• Title, Summary, Keyword: Pancreas

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Effects of Dietary Resveratrol on Growth Performance, Blood Biochemical Parameter, Immunoglobulin, and Blood Antioxidant Activity in Broiler Chicks (Resveratrol의 첨가가 육계의 생산성, 혈액 생화학 특성, 혈액 내 면역글로불린과 혈액 내 항산화 인자에 미치는 영향)

  • Kim, Dong-Wook;Hong, Eui-Chul;Ji, Sang-Yoon;Lee, Wang-Shik;Bang, Han-Tae;Kang, Hwan-Ku;Kim, Hyun-Soo;Kim, Sang-Ho
    • Korean Journal of Poultry Science
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    • v.42 no.2
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    • pp.147-156
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    • 2015
  • This study was conducted to investigate the effects of dietary resveratrol on growth performance, blood biochemical parameters, immunoglobulin, and blood antioxidant activity in broiler chicks. Three hundred twenty one-day old broiler chicks were divided 8 treatments (C(-), basal diet; C(+), basal diet with antibiotics; DL-${\alpha}$-tocopherol 20 IU; DL-${\alpha}$-tocopherol 200 IU; resveratrol 20 ppm; resveratrol 200 ppm; methylated resveratrol 20 ppm; methylated resveratrol 200 ppm) with 4 replicates and 10 birds per replicate. Birds were reared for 35 days, and, at the age of 35 days, eight birds of average weight from each replicate were selected for blood samples collection. There were no significant differences on feed intake and feed conversion ratio. But final body weight and weight gain in antibiotics, resveratrol and methylated resveratrol treatments were significantly higher than no-antibiotics and ${\alpha}$-tocopherol treatments (P<0.05). There were no significant differences on carcass rate and relative organ weights among treatments, however, weights of liver and bursa of februcius in antibiotics, resveratrol and methylated resveratrol treatment were lower than other treatments. Weight of pancreas was high in resveratrol and methylated treatment. On the cecal microflora (total microbes, Coliform bacteria, Salmonella spp., and lactic acid bacteria), these in resveratrol and methylated resveratrol treatments didn't show the differences compared with those in no-antibiotics, antibiotics, and ${\alpha}$-tocopherol treatments. In the serum, there were no significant differences on creatinine, blood urea nitrogen (BUN), total protein, albumin, globulin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) among treatments, though globulin contents of reseveratrol 200 ppm and methylated resveratrol 20 ppm treatments decreased compared to those of other treatments. Immunoglobulin (IgA, IgG and IgM) were significantly decreased in antibiotics and resveratrol treatments compared to that of no-antibiotics and ${\alpha}$-tocopherol treatments (P<0.05). Superoxide dismutase (SOD) like activity tended to increase in resveratrol groups (P<0.05), however, there was no significant difference on malondiakdehyde (MDA) content among treatments. In conclusion, these results showed that resveratrol derived from mulberry can be used as alternative of antibiotics through improvement of broiler's performance and maintain of health.

Effect of MRI Media Contrast on PET/MRI (PET/MRI에 있어 MRI 조영제가 PET에 미치는 영향)

  • Kim, Jae Il;Kim, In Soo;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.19-25
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    • 2014
  • Purpose: Integrated PET/MRI has been developed recently has become a lot of help to the point oncologic, neological, cardiological nuclear medicine. By using this PET/MRI, a ${\mu}-map$ is created some special MRI sequence which may be divided parts of the body for attenuation correction. However, because an MRI contrast agent is necessary in order to obtain an more MRI information, we will evaluate to see an effect of SUV on PET image that corrected attenuation by MRI with contrast agent. Materials and Methods: As PET/MRI machine, Biograph mMR (Siemens, Germany) was used. For phantom test, 1mCi $^{18}F-FDG$ was injected in cylinderical uniformity phantom, and then acquire PET data about 10 minutes with VIBE-DIXON, UTE MRI sequence image for attenuation correction. T1 weighted contrast media, 4 cc DOTAREM (GUERBET, FRANCE) was injected in a same phatnom, and then PET data, MRI data were acquired by same methodes. Using this PET, non-contrast MRI and contrast MRI, it was reconstructed attenuation correction PET image, in which we evanuated the difference of SUVs. Additionally, for let a high desity of contrast media, 500 cc 2 plastic bottles were used. We injected $^{18}F-FDG$ with 5 cc DOTAREM in first bottle. At second bottle, only $^{18}F-FDG$ was injected. and then we evaluated a SUVs reconstructed by same methods. For clinical patient study, rectal caner-pancreas cancer patients were selected. we evaluated SUVs of PET image corrected attenuastion by contrast weighted MRI and non-contrast MRI. Results: For a phantom study, although VIBE DIXON MRI signal with contrast media is 433% higher than non-contrast media MRI, the signals intensity of ${\mu}-map$, attenuation corrected PET are same together. In case of high contrast media density, image distortion is appeared on ${\mu}-map$ and PET images. For clinical a patient study, VIBE DIXON MRI signal on lesion portion is increased in 495% by using DOTAREM. But there are no significant differences at ${\mu}-map$, non AC PET, AC-PET image whether using contrast media or not. In case of whole body PET/MRI study, %diff between contras and non contrast MRAC at lung, liver, renal cortex, femoral head, myocardium, bladder, muscle are -4.32%, -2.48%, -8.05%, -3.14%, 2.30%, 1.53%, 6.49% at each other. Conclusion: In integrated PET/MRI, a segmentation ${\mu}-map$ method is used for correcting attenuation of PET signal. although MRI signal for attenuation correciton change by using contrast media, ${\mu}-map$ will not change, and then MRAC PET signal will not change too. Therefore, MRI contrast media dose not affect for attenuation correction PET. As well, not only When we make a flow of PET/MRI protocol, order of PET and MRI sequence dose not matter, but It's possible to compare PET images before and after contrast agent injection.

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Total Folate Contents of 15 Edible Plants Consumed in Korea Using Trienzyme Extraction Method (국내 소비되는 봄나물의 Trienzyme 추출법을 적용한 엽산 함량 분석)

  • Kim, Bo Min;Kim, So-Min;Oh, Ji Yeon;Cho, Young-Sook;Kim, Se-Na;Choi, Youngmin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.11
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    • pp.1796-1800
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    • 2014
  • Trienzyme digestion (AOAC Official Method 2004.05) procedure using protease, ${\alpha}$-amylase, and chicken pancreas conjugase was evaluated to determine its usefulness in the microbiological quantitation of total folate in foods. Folate values obtained by alkali hydrolysis (Korean Food Standards Codex) were compared to those obtained by the trienzyme method for four certified reference materials (CRM) representing diverse matrixes. Trienzyme treatment increased measurable folate from most CRM compared to levels found after alkali hydrolysis. The largest increases were observed with CRM 487 (pig liver, 5.8-fold) and CRM 121 (whole meal flour, 3.1-fold) after trienzyme digestion. Using trienzyme digestion method, total folate contents of raw and blanched edible plants were determined. Eleutherococcus senticosus ($146.9{\mu}g/100g$) showed the highest total folate content, followed by Aster glehni F. Schmidt ($142.8{\mu}g/100g$) and Ledebouriella seseloides H. Wolff ($140.4{\mu}g/100g$) on a wet weight basis. Blanching of samples resulted in an insignificant decrease in folate content for five samples and 11~63% reduction for nine samples. Our finding suggests that trienzyme digestion method is accurate for the determination of food folate in leafy vegetables.

Evaluation on Organ Dose and Image Quality of Lumbar Spine Radiography Using Glass Dosimeter (유리선량계를 이용한 요추검사의 장기선량 및 영상의 평가)

  • Kim, Jae-Kyeom;Kim, Jeong-Koo
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.1-11
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    • 2016
  • The purpose of this study was to provide resources for medical exposure reduction through evaluation of organ dose and image resolution for lumbar spine around according to the size of the collimator in DR system. The size of the collimator were varied from $8^{\prime\prime}{\times}17^{\prime\prime}$ to $14^{\prime\prime}{\times}17^{\prime\prime}$ by 1" in AP and lateral projection for the lumbar spine radiography with RANDO phantom. The organ dose measured for liver, stomach, pancreas, kidney and gonad by the glass dosimeter. The image resolution was analyzed using the Image J program. The organ dose of around lumbar spine were reduced as the size of the collimator is decreased in AP projection. There were no significant changes decreasing rate whenever the size of the collimator were reduced 1" in the gonad. The organ dose showed higher on liver and kidney near the surface in lateral projection. There were decreasing rate of less than 5% in liver and kidney, but decreasing rate was 24.34% in the gonad whenever the size of the collimator were reduced 1". Organ dose difference for internal and external of collimator measured $549.8{\mu}Gy$ in the liver and $264.6{\mu}Gy$ in the stomach. There were no significant changes organ dose difference that measured $1,135.1{\mu}Gy$ in the gonad. Image Quality made no difference because SNR and PSNR were over than 30 dB when the collimator size is less than $9^{\prime\prime}{\times}17^{\prime\prime}$ on AP projection and $10^{\prime\prime}{\times}17^{\prime\prime}$ on lateral projection. Therefore, we are considered that the recommendations criterion for control of collimator were suggested in order to reduce unnecessary X-ray exposure and to obtain good image quality because lumbar spine radiography contains a lot of peripheral organs rather than other area radiography.

A Clinical Evaluation of Splanchnic Nerve Block (내장신경차단에 관한 임상적 연구)

  • Kim, Soo-Yeoun;Oh, Hung-Kun;Yoon, Duek-Mi;Shin, Yang-Sik;Lee, Youn-Woo;Kim, Jong-Rae
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.34-46
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    • 1988
  • Intractable pain from advanced carcinoma of the upper abdomen is difficult to manage. One method used to control pain associated with these malignancies is to block off the splanchnic nerve. In 1919 Kappis described a technique by which the splanchnic nerve of the upper abdomen could be anesthetized, using a percutaneous injection. This method has been used for the relief of upper abdominal pain due to hematoma and cancer of the pancreas, stomach, gall bladder, bile duct, and colon. During the Period from November 1968 to January 1986, this method was used in 208 cases of malignancy at Severance Hospital and clinically evaluated. Patients were retroactively grouped according to the stage of development of technique used. Twelve patients who received the treatment in the period from November 1968 to March 1977 were designate4i as group 1, 26 patients from April 1977 to April 1979 as group 2, and 170 from May 1979 to January 1986 as group 3. The results are as follows: 1) The number of patients receiving splanchnic nerve block has been increasing since 1977. 2) A total of 208 patients, including 133 males and 75 females, ranging in age from 18 to 84 and averaging 51. 3) The causes of pain were stomach cancer 90, pancreatic cancer 69, and miscellaneous cancer 49 cases respectively. 4) There were 57.7% who had surgery. and 3.7% of whom had chemotherapy before the splanchnic nerve block was done. 5) These blocks were carried out with the patient in the prone position as described by Dr. Moore. For group 2 and 3, C-arm image intensifier was used. In group 1, a 22 gauze loom long needle was inserted at the lower border of the 12th rib on each aide about 7\;cm from the midline. The average distance from the midline was $6.60{\pm}0.61\;cm$ on the left side and $6.60{\pm}0.83\;cm$ on the right side in group 2, and $5.46{\pm}0.76\;cm$ on the left side and $5.49{\pm}0.69\;cm$ on the right side in group 3. The average depth to which the needle was inserted was $8.60{\pm}0.52\;cm$ on the left side and $8.74{\pm}0.60\;cm$ on the right side in group 2, and $8.96{\pm}0.63\;cm$ on the left side and $9.18{\pm}0.57\;cm$ on the right side in group 3. 6) The points of the inserted needles were positioned in the upper quarter anteriorly, 51.8% on the left side and 54.4% n the right side of the L1 vertebra by lateral roentgenogram in group 3. The inserted needle points were located in the upper and anterolateral part, of the L1 vertebra 68.5% on the left side and 60.6won the right side, on the anteroposterior rentgenogram in group 3. The needle tip was not advanced beyond the anterior margin of the vertebral body. 7) In some case of group 3, contrast media was injected before the block was done. It shows, the spread upward along the anterior mal gin of the vertebral body. 8) The concentration and the average amount of drug used in each group was as follows: In group 1, $39.17{\pm}6.69\;ml$ of 0.5% -l% lidocaine or 0.25% bupivacaine were injected for the test block and one to three days after the test block $40.00{\pm}4.26\;ml$ of 50% alcohol was injected for the semipermanent block. In group 2, $13.75{\pm}4.88\;ml$ of 1% lidocaine were used as the test block and followed by $46.17{\pm}4.37\;ml$ of 50% alcohol was injected as the semipermanent block. In group 3, $15.63{\pm}1.19\;ml$ of 1% lidocaine for test block followed by $15.62{\pm}1.20\;ml$ of pure alcohol and $16.05{\pm}2.58\;ml$ of 50% alcohol for semipermanent block were injected. 9) The result of the test block was satisfactory in all cases. However the semipermanent block was 83.3 percent of the patients in group 1 who received relief from pain for at least 2 weeks after the block, 73.1% in group 2, and 91.8% in group 3. In these unsuccessful cases, 2 cases in group 1 were controlled by narcotics but 7 cases in group 2 and 14 cases in group 3 received the same splanchnic nerve block 1 or 2 times again within 2 weeks. But, in some cases it was 3 to i months before the 2nd block and in 1 cases even 7 years. 10) The most common complications of splanchnic nerve block were hypotensino(25.5%) occasional flushing of the face, nausea, vomiting, and chest discomfort. 11) For the patients in group 3, the supplemental block most commonly used was a continuous epidural block; it was used as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 12) The interval between the receiving of the alcohol block and discharge was from 5 to 8 days in 61 cases(31.1%) and from 1 to 2 days in 48 cases(24.5%). From the above results, it can be concluded that the splanchnic nerve block done in the prone position with pure and 50% alcohol immediately after an effective test block with 1% lidocaine under C-arm fluoroscopic control is satisfactory and reliable. How to minimize the repeat block is still a problem to be solved.

