Malignant mixed mullerian tumor of the ovary are very aggressive tumors that were usually diagnosed at an older age. They are usually at an advanced stage at the time of diagnosis, and survival after diagnosis varies by stage of disease and histological type. Despite aggressive treatment that includes surgery and chemotherapy, women with these tumors have a significantly increased risk of death giving them a very poor prognosis. The poor prognosis associated with this rare disease represents a need to new therapeutic regimens to improve patients' survival. We experienced two cases of primary malignant mixed mullerian tumor of the ovary.
Diagnosis ; Drug Therapy ; Female ; Humans ; Ovary* ; Prognosis ; Rare Diseases

Malignant mixed mullerian tumor of the ovary are very aggressive tumors that were usually diagnosed at an older age. They are usually at an advanced stage at the time of diagnosis, and survival after diagnosis varies by stage of disease and histological type. Despite aggressive treatment that includes surgery and chemotherapy, women with these tumors have a significantly increased risk of death giving them a very poor prognosis. The poor prognosis associated with this rare disease represents a need to new therapeutic regimens to improve patients' survival. We experienced two cases of primary malignant mixed mullerian tumor of the ovary.
Diagnosis ; Drug Therapy ; Female ; Humans ; Ovary* ; Prognosis ; Rare Diseases

Acquired perforating dermatosis (APD) triggers severe itching, and is observed most often in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). Various treatments, such as topical steroids, topical and oral retinoids, allopurinol, and ultraviolet B (UVB) phototherapy, have been used. However, as the precise etiology is unknown, there are a lack of well-established treatment guidelines. We report a peritoneal dialysis patient with a diagnosis of APD who was resistant to topical steroids, phototherapy, allopurinol, and topical retinoids. Severe pruritus persisted, which compromised his ability to lead a normal life. As a final treatment option, we used oral isotretinoin and the patient experienced a dramatic improvement.

PURPOSE: Multiple trauma is one of the major causes of deaths and physical disabilities of the young. Thus, a trauma scoring system which is easy, fast, and accurate is the most important factor for reducing the mortality due to multiple trauma. As studies have shows the systemic inflammatory response syndrome (SIRS) score is useful in estimating the severity of and determining the prognosis of the disease, so we investigated the usefulness of the SIRS score as a trauma score. METHODS: This study was a retrospective analysis of data collected from January 2002 to December 2002. Three hundred sixity nine trauma patients who were admitted to the emergency department were included. Patients who were transferred from other hospitals, children under the age of 15 years and patients transferred to other hospitals for ICU care and emergency operations were excluded. The SIRS score was defined according to the criteria of the American College of Chest Physicians and the Society of Critical Care Medicine (ACCP/SCCM). Patients were grouped by using the SIRS score(0 to 4) calculated at admission. RESULTS: Among the 369 trauma patients, 174 patients (47.2%) had a SIRS score > or =2 at admission, and 30 of the 369 patients expired. The admission SIRS score was significantly correlated with the injury severity score (ISS). The mortality rate and the length of stay (LOS) significantly increased as the admission SIRS score increased. Analysis of the variance, adjusting for age and ISS, should that are SIRS score> or =2 was a significant predictor of mortality and LOS. CONCLUSION: The admission SIRS score has been shown to be useful in estimating the severity of and the prognosis for a trauma. If we apply it to the trauma patients who visit ED, it should provide a more useful means for determining the severity of the trauma and the prognosis for the patient.
Cause of Death ; Child ; Critical Care ; Emergencies ; Emergency Service, Hospital ; Humans ; Injury Severity Score ; Length of Stay ; Mortality ; Multiple Trauma ; Prognosis ; Retrospective Studies ; Systemic Inflammatory Response Syndrome* ; Thorax

OBJECTIVES: This study aimed to evaluate the mental health status of the children of psychiatric patients in order to plan for the resources that may be necessary to help these children achieve their full potential. METHODS: Forty-eight children (age 9–18) whose parents were registered in 5 community mental health centers located in Seoul were recruited. Tests assessing 3 psychological domains were conducted: 1) cognition: Korean version of Learning Disability Evaluation Scale, Comprehensive Attention Test, 2) parent reported emotion and behavior: Korean Child Behavior Checklist, Korean attention-deficit hyperactivity disorder Rating Scale, and 3) self-reported emotion and behavior: Korean Beck's Depression Inventory-II/Children's Depression Inventory-II, Korean Youth Self Report). We defined the children as having a high risk of developing mental health problems if their test scores were over the cut-off levels in 2 or more of the 3 domains assessed. RESULTS: Twelve (25%) children were classified as having a high risk of developing mental health issues. 20 (41.6%) children scored above the cut-off in only one of the domains. CONCLUSION: Our results suggest that the children of psychiatric patients might be vulnerable to mental illness and need early prevention or interven-tions for the sake of their mental health.
Adolescent ; Checklist ; Child Behavior ; Child* ; Cognition ; Community Mental Health Centers ; Depression ; Humans ; Learning Disorders ; Mass Screening* ; Mental Health* ; Parents* ; Seoul

