No abstract available.
Diagnosis*

The central venous catheter(Quinton) was replaced in the right atrium for chemotherapy and blood sampling to a eight-year old girl with acute lymphoblastic leukemia. The catheter was flushed with heparin two times daily and the chemotherapeutic drug regimens by CCSG-105 protocol were vincristine, prednisone, L-asparaginase, daunomycin, methotrexate, cyclophosphamide, cytosine arabinoside, 6-mercaptopurine and adriamycin. On day 31 of catheterization, the lumen for blood sampling was blocked. From day 60 of catheterization, anorexia, nausea, vomiting, abdominal distension and tachypnea were developed. Echocardiogram, lung scan, pulmonary function test(PFT), arterial blood gas analysis (ABGA) were done. Two cemtimeters in diameter of thrombosis was found in the right atrium on echocardiogram. The lung scan showed slight decrease in uptake of Tc-99m on the whole lung fields. Restrictive ventratory impairment on PFT and decreased PaO2(48 mmHg) on ABGA were found. To lysis of thromboembolism, urokinase(4,400 IU/kg for initial 10 minutes and the 4,400 IU/kg for 12 hours) was injected intravenously and aspirin(30 mg/kg/d, po) was given. The thrombosis was disappeared from the atrium on echocardiogram and PaO2 was increased up to 97 mmHg temporary. The catheter was removed but total haziness on the right middle and lower lobes were developed after 5 days. The same dose of urokinase was injected just infront of the embolism through Pitfall catheter for 8 days intermittently as results of pulmonary angiography. Symptoms and PaO2 were alleviated and the lung was expanded with mild atelectasis on day 55 of the first fibrinolytic enzyme therapy. Although the frequent complications of central venous catheter are catheter occlusion and infection, we have to check the development of thromboembolism with echocardiogram periodically or in case of unexplained respiratory symptoms.
6-Mercaptopurine ; Angiography ; Anorexia ; Blood Gas Analysis ; Catheterization ; Catheters ; Central Venous Catheters* ; Cyclophosphamide ; Cytarabine ; Daunorubicin ; Doxorubicin ; Drug Therapy ; Embolism ; Enzyme Therapy ; Female ; Heart Atria ; Heparin ; Humans ; Lung ; Methotrexate ; Nausea ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prednisone ; Pulmonary Atelectasis ; Tachypnea ; Thromboembolism* ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Vincristine ; Vomiting

The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.
Female ; Humans ; Military Personnel ; Public Health ; Schools, Medical

PURPOSE: To describe the sonographic features of angioleiomyoma arising from superficial soft tissue. MATERIALS AND METHODS: A retrospective study of the sonographic findings of 11 pathologically proven angioleiomyomas was performed. We evaluated the location, layer, size, shape, margin, echotexture, echogenicity, internal content, presence of calcification, and relationship to adjacent structures on gray scale sonography. We evaluated the presence, degree, and distribution pattern of vascularity within the mass on color Doppler sonography. RESULTS: All tumors were located in the subcutaneous layers of the extremities (5 in hand, 2 in elbow, 2 in knee, 1 in foot, 1 in calf). The sizes ranged from 8 to 30 mm, with an average size of 15.5 mm. All lesions were relatively homogeneous and hypoechoic, with well-defined margins and oval to round shape. There were no intratumoral calcifications or cystic portions in any of the masses. Vascularity was not detected in any patient (type 1), but was easily detected in 10 other patients. The degree of vascularity was mild (type 2) in 1 patient, moderate (type 3) in 4, and abundant (type 4) in 5. CONCLUSION: Although angioleiomyoma is an uncommon entity, our study suggests that it must be included in the differential diagnosis of well-defined, hypoechoic, vascular subcutaneous tumors in the extremities.
Angiomyoma ; Diagnosis, Differential ; Elbow ; Extremities ; Foot ; Hand ; Humans ; Knee ; Retrospective Studies

No abstract available.
Gastrostomy*

No abstract available.
Granuloma, Lethal Midline*

OBJECTIVE: The purposes of the present study were to investigate the effect of gamma-radiation on the expression of inhibin-alpha proteins and genes for inhibin alpha, betaA, and betain the ovary. METHODS: Immature mice were whole-body gamma-irradiated with 25% of a lethal dose. At time 0, 3, 6, 12, and 24 hours after the irradiation,the ovaries were collected and used for immunohistochemistry for inhibin-alpha, and RT_PCR for inhibin-alpha, betaA, and betaB. RESULTS: The expression of the immunoreactive inhibins-alpha was maintained at 12 hours post-irradiation and reduced thereafter. The expression of inhibin-alpha mRNA was significantly increased with the time after the irradiation. However there were no significant changes in the expression of betaA and betaB mRNAs. CONCLUSION: It might be thought that inhibin acts as one of the regulatory factors in the gamma-radiation-induced follicular atresia in mice
Animals ; Female ; Follicular Atresia ; Immunohistochemistry ; Inhibins* ; Mice* ; Ovary* ; RNA, Messenger