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Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model (저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Chun, Eui-Kyung;Chi, Je-Geun;Won, Tae-Hee;Lee, Young-Tak;Chee, Hyun-Keun;Kim, Jun-Woo
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.30 no.5
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    • pp.471-478
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    • 1997
  • Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

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EFFECT OF OCTANOL, THE GAP JUNCTION BLOCKER, ON THE REGULATION OF FLUID SECRETION AND INTRACELLULAR CALCIUM CONCENTRATION IN SALIVARY ACINAR CELLS (흰쥐 악하선 세포에서 gap junction 봉쇄제인 octanol이 타액분비 및 세포내 $Ca^{2+}$ 농도 조절에 미치는 영향)

  • Lee, Ju-Seok;Seo, Jeong-Taeg;Lee, Syng-Il;Lee, Jong-Gap;Sohn, Heung-Kyu
    • THE JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.26 no.2
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    • pp.399-415
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    • 1999
  • From bacteria to mammalian cells, one of the most important mediators of intracellular signal transduction mechanisms which regulate a variety of intracellular processes is free calcium. In salivary acinar cells, elevation of intracellular calcium concentration ($[Ca^{2+}]_i$) is essential for the salivary secretion induced by parasympathetic stimulation. However, in addition to $[Ca^{2+}]_i$, gap junctions which couple individual cells electrically and chemically have also been reported to regulate enzyme secretion in pancreatic acinar cells. Since the plasma membrane of salivary acinar cells has a high density of gap junctions, and these cells are electrically and chemically coupled with each other, gap junctions may modulate the secretory function of salivary glands. In this respect, I planned to investigate the role of gap junctions in the modulation of salivary secretion and $[Ca^{2+}]_i$, using mandibular salivary glands of rats. In order to measure the salivary flow rate, fluid was collected from the cannulated duct of the isolated perfused rat mandibular glands at 2 min intervals. $[Ca^{2+}]_i$, was measured from the cells loaded with fura-2 by spectrofluorometry. The results obtained were as follows: 1. CCh-induced salivary secretion was reversibly inhibited by 1 mM octanol, a gap junction blocker. 2. CCh-induced increase in $[Ca^{2+}]_i$, was also reversed by the application of 1 mM octanol. 3. Octanol did not block the initial increase in $[Ca^{2+}]_i$ caused by CCh, which suggested that the reduction of $[Ca^{2+}]_i$, caused by gap junction blockade was not resulted from the inhibition of $Ca^{2+}$ release from intracellular $Ca^{2+}$ stores. 4. Addition of octanol during stimulation with $1{\mu}M$ thapsigargin, a potent microsomal ATPase inhibitor, reduced $[Ca^{2+}]_i$, to the basal level. This suggested that inhibition of gap junction permeability closed plasma membrane $Ca^{2+}$ channels. 5. 2,5-di-tert-butyl-1,4-benzohydroquinone (TBQ) generated $[Ca^{2+}]_i$ oscillations resulting from periodic influx of $Ca^{2+}$ via plasma membrane. The TBQ-induced $[Ca^{2+}]_i$ oscillations were stopped by the application of 1mM octanol which implicated that gap junctions modulate the permeability of plasma membrane $Ca^{2+}$ channels. 6. Glycyrrhetinic acid, another well known gap junction blocker, also inhibited CCh-induced salivary secretion from rat mandibular glands. These results suggested that gap junctions play an important role in the modulation of fluid secretion from the rat mandibular glands and this was probably due to the inhibition of $Ca^{2+}$ influx through the plasma membrane $Ca^{2+}$ channels.

