No abstract available.
Byssinosis*

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of [18F]FDG PET in the diagnosis of recurrent head and neck cancer after the completion of surgery and radiotherapy in patients with head and neck cancers. MATERIALS AND METHODS: In fifty-nine patients with head and neck cancers, whole body [18F]FDG PET studies were performed. According to the different therapeutic modalities, patients were divided into four groups (Group I; pre-treatment, Group II; surgery, Group III; radiotherapy, Group IV; both surgery and radiotherapy). [18F]FDG PET images were compared with clinical, CT and histopathologic findings. RESULTS: For detection of metastatic lymph nodes in 14 patients of pre-treatment group (group I), the sensitivity and specificity of PET were 100% (10/10) and 75% (3/4), and those of CT were 80% (8/10) and 100% (4/4). For detection of recurrence in 45 patients of post-treatment group, overall sensitivity and specificity of PET were 96.2% (25/26) and 78.9% (15/19) [(100% and 75% in group II, 80% and 50% in group III, and 100% and 100% in group IV)] without significant difference from pre-treatment group (p>0.1). In detecting recurrence, the sensitivity and specificity of [18F]FDG PET were 90.9% (10/11) and 20% (1/5) in 16 patients who underwent [18F]FDG PET within 2 months after the completion of treatment. The specificity of these patients was significantly lower than that of 29 patients (100% of sensitivity and specificity) who underwent [18F]FDG PET 2 months after treatment (p<0.05). CONCLUSION: [18F]FDG PET is an accurate diagnostic modality for the detection of recurrence in head and neck cancer. Post-therapy [18F]FDG PET should be obtained at least 2 months after the completion of surgery or radiotherapy.
Diagnosis ; Head and Neck Neoplasms ; Head* ; Humans ; Lymph Nodes ; Neck* ; Radiotherapy* ; Recurrence ; Sensitivity and Specificity

PURPOSE: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. MATERIALS AND METHODS: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. RESULTS: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). Follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. CONCLUSION: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our RESULTS suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.
3-Iodobenzylguanidine ; Female ; Follow-Up Studies ; Gamma Cameras ; Humans ; Kidney ; Lymph Nodes ; Mediastinum ; Middle Aged ; Neoplasm Metastasis ; Nuclear Medicine ; Pheochromocytoma

PURPOSE: It is important to differentiate malignant from benign lesions of intraocular masses in choosing therapeutic plan. Biopsy of intraocular tumor is not recommended due to the risk of visual damage. We evaluated the usefulness of F-18-FDG PET imaging in diagnosing intraocular neoplasms. MATERIALS AND METHODS: F-l8-FDG PET scan was performed in 13 patients (15 lesions) suspected to have malignant intraocular tumors. There were 3 benign lesions (retinal detachment, choroidal effusion and hemorrhage) and 10 patients with 12 malignant lesions (3 melanomas, 7 retinoblastomas and 2 metastatic cancers). Regional eye images (256*256 and 128*128 matrices) were obtained with or without attenuation correction. Whole body scan was also performed in eight patients (3 benign and 6 malignant lesions). RESULTS: All malignant lesions were visualized while all benign lesions were not visualized. The mean peak standardized uptake value (SUV) of malignant lesions was 2.64+/-0.57 g/ml. There was no correlations between peak SUV and tumor volume. Two large malignant lesions (>1000 mm3 ) showed hot uptake on whole body scan. But two medium-sized lesions (100-l000 mm3) looked faint and two small (<100 mm3) lesions were not visualized. The images reconstructed with 256*256 matrix showed lesions more clearly than those with 128X128 matrix. CONCLUSION: F-18-FDG PET scan is highly sensitivity in detecting malignant intraocular tumor. For the evaluation of small-sized intraocular lesions, whole body scan is not appropriate because of low sensitivity. A regional scan with sufficient acquisition time is recommended for that purpose. Image reconstruction in matrix size of 256*256 produced clearer images than the ones in 128X128, but it does not affect the diagnostic sensitivity.
Biopsy ; Choroid ; Diagnosis* ; Humans ; Image Processing, Computer-Assisted ; Melanoma ; Orbital Neoplasms ; Positron-Emission Tomography ; Retinoblastoma ; Tumor Burden ; Whole Body Imaging

