BACKGROUND: Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model. METHODS: Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF). RESULTS: Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF. CONCLUSIONS: Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Acute Lung Injury* ; Animals ; Arrhythmias, Cardiac ; Bronchoalveolar Lavage ; Flecainide* ; Infusions, Subcutaneous ; Injections, Intraperitoneal ; Interleukin-8 ; Leukocytes ; Lung ; Lung Injury ; Models, Animal ; Neutrophils ; Rats ; Sepsis*

In the anesthesia for Cesarean section, the anesthetists should select the agent and technique which is safe for both the morther and baby. It seems to be a general tendency that delivery by Cesarean section has been increasing because of the development of anesthetic techniques and agents with which one can give a safter anesthesia than before and in turn, has led to increased anesthetic dependence. A small dose of ketamine with nitrous oxide was tried for the induction of anesthesia for Cesarean section in the first group. In the second group, thiopental was given intravenously and anesthesia was maintained with 2% halothane in 100% oxygen for the delivery. After delivery, morphine, diazepam, and muscle relaxant were added to 0.5~1.0% halothane if necessary. These two groups were compared with conventional thiopental N2O-O2 anesthesia and the results were as follws: 1) Changes in blood pressure were similar aspect in each group, but in the hypertensive mother, the ketamine caused a higher blood pressure than the other agents. 2) Changes in pulse rate also had a similar pattern in each group. 3) I-D and U-D interval was the shortest in the halothane group. 4) The Apgar score at 1 min after delivery wasrelatively higher in the ketamine and halothane group than in the thiopental group, while the score at 5 min was almost the same in each group. 5) The analgesic effect of ketamine was superior to that of other agents. The above data suggest that halothane seems to be superior when the fetal position is abnormal or in case when complicated intrauterine manipulation is expected. A small dose of ketamine with nitrous oxide is better in the hypertensive mother or when fetal distress exists.
Anesthesia* ; Apgar Score ; Blood Pressure ; Cesarean Section* ; Diazepam ; Female ; Fetal Distress ; Halothane ; Heart Rate ; Humans ; Ketamine ; Morphine ; Mothers ; Nitrous Oxide ; Oxygen ; Pregnancy ; Thiopental

OBJECTIVE: This study was performed to identify the prognostic factor for survival of patients with recurrent cervical cancer. METHODS: Sixty-eight patients were diagnosed as recurrent cervical cancer at the Seoul National University Hospital from January, 1988 to December, 1998. Recurrence was defined as new evidence of tumor after 6 months of disease free survival. Retrospective analysis was done in terms of clinical features and the Cox proportional hazard model was used to identify independent variables associated with an improved survival rate. Histopathologic types were distributed as follows; squamous cell carcinoma in 70.6%, adenocarcinoma in 11.8%, adenosquamous cell carcinoma in 11.8%, and small cell carcinoma in 1.5%. Distribution of FIGO stage was as follows; stage I in 25.0%, stage II in 66.2%, and stage III in 4.4%. Sites of recurrence were as follows; central pelvic recurrence in 44.1%, pelvic side wall recurrence in 11.8%, and distant metastasis in 44.1% and the most common site of distant recurrence was extrapelvic lymph nodes (29.4%). 29.4% of recurrences were observed within the first 12 months after initial therapy, 50.0% within 2 years and 64.7% within 3 years. RESULTS: Positive rate of SCC-Ag at initial diagnosis was 45.2% with cutoff value of 2.0 ng/ml. Positive rate of SCC-Ag at the diagnosis of recurrence was 60.0%. Overall response rate to the treatment was 29.1%. Complete response rate was higher in central pelvic recurrrence than pelvic side wall recurrence and distant metastasis (P = 0.002) and also higher in normal SCC-Ag level (< or = 2.0 ng/ml) at the diagnosis of recurrence than elevated level (P = 0.032). Cumulative survival rates of 1 year after recurrence was 66.8%, 2 year 36.7%, and 5 year 18.7%. Central recurrence showed higher cumulative survival rate than pelvic side wall or distant recurrence (P = 0.029). The patients with elevated SCC-Ag level at the time of diagnosis of recurrence showed lower cumulative survival rate than those with normal SCC-Ag level (P < 0.001). Cox proportional hazard model showed that SCC-Ag elevation at the time of diagnosis of recurrence retained significant values in predicting survival(OR = 2.56; 95% CI = [1.22-5.39]; P = 0.01). CONCLUSION: SCC-Ag elevation at the diagnosis of the recurrence is a strong independent prognostic indicator for survival of patients with recurrent cervical cancer.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Disease-Free Survival ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Uterine Cervical Neoplasms*

