One hundred fifty-seven patients wha underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB and IIA carcinoma of the cervix between February l975 and May 1987 were retros-pectively analysed to identify specific risk factors associsted with treatment failures. Prognostic factors inciuded clinical stage, histologic cell type, degree of differentiation, size of primary tumor, depth of stromal invasian, lymph-vaseular space invasion, and lymph node metastasis. Treatment results were evaluated according to the recurrence rate and 2-year absolute recurrence-free survival(NED) rate by the prognostie faetors and treatment modalities. Patients with lymph node me tases had a significantly higher incidence of bulky primary(-> 4cm), depth of stromal invasion(> 60% thickness), and lymph-vascular invasion(P<0.005). There was significant difference in the recurrence rate and 2-year, NED rate between cervical carcinoma stage IB and I1A(P <0.005). The pat,ients who had bulky primary tum~or(>4cm) and/or depth of stromal invasion (>60% thickness) had a higher recurrence and lower 2-year NKD rate(P<0.025, P<0.005), Unfortunately, it was not possible to demonstrate that these detrimentel effects could be overeorne by postoperetive radiation. When adjoined for these risk group, traditionally reported poor prognostic factors such as nodal metatasis, cell type and differentiation, lyrnphi-vascular mvasion assume less importance in our studies. In this study, prognosis is most inf1ueneed by clinical stage, depth of stromal invasion, and size of primary tumor,
Cervix Uteri* ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors ; Treatment Failure*

During a period of 5 years and 3 months, from January, 1980 to march, 1985, 42 cases of ventricular septal defects were observed to be closed spontaneously during their follow up period and were evaluated at pediatric department, hanyang University hospital. 1) Sex incidence shows female preponderance with male to female ration of 1:2. 2) The mean age when they were diagnosed as ventricular septal defect was 5.0+/-6.4 months, and that of VSD murmur last noted was 13.3+/-11.5 months. The mean age when typical VSD murmur disappeared due to spontaneous closure of the defects was 21.1+/-18.7 months. Spontaneous closure of ventricular septal defects disclosed under one year in 22 cases (52.4%). Of those 22 cases, ventricular septal defects were spontaneously closed under 6 months of age in 16 cases(38.8% of whole study population). From the whole study population 90.5%(38 cases) were spontaneously closed under the age of 5 years. 3) Major clinical and physical characteristics before spontaneous closure of ventricular septal defects were typical pansystolic murmur with maximum intensity at left lower sternal border in all cases, palpable thrill in 5 cases(12.8%), ventricular heaves in 4 cases(10.2%) and frequent respiratory infection histories in 27 cases(64.3%). 4) Electrocardiographic findings when they were initially presented as ventricular septal defects revealed normal axis in 28 cases(84.8%), left axis deviation in 3 cases(9.1%), right axis deviation in 2 cases(6.1%) as frontal QRS axis and left ventricular hypertrophy in 8 cases(24.2%), right ventricular hypertrophy in 5 cases(15.6%) and biventricular hypertrophy in 3 cases(8.7%). Other electrocardiographic abnormalities when they had ventricular septal defects were left atrial enlargement in 12 cases(36.4%) and intraventricular conduction delay in 12 cases(36.4%). After spontaneous closure of ventricular septal defects, the electrocardiographic findings revealed normal axis in 36 cases(92.3%), left axis deviation in 3 cases(7.7%) and left ventricular hypertrophy in one case(2.6%). The remaining abnormalities after spontaneous closure of ventricular septal defect were intraventricular conduction delay in 14 cases(35.9%), deep SV6 in 4 cases(10.3%), tall RV6 in 5 cases(12.8%) and long QTc in 1 case(2.6%). Thirty-eight cases(97.4%) do not show ventricular hypertrophy pattern in EKG after spontaneous closure of their defects. 5) When we analyse their frontal plain chest X-ray films after spontaneous closure of ventricular septal defects, cardiomegaly(cardiothoracic ratio)55%) noted in 7 cases(17.9%) and pulmonary plethora in 5 cases(12.8%);while those before the defect were closed spontaneously were 67.6% and 64.7%, respectively. 6) Among 26 cases who underwent follow up 2 dimensional echocardiographic study so-called septal aneurysm were noted with the process of spontaneous closure of ventricular septal defects in 15 cases(57.7%) and the remaining 11 cases do not have any evidence of 'septal aneurysm' even after the completion of spontaneous closure of their defects. In the patient group with so-called 'septal aneurysm' the proportion of female sex was 60% and early systolic clicky sound were heard in 9 patients from 15 cases(60.0%), while those without 'septal aneurysm'were 55% and 18.2%, respectively.
Aneurysm ; Axis, Cervical Vertebra ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Thorax ; X-Ray Film

