Tumors of umbilical cord, especially angiomyxoma, are extremely rare lesions. To our knowledge, five cases of angiomyxoma have been reported previously in the umbilical cord. Sonography two weeks after the finding of an elevated serum alpha-fetoprotein, detected a mass of the umbilical cord in a 27-year-old multiparous woman at 18(+3) weeks gestation. Previous sonogram was normal (11 weeks gestational age). At 26 weeks, a premature female infant was delivered by induction and a mass was located in the region of placental insertion of the cord. Section through the mass revealed rubbery myxoid appearance. Microcopically, numerous small vascular channels with thin walls were embedded in loose myxoid matrix. A case of angiomyxoma of umbilical cord with elevation of serum alpha-fetoprotein is presented together with a review of the literature. We hope that this case will help define the natural history of primary angiomyxoma of umbilical cord.
Infant ; Male ; Female ; Humans

PURPOSE: Objective measurements of knee of flexor and extensor strength using isokinetic equipment and function after total knee arthroplasty (TKA) were evaluated until postoperative 12 months. MATERIALS AND METHODS: The control group constituted of 15 persons who were of same age and weight without knee problems. Most of the patients (70%) were operated on both knees simultaneously. The patient group consisted of constituted with 20 patients (34 cases). Isokinetic testing (Cybex) of knee flexor and extensor strength of knee and functional evaluation by HSS score was performed preoperatively and at 3, 6, 12 months postoperatively. RESULTS: The peak torque of the knee extensor and flexor muscle in the patient group was decreased by 17-41% compared to the control group. Especially, the peak torque of extensor was more decreased than flexor muscles. At postoperative 12 months, the peak-torque values of hamstring and quadriceps were able to attain the same strength levels of the preoperative knee. According to the grade of the Hospital for Special Surgery knee rating scales by Insall, 28 cases (82 %) in the patient group could obtain good result at postoperative one year. CONCLUSIONS: Exercises to increase the strength of extensor should be emphasized in the rehabilitation programs after TKA
Arthroplasty* ; Exercise ; Humans ; Knee* ; Muscle Strength* ; Muscles ; Rehabilitation ; Torque ; Weights and Measures

The major presenting manifestations of systemic lupus erythematosus (SLE) in Korea are known to be cutaneous manifestations, arthritis, nephritis, and fever. The ascites due to peritoneal involvement in SLE is quite common. However, it is unusual for massive ascites to be major presenting manifestations of SLE. In this report, we describe a case of SLE patient whose disease manifested as intractable ascites. This illustrates an unusual presentation and natural history of a complex autoimmune disease.
Arthritis ; Ascites* ; Autoimmune Diseases ; Fever ; Humans ; Korea ; Lupus Erythematosus, Systemic* ; Natural History ; Nephritis

OBJECTIVES: The purpose of this study is to examine the moderating effect of social supports on the relationship between grief level and suicidal ideation of the elderly living alone. METHODS: We analyzed data from a questionnaire administered to subjects aged 65 years or older living alone for a 2017 community mental health project in Gyeongnam S city. To investigate the moderating effects of variables, we conducted a hierarchial regression analysis and confirmed the change R2. RESULTS: When adjusted for education and economic level, grief level had not a direct impact on suicidal ideation. And it was found that interdependent social support was moderating variables in the relationship of grief level and suicidal ideation of the elderly living alone. CONCLUSIONS: There is a need for appropriate programs that reduce suicidal ideation and therefore suicidal action. Moreover, it is especially necessary to enhance interdependent social supports.
Aged* ; Education ; Grief* ; Humans ; Mental Health ; Suicidal Ideation*

If hypertensive emergencies are left untreated, multiple damages on heart, brain and kindney can develop. So rapid control of blood pressure within safty with effective antihypertensive agents is mandatory. For the comparison of antihypertensive effects among hydralazine (IV or IM), clonidine (IV), and nifedipine (sublingual) in hypertensive emergency, which were frequently used in our hospital, we performed propective study with hypertensive emergency patients(243 cases) who visited emergency room from Oct. 1986 until Aug. 1987. The results are as follows ; 1) For 58 patients who recieved hydralazine (IV or IM), initial mean arterial blood pressure(MAP) was 167.2+/-21.5mmHg and 15 minutes later 138.9+/-24.4mmHg, 45 minutes later 141.7+/-21.1mmHg, 90 minutes later, 133.9+/-26.6mmHg and, respectively. For 55patients who recived clonidine(IV), initial MAP was 164+/-21.9mmHg and 15minytes later 137.4+/-18.9mmHg, 45 minutes later 127.5+/-34.9mmHg, respectively. For 130 patients who recived nifedipine(sublingual), initial MAP was 159.8+/-21.4mmHg and 15 minutes later 143.0+/-22.8mmHg, 45 minutes later 127.5+/-21.1mmHg, 90 minutes later 119.3+/-20.0mmHg, respectibely. 2) Pulse rate showed 12.9% increase afer administration of hydralazine, 15.8% decrease in clonidine, 5.6% increase in nifedipine, respectively. 3)Severe reduction of blood pressure(systolic BP<130mmHG) after administration of following antihypertensive agents was found. i.e., hydralazine 5.2%, clonidine 1.8%, nifedipine 1.5%, respectively. 4) In 4 cases(6.9%) out of the 58 cases using hydralazine, 3 cases(5.5%) out of the 55 cases using clonidine, 9 cases(6.9%) out of the 130 cases using nifedipine, acute paradoxic hyertensive effects were observed.
Antihypertensive Agents ; Blood Pressure ; Brain ; Clonidine* ; Emergencies* ; Emergency Service, Hospital ; Heart ; Heart Rate ; Humans ; Hydralazine* ; Nifedipine*

