No abstract available.

Germ cell tumors(GCT) are not infrequently encounted tumor in pediartic age group. In order to study the clinical behaviors of the disease, we reviewed 29 cases of GCT diagnosed and treated at Kosin Medical Center in the period of 7 years form Jan. 1984 to Dec. 1991 and the results are summarized as follows: 1) The age distribution is the highest between 10 and 15 years(45%) and girls have 1.9 times higher frequency than that of boys. 2) The most frequent primary site of GCT was ovary(15). The next common primary site was testis(5), pineal body(4), sacrococcygeal region(2), retroperitoneum(1), soft palate(1), anterior mediastinum(1) in descending order of frequency. 3) In the pathological analysis of tumors, the most frequent type was mature teratoma(12). The next common type was endodermal sinus tumor(6), immature teratoma(5), dysgerminoma(3), mixed type(2), and choriocarcinoma(1)in descending order of frequency. 4) All the 5 cases of EST have elevated serum levels of alpha-fetoprotein. Two of the three dysgerminoma, one of the two mixed type tumors both of which have germinoma components, and one choriocarcinoma have elevated serum levels of beta-HCG above the age related physiological levels. 5) Among 17 cases of malignant GCT, 9 cases have metastatic areas such as regional lymph nodes, scrotum, pleura, retroperitoneum, omentum and lumbar spine. 6) All except on case of immature teratoma in the anterior mediastinum underwent surgery. Chemotherapy was given to 12 of 17 malignant GCT and radiotherapy was given to 4 of 17 malignant GCT. 7) Among the 4 expired cases within 12 months of follow up, three were originated from pineal body, which had been underwent simple V-P shunt or incomplete resection, and one case was metastatic immature teratoma of anterior mediastinum to the pleura which had not been undergone surgery. Finally, in review of literature and or cases, the survival of properly managed GCT except some of those difficult surgical access is relatively good. To continue the survival of children of GCT to be impoved, we should use all the treatment modalit properly with more positive outlook about the disease.
Age Distribution ; alpha-Fetoproteins ; Child* ; Choriocarcinoma ; Drug Therapy ; Dysgerminoma ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Germinoma ; Humans ; Lymph Nodes ; Mediastinum ; Neoplasms, Germ Cell and Embryonal* ; Omentum ; Pineal Gland ; Pleura ; Pregnancy ; Radiotherapy ; Scrotum ; Spine ; Teratoma

PURPOSE: In most emergency department (ED), sedation is required before carrying out an invasive procedure on a pediatric patient. In the ED setting, it is essential to determine the optimal dose and administration route of CH for successful sedation. The aim of this study was to determine the optimal dose of CH for an invasive procedure and to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likert-scale to evaluate satisfaction of medical staffs in ED with administration routes. METHODS: This study was conducted prospectively. The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea within a period of 12 months. RESULTS: Overall, 300 patients were included in this study. The age, sex, and weight of the patients were not shown to influence the sedation time. Chloral hydrate dosage is the independent factor to influence the both sedation and discharge time (p<0.01). In the comparison of the groups, groups 1, 2, and 5 showed no significant difference. On the other hand, groups 3 and 4 were shown to be statistically significantly different from group 1. CONCLUSION: Up to 100 mg/kg CH is safe to use in the emergency department for pediatric patients, but the initial dose of 50 mg/kg for oral administration should be considered in advance because it can provide safe and effective sedation with a lower possibility of causing an adverse effect.
Administration, Oral ; Chloral Hydrate* ; Deep Sedation ; Emergency Service, Hospital ; Hand ; Humans ; Korea ; Medical Staff ; Prospective Studies ; Tertiary Care Centers

