Small round cell tumors such as neuroblastoma, rhabdomyosarcoma, Ewing's tumor, malignant lymphoma and small cell carcinoma are often confused clinically and histologically. To clarify the similarites and differences and to get more information on the histogenesis among the small round cell tumors, we examined histological, immunohistochemical and ultrastructural features of ten cases of neuroblastomas, twenty Ewing's tumors, ten embryonal rhabdomyosarcomas and twelve small cell carcinomas in children and young adults. Antibodies against desmin, vimentin, cytokeratin, neuron-specific enolase, synaptophysin, neurofilament, S-100 protein, chromogranin and HBA 71 were used in biotin streptavidin procedures. The results of the immunohistochemical and electron microscopical examinations yielded virtually identical findings in each group as followings. 1) Among the twenty cases of Ewing's tumors, eighteen cases were positive in staining for HBA-71. The staining for HBA-71 was negative in neuroblastoma, embryonal rhabdomyosarcoma and small cell carcinoma. 2) Neuroblastomas had marked interdigitating cytoplasmic processes containing many microtubules and dense-core secretory granules, however, they were sparse and rare in Ewing's tumor. 3) Embryonal rhabdomyosarcoma showed actin-myosin bundles. According to differentiation, well differentiated rhabdomyosarcoma exhibited Z-band materials and external lamina. 4) Neuroblastoma showed ultrastructural evidence of a neuronal differentiation, but neuronal differentration is a sparse and rare in Ewing's tumor. This ultrastructural feature strengthens the hypothesis that Ewing's tumor is derived not only from an undifferentiated neuroectodermal stem cell but from primitive cell of neuroectodermal origin.
Antibodies ; Biotin ; Carcinoma, Small Cell ; Child ; Cytoplasm ; Desmin ; Humans ; Immunohistochemistry ; Keratins ; Lymphoma ; Microtubules ; Neural Plate ; Neuroblastoma ; Neurons ; Phosphopyruvate Hydratase ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal ; S100 Proteins ; Sarcoma, Ewing ; Secretory Vesicles ; Stem Cells ; Streptavidin ; Synaptophysin ; Vimentin ; Young Adult

PURPOSE: The aim of the study is to evaluate the possibility of giving student interns intern- level responsibilities and to discuss the various obstacles. METHODS: Modifications were made to the student internship program, including rotations through major departments, for 4th-year medical students and was conducted at the College of Medicine, Kangwon National University. We surveyed 49 students for the evaluation of the program, administered a checklist evaluation for their performance, and interviewed two focus groups of faculties and residents to find out the obstacles of the program. RESULTS: Most of the students answered that the program was satisfactory and necessary. Of the students, 71.4% performed as an acting intern. The mean score of the students' performance was 84.1. The students had the most difficulty with time management and making diagnostic and management decisions. Initially, at the start of the program, both students and residents were somewhat confused about the student interns' duties. They suggested that definite learning objectives, legal and institutional support to students' clinical practice, and announcements to patients and hospital staff should be put in place prior to the implementation of such a program. CONCLUSION: We discovered that it was possible for student interns to perform at the level of interns. We suggest that systemic improvements continue for the establishment of such student internship program.
Checklist ; Education, Medical ; Focus Groups ; Gangwon-do ; Humans ; Internship and Residency* ; Learning ; Students, Medical ; Time Management

In 1952, Zoon described eight cases of benign circumscribed chronic balanitis characterized by an extensive infiltration of plasma cells with no evidence of dysplasia of the overlying epidermis. Plasma cell balanitis can often be confused clinically with other conditions, such as erythroplasia of Queyrat, fixed drug eruptions, secondary syphilis, candidiasis and Reiters disease. We report a case of plasma cell balanitis in a 65-year-old man. He complained of a single, red, shiny and smooth patch involving the glans penis and adjacent prepuce. This patch was unresponsive to systemic and topical steroid treatment. Laboratory studies were negative or within the normal range. Histopathological findings showed a band-like mainly plasmacytic inflammatory infiltrate of the upper dermis. This patient was treated once daily with 2% fusidic acid cream topically for 5 weeks. The lesions resolved and no recurrence was observed during 2 years of follow-up.
Aged ; Arthritis, Reactive ; Balanitis* ; Candidiasis ; Dermis ; Drug Eruptions ; Epidermis ; Erythroplasia ; Follow-Up Studies ; Furosemide* ; Fusidic Acid* ; Humans ; Male ; Penis ; Plasma Cells* ; Plasma* ; Recurrence ; Reference Values ; Syphilis

