In recent years, marked increase in incidence of congenital syphilis has occured throughout the world due tochanges in social norms and development of penicillin-resistant strains. Early diagnosis plays an important rolein congenital syphilis as the clinical manifestations may simulalte many other conditions in the paediatric agegroup. The authors analized 52 cases of congenital syphilis admitted tot he department of paediatrics, ChosumUniversity Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 caseswere admitted from OPD, during the period of 8 years from Jan. 1975 to Dec. 1982. The reults obtained were asfollows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Amongthe 52 cases, a male predominance was observed with a male to female ratio of 2:1. 3. The serologic test (VDRL) ofthe 52 studied cases showed reactive in 49 cases (94%), and that of syphilitic mothers except 6 cases, rective inall studied cases. 4. The major manifstations of the 52 cases were bone tenderness (12%) and swelling of thejoints(7%) inskeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. Theradiological skeletal changes were detected in 45 of 52 cases(87%), and the commonest findings were detected in 45of 52 cases (87%), and the commonest findings were metaphsitis(83%) and periostitis(81%). The most characteristictype of metaphysitis were transverse trophic line(74%) and zone of rarefaction (65%). 6. The comonest bones to beaffected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order offreqeuncy were radius (80%), ulna(80%), tibia(77%), femur(69%) and hymerus(40%).
Early Diagnosis ; Female ; Humans ; Incidence ; Knee ; Male ; Mothers ; Radius ; Serologic Tests ; Skin ; Social Norms ; Syphilis, Congenital ; Wrist

BACKGROUND: It was recently shown that human atherosclerotic plaque contains large numbers of T lymphocytes : this indicates that immune and inflammatory mechanism may be important factors in the pathogenesis of atherosclerosis. By measuring the soluble interleukin 2 receptor(sIL-2R) level we can evaluate the activation of T lymphocyte. The purpose of this study is to evaluate relationship between T cell activation and ischemic heart disease by measuring the soluble interleukin 2 receptor (sIL-2R) level in patient with ischemic heart disease. METHOD: Seventy-two patients(40 males and 32 female, mean age : 56.5+/-9.9 years) who were taken coronary angiography were included in this study. Among them, 49 patients showed abnormal coronary angiographic findings and 23 patients showed normal coronary angiographic findings. Ten mililiters of arterial blood was drawn at the time of coronary angiography. The blood was allowed to coagulate and then the serum was removed and tested in duplicate for soluble interleukin 2 receptor (sIL-2R) level by ELISA. RESULTS: 1) The soluble interleukin 2 receptor (sIL-2R) level was significantly different between abnormal coronary angiographic findings and normal coronary angiographic findings (P < 0.001). 2) According to clinical severity of ischemic heart disease (i.e. stable angina, unstable angina, acute myocardial infarction.), soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05), but showed increasing tendency with clinical severity. 3) According to numbers of involved coronary vessels, soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05). CONCLUSION: T lymphocyte activation, as reflected in elevated soluble interlekin 2 receptor (sIL-2R) level, is frequent in patient with ischemic heart disease. In the further we will investigate relationship between clinical diagnosis of ischemic heart disease of the numbers of involved coronary vessels and T cell activation.
Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Coronary Angiography ; Coronary Vessels ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-2 ; Lymphocyte Activation ; Lymphocytes ; Male ; Myocardial Ischemia* ; Plaque, Atherosclerotic ; Receptors, Interleukin-2 ; T-Lymphocytes

