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

Cavernous angiomas are considered to be congenital in origin. Patients under age of 14 years usually does not require imaging because they are likely to have a benign abducens nerve palsy, unless they develop additional signs or symptoms of neurologic disease during observation. Here we report a case of an isolated abducens nerve palsy caused by overt hemorrhage from de novo formation of cavernous angioma in the pons. Cavernous angiomas of the brain stem should be considered as a possible cause of isolated abducens nerve palsy in young adult and MRI, including gradient-echo sequences should be performed.
Abducens Nerve Diseases* ; Abducens Nerve* ; Brain Stem ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Pons ; Young Adult

Cavernous angiomas are considered to be congenital in origin. Patients under age of 14 years usually does not require imaging because they are likely to have a benign abducens nerve palsy, unless they develop additional signs or symptoms of neurologic disease during observation. Here we report a case of an isolated abducens nerve palsy caused by overt hemorrhage from de novo formation of cavernous angioma in the pons. Cavernous angiomas of the brain stem should be considered as a possible cause of isolated abducens nerve palsy in young adult and MRI, including gradient-echo sequences should be performed.
Abducens Nerve Diseases* ; Abducens Nerve* ; Brain Stem ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Pons ; Young Adult

No abstract available.
Cardiomyopathy, Dilated* ; Doxorubicin

Synovial sarcoma occurring in the pleura and lung is extremely rare. We report a case of pleuropulmonary synovial sarcoma as a second malignant neoplasm. The patient had been diagnosed with acute myelomonocytic leukemia at 5 years of age, and received matched sibling donor allogeneic bone marrow transplantation, with total body irradiation and cyclophosphamide conditioning. At 22 years of age, he complained of worsening chest discomfort and exertional dyspnea. Chest CT revealed a huge mass in the right middle lobe, pleura, and diaphragm. The patient was initially diagnosed as sarcomatoid malignant mesothelioma, without any environmental or occupational asbestos exposure. Five months later, the patient presented with soft tissue metastasis and underwent needle biopsy. Pathological examination including SYT-SSX RT-PCR revealed synovial sarcoma, which led to a review of the original tumor findings and confirmed the diagnosis of pleuropulmonary synovial sarcoma.To the best of our knowledge, our patient is the first case of pleuropulmonary synovial sarcoma developed after allogeneic hematopoietic stem cell transplantation.

Synovial sarcoma occurring in the pleura and lung is extremely rare. We report a case of pleuropulmonary synovial sarcoma as a second malignant neoplasm. The patient had been diagnosed with acute myelomonocytic leukemia at 5 years of age, and received matched sibling donor allogeneic bone marrow transplantation, with total body irradiation and cyclophosphamide conditioning. At 22 years of age, he complained of worsening chest discomfort and exertional dyspnea. Chest CT revealed a huge mass in the right middle lobe, pleura, and diaphragm. The patient was initially diagnosed as sarcomatoid malignant mesothelioma, without any environmental or occupational asbestos exposure. Five months later, the patient presented with soft tissue metastasis and underwent needle biopsy. Pathological examination including SYT-SSX RT-PCR revealed synovial sarcoma, which led to a review of the original tumor findings and confirmed the diagnosis of pleuropulmonary synovial sarcoma.To the best of our knowledge, our patient is the first case of pleuropulmonary synovial sarcoma developed after allogeneic hematopoietic stem cell transplantation.

PURPOSE: The purpose of this study was to describe the components and content of nursing intervention studies on mother-infant interactions and to present strategies for future studies. METHODS: Four electronic databases in the Korean language were searched to identify studies done between January 1998 and December 2011. The search yielded 145 articles. From these articles, 19 studies met the inclusion criteria. RESULTS: Mother-infant interactions in these studies were found to include verbal and non-verbal communication basic for optimal growth and development of the child. Six kinds of interventions for mother-infant interactions were identified as follows: sensory stimulation, education program, whole body massage, kangaroo care, visiting support, and music therapy. CONCLUSION: Further studies with well designed clinical trials need to be done in the area of child nursing to provide evidence based data for the development of strategies to promote positive mother-infant interactions.
Child ; Education ; Growth and Development ; Humans ; Clinical Trial* ; Macropodidae ; Massage ; Mother-Child Relations* ; Music Therapy ; Nursing* ; Parent-Child Relations

The failure of large-scale drug trials targeting the amyloidogenic pathway in Alzheimer's disease (AD) is increasing the need to identify a novel pathogenic mechanism. Studies finding a relationship between sporadic AD and type-2 diabetes mellitus (T2DM) are now receiving more attention. The risk for developing both T2DM and sporadic AD increases exponentially with age, and having T2DM doubles the risk of developing AD. The postmortem brains of AD patients show altered activities of insulin receptors and downstream molecules, as well as reduced protein and mRNA levels of insulin. More-recent laboratory research using animal models has identified mechanisms that are shared by diabetes and AD. Exogenous application of streptozotocin, which disrupts systemic insulin secretion, results in insulin deficiency, increased tau phosphorylation, and cognitive impairments that can be reversed by exogenous insulin supplementation. However, AD pathology is more severe in T2DM animal models exhibiting hyperinsulinemia and insulin resistance, and this is not modulated by insulin. The symptoms of this AD pathology included increased tau phosphorylation at multiple sites, increased tau cleavage, and greater neuronal and synaptic damage, even with increased amyloid beta protein production. It has therefore been suggested that hyperinsulinemia and insulin resistance represent major factors underlying AD in T2DM. A recent study involving cross-mating ob/ob and amyloid precursor protein transgenic mice provided evidence that T2DM and AD aggravate each other, and suggested that cerebral vessels constitute an important substrate that is commonly damaged by the two major disorders. Given the evidence provided by animal models, further investigation of the mechanisms underlying T2DM in AD should help to identify potential treatment targets in AD.
Alzheimer Disease ; Amyloid ; Amyloid beta-Peptides ; Animals ; Brain ; Diabetes Mellitus ; Humans ; Hyperinsulinism ; Insulin ; Insulin Resistance ; Mice ; Mice, Transgenic ; Models, Animal ; Neurons ; Phosphorylation ; Receptor, Insulin ; RNA, Messenger ; Streptozocin

PURPOSE: The study was done to evaluate the effects a Stress Management Program (SMP) on stress, problem solving skills, and quality of life for hospitalized patients with Schizophrenia. METHODS: A mixed method design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 40 patients with schizophrenia admitted in three psychiatric hospitals. The experimental group (n=20) received the SMP twice a week for a total of 8 weeks. RESULTS: Study results revealed that the SMP was effective for stress (F=321.02, p<.001), problem solving ability (F=246.28, p<.001), and quality of life (F=63.35,p<.001) for hospitalized persons with schizophrenia. CONCLUSION: The results suggest that a SMP can be an effective strategy to reduce patients' hospitalization stress, and improve problem solving skills and quality of life. Therefore, it is recommended that mental health nurses use this stress management program in clinical practice to assist adaptation to hospitalization for persons with schizophrenia.
Data Collection ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Mental Health ; Methods ; Problem Solving* ; Quality of Life* ; Schizophrenia

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