BACKGROUND & AIMS: Management of ovarian carcinoma presents most commonly by surgery and subsequent platinum-based chemotherapy, but most patients will have either residual or recurrent disease. Taxol, a new antimicrotubule agent, has been indicated as a salvage measure after failure of first-line or subsequent chemotherapy. The purpose of this study is to investigate the efficacy and toxicity of Taxol used as a salvage therapy. MATERIALS & METHODS: Between January 1994 and Jun 1996, 19 patients aged 38-64 years(median 52) with ovarian carcinoma were given Taxol-containing regimen. Taxol was administered at a dose of 135mg/m2 intravenously with cisplatin or carboplatin every 3 weeks. The patients who treated with Taxol only were received 175mg/m2 intravenously with same interval. The median treatment cycle was 6.6 cycles(range, 3 to 15 cycles). Patient's response were evaluated with tumor marker(CA-125) and CT or MRI before and after chemotherapy. Responses and toxicities were defined according to the Gynecologic Oncology Group criteria. (continue)
Carboplatin ; Cisplatin ; Drug Therapy* ; Humans ; Magnetic Resonance Imaging ; Ovarian Neoplasms ; Paclitaxel* ; Salvage Therapy*

To achieve optimal decalcification in tissue and tissue preservation, we have tried magnetic field method and made some promising results. We used pulsed unipolar magnetic field obtained by rectification of 250 V-60 cycle, A.C. As a new method of bony decalcification, using 5% nitric acid, 10% formic acid and 10% formic acid+3% hydrochloric acid solutions, experimental groups were decalcified in the center of the magnetic field. The concentration of calcium ion in the decalcifying solution was measured by calcium-oxalate turbidity test by photometry method, and direct visualization of calcium radiopacity was obtained by soft X-ray view during the decalcification process. The pH change during decalcification was continuously checked and needle penetration method was also used. All the decalcification solution used in this study showed accelerated effect of bony decalcification in the strong magnetic field. Among them 5% nitric acid produced complete decalcification for the medium size bony specimen (less than 10x10x10 mm) within 24 hours, and the histologic feature was almost free of acid-chemical degeneration. The pH of all the decalcification solutions decreased in the strong magnetic field, maximum within 4~6 hours, and kept strong acidity throughout the decalcification procedure. After removal of the magnetic field the pH of all the decalcification solution returned to their original values after 24 hours. It was presumed that the cause of the accelerated decalcification in the magnetic field was due to combined effects of the rapid increase of acidity and the increased molecular resonance to stimulate the ionization of mineral elements.

This phase II study aimed to assess the clinical activity and toxicity of ifosfamide based regimen in patients with epithelial ovarian cancer, relapsed or refractory to cisplatin-containing combination chemotherapy. From July 1991 to June 1993, 18 patients with epithelial ovarian cancer, relapsed or refractory to cisplatin were treated as follows. Relapsed cases were treated with IP(ifosfamide 4,0g/m2 intravenously and cisplatin 60mg/m2 intravenously on day 1) regimen every 3-4 weeks. The regimen used in refractory cases was Et-I(etoposide 100mg/m2 intravenously on days 1 to 3 and ifosfamide 1.0g/m2 intravenously on days 1 to 5) regimen every 3 or 4 weeks. The uroprotectant mesna was concomitantly used. Responses and toxicities were evaluated according to the WHO Criteria. The overall response rate was 27.8%(5/18), including 2 complete response and 3 partial response. There were four episodes(22.2%) of grade 3, 4 myelosuppression, but no other grade 3, 4 non-hematologic toxicity. Salvage therapy with ifosfamide based regimen is a useful and well tolerated treatment strategy in selected patients with relapsed ovarian cancer.
Cisplatin ; Drug Therapy, Combination ; Humans ; Ifosfamide ; Mesna ; Ovarian Neoplasms* ; Recurrence ; Salvage Therapy

