No abstract available.
Thanatophoric Dysplasia*

Spinal dimensions (anterior, mid, and posterior height of the vertebral body) and shape variation (wedge compression, biconcave, and crush ratio) were obtained from plain radiographs of healthy Korean men and women. The purpose of this study was to define vertebral fracture from normal spinal morphometry of Korean men and women and to compare spinal dimension between men and women. Healthy 100 men and 100 women were included in this study. Plain lateral radiographs of thoracic and lumbar vertebrae were taken with standard method. Quantitative morphometry (anterior, mid, and posterior height of the vertebral body) was performed with plain radiographs. Spinal shape variations (wedge compression, biconcave, and crush ratio) were calculated from morphometric data. Spinal dimensions and shape variation of Korean men and women were presented, and morphometric cut-off vaiues for vertebral fracture were evaluated(mean-3xSD). Spinal dimensions of men were greater than women in all level (p<0.01). Wedge compression ratios (T6, 7, 8, 9, 12, L5 level) and biconcave ratios (T12, Ll, 4, 5 level) and crush ratios (Tll, L4, L5 level) were different between men and women (p<0.01). Spinal dimensions and shape variation from quantitative morphometry can be used in objective definition of vertebral fracture which can be used in medicolegal problem, workers compensation and medical insurance.
Female ; Humans ; Insurance ; Lumbar Vertebrae ; Male ; Spine ; Workers' Compensation

Intramuscular injection is a commonly used route of parenteral drug administration. Many types of complications following intramuscular injection into the gluteal muscles have been described. A retrospective review of 32 patients requiring surgical treatment for local compli-caations of the buttock injections in children was made at the Taegu Fatima Hospital from March 1990 to December 1997. Local complications consisted of acute inflammatory compli-cations including cellulitis and abscess (71.9%), fat necrosis (21.9%), and injection granu-loma (6.2%). Over the half of complications were situated in the upper outer quadrant of the buttock but the other 43.7% of them were in the upper inner or lower outer quadrant which were unsuitable sites for intramuscular injection. And the majority of complications were de-veloped within fat tissue (90.6%) rather than within muscle (9.4%). Two thirds of the patients were under 2 years of age, which suggested that there were some difficulties in accurate intra-muscular injection in small children who had smaller muscle masses compared with subcuta-neous fat and were irritable during injection. In patients with abscess, Staphylococcus aureus was the predominant organism, isolated in 84.6% of the patients. The treatment consisted of needle aspiration, incision and drainage or curettage, and surgical excision. In conclusion, we think that the major factor contributing development of complications following intramuscular injection in the buttock was inadvertent intrafat injection instead of intramuscular injection. In order to prevent those complications, it is necessary to inject accurately into the muscle with a knowledge of pelvic anatomy and complications associated with intramuscular injection.
Abscess ; Buttocks* ; Cellulitis ; Child* ; Curettage ; Daegu ; Drainage ; Fat Necrosis ; Humans ; Injections, Intramuscular* ; Muscles ; Needles ; Retrospective Studies ; Staphylococcus aureus

Intussusception is common cause of intestinal obstruction in children. Most of intussusceptions can be treated with non-operative reduction using air or barium. However, about 10% patients need operative treatment due to failure of reduction, peritonitis, and recurrence after reduction. We introduce our experience of laparoscopic surgery for intussusception. From April 2010 to March 2013, we reviewed 57 children who diagnosed intussusception. Twelve patients underwent an operation. The cause of operation was 7 of failure of air reduction and 5 of recurrence after air reduction. Median age was 21.5 months (range: 5.0~57.7 months) and 11 children (91.7%) underwent successful laparoscopic reduction. Median operating time was 50 minutes (range: 30~20 minutes) and median hospital days was 4.5 days (range: 3~8 days). One patient had a leading point as a heterotopic pancreas and underwent bowel resection through conversion. There was neither intra-operative nor postoperative complication. Laparoscopic reduction for intussusception can bring an excellent cosmetic effect with high success rate.
Barium ; Child* ; Humans ; Intestinal Obstruction ; Intussusception* ; Laparoscopy* ; Pancreas ; Peritonitis ; Postoperative Complications ; Recurrence

