosis as well as cell migration and transformation happen in the mechanism of cleaning the epithelium at the contact site, and that retinoic acid injures directly intracytoplasmic organelles and disturbs apoptosis, a sort of normal developmental process. More studies should be done to verify relations between apoptosis and large-sized glycogen granule in superficial epithelium.
Animals ; Apoptosis ; Cell Death ; Cell Movement ; Cleft Palate ; Epithelial Cells ; Epithelial-Mesenchymal Transition ; Epithelium* ; Fetus* ; Gestational Age ; Glycogen ; Golgi Apparatus ; Membranes ; Mesoderm ; Microscopy ; Olea ; Organelles ; Periodic Acid-Schiff Reaction ; Pregnancy ; Rats* ; Ribosomes ; Tretinoin* ; Olive Oil

BACKGROUND AND OBJECTIVES: Brachytherapy is a promising method in the prevention and treatment of coronary stent restenosis. We sought to observe the therapeutic effects of a radioactive balloon loaded with Holmium-166 (166Ho) in a porcine coronary stent restenosis model. Materials and Methods: A radioisotope of (166Ho) was coated on the balloon surface using a polyurethane coating (20 Gy in 0.5 mm depth). Stent overdilation injuries were performed in two coronary arteries in 8 pigs. Four weeks after the stent overdilation injury, radiation therapies were performed using a control balloon dilation in one coronary artery (Group I:n = 8) and a 166Ho-coated balloon in the other coronary artery in each pig (Group II:n = 8). Follow-up coronary angiogram and histopathologic assessment were performed at 4 weeks after the therepy was administered. RESULTS: Laboratory findings did not differ significantly between the pre-treatment baseline and the measurements taken after radiation. On quantitative coronary angiogram, the coronary artery diameters were not significantly different between the two groups before stenting or at 4 and 8 weeks after stenting. On histopathologic analysis, injury score, internal elastic lamina area and lumen area did not differ significantly between the two groups. The neointimal area was 1.78 +/- 0.11 mm2 in group I and 1.36 +/- 0.12 mm2 in group II (p=0.017), and the histopathologic area of stenosis was 35.1 +/- 1.6% in Group I, 27.6 +/- 1.9% in Group II (p=0.005). CONCLUSION: A treatment of beta-radiation in a stented porcine coronary artery using radioactive Ho-166 coated balloon inhibits stent restenosis without any side effects.
Brachytherapy ; Constriction, Pathologic ; Coronary Disease ; Coronary Restenosis ; Coronary Vessels ; Follow-Up Studies ; Hyperplasia* ; Polyurethanes ; Radiation Injuries ; Radioisotopes ; Stents* ; Swine

BACKGROUND: The inflammation is an important feature of atherosclerotic lesions, and high level of C-reactive protein (CRP) is known to be associated with increased coronary events and poor prognosis in acute myocardial infarction (AMI). We examined the clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI), and long-term survival rate after PCI according to the level of CRP on admission. METHODS: Two hundred and eight patients with AMI who underwent primary or rescue PCI between 1997 and 1999 at Chonnam National University Hospital were divided into two groups: Group I (n=86, 59.9+/-9.3 years, male 74.4%) with normal CRP (<1.0 mg/dL, mean value=0.43+/-0.14 mg/dL) on admission and Group II (n=122, 59.1+/-10.4 years, male 83.6%) with elevated CRP (> or = 1.0 mg/dL, mean value=3.50+/-0.93 mg/dL) on admission. RESULTS: There were no significant differences in baseline characteristics between two groups. The incidence of cardiogenic shock was higher in Group II than in Group I (Group I; 3/86, 3.5% vs Group II; 15/122, 12.3%, p=0.026). The coronary angiographic findings were not different between two groups. The ejection fraction and Thrombolysis In Myocardial Infarction flow were improved after PCI in both groups (Group I; 49.4+/-10.5 to 52.0+/-9.0%, 1.52+/-1.13 to 2.77+/-0.55, p<0.001 vs Group II; 50.1+/-11.2 to 52.7+/-9.7, 1.55+/-1.11 to 2.76+/-0.53, p<0.001). Primary success rate of PCI was 94.2% (81/86) in Group I and 95.1% (116/122) in Group II (p=0.776). The survival rates of Group I was 97.7%, 97.7% and 96.5%, and those of Group II was 91.8%, 91.0% and 86.9% at 1, 6 and 12 months, respectively (p=0.043 at 1 month, p=0.040 at 6 months, p=0.018 at 12 months). CONCLUSION: Higher incidence of cardiogenic shock and worse long-term survival after PCI are observed in AMI patients with elevated CRP.
C-Reactive Protein* ; Humans ; Incidence ; Inflammation ; Jeollanam-do ; Male ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Prognosis ; Shock, Cardiogenic ; Survival Rate

