No abstract available.
Chondrosarcoma*

The multiple lentigines syndrome or LEOPARD syndrome is an autosomal dominantly inherited disorder with a variety of abnormalities and a familial occurrence. This syndrome is characterized by the presence of numerous dark brown macules on the skin but not the mucous surface, and by a marked increase in the number of lentigines from birth to puberty. The eponym LEOPARD stands for lentigines, EKG abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of the genitalia, retardation of growth and deafness. We report a case of multiple lentigines syndrome in 7-year-old boy. He had numerous pinhead to pea sized, dark brownish macules scattered on the entire body and also had pulmonary stenosis, EKG abnormality, ocular hypertelorism and right exotropia. Interestingly, he also had a labial melanotic macule on the lower lip, which is usually spared in the multiple lentigines syndrome. Histologically, the biopsy specimen taken from the macule revealed an elongation of rete ridges, an increase of melanin pigments in the basal layer and mild inflammatory infiltrates intermingled with the melanophages in the upper dermis.
Adolescent ; Biopsy ; Child ; Deafness ; Dermis ; Electrocardiography ; Eponyms ; Exotropia ; Genitalia ; Humans ; Hypertelorism ; Lentigo ; LEOPARD Syndrome* ; Lip ; Male ; Melanins ; Panthera ; Parturition ; Peas ; Puberty ; Pulmonary Valve Stenosis ; Skin

An accurate and relatively simple method for estimating the amount of acute blood loss is essential in the hemorrhagic shock patients. Conventional physiologic parameters, blood pressure, pulse rate and CVP, could not serve for evaluation of the adequate oxygen transport in the tissue. Pulmonary artery catheter is a best tool for evaluating the cardiopulmonary function and the oxygen transport system, and mixed venous oxygen saturation(SvO2) monitoring have made a great advances for early detection of cardiovascular dysfunction and the changes in peripheral tissue oxygenation. But pulmonary artery catheterization is complicated procedure in emergency setting. Although the central venous oxygen saturation(ScvO2) cannot completely replace the SvO2 value, it has a close relation with SvO2 change in variable clinical situations. We testify the usefulness of ScvO2 monitoring in 24 patients of the hemorrhagic shock. Initial resuscitation was performed with ATLS standard and continuous ScvO2 was monitored. Systolic blood pressure and pulse rate were recorded for one hour from initial resuscitation in each 15 minutes. Nineteen patient was traumatic hemorrhagic shock and five was non traumatic. Twelve of 19 patients was blunt trauma, and remains were stab in injury mechanism. Mortality rate was 29.2%. Initial ScvO2 of nonsurvivor was 43.6%, and 51.3% in survivor groups(p>0.05). In the group of stab wound and non-traumatic hemorrhage, the ScvO2 was gradually increase by time. But ScvO2 in survivors of blunt trauma was increased first 30 minutes and decrease afterthen. Continuous monitoring of ScvO2 may by partly useful in resuscitation for hemorrhagic shock. It is more valuable in the blunt trauma than in the penetrating injury or non-traumatic hemorrhage.
Blood Pressure ; Catheterization, Swan-Ganz ; Catheters ; Emergencies ; Heart Rate ; Hemorrhage ; Humans ; Mortality ; Oxygen* ; Pulmonary Artery ; Resuscitation ; Shock, Hemorrhagic* ; Survivors ; Wounds, Stab

Thelazia callipaeda, parasitic in the eye of 24 years old Korean male, was extracted from the left eye of the patient in Seoul, Korea. We confirmed that as T. callipeada morphologically, based on the descriptions of Hsu and other literature. We presents the 7th human thelaziasis case in Korea with the historical review of the literature.
parasitology-helminth-nematoda ; Thelazia callipaeda ; thelaziasis ; case report

BACKGROUND: Laryngomicrosurgery has some special characteristics. It is stressful due to intubation and direct laryngoscopy during a short operation time. Therefore both adequate anesthesia and quick recovery for the slience therapy after the operation are needed. This study compared the cardiovascular responses and recovery pattern between propofol and Thiopental-Enflurane anesthesia. METHODS: Sixty outpatients of ASA class 1 or 2 for microlaryngoscopy were randomly assigned to receive either anesthesia with propofol (Group P, n = 30) and thiopental-enflurane (Group E, n = 30). Group P was induced with propofol 2 mg/kg and succinylcholine 1 mg/kg and maintained with vecuronium 0.04 mg/kg, propofol 10 - 6 mg/kg/h, and N2:O2/3 L/min:2 L/min. Group E was induced with thiopental 5 mg/kg and succinylcholine 1 mg/kg and maintained with vecuronium 0.04 mg/kg, enflurane 1 3 vol%, and N2O:O2/3 L/min:2 L/min. Ketorolac (30 mg) and hydrocortisone (100 mg) were added for postoperative pain in both groups. The changes in blood pressure and heart rate, pre and post induction, were compared in both groups. In addition, we compared energence time and the state of recovery (Steward's score) 5 minutes and 15 minutes after extubation and the frequencies of other complications. RESULTS: No significant differences in age, wt, sex and anesthesia time of the two groups were observed. Mean arterial pressures were significantly different after anesthesia and after intubation between the two groups. However the heart rates were not different among the groups. The extubation time was significantly shorter in Group P. The recovery score at 5 min and 15 min after extubation was significantly higher in Group P. CONCLUSIONS: We conclude that propofol with nitrous oxide may be useful in laryngeal microsurgery, especially, when silence therapy is needed.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Enflurane ; Heart Rate ; Humans ; Hydrocortisone ; