No abstract available.
Cardiac Output* ; Ultrasonography*

Anthracycline drugs are chemotherapeutic agents highly effective against a wide range of neoplasms. However, its administration may be complicated by cardiotoxic reactions. There is a continuum of increasing risk with increasing total dose of drug rather than an absolute cutoff point for total dose drug of that should not be exceeded under any circumstances. At the present time it appears that a potentially important clinical application of Doppler echocardiography would be the noninvasive evaluation of global ventricular function. To assess the value of serial Doppler echocardiography in detecting early signs of anthracycline cardiotoxicity in children, we studied 50 patients (35 male and 15 female children, age range 1.6 to 20 years) admitted to the Department of Pediatrics in the Kyungpook National University Hospital for treatment of neoplasia between July 20, 1988 and April 20, 1991 prospectively. Eight three Doppler echocardiograms were performed prior to and at intervals after receiving varying doses of anthracycline and aortic velocity, acceleration time (AT), ejection time (ET), ratio at AT to ET (AT/ET), acceleration and velocity time integral, and mitral velocity of E and A waves and velocity time integral were measured. Pretreatment parameters were not differ from those of normal age matched control children. The aortic AT/ET showed significant increase with increase in anthracycline dosage, being a mean (+/-SD) of 0.30+/-0.07 in the pretreatment group, 0.33 (+/-0.09) after 100 mg/M2 (p<0.001) but the mitral E/A peak velocity ratio showed significant decrease, being a mean (+/-SD) of 1.47 (+/-0.26) in the pretreatment group and 1.36 (+/-0.09) after 400mg/M2(p<0.05). We could not reliably ascertain the relationship between Doppler echocardiographic changes and development of anthracycline cardiomyopathy but these preliminary data show that Doppler echocardiography may detect incremental changes in left ventricular function in anthracycline cardiomyopathy. It is hoped that further study at higher dose levels in large populations for a sufficient follow up time will identify those patients with a risk of developing cardiomyopathy and then manage them appropriately.
Acceleration ; Cardiomyopathies ; Child* ; Echocardiography* ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Hope ; Humans ; Male ; Pediatrics ; Prospective Studies ; Ventricular Dysfunction, Left* ; Ventricular Function ; Ventricular Function, Left

OBJECTIVES: Objective: Cellular immortality is believed to be a critical step in tumorigenesis. As an important component of the telomere maintenance mechanism, the activation of the enzyme telomerase is tightly associated with cellular immortality and cancer. However, little is known about the status of telomerase during human cervical cancer development. To assess the role of telomerase in the development of malignant transformation of the uterine cervix, this investigation was performed. PATIENTS AND METHODS: Telomerase activity was measured by telomeric repeat amplification protocol(TRAP) assay in 8 cervical intraepithelial neoplasia(CIN) and 24 cervical cancers. The tissue adjacent to the lesions from the same patients was also examined for the presence of telomerase activity. RESULTS: Thirty one of the 32(96.9%) lesions were positive for telomerase activity. In the CIN patients, four of the 8(50.0%) lesions showed moderately to strongly positive activities. In the cervical cancer Ia lesions, five of the 9(55.6%), and beyond the stage Ib lesions, fourteen of the 15(93.3%) showed moderately to strongly positive activities. There was a positive correlation between the grade of the lesion and the telomerase activity(P=0.023). Patient's gravida and telomerase activity also had a positive correlation(P=0.022). CONCLUSION: Relatively weak telomerase activity was detected in the low grade cervical lesion and strong activity was detected in the high grade lesion. There was a progressive increase of telomerase activity in association with an increased degree of cervical lesion. Patient's gravida also had an association with telomerase activity. These results suggest that the expression of telomerase activity may play a crucial role in cervical carcinogenesis.
Carcinogenesis ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Female ; Humans ; Telomerase* ; Telomere ; Uterine Cervical Neoplasms

OBJECTIVES: The purpose of this study was to evaluated the difference of depressive symptoms and attention between estrogen user and non-user in postmenopausal women. METHODS: 30 Estrogen users and 30 non-users were participated in this study. They were all menopausal for at least 1 year and have 12 or more education years. We used BDI(Beck Depression Inventory), digit span and digit symbol to evaluate depressive symptoms and attention in both groups. We also measured the plasma estradiol level and identified the correlation between estradiol level and BDI, digit span and digit symbol. RESULTS: The demographic data was not different between both groups. Estrogen users scored higher than non-users in digit span(forward) and lower than non-users in BDI. The correlation between estradiol level BDI, digit span and digit symbol was not significant. CONCLUSION: Estrogen replacement therapy was effective in alleviation depressive symptoms but ineffective in improving attention in postmenopausal women.
Depression* ; Education ; Estradiol ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Plasma

Injuries to the extensor mechanism include a wide range of injuries from minor one to massive defect. And the methods of treatment must be individualized according to the anatomical site, extent and chronicity of injuries. The extensor mechanism is a triangular thin sheet like structure, the function of which cannot be explained completely by the Tubiana's church-steeple like diagram. Authors think that the extensor mechanism should be repaired or reconstructed as a triangular sheet. The tension of the repaired or reconstructed tendon was estimated as good when the neutral extensions were obtained in all the MP, PIP and DIP joints after the completion of sutures. Also authors think that stable sutures are mandatory for the early rehabilitation postopoeratively. Seventy-five patients have been treated by the authors from 1982 to 1994. According to zonal classification, forty-two patients were injured in Zone I. 5 in Zone II, 21 in Zone III, 5 in Zone IV and 2 patients were unclassified due to massive defects of the extensor mechanism. Mostly bony mallet injuries were treated by open reduction and K-wire fixation. Acute tendinous mallet injuries were treated by conservative splinting and old injuries were treated by anatomical plication of the terminal extensor tendon. Old buttonhole deformities were generally treated by the central tendon plication. Massive defects were managed by skin coverage and reconstruction of the extensor mechanism by using a tendon graft which was tailored like a triangular thin sheet. With author's treatment principles, excellent or good results were obtained in about 87%. Consequently, authors emphasize that an anatomical repair or reconstruction is a keystone in the treatment of injuries to the extensor mechanism.
Classification ; Congenital Abnormalities ; Fingers ; Fluconazole ; Humans ; Joints ; Rehabilitation ; Skin ; Splints ; Sutures ; Tendons ; Transplants

To study the site of release and factors affecting the release of the atrial natriuretic peptide(ANP) in the pediatric patients, we measured the plasma ANP concentrations in 23 normal healthy children, 19 patients with congestive heat failure and 16 patients with cardiac disease undergoing diagnostic cardiac catheterization. The following results were obtained. 1) The plasma ANP concentrations of the vein(226.3(74.9pg/ml)in patients with congestive heart failure were significantly higher than those(p<0.01)of the mormal healthy children(13.4 (7.9pg/ml)and those(43.3 40(.7pg/ml)in patients undergoing cardiac catheterization. The plasma ANP concentrations of the femoral vein in patients undergoing cardiac catheterization were also significantly higher than that of the peripheral vein in the normal healthy children(p<0.01). 2) The plasma ANP concentrations of the pulmonary artery(110.9( 80.7pg/ml)were 2 to 3 times higher than that of the femoral vein(43.3( 40.3pg/ml, p<0.01). However there were no significant differences of the plasma ANP concentrations between pulmonary artery and aorta(65.4 (36.1pg/ml),and between aorta and femoral vein. 3) There was a significant correlations of the plasma ANP concentrations vetween pulmonary artery and femoral vein, and pulmonary artery and aorta, but no correlation of those between femoral vein and aorta. 4) The plasma ANP concentrations of the vein were over 3 times more higher in cases of left atrial area over 20 cm2/M2 measured by 2-dimensional echocardiography(213.2 (292.9pg/ml)than those in cases of left atrial area under 20(65.0 66.9pg/ml, p<0.05). The plasma ANP concentrations of the vein were over 3 times more highger in cases of left atrial area over 20 cm2/M2(88.6(19.1pg/ml) than those in cases of left atrial area under 14(57.1 (39.5pg/ml,p<0.05), and in cases of the sum of both atrial mean pressure over 11mmHg(189.5( 42.8pg/ml) than those in cases of the sum under 11(79.3 (52.3pg/ml, p<0.01). The plasma ANP cocentrations of the aorta were significantly higher in cases of left atrial area over 14 cm2/M2(88.6 (19.1pg/ml)than those in cases of left atrial area under 14(57.1 (39.5pg/ml;p 0.05), in cases of the sum of both atrial area over 25cm2/M2(93.9 (21.7pg/ml)those in cases of the sum under 25(46.6 (33.8pg/ml, p<0.01), in cases of sum of mean atrial pressure over 11 mmHg(90.5 (30.3pg/ml)than those in cases of under 11(53.8( 24.6pg/ml, p<0.05),in cases of the sum of both atrial wall stress over 190 mmHg.cm2/M2(101.4 (23.5pg/ml) than those in cases of the sumunder 190(57.5 (26.4pg/ml, p<0.01), and also in cases of pulmonary artery mean pressure over 20mmHg(83.3( 18.2pg/ml) than those in cases o pulmonary artery under 20(47.8( 39.8pg/ml, p<0.05). In conclusion, the plasma ANP concentrations of the pulmonary artery were significantly higher than those of the frmoral vein and the aorta, which indicater that the ANP is predominantly secreted via coronary sinus into the right atrium. The plasma ANP concentrations of the peripheral and femoral vein, the pulmonary artery and the aorta, especially that of the aorta, correlated well with the atrial pressure, the area and the wall stress. This suggests that the arterial blood may be the most appropriate sample for measurement of the ANP.
Aorta* ; Atrial Natriuretic Factor ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Coronary Sinus ; Estrogens, Conjugated (USP) ; Femoral Vein ; Heart Atria ; Heart Diseases ; Heart Failure ; Hot Temperature ; Humans ; Plasma* ; Pulmonary Artery* ; Veins*

Behavioral problems are thought to be pervasive and devasting to patients with dementia of the Alzheimer's type and their families. Despite this, little empirical data are available concerning the nature of such impairments, their rate of occurrence or their relationship to the disease process. This study was designed to investigate the nature and the rates of behavioral disturbance among DAT patients. The subjects involved in this study were 72 patients who were hospitalized and had primary diagnosis of dementia of the Alzheimer's type. Severity of the dementia was assessed by MMSE, and abnormal behavior by E-BEHAVE-AD. Pearson correalation was used to analysis data. The subjects were divided into mild/moderate dementia group and severe, and then evaluated significant differences. Independent-samples T-test was used to analysis data. The results were as follows: 1) Wandering and delusional ideation were associated with declining MMSE score 2) Wandering was only differenciated between mild to moderate group. In conclusion, problems found associated with level of impairment such as wandering and delusion are thought to be characteristic of the disease and therefore predictable. Problems found not associated with level of impairment, are likely to be idiosyncratic. The former should probably be incorporated into education and intervention programs, the latter addressed as needed on an individual basis.
Alzheimer Disease* ; Delusions ; Dementia* ; Diagnosis ; Education ; Humans ; Psychopathology*

Behavioral problems are thought to be pervasive and devasting to patients with dementia of the Alzheimer's type and their families. Despite this, little empirical data are available concerning the nature of such impairments, their rate of occurrence or their relationship to the disease process. This study was designed to investigate the nature and the rates of behavioral disturbance among DAT patients. The subjects involved in this study were 72 patients who were hospitalized and had primary diagnosis of dementia of the Alzheimer's type. Severity of the dementia was assessed by MMSE, and abnormal behavior by E-BEHAVE-AD. Pearson correalation was used to analysis data. The subjects were divided into mild/moderate dementia group and severe, and then evaluated significant differences. Independent-samples T-test was used to analysis data. The results were as follows: 1) Wandering and delusional ideation were associated with declining MMSE score 2) Wandering was only differenciated between mild to moderate group. In conclusion, problems found associated with level of impairment such as wandering and delusion are thought to be characteristic of the disease and therefore predictable. Problems found not associated with level of impairment, are likely to be idiosyncratic. The former should probably be incorporated into education and intervention programs, the latter addressed as needed on an individual basis.
Alzheimer Disease* ; Delusions ; Dementia* ; Diagnosis ; Education ; Humans ; Psychopathology*

No abstract available.
Carcinoma, Squamous Cell*

Cellular schwannoma is a variant of schwannoma, and is diagnosed as malignant tumor in over one fourth of cases because of its cellularity, mitotic activity and the occasional presence of bone destruction. This tumor is a tumor with low malignant potential and usually occurs in peripheral nervous system, mainly in the posterior mediastinum and retroperitoneal space. But pelvic retroperitoneal cellular schwannoma is very rare. Recently, we experienced a case of pelvic retroperitoneal cellular schwannoma in a 42-year-old woman; in reporting the case a brief review of the literature is included.
Adult ; Female ; Humans ; Mediastinum ; Neurilemmoma* ; Peripheral Nervous System ; Retroperitoneal Space