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Comparison between Propofol/Remifentanil and Ketamine/Remifentanil for TIVA in Beagle Dogs (비글견에서 Propofol/Remifentanil과 Ketamine/Remifentanil을 사용한 완전 정맥 내 마취법의 비교)

  • Choi, Woo-Shik;Jang, Hwan-Soo;Park, Jai-Soon;Yun, Sung-Ho;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.479-485
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    • 2011
  • The cardiopulmonary responses during total intravenous anesthesia (TIVA) between remifentanil/propofol infusion and remifentanil/ketamine infusion in dogs were compared. Fourteen healthy adult beagle dogs were premedicated with acepromazine (0.1 mg/kg, SC) and medetomidine (20 ${\mu}g$/kg, IV), and anesthetized for 3 hr with remifentanil (0.5 ${\mu}g$/kg/min)/propofol (loading dose: 1 mg/kg, CRI: 0.3 mg/kg/min) CRI (group 'P') or remifentanil/ ketamine (loading dose : 5 mg/kg, CRI: 0.1 mg/kg/min) CRI (group 'K'), respectively. Hemodynamics, blood gas analysis and behavioral changes during recovery were measured. The level of anesthesia was determined by toe-web clamping test. The level of surgical anesthesia was maintained throughout the experiment in both groups. Systolic arterial pressure, mean arterial pressure, $PaO_2$ and $SpO_2$ in group 'K' were significantly higher than in group 'P', and were maintained near the normal ranges. In addition, $PaO_2$ in group 'K' was significantly lower than in group 'P'. However, diastolic arterial pressure, heart rate and respiratory rate were not significantly differed. Mean extubation time from the end of infusion was significantly reduced in group 'K', but mean sitting time was significantly reduced in group 'P'. Mean head-up time and mean walking time were not significantly differed. In group 'K', brief muscle rigidity, head waving and licking during recovery were observed. In conclusion, infusion rate of ketamine (0.1 mg/ kg/min) with remifentanil (0.5 ${\mu}g$/kg/min) is an appropriate for obtaining the surgical plane of anesthesia. These results showed that group 'K' had better cardiopulmonary function than group 'P'. That is, remifentanil/ketamine CRI is better TIVA protocol than remifentanil/propofol CRI for 3 hr surgery.

Long-term Follow-up after Radiation Therapy Alone for Esophageal Carcinoma (식도암의 방사선치료 성적 - 장기 추적관찰의 결과)

  • Wu Hong-Gyun;Park Suk-Won;Park Charn-Il
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.441-446
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    • 1998
  • Purpose : The incidence of esophageal carcinoma is increasing. Radical surgery is the treatment of choice, but large proportion of the esophageal cancer patients are with unresectable disease at the time of initial diagnosis, so radiation therapy has been the major treatment modality. We carried out retrospective analysis to see the outcome and prognostic factors of radiation therapy alone for esophageal carcinoma. Methods and Materials : From June of 1979 through December 1992, 289 patients with esophageal carcinoma were treated with radiation therapy alone at Department of Therapeutic Radiology, Seoul National University Hospital. Of these patients, 84 patients were excluded as they were ineligible for the current analyses. Twenty-two patients had distant metastasis other than supraclavicular lymph node metastasis, 52 patients received less than 45 Gy, and 10 patient were lost from follow-up. Therefore 205 patients constituted the base population of this study. According to AJCC s1aging system, there were 2 patients with stage 1, 104 with stage IIA, 26 with stage IIB, 48 with stage III, and 25 with stage IV Radiation dose ranged from 4500 cGy to 6980 cGy with median dose of 5940 cGy. Follow-up period of the alive patients ranged from 77 to 180 months. Results : The Median survival period of all the patients was II months and the 2-, 5-, and 10-year overall survival rates were 22.4$\%$, 10.2$\%$ and 5.3$\%$, respectively. Most of the failures were local recurrences. Of 169 failures, 134 had local failure as a component and 111 had local recurrence only. The Lymph node was most common distant metastatic site and the next was the lung. The stage, T-stage, N-stage, functional status, tumor size, and aim of treatment were statistically significant prognostic factors for survival by univariate analyses. But only tumor size and N-stage were significant by multivariate analyses. Conclusion : We could get 10.2$\%$ of 5 year survival rate and 5.3$\%$ of 10 year survival rate with radiation therapy alone. The size of tumor and N-stage were statistically significant prognostic factors for survival on multivariate analyses.

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Assessment of the Activities of General Physicians in Health Subcenters and a Scheme to Improve the Training Program (보건지소 공중보건 일반의사의 업무수행정도와 수련개선방안)

  • Park, Jung-Han;Chun, Byung-Yeol;Woo, Kuck-Hyeun
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.2 s.20
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    • pp.193-202
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    • 1986
  • The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook, Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees were asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs should provide the GPs with a continuing education to assist the problem solving in the field and motivate them to actively carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.

