Fatigue is regarded as a universal and unavoidable side effects of chemotherapy. Most of patients in chemotherapy prefer resting and reducing their level of activity, but reduced physical activity can actually decrease physical strength and functional status to produce secondary fatigue. The purpose of this study was to determine the effects of rhythmic walking exercise on physical strength, fatigue, and functional status of breast cancer patients in adjutant chemotherapy. A matched control group pretest-pottiest design was used. Seventeen subjects of the experimental group were taught the rhythmic walking exercise(Winningham etal, 1990) on their first visiting day and encouraged to practice it at home throughout that treatment cycle(four weeks). Participants kept an everyday exercise diary that included pulse rates, exercise time and subjective data. The rhythmic walking exercise consists of approximately 30-minute walking, everyday if possible for 4 weeks. Outcomes were measured by each instrument :1) physical strength by the treadmill test estimated the walking ability. The subject is instructed to walk as long as possible to the level of their tolerance ;2)functional status by the Inventory of Functional Status-Cancer(Tollman et al, 1991) ; and 3)fatigue was measured by the Piper Fatigue Scale in both groups at five different times-before beginning chemotherapy(pretest) and one time per week for 4 weeks. Data were analyzed with mean, standard deviation, X2-test, t-test, repeated measure MANOVA using SPSSWIN program. Results were obtained as follows :1)The physical strength of the experimental group was significantly higher than that of the control group following the rhythmic walking exercise(t=3.92, p<.001). 2)The fatigue scores of the experimental group measured at the end of each week were significantly lower than those of the control group following the rhythmic walking exercise (1st week ; F=6.51, p<.016, after 1st week ; 863, p<.0001, after 2nd week ; F=46.754, p<.0001, after 3rd week ; F=60. 183, p<.0001, after 4th week). 3)The functional status of the experimental group was significantly higher than that of the control group following the rhythmic walking exercise (t=13.20, p<.0001). The results suggest that the appropriate rhythmic walking exercise for the breast cancer patients in adjutant chemotherapy can improve physical strength and functional status, and ultimately decrease the secondary fatigue.
Breast Neoplasms* ; Breast* ; Drug Therapy* ; Exercise Test ; Fatigue* ; Heart Rate ; Humans ; Motor Activity ; Piper ; Walking*

Clinical characteristics of 336 infants referred for chromosomal study during neonatal period from Jan. 1985 to Dec. 1994 to the cytogenetic laboratory of St. Mary's Hospital, Catholic University Medical College were reviewed. Karyotypes were analysed from peripheral blood lymphocyte cultures and G-banding was carried out. A thorough survey of the clinical reasons for chromosomal analysis, prevalence of chromosomal abnormalities in each disease category, and the patterns of chromosomal aberrations were done. The results were as follows, 1) Down syndrome was the most common indication for chromosome analysis in the newborn period, consisting of 37.8 % of all cases referred. Other indications included skeletal anomaly, multi-organ anomalies, cleft lip/palate, ambiguous genitalia, odd looking face, gastrointestinal anomaly, central nervous system anomaly, and Turner syndrome. 2) Overall in 42.9 percent of cases referred, chromosomal abnormalities was found. 3) 1'he percentage of final diagnosis in suspected Down syndrome was 85.0 #96. Overall, of the non-Down syndrome cases, 16.7 96 was given a definitive diagnosis of chromosomal abnomality. In each disease category, 57.1 % of suspected Turner syndrome and 37.2 % of multi-organ anomalies had been proved having chromosomal abnormalities. The percentages of chromosomal aberrations in isolated odd looking face, ambiguous genitalia, and skeletal anomaly were relatively low, around 5 %. None of the newborns referred because of cleft lip/palate, congenital anomalies of gastrointestinal tract or central nervous system had abnormal karyotype. 4) 95.1 % of all cases diagnosed to have chromosomal abnormality had autosomal aberrations, the remainder 4.9 % had sex chromosomal aberrations. 5) Trisomy 21 was the most common numerical aberrations of autosomes, consisting of 87.5 % and trisomy 18, trisomy 13, and mosaicism was 7.1 %, 3.6 96 and 1.8 % of total. 6) 90.7 % of Down syndrome were due to trisomy 21, the rest being translocation (7.4 %) and mosaicism (1.9 %).
Abnormal Karyotype ; Central Nervous System ; Chromosome Aberrations ; Cytogenetics ; Diagnosis ; Disorders of Sex Development ; Down Syndrome ; Gastrointestinal Tract ; Humans ; Infant ; Infant, Newborn* ; Karyotype* ; Lymphocytes ; Mosaicism ; Prevalence ; Trisomy ; Turner Syndrome

A three year old girl with a left renal teratoid Wilms tumor is reported. The tumor was located both inside and outside the kidney parenchyme, to form a well encapsulated mass containing two lobulated solid and cystic masses. The tumor consists predominantly of otherwise typical Wilms tumor irregularly mixed with teratoid tissue elements such as intestinal tract, mucous glands with argentaffin cells, goblet cells and transitional epithelium. These heterologous elements were regarded as diverse epithelial differentiation of totipotent cells in certain nephrogenetic period, and this tumor was considered to be hest called "teratoid Wilms tumor".

Rupture of anterior communicating artery aneurysm is one of the most important casuses of subarachnoid hemorrhage. Subarachnoid hemorrhage due to ruptured anterior communicating artery aneurysm shows characteristic CT findings, such as forntal hematoma or septum pellucidum hematoma. In some patients with the ruptured aneurysm, direct carotid angiography may be needed. particularly when transfemoral approach is not possible. However, not much have been known about the puncture site selection between the two carotid arteries in relation to the location of hematoma in CT scans. To determine the ideal puncture site of the direct carotid angiography, seventy-five cases of anterior communicating artery aneurysm confirmed by operation from May 1988 to April 1992, were analyzed in terms of relationship between location of hematoma on CT, direction of aneurysm and A1 artery on angiograms. Frontal lobar hematoma was more prevalent than septal hematoma, and was more common on the right side. In cases of lobar hematoma, aneurysm was directed to the ipsilateral side of the hematoma (67%) and was most commonly fed by contralateral A1 artery(75%). Septal bematoma consisted 36% of the cases and among there, midline directed aneurysm was most common, frequently fed by left A1 artery. In conclusion, when performing direct carotid angiography in patients with anterior communicating artery aneurysm, if forntal hematoma is observed on CT, it may be beneficial to puncture contralateral carotid artery. Meanwhile, if hemorrhage of septum pellucidum is observed, it may be better to puncture left carotid artery.
Aneurysm ; Aneurysm, Ruptured* ; Angiography ; Arteries* ; Carotid Arteries ; Hematoma ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Punctures ; Rupture ; Septum Pellucidum ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

No abstract available.
Carcinoma, Hepatocellular*

No abstract available.
Cholesterol* ; Triglycerides*

PURPOSE: To illustrate frequently encountered anatomic variations on PNS computed tomography(CT) and to assess their clinical significance. MATERIALS AND METHODS: CT findings of 1523 patients, who underwent PNS CT with no history of sinus surgery, were reviewed, and prevalence of each anatomic variation and its relationship with mucociliary clearance pathway was evaluated. RESULTS: Two categories of anatomic variations were encountered. The first group included variations of the turbinates, such as concha bullosa(28.6% ), paradoxical middle turbinate(31.5%), of the uncinate process, such as medially bent or folded(36.3%), laterally bent(3.7%) or uncinate bulla(0.5%), of the ethmoidal sinus, such as Haller's ce11(28.2%), large agger nasi ce11(9.6%) or large ethmoidal bulla(23.5%) and nasal septal deviation(24. 1%), which might cause obstruction of mucociliary clearance pathway and thus give rise to secondary obstructive sinusitis. The second group included Onodi ce11(1.4%) and medial depression of the lamina papyracea (3.5%), which were not related with obstructive sinusitis. 87 cases of large agger nasi cell were associated with obstruction of nasofrontal recess. Large ethmoidal bulla(452 cases), Haller's ce11(245 cases) and true concha bullosa (25 cases) contributed to narrowing of the infundibulum. Medially bent uncinate process(220 cases), concha bullosa(157 cases), paradoxical middle turbinate(126 cases) and nasal septal deviation(93 cases) were observed in middle meatal obstruction and supreme concha (3 cases) accompanied sphenoethmoidal recess obstruction. CONCLUSION: Recognition of anatomic variations on PNS CT is important to build a treatment plan in patients with obstructive sinusitis as they may represent causes of the disease, and to avoid critical complications during functional endoscopic sinus surgery.
Anatomic Variation ; Depression ; Humans ; Mucociliary Clearance ; Prevalence ; Sinusitis ; Turbinates

PURPOSE: To evaluate the incidence and the site of osteomas and their relation to sinonasal inflammation. MATERIALS AND METHODS: 1578 PNS computed tomography (CT) of patients with symptoms of sinusitis were evaluated and correlation with plain radiographic finding was done. RESULTS: The total incidence of osteomas was 0.82%(13/1578) on plain radiography and 3.29% (52/1578) on CT. Fifty-seven osteomas were found in 1578 PNS CT, including 2 osteomas in 5 cases. The most common site was the ethmoid sinus(54%, 31/57) and the next was the frontal sinus(35%, 20/57) on CT. Forty-five osteomas (78.9%) were associated with the sinonasal inflammatory change. CONCLUSION: The total incidence of osteomas from our results was higher than previous reports. And based on the analysis of CT, the most common site was not the frontal sinus as all the previous reports stated, but the ethmoid sinus, probably by virtue of high resolution of CT and/or higher prevalence of inflammation in the ethmold sinus.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Incidence ; Inflammation ; Osteoma* ; Prevalence ; Radiography ; Sinusitis ; Virtues

The paramount importance of breast feeding for the health of the infants has been recognized by untritionists and physicians. Although many advantages of the breast feedng, exclusive breast feeding without weaning diet or supplement food during prolonged perind in infants may produce iron deficiencyh anemia. This study was conducted to find out the hematologic state in exclusively prolonged breast-fed infants among these anemic patients and the way of thinking about their baby's feeding method in their mothers. Mothers of the anemic patients has been surveyed with questionare. The results and problems obtained from this study are summerized as follows. 1) Among 40 patients of this study, 27 were male (67.5%) and 13 were female (32.5%). Mean age was 12.6+/-2.7 month and 9 & 11 month of age were the most common, respectively (15.0%). 2) Mean age of mothers was 29.5 year. The 25 34 year-old group was most common. 3) Education levels of mothers were primary 10%, middle 10%, high 60%, and college graduate 20%. 4) In motivatins of breast feeding. Persuasion of husband or the parent of husband' 19(47.5%). 'Convenience for use' 12 (30.0%), and 'Through mass media or public information' 9 (22.5%). 5) In the causes of prolonged breast feeding, 'Think that satisfactory nutrition for baby is possible with breast milk alone' 4(10.0%), 'Due to persuasion of husband or the parents of husband' 11 (27.5%), 'Baby did no suck milk bottle or eat other diet except breast milk' 25 (62.5%). 6) In whether or not acknowledgment of the necessity of weaning diet, 'Know it but not consider so important 22 (55.0)%, 'Do not know at all) 15 (37.5%), and 'Breast milk, that will do' 3(7.5%). 7) Hb level in patient group, from 6 to 6.9g/dl was 2 (50.0%), from 7 to 7.9g/dl was 3 (7.5%), from 8 to 8.9%g/dl was 15 (37.5%), and from 9 to 10 g/dl was 20 (50.0%). From 9 to 10g/dl was the most common. Hematologic findings were Hb 8.8+/-0.9g/dl, Hct 28.8+/-3.0%, MCV 64.7+/-6.7 fl, MCH 20.0+/-2.5pg, MCHC 30.8+/-1.5g/dl. Platelet 452.5+/-142.9x103/mm3, Reticulocyte count 1.4+/-0.6%, Fe 28.6+/-14.1 g/dl, TIBC 446.7+/-66.2 g/dl, Ferritin 10.5+/-7.0ng/ml. Transferrin saturation 6.6+/-3.5%. 8) In association with duration of breast milk feeding and hematologic findings, as duration was prolonged, Hb, Hct, MCV & MCH were significantly decreased (p<0.01).
Adult ; Anemia* ; Blood Platelets ; Breast Feeding* ; Breast* ; Diet* ; Education ; Feeding Methods ; Female ; Ferritins ; Humans ; Infant ; Iron ; Male ; Mass Media ; Milk ; Milk, Human ; Mothers ; Parents ; Persuasive Communication ; Reticulocyte Count ; Spouses ; Thinking ; Transferrin ; Weaning*

No abstract available.
Lymphangioleiomyomatosis* ; Tuberous Sclerosis*