No abstract available.
Aprotinin* ; Heart* ; Hemostasis* ; Thoracic Surgery*

PURPOSE: The purpose of this study is to analyze the usefulness of breast thermography in assessing the prognosis in breast cancer and to obtain correlative evidence between thermographic prognosis and prognostic factors for breast cancer. MATERIALS AND METHODS: Thermographic examinations were performed in a room maintained at 20C. The patient was undressed to the waist, with both arms elevated for 10 minutes prior to the examination in order to cool and equilibrate the breast skin at room temperature. Digital infrared thermographic system was used (NEC, San-ei, Therm Tracer 6T67). The thermographic prognosis was classified according to Dr. Hobbins (Sl good, S2=fair and S-poor) suggested by Dr. Hobbins. The results were analyzed by Chi-Squire. One hundred three patients of breast cancer were examined by digital infrared thermographic system between Jan 1992 and December 1996. RESULTS: The mean age was 48, with a range from 20 to 85. According to the TNM classification 25 (24%) were in stage I, 47 (46%) stage II, 29 (28%) stage III, and 2 (2%) stage IV. The tumor size ranged from 0.5 to 20 cm (mean 4 cm), On histologic examination, 43 (43.%) patients had metastasis in the axillary nodes, 40 (55%) patients was estrogen-receptor positive. The nuclear grade I was 46 (35%) patients, II 24 (28%) and III 16 (19%). The classification of thermographic prognosis were Sl in 47 cases (46%), 82 in 32 (31%) and 83 in 24 (23%). The classification of the thermographic prognosis was found to be statistically correlated with tumor size (p<0.0001), axillary node status (p<0.0001) and TNM tumor stage (p<0.0001). But nuclear grade and estrogen receptor were not statistically correlated with the thermographic prognosis. The correlation between thermographic prognosis and actual survival rate was not available. CONCLUSION: These results suggest that breast thermography would be useful as a predictor in breast cancer before surgery.
Arm ; Breast Neoplasms* ; Breast* ; Classification ; Estrogens ; Humans ; Neoplasm Metastasis ; Prognosis* ; Skin ; Survival Rate ; Thermography*

PURPOSE: This study was to determine the incidence and severity of venous irriation in patients receiving vinorelbine tartrate (Navelbine ) in combination chemotherapy. MATERIAL AND METHODS: Twenty four patients histologically confirmed non-small cell lung cancer were enrolled in this study who receiving vinorelbine in combination chemotherapy through a peripheral vein from Oct. 1997 to Mar. 1999 with retrospective study design method. One group was 6~10 minutes infusion rate, the other was 10~20 minutes infusion rate with the same free-flow intravenous infusion. RESULTS: A total of 126 infusions were observed in this study. Sixty-two infusions were admi nistered at the 6~10 minutes, and 64 infusions were administered at the 10~20 minutes. The incidence of any venous irritation was 3.2% (2/62) in the group that received the infusion in 6~10 minutes and 10.9% (7/64) in 10~20 minutes (p=0.164), so we could not acquire any statistical significance. However the incidence of severe venous irritation (grade 3, 4) was 0% (0/62) in 6~10 minutes infusion group and 9.4% (6/64) in 10~20 minutes infusion group. There was a significant difference between two groups (p=0.028) CONCLUSION: Our results suggest that venous irritation associated with vinorelbine tartrate infusion can be reduced by shorter duration of administration and vinorelbine tartrate might be recom mended to administer at 6~10 minutes infusion in clinical practice.
Carcinoma, Non-Small-Cell Lung ; Drug Therapy, Combination ; Humans ; Incidence* ; Infusions, Intravenous ; Retrospective Studies ; Veins

BACKGROUND: The accurate information about the volume of pericardial effusion can assist in clinical decisions and has impartant prognostic value. In addition, accurate quantification of serial change in effusion volume is necessary in assessing pericardial disease and making a decision of immediate drainage. This study was performed to evaluate the efficacy of 2-D echocardiographic quantification of pericardial effusion. METHOD: The study populations are 22 patients with large pericardial effusion whose volume of effusion is confirmed by paracentesis or surgical drainage. Through the echocardiographic reviw, the volume of pericardial sac and heart was calculated by method of D'cruz and then, the effusion volume was derived as the difference of two volumes. Each echocardiographically calculated volume of pericardial effusion was compared with the measured volume drained percutaneously or surgically. RESULTS: The volume of pericardial effusion calculated echocardiographically was excellently correlated with the drained volume(r=0.90, p < 0.01). The echo-free space was well correlated with the volume of pericardial effusion in the anterior aspect of the heart(r=0.71, p < 0.01), but not in the posterior aspect. CONCLUSION: 2-D echocardiographic Quantification of pericardial effusion is simple and reliable method, and its clinical efficacy may be great.
Drainage ; Echocardiography ; Heart ; Humans ; Methods ; Paracentesis ; Pericardial Effusion ; Treatment Outcome

