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

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*

No abstract available.
Arthritis*

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

PURPOSE: The purpose of this study was to analyze periodic screening behaviors for breast cancer and factors affecting the screening behaviors among hospital nurses. METHODS: A total of 461 nurses were recruited from 15 hospitals located in two southern areas of Korea. The Champion's Health Beliefs Model Scale-Korean version and a structured study questionnaire were used for data collection. Data were collected during July and August 2008. RESULTS: Nurses who performed periodic mammography accounted for 15.6% of the total, while 22.8% performed periodic breast self-examination (BSE). Among married nurses, the rates of periodic mammography and BSE were significantly different by age, menopausal status, delivery experience, family history of breast cancer, and experiences of cervical cancer screening. Significant factors affecting periodic mammography were family history of breast cancer, experiences of cervical cancer screening, age above 40, and performance of periodic BSE. For health beliefs, levels of severity, confidentiality and barrier were significant factors for periodic BSE. CONCLUSION: Nurses, who are role models for health promoting behaviors, did not adequately performing periodic BSE and mammography. A health promotion program for breast cancer designed for hospital nurses is needed to improve performance rates for periodic screening behaviors for breast cancer.
Breast ; Breast Neoplasms ; Breast Self-Examination ; Confidentiality ; Data Collection ; Health Promotion ; Humans ; Korea ; Mammography ; Mass Screening ; Surveys and Questionnaires ; Uterine Cervical Neoplasms

Spinal cord injury may occur during surgical correction of spinal deformity. In this situations, administrations of opiate receptor antagonists have known to improve spinal cord damage. Although those therapeutic modalities for the management of acute trauma of the spinal cord, impsoved the mean systemic arterial pressure controversy continues regarding their effectiveness Because opioids or inhalational anesthetics are used clinically, the effect of an opiate antagonist was evaluated by cortical somatosensory evoked potentials(cortical SEPs) which occur in 24 cats undergoing compressive injury on the posterior spinal cord during fentanyl or halothane anesthesia. Anesthesia was induced with pentobarbiturate(50 mg/kg, im). A balloon tipped catheter was inserted in the epidural space with tip located at thoracolumbar Junction. Spinal cord compressive injury was produced by balloon inflation for 20 minutes during intravenous saline infusion (control group), fentanyl(group l) or halothane(group 2) anesthesia Naloxone(5mg/kg) was administered intravenously following injury to all animals. Cortical SRPs were determined before and after induction of anesthesia, during the spinal cord compressive injury for 5 minutes, 10 minutes, l5 minutes, 20 minutes, after naloxone administration, and after removal of compressive injury. General anesthesia resulted in increases of latency and reductions of amplitude in the cortical SEPs. The reductions of amplitude were more marked than increases of latency in group 1, 2. During the cord injury, group 1 resulted in more reductions of amylitude than the other groups. But there were no significant differences among the groups. The administration of naloxone far improved latencies and amplitudes in the cortical SEPs of group 1 more than in other two groups. But there were no significant differences among the groups. Less recovery of the cortical SRPs response to naloxone in control group than the other groups. These results do nat support the supposition that opioid anesthesia produces an adverse effect upon cortical SEPs following spinal cord compressive injury and treatment with naloxone in the dose used in this study improves neurologic recovery of cortical SEPs less significantly.
Analgesics, Opioid ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Animals ; Arterial Pressure ; Catheters ; Cats ; Congenital Abnormalities ; Epidural Space ; Evoked Potentials, Somatosensory ; Fentanyl* ; Halothane* ; Inflation, Economic ; Naloxone* ; Receptors, Opioid ; Spinal Cord Injuries* ; Spinal Cord*