Preliminary Result in Patients with Primary Hepatoma Treated by Stereotactic Radiotherapy / 대한방사선종양학회지

PURPOSE: It is not common to evaluate the response of the fractionated stereotactic radiotherapy (SRT) to primary hepatoma as compared with conventional radiotherapy. The purpose of the study was to take the preliminary result on the clinical trial of primary hepatoma by SRT. MATERIALS AND METHODS: From July 1999 to March 2000, thirty three patients were hospitalized in the St. Mary's Hospital, and treated with SRT for extracranial tumors. Among them, 13 patients were diagnosed to primary hepatoma and then applied by frameless SRT using 6 MV linac accelerator. There were 12 male and 1 female patients. They had the age of 44~66 year old (median : 59) and the tumor size of 10~825 cc (median : 185 cc). SRT was given to them 3~5 fractions a week (5 Gy/fraction, 90% isodose line) for 2~3 weeks. Median dose of SRT was 50 Gy and the range was 30~50 Gy. RESULTS: Follow-up period ranged from 3 months to 13 months with median of 8 months. After treating SRT to thirteen patients with primary hepatoma, the response of the tumor was examined by abdominal CT : they are classified by 1 complete regression (7.7%), 7 partial regression (53.8%), 4 minimal regression (30.8%), 1 stable disease (7.7%). The positive responses more than partial remission were 8 patients (61.5%) after the treatment. The level of serum alpha-fetoprotein (AFP) after the treatment as compared with pretreatment had been 92.3% decreased. There was no severe complication except dyspepsia 84.6%, mild nausea 69.2%, transient decreased of hepatic function 15.4% and fever 7.7%. CONCLUSION: SRT to the patients with primary hepatoma was potentially suggested to become the safe and more effective tool than the conventional radiotherapy even though there were relatively short duration of follow-up and small numbers to be tested.

The Diagnostic Utility of MR Cholangiography before Laparoscopic Cholecystectomy

PURPOSE: The purpose of this study was to prospectively compare the clinical applicabillity of magnetic resonance cholangiography(MRC) with that of endoscopic retrograde cholangiography(ERC) in the evaluation of combined choledocholithiasis in patients with gall stones who were candidates for laparoscopic cholecystectomy. MATERIALS AND METHODS: Twenty-seven patients with gall stones underwent fast spin-echo MR cholangiography using the half-Fourier acquisition single-shot turbo spin echo(HASTE) method, and half-Fourier rapid acquisition using the relaxation enhancement(RARE) method. Within five hours the same patients underwent ERC. The results of MRC was reviewed by two radiologists blinded to the results of ERC. The number and size of CBD stones and gall stones, and the degree of CBD dilatation, as seen on HASTE and RARE images, were compared with the results of ERC. RESULTS: MRC depicted common bile duct stones in 10 of 11 patients shown by ERC to have stones, while in the 16 patients in whom ERC did not reveal stones, MRC demonstrated the same finding. The number of CBD stones was exactly demonstrated by HASTE imaging in eight of eleven patients(73%) and by RARE imaging in ten of eleven patients(91%) in whom ERC revealed choledocholithiasis. The size of common bile duct stones visualized by ERC correlated in nine of eleven patients(82%) on HASTE images and in seven of eleven(64%) on RARE images. MRC showed CBD dilatation in all patients in whom dilatation was demonstrated by ERC. CONCLUSION: For the evaluation of choledocholithiasis before laparoscopic cholecystectomy in patients with gall stones, MRC and ERC are equally accurate. A comparison of HASTE imaging with RARE imaging, as used in the diagnosis of choledocholithiasis, revealed no significant differences.

A Comparative Analysis of Cervical Pap Smears Prepared by Conventional and ThinPrep Method / 대한산부인과학회잡지

No abstract available.

Statistical Analysis of Twin Pregnancy / 대한주산의학회잡지

Twin pregnancies represent a high risk obstetric population with perinatal morbidity and mortality much greater than that of singleton pregnancies. A retrospective dinical evaluation was attempted to analyse 211 cases of twin pregnancies in Chunchon Sacred Heart Hospital of Hallym University from Jan. l. 1988 to Dec. 31. 1997. The results were as follows. 1) The incidence of twin pregnancy was 1 in 93.9 deliveries. 2) The age of mother ranged from 19 to 42 years and predominant age group was 26-30 which covers 43.1% of all. 3) Nullipara was 61.1% and multipara was 38.9%. 4) The predominant gestational age group at delivery was 36-37 weeks, 33.2%. 5) In presentation, both cephalic combination was 46.4%, cephalic-breech was 26.1%. 6) The birth weight was less than 2500gm in 64.9% of the 1st babies and 70.6% of the 2nd babies, respectively. 7) The rate of cesarean section was 89.0%. The indications of cesarean section were malpresention (48.9%), elective cesarean section(38.8%), and toxemia(9.0%). 8) In 23 cases of vaginal delivery, the average duration of labor was 7.0 hours and 43.5% of 2nd baby was delivered within 5 min after 1st baby delivery, 9) The most frequent maternal complications during pregnancy were anemia(36.0%), preterm labor(34.6%) and preeclamsia(17.5%). 10) The perinatal mortality rate of the first and second twins was 10.4% and 12.3%, respectively. The main causes of perinatal death were prematurity(52.1%) and stillborn(22.9%). 11) Both female was 43.6%, both male was 39.3%, and opposite sex was 17.1% in infant.

Therapeutic Effect of Combined Radiotherapy and Hyperthermia in Primary Hepatocellular Carcinoma / 대한치료방사선과학회지

PURPOSE: This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma. MATERIALS AND METHODS: Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients (78.8%) were men, and 7 (21.2%) were women. According to Child's classification, nine patients (27.3%) were A group, 9 (27.3%) were B group, 15 (45.4%) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cGy to doses of 2550 cGy - 4950 cGy (median: 3000 cGy). Local hyperthermia was done by 8 MHz RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patients. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, a-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky performance status. RESULTS: The overall 1-year survival was 24.2%, with a mean survival of 10 months. Of 33 patients, tumor regression (PR+MR) was seen in 30.4%, no response was seen in 52.2%, 17.4% patient was progressed. In patients who had tumor regression, the overall 1-year survival was 42.1% with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky performance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain, 5 fat necrosis, 3 transient fever, 2 nausea and vomiting. CONCLUSION: In this study, the results suggests that combined radiotherapy and hyperthermia may improve the survival rate of hepatoma.

Transbronchial brush biopsy in the diagnosis of lung disease

The technic of selective transbronchial brush biopsy has been described by authors in a number of medialcenters. The procedure was popularized by Fennessy. This procedure should be considered for any hospital that isprovided with an image intensifier and adequate laboratory facilities. Between May and Aug. 1982, 13 patientsunderwent transbronchial brush biopsy at the Department of Radiology, St. Mary's Catholic Medical College. In mostcases, biopsy was performed was perforemd because of the presence of a pulmonary lesion or lesions suspicious ofmalignancy or infection in which cytologic and bacteriologic tests had failed to establish a diagnosis. Our recentclinical experience forms the basis of this communication. 1. As a reulst of bronchial brush biopsy, 4 cases ofpulmonary tuberculosis, 1 case each of alveolar cell ca, small cell ca, undifferentiated ca, and 3 cases ofbacterial pneumonia could be positively diagnosed. 2. The complications are transient hemoptysis and fever in 1case. 3. Bronchial brush biopsy has been proven to be a safe procefure with a high yield in the cytologic andbacteriologic diagnosis of diseases of the respiratory tract.