We retrospectively analysed plain radiographs and MR imaging of 16 conventional osteosarcoma cases(8 children, 8 adults) which underwent amputations or limb salvage operations. Pathologic correlation was performed with gross and microscopic sections to evaluate 1) whether the open epiphyseal plate can function as a barrier against transphyseal spread of osteosarcoma and 2) the diagnostic value of MR imaging for the detection of the detection of the epiphyseal involvement of osteosarcoma. In children with open epiphyseal plates, conventional radiographs suggested transphyseal tumor growth in one of eight cases(12.5% and MR imaging in seven cases(87.5%). Pathologic examination confirmed epiphyseal involvement in six of seven cases noted with MR imaging(75%). On the the other hand, in adult patients with closed epiphyseal plates, conventional radiographs showed transphyseal tumor growth in six of eight cases(75%), while MR imaging and pathologic exam demonstrated tumor invasion in all cases(100%). We conclude that open epiphyseal plate does not function as and effective barrier against tumor extension, and MR imaging is an excellent method in detecting the extent of transphyseal tumor growth.
Adult ; Amputation ; Child ; Growth Plate ; Hand ; Humans ; Limb Salvage ; Magnetic Resonance Imaging* ; Methods ; Osteosarcoma* ; Retrospective Studies

Pancreatic islet cell adenoma is a benign tumor of pancreatic beta-cell and a rare cause of hyperinsulinemic hypoglycemia in children. The authors experienced a case of pancreatic islet cell adenoma(Insulinoma)in a 11 year and 8 month old male who had frequent loss of consciousness and seizure. Enucleation was done after localization of tumor by selective celiac artery angiography and abdominal computed tomography. Diagnosis was confirmed by histologic findings as pancreatic-adenoma, gyriform growth pattern. A brief review of related literature was made.
Adenoma* ; Angiography ; Celiac Artery ; Child ; Diagnosis ; Humans ; Hyperinsulinism ; Hypoglycemia ; Infant ; Islets of Langerhans ; Male ; Seizures ; Unconsciousness

PURPOSE: To determine the effects of hand massage on nausea and vomiting, and anxiety in children with lymphocytic leukemia receiving high dose chemotherapy. METHOD: The children were assigned to an experimental group(15) or a control group(15). All of the children were diagnosed with acute lymphocytic leukemia and admitted for high dose chemotherapy at C University Medical Center in Seoul. The hand massage was performed for 10 minutes twice a day over three days. To measure the effects of hand massage, the Index of Nausea and Vomiting by Rhodes et al. and the State-Trait Anxiety Inventory for children by Spielberger were used. The level of anxiety was measured by systolic blood pressure, diastolic blood pressure, and pulse rate. RESULTS: The score for nausea and vomiting decreased in the experimental group. State anxiety for the experimental group was significantly more positive than for the control group at the 2nd measurement. There was a significant difference in systolic blood pressure between the two groups. The level of diastolic blood pressure in the two groups decreased significantly over time. CONCLUSION: Hand massage could be effective in decreasing nausea and vomiting, state anxiety, pulse rate and blood pressure in children with acute leukemia receiving high dose chemotherapy.
Academic Medical Centers ; Anxiety* ; Blood Pressure ; Child ; Drug Therapy* ; Hand* ; Heart Rate ; Humans ; Leukemia* ; Leukemia, Lymphoid ; Massage* ; Nausea* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Seoul ; Vomiting* ; Child Health

No abstract available.
Knee Joint* ; Knee*

Sir James Paget described the first case of Paget's disease of the breast in 1874, and Du-breuilh, in 1901, reported the first case of extramammary Paget's disease of the vulva. Paget's disease of vulva is a rare intraepithelial neoplasm of uncertain histogenesis. Recently we expe-rienced a case of Paget's disease of the vulva that we present a brief review of literature.
Carcinoma in Situ ; Paget Disease, Extramammary ; Paget's Disease, Mammary ; Vulva*

The purpose of this study is to evaluate the ventricular conduction abnormalities, especially RBBB, observed electrocardiographically after surgical closure of VSD. The present study population consists of 92 patients with VSD who were surgically corrected at the Hanyang University Hospital during 6 years period from Jan. 1985 to Dec. 1990. We reviewed their clinical records including surgical notes and EKG findings before and after operations. The results of the study were as follows: 1) Male to female ratio was 1.1:1 (48:44) 2) Out of a total of 92 cases of VSD, 65cases(70.7%)were perimembranous type and 27 cases (29.3%)were subarterial type. 3) The normal preoperative EKG findings were seen in 22 patients, LVH in 21 patients, BUH in 47patients, and RVH in 3 patiens. 4) A transatrial approach was performed in 55 cases, right ventriculotomy with or without resection of muscles in right ventricle in 13 cases, and pulmonary arteriotomy alone in 24 cases. 5) The right bundle branch block after operation developed in 33 patients out of the 65 patinets with perimembranous defect and 5 patients out of the 27 patients with subarterial defects. Postoperative RBBB developed more frequently in perimembranous defect than in subarterial defect. 6) Postoperative RBBB occured in 31.8% of the patients with normal preoperative EKG findings, 23.8% with preoperative LVH, 52.1% with BVH and 66.7% with RVH. Postoperative RBBB was more frequently observed in the patients group with preoperative BVH or RVH than the patients with normal or LVH. 7) Postoperative RBBB was observed in 84.6% after right wentriculotomy, in 43.6% after right atriotomy and in 12.5% with pulmonary arteriotomy alone.
Bundle-Branch Block* ; Electrocardiography ; Female ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Male ; Muscles