Segmentalization of spinal fixation enhances correction of the coronal plane deformity and allows preservation of normal sagittal contour offering rigid fixation. Purpose of this paper was to evaluate the efficacy and safety of segmental pedicle screw fixation in the treatment of idiopathic thoracic scoliosis. From 1987 to 1991, 78 idiopathic thoracic scoliosis patients were treated with CD instrumentation. Thirty-one were treated with hooks, 23 with pedicle screws inserted in hook pattern and 24 with segmental pedicle screws. In segmental screw group, the screws were inserted for every other on the convex side. After follow up of minimum 2 years(range:24 to 52 months), the results of coronal, sagittal and rotational correction were compared. Major curve correction was 55% with hooks, 66% with hook pattern screws and 72% with segmental screws, with loss of correction of 6%, 2% and 1% respectively. Compensatory curve correction was 57% with hooks, 67% with hook pattern screws and 70% with segmental screws. In patients with hypokyphosis, all groups showed significant improvement, with best restoration in segmental screws. Rotational correction of the apical vertebra was 19% with hooks, 26% with hook pattern screws and 59% with segmental screws. Thirteen(3%) screws were malpositioned but they did not cause neurologic impairment nor adversely affect the results of treatment. This study implies that the segmental pedicle screw fixation is safe and effective method of correcting the triplanar deformity of the thoracic idiopathic scoliolis.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Methods ; Pedicle Screws ; Scoliosis ; Spine

OBJECTIVE: The purpose of this study was to evaluate the relationship between the visual acuity and visual evoked potentials of the amblyopia patients and normal persons for the demonstration of the visual disability. METHOD: We performed visual evoked potential study, in 49 eyes of the 43 amblyopia patients and in 76 eyes of 38 normal young adults. Our study was carried out to evaluate the relationship of the visual acuity with N1, P1, N2, P2 latency, P1-N2 amplitude and to compare the latency of N1, P1, N2, P2, and P1-N2 amplitude in amblyopia patients and normal young adults. RESULTS: The mean values of N1, P1, N2, P2 latency were prolonged in amblyopia patients compared to normal young adults (p <0.05). There was no correlation between the visual acuity and P1 latency (p> 0.05), but significant correlation was noted between the visual acuity and P1-N2 amplitude (p <0.05). CONCLUSION: These results showed prolonged latency of N1, P1, N2, P2 in amblyopia group as well as significant correlation between visual acuity and P1-N2 amplitude in both groups. So, P1 latency and P1-N2 amplitude are good parameters in evaluating the visual disability.
Amblyopia* ; Evoked Potentials, Visual* ; Humans ; Visual Acuity ; Young Adult

PURPOSE: The aim of this study was to investigate the effects of extracorporeal shock wave therapy (ESWT) an lateral epicondylitis of the elbow. MATERIALS AND METHODS: Twenty-four patients with refractory lateral epicondylitis were treated with shock waves. The patients were evaluated by assessing of pain using visual analog scale (VAS) and a simple elbow test (SET). Overall clinical outcomes were evaluated using Roles and Maudsley scores at 12 months after ESWT. RESULTS: Significant symptom improvement were observed in 20 (83%) patients at the 12 months follow up according to the Roles and Maudesley scores. Average SET and VAS scores were also significantly improved after ESWT (p<0.05). CONCLUSION: This study suggests that shock waves therapy could be considered as an effective and noninvasive treatment modality for refractory lateral epicondylitis of the elbow.
Elbow ; Follow-Up Studies ; Humans ; Shock ; Tennis Elbow* ; Tennis* ; Visual Analog Scale

Signet ring cell carcinoma has been previously described in many organs, most frequently in the stomach, and rarely in the colon, rectum, gallbladder, pancreas, breast, nadsal cavity, prostate, urinary bladder and ureter. Signet ring cell carcinomas in the lung, especially, when examined by small biopsies, are generally believed to be metastatic. This case was diagnosed by bronchoscopic biopsy. We also examined various organs by noninvasive method, including UGI series, barium enema and abdomen CT scarf, but all studies were nomal. Patient received cisplatin and etoposide combination chemotherapy followed by local radiotherapy ai a primary non-small cell lung cancer. Patient died of his disease 6 months after diagnosis. Now we report a case of primary signet ring cell carcinoma of the lung.
Abdomen ; Barium ; Biopsy ; Breast ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Signet Ring Cell* ; Cisplatin ; Colon ; Diagnosis ; Drug Therapy, Combination ; Enema ; Etoposide ; Gallbladder ; Humans ; Lung Neoplasms ; Lung* ; Pancreas ; Prostate ; Radiotherapy ; Rectum ; Stomach ; Ureter ; Urinary Bladder