Ouarian tumors of low malignant potential(OTLMP) or borderline tumors account for approximately 10% of all ovarian neaplasms. Borderline tumors have some but not all of the histologic characteristics af ma lignancy : stratification of epitheliial cells, with some degree of nuclear atypia a,nd inereased mitotic actitity but. without stromal invasion. We reviwed 20 published Rnglish written articlea from 1978 to 1992 and Korean gynecologic cancer regestry of 1990. In this review, we tried to concentrate on several debating is sues in OTLMP: 1) What kind of surgery is needed for each stages?, 2) Is postoperative adjuvant t.herapy needed?, 3) Jf needed, which type? Following result were obtained from the besis of 1516 patients with OTLMP. Patients withh OTLMIP are younger than those with invasive ovarian cancers', mean age was in their forties. The majority of patients(74.5%) had stage I disease, and the incidence dropped ahruptly to 9.4% for stage ll, 15.7% for stage III and 0.4% for stage IV. The most cammon histologic subtype was serous(56.7%), followed by muci noua(38.1%), However, interestingly in Korea and Japan, the mucinous type was the most common one. The primary treatment for OTLMP was surgery, and the conservative surgery to preserve fertility in young women was sufficient for stage I disease with careful follow-up. The majority of patients(79.1%) with stage I disease were treated by surgery alone. Adjuvant such as chemotherapy (CT) and/or radiotherapy(RT) could prolong the recurrence of disease a little later, but failed to increase diaease-free survival significantly in stage I disease. In stageII disease, the surgery should be a total abdominal hysterectomy and bilateral salpingo-oophorectomy with multiple sampling of the peritoneal cavity. About a third of patients with stageII disease received no adjuvant therapy and the others received CT and/or RT, however, there was no difference in outcome of recurrence and survival. In advanced stage. 15% of patients received no adjuvant therapy after initial debulking surgery, and the rest of patients received CT and/or RT. No differences in recurrence and survival between each groups were noticed , too. The status of second-look laparotomy(SLL) did not depend on the stage of the disease. Positive rate of SLL for stage I diaease was not statistically different from that for the combined stages II-IV. Survival for stage I at 5 years was reported to range from 80 to 100%, and even stage III had survival ranging from 64 to 96%. Long-term survival at 15~20 years was also good. Although it is quite difficult to make conclusions because of the lack of prospective randomized studies from this review, it appears clear that surgical removal of the tumor and careful follow-up of patients are all that are necessary in stage I disease and further multi-center prospective study for the effect of adjuvant therapy in advanced disease is definitely needed.
Drug Therapy ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Incidence ; Japan ; Korea ; Mucins ; Peritoneal Cavity ; Prospective Studies ; Recurrence

PURPOSE: The aim of this study was to compare the relation between differently measured sports activities (metabolic equivalent [MET] and peak strain score) and distal radius bone mineral density in college-aged women. METHODS: Lifetime sports activity was scored in two different ways: 1) a sports activity score by multiplying the intensity (METs) and duration and 2) a sports activity score by adding up physical strain scores based on the ground reaction force of each sports activities. Bone mineral density was measured using dual energy x-ray densitometry (DTX-200) in the distal radius site. RESULTS: In stepwise multiple regression analysis, body weight and sports activities during the college period were significant positive predictors for distal radius bone mineral density. The explained variance of sports activity measured with a peak strain score (8.8%) for distal radius bone mineral density was higher than one measured with the MET score (3.3%). CONCLUSION: It can be concluded that sports activity scores based on MET and peak strain scores during college are very important for determining the bone mineral density in the distal radius site in women under 30.
Absorptiometry, Photon ; Bone Density/*physiology ; Data Interpretation, Statistical ; *Exercise ; Female ; Humans ; Interviews as Topic ; *Metabolic Equivalent ; Predictive Value of Tests ; Questionnaires ; *Sports ; Young Adult

PURPOSE: The purpose of this study was to identify the attributes, antecedents, and consequences of nurse's work interruptions. METHODS: Walker and Avant's concept analysis method was used to analyze this concept. Relevant articles published before August 2018 were searched through MEDLINE, CINAHL, EMBASE, KISS, and RISS databases using “interruption,” “work or task,” and “nurse” as keywords. RESULTS: The attributes of work interruption by nurses were as follows: 1) new tasks to do; 2) cognitive transition of work priorities; 3) loss of work continuity; 4) tasks to be resumed. The antecedents of work interruption were intrusion of unplanned events, internal and external factors that result in nurses forgetting their original intentions, an unpredictable work environment, and cultural climate where interruptions are considered as a part of the work process. The consequences of work interruption were decline in job satisfaction, trigger of work errors, lengthening of work completion time, decline in work productivity, increase in work stress, and delay of transferring needed information in a timely manner. CONCLUSION: The results of this study provide basic data to reduce the negative consequences of nurses' work interruptions, and contribute to expanding the knowledge necessary for improving patients' safety and nurses' performance.
Climate ; Efficiency ; Intention ; Job Satisfaction ; Methods ; Walkers ; Work Performance