No abstract available.
Epilepsy* ; Video Games*

Between June 1990 and May 1994, 350 laser conization and 200 LEEP were performed. Indications of conization were that directed biopsy specimen was proved CIN II, III or suggests possible microinvasion. In all the cases the procedures were carried out with the patients under local anesthesia. Excisional cone sections(6,600) were evaluated for lesion length,depth and margin status. Invasive cancer was found in 5(1.4%) women of laser group. Operative time was shorter LEEP group than laser group significantly. In laser group, 25(8.3%) women had bleeding that required treatment. One case(0.3%) of pelvic infection and 7 cases(2.3%) of cervical stenosis were observed. In LEEP group, 10(5.3%) women had bleeding, 3(1.6%) patients became cervical stenosis. The diameter of bumed tissue was 0.28mm in laser group and 0.25mm in LEEP group. Success rate were 97.4% in former and 96.3% in later. This study demontrated that CO2 laser conization and LEEP were effective methods for treating high grade cervical intraepithelial neoplasia and added benefit of preserving reproductive function and rule out invasive carcinoma.
Anesthesia, Local ; Biopsy ; Cervical Intraepithelial Neoplasia* ; Conization* ; Constriction, Pathologic ; Female ; Hemorrhage ; Humans ; Lasers, Gas* ; Operative Time ; Pelvic Infection

BACKGROUND: Although several risk factors associated with reduced age at natural menopause (ANM) have been investigated, the results are inconsistent. Excessive stress, which leads to elevation of stress hormones, can also negatively affect reproductive ability, including by accelerating menopause. However, a direct association between stress level and ANM has not yet been demonstrated. Therefore, the object of this study was to investigate the association between stress level and ANM in Korean women. METHODS: Study participants were Korean women between 40 and 70 years old who were in natural menopause during the 5th Korean National Health and Nutrition Examination Survey (n=3,176). The level of stress in daily life was estimated based on data from the mental health topics of the survey. We used the t-test and one-way analysis of variance to analyze the correlation between stress level and ANM. Regression (beta) coefficients calculated by multiple regression analysis were used to estimate various factors affecting ANM. RESULTS: Women who experienced a high level of stress in daily life had a lower mean ANM than women with a low stress level (50.17+/-3.7 and 50.58+/-3.5 years, respectively), with a statistically significant correlation (P<0.05). This correlation was still observed after adjusting for age, body mass index, menstrual regularity, and personal income (P<0.05 for variables). CONCLUSION: In Korean women between 40 and 70 years of age who are in natural menopause, there is a statistically significant correlation between stress level and ANM. In particular, women who experience a high level of stress in daily life have reduced ANM.
Body Mass Index ; Female ; Humans ; Menopause* ; Mental Health ; Nutrition Surveys* ; Risk Factors

OBJECTIVE: The link among carotid intima-media thickness (IMT), vascular elastic property and the disease activity of systemic lupus erythematosus (SLE) is not well defined. We investigated the association between carotid atherosclerosis, elastic properties of the carotid arterial wall and clinical parameters of SLE. METHODS: Fifty-one SLE patients and fifty healthy controls were included. Peak systolic global circumferential and posterior radial strains of carotid artery were measured to assess the elastic properties. Beta stiffness index was used as conventional method for the distensibility of the carotid artery. Information concerning SLE duration, cumulative dose of steroids and/or immunosuppressive drug intake was recorded, and SLE activity was assessed by SLE disease activity index (SLEDAI) score. RESULTS: Carotid plaques were more common in SLE patients. SLE patients with plaques were older and showed the increased mean IMT, high sensitivity C-reactive protein (hs CRP), IgG anti-cardiolipin antibody (aCL), and longer disease duration compared with those without plaques. Peak systolic global circumferential and posterior radial strain as well beta stiffness index were significantly lower in SLE group. Age, disease duration, hsCRP, IgG aCL showed significant correlations with mean IMT and parameters of carotid elastic property (all P's<0.05). CONCLUSIONS: Carotid atherosclerosis was more common in SLE patients, and carotid arterial stiffness had significant correlation with disease duration, hsCRP and IgG aCL level. Speckle tracking strain imaging is a comparative method for the assessment of elastic properties of carotid artery of SLE patients.
C-Reactive Protein ; Carotid Arteries* ; Carotid Artery Diseases* ; Carotid Intima-Media Thickness ; Humans ; Immunoglobulin G ; Lupus Erythematosus, Systemic* ; Steroids ; Ultrasonography ; Vascular Stiffness