OBJECTIVE: Our purpose was to establish whether FHR recording tape and telemetry system at home interpreted by remote telemedicine link is comparable to interpretation at hospital in a high-risk patient population. Patients and METHODS: Twenty women whose pregnancy was suspected as high risk were entered to study. All pregnancies were at term(7 at 38th weeks, 7 at 39th weeks, 6 at 40th weeks). Remote FHR monitoring at hospital was made for consecutive 6 days, using FHR-telemetry system at home which already developed and used by authors from 1991. Patients recorded FHR sound using recording tape for 5 days. On the 5th day, real-time transmitting of FHR sound to the hospital was also done via telephone lines after recording of FHR sound. On the 6th day, FHR test(NST) was performed at hospital. The signal loss(%), baseline FHR(bpm), and FHR variability were compared using computerized FHR analysis system(HYFM-I) after re-play of 5-days recording tapes at hospital with real-time transmitting data and in-hospital FHR test results. RESULTS: The signal loss was highest with real-time transmiting data when comparing with in-hospital FHR analysis. No significant differences were observed among 5-days data of FHR recording tapes. CONCLUSIONS: Frequent antenatal visit of high-risk pregnancy patients were in diHuities of their pregnancy outcomes. And many rural areas of our country are without adequate access to basic maternity services. From this point of view, a fetal telemedicine service is needed, and in fact, technically and clinically feasible. Our demonstration suggests that such a service reduces the need for hospital visit of high risk pregnancy women. Further evaluation in a variety of clinical settings is now indicated, along with cost-benefit analysis.
Cost-Benefit Analysis ; Female ; Fetal Heart* ; Heart Rate, Fetal* ; Humans ; Pregnancy ; Pregnancy Outcome ; Pregnancy* ; Pregnancy, High-Risk ; Telemedicine ; Telemetry ; Telephone

PURPOSE: The present study reviewed the surgical outcomes of conjunctival flap advancement with pterygial tissue excision in primary and recurrent pterygium. METHODS: In a retrospective survey of 169 eyes of 169 patients who underwent pterygial tissue excision and conjunctival flap advancement surgery, after a three-month follow-up minimum, history of pterygium surgery, surgical outcomes, recurrence rates, and complications were evaluated. RESULTS: The study included 74 male and 95 female patients. The mean age was 56 +/- 11.93 years (range: 31-81 years). One hundred and forty eyes were considered as primary pterygium without history of surgery and 29 eyes were considered as recurrent pterygium. In the cases of primary pterygium, 139 eyes were treated after the surgery without recurrence (success rate: 99.2%) and one recurred case was localized to the sclera. Among the 29 eyes with recurrent pterygium, 26 eyes were treated without recurrence (success rate: 89.7%) and 3 recurred cases were localized to the sclera. There were no significant complications related to the surgical procedures. CONCLUSIONS: Conjunctival flap advancement surgery with pterygial tissue excision was an effective method in primary and recurrent pterygium treatment and showed low recurrence and minimal complications.
Eye ; Female ; Follow-Up Studies ; Humans ; Male ; Pterygium ; Recurrence ; Retrospective Studies ; Sclera

From the young neurosurgeon's standpoint, the authors analyzed eighty patients of spontaneous subarachnoid hemorrhage who were admitted to the department of neurosurgery in Taejeon Eulji General hospital from May 1989 to Jan. 1992. The results of analysis were as follow: 1) Of 80 total cases, sixty six were managed from beginning to end, and forty two were operated on for neck clipping. The most common cause of SAH was aneurismal rupture(70%), and the idiopathic comprised 30%. The male versus female ratio was 1:1.7, and the most frequently involved decade was the 7th. 2) Fifty six of total aneurismal cases turned out to be ruptured prior to admission. Common locations of aneurysms were A-com., P-com., and M.C.A. in order of descending frequency. Mirror aneurysms were 4%, and the multiple, 21%. The smallest size of aneurysm that had already ruptured was 3mm in its largest diameter of sac. The giant cases were 2(4%). 3) The most common chief complaint was headache(62.5%), and the most common symptom and/or sign was vomiting(90%). The hypertension accompanied in 29% and the most common neurological sign was nuchal rigidity(71%). 4) The brain CT was performed with the frequency of 1.44 per patient, and it detected SAH in 86%, The most frequently obliterated cistern was basal cistern. In 11 cases(14%), there were no evidence of SAH at all. Contrastingly in 12 cases(15%), aneurismal sacs were directly visualized in post-contrast films. 5) The angiographic study was performed in 59 cases(74%) to detect abnormality in 54 cases all of which turned out to be aneurysms. The mean size of detected 69 sacs was 7.7mm in diameter, and of 26 cases(44%) of normal variation, hypoplasia was the most frequent type. It occurred most frequently at right A1 portion. 6) Of 66 patients who were managed from start to finish, the mortality was 43%, and that of 46 operated cases, 21%. The best operative results were harvested in delayed operation group, the next in intermediate one, and the worst in early one.
Aneurysm ; Brain ; Daejeon ; Female ; Hospitals, General ; Humans ; Hypertension ; Male ; Mortality ; Neck ; Neurosurgery ; Subarachnoid Hemorrhage