PURPOSE: Serum squamous cell (SCC) antigen levels were examined in uterine cervix cancer undergoing radiation therapy, and authors analyzed the relationship between SCC antigen levels and treatment results. MATERIALS AND METHODS: This is a retrospective study of 181 cervical carcinoma patients who received radiotherapy and examined serial serum SCC antigen from 1991 to 1997 at Soonchunhyang University Hospital. One hundred and eighteen patients underwent SCC antigen evaluation at diagnosis The relationship between the serum tumor marker level and disease free survival, recurrence pattern, and other prognostic factors were analyzed according to various statistical methods. RESULTS: The positivity rate (initial serum value above 2.5 ng/ml) was increased with FIGO stage (IB-IIA 57% to IV 91%) and more discriminative than cutoff value of 1.5 ng/ml. Five year disease free survival rates for the stage IB-IIA, IIB, III and IV were 79.2%, 68.7%, 33.4% and 0%, respectively. The 5-year disease free survival rate for patients with serum SCC antigen levels above 5.0 ng/ml was 34% versus 55~62% for patients with normal range (<1.5 ng/ml) or mildly elevated levels (1.5~5.0 ng/ml). Rising SCC antigen levels preceded the clinical detection of disease by a mean of 4.8 months (range 1~13 months). Negative linear corelation was observed between initial SCC antigen levels and relapse free survival (r=-0.226), and by multivariate analysis, initial SCC antigen level had a large impact on the relapse free survival. CONCLUSIONS: SCC antigen assay is a useful aid to predict the prognosis of squamous cell carcinoma of the uterine cervix and to detect recurrence.
Carcinoma, Squamous Cell ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Female ; Humans ; Multivariate Analysis ; Prognosis ; Radiotherapy ; Recurrence* ; Reference Values ; Retrospective Studies ; Uterine Cervical Neoplasms

PURPOSE: The purpose of this study was to understand the coping experience of nursing students in clinical practice. METHODS: In-depth interview was done with semi-structured questionnaire on 32 nursing students taking clinical practice. Data was analyzed through the grounded theory. RESULTS: Core category of coping experience of nursing students was ‘trying to be a meaningful presence’ while clinical practice. Students' coping strategies were ‘overcoming inexperience’, ‘receiving the recognition from the clinical instructors’, and ‘governing mind and body’. Helping components for their coping behaviors were ‘support from people’, ‘personal experience before clinical practice’, ‘dynamics with partners’. Through the coping experience during clinical practice, nursing students became mature and confirmed their identities as student nurses. CONCLUSION: Nursing students taking clinical practice tried to be a meaningful presence.
Adaptation, Psychological ; Grounded Theory ; Humans ; Nursing* ; Students, Nursing*

PURPOSE: Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. METHODS AND MATERIALS: Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcioma in situ (38 cases), severe dysplasia(2), myoma(6), uterine bleeding (4), uterine prolapse (2), and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy form August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients reveived ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. RESULTS: Overall 5-year survival rate and relapse-free survival rate were 83.8%, 86.9% respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were 90.9%, 88.8%, 38.4%, and 100% respectively. There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cncer (stage IA) had no treatment related failure. Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. CONCLUSION: Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy. Survivals for patients with gross disease remained after inappropriate hysterectomy was poor. So, early cancer detection and proper management with precise pretreatment staging is necessary to avoid inadherent hysterectomy especially in the cases of gross residual disease.
Carcinoma in Situ ; Cervix Uteri ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Node Excision ; Myoma ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms ; Uterine Hemorrhage ; Uterine Prolapse

