No abstract available.
Humans ; Hypoplastic Left Heart Syndrome* ; Survivors*

OBJECTIVE: Sural nerve conduction study is known to be one of the sensitive tests for detecting neuropathies. In peripheral neuropathy, the distal sural nerve, lateral dorsal cutaneous branch of sural nerve (LDCBSN), may be more easily affected than proximal portion of the sural nerve. To evaluate the clinical application of LDCBSN conduction study and amplitude comparison between sural nerve and LDCBSN in peripheral neuropathy. METHOD: Antidromic conduction studies were performed for sural nerve and LDCBSN and amplitude between two nerve responses were obtained in 30 controls (mean age, 46) and 30 patients with diabetic neuropathy (mean age, 54), but obtainable sural sensory response. The active recording electrodes were placed were placed over the dorsolateral surface at the midpoint of the fifth metatarsal for LDCBSN and posterior aspect of lateral malleolus for sural nerve. The stimulating electrodes were placed 12 cm proximal to the active electrodes in both nerves. RESULTS: LDCBSN response was obtainable in all controls and not obtainable in 7 diabetic patients in whom the amplitude of sural response was less than 5 uV. The amplitude of LDCBSN to sural nerve was approximately 35% in controls and 22% in diabetic patients, which was statistically significant (p=0.00). CONCLUSION: LDCBSN conduction study is sensitive test to detect peripheral neuropathies and amplitude ratio of LDCBSN to sural nerve can be used in the evaluation of peripheral neuropathies.
Diabetic Neuropathies* ; Electrodes ; Humans ; Metatarsal Bones ; Peripheral Nervous System Diseases ; Sural Nerve*

OBJECTIVE: The aim of present study is to obtain the reference values of motor and sensory nerve conduction study (NCS) of the median nerve and to re-assess the values of criteria for abnormal findings in the electrophysiological diagnosis of Carpal tunnel syndrome (CTS). METHOD: Median and ulnar NCS were performed in 62 neurologically healthy adults as controls and 142 patients with CTS. Reference values of the median and ulnar NCS were obtained from the controls and the criteria for the diagnosis of CTS were made. Sensitivities of diagnostic criteria were calculated. RESULTS: The criteria included 7 items: (1) A 5-cm short segment study through carpal tunnel, > or =1.3 msec; (2) median motor latency (8 cm), > or =4.0 msec; (3) median sensory latency (14 cm, onset), > or =3.0 msec; (4) median sensory nerve action potential amplitude (baseline to peak), < or =20 uV; (5) ratio of median to ulnar motor latency, > or =1.5; (6) ratio of median to ulnar sensory latency, > or =1.2; (7) ratio of median to ulnar sensory amplitude, < or =0.6. The order of the highest to lowest sensitivity were as follows: a 5-cm short segment study, median sensory latency, median motor latency, ratio of median to ulnar sensory latency, and ratio of median to ulnar motor latency. Approximately 65% of the patients met all the 7 diagnostic criteria and 95% of the patients met 3 or more. CONCLUSION: The criteria proposed in this study would enhance the diagnostic sensitivity for the CTS.
Action Potentials ; Adult ; Carpal Tunnel Syndrome* ; Diagnosis ; Humans ; Median Nerve ; Neural Conduction* ; Reference Values

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic*

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic*

Nocardiosis is a rare infection seen most commonly in immunocompromized patients. Most patients have pulmonary involvement, but some develop disseminated infection. A 52-year-old man, treated with immunosuppressive drugs for 3 months after kidney transplantation, developed pulmonary nocardiosis and disseminated infection involving brain, skin, and both uvea. The diagnosis was made by open lung biopsy specimens showing characteristic weak acid fastness with modified Ziel-Neelsen stainig and histologic examination. Immunosuppressive therapy was continued and combination of surgical drainage of brain abscess and chemotherapy with Minocycline were successful. With the increasing number of allograft recipients and concomitant immunosuppression, the possibility of an increase in Nocardia opportunistic infections exists.
Allografts ; Biopsy ; Brain ; Brain Abscess ; Diagnosis ; Drainage ; Drug Therapy ; Humans ; Immunosuppression ; Kidney Transplantation ; Kidney* ; Lung ; Middle Aged ; Minocycline ; Nocardia ; Nocardia Infections* ; Opportunistic Infections ; Skin ; Transplantation* ; Uvea