The main objectives of the surgical treatment of intrahepatic stones are complete removal of the stones and correction of biliary stasis and strictures. Hepatic resection is expected to yield a most satisfactory treatment result by eradicating the stones and the strictured bile duct as well. To evaluate the effectiveness and the risk of hepatic resection, we reviewed 149 patients who underwent hepatic resection due to intrahepatic stones over a fourteen-year period and who were followed up. There were 48 males and 101 females, and ages ranged from 20 to 70 years. The stones were located in the left lobe in 96 patients, the right lobe in 13 patients, and both lobes in 40 patients. The operative procedures executed in the patients were 96 lateral segmentectomies, 33 left lobectomies, 14 right lobectomies, one extended right lobectomy, and five partial resections. Biliary drainage procedures were added in 40 patients. Postoperatively, retained stones were found in 24.2% of the patients which was lowered to 10.7% at the time of discharge with assistance of radiologic interventions. During follow-up over a mean period of 63 months, 93.2% of the patients showed good rehabilitation, and recurrent stones had developed in 5 patients (3.5%). Operative complications were biliay fistula in 10 patients, intra-abdominal abscess in seven patients, hepatic failure in two patients, and postoperative bleeding in one patient, and the overall operative mortality rate was 2.0%. We conclude that hepatic resection is a safe and satisfactory treatment option for patients with intrahepatic stones.
Abdominal Abscess ; Bile Ducts ; Cholestasis ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver Failure ; Male ; Mastectomy, Segmental ; Mortality ; Rehabilitation ; Surgical Procedures, Operative

BACKGROUND: Caudal administration of local anesthetics, opioids, and the alpha2 adrenergic agonists is effective for postoperative pain. Intrathecal and epidural opioids may commonly result in urinary retention. The purpose of this study was to evaluate the effects of fentanyl or clonidine on postoperative analgesia and urinary retention. METHODS: Forty patients undergoing a hemorrhoidectomy were randomly assigned to receive 20ml of 2% lidocaine and 1 : 200,000 epinephrine plus clonidine 100 microgram (group C100, n = 10), clonidine 150 microgram (group C150, n = 10), fentanyl 50 microgram (group F50, n = 10), or fentanyl 100 microgram (group F100, n = 10) for caudal anesthesia. Mean arterial pressure (MAP) and heart rate (HR) were measured before anesthesia and immediately postanesthesia, and every 5 min after caudal administration for 30 min. The following variables were recorded: onset time, analgesic time, voiding time, and urinary retention. RESULTS: The MAP at 20, 25, and 30 min in group C150 (91 +/- 7, 91 +/- 6, and 90 +/- 7 mmHg, respectively) was less than in group F50 (99 +/- 4, 101 +/- 6, and 101 +/- 5 mmHg, respectively) (P < 0.05). There was no difference in HR and onset time of anesthesia among the groups. Analgesic times in groups C150, F50, and F100 (270 +/- 22, 265 +/- 23, and 323 +/- 82 min, respectively) were longer than in group C100 (207 +/- 59 min), (P < 0.05). The number of patients using a urinary catheter to void was much higher in group F100 (7 patients) than in the groups C100, C150, or F50 (4, 5, and 3 patients, respectively) (P < 0.05). The voiding time was longer in group C150 than in group C100 (369 +/- 122 min vs 266 +/- 83 min, P < 0.05). No side effects were reported. CONCLUSIONS: We conclude that clonidine 150 microgram is adequate to provide effective analgesia and a low incidence of urinary retention during caudal anesthesia.
Adrenergic Agonists ; Analgesia* ; Analgesics, Opioid ; Anesthesia ; Anesthesia, Caudal* ; Anesthetics, Local ; Arterial Pressure ; Clonidine* ; Epinephrine ; Fentanyl* ; Heart Rate ; Hemorrhoidectomy ; Humans ; Incidence ; Lidocaine ; Pain, Postoperative ; Urinary Catheters ; Urinary Retention*

BACKGROUND: Several studies have indicated that lumbar epidural anesthesia may decrease the incidence of deep vein thrombosis and pulmonary embolism, particulary after total hip replacement. Moreover venous thromboembolism also occurs after the release of a tourniquet in orthopedic surgery. The d-dimer test has been reported to be useful for predicting lower limb DVT and PE. Of the d-dimer test methods, the latex agglutination method shows excellent sensitivity and specificity. METHODS: We compared the quantity of d-dimer for General (n = 21) and Epidural (n = 20) anesthesia after tourniquet release in patients undergoing arthroscopic knee surgery. RESULTS: D-dimer significantly increased after tourniquet release in both groups, whereas the increase of d-dimer in the Epidural group was no smaller than that in the General group. Epidural group showed a correlation between tourniquet application and d-dimer. CONCLUSIONS: The present data suggest that DVT and PE after tourniquet release could occur during arthroscopic knee surgery and that epidural anesthesia may increase the fibrinolysis of a tourniquet induced thrombus.
Agglutination ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General* ; Arthroplasty, Replacement, Hip ; Fibrinolysis ; Humans ; Incidence ; Knee* ; Latex ; Lower Extremity ; Orthopedics ; Pulmonary Embolism ; Sensitivity and Specificity ; Thromboembolism ; Thrombosis ; Tourniquets* ; Venous Thromboembolism ; Venous Thrombosis

BACKGROUND: Propofol is a good induction agent. but it has a disadvantage of pain on intravenous injection. Pretreatment of metoclopramide or lidocaine have been reported to reduce pain on injection. thus, we have evaluated the quantity and quality of anagesic effect of metoclopramide and lidocaine. We observed differences in quality of pain according to venous cannula sizes and intravenous injection sites as well as nausea and vomiting in the postoperative state. METHODS: Eighty patients scheduled for an elective operation by general anesthesia were chosen according to ASA (I or II) and divided into four groups randomly. Each group was injected through venous cannulas with normal saline (control group), metoclopramide 5 mg (group 1), metoclopramide 10 mg (group 2), or 2% lidocaine 40 mg (group 3) respectively. Then, propofol was injected of a 2 mg/kg dose with 0.5 ml/sec to all groups and we asked questions about injection pain after 10 seconds. RESULTS: Pain relief was shown in all groups compared with the control. but metoclopramide 10 mg and lidocaine 40 mg pretreatment groups showed significant pain reief. Pain was relieved significantly when the drug was injected in the antecubital area. Postoperative nausea and vomiting were not observed. CONCLUSIONS: Metoclopramide 10 mg or lidocaine 40 mg pretreatment to induction by propofol revealed a good analgesic effect for propofol injection pain.
Anesthesia, General ; Anesthetics ; Catheters ; Humans ; Injections, Intravenous ; Lidocaine ; Metoclopramide* ; Nausea ; Postoperative Nausea and Vomiting ; Propofol* ; Vomiting

No abstract available.
Humans ; Polyamines*

OBJECTIVE: This study was to evaluate the association of the G1691A mutation of factor V gene with preeclamptic patients in Korea. METHODS: Factor V genotype were determined in 113 preeclamptic patients and 100 normotensive pregnant women. A 267 base-pair DNA fragment of the factor V gene that includes nucleotide 1691 was amplified by PCR. PCR product was digested with MnlI restriction enzyme and the fragments were analysed by electrophoresis using 2% agarose gel. RESULTS: The difference of genetic and allelic frequencies between two groups could not be mentioned because all women were G1691G homozygotes. There was no individuals with mutant allele among preeclamptic patients and control women. CONCLUSION: There was no evidence of association between preeclampsia and factor V gene polymor- phism in Korean population.
Alleles ; DNA ; Electrophoresis ; Factor V* ; Female ; Genotype ; Homozygote ; Humans ; Korea* ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnant Women ; Sepharose