Hepatoblastoma is a rare malignant liver tumor found in children. Its biological characteristics and prognostic factors have not been well known. We investigated 29 cases of hepatoblastoma, registered in university hospitals in Seoul from 1984 to 1996. By the immunohistochemical method, p53, Waf-1 (p21), bcl-2, heat shock protein 70 (hsp70), c-jun, transforming growth factor-alpha (TGF-alpha) expressions were studied. Those data were compared with clinico-pathologic features; age, sex, tumor size, tumor stage and histologic subtypes. Expression of p53 and bcl-2 were each observed separately in single cases. Expression of c-jun was more frequently noted in patients at higher stages. Expression of TGF-alpha decreased in the order of pure fetal, mixed, embryonal and small cell anaplastic subtypes. Cumulative survival rate was lower in females than in males and in patients with a higher tumor stage. According to histologic subtypes, survival rates decreased in the order of pure fetal, mixed, embryonal and small cell anaplastic subtypes. Survival rate was lower in patients with c-jun expression. Group of TGF-alpha labelling index under 19 showed a lower survival rate than that over 19. In conclusion, we found that tumor associated proteins, c-jun and TGF-alpha, are closely related to the prognosis of hepatoblastoma but p53 and bcl-2 may not be related to it.
Child ; Female ; Hepatoblastoma* ; Hospitals, University ; HSP70 Heat-Shock Proteins ; Humans ; Liver ; Male ; Population Characteristics ; Prognosis ; Seoul ; Survival Rate ; Transforming Growth Factor alpha

The diagnosis of a Battered Child Syndrome is made by the pediatrician, surgeon and the radiologist because almost parents deny the diagnosis or refuse to answer the doctor's questions. The imaging modalities play a key role in the investigation and documentation of the battered child syndrome, because of the high frequency of the typical skeletal lesion. Although physical abuse is denied by parents, the recognition of this entity is possible by the primary diagnostic imaging study in the suspected child abuse. The imaging studies are either a bone scan and x-ray series or a complete radiolographic skeletal survey by X-ray series. In an expected intracranial injury, a CT scan of the head is mandatory We experienced a case of Battered Child Syndrome in a 6 month-old male infant who had subdural hemorrhage and fractures of skull and ribs in different stages of healing and repair. The brief review of the literature was made.
Battered Child Syndrome* ; Child ; Child Abuse ; Diagnosis ; Diagnostic Imaging ; Head ; Hematoma, Subdural* ; Humans ; Infant ; Male ; Parents ; Ribs ; Skull ; Tomography, X-Ray Computed

Paraganglioma is a benign tumor arising in the paraganglion system scattered throughout the body, but its cytopathologic findings arenot well known. We experienced a case of paraganglioma of carotid body diagnosed by fine needle aspiration. The patient was a 30 year-old female who suffered from the left neck mass for 3 years. The mass was 3x3crn in size without pulsation or bruit. Cytologically, the smear revealed aggregated and singly scattered tumor cells having abundant pale cytoplasm and indistinct cell borders. Their nuclei were round to oval, but enlarged nuclei were occasionally observed. The nuclear membrane was smooth with fine clumping of chromatin. Differentiation from metastatic follicular carcinoma of the thyroid gland was difficult.
Adult ; Biopsy, Fine-Needle ; Carotid Body ; Chromatin ; Cytoplasm ; Female ; Glomerulosclerosis, Focal Segmental* ; Humans ; Neck ; Nephrotic Syndrome* ; Nuclear Envelope ; Paraganglioma ; Thyroid Gland

No abstract available.
Anemia, Iron-Deficiency* ; Iron* ; Milk*

There are some errors in the published article. The authors would like to make corrections in the original version of the article.

The treatment of extensive soft tissue injury of the lower extremities is known to be one difficulty in the field of orthopedic surgery. At present, reconstructive surgery with large cutaneous flaps is being employed, and the authors present 2 cases of a combination of flaps for extensive soft tissue injury of the lower extremity at the Department of Orthopedic Surgery of Severance Hospital during a 5 months period from June, 1983 to November, 1983. The results of the study are as follows: 1. A one-stage reconstruction of extensive soft tissue injury was done with a combination of a scapular and a latissimus dorsi flap. 2. There was no limitation of motion of the shoulder in spite of the excision of the scapular and the latissimus dorsi flaps around the axillary area. 3. The primary closure of the donor flap sites was feasible. 4. The reconstructive surgery of the extensive soft tissue injury using the above combination of the scapular and latissimus dorsi flaps can be used without restriction as to the age of the patient.
Humans ; Lower Extremity ; Orthopedics ; Shoulder ; Soft Tissue Injuries ; Superficial Back Muscles ; Tissue Donors

BACKGROUND: The study was designed to provide a comprehensive comparison of the nerve conduction velocities(NCVs) and current perception thresholds(CPTs) in evaluating the clinical severity of diabetic neuropathy. METHODS: The seventy-eight individuals(mean age : 43.5 years, M:F = 40:38) with diabetes neuropathy of varying degrees of severity were selected after exclusion of any other potential causes of peripheral neuropathies or radiculopathies. Detailed, scored neurological symptoms(symptom score . 0-10) and physical examination(physical score : 0-48), emphasizing sensory assessment, were performed in all subjects. In addition, NCVs of motor and sensory nerves, CPTs at 5, 250, 2000Hz of the upper and lower extremities were determined. Non-parametric correlation analysis(Spearman rho) was performed as a measure of association of symptoms and physical score with the various electrodiagnostic variables. RESULTS: Correlations between physical scores(PS) and symptom scores(55) and NCVs were significant. In most parameters, but their values of coefficients were relatively weak(rho = 0.12-0.41), particularly for the correlations of symptom scores with the motor NCVs. But, correlations of the 55 and PS with CPTs were higher than with NCVs[rho(ss): 0.25-0.38, rho(PS) : 0.32-0.60]. The correlations between PS and subgroups of CPTs were significant, but those between SS, PS and NCV were insignificant. Among the 3 types of frequencies, CPTs at 5Hz was the most effective discriminator in the lowest physical and symptom scores. CONCLUSIONS: CPT measurements were more effective as discriminators of both symptomatic and physical status than NCV measurements. So, the supplementary use of CPT testing may improve the quantitative assessment of this condition.
Diabetic Neuropathies* ; Lower Extremity ; Neural Conduction ; Peripheral Nervous System Diseases ; Radiculopathy

In order to investigate the fundus fundings in myopic eyes and to clarify the correlation between the refractive error and the myopic fundus changes, 7968 eyes of school children with refractive error in Seoul were selected and the observation of ophthalmoscopic features of crescent of optic nerve, cup to disc(C/D) ratio and the spontaneous venous pulsation were attempted. The result of the study were summarized as follows: 1. The optic nerve crescent was counted in 2643 eyes(33.2%) among 7968 eyes and the temporal crescent was the most frequent localization(72.8%) in 2643 eyes. 2. The incidence of the optic nerve crescent was increased in proportion to the degree of myopia regardless of its localization type, however the incidence of the crescent was decreased at -7.0 D or higher myopes. 3. The mean horizontal C/D ratio was 0.24 +/- 0.13 and the C/D ratio of 0.4 or more were common in the myopia of -2.0 D or more. The correlation between the C/D ratio and the refractive error appeared statistically significant(p<0.05). 4. In most of eyes(98.6%), difference of the C/D ratio between right and left eye was 0.2 or less. 5. The spontaneous venous pulsation on the optic disc was observed in 594 of 7968 eyes(7.5%).
Child ; Financial Management ; Humans ; Incidence ; Myopia ; Optic Nerve ; Refractive Errors* ; Seoul

BACKGROUND: Midkine (MK) is a member of the heparin-binding growth factor family. Overexpression of MK is observed not only in cancerous tissue but also in precancerous lesions of the colon and the prostate. Using immunohistochemical methods, we investigated MK expression in preinvasive and invasive neoplasia of the uterine cervix. METHODS: We performed immunohistochemical analysis of archived cone biopsy and hysterectomy specimens from 161 squamous cell lesions of the uterine cervix (29 cervical intraepithelial neoplasia 1 (CIN1), 35 CIN2, 49 CIN3, 30 microinvasive squamous cell carcinomas (MIC), and 18 invasive squamous cell carcinoma). In addition, we examined if there is a correlation between MK expression and status of human papilloma virus infection determined by a commercially available DNA chip. RESULTS: None of the normal cervical mucosa showed MK immunostaining. The level of MK expression gradually increased according to the histologic grade. Moderate and strong expressions were most frequently observed in cervical tissue with CIN3 and MIC. MK immunostaining was more accentuated in the invasive border of MIC. CONCLUSION: MK may play a functional role in the disease progression of cervical squamous cell neoplasia.
Biopsy ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Colon ; Disease Progression ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Mucous Membrane ; Oligonucleotide Array Sequence Analysis ; Papilloma ; Prostate

There were 21 cases of tibial pilon fractures in total: type I-2 cases, type II-14 cases, type III-5 cases according to Rued's classification. In type I and II, ring fixators were applied to tibia and foot and closed reduction was performed monitoring the quality of the reduction with an image intensifier. When the quality of the reduction was questionable, we rechecked it using arthroscopy and if neces- sary, the reduction was readjusted. Instead of using plate and screws, we used olive stop wires to achieve stable fixation. In type III, a limited open reduction was performed in the place of arthroscopy. Approximately at the eighth week after operation, we removed the fixation of calcaneus, metatarsal and foot mounting. Between 16 and 28 weeks, we removed the foot mounting after achieving bony union in all cases except one case(20 cases). In the follow-up cases of 2 years and more, we obtained the fine functional results of 15 good, 4 fair and 2 poor cases. Fewer major complications were observed except 8 cases of pin tract infection(grade 1) and 1 case of reduction loss. Using ring fixators and arthroscopy, we had fewer surgical complications.
Arthroscopy ; Calcaneus ; Classification ; Follow-Up Studies ; Foot ; Metatarsal Bones ; Olea ; Tibia