BACKGROUND AND OBJECTIVES: There has been few study on the epidemiology and clinical characteristics of ventricular tachycardia (VT) in Korea, although their determination is crucial to the management of VT. The purpose of this study is to determine the clinical characteristics of VT. MATERIALS AND METHODS: Hospital medical records were reviewed on clinical characteristics including demographic feature, underlying disease, and clinical presentation in 66 patients who visited emergency room or out-patient clinic with VT as a primary medical problem from April 1996 to March 1999. The diagnosis of VT was made based on physical signs and ECG recording during the VT and confirmed with electrophysiology study in some cases. RESULTS: There were 42 men and 24 women (mean age: 50.218.9 years). The most common presenting symptom was palpitation (n=30), which was followed by dyspnea (n=18), syncope (n=11), sudden death (n=5). Five patients had no specific symptom. Underlying disease was coronary artery disease in 18 (27.3%) patients, dilated or hypertrophic cardiomyopathy in 11 (16.7%), valvular heart disease in 7 (10.6%), myocarditis in 3 (4.5%), but absent in 20 (30.3%). Idiopathic VT (n=16) usually originated from either right ventricular outflow tract (RVOT, 56.3%) or left ventricular septum (LVS, 31.3%). One-year cardiac mortality rate was 43.8% in coronary artery disease (n=16), 20.0% in cardiomyopathy (n=10), 33.3% in valvular heart disease (n=6), but zero in idiopathic VT (n=19). CONCLUSIONS: These findings suggest that idiopathic VT may be the most common type of VT in Korea and usually originates from either RVOT or LVS. The response to medical therapy is poor in VT with underlying heart disease but excellent in idiopathic VT.
Cardiomyopathies ; Cardiomyopathy, Hypertrophic ; Coronary Artery Disease ; Death, Sudden ; Diagnosis ; Dyspnea ; Electrocardiography ; Electrophysiology ; Emergency Service, Hospital ; Epidemiology ; Female ; Heart Diseases ; Heart Valve Diseases ; Humans ; Korea ; Male ; Medical Records ; Mortality ; Myocarditis ; Outpatients ; Syncope ; Tachycardia, Ventricular* ; Ventricular Septum

BACKGROUND AND OBJECTIVES: Despite marked advances in the design of percutaneous coronary intervention hardware, total occlusion remains associated with a low primary success rate. The most common cause of failure is the inability to cross the lesion with a guidewire. We report the results of a non-randomized single-center investigation using a hydrophilic coated guidewire (Crosswire NT). SUBJECTS AND METHODS: We analyzed the angiographic results of 92 patients (68 males, 24 females, age 58.8+/-9.7 years-old) who underwent angioplasty utilizing Crosswire NT for either total (TIMI flow 1) or subtotal occlusion at Chonnam National University Hospital between December 2000 and July 2001. RESULTS: Clinical diagnoses of the studied subjects revealed 40 cases of acute myocardial infarction, 15 of myocardial infarction, 29 of unstable angina and 8 of stable angina. The primary success rate was 79.3% (73/92), the success rate in total occlusion was 69.0% (40/58), and that of the chronic total occlusion cases among the total occlusion group was 64.3% (18/28). The success rates in the use of Crosswire NT as the first and second choice were 85.7% and 78.8%, respectively. The abrupt occlusive lesions, complex lesions more than type B 2, and presence of collateral circulation were all associated with a lower success rate. Coronary artery perforation occurred in one case. CONCLUSION: The new nitinol hydrophilic wire, Crosswire NT, is a safe and effective tool for the recanalization of total occlusive coronary lesion.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary ; Collateral Circulation ; Coronary Disease ; Coronary Vessels* ; Diagnosis ; Female ; Humans ; Jeollanam-do ; Male ; Myocardial Infarction ; Percutaneous Coronary Intervention*