PURPOSE: The present study was done to examine the effect of music therapy on anxiety and pain in patients for whom a ureteral stent was inserted under local anesthesia. METHOD: The participants in this study were 22 patients who received a ureteral stent at the Day Surgery Center of C University Hospital during the period from May to October in 2006. The patients were divided into a control group (n=11) and an experimental group (n=11). For the experimental group, music was played according to their musical preference using headphones. The music was provided from the point when the patient took the posture for the operation and was covered with a sterilized drape to the point when the cystoscope was removed after finishing the operation. The control group was only provided with ordinary nursing services. RESULTS: The results show that the provision of music therapy to these patients is effective in reducing the patients' salivary cortisol and Vas-anxiety score and stabilizing their systolic blood pressure. CONCLUSION: We conclude that music therapy can be actively used as a nursing intervention for reducing anxiety in patients who receive operations under local anesthesia.
Ambulatory Surgical Procedures ; Anesthesia, Local* ; Anxiety* ; Blood Pressure ; Cystoscopes ; Humans ; Hydrocortisone ; Music Therapy* ; Music* ; Nursing ; Nursing Services ; Posture ; Stents* ; Ureter*

No abstract available.
Cryptococcosis* ; Humans

This study was conducted to evaluate the effect of a teaching program on patients with myocardial infarction. Forty-five patients were randomly selected 22 were assigned to a teaching group and 23 to a control group. An individualized teaching program was delivered to the teaching group during the hospitalization period. It covered aspects such as: the characteristics of heart disease, the anatomy and physiology of the heart, risk factors of atherosclerosis, medication and diet and exercise therapy. When these subjects were discharged to their homes, they received regular supportive care via telephone or mail for 12 weeks. Atherosclerotic risk factors, including, smoking, exercise, blood lipid profile and BMI were measured before and after the teaching program. Post-testing revealed that the numbers of those who exercised and the number of non-smokers were significantly higher in the teaching group than in the control group. Increased HDL cholesterol (High-Density Lipoprotein cholesterol) was significantly greater in the teaching group than in the control group. The above findings suggest that this individualized teaching program might be helpful at reducing the risk factors of atherosclerosis in myocardial infarction patients.
Adult ; Aged ; Arteriosclerosis/etiology/*prevention & control ; Comparative Study ; Exercise ; Female ; Human ; Lipids/blood ; Male ; Middle Age ; Myocardial Infarction/*prevention & control ; *Patient Education ; Risk Factors ; Smoking

BACKGROUND: Hepatocyte growth factor (HGF) is a potent mitogenic cytokine. C-met protein, which is known to be the HGF receptor has transmembrane tyrosine kinase activity and is encoded by the c-met oncogene. The HGF/c-met signaling pathway may play various roles in the carcinogenesis of various organs. METHODS: We examined HGF and c-met mRNA expression by utilizing reverse transcription polymerase chain reaction on 40 surgically resected intracranial meningiomas (25 benign, 10 atypical, and 5 anaplastic cases). RESULTS: An HGF overexpression was detected in 28%, 50%, and 80% of the benign, atypical and anaplastic meningiomas, respectively; a high expression of HGF or the coexpression of HGF/c-met was detected in the high grade meningiomas (the atypical and anaplastic cases, p=0.046, p=0.014). An HGF expression was statistically significant in the recurrent meningiomas (p=0.003), and HGF expression was significantly lower than c-met mRNA expression in benign meningiomas (p=0.034). CONCLUSIONS: There was no correlation between histologic subtypes and HGF/c-met expression. Determination of HGF expression can be used as a molecular predictor for recurrence of meningioimas. These results suggest that HGF and c-met expression in meningiomas may be associated with anaplastic progression.
Hepatocyte Growth Factor ; Hepatocytes ; Meningioma ; Neoplasm Recurrence, Local ; Oncogenes ; Polymerase Chain Reaction ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins c-met ; Recurrence ; Reverse Transcription ; RNA, Messenger

Single breath-hold gradient echo images with Small Tip. Angle Gradient Echo(STAGE) were evaluated in the study of liver in 16 patients(4 normal liver, 5 hepatoma, 5 cholangiocarcinoma, 1 hemangioma, 1 cavernous transformation of portal vein). We obtained one slice of gradient echo during single breath-hold at the level of pathology defined on conventional spin echo inage. Single breath-hold gradient echo images were compared with spin echo images for image quality and artifacts. Single breath-hold gradient image showed improved resolution of vascular detail and excellent contrast between lesion and adjacent normal liver in hepatoma. Cholangiocarcinoma showed decreased contrast between lesion and biliary trees but improved contrast between lesion and blood vessel. Cavernous transformation of porta vein was noted as tortuous vessel of high signal intensity. Single breath-hold gradient echo scan increased vascular artifact, but decreased respiratory artifact leading to improved image quality. Single breath-hold technique can reduce can reduce imaging time and improve image quality and may be used as complementary method to the spin echo scan.
Artifacts ; Blood Vessels ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Hemangioma ; Liver* ; Magnetic Resonance Imaging* ; Methods ; Pathology ; Trees ; Veins

Pacemaker twiddler's syndrome is reported as a very rare complication of permanent pacemaker implantation. There was a recent report suggesting that the incidence of pacemaker twiddler's syndrome increase recently presumably as a result of the implantation of thinner and smaller pacemaker system than before. We experienced a case of pacemaker twiddler's syndrome complicated 3 times with the conventional method of implantation or replacement during 14 months after the first implantation(Optims MP 158C and Pacing lead 400, Telectronic)on June 13th 1987. This case was an 18 year-old high school girl who had suffered frequent syncope for 2 years and extertionl dyspnea for 5 years due to congenital complete heart block, of which block site was proved to be AV nodal by His bundle electrogram. Pacemaker twiddler's syndrome developed 3 times;firstly 6 weeks after the first implantation in the right subclavicular fossa, secondly 10 weeks after the replacement of the twisted pacing lead, thirdly 10 months after the change of implantation site to the left subcalvicular fossa with the replacement of the twisted and fractured lead. Finally, the pacemaker generator was anchored to the clavicular periostium and pectoralis fascia at several points by using Dacron pouch.
Adolescent ; Dyspnea ; Electrophysiologic Techniques, Cardiac ; Fascia ; Female ; Heart Block ; Humans ; Incidence ; Polyethylene Terephthalates ; Syncope

The only clinically avilable levo-isomer type of beta-recepter blocker is penbutolol sulfate, and it is already accepted as one of beta-receptor blockers for initial antihypertensive drug therapy according to the report of 1988 Joint National Committee on Detection, Evaluation, and Tratment of High Blood Pressure. To evaluate the antihypertensive efficacy, effect on the quqlity of life, and side effects of penbutolol recently introduced into Korea, penbutolol was administered to 29 essential hypertensive(mild 9, moderate10, and severe 10) patients for 12 weeks or longer. The result of the clinical analysis are as follows; 1) The mean age was 50.0+/-10.9(M+/-SD), and the sex distribution between male and female was16:13. 2) The blood pressure lowering effects of penbutolol as a monotherapy were marked in 16, moderate in 6, and insignificant in 2 cases. The systolic blood pressure was significantly decreased from 179.1+/-20.2 to 135.4+/-16.5mmHg(P<0.005), and the diastolic blood pressure from 112.6+/-13.5 to 84.0+/-11.9mmHg(P<0.005)after 12 weeks' penbutolol therapy. 3) The heart rate was significantly decreased from70.3+/-13.3 to 65.5+/-9.1 per minute(P<0.05). 4) The quality of life was improved markely in 5(17.2%) and slightly in 8 cases(29.6%). 5) There were no significant laboratory changes after 12 weeks' penbutolol therapy. 6) Two out of three cases with non-specific ST segment and T wave changes in EKG and two out of 9 cases with EKG were normalized, 2 cases of LAH with strain were improved. 7) The side effects of penbutolol were dizziness in 4, sexual dysfunction in 2, and skin rash in 1 case. 8) Final multifarious assessment of penbutolol therapy showed that it was very useful in 11(37.9%), useful in 4(13.8%) and slightly useful in 7 cases(24.1%). These reult suggest that penbutolol is a first-line antihypertensive agent with an effective antihypertensive action, improving quality of life, with no significant laboratory changes and few side effects.
Blood Pressure ; Dizziness ; Drug Therapy ; Electrocardiography ; Exanthema ; Female ; Heart Rate ; Humans ; Hypertension ; Joints ; Korea ; Male ; Penbutolol ; Pheniramine ; Quality of Life ; Sex Distribution