Desmoplastic small round cell tumor (DSRCT) is a rare neoplasm of young adults and it is characterized by polyphenotypic differentiation. We experienced a case of abdominal DSRCT that occurred in a 19-year-old female who presented with painful swelling of her right forearm. The tumor was cytokeratin-negative and it exhibited some tumor cells with intranuclear inclusions. Molecular demonstration of EWS-WT1 fusion transcripts is particularly useful to confirm the diagnosis of DSRCT without epithelial differentiation. We report here on a case of cytokeratin-negative DSRCT that showed an unusual feature of intranuclear inclusions.
Desmoplastic Small Round Cell Tumor ; Female ; Forearm ; Humans ; Intranuclear Inclusion Bodies ; Keratins ; Young Adult

No abstract available.
Abscess* ; Fistula*

Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

PURPOSE: This study was to examine the effect of postpartum exercise on mental health. Mental health comprises a 9 symptom dimension of Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid Ideation, and Psychoticism. METHOD: A non-equivalent pre-test, post-test control group study was conducted. Fifty-two puerperal women who were admitted to a postpartum ward of a mother-baby clinic in Pusan were recruited; 26 women were assigned to the experimental group and 26 women to the control group. Postpartum exercise was applied to the experimental group from postpartum day 3 for a period of 8 weeks while no exercise program was applied to the control group. Mental health with SCL-90-R was measured before and after exercise. Data was analyzed using mean, x2-test, t-test, and ANOVA by SPSS 10.0. RESULT: The mental health status in the exercise group did not show a statistically significant decrease when compared to that of the control group. CONCLUSION: There is no effect of postpartum exercise on women's mental health during the first 8 weeks of the postpartum period. Further studies are needed for randomized clinical trials with a larger sample size.
Anxiety ; Busan ; Depression ; Female ; Hostility ; Humans ; Mental Health* ; Postpartum Period* ; Sample Size

Sixty-three patients with permanent sigmoid colostomy were surveyed to evaluate their satisfaction and complications with the "irrigation technique" and the "atural evacuation" of the colostomy management (irrigation technique; 32 patients, natural evacuation; 31 patients). All patients had colostomy for at least 12 months without disease recurrence. Each patient was interviewed in addition to standard questionnaire. The irrigation was not associated with any major complication including colonic perforation. The irrigation was used younger age group than the natural evacuation (53+/-10 vs. 62+/-12, P=0.01). The frequency of bowel movement was lower in the irrigation than in the natural evacuation (5.1+/-2.5/wk vs. 10.8+/-9.0/wk, P=0.04). Five patients (16%) of the irrigation experienced spontaneous bowel action but only one patient suffered from it. The time spent for managing irrigation was 59+/-13 minutes. Twenty-three patients (74%) of the natural evacuation suffered from one or moreproblems such as expensive apparatus, leakage, skin irritation or odor. Sixteen patients (52%) of the natural evacuation and 2 patients (6%) of the irrigation were restricted in social activity (P=0.0001). Thirteen patients (42%) of the natural evacuation and 1 patient (3%) of the irrigation were dissatisfied with colostomy management (P=0.002). Thus, the irrigation technique seems to be more effective and satisfactory method for managing colostomy without compromising patient's social activity when it is performed in appropriately selected patients.
Colon ; Colon, Sigmoid ; Colostomy* ; Humans ; Odors ; Surveys and Questionnaires ; Rectal Neoplasms ; Recurrence ; Skin

No abstract available.
Arthritis*

The individual onset of action of pancuronium and vecuronium has been examined with a priming dose of same or the other agent or two times priming. Measurement of changes in the Tl% of TOF ratio of the adductor pollicis muscle were performed by Accelograph (Biometer). Sixty adult patients were administered Vecuronium(V) 0.015mg/kg (group 1), V 0.005mg/kg 3 minutes after 0.01mg/ kg(group 2), Pancuronium(P) 0. 015 mg/kg(group 3,4) as a priming agents. After 5 minutes, the intubating dose of V 0.085mg/kg (group 1,2,3), P 0.085 mg/kg (group 4) were administered with the induction agent, thiopental sodium 5 mg/kg. All sixty patients underwent orotracheal intubation at 60 seconds after the injection of intubating dose. Intubation condition, reduction of Tl% at 60 seconds, the onset time of maximal blockade (Tl 0%) were evaluated. There was no difficulty in intubation. Fifty-two (86%) patients were distributed in exellent and satisfactory grade of largest in group 2. While group 3 showed more rapid than group 4, group 2 showed the most rapid onset time significantly. These results indicate that the twicely divided dose of vecuronium for priming agent may be adequate and vecuronium after priming with pancuronium is more rapid than priming with same agent.
Adult ; Humans ; Intubation ; Intubation, Intratracheal* ; Pancuronium* ; Thiopental ; Vecuronium Bromide*