OBJECTIVES: Ginseng has a long history of being used in insomnia treatment and there is some evidence from animal studies of its sleep-enhancing property. From this, it can be assumed that ginseng has sleep-promoting effect in humans. The purpose of this study was to investigate the effect of Korean red ginseng on change of sleep architecture in humans. METHODS: A total of 20 healthy young males with regular sleep and wake habits and without any psychiatric nor cognitive problems were selected based on review of sleep questionnaires and sleep diaries they completed followed by an interview with a board-certified psychiatrist. The subjects were randomly assigned to red ginseng or placebo for 2 weeks of trial. The total daily dose of ginseng was 4,500 mg. The polysomnographic recordings were made at baseline and at 2 weeks after. The effects of red ginseng and placebo on sleep were assessed by comparing the changes in polysomnographic variables between the two groups. RESULTS: A total of 15 subjects, 8 from red ginseng group and 7 from placebo group, were included to undergo polysomnographic procedures. The red ginseng group showed tendencies to increase stage 3 sleep (p=0.087) and to decrease stage 2 sleep (p=0.071) from the baseline compared with the placebo group. CONCLUSION: Korean red ginseng tends to increase deep sleep and decrease shallow sleep. Our result is in line, at least in part, with previous findings that Korean red ginseng increased total and NREM sleep in rats. Further studies with higher ginseng dosage, larger sample size and longer trial duration should be conducted to confirm the sleep stabilizing and balancing effects of Korean red ginseng.
Animals ; Humans ; Male ; Panax ; Polysomnography ; Psychiatry ; Surveys and Questionnaires ; Rats ; Sample Size ; Sleep Initiation and Maintenance Disorders

No abstract available.
Animals ; Microscopy, Electron* ; Muscle Fibers, Skeletal* ; Muscle, Skeletal* ; Rats*

No abstract available.
Cardiomyopathy, Dilated* ; Doxorubicin

End-stage renal disease(ESRD) is the fatal retention of non-volatile, metabolic waste products, salt, and water due to extensive loss of functioning nephrons. Renal replacement therapy is primarily aimed to remove retained waste products and fluid. Adequacy of dialysis is the dose of dialysis below which one observes a significant worsening of morbidity and mortality. Urea kinetic modeling, Kt/Vurea, etc. is regarded as a quantitative guideline of dialysis adequacy in both hemodialysis(HD) and peritoneal dialysis(PD). Water is one of the most important uremic toxin retained in ESRD patients. The importance of fluid overload on morbidity and/or mortality in dialysis patients is yet to be evaluated. Recent technology of HD provides adequate Kt/ Vurea for relatively short dialysis time and higher patient survival. Blood pressure control and extracellular fluid(ECF) volume are closely related with dialysis time in HD patients. Short dialysis time, 3-4 hours per session may not enough to control blood pressure. Hypertension is an important risk factor of survival in dialysis patients. Fluid overload is the most important factor of hypertension in dialysis patients. Patients with uncontrolled hypertension have higher mortality rate despite similar Kt/Vurea compared with patients with good blood pressure control. A longer dialysis time improves ECF volume and blood pressure control and decreases cardiovascular mortality. Continuous ambulatory peritoneal dialysis(CAPD) is a slow continuous therapy and is believed to maintain better control of ECF volume and blood pressure compared with hemodialysis. ECF volume and blood pressure controls are improved after initiation of CAPD, however, return to pre-CAPD levels after a few years of CAPD when residual renal function disappears. Patients transferred to hernodialysis from CAPD lose around 4kg of body weight for a few months on HD. Approximately 25% of CAPD patients are clinically fluid overloaded. Increased peritoneal permeability is an independent risk factor for patient and technique survivals in CAPD patients. Fluid overload in CAPD patients with increased peritoneal pernability is believed to be an important underlying mechanism of increased mortality and technique failure in this group. In conclusion, fluid overload is an important risk factor of mortality in dialysis patients. Sufficient dialysis time resulting good controls of ECF volume and blood pressure in hemodialysis patients and individualized dialysis prescription according to the peritoneal permeability in CAPD patients are vital to provide adequate dialysis and to decrease cardiovas-cular mortality.
Blood Pressure ; Body Weight ; Dialysis* ; Humans ; Hypertension ; Kidney Failure, Chronic ; Mortality ; Nephrons ; Peritoneal Dialysis, Continuous Ambulatory ; Permeability ; Prescriptions ; Renal Dialysis ; Renal Replacement Therapy ; Risk Factors ; Urea ; Waste Products ; Water

