A review of the literature on cancer pain revealed that many persons with cancer receive inadequate analgesia for pain control, due in part to a lack of knowledge of the control of cancer pain by both physicians and nurses. This study is composed of two parts : one is to train nurses to change their knowledge of and attitude toward the pain management of patients having cancer and to evaluate the effectiveness of this training in comparison with other non-trained group ; the other is to test the applicability of the pain management method knowledge and attitude in the levels of pain of oncology patients. General characteristics of nurses such as age, education, educational experiences of cancer pain management were not different in both groups except the clinical experience. General characteristics of cancer patients and pain-related variables such as pain, sleep, daily activities, treatment modalities, causes of pain were not different in both groups except the educational levels of patients. After an eight-hour educational program given to the experimental nurse group, the knowledge and attitude about assessment of cancer pain, pain medication, and pharmacological knowledge were significantly higher in the experimental group than in the control group, while knowledge about classification of analgesics was not significantly different. The amount of analgesics, measured by the morphine equivalent doses, used in the experimental group was significantly lower than in the control group in the first and the last days. The experimental group used more systematic ways of drug changes from non-narcotic analgesics to narcotic analgesics than the control group. This indicated that the control group used fentanyl patches more commonly than in the control group. Cancer pain scores of both group of patients were measured on an hourly bases for a week in both groups. The patients' pain scores of the first day of measurement in experimental group were not significantly higher than those of control group of patients, while those of the last day were significantly higher than those of the control group. This study supports the need for educational program for the management of cancer pain to the nurses and the doctors.
Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Classification ; Education ; Fentanyl ; Humans ; Morphine ; Narcotics ; Pain Management*

Malignant germ cell tumore occur in children and young women in reproductive age, of all the germ cell maligaanci orily pure dysgerminiomas had a high cure rate prior to 1970. This was due to the exquisite wdioseneitivity of these tumors. Multiple agent chemotherapy has dramatieally improved the pr nosis af patients with malignant ovarian germ cell tumors. The purpose of this study is to report the experience at Aaan Medical Center, department of Obstetrics and Gynecology, in 16 patients withmalignant ovarian germ cell tumors treated between July, l989 and June, l994. We analyzed the effect of age, histolagic subtype, FIGO stage, surgical pmcedurse and regimens of chemotherapy, on the prognosis of thwe tumors. The results obtained were as follows: 1. In histologic subtypes, dysgenninoma(38.0%), endodermal sinus tumor(25.0%), squamous cell carcinoma arising in mature cystic teratoma(19.0%), mixed cell tumor(6.0%), immature teratoma(6.0%), malignant ectodermal tumor in mature cystic teratoma(6.0%), were counted in order. 2. No site predilection was identifed. 3. Main initial symptoms were abdominal distension(31.0%), abdominal pain(31.0%), abdominal mass palpation(25.0%), amenorrhea(6.0%) in order. 4. Multiple tumor markers were considered to be useful in diagnosis and follow up of malignant germ cell tumors of ovary. 5. The mean age of malignant ovarian germ cell tumors was 29.5 years, and 11 cases(69.3%) of tumors under the age of 30.0 years. 6. The survival rate seemed to be decreased with advancing FIGO stage.
Carcinoma, Squamous Cell ; Child ; Diagnosis ; Drug Therapy ; Ectoderm ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Prognosis ; Survival Rate ; Biomarkers, Tumor

We studied the ultrastructural alteration of glomerular anionic sites in 6 patients with minimal change nephrotic syndrome, 5 patients with membranous glomerulonephritis, 4 patients with focal segmental glomerulosclerosis, and 4 patients with IgA nephropathy by staining with polyethyleneimine (PEI) as a cationic probe. The control study was examined by using a nephrectomy specimen of non-glomerular disease which had no proteinuria. This method seems to selectively stain heparan sulphate in the basement membranes and has been widely used to evaluate changes in basement membrane charge in various human diseases as well as in experimental studies. The anionic sites in the lamina rara interna and lamina densa of normal glomerular basement membrane were always less numerous and less regularly distributed than those in the lamina rara externa. Characteristic common findings in these glomeruli showed a marked decrease of glomerular anionic sites in the regions with immune-complex deposits and normal distribution in the regions with focally those being absorbed and newly forming glomerular basement membrane. They were not detected in the gap of the basement membrane and on the area of the detached overlying epithelium using the PEI method. But the foot process fusion of epithelial cells seems not to influence the loss of anionic sites on the glomerular basement membrane.
Basement Membrane ; Epithelial Cells ; Epithelium ; Foot ; Glomerular Basement Membrane* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Nephrectomy ; Nephrosis, Lipoid ; Polyethyleneimine ; Proteinuria

BACKGROUND & OBJECTIVES: The degree and the nature of performance deficit in confrontation naming tasks of patients with dementia of the Alzheimer type (DAT) are multifaceted depending on the stage of illness. Quantative analysis of patients responses may reveal the gradual deterioration of naming ability as the illness exacerbrates. In addition, based on the cognitive model proposed by Ellis and Young (1988), functional components and network involved in naming can be scrutinized for their integrity. The aim of this study is then two fold: first, it is to determine whether thee are quantitative differences in naming performance among the normal control and three DAT groups of different severities. Secondary it is to observe whether there are qualitative differences among the groups and if so, what categories of errors could differentiate one group from the others. METHOD: The DAT patients were trichotomized (CDR 0.5, CDR 1, and CDR 2) according to the severity of the illness based clinical dementia rating (CDR) scale. The Korean version of Boston Naming Test (K BNT) was administered to each DAT group and the normal. The responses were analysed according to six categories and then by detailed subcategories under each of the six categories. RESULTS & CONCLUSION: The results revealed significant mean value differences between the normal and CDR I & 2 groups. The CDR 0.5 group differentiated from the normal group since indefinite response were more evident in the former. Moreover, semantically unrelated errors and no-response errors became predominant as the illness worsens. These findings explicate that qualitative analysis of naming errors may be a valuable tool for us to understand the nature of naming deficits in DAT patients.
Dementia* ; Humans

PURPOSE: To evaluate the imaging findings of endometrial stromal sarcoma (ESS) according to histopathologic grade. MATERIALS AND METHODS: Six patients with pathologically proven ESS were included in this study. The histopathologic diagnosis was low-grade ESS for three patients and high-grade ESS for the three others. Preoperative CT or MR images were evaluated in terms of tumor size, location, growth pattern, the presence of hemorrhage or necrosis, status of the endometrial cavity, and invasion of surrounding structures. The imaging features of ESSs, which varied according to their histopathologic grade, were compared. RESULTS: The mean maximal diameter of low-and high-grade ESSs was 6 cm and 11.2 cm, respectively. All three low-grade ESSs were located mainly in the myometrium, but two high-grade ESSs were situated in the endometrial cavity and associated with focal tumor extension into the myometrium. One high-grade ESS had completely replaced the uterus. Low-grade ESSs were relatively well-defined, but high-grade ESSs had an irregular and lobulated margin. Intratumoral hemorrhage and necrosis were, respectively, found in two and three high-grade ESSs. Widening of the endometrial cavity was noted in all three high-grade ESSs, and lymph node metastasis had occurred in one. CONCLUSION: The imaging findings of ESS vary from a well-defined intramural mass to a bulky infiltrating mass, and depend on their histopathologic grade.
Animals ; Diagnosis ; Female ; Hemorrhage ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mice ; Myometrium ; Necrosis ; Neoplasm Metastasis ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Uterine Neoplasms ; Uterus

OBJECTIVE: The purpose of this study was to determine, when measuring prostate volume by TRUS, whether height is more accurately determined by transaxial or midsagittal scanning. MATERIALS AND METHODS: Sixteen patients who between March 1995 and March 1998 underwent both preoperative TRUS and radical prostatectomy for prostate cancer were included in this study. Using prolate ellipse volume calculation (height x length x width x pi/6), TRUS prostate volume was determined, and was compared with the measured volume of the specimen. RESULTS: Prostate volume measured by TRUS, regardless of whether height was determined transaxially or midsagittally, correlated closely with real specimen volume. When height was measured in one of these planes, a paired t test revealed no significant difference between TRUS prostate volume and real specimen volume (p = .411 and p = .740, respectively), nor were there significant differences between the findings of transaxial and midsagittal scanning (p = .570). A paired sample test, however, indicated that TRUS prostate volumes determined transaxially showed a higher correlation coefficient (0.833) and a lower standard deviation (9.04) than those determined midsagittally (0.714 and 11.48, respectively). CONCLUSION: Prostate volume measured by TRUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, height is more accurately determined by transaxial than by midsagittal scanning.
Human ; Male ; Middle Age ; Prostate/*pathology/*ultrasonography ; Prostatectomy ; Prostatic Neoplasms/pathology/surgery/*ultrasonography