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Purification and Characterization of Sulfated Polysaccharide Isolated from Hot Water Extract of Pachymeniopsis elliptica (Pachymeniopsis elliptica의 열수 추출물로부터 분리한 함황 다당류의 정제 및 특성)

  • Lee, Sun-Hee;Jun, Woo-Jin;Yu, Kwang-Won;Chun, Hyug;Shin, Dong-Hoon;Hong, Bum-Shik;Cho, Hong-Yon;Yang, Han-Chul
    • Korean Journal of Food Science and Technology
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    • v.32 no.5
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    • pp.1191-1197
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    • 2000
  • In the preliminary study, we investigated the anti-complementary activities of 62 extracts from Korean edible seaweeds. Of those, Pachymeniopsis elliptica showed the highest anti-complementary activity. Therefore, it was purified as follows; i) PE-1 by ethanol precipitation, ii) PE-1-C by ultrafiltration, iii) PE-1-CIV by DEAE-Toyopearl 650C, and iv) PE-1-CIV-ii by Sepharose CL-6B. The purified compound, PE-1-CIV-ii, was the complexed homogeneous polysaccharide (molecular mass: 780 kDa) with 82.9% of anti-complementary activity. Also, it contained a significant amount of sulfate group (30.5%), which indicated it as a sulfated algal polysaccharide. Its structural monosaccharides were galactose (44.3%), 3,6-anhydrogalactose (34.0%), glucose (8.2%), fucose (5.4%), xylose (5.2%) and rhamnose (2.9%). After the treatment of periodate on a sample, a significant decrease in anti-complementary activity was found, which was a characteristic of bioactive polysaccharides. And-tumor activity of PE-1-A, B and C was tested in the sarcoma-180 solid tumor model. The PE-1-C with the largest molecular mass (more than 300 kDa) showed 81% of inhibition on the solid tumors, suggesting that the anti-complementary activity was, at least in part, related to anti-tumor activity. Based upon these results, the purified polysacchardes could be an immunopotentiator in vivo.

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Some Chemical Properties and Composition of Lipid Extracts of Riced Dehydrated Potato Granules (감자분말(粉末)의 지방질조성(脂肪質組成)과 저장중(貯藏中)의 변화(變化)에 관(關한) 연구(硏究))

  • Yoon, Jeong-Won;Hong, Bum-Shik;Yang, Han-Chul;Kim, Dong-Hoon
    • Korean Journal of Food Science and Technology
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    • v.10 no.3
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    • pp.320-330
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    • 1978
  • Riced dehydrated potato granules with a good reconstituton quality was made from Irish Cobber (IC) and Shimabara which are representative varieties in Korea. A part of IC potato granules was packed in small vinyl-bags while the rest, including some BHA (75ppm)-treated granules, was packed in $301{\times}407$ plain tin cans. These granules were stored in a room at room temperature, and their physico-chemical properties and lipid composition were studied. The color of the granules was measured with a Hunter-type Tristimules colorimeter. L, $a_L,$ and $b_L-values$ were respectively 83.8, -1.1 and 18.3. Variety and package-type did not affect the color. In general, it was darker than that of commercial wheat flour, but whiter than that of commercial defatted soy flour. At $100^{\circ}C$, the granules, irrespective of variety and package-type, absorbed water rapidly, and reached the maximum moisture content of $90{\sim}92%$ in 3 min., whereas they absorbed water more slowly at $8{\sim}14^{\circ}C$, and reached the maximum content of $72{\sim}74%$ in 5 minutes. Peroxide, TBA, carbonyl, acid, and iodine values of the granules after 3 months storage were respetively $150{\sim}460\;meq/kg,\;20{\sim}26,\;154{\sim}380$ micromole, $24{\sim}59,\;and\;70{\sim}78$. Except iodine values, all the chemical values were affected by variety and package-type. Ether and $CHCl_3-extracts$ of the granules from IC and Shimabara were subjected to GLC and TLC analyses. In case of IC, the major fatty acids were palmitic, stearic, and oleic (30.0, 18.8, 40.6), while in case of Shimabara they were palmitic, oleic, and linoleic acids (26.7, 39.6, 23.4%). The major lipid classes were, in both cases, triglycerides and phospholipids. Their contents were raspectively 19.1 and 43.1 (IC), and 30.1 and 37.4% (Shimabara).