BACKGROUND: Many women have experienced artificial abortion, but artificial abortion itself may take a life away from a fetus and also influence serious effect on operated womens health condition. So this study was attempted to offer basic information for improving maternity health condition by knowing womens artificial abortion performance status and recognition about its complication. METHODS: The 215 married women who visited in OPD of certain hospital in Pusan from november 1994 to January 1995, answered the question about experience of artifial abortion the recognition about its complication, and artificial abortioned group answered the reason of artificial abortion and the experience of complication. RESULTS: The number of women who experienced artificial abortion was 107 persons(49.8%). More educated women have experienced less artificial abortion. The causes of artificial abortion were birth control as of 40.6%, continuation of occupation or study as of 20.6%, for preserving health condition as of 14.2%, impossible marriage as of 14.2%. 115 persons out of 215 persons (53.4% ) answered they heard about, its complicatons. In relation to health, 66 persons(30.7% ) answered that the abortion had no relation with health condition or they answered they have no idea about the issue, 68 persons(31.6%) answered that the abortion had relation with but its complication would be soon recovered. Higher understanding was obtained in higher educated group(P<0.05). If unwanted pregnancy occur to them in the future, 32 persons(27.8%) in recognized group and 38 persons(38%) in unrecognized group answered they would perform artificial abortion. So understanding about complicaton of artificial abortion has little effect on their artificial abortion rate. CONCLUSIONS: Recognition of complications of married women is low, and recognition degree doesnt affect artificial abortion. So, not only education about complications of artificial abortion and contraception but also social performance of sharing womens responsibility for birth control or bringing up infants is necessary.
Abortion, Induced ; Busan ; Contraception ; Education ; Female ; Fetus ; Humans ; Infant ; Marriage ; Occupations ; Pregnancy ; Pregnancy, Unwanted ; Women's Health

PURPOSE: The purpose of this study was to evaluate the usefulness of CT-guided percutaneous needle aspiration(PCNA) of paraaortic and pelvic lymph nodes in patients with uterine cervical carcinoma. MATERIALS AND METHODS: CT-guided PCNA was performed in 18 patients with treated cervical carcinoma. initial clinical stages were CIS in one, lb in three, lib in ten, and IIIb in four cases. We used 20 gauge Westcott needles for aspiration. Mean depth from skin to lymph nodes was 10.0cm in paraaortic group (n=13) and was 7.9cm in pelvic group (n=5). The size of lymph nodes ranged 1.0-3.0cm (mean :1.8) and 1.5-5.0cm (mean :2.6cm), respectively. RESULTS: All cases with paraaortic lymph node enlargement were proved to be metastatic lymphadenopathy. In five cases with pelvic lymph node enlargement, three were proved to be malignancy and two were negative. Among 16 cases with metastatic lymphadenopathy, eight patients were treated with chemotherapy, five with radiation therapy, and three with chemotherapy and radiotherapy. In two cases with negative results lymph nodes were disappeared or unchanged on follow up CT scans. No complications were encountered during CT-guided PCNA procedure. CONCLUSION: CT-guided PCNA of paraaortic and pelvic lymph nodes is a useful method in determining metastasis from cervical carcinoma and in planning further treatment.
Biopsy, Fine-Needle* ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Lymphatic Diseases ; Needles ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen ; Radiotherapy ; Skin ; Tomography, X-Ray Computed

Painful ophthalmoplegia is an unusual presentation of malignant lymphoma. Moreover, spontaneous remission and exacerbation of it has quite rarely been reported. We present a patient who showed spontaneous remission and exacerbation of the painful ophthalmoplegia. Brain MR imagings showed infiltrating, iso-intensity mass a, TlWl and T2WI, and strong enhancement with gadolinium on TIWI in parasellar area. Malignant lymphoma of diffuse large cell type was found in cervical lymph node biopsy.
Biopsy ; Brain ; Gadolinium ; Humans ; Lymph Nodes ; Lymphoma* ; Ophthalmoplegia* ; Remission, Spontaneous*