Peritoneal lavage cytology was performed at the time of gastrectomy for 295 patients with gastric cancer from September 1991 to January 1996 in the Department of Medical Sciences,Chonbuk National University Graduate School. The results were as follows;1) Positive intraperitoneal free cancer cells were observed in 9.8% of all case. And,the higher the S-category, the higher the increase in positive intraperitoneal free cancer cells, but the lower the rate of survival. 2) The higher the spatial extent of the invasion of the gastric serosa,the higher the increase in the positive intraperitoneal free cancer cells. However, There was no statiscal relation between the areas of gastric serosa invasion and the 3-year survival rate. But, especially when the areas of serosa invasion are 5-10cm2, the 3-year survival rate was statiscally higher in the negative intraperitoneal free cancer cell group than in the positive free cancer cell group.(P<0.012). 3) The rate of positive intraperitoneal free cancer cells become higher progressively with increasing the peritoneal invasion, but, there were no 3-year survival patients who have positive peritoneal invasion . In patients with no evidence of peritoneal spread, negative intraperitoneal free cancer cell group had a statistically signigficant higher 3-year survival rate than the positive group.(P<0.0004). 4) For histopathological types of tumors, the incidence of positive intraperitoneal free cancer cells was higher in undifferentiated adenocarcinomas than in differentiated types, though the difference was statistically insignificant. For signet-ring cell carcinomas, the 3-year survival rate of the negative intraperitoneal free cancer cell group was statistically higher than that of the positive group.(P<0.0005). 5) The incidence of positive intraperitoneal free cancer cells increased as the stage of gastric cancer increased, but the survival rate was decreased. 6) In the noncurative resection group, the incidence of positive intraperitoneal free cancer cells was higher, but the survival rate was lower, than in the curative resection group. The 3-year survival rates were higher for the patients with curative resection and negative intraperitoneal free cancer cells than for the patients with curative resection and positive intraperitoneal free cancer cells (P<0.0009). The difference in the 3-year survival rate between the noncurative resection with positive intraperitoneal free cancer cell group and the noncurative resection with negative intraperitoneal free cancer cell group was stastistically significant. (P<0.0000). 7) For the types of recurrence, hematogenous metastasis was the most common type of recurrence in the negative intraperitoneal free cancer cell group; peritoneal metastasis was the most common type of recurrence in the positive intraperitoneal free cancer cell group. In conclusion; at the time of gastrectomy, peritoneal lavage cystology is very impotant and basic examination which can help early detection of intraperitoneal free cancer cells. Therefore, when intraperitoneal free cancer cells are negative,radical curative gastrectoy make the high survival rate of patients.
Adenocarcinoma ; Gastrectomy ; Humans ; Incidence ; Neoplasm Metastasis ; Peritoneal Lavage ; Prognosis* ; Recurrence ; Serous Membrane ; Stomach Neoplasms ; Survival Rate

This study is concerned with a comparison of lower tibial and fibular epiphyseal growth and deformities of the ankles in normal and paralysed children. The data were based on 87 children with residual paralysis due to poliomyelitis an 20 non-paralysed children who were admitted to Severance Hospital and Sam Yook Children's Rehabilitation Center. The difference in level between the lower tibial and fibular ends and between the lower epiphysial lines of the tibia and fibula in X-rays of the ankles were measured in order to investigate the growth pattern of the lower tibio-fibular epiphysis. The difference between the level of the lower ends of the fibula was an avergage of 15.3mm in the normal and 6.2mm in paraysed children. Thus the fibular ends in paralysed limbs was an average of 9.1mm less than that of the normal. The difference between the level of the lower epiphyseal lines of the tibia and the fibula was an average of 13.7mm in normal and 5.5mm in paralysed children. Therefore, the level of the fibular epiphyseal lines in paralysed limbs was sn average of 8.2mm less than that of normal. In paralysed limbs, the lower tibial epiphyses showed lateral epical wedge shaped deformities. The tilting angle of the ankles and the wedging angle of the of the lower tibial epiphyses were measured in erder to investigate the degree of deformities of the ankles and the lower tibial epiphyses in paralysed limbs. The tilting angle of the ankles averaged 1.3° in normal and 7.6° in paralysed limbs. The wedging angle of the lower tibial epiphyses averaged 3.7° in normal and 11.5° in paralysed limbs. In paralysed children, muscle strength examination was performed to clarify the relationship between the degree of growth disturbance and the severity of the muscular paraysis. This lead us to conclude that: 1. In paralysed children, the growth disturbance of the lower fibular epiphyses was greater than that of the lower tibial epiphyses. 2. The difference of the growth disturbance between the tibial and fibular epiphyses was not due to muscle imbalance of the foot invertors and evertors but to muscle weakness. 3. In paraysed children, the shape of the lower tibial epiphyses changed to a wedge shape, a deformity which might be considered secondary to growth disturbance of the fibula. 4. In paralysed children, the lower tibial ends were tilted upward and laterally. This was thought to be the cause of valgus deformities of the ankles. 5. The relationship between the degree of muscle paralysis and the deformities of the ankles was not proved in this study.
Ankle ; Child ; Congenital Abnormalities ; Epiphyses ; Extremities ; Fibula ; Foot ; Humans ; Muscle Strength ; Muscle Weakness ; Paralysis ; Poliomyelitis ; Rehabilitation Centers ; Tibia

No abstract available.
Intracranial Hypotension*