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The Analysis of the Need Rate of Shunt and the Outcome in Hydrocephalus Following SAH - Relationship between the Outcome and the Duration, Daily and Total Amount of CSF Drainage at EVD - (자발성 지주막하출혈 후 발생하는 수두증에 대한 단락술의 필요성 및 예후에 관한 분석 - 뇌실외배액술의 기간, 일일배액량 및 총배액량과 예후관계 -)

  • Lee, Won Chang;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.99-107
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    • 2001
  • Objective : Hydrocephalus and vasospasm are the common complications following subarachnoid hemorrhage (SAH). In spite of development of perioperative management and operative technique, hydrocephalus cause neurological deficit and poor prognosis. Usually CSF drainage procedure(external ventricular drainage(EVD) or shunt) is needed in hydrocephalus following SAH. The aim of this study was to investigate whether the need for shunting and the outcome after shunting in hydrocephaus following SAH can be related to the duration, daily and total amount of cerebrospinal fluid(CSF) drainage at EVD. Material and Method : IVH is one of several factors which cause hydrocephalus. In this retrospective study, firstly we investigated the incidence of IVH in total cases and frequency of IVH according to aneurysmal site and then prognosis of IVH following SAH. Among 629 patients with SAH, hydrocephalus was diagnosed by CT scan and symptoms. And then those 102 hydrocephalus following SAH were divided into two groups which were hydrocephalus with IVH group and without IVH group. In these two groups, we investigated and compared the incidence of hydrocephalus in all case, frequency of hydrocephalus according to aneurysmal site, the outcome according to H-H grade on admission and the need rate of shunt, etc. Of those hydrocephalus, 100 EVD procedures were done. The duration, daily and total amount of CSF drainage at EVD were investigated. Fifty cases expired during EVD was excluded. We analyzed whether the need rate of shunt and the final outcome after shunting can be related to IVH, the duration and daily and total amount of CSF drainage. Result : The incidence of hydrocephalus following SAH was 20%(with IVH group ; 64%, without IVH group ; 11%). As H-H grade on admission was better, the outcome of hydrocephalus was also better. The mortality rate of hydrocephalus with IVH was 64% which was higher than 40% that of hydrocephalus without IVH. The need rate of shunt in all cases of hydrocephalus following SAH was 20%, but those with IVH group excluding expired patients before shunt was 40%. This was very similar to 41% of the need rate of shunt in hydrocephalus without IVH. The total amount of CSF drainage was statistically related to the need rate of shunt(total amount : need rate of shunt/<1000cc : 15%, 1000-2000cc : 40%, >2000cc : 50%). The duration and daily amount of CSF drainage were not statistically related to the need rate of shunt, but as daily amount of CSF drainage was more and duration was longer, the need rate of shunt was increased(daily amount : need rate of shunt /<100cc : 16%, 100-200cc : 25%, >200cc : 40%//duration : need rate of shunt/<1week : 8%, 1-2weeks : 30%, >2weeks : 47%), and also the final outcome after shunting was poor. Especially the total amount of CSF drainage was significant related to the final outcome after shunting(total amount : GOS/<1000cc : I&II(3/4), 1000-2000cc : II(2/4), III(2/4), >2000cc : III&IV(6/7)). Conclusion : This study revealed that the incidence and mortality rate of hydrocephalus following SAH were influenced by IVH. So SAH associated IVH has the higher incidence of hydrocephalus and poor outcome. As the CSF drainage amount was more and duration of drainage was longer, the need rate of shunt was increased and the final outcome after shunting was poor. Especially the total amount of CSF drainage were strongly related to the need rate of shunt and the outcome after shunting.

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DIFFERENCE IN BOND STRENGTH ACCORDING TO FILLING TECHNIQUES AND CAVITY WALLS IN BOX-TYPE OCCLUSAL COMPOSITE RESIN RESTORATION (박스 형태의 복합레진 수복시 충전법 및 와동벽에 따른 결합력 차이에 관한 연구)

  • Ko, Eun-Joo;Shin, Dong-Hoon
    • Restorative Dentistry and Endodontics
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    • v.34 no.4
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    • pp.350-355
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    • 2009
  • Bond strength depends on characteristics of bonding surface and restorative technique. The majority of studies dealing with dentin bond strength were carried out on flat bonding surface, therefore, difference of bond strength between axial wall and pulpal wall is not clear yet. This study evaluated bonding difference between cavity walls in class I composite resin restoration with different filling techniques. Twenty extracted caries-free human third molars were used. Cavities were prepared in 6 ${\times}$4 ${\times}$3 mm box-type and divided into four groups according to filling technique and bonding surface: Group I; bulk filling - pulpal wall, Group II; bulk filling - axial wall, Group III; incremental filling - pulpal wall, Group IV; incremental filling - axial wall. Cavities were filled with Filtek $Z250^{(R)}$(3M/ESPE., USA) and Clearfill SE $bond^{(R)}$(Kuraray, Japan). After 24 hour-storage in $37^{\circ}C$water, the resin bonded teeth were sectioned bucco-lingualy at the center of cavity. Specimens were vertically sectioned into 1.0 ${\times}$1.0 mm thick serial sticks perpendicular to the bond surface using a low-speed diamond saw (Accutom 50, Struers, Copenhagen, Denmark) under water cooling. The trimmed specimens were then attached to the testing device and in turn, was placed in a universal testing machine (EZ test, Shimadzu Co., Kyoto, Japan) for micro-tensile testing at a cross-head speed of 1 mm/min. The results obtained were statistically analyzed using 2-way ANOVA and t-test at a significance level of 95%. The results were as follows: 1. There was no significant difference between bulk filling and incremental filling. 2. There was no significant difference between pulpal wall and axial wall, either. Within the limit of this study, it was concluded that microtensile bond strength was not affected by the filling technique and the site of cavity walls.