PURPOSES: Transurethral resection of the prostate (TURP) for symptomatic benign prostate hyperplasia (BPH) remains a gold standard for surgical treatment, but significant morbidities are associated with the procedure. Transurethral electro-vaporization of prostate (TVP) using a grooved ball electrode, a modification of standard TURP, was tried on bladder outlet obstruction in an attempt to reduce the morbidity rate of TURP. We compared between the TVP and standard TURP to estimate the efficacy and safety. MATERIALS AND METHODS: A comparative trial of 44 patients with symptomatic BPH from May 1995 to December 1995 was performed. Of the patients 20 were received operation with TVP (Group I) and 24 were received with standard TURP (Group II). Patients were assessed at baseline for both safety and efficacy and in follow-up at 1 and 3 months. Efficacy parameters evaluated included American Urological Association (AUA) symptom score, peak urine flow (Qmax) and postvoid residual urine (ml). Safety parameters evaluated included incidence of side effects, operative time (in minutes), postoperative catheterization time, change in hematocrit and serum sodium. RESULTS: The mean age of each group was 63.7+-6.4 years (Group I) and 68.8+-7.6 years (Group II), the prostate size was 32.4+-3.4g and 34.5+-6.5g. The mean operation time was shorter in Group I (56+-11min) than Group II (85+-34min), (P<0.05). The change of Hematocrit(ml/dl) was lower in group I (from 41.1+-5.0 to 39.5+-4.2) than group II (from 39.6+-4.4 to 35.2+-5.5), (P<0.05). The mean catheterization time was 3.3+-1.3 days and 4.8+-1.7 days, (P<0.05). change of maximal flow rate, post-void residual volume and AUA symptom score was not significantly different between each group. The incidence of postoperative complications were not significantly different between each group. CONCLUSIONS: Although the TURP is the gold standard for the treatment of symptomatic BPH with high success rate, but significant morbidities rate are associated with this procedure. So, TVP is new and potentially useful modification of TURP. In this preliminary study, there has been significant clinical improvement maintained with minimal morbidity. This early clinical experience highlights several potential advantages of TVP, including rapid convalescence time, short hospital day, and minimal blood loss. So, TVP is one of the various therapeutic alternatives for BPH lowering the morbidity rate of standard TURP.
Catheterization ; Catheters ; Convalescence ; Electrodes ; Follow-Up Studies ; Hematocrit ; Humans ; Hyperplasia ; Incidence ; Operative Time ; Postoperative Complications ; Prostate* ; Residual Volume ; Sodium ; Transurethral Resection of Prostate ; Urinary Bladder Neck Obstruction

Iridocorneal endothelial syndrome is a disease characterized by corneal endothelial degeneration, corneal edema, peripheral anterior synechia, iris stromal change, and secondary glaucoma. This syndrome is considered to have three major variations: Chandler's syndrome, progressive (essential) iris atrophy, and Cogan-Reese syndrome. We experienced three cases of iridocorneal endothelial syndrome with transient intraocular pressure elevation.

OBJECTIVES: This study was carried out to evaluate the effects of industrial noise on blood pressure and heart rate. METHODS: Resting blood pressure, hearing loss, and general characteristics of the 102 subjects who were engaged in a factory in Pusan were measured from March to June for two years, in 1998 and 1999. With noise dosimeter, noise exposure level was measured from 8 A.M. to 4 P.M. Ambulatory blood pressure and heart rate were also measured every 30 minutes from 8 A.M. to 10 P. M. RESULTS: Controlling for age, smoking, and Quetelet's index, in subjects of under 40 years old exposed to higher than 85dBA, noise exposure and systolic blood pressure had a statistically significant correlation, and the same result was obtained in all subjects. The daily variability of ambulatory blood pressure and heart rate were observed in older than 40 years old group, but only heart rate in under 40 years old. CONCLUSIONS: The blood pressure and heart rate would be elevated when the workers exposed to noise. And in under 40 years old, the systolic blood pressure was elevated to the workers exposed to higher than 85dBA.
Adult ; Blood Pressure* ; Body Mass Index ; Busan ; Hearing Loss ; Heart Rate* ; Heart* ; Humans ; Noise* ; Smoke ; Smoking