OBJECTIVE: Total laparoscopic hysterectomy (TLH) is becoming more commonly used as an alternative to traditional abdominal hysterectomy and Analyzing the turning point of a learning curve can be useful in planning training programs. This study was to define the average turning point of a learning curve of TLH by comparing three separate gynecologists in one institute. METHODS: Retrospective analysis of the first 140 consecutive cases of TLH performed by three separate gynecologists A, B, and C. Patients of each gynecologist were divided into 7 equal groups of 20 operations classed chronologically. Patient's age, uterus weight, operation time and pre-post operative hemoglobin difference of the three gynecologists were compared. Operation time and pre-post operative hemoglobin difference were evaluated to build learning curves for each gynecologist. RESULTS: Learning curve built by operation time showed turning point after 80~100 cases in all three gynecologists. Learning curve built by pre-post operative hemoglobin difference did not show a decreasing pattern. There were no statistical differences in patient's age and pre-post operative hemoglobin difference between the three gynecologists. However, mean uterine weight of gynecologist C was significantly lighter than that of gynecologist A and B. Operation time was significantly longer in cases by gynecologist C than in cases by A and B. CONCLUSION: At least 80~100 cases of experience in TLH is needed for a gynecologist to reach the turning point of the learning curve. This result can be used as a guide to the training program of TLH.
Hemoglobins ; Humans ; Hysterectomy ; Learning ; Learning Curve ; Retrospective Studies ; Uterus

As a consequence of the incomplete resolution of embryologic mammary ridges, ectopic breast tissue can be present anywhere along the "milk line", including the axillary region. Aberrant breast tissue can develop with any disease that affects the normal breast, including a breast carcinoma. A carcinoma of aberrant breast tissue is rare, but should still be investigated and treated properly with respect to other breast cancers in the embryonic milk-line. Herein is reported our recent experience of a carcinoma originating from aberrant breast tissue in the right axilla. An abnormal nodule around the periphery of the normal breast should be suspected as a breast carcinoma and differential diagnosis and properly treated.
Axilla ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Diagnosis, Differential

PURPOSE: To compare the outcomes between laparoscopic total extraperitoneal (TEP) repair and prolene hernia system (PHS) repair for inguinal hernia. METHODS: A retrospective analysis of 237 patients scheduled for laparoscopic TEP or PHS repair of groin hernia from 2005 to 2009 was performed. RESULTS: The mean age was 52.3 years in TEP group and 55.7 years in PHS group. Of 119 TEP cases, 98 were indirect inguinal hernia, 15 direct type, 5 femoral hernia and 1 complex hernia; Of 118 PHS cases, 100 indirect, 18 direct type. All in TEP group were performed under general anesthesia and 64% of PHS group were performed under spinal or epidural anesthesia. Preoperatively, 10 cases of recurrent inguinal hernia were involved in our study (4 in TEP, 6 in PHS group). The mean operative time was similar in both groups (74.8 in TEP, 71.2 in PHS group), however mean hospital stay (1.6 days in TEP, 3.2 days in PHS group, P = 0.018) and mean usage of analgesics (0.54 times in TEP, 2.03 times in PHS group, P < 0.01), complications (36 cases in TEP, 6 cases in PHS group, P < 0.01) showed statistical differences. There is only 1 case of postoperative recurrence inguinal hernia in PHS group but it has no statistical significance (P = 0.314). CONCLUSION: Compared to PHS repair, laparoscopic TEP repair has some advantages; shorter hospital stay, less frequent need of analgesics; as well as more postoperative complications such as hematoma, seroma, scrotal swelling.
Analgesics ; Anesthesia, Epidural ; Anesthesia, General ; Groin ; Hematoma ; Hernia ; Hernia, Femoral ; Hernia, Inguinal ; Humans ; Hydrogen-Ion Concentration ; Laparoscopy ; Length of Stay ; Operative Time ; Polypropylenes ; Postoperative Complications ; Pyrazines ; Recurrence ; Retrospective Studies ; Seroma ; Surgical Mesh

A 48 year old woman was diagnosed with a huge cystic mass in her abdominal cavity. She complained of significant abdominal discomfort due to the mass. The abdominal computed tomography revealed a giant multi-lobulated mass, measuring 26x12 cm in size, adjacent to the lesser curvature of the stomach. In the operation field, the mass was found to originate from the lesser omentum, including the right and left gastric vessels and the vagus nerves, and to invade the lesser curvature of the stomach. For curative resection, distal subtotal gastrectomy with mass excision followed by gastroduodenostomy were performed. This mass was pathologically diagnosed to be a mesenteric cystic lymphangioma; in fact, the largest ever reported. The patient had no complications during the postoperative period and was discharged from the hospital on the seventh day after surgery.
Abdominal Cavity ; Female ; Gastrectomy ; Humans ; Lymphangioma ; Mesenteric Cyst ; Omentum ; Postoperative Period ; Stomach ; Vagus Nerve