OBJECTIVE: The purpose of this study was to determine, when measuring prostate volume by TRUS, whether height is more accurately determined by transaxial or midsagittal scanning. MATERIALS AND METHODS: Sixteen patients who between March 1995 and March 1998 underwent both preoperative TRUS and radical prostatectomy for prostate cancer were included in this study. Using prolate ellipse volume calculation (height x length x width x pi/6), TRUS prostate volume was determined, and was compared with the measured volume of the specimen. RESULTS: Prostate volume measured by TRUS, regardless of whether height was determined transaxially or midsagittally, correlated closely with real specimen volume. When height was measured in one of these planes, a paired t test revealed no significant difference between TRUS prostate volume and real specimen volume (p = .411 and p = .740, respectively), nor were there significant differences between the findings of transaxial and midsagittal scanning (p = .570). A paired sample test, however, indicated that TRUS prostate volumes determined transaxially showed a higher correlation coefficient (0.833) and a lower standard deviation (9.04) than those determined midsagittally (0.714 and 11.48, respectively). CONCLUSION: Prostate volume measured by TRUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, height is more accurately determined by transaxial than by midsagittal scanning.
Human ; Male ; Middle Age ; Prostate/*pathology/*ultrasonography ; Prostatectomy ; Prostatic Neoplasms/pathology/surgery/*ultrasonography

Supraaortic stenosis is a localized or diffuse congenital narrowing of the ascending aorta at the levels of superior margin of the sinus of Valsalva, just above coronary arteries. Hemodynamically, it is a usually manifestated as aortic stenosis especially when it combined with subaortic membrane. And there is no case report of supraaortic stenosis combined with subaortic membrane which has aortic valvular reurgitation due to secondary change of dilated sinus of Valsalva by supraaortic ridge. We have experienced a case of aortic regurgitation associated with supraaortic ridge combined with subvalvular aortic membrane.
Aorta ; Aortic Valve Insufficiency* ; Aortic Valve Stenosis ; Constriction, Pathologic ; Coronary Vessels ; Membranes* ; Sinus of Valsalva

PURPOSE: Intramedullary spinal lesions in the conus medullaris (CM), including tumors and vascular lesion, are rarely reported. We reported various MR features of intramedullary spinal cord lesions involving the CM including ependymoma, hemangioblastomas, dermoid cyst, ventriculus terminalis and spinal AVF and tried to discuss them for differential diagnosis. MATERIALS AND METHODS: Six patients (male: female = 4:2, mean age = 44.3 year old) were enrolled from the clinical database of our institute from 2004 to 2010 and their radiological images and clinical symptoms were reviewed retrospectively. All patients had taken initial and postoperative MRI with contrast enhancement using gadopentate dimeglumine (Gd-DTPA). These images were analyzed by tumor size, location, signal intensity relative to the spinal cord, vascular flow voids, syrinx or cyst, edema and enhancement pattern. RESULTS: Contrast enhancement was seen in all intramedullary masses. An eccentric enhancing nodule was noted in two hemangioblastomas and unusual peripheral rim enhancement with septation was seen in ventriculus terminalis. Patchy enhancement of the CM was observed in spinal arteriovenous fistula (AVF). Extensive cord edema adjacent to the intramedullary lesions was seen in four cases and syrinx was noted in three cases. Vascular signal voids were found in two hemangioblastomas and one spinal AVF. CONCLUSION: In evaluation of intramedullary spinal lesions in the CM, it is necessary to consider these unusual MR findings and discriminate various pathologies with prudence and caution.
Arteriovenous Fistula ; Conus Snail* ; Dermoid Cyst ; Diagnosis, Differential* ; Edema ; Ependymoma ; Female ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging* ; Pathology ; Retrospective Studies ; Spinal Cord

Burn in neonates have been reported following the use of pulse oximeters, phototherapy blanket, infrared heating lamp, laryngoscope, and warming bottle. This case reports a newborn who had major burn injuries of 45% total body surface area (TBSA) including 3rd degree burns of 20% TBSA on her back, buttocks, both thighs and heels by exposure to an electrical heating pad for 3 hours. She developed significant systemic response, showing disseminated intravascular coagulation, electrical imbalance, jaundice, hypoalbuminemia, acute renal failure, and persistent pulmonary hypertension of the newborn. The potential hazard of the electric heating pad is reported in order to alert clinicians to this specific risk, to stimulate concern about other similar problems with materials in contact with skin, and to prevent burn of newborns in the neonate unit.
Acute Kidney Injury ; Body Surface Area ; Burns ; Buttocks ; Disseminated Intravascular Coagulation ; Heating ; Heel ; Hot Temperature ; Humans ; Hypertension, Pulmonary ; Hypoalbuminemia ; Infant, Newborn ; Jaundice ; Laryngoscopes ; Phototherapy ; Skin ; Thigh