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*

PURPOSE: To describe the MR features of intraspinal cysticercosis. MATERIALS AND METHODS: Medical records and MR images of four cases of intraspinal cysticercosis were retrospectively reviewed. The MR findings were described with regard to the location and signal intensity of the lesions, contrast enhancement, presence or absence of associated intracranial cysticerci, and other findings. RESULTS: There were three cases of subarachnoidal form and one case of intramedullary form. Cysticerci of subarachnoidal form in three cases were located in retromedullary space at C2 level, anterior to cord at C1 -C6 levels, and lumbosacral area, respectively. The signal intensities of the lesions were same as those of CSF. Localized arachnoidal enhancement was found in all three cases. In one case there was a large area of high signal intensity within the spinal cord on T2 weighted image suggesting either ischemia secondary to vascular compromise or inflammatory edema. All of these three cases accompanied intracranial cysticercosis. Intramedullary cysticercosis in one case was shown as a single I cm cystic lesion at C2 level, which showed hypointense signal on T1 weighted image, hyperintense signal on T2-weighted image, and signet-ring-like enhancement. This lesion did not accompany intracranial cysticerci. CONCLUSION: lntraspinal cysticercosis manifested as single or multiple cysts within either spinal cord or subarachnoid space, and were frequently associated with arachnoiditis.
Arachnoid ; Arachnoiditis ; Cysticercosis* ; Edema ; Ischemia ; Magnetic Resonance Imaging* ; Medical Records ; Retrospective Studies ; Spinal Cord ; Subarachnoid Space

The prognostic factors for extrahepatic biliary atresia (EHBA) after Kasai portoenterostomy include the patient's age at portoenterostomy (age), size of bile duct in theporta hepatis (size), clearance of jaundice after operation (clearance) and the surgeon's experience. The aim of this study is to examine the most significant prognostic factor of EHBA after Kasai portoenterostomy. This retrospective study was done in 51 cases of EHBA that received Kasai portoenterostomy by one pediatric surgeon. For the statistical analysis, Kaplan-Meier method, Logrank test and Cox regression test were used. A p value of less than 0.05 was considered to be significant. Fifteen patients were regarded as dead in this study, including nine cases of liver transplantation. There was no significant difference of survival to age. The age is also not a significant risk factor for survival in this study (Cox Regression test; p = 0.63). There was no significant difference in survival in relation to the size of bile duct. However, bile duct size was a significant risk factor for survival (Cox Regression test; p = 0.002). There was a significant difference in relation to survival and clearance (Kaplan-Meier method; p = 0.02). The clearing was also a significant risk factor for survival (Cox Regression test; p = 0.001). The clearance of jaundice is the most significant prognostic factor of EHBA after Kasai portoenterostomy.
Bile Ducts ; Biliary Atresia* ; Humans ; Jaundice ; Kaplan-Meier Estimate ; Liver Transplantation ; Prognosis ; Retrospective Studies ; Risk Factors

No abstract available.
Adult* ; Humans ; Orbit*

No abstract available.
Hyperostosis, Cortical, Congenital*

Carotidynia is defined as an atypical craniofacial pain syndrome caused by the dilatation or distension of the extracranial arteries. We report an unusual case of carotidynia mimicking trigeminal neuralgia caused by an arterioscle-rotic tortous carotid artery. A 68-year-old woman suffered from frequent episodes of severe electrical shock-like radiating pain around her left ophthalmic and maxillary division of the trigeminal nerve for 5 years. Initially, under the impression of trigeminal neuralgia, carbamazepine was tried. She was reevaluated due to an unsatisfactory pharmacological response. On examination, no abnormalities were found on the craniofacial region except for a tortous pulsating tender mass on the region of the left carotid artery. Routine laboratory findings and a connective tissue study were normal. Neck sonography and a 4-vessel angiography showed a tortous left internal carotid artery with stenosis extending near to the skin. The patient was treated for 2 weeks with a nonsteroidal anti-inflammatory agent, steroids, a prophylctic beta blocker, and a TCA antidepressant. The pain gradually subsided.
Aged ; Angiography ; Arteries ; Carbamazepine ; Carotid Arteries ; Carotid Artery, Internal ; Connective Tissue ; Constriction, Pathologic ; Dilatation ; Facial Neuralgia ; Female ; Humans ; Neck ; Skin ; Steroids ; Trigeminal Nerve ; Trigeminal Neuralgia*

PURPOSE: With the increase of foreigners using Korea health facilities, it is important for nurses to be culturally competent. Thus, the purpose of this study was to examine the effects of a cultural competence educational program on the cultural competence of nursing students. METHODS: A quasi-experimental study with a non-equivalent control group pretest-posttest design was used. For the experimental group there were 42 participants from one school and for the control group, 40 from another school. The experimental group participated in the 14 week multicultural nursing education program while the control group participated later after the experiment was finished. Data were collected using self-report structured questionnaires prior to the intervention and right after the intervention, and were analyzed using descriptive statistics, χ² test, and independent t-test with SPSS 18.0 program. RESULTS: The experimental group reported significant positive changes for cultural knowledge (t=3.99, p<.001), cultural awareness (t=3.92, p<.001), cultural acceptance (t=2.25, p=.027), and cultural competence behaviors (t=4.30, p<.001) compared to the control group. CONCLUSION: The results of the study indicate that the cultural competence educational program developed by the researchers is effective in raising the level of cultural knowledge, cultural awareness, cultural acceptance, and cultural competence behaviors of nursing students.
Cultural Competency* ; Education, Nursing ; Emigrants and Immigrants ; Health Facilities ; Humans ; Korea ; Non-Randomized Controlled Trials as Topic ; Nursing* ; Students, Nursing* ; Transcultural Nursing

No abstract available.
Birth Certificates* ; Parturition*

Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

PURPOSE: After Langendorff made aortic perfusion system with the extracted animal heart for the experimental study regarding cardiac mechanical action and rhythm, this system has been modified by various methods for the hemodynamic studies. The authors developed cardiac perfusion system using personal computer for mechanical cardiac contraction and electrophysiologic studies without the effects of autonomic nervous system and hemodynamic influences from various causes. METHODS: This system consisted of perfusion system, electrical pulse generator, and data acquisition system. the perfusion system has reservoir containing physiologic solution, heat exchange system, and organ chamber. The pulse generator composed of personal computer and digital/analog converter can produce electrical pulses with adjustable amplitude and cycle length. The mode of stimulations were as follows; maintenance, programmed, and burst mode. The data acquisition system was composed of amplifier, analog/digital converter, and AcqKnowledge program that are provided by Biopac system. The data were sampled at 1kHz as a digitized form, and the noises wee reduced by filtering at band width 30-500Hz. Krebs' solution was used as perfusate through the aorta of isolated heart with mean pressure of 40mmHg. RESULTS: With this system, AH and HV interval, refractory period of AV node and His-Purkinje system, and Wenckebach cycle length were measured. CONCLUSION: Studies for cardiac mechanical contraction as well as electrophysiologic properties in vitro with or without specific cardiac drugs would be possible with this system in isolated experimental heart without autonomic nervous effects.
Animals ; Aorta ; Atrioventricular Node ; Autonomic Nervous System ; Electrophysiology ; Heart ; Hemodynamics ; Hot Temperature ; Humans ; Microcomputers* ; Noise ; Perfusion*