The Analysis of Forest Vegetation in Mt. Kumjeong (금정산(金井山) 일대(-帶)의 삼림식생분석(森林植生分析))

  • Yun, Chung Weon;Bae, Kwan Ho;Hong, Sung Cheon
    • Current Research on Agriculture and Life Sciences
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    • v.13
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    • pp.31-44
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    • 1995
  • Mt. Kumjeong is located in south-eastern part of the Korean Peninsular($129^{\circ}$01' to $129^{\circ}$05' E, $35^{\circ}$03' to $35^{\circ}$17' N) and the altitude of the summit is 802 meter. In order to find out the vegetation units which made it possible to classify subtropical forest and south-temperate forest, Mt. Kumjeong (which is located in a border of between subtropical forest and south-temperate forest) was selected as a study area. The primary result of actual vegetation analysis in Mt. Kumjeong based upon the vegetation community analysis methods by the ZM-school, and the relationships between vegetation community and two parameters(altitude, topography) analyzed by using coincidence analysis method were summarized as followings. 1. Based upon analytic methods of the vegetation community by the ZM-schools, the primary analytic result of the analysis of vegetation community in Mt. Kumjeong was divided into 10 communities, 9 groups, 2 subgroups. 2. Eurya japonica group of Pinus densiflora community out of 16 vegetation units was thought as a indicator vegetation group which made it possible to border subtropical forest and south-temperate forest. 3. Natural regeneration of Stewartia koreana group was thought to be difficult because seedling and sapling was rarely showed, 4. In relationship between vegetation units and altitude, Carpinus tschonoskii community, Quercus variabilis community, Quercus serrata community, Wisteria floribunda community,. Eurya japonica group of Pinus densiflora community, Pinus thunbergii community mainly distributed below altitude 500 meter, and Quercus mongolica community, Typical group of Pinus densiflora community, Quercus dentata community, Carpinus coreana community, Quercus acutissima community mainly distributed above altitude 500 meter. 5. In relationship between vegetation units and topography, Carpinus tschonoskii community, Quercus variabilis community, Quercus serrata community, Wisteria floribunda community,. Eurya japonica group of Pinus densiflora community distributed below middle slope, Quercus mongolica community, Typical group of Pinus densifiora community, Quercus dentata community, Carpinus coreana community, Pinus thunbergii community Quercus acutissima communily clistributed above midclle slope.

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Prognostic Factors in Postpsychotic Depressive Disorder of Schizophrenia (정신분열증의 정신증 후 우울장애의 예측인자)

  • Kim, Jin-Sung;Lee, Jong-Bum;Seo, Wan-Seok;Koo, Bon-Hoon;Bae, Dae-Seok;Kim, Yi-Youg;Kim, Jung-Youp
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.150-165
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    • 2005
  • Purpose: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. Materials and Methods: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. Results: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20(25.0%) for the BDI, 16(20.0%) for the ZDS, 18(22.5%) for the CDSS and 6(7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. Conclusion: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

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The Effect of Percutaneous Bilateral Metalic Stent for Hilar Cholangiocarcinoma (간문부 담관암 환자에서 경피경관 양측성 금속 배액관의 효과)

  • Kim, Kum-Rae;Kim, Joo-Hyung;Park, Won-Kyu;Jang, Jay-Chun;Cho, Jae-Ho;Kim, Tae-Nyen;Kim, Jun-Hwan;Jang, Byeng-Ik
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.211-220
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    • 2005
  • Background: The purpose of this study was to determine the effectiveness of a percutaneously placed self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. Materials and Methods: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral selfexpanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. Results: There were 4 cases of Bismuth type II, 21 cases of Bismuth type IIIa, 8 cases of Bismuth type IIIb and 15 cases of Bismuth type IV. Stent placement was technically successful in all patients. All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage rate of 91.1%. There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and median survival time were 303 days (range, 60~815) and 338 days (range, 60~1175), respectively. Conclusion: Placement of a percutaneous metallic stent is an effective and safe method for palliation of patients with hilar cholangiocarcinoma.

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