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OBJECTIVES: This study was to determine whether drainage after radical hysterectomy and bilateral pelvic lymphadenectomy can reduce the risk of postoperative morbidity as compared with no drainage. METHODS: 165 patients with stage Ia2 to Ilb underwent radical hysterectomy and bilateral pelvic lymphadenectomy between January 1995 and May 1997, and those medical records were analyzed, Closed suction drains were placed in group I (n 102), not in group II (n 67). All surgeries were perforrned by the same surgeon in a uniform method. RESULTS: The characteristics of two groups were similar for mean age, preoperative weight, total protein, serum albumin, tumor cell histology, invasion depth, and tumor stage. There was no difference in mean operation time in two groups. But mean estimated blood loss was more in group I than group lI(p<0.05), Postoperative ileus and postoperative stay was similar in both groups. The incidence of pelvic lymphocyst and febrile morbidity in two groups were comparable with 17% in group I and 27% in poup II, but not statistically significant(p>0.05). Rehospitalization rate was higher in group I than in group II. CONCLUSION: Pelvic drainage didn't reduce the postoperative febrile morbidity and lymphocyst formation. Therefore the author could not find any necessity to perform the drainage following radical hysterectomy and pelvic lymphadenectomy.
Drainage* ; Humans ; Hysterectomy* ; Ileus ; Incidence ; Lymph Node Excision* ; Medical Records ; Serum Albumin ; Suction ; Uterine Cervical Neoplasms*

Oral mucositis continues to be a major complaint of patients who have chemotherapy for the acute leukemia. An innovative and inexpensive remedy which produces favorable results for those afficted is not yet introduced. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. The one is sodium bicarbonate-normal saline gargling, and the other consists of chlorhexidine gargling. This quasi-experimental study was performed to compare the efficacy of these two different oral care protocols. Twenty subjects were assigned to one of the two specific diagnosis of leukemia, aim of the chemotherapy. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort, WHO Grading system fot mucositis and the discomfort of oral gargling solution were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count(ANC) reached 1,000. It continued about 2-4 weeks. The data analyzed by Mann-Whittney U test and ANCOVA. The result was follows as: The patient who used sodium bicarbonate-normal saline gargling showed significantly higher mean score of the discomfort of oral gargling solution than chlorhexidine gargling. The other scores were not significantly different between two groups. However the subjects using the sodium bicarbonate-normal saline gargling showed a lower level of oral mucositis. We concluded that oral using sodium bicarbonate-normal saline gargling was between to reduce the level of oral mucositis during chemotherapy and nursing assessments of the oral cavity seemed to promote patient's compliance with the oral care regimen.
Chlorhexidine* ; Compliance ; Diagnosis ; Drug Therapy ; Humans ; Leukemia* ; Mouth ; Mucositis ; Neutrophils ; Nursing Assessment ; Sodium* ; Stomatitis*

The term "pineal anlage tumor" has been recently proposed and few cases have been reported. We report the first Korean case of pineal anlage tumor in a 6-year-old girl who complained of headache and vomiting for 2 months. Brain MRI revealed a well defined, lobulated, calcifying mass in the pineal region. Tumor was totally removed. Pathological examination revealed a primitive pineal parenchymal tumor with melanotic epithelial component that was similar to histologic findings of melanotic neuroectodermal tumor of infancy, so-called retinal anlage tumor and of the developing pineal gland. The tumor was composed mostly of small, undifferentiated cells, Flexner-Wintersteiner rosettes, and ganglionic differentiation. The tumor also contained the cartilage and skeletal muscle cells.
Brain ; Cartilage ; Child ; Female ; Ganglion Cysts ; Headache ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal ; Neuroectodermal Tumor, Melanotic ; Pineal Gland ; Pinealoma ; Vomiting

Intraosseous ganglion is a rare disease and identified as a cystic lesion on plain radiograph. One case ofintraosseous ganglion is examined by plain radiography and CT and findings are analyzed.
Bone Cysts ; Ganglion Cysts ; Radiography ; Rare Diseases

Maintaining blood glucose levels within recommended targets during pregnancy is associated with improved maternal and fetal outcomes. Optimal gestational nutrition care is required for maintenance of normoglycemia, appropriate gestational weight gain and prevention of ketosis. Energy intake is not different from pregnant women without diabetes and an optimal eating plan for gestational diabetes has not been not developed. Because carbohydrates affect blood glucose levels, especially postprandial levels, it is important to monitor the quantity and quality of carbohydrate intake in women with gestational diabetes. Macronutrient and micronutrient planning must be considered. After childbirth, postpartum care is important to women with gestational diabetes mellitus. To decrease the risk of type 2 diabetes, metabolic syndrome and hypertension, weight control and breastfeeding is recommended to women with gestational diabetes mellitus.

Congenital hepatic fibrosis is an uncommon disease of children and young adults with two major risks: gastrointestinal hemorrhage caused by portal hypertension, and cholangitis related to bacterial infection of dilated intrahepatic bile ducts. It is characterizeed by stony hard hepatomegaly and portal hypertension with rather well preserved hepatic function and architecture, and frequent association of the renal lesions. We have recently experienced a case of congenital hepatic fibrosis in a 24 year-old Korean male. The chief complaint was hematemesis from esophageal varices. There were marked hepatosplenomegaly, mild pancytopenia and the liver function test was within normal engorgement and dilatation of portal and splenic veins and multiple cysts of both kidneys.
Child ; Adult ; Male ; Female ; Humans ; Cysts

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

The prevalences of many chronic diseases (obesity, diabetes mellitus, hypertension, stroke, etc.) are increasing in worldwide, and the association between chronic diseases and dietary habit has been established. Many people are thus concerned with dietary habits and nutrition information. In order to prevent and treat chronic disease, it is necessary to provide proper nutrition information for foods, including data on balanced diets, adequate intake amounts and food choice. I will review the available materials (books, web-sites, smart phone applications, nutrition information labeling) containing nutrition information for foods.
Chronic Disease ; Diabetes Mellitus ; Diet ; Food Habits ; Food Labeling ; Hypertension ; Prevalence ; Stroke

Pigmented squamous cell carcinoma is a very rare malignant, pigmented, epidermal tumor. The rarity of pigmented squamous cell carcinomas may reflect in part their misdiagnosis as other pigmented neoplasms, particularly malignant melanoma. To our knowledge, only five cases have been reported in literature. We recently experienced a case of pigmented squamous cell carcinoma arising from pigmented actinic keratosis in a 77 years old female. Physical examination showed a 0.8 0.6 cm, smooth, dark brown pigmented patch with irregular but sharply defined borders located on the upper left chest. The biopsy specimen showed histologic findings of pigmented actinic keratosis with abundant melanin pigments, which became pigmented squamous cell carcinoma. Most of pigments in the squamous cell carcinoma were contained within the melanocytes along with the neoplastic squamous cells.
Actins* ; Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Diagnostic Errors ; Female ; Humans ; Keratosis, Actinic* ; Melanins ; Melanocytes ; Melanoma ; Physical Examination ; Skin ; Thorax