PURPOSE:We investigated the production of oxygen hydroxyl radicals in the striatum of neonatal rat brain after intrastriatal injection of dopamine (DA) and the effect of growth hormone (GH) on the apoptosis of striatal neurons injured by hypoxia-ischemia. METHODS:The extracellular striatal levels of 2,3-dihydroxybenzoic acid (DHBA) and 2,5-DHBA as indicators of hydroxyl radical(OH-) production were measured by in vivo microdialysis in the striatums of 7 day-old newborn rats (n=10) after direct intrastriatal infusion of dopamine hydrochloride (1.0 micromol/microL). The samples of perfused artificial cerebrospinal fluid (CSF) were collected every 10 minutes interval. The levels of DA, 2,3-DHBA and 2,5-DHBA of CSF were analysed by HPLC (high performance liquid chromatography). Also, the brains were removed at 24 hour after hypoxic-ischemic injury by Rice-Vannucci method. The coronal sections (12 micrometer) of paraffin-fixed brains were stained by TUNEL (terminal transferase-mediated dUTP nick-end-labelling) technique, and the neuronal cells undergoing apoptosis in the striatum were observed by fluorescent microscopy and compared between GH-treated (50 mg/kg, Dong-Ah Pharmacy Co.) and saline-treated rats. RESULTS:The extracellualr striatal levels of 2,3-DHBA and 2,5-DHBA increased abruptly in the first 10 minutes samples after intrastriatal injection of DA. After then, the levels declined slowely. The levels of striatal extracelluar 2.3-DHBA increased up to 621.8+/-508.7% of basal levels (P<0.05), and the levels of 2.5-DHBA increased up to 262.8+/-198.1% of basal levels (P<0.05). GH reduced markedly the number of apoptotic neuronal cells in the striatum after hypoxic-ischemic brain injury. CONCLUSION: The level of hydroxyl radicals increased abruptly after intrastriatal injection of DA and GH reduced markedly the number of apoptotic neuronal cells in the striatum after hypoxic-ischemic brain injury.
Animals ; Apoptosis* ; Brain Injuries ; Brain* ; Cerebrospinal Fluid ; Chromatography, High Pressure Liquid ; Dopamine* ; Growth Hormone* ; Humans ; Hydroxyl Radical* ; In Situ Nick-End Labeling ; Infant, Newborn* ; Microdialysis ; Microscopy ; Neurons* ; Oxygen ; Pharmacy ; Rats*

Chromosomal abnormalities, which are valuable markers for diagnosis and prognosis of cancer, provide useful clues in characterizing cancer at molecular level. Gastric cancer is the major cause of cancer deaths in Asian countries, including Korea. Genetic changes during the progression and metastasis of gastric cancer remain unclear. Recently, technique of degenerate oligonucleotide primed (DOP) PCR-comparative genomic hybridization (CGH) permits genetic imbalances screening of the entire genome using only small amounts of tumor DNA. In non-metastatic gastric cancers the common sites of copy number increases were detected at 8q (64%), 4p12-q24 (64%), 5p13-q23 (64%), 13q21-q32 (64%), 6q11-q21 (55%), 7q(50%), 14q11.2-q21 (45%), 3q11-q13.3 (41%), and 2q23-q32 (41%). In metastatic gastric cancers, the frequent sites of gains were detected at 8p21-qter (60%), 5 (54%), 20 (42%), 6pter-q24 (51%), 1q21-qter (46%), 3p14-qter (46%), 22q (46%), and 4 (43%). Deletion or chromosomal loss was found to be less frequent in this study. The frequent sites of copy number decreases were detected at 1p34-pter (23%), 16q23-q24 (18%), and 19q13 (18%) in non-metastatic gastric cancers. In metastatic gastric cancers, chromosome losses were detected at X (37%), 1p33-pter (37%), and 16p (23%). The recurrent gains and losses of chromosomal regions identified in this study provide candidate regions that may contain oncogenes or tumor suppressor genes respectively involved in the tumorigenesis of gastric cancer.
Asian Continental Ancestry Group ; Carcinogenesis ; Chromosome Aberrations ; Comparative Genomic Hybridization* ; Diagnosis ; DNA ; Genes, Tumor Suppressor ; Genome ; Humans ; Korea ; Mass Screening ; Neoplasm Metastasis ; Nucleic Acid Hybridization ; Oncogenes ; Prognosis ; Stomach Neoplasms