PURPOSE: Phyllodes tumor is a rare fibroepithelial tumor of the breast, first described by Johannes Muller in 1838. Much has been written about phyllodes tumor, but very few widely accepted conclusions about its clinical behavior, treatment modality, and prognosis have been reached. This study aims to analyze the clinical, radiological, and pathological characteristics of phyllodes tumor of the breast. METHODS: The medical records of 41 patients with phyllodes tumor who had been treated between February 1982 and August 1998 at the Department of Surgery, Seoul National University Hospital, were retrospectively reviewed for clinical, radiological and pathological findings, treatment modalities, and follow-up results. RESULTS: Of these 41 cases, there were 28 cases (68.3%) of benign tumors and 13 cases (31.7%) of malignanat tumors. All patients were females, and the mean ages of onset were 33.2 years for benign tumors and 40.8 years for malignant tumors. Most patients, 100% of benign and 92.3% of malignant, presented with a papable mass in the breast. The median duration of illness was 2 months for malignant tumors and 8 months for benign tumors. The tumor size was greater than 10 cm in diameter in 5 cases (38.5%) of malignant tumors and in 3 cases (10.7%) of benign tumors. Only 4 cases were preoperatively diagnosed as having a phyllodes tumor by using radiological and fine needle aspiration cytology. Out of the 10 malignant cases reviewed, 5 cases were confirmed as malignant, and 5 cases were confirmed as borderline phyllodes tumors. Cellularity was moderate or above in all 5 malignant and 5 borderline cases. Atypism above moderate degree was found in 4 of 5 (80%) malignant tumors, in 3 of 5 (60%) borderline tumors, and in 4 of 24 (16.7%) benign tumors. Mitotic counts in all 5 malignant cases were 5 or more per 10 high power field while those in the 5 borderline tumors were 2-5 mitoses per 10 high power field. The most commonly performed operative procedures were a simple mastectomy (50%) for malignant tumors and a simple excision (64.3%) for benign tumors. Post-operative adjuvant therapy was done for 4 cases; out of these, 1 case had been initially diagnosed as a malignant phyllodes tumor, but the diagnosis was changed to a benign phyllodes tumor upon review. Of the 27 follow-up cases, recurrences developed in 3 cases (16.7%) of benign tumors. CONCLUSION: From the above results, there were no specific clinical features for differentiating benign from malignant phyllodes tumor preoperatively; therefore, we cannot help depending on the pathologic findings. Pathologic reviews showed that among several criteria, atypism, cellularity, and mitotic count were the most definite pathologic characteristics in differentiating benign from malignant phyllodes tumor. But much more experience and long-term follow-up may be needed to define optimal treatments and to analyze the prognosis for phyllodes tumors of the breast.
Biopsy, Fine-Needle ; Breast* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Simple ; Medical Records ; Mitosis ; Phyllodes Tumor* ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Surgical Procedures, Operative

Authors have recently experienced a rare case of avulsion of the left eye ball due to ocular injury in 7 years old Korean girl. The eye ball was completely exposed out of the lid margin. In this case authors supposed that the dynamic inertia was played a major role in the mechanism of avulsion of this eye ball. A breief review of other literatures has also been described.
Child ; Female ; Humans

We have experienced 20 cases of anesthesia for Total Hip Replacement(Charnleys Lov Frictinn Arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. Preoperative diagnosis was, 7 cases of Hip Joint Tuberculosis, 6 cases of Femur Neck Fracture, 5 cases, of Osteoarthritis of Hip Joint, and 2 cases, of Avascular Necrosis. Average blood loss has 1500 ml for one side operation, and 2400 ml for bilateral one. In 12 cases, hypotensive response was occurred during the application of Acrylic bone cement to the medullary canal of femur, however in 4 cases, hypotensive responses was more prominentafter the application of Acrylic bone cement to the Acetabulum fossa and the rest of cases were no changes in blood pressure and pulse rate whatsoever. In two cases, hypotensive range was over 30%(in compare with preoperative one), but recovery was soon after administration of Effortil corticosteroids, volume expanders etc. There was no mortality.
Acetabulum ; Adrenal Cortex Hormones ; Anesthesia* ; Blood Pressure ; Clinical Study* ; Diagnosis ; Etilefrine ; Femoral Neck Fractures ; Femur ; Heart Rate ; Hip ; Hip Joint ; Joints ; Mortality ; Necrosis ; Osteoarthritis, Hip ; Polymethyl Methacrylate ; Tuberculosis ; Wounds and Injuries

PURPOSE: Refractory small-cell lung cancer (SCLC) has a poor prognosis, and current salvage chemotherapy for refractory SCLC, such as CAV (cyclophosphamide, adriamycin, vincristine) or topotecan, has an unsatisfactory outcome, with a response rate and overall survival of less than 10% and 6 months, respectively. This phase II study evaluated the role of topotecan combined with etoposide in SCLC patients that have progressed, or relapsed, within 3 months following completion of the initial chemotherapy. MATERIALS AND METHODS: Twenty-seven patients were entered into this study. Eligible patients had an ECOG performance status of less than, or equal to, 2, at least one bidimensionally measurable lesion and adequate end organ function. IV topotecan, 1.0 mg/m2/d for 5 consecutive days, and etoposide, 100 mg/m2/d through days 1 to 3, were administered every 3 weeks until disease progression or undue toxicity. RESULTS: The major toxicity was myelosuppression. Grade 3/4 anemia, granulocytopenia, and thrombocy-topenia occurred in 14.2, 34.8, and 27.3% of cycles, respectively. There was no treatment-related death, and other non-hematologic toxicities were generally mild. Four patients achieved partial responses, with a response rate RR of 14.8%. The progression-free survival PFS ranged from 1 to 7 months, with a median of 2.0 months (95% confidence interval 1.22~2.78 months). Twenty-five patients died, with a median overall survival of 5.5 months (ranging from 1 to 21 months, 95% CI 4.32~6.68 months), and the 6-month survival rate was 32.1% (95% confidence interval 14.4~49.8%). CONCLUSION: The combination of topotecan and etoposide chemotherapy showed a modest response rate, but failed to prolong survival of refractory SCLC patients compared to topotecan monotherapy.
Agranulocytosis ; Anemia ; Carcinoma, Small Cell ; Disease Progression ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Etoposide* ; Humans ; Lung Neoplasms* ; Lung* ; Prognosis ; Survival Rate ; Topotecan*