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The Use of Analgesics in the Last 24 hours of Life of Patients with Advanced Cancer : A Comparison of Medical Physicians and Surgeons (말기 암 환자의 마지막 24시간 동안 진통제 사용의 분석 : 내과의사와 외과의사의 비교)

  • Choi, Youn-Seon;Kim, Jong-Min;Lee, Young-Mee;Lim, Jong-Kuk;Lee, Tai-Ho;Hong, Myung-Ho
    • The Korean Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.47-55
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    • 1998
  • Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

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The Palliative Radiation Therapy in Malignant Extra-Hepatic Biliary Obstruction (간외 폐쇄성 황달 환자에서 고식적 방사선치료의 결과)

  • Kay Chul-Seoung;Jang Hong-Suk;Kim Sung-hwan;Ryu Mi-Ryeong;Kim Yeon-Shil;Chung Su-Mi;Yoon Sei-Chul
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.209-216
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    • 1999
  • Purpose : To evaluate the effectiveness of external radiation therapy and the prognostic factors, we retrospectively analyzed therapeutic results of malignant extrahepatic biliary obstruction (EHBO). Methods and Materials : We analyzed the results of the external radiation therapy in 59 patients of inoperable malignant EHBO who had been treated with more than 10 Gy of external radiation therapy from April 1984 to December 1990. There were 21 stomach cancer ($35.6\%$), 12 pancreas cancer ($20.3\%$), 15 extrahepatic biliary cancer ($18.0\%$) and 11 another cancer ($18.0\%$). Their pathologies were confirmed in 31 patients ($52.5\%$). They divided into 27 adenocarcinoma and 4 nonadenocarcinoma. Their chief complaints were jaundice in 47 patients ($79.7\%$) and abdominal pain in 15 patients ($49.2\%$). Twelve patients had slightly increased bilirubin level in liver function test without jaundice. We treated twenty four patients ($40.6\%$) with percutaneous transhepatic biliary drainage (PTBD) and 32 patients ($54\%$) with systemic chemotherapy (CT). We performed external radiation therapy (ERT) upto $10.8\~55.8$ Gy (median 37.8 Gy) with palliative aim. Results : Overall median survival duration was $7.80\pm1.15$ months. The response rates of jaundice were $81.8\%$ in PTBO group and $66.7\%$ in non-PTBD group without statistical significance. The improving rate of jaundice was not significantly different in decreased ratio of total bilirubin level. But abdominal pain was more decreased in CT group than non-CT group (p<0.05). The significant prognostic factors were high performance status (Karnofski Performance Status >70), total radiation dose more than 35 Gy and good response of pain after therapy. There were increased in bacterial cholagitis in PTBD group and gastrointestinal complications in CT group. Conclusion : External radiotheapy could improve jaundice and abdominal pain in malignant EHBO patients, Overall survival duration was prolonged in patients with higher performance status and patients who had been treated with more than 35 Gy of total radiation dose. In the future, we expect not only better palliative role but also the prolongation of survival of using the ERT combined with other treatment method. But to achieve certain conclusion, we need luther study consisted with many kinds of treatment methods including new technologies in RT.

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