In the case of brachial plexus block, mixtures of local anesthetics can combine better features of both components, rapid onset and long duration. Combining effects may influence the onset and duration of neural blockade. Our study was undertaken in order to compare the onset time (time of injection to time of loss of pain on pin prick) and duration of analgesia (time of return of sense of pain on pin prick minus time required for onset of analgesia) of a lidocaine and bupivacaine mixture with 5 minutes interval injection of lidocaine and bupivacaine. The patients admitted to our hospital for hand or forearm operations were divided into three groups. In Group 1, 9 patients were injected with 0.5% bupivacaine 150 mg only, in Group 2, 11 patients were injected with a mixture of 29: lidocaine 200 mg and 0.5% bupivacaine 100 mg, in Group 3, 10 patients were injected with 2% lidocaine 200 mg and 5 minutes later, 0.5% bupivacaine 100 mg was injected through the same needle. Group 3 had the shortest onset time (7.2+/-0.2 minutes) with moderately long duration (9.4+/-2.4hours). Group 2 had a moderately rapid onset time (9.4+/-2.3 mintes) with the shortest duration (8.6+/-1.6 hours). Group 1 had the slowest onset time (14.8+/-4.3 minutes) with the longest duration (11.3+/-2. 4 hours). The time for analgesia to reach the C7 dermatome was the slowest in group 1 and Group 2, but in Group 3, there was no difference in the time needed to achieve analgesia in all dermatomes.
Analgesia ; Anesthetics, Local* ; Brachial Plexus ; Bupivacaine ; Forearm ; Hand ; Humans ; Lidocaine ; Needles

Adenoid is a kind of tonsil located in the posterior wall of nasopharynx. Enlargement of the adenoid can produce obstruction of the nasopharynx and Eustachian tube. Disturbance in discharge of nasal and paranasal secretions can be a cause of chronic rhinitis, sinusitis, and otitis media. Diagnosis of enlarged adenoid simply by inspection is difficult due to its location. Measurement of nasopharyngeal airway and adenoid using lateral radiographs of nasopharynx may be inaccurate for magnification and rotation. It was some limitations in demonstrating the actual state of nasopharyngeal airway and adenoid because it gives only two-dimensional informations. The authors measured the sizes and areas of nasopharyngeal airway and adenoid using MRI with sagittal and oblique coronal pilot views of T1 weighted spin echo. We categorized the patients into 4 groups according to the scoring system by symptoms such as apnea, mouth breathing, and snoring. The results of several measurements and their ratios were evaluated in these 4 categorized patients. The ratios of area of adenoid and nasopharyngeal airway(AA/Na) in each patient group were 6.52, 7.76, 10.53, 15.93, respectively. And the ratios of adenoid and nasopharyngeal airway (A/N) by Fujioka's method were 0.6, 0.65, 0.69, 0.71, respectively. We found that AA/Na might be the most effective index as an objective indicator in the evaluation of nasopharyngeal obstruction by the enlarged adenoid.
Adenoids* ; Apnea ; Diagnosis ; Eustachian Tube ; Humans ; Magnetic Resonance Imaging* ; Methods ; Mouth Breathing ; Nasopharynx ; Otitis Media ; Palatine Tonsil ; Rhinitis ; Sinusitis ; Snoring

This study was performed to investigate the clinical efficacy of intralesional recombinant interferon-γ (IFN-γ) in the treatments of warts, using a placebo comparison. Warts of each groups were injected with INF-γ containing 5×10⁶ IU/ml (high dose), 1×10⁶ IU/ml (low dose), or distilled water for injection as placebo, respectively, twice weekly for three weeks. The final therapeutic efficacy was determined on the fourth week after the beginning of therapy. Among the 74 patients with periungual warts, plantar warts, or warts of other sites, complete clearing of the treated warts at week four occurred in 56% of the 36 patients receiving the high dose IFN-γ compared to 30% of the 53 receiving the low dose IFN-γ and 17% of the 36 receiving the placebo. Marked improvement showing 75% or greater regression of wart lesions was noted as 89% of patients receiving the high dose INE compared with 55% receiving the low dose IFN and 50% receiving the placebo. The group of patients with warts of other sites showed the best response. The group receiving the high dose IFN experienced some adverse effects more frequently or more severely than the group receiving low dose IFN. However, the effects were relatively tolerable to the patients. Therefore, intralesional injection of the high dose IFN-γ may be more useful in treating warts than a low dose IFN-γ.
Humans ; Injections, Intralesional ; Interferon-gamma* ; Treatment Outcome ; Warts* ; Water