BACKGROUND: Doppler echocardiography is a non-invasive technique that has been used to evaluate LV diastolic dysfunction. Impaired left ventricular diastolic filling is known to occur in patients with coronary artery disease. Compared with those in normal subjects, Doppler-derived transmitral blood flow velocities have been reported to be reduced during early diastolic filling and to be compensatory elevated subsequent to atrial systole in patinets with coronary artery disease. But stiffness of myocardium normalize the E/A ratio, and normal E/A ratio may reveal increased ventricular filling pressure. We tried to investigate left ventricular filling parameters by Doppler echocardiography in patients with early myocardial infarction, and to compare left ventricular diastolic function regarding infarct location on EKG, one or multivessel disease on coronary angiography, and treatment modality. METHODS: From September 1993 to August 1995, Pulsed wave Doppler echocardiography was performed in patients with early acute myocardial infarction(N=95) and control group(N=20) within 5 days after admission, and parameters of diastolic function was evaluated. RESULTS: Echocardiographic data showed significant differences in mean ejection fraction, mean left ventricular mass, and mean left ventricular mass index between two groups. There was no significant difference in E/A ratio, deceleration time, and isovolumetric relaxation time between two groups. Neither, there was significant difference in each diastolic parameter for infarct related wall on EKG. And there was no significant difference in deceleration time for one or multi vessel disease on coronary angiography, treatment modality(conservative treatment, thrombolytic therapy, or primary PTCA). CONCLUSION: In patients with early acute myocardial infarction, left ventricular diastolic dysfunction was absent. And there was no significant correlation between the presence of diastolic dysfunction and the location of infarct related wall on EKG, or one or multi vessel disease, or treatment modality.
Blood Flow Velocity ; Coronary Angiography ; Coronary Artery Disease ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Humans ; Myocardial Infarction* ; Myocardium ; Relaxation ; Systole ; Thrombolytic Therapy

Mesoblastic nephroma is an important differential diagnosis of a renal mass occurring in the neonatal period or in early childhood. It is a rare monomorphous congenital renal neoplasm most commonly recognized during the first 3 months of life. With the widespread application of ultrasound imaging, many cases are recognized prior to birth. We report a case of mesoblastic nephroma detected by ultrasonograph at 36 weeks of intrauterine fetal life and removed after birth. It showed a well circumscribed, grayish white, solid mass measuring 4x3x2 cm. The tumor was predominantly a classic type with a focal cellular pattern. Immunohistochemical and electron microscopic studies were done.
Diagnosis, Differential ; Kidney ; Kidney Neoplasms ; Nephroma, Mesoblastic* ; Parturition ; Ultrasonography

Lobular carcinoma of the male breast is very rare, because of the absence of lobules in the normal male breast. Herein, a case of lobular carcinoma of the male breast with cellular features of signet ring cells is described. A 57-year-old man presented with a left breast mass. Histologic examination showed classic invasive lobular carcinoma with in situ component. Most infiltrating tumor cells had a prominent signet ring cell appearance. The patient was phenotypically male and had fathered children. There was no history of predisposing factors to breast lesion, such as hormone use or gynecomastia.
Breast* ; Carcinoma, Lobular* ; Causality ; Child ; Fathers ; Gynecomastia ; Humans ; Male* ; Middle Aged

Lobular carcinoma of the male breast is very rare, because of the absence of lobules in the normal male breast. Herein, a case of lobular carcinoma of the male breast with cellular features of signet ring cells is described. A 57-year-old man presented with a left breast mass. Histologic examination showed classic invasive lobular carcinoma with in situ component. Most infiltrating tumor cells had a prominent signet ring cell appearance. The patient was phenotypically male and had fathered children. There was no history of predisposing factors to breast lesion, such as hormone use or gynecomastia.
Breast* ; Carcinoma, Lobular* ; Causality ; Child ; Fathers ; Gynecomastia ; Humans ; Male* ; Middle Aged

Tricho-rhion-phalangeal syndrome is characterized by the triad of slow growing, brittle hair and early loss of hair, distinctive faces which include a long philtrum and pear-shape nose, and peripheral cone shape epiphysis with brachyphalangia. Tricho-rhion-phalangeal syndrome is probably not so much uncommon. The tricho-rhion-phalangeal syndrome, however, is not well recognized to orthopaedic surgeons due to the minor finger deformities. We report a case of tricho-rhion-phalangeal syndrome with brief review of literature.
Congenital Abnormalities ; Epiphyses ; Fingers ; Hair ; Lip ; Nose ; Surgeons

We investigated the overall survival rate after pulmonary metastasectomy in the bone and soft tissue sarcoma and the available prognostic factors related with the survival rate after pulmonary metastasectomy. Between 1986 and 1995, 9 patients (median age 32) with bone and soft tissue sarcoma with pulmonary metastasis were managed in the Catholic University of Korea. Until the final follow-up in May 1996, 6 patients have died of disease and their mean survival period was 28 months (9- 58months). The actual 5-year survival rate by Kaplan-Meier method was 33%. Prognostic factors such as tumor free interval, number of metastatic lesion, postoperative chemotherapy and histologic grade were analyzed. Three patients who had the tumor free interval over 3 years were alive (mean survival period: 52.6 months), whereas six patients who had the tumor free interval less than 3 years were dead (mean survival period: 19 months). Out of four patients with low grade tumor, three patients were alive with average 39.2 months survival period, whereas five patients with high grade tumor were all dead with average 19.2 months survival period. These results suggested that pulmonary metastasectomy in bone and soft tissue sarcoma may prolong the survival rate. The long tumor free interval, histological low grade and soft tissue sarcoma may influenced on prolonged survival rate. However, number of metastatic lesion or postoperative chemotherapy has not influenced on the survival rate.
Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Metastasectomy* ; Neoplasm Metastasis ; Sarcoma* ; Survival Rate*

OBJECTIVE: To evaluate the effects of the dilution volume of botulinum toxin A on spasticity of children with cerebral palsy. METHOD: Total 18 legs of 9 children with cerebral palsy were enrolled. 100 units of botulinum toxin were diluted with 4 cc or 2 cc of normal saline and injected to the medial and lateral heads of Gastrocnemius. Modified Ashworth scale, modified Tardieu test and range of motion (ROM) of ankle and knee were measured. Measurements were obtained before and at 1, 7, 14, 30, 60, 90, and 180 days after injection, respectively. RESULTS: Spasticity tested by modified Ashworth scale and modified Tardieu test decreased and ROM of ankle and knee increased after 14 days since injection in both groups (p<0.05). In low dilution group, maximal ROM of ankle and knee was obtained at 30th day after injection. In high dilution group, maximal ROM of ankle and knee was achieved at 14th day after injection and maximal ROM of knee at 30th day after injection. However, there was no significant differences between high dilution group and low dilution group in different times. CONCLUSION: Management of spasticity with botulinum toxin in cerebral palsy was not related to dilution volume.
Animals ; Ankle ; Botulinum Toxins ; Cerebral Palsy ; Child ; Head ; Humans ; Knee ; Leg ; Muscle Spasticity ; Range of Motion, Articular

BACKGROUND: Circadian rhythms have been described for acute myocardial infarction, sudden cardiac death, cerebrovascular disease, ischemic heart disease, and ventricular arrhythmia. Most of studies reported that the frequency of ventricular permature contractions(VPC's) shows a peak in day time. We tried to see that the circadian rhythm of VPC's in hypertension and ischemic heart disease(IHD) patients. And we will also studied the relationship between heart rate and frequencey of VPC's. METHOD: Twenty four hour holter monitoring was performed in hypertensive patients (N=23), ischemic heart disease patients(N=25), and normal control group(N=30). We tested the circadian pattern of VPC's and heart rates and the relationships of the frequency of VPC's and heart rates. RESULT: In hypertension group, a peak incidence of heart rate is between 5 and 8 P.M., in ischemic heart disease group, between 3 and 6 P.M.. In control group, the heart rate shows a peak beteen 1 and 3 P.M.. The frequency of VPC's in hypertension group shows the first peak between 4 and 10 P.M., and the second peak beteen 7 and 10 A.M.. In ischemic heart disease group, they show a peak between 2 and 8 P.M..In control group, there was no circadian variation for the frequency of VPC;s. Both in hypertension and IHD patients group, there was significant correlation between the frequency of VPC's and the heart rates. CONCLUSION: It seemed that VPC' were more frequently occurred in relation to the increase of heart rate in the afternoon, in hypertensive and ischemic heart disease patients.
Arrhythmias, Cardiac ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Heart ; Heart Rate ; Humans ; Hypertension* ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Ventricular Premature Complexes*

It has been widely accepted that complete surgical resection of hepatoblastoma is essential for long-term survival. But unfortunately less that 50% of hepatic tumors in children can be totally removed at the time of diagnosis. This report is to present the experience of successful resection of hepatoblastoma after concurrent radiotherapy with transarterial chemoinfusion in a child. We believe this modality of treatment enables complete resection of unresectable hepatoblastoma, which is resistant to the systemic chemotherapy.
Child ; Diagnosis ; Drug Therapy ; Hepatoblastoma* ; Humans ; Radiotherapy*

Proliferative activity of a malignant tumor is known to reflect its biological aggressiveness. Proliferating cell nuclear antigen (PCNA) is a marker of cellular proliferation, and silver-stained nucleolar organizer regions (AgNORs) have been shown to correlate with ploidy and proliferative activity of cells. In transitional cell carcinoma of the renal pelvis, the prognostic value of these markers has not been well defined. We studied PCNA expression and the AgNORs count in 22 transitional cell carcinoma of the renal pelvis to assess their prognostic significance compared with their cumulative survival rate, the stage of disease and histopathologic features of the tumors. An immunohistochemical method and a standard colloidal silver staining were used. The mean percentage of PCNA positivity (PCNA index) and the mean number of AgNORs per nucleus (AgNORs score) were determined. In a multivariable analysis, PCNA indexes were significantly associated with tumor stage (p=0.024), whereas AgNORs scores were not significantly associated with the stage or histopatholgic features of the tumors. Histologic grade was correlated to disease stage at a significant level (p=0.000). But there was a trend of low tumor PCNA-indices or AgNORs counts with survival advantage for patients, but this did not reach statistical significance. The results suggest that the fraction of PCNA positive nuclei would be useful for investigating the malignant potential of renal pelvic cancers, although their clinical use as markers of biologic behavior may be limited.
Carcinoma, Transitional Cell* ; Cell Proliferation ; Colloids ; Humans ; Kidney ; Kidney Pelvis* ; Nucleolus Organizer Region ; Pelvic Neoplasms ; Ploidies ; Proliferating Cell Nuclear Antigen* ; Silver Staining ; Survival Rate