BACKGROUND: The risk of various complications after Achilles tendon lengthening is mainly related to the length of surgical exposure and the lengthening method. A comprehensive technique to minimize the complications is required. METHODS: The treatment of Achilles tendon tightness in 57 patients (95 ankles) were performed by using a short transverse incision on a skin crease of the heel and by Z-lengthening of the tendon. In the severe cases, two or three transverse incisions were required for greater lengthening of the tendon, and a serial cast or Ilizarov apparatus was applied for the gradual correction. The results of these 95 ankles were compared to those of 18 ankles, which underwent percutaneous sliding lengthening, and to the 19 ankles, which received Z-lengthening with a medial longitudinal incision. RESULTS: The functional and cosmetic satisfaction was achieved among those who underwent the tendon lengthening with the new technique. The mean American Orthopaedic Foot & Ankle Society (AOFAS) score improved from 56.1 to 81.8. The second operations to correct recurrence were performed in the two cerebral palsy patients. CONCLUSIONS: The new technique has a low rate of complications such as scarring, adhesion, total transection, excessive lengthening, and recurrence of shortening. The excellent cosmesis and the short operation time are the additional advantages.
Achilles Tendon/*surgery ; Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Male ; Musculoskeletal Diseases/complications ; Tendinopathy/etiology/*surgery ; Tenotomy/*methods ; Young Adult

No abstract available.
Lipomatosis* ; Neoplasm Metastasis* ; Small Cell Lung Carcinoma*

PURPOSE: We evaluated the results and complications of surgical treatment for congenital thumb abnormalities. MATERIALS AND METHODS: Between 2002 and 2011, nine thumbs were surgically treated (Pusan National University Hospital, Busan, Korea). There were five males and four females. The mean age of patients at the time of operation was 4.7 years (seven patients were under five years old and two patients were over 10). Five cases of Blauth type V hypoplasia (aplasia) were treated by pollicization (using the Buck-Gramcko technique). Four cases of type I or II hypoplasia were treated by opponensplasty and tendon transfer (for extensor and abductor augmentation). The Mehta scoring system was used for analysis of outcomes. RESULTS: Among nine cases, outcomes were good in five cases, fair in three cases, and poor in one case. Second operations were required due to muscle weakness and metacarpo-phalangeal joint subluxation in three cases of aplasia and one case of hypoplasia. In all cases, the range of active abduction of the thumb was more than 40degrees and pinch power was at least 40% of that on the normal side at the latest follow up. CONCLUSION: Surgical reconstruction using pollicization and opponensplasty for congenital thumb aplasia and hypoplasia, with additional surgery for muscle weakness, provided good results both functionally and cosmetically.
Busan ; Female ; Follow-Up Studies ; Humans ; Joints ; Male ; Muscle Weakness ; Tendon Transfer ; Thumb*

PURPOSE: Metabolic encephalopathy is not an infrequent condition. However it is very difficult to diagnose and treat because of its various causes and clinical manifestations. Our purpose was to clarify the cause of metabolic encephalopathy by evaluation of MR findings and clinical features. METHODS: We reviewed MR images and clinical features for 25 patients with metabolic encephalopathy who showed abnormal signal changes on the MR images with neurologic deterioration. RESULTS: The 25 patients had underlying diseases such as chronic liver disease (n=16) or renal failure (n=9). The MR findings showed significant differences in the involved sites according to the underlying disease. In 10 of the 16 patients with liver disease, corpus callosal involvement was observed. Red nucleus involvement was seen in 6 patients, dentate nucleus involvement in 5 patients. These lesions were seen to have a high signal intensity on the diffusion weighted image. Contrary to liver disease, encephalopathy with renal disease showed typical central pontine myelinolysis in 6 of the 9 patients and a relatively benign clinical course. CONCLUSION: Our results showed that the typically involved site and clinical manifestations depended on the underlying disease. We think that involvement of the corpus callosum, the red nucleus, and the dentate nucleus is a typical pattern of injury in metabolic encephalopathy with chronic liver disease and that these findings will be helpful for diagnosing and treating metabolic encephalopathy.
Brain Diseases, Metabolic* ; Cerebellar Nuclei ; Corpus Callosum ; Diffusion ; Humans ; Liver Diseases ; Myelinolysis, Central Pontine ; Red Nucleus ; Renal Insufficiency

PURPOSE: This study aimed to test whether rotavirus-associated necrotizing enterocolitis (RV+NEC) produced diffe rent clinical findings or outcomes from those of non-rotavirus necrotizing enterocolitis (RV-NEC). METHODS: Eight patients from the RV+NEC group and 22 patients from the RV-NEC group diagnosed with modified Bell stage II or higher NEC were selected for this study. Fecal specimens from all infants were tested for rotavirus infection using a monoclonal antibody-based enzyme immunoassay (EIA). Clinical, radiographic, and clinical outcome data were analyzed retrospectively. RESULTS: RV+NEC infants had a significantly higher birth weight and were born at a significantly higher gestational age (33.5+/-3.3 weeks vs. 29.3+/-4.4 weeks; P=0.01). There were no differe nces in the occurrence of thrombocytopenia, mural gas, and pneumoperitoneum between the 2 groups. However, portal vein gas was more common in the RV+NEC group (88% vs. 9%; P<0.01). Neither the incidence of Bell stage III (or higher) NEC nor surgical inte rvention differed between the two groups. The number of complications and mortality rates were also similar. CONCLUSION: Rotavirus-associated NEC occurs in infants with a higher birth weight and those born at a greater gestational age. However, the severity of the condition and the resulting outcomes did not differ from those for infants affected by non-rotavirus NEC.
Birth Weight ; Enterocolitis ; Enterocolitis, Necrotizing ; Gestational Age ; Humans ; Immunoenzyme Techniques ; Incidence ; Infant ; Infant, Newborn ; Pneumoperitoneum ; Portal Vein ; Retrospective Studies ; Rotavirus Infections ; Thrombocytopenia