Systemic sclerosis is a generalized connective tissue disorder. It is characterized by fibrosis, degenerative changes and vascular lesions affecting the skin, joints, skeletal muscles and multiple internal organs. Clinical renal disease in systemic sclerosis ranges from scleroderma renal crisis to more subtle abnormalities. Scleroderma renal crisis is characterized by malignant hypertension and rapidly progressive renal failure. It can be successfully treated with angiotensin converting enzyme inhibitors, but remains the most feared complication of systemic sclerosis. We have experienced a 57 year old female patient who visited emergency room with a sudden onset of mental deterioration, azotemia and oliguria. She was under symptomatic treatment for Raynaud's phenomenon for 2 years. Renal biopsy of the patient showed onion-skin configuration in the interlobular arteries which is characteristic of scleroderma renal crisis. She proceded to maintenance hemodialysis despite a angiotensin converting enzyme inhibitor treatment. We report a case of SRC with a brief review of literature.
Angiotensin-Converting Enzyme Inhibitors ; Arteries ; Azotemia ; Biopsy ; Connective Tissue ; Emergency Service, Hospital ; Female ; Fibrosis ; Humans ; Hypertension ; Hypertension, Malignant ; Joints ; Middle Aged ; Muscle, Skeletal ; Oliguria ; Peptidyl-Dipeptidase A ; Renal Dialysis ; Renal Insufficiency ; Scleroderma, Systemic ; Skin

No abstract available.
Arrhythmias, Cardiac*

No abstract available.

To determine the perinatal mortality and morbidity of fetuses with absent end-diastolic velocities (AEDV) of the umbilical artery in severe pre-eclampsia and eclampsia, the outcome of 5 fetuses with AEDV was compared with that of 35 fetuses with positive end-diastolic velocities (PEDV). The study population comprised 38 cases of severe pre-eclampsia and 2 cases of eclampsia with structurally normal singletons, who had had umbilical artery Doppler velocimetry weekly from admission to delivery. The Doppler velocimetry result was not used for the clinical management. Perinatal death and neonatal morbidity from both groups were further examined in gestational age category to control the influence of preterm births. The incidence of AEDV of the umbilical artery Doppler velocimetry in severe pre-eclampsia and eclampsia was 12.5% (5/40). The AEDV group had a significantly higher incidence than the PEDV group in terms of ceasarean section due to fetal distress (60% : 17%), Apgar score < 7 at 5 minutes (60% : 14%), perinatal death (25% : 0%) and assisted mechanical ventilation (67% : 9%) both at 32-36 weeks. Time intervals from the detection of AEDV to delivery of live neonates varied from the day to 15 days. In conclusion, AEDV in the umbilical artery might be of clinical value in routine surveillance of pregnancies complicated by severe pre-eclampsia and eclampsia, and predict hypoxic fetal condition which needs operative interventions before or during labor and mechanical ventilation after birth.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

No abstract available.
Broad Ligament* ; Female ; Liposarcoma*

Intrathecal administration of methotrexate(IT-MTX) has constituted the standard approach to prophylaxis and treatment of central nevous system(CNS) leukemia. We experienced a quadriplegia and motor aphasia in a 14-year-old boy following repeated IT-MTX for the prophylaxis of meningeal leukemia. He was diagnosed as ALL without CNS involvement and treated by CCG- 1882 protocol. IT-MTX was administered for CNS prophylaxis. The patient began complaining of urinary incontinence, motor aphasia and weakness in his right leg from 12 days after the 5th dose of the IT-MTX therapy. Even though the IT-MTX was discontinued, loss of muscle power progressed upward resulting in quadriplegia. The patient showed slow and partial recovery on right extremities over 3 months. We report this case with brief review of literature.
Adolescent ; Aphasia, Broca* ; Extremities ; Humans ; Leg ; Leukemia ; Male ; Methotrexate* ; Quadriplegia* ; Urinary Incontinence

No abstract available.
Teratoma*

No abstract available.
Female ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy*