We report computed tomography (CT) and magnetic resonance (MR) findings of a patient with polyostotic Paget disease and multicentric giant cell tumor (GCT). Brain CT scan showed widening of diploic space, cortical thickening and enhancing soft tissue mass in occiput with underlying calvarial destruction. Ill-defined soft tissue masses were also detected in maxillary sinus and buttock with underlying bony destruction on CT. MR image showed multifocal nodules in wide diploic space with low signal intensity on T1 -weighted image and bright signal intensity on T2-weighted image. Mass in occiput showed homogeneous hypointensity to bone marrow on T1-weighted image and homogeneous iso- intensity on T2-weighted image. Multiple nodules in diploic space and occipital mass showed contrast enhancement following administration of Gd-DTPA. Biopsy was performed at scal p, maxillary sinus and buttock, and histologic analysis revealed GCT.
Biopsy ; Bone Marrow ; Brain ; Buttocks ; Gadolinium DTPA ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Maxillary Sinus ; Tomography, X-Ray Computed

Objective : The breast-feeding rate has decreased in Korea despite of the active encouraging effort of breast-feeding for the last 10 years. So we investigated the factors that are related to breast-feeding failure. METHOD: 1807 specific questionares of mothers who visited the six university hospitals in Seoul from October 1993 to December 1995 were analysed by ANOVA and multiple logistic regression using SAS program. RESULTS: 1) Exclusive breast-feeding rate for the first 6 months was 20.0%. The factors of breast feeding success were antenatal plan for breast-feeding, the first successful breast-feeding and breast-feeding in the hospital after delivery (P<0.01). 2) The duration of breast-feeding was 5.2+/-4.4 months. It was significantly longer in the first successful breast-feeding (P<0.01). The earlier the first breast-feeding, the longer the breast-feeding duration (P<0.01). 3) The breast feeding rate for the first feeding after delivery was significantly higher in normal delivery (46.5%) and the rooming-in (57.4%) than in Cesarean section (37.1%) and the nursery (39.1%) (P<0.01). 4) The first time of breast-feeding was 64.8+/-62.8 hours after delivery and was significantly earlier in the local clinic, normal delivery and rooming-in than in the hospital, Cesarian section and the nursery (P<0.01). The first breast-feeding was successful in 46.9% and was significantly higher in antenatal education (P<0.01). 5) The reasons for the breast-feeding failure within postnatal one month were the insufficient milk (37.1%), the physician' s recommendation (18.8%), the inverted nipple (12.1%), the baby's poor suckling power (10.5%) and thin breast-milk (7.0%). The reasons to switch the successful breast-feeding to formula-feeding before 6 months of age were the return to work (25.1%), the convenience of formula-feeding (17.4%), the excellency of formula (10.0%) and maternal conveniency (6.2%). 6) The reasons to consider the breast milk insufficient were too frequent feeding with crying (38.7%) and poor sleeping with irritability (19.0%). The reasons to consider the breast milk thin were the loose stool (51.1%) and watery nature of breast milk (48.9%). The effort to increase the breask milk was present in 68.2%. The most frequent effort was to increase the maternal intake (67.6%) instead of the frequent baby' s suckling (25.6%). 7) Persons who recommended to stop breast feeding were family members 62.7%, pediatricians 25.5%, obstetricians 10.7%, nurses 1.1%. The maternal diseases to stop breast feeding by physician such as mastitis (11.1%), hepatitis B (4.9%) and tuberculosis (2.5%) were relatively appropriate. But the baby' s diseases such as jaundice (29.9%), loose stool (22.2%) and vomiting (2.8%) were inappropriate. CONCLUSIONS: To increase the breast-feeding rate, we recommend the antenatal plan for breast-feeding, the early breast-feeding as soon as possible and the exclusive breast-feeding in the hospital after delivery. The mothers should make an effort to increase the breast milk by frequent suckling. The physicians should be better prepared to assist the breast-feeding mothers and monitor continuously to resume even after the temporary hold of breast-feeding.
Breast Feeding ; Cesarean Section ; Crying ; Female ; Hepatitis B ; Hospitals, University ; Humans ; Jaundice ; Korea ; Logistic Models ; Mastitis ; Milk ; Milk, Human ; Mothers ; Nipples ; Nurseries ; Pregnancy ; Prenatal Education ; Return to Work ; Seoul ; Tuberculosis ; Vomiting

Broussonetia kazinoki Siebold. (B. kazinoki) has long been used in the manufacture of paper in Asian countries. Although B. kazinoki leaves (BK) have been employed in dermatological therapy, use of BK has not been tested in patients with atopic dermatitis (AD). Using Nc/Nga mice, which are genetically predisposed to develop AD-like skin lesions, we confirmed the efficacy of BK in AD treatment. BK extract was applied topically to Dermatophagoides farinae-induced AD-like lesions in Nc/Nga mice, and the effects were assessed both clinically and by measuring skin thickness on the back and ears. We measured the effects of BK extract on plasma levels of IgE and IL-4. We also measured the ability of BK extract to inhibit the secretion of hTARC in HaCaT cells after stimulation by TNF-alpha and IFN-gamma. We found that BK extract significantly reduced ear and dorsal skin thickness and the clinical signs of AD, as well as significantly down-regulating the plasma levels of IgE and IL-4 (p<0.01 for each comparison). Moreover, 500 mug/mL of BK extract inhibited hTARC secretion in HaCaT cells by activated TNF-alpha/IFN-gamma by about 87%. These findings suggest that topical application of BK extract has excellent potential in the treatment of AD.
Animals ; Asian Continental Ancestry Group ; Broussonetia* ; Dermatitis, Atopic ; Ear ; Humans ; Immunoglobulin E ; Interleukin-4 ; Mice* ; Mites* ; Plasma ; Pyroglyphidae ; Skin ; Tumor Necrosis Factor-alpha

OBJECTIVES: The aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. METHODS: Parents of 946 elementary school students(age 9.54±1.72 years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age 13.98±0.93 years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. RESULTS: Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). CONCLUSION: Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.
Adolescent* ; Aggression* ; Child Behavior ; Child* ; Female ; Humans ; Parents

Oncogenic osteomalacia is a rare clinicopathological condition. The syndrome is characterized by hypophosphataemic osteomalacia with hyperphosphaturia, low plasma 1,25-dihydroxyvitamin D and normal plasma calcaemia and parathyroid hormone, associated with a tumor, generally of mesenchymal origin. Complete excision of the tumour results in cure of the whole syndrome. Recently we experienced 56-year-old woman with oncogenic osteomalacia caused by a chondromyxoid fibroma of the left foot. We report this case with the review of literatures.
Female ; Fibroma* ; Foot ; Humans ; Hypophosphatemia, Familial ; Middle Aged ; Osteomalacia* ; Parathyroid Hormone ; Plasma

PURPOSE: Effective hemodialysis for a patient with end-stage renal disease (ERDS) is dependent upon a durable, low-morbidity vascular access. Although It is generally agreed that the distal radiocephalic fistula originally discribed by Brescia and Cimino is the most effective primary access constrruction, no consensus exists regarding primary and secondary alternatives for patients with inadequate of failed rediocephalic prodedures. Many options are available, but the relative value of these alternative operations is unclear. Therefore the place of the basilic vein in secondary acccess construction needs to be assessed. We evaluated if the basilic vein can be used to construct a durable, low-morbidity access. METHODS: A native brachio-basilic arterio-venous fistula with superficial transposition has been performed, for lack of usuable vein on 54 forearm in 47 patients from August 1995 to October 1999 (Male: 15, female: 32) with mean age 51 years (26 to 70 years). RESULTS: The main cause of renal insufficiency were: diabetes 27 (57.4%), hypertensive 19 (40.4%), renal tuberculosis 2 (4.3%) and renal cyst 1 (2.1%). The waiting period before vascular access puncture has been 28 6 days. Eight (17.0%) stenosis has been detected and, forearm and/or hand edema occured in three (6.4%); thrombosis in two (4.3%); bleeding in two (4.3%); pseudoaneurysm in one. Through the follow-up periods of 50 months, the primary patency was 80.9% at 12 months and 78.7% at 24 months. CONCLUSION: The brachio-basilic fistula with superficial transposition of basilic vein is a valuable vascular access for diabetes, female old patients, and can remain an alternative method for even younger patients by avoiding the installation of artificial graft after failed forearm arteriovenous fistula.
Aneurysm, False ; Arteriovenous Fistula* ; Consensus ; Constriction, Pathologic ; Edema ; Female ; Fistula ; Follow-Up Studies ; Forearm ; Hand ; Hemorrhage ; Humans ; Kidney Failure, Chronic ; Ocimum basilicum* ; Punctures ; Renal Dialysis* ; Renal Insufficiency ; Thrombosis ; Transplants ; Tuberculosis, Renal ; Veins*