OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

At least 50% of the diabetics are affected by retinopathy in the western world since the 1950s and in Japan since the 1960s. In Korea, the incidence seems to be about 30%. The lower incidence of diabetic retinopathy in Korea may not be related with racial differences but rather with social and economic problems. This study covered 80 Korean diabetics (120 eyes) who were examined by means of the fluorescein fundus angiography and the results were compared with ordinary ophthalmoscopic findings. Diabetic retinopathy was found in 71% of the total studied cases by means of the fluorescein fundus angiography, but only 33% of the cases were recognized having diabetic retinopathy by ophthalmoscopic examination. It is very important to detect vascular changes in their early stage of diabetic retinopathy from view point of treatment. The earliest fluorescein fundus angiographic findings in diabetic retinopathy are microaneurysm, microvascular leakage, and capillary nonperfusion. On the fluorescein fundus angiographic findings, microaneurysm was found in 75 out of 120 eyes studied but only 30 eyes were found to have microaneurysms on the ophthalmoscopic examination. Among the retinal lesions referred to duration of diabetes mellitus, microaneurysms were observed in 13 out of 34 eyes in less than one year duration, and in 31 of 52 eyes during the period from one to five years. Leakage from microaneurysm was found in 18 out of 86 eyes within five years duration. Capillary non perfusion area was found in 10 among 34 eyes in less than one year duration, and 27 out of 52 eyes in one to five years duration. The longer the patient suffered from diabetes, the greater number of eyes showed microaneurysms and capillary non perfusion areas. Of 120 eyes examined by the fluorescein fundus angiography, 53 eyes were found having retinal edema and of 53 eyes, 6(4 patients) showed macular edema but through the ophthalmoscopy, only 10 eyes were found having retinal edema. Retinal neovasculation was found in 7 eyes (4 patients) through the fluorescein fundus angiography but only 5 eyes (3 patieuts) were found by ophthalmoscopic examination. The rate of having macular edema and neovascularization which were revealed through the fluorescein fundus angiographic findings clearly indicates the fact that at least 10% out of toral diabetic retinopathy studied so far are definitely indicative of photocoagulation therapy.
Angiography ; Capillaries ; Diabetes Mellitus ; Diabetic Retinopathy ; Fluorescein* ; Humans ; Incidence ; Japan ; Korea ; Light Coagulation ; Macular Edema ; Ophthalmoscopy ; Papilledema ; Perfusion ; Retinaldehyde ; Western World

No abstract available.
Drug Therapy*

No abstract available.
Female ; Humans ; Hysterosalpingography* ; Laparoscopy*

No abstract available.
Fibronectins* ; Granulation Tissue* ; Wound Healing* ; Wounds and Injuries*

Pulmonary vein stenosis is a rare condition which is usually congenital in origin and is almost invariably fatal in its bilateral and severe forms. It is often overlooked, however, during clinical examination, routine echocardiography, and even at cardiac catheterization. This report describes pulsed Doppler, color flow echocardiography, and hemodynamic findings of bilateral pulmonary vein stenosis accompanying ventricular septal and atrial septal defects successfully corrected by surgery.
Cardiac Catheterization* ; Cardiac Catheters* ; Catheterization ; Constriction, Pathologic* ; Echocardiography ; Echocardiography, Doppler, Color* ; Heart Septal Defects, Atrial ; Hemodynamics ; Pulmonary Veins*

OBJECTIVE: To estimate the burden of cardiovascular disease attributable to the total suspended particulates (TSP) and sulfur dioxide (SO2) in Korea using the YLD (years lived with disability) measurement. METHODS: Congestive heart failure(CHF) and myocardial infarction (MI) were chosen as the main cardiovascular diseases whose causes are attributable to the TSP and SO2 levels. In order to calculate the YLD (years lived with a disability), the following parameters in the formula were estimated. : the incidence rate, the case fatality rate, The expected duration of a disability and the average age of onset were estimated. The expected duration of a disability and the average age of onset were calculated using the DISMOD method, as developed by the GBD researchers. The burden of cardiovascular disease due to TSP and SO2 was estimated using the number of years that the patient lived with a disability. RESULTS: The YLD of the CHF due to the TSP and SO2 was attributed to the TSP (94.4 person-year) and SO2 levels (35.0 person-year). The YLD of the MI due to the TSP and SO2 was attributed to the TSP (148.4 person-year) and SO2 levels(27.6 person-year). CONCLUSION: The YLD method employed in this study was appropriate for quantifying the burden of cardiovascular disease. Therefore, it would provide a rational basis for planning a national health policy regarding the disease burden of the risk factors in Korea.
Age of Onset ; Air Pollution ; Cardiovascular Diseases* ; Estrogens, Conjugated (USP) ; Health Policy ; Heart ; Humans ; Incidence ; Korea ; Mortality ; Myocardial Infarction ; Risk Factors ; Sulfur Dioxide* ; Sulfur*

The authors evaluated the incidence of hip fracture and subsequent mortality in Korea using nationwide data obtained from the Health Insurance Review and Assessment Service. This study was performed on patient population, aged 50-yr or older who underwent surgical procedures because of hip fracture (ICD10; S720, S721). All patients were followed using patient identification code to identify deaths. Crude hip fracture rates increased from 191.9/100,000 in 2005 to 207.0/100,000 in 2008 in women and from 94.8/100,000 in 2005 to 97.8/100,000 in 2008, in men respectively. Crude mortality within 12 months after hip fracture showed a similar trend (18.8% in 2005 and 17.8% in 2007). The mean of standardized mortality ratio of hip fracture was 6.1 at 3 months, 3.5 at 1 yr, and 2.3 at 2 yr post-fracture. The increasing incidence and the high mortality after hip fracture are likely to become serious public health problems and a public health program should begin to prevent hip fractures in Korea.
Aged ; Aged, 80 and over ; Female ; Hip Fractures/*epidemiology/mortality ; Humans ; Incidence ; Male ; Middle Aged ; Republic of Korea/epidemiology

BACKGROUND: The efficacy of bisphosphonates for osteoporotic fracture has been consistently reported in recent randomized controlled trials (RCTs) enrolling hundreds of patients. The objective of this study was to update knowledge on the efficacy of available bisphosphonates in the prevention of vertebral and non-vertebral fractures. METHODS: An approach “using systematic reviews” on PubMed and Cochrane Library was taken. Twenty-four RCTs investigating the effects of bisphosphonates for the prevention of osteoporotic fracture were included in final analysis. A pairwise meta-analysis was conducted with a random effects model. Subgroup analysis was performed according to the type of bisphosphonate. RESULTS: The use of bisphosphonate decrease the risk of overall osteoporotic fracture (odds ratio [OR] 0.62; P<0.001), vertebral fracture (OR 0.55; P<0.001) and non-vertebral fracture (OR 0.73; P<0.001). Subgroup analysis indicated that zoledronic acid showed the lowest risk reduction (OR 0.61; P<0.001) for overall osteoporotic fractures but no significance was observed for etidronate (OR 0.34; P=0.127). CONCLUSIONS: This update meta-analysis re-confirmed that bisphosphonate use can effectively reduce the risk of osteoporotic fracture. However, there is a lack of evidence regarding etidronate for the prevention of osteoporotic fracture.
Diphosphonates* ; Etidronic Acid ; Humans ; Meta-Analysis as Topic ; Osteoporosis ; Osteoporotic Fractures* ; Risk Reduction Behavior

Systemic anticoagulation in routine hemodialysis is not desirable in patients with high risk of bleeding. Since heparin can bind to Hemophan, we evaluated the risk of bleeding and efficiency of hemodialysis using heparin bound Hemophan membranes in patients with high risk of bleeding. Heparin solution (1liter, 20IU/ml saline) was recirculated through the Hemophan(Gambro dialyzer, GFS Plus 11) for 1hour while removing saline solution(700ml/hr) by application of transmembrane pressure gradient, followed by a single pass rinse with 1 liter of saline solution. As a pilot study, we performed 17 hemodialyses on 15 chronic dialysis patients with contraindication to systemic anticoagulation. The duration of each dialysis was standardized to 4 hours at blood flow of 200 to 250ml/min. Blood samples were obtained to measure activated partial thromboplastin time (aPTT), and heparin concentrations (HC) before dialysis, at 15min, 60min, 120min after initiation of dialysis and at the end (240min) of dialysis. Dialysis efficiency was assessed by measuring Kt/V and urea clearance of dialyzer (K) by the direct quantification of dialysate urea and then compared with the 25 control dialyses with systemic anticoagulation. We successfully completed all 17 hemodialyses without severe clotting defined as, requiring replacement of the dialyzer and/or the extracorporeal blood lines. There was a slight increase in the aPTT (mean+/-SD, 42.9+/-4.4sec) and HC (0.15+/-0.03IU/ml) taken at 15min from predialysis levels of 36.3+/-6.3sec and 0.11+/-0.03U/ml, respectively. But no increase in aPTT, HC was observed in measurements taken at 60min, 120min, and at the end of dialyses. The value (mean+/-SD) of Kt/V and K was 1.27+/-0.25 and 134+/-19ml/min respectively, which did not differ from those of the control dialyses which was 1.24+/-0.21 and 136+/-13ml/min respectively. We performed 82 hemodialyses using such treated Hemophan on 27 patients for 4 hours basing the result of the pilot study. Clotting of dialyzer necessitating termination of dialysis occurred in 1 dialysis(1.2%) at 150min and clotting in the venous blood lines requiring change of blood lines occurred in 6 dialyses(7.3%) on 4 patients from 180min to 230min after initiation of dialysis. We conclude that the use of heparin bound Hemophan can be a safe and effective technique of hemodialysis with careful monitoring of extracorporeal clotting in patients with high risk of bleeding.
Dialysis* ; Hemorrhage* ; Heparin* ; Humans ; Membranes ; Partial Thromboplastin Time ; Pilot Projects ; Renal Dialysis* ; Sodium Chloride ; Urea