The long QT syndromes have been classified into acquired or inheritary forms, both of which are associated with a characteristic type of life-threatening polymorphic ventricular tachycardia called torsade de points. Beta-adrenergic blocker is the first cholic treatment, but in those whom cardiac events are not prevented by beta - blockade, left thoracic sympathetic ganglionectomy may be useful in selected cases. A 50-year-old woman had an recurrent syncopal attack in which she was unconscious for 1-2 min and 1-2 times a month for 10 years. The EKG revealed that QT & QTc intervals were 744 and 632 msec respectively. Treatment with Beta-adrenergic blocker and calcium channel blocker was ineffective in preventing recurrence of syncopal spell. Therefore, she underwent left thoracic sympathetic ganglionectomy with thoracoscope. During the 9 months after operation, she was free of syncopal episodes and is doing well.
Calcium Channels ; Electrocardiography ; Female ; Ganglionectomy* ; Humans ; Long QT Syndrome* ; Middle Aged ; Recurrence ; Syncope ; Tachycardia, Ventricular ; Thoracoscopes*

Isolated congenital aneurysm of the left atrium with intact pericardium is a rate anomaly, which usually presents with arrhythmia, cerebral embolism or abnormalities on routine chest X-ray. Surgery is indicated in most cases to eliminate a potential source of systemic emboli and arrhythmias. A 42-year-old woman having cervical cancer, she was suspected of having a left atrial aneurysm on review of chest X-ray and confirmed by echocardiography and cardiac catheterization. Surgical resection of Left atrial aneurysm was achieved without complication using median sternotomy with cardiopulmonary bypass. The postoperative course was uneventful.
Adult ; Aneurysm* ; Arrhythmias, Cardiac ; Cardiac Catheterization ; Cardiac Catheters ; Cardiopulmonary Bypass ; Echocardiography ; Female ; Heart Atria* ; Humans ; Intracranial Embolism ; Pericardium ; Sternotomy ; Thorax ; Uterine Cervical Neoplasms

BACKGROUND: Cardiopulmonary bypass during open heart surgery causes systemic inflammatory respose. IL-10 is an anti-inflammatory cytokine that inhibits inflammatory process and protects organ function by down regulation of pro-inflammatory cytokine release and maintenance of blood level balance with pro-inflammatory cytokines. MATERIAL ateial and Method: Plasma IL-10 levels were measured and analyzed in 22 patients who underwent open heart surgery (11 cases of coronary artery bypass graft, 11 cases of valve replacement) under cardiopulmonary bypass since 1988 January to July at Department of Thoracic and Czardiovascular surgery, Yeungnam University Hospital. 1g of methylprednisolone was administrated to thirteen patients randomly. Blood samp.es were taken and collected at the time of induction of anesthesia, 10 min before cardiopulmonary bypass, 10 min after starting of CPB, 10 min aftr aortic cross clamping, 10 min after ACC release, and 10 min, 2 hours, and 5 hours after CPB respectively. The plasma levels of IL-10 were determined by enzyme-linked immunosorbent assays (ELISA). Wilcoxon-Raule Sum test was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was 171+/-41.4 min and aortic cross clamp time was 118+/-36.5 min. Peak IL-10 level was achieved at 10 min after ACC (361.0+/-52.81pg/ml) and was decreased sharply at 2 hours after CPB. Peak IL-10 level was correlated positively with aortic cross clamp time (p=0.011); however, it did not correlated with bypass time (p=0.181). In valve replacement group, mean IL-10 level at peak point was 567.89+/-107.69 pg/ml and was significantly higher than that of coronary artery bypass group (205.67+/-192.70 pg/ml) (p<0.001). ACC time in valve replacement group was significantly longer than that of coronary artery bypass group (p<0.01), however, bypass time was not (p=0.212). Thirteen patients with steroid pretreatment before starting of CPB showed relatively higher plasma IL-10 level than in control group, however, no statistical significance was noted (p=0.19). CONCLUSION: plasma level of IL-10 was increased in association with cardiopulmonary bypass and revealed peak at 10 min after ACC release. IL-10 level was correlated positively with ACC time. Therefore, systemic inflammatory respeonse in association with cardiopulmonary bypass could be decreased by reducing ACC time during cardiac surgery.
Anesthesia ; Cardiopulmonary Bypass* ; Constriction ; Coronary Artery Bypass ; Cytokines ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-10* ; Methylprednisolone ; Plasma ; Thoracic Surgery ; Transplants

No abstract available.
Azoospermia* ; Sarcoidosis*

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

A fetal rhabdomyomatous nephroblastoma is considered to be a predominantly monophasic mesenchymal variant of Wilms' tumor, which acts less aggressively than a conventional Wilms' tumor despite its much larger size. Bilaterality of this tumor in a nine month-old girl, however, may negatively affect the overall prognosis. A radical nephrectomy for bulky masses in the left kidney and a partial nephrectomy for right kidney with five small tumor masses was performed at the same time. Two small tumor masses in the upper part of right kidney were left behind because of preserving minimal renal functional capacity. Pathological study revealed a mixed type of nephroblastoma which was composed predominantly of mesenchymal components with fetal rhabdomyomatous differentiation. After post-operative chemotherapy with vincristine, actinomycin D and adriamycin, and radiotherapy(2,130 rad), residual tumor masses became a single tumor 5 cm in diameter and well demarcated, which was resected at 15 months after first operation when the size and renal function of remained right kidney was appropriate to resect out the residual tumor. The tumor resected out at second operation was entirely composed of scattered differentiated fetal skeletal muscle cells in the fibrovascular tissue. Only a few entrapped epithelial components were seen but no blastemal cornponents were present. Follow up abdominal CT and ultrasonographic examinations revealed no evidence of tumor recurrence. The girl has developed normally without disease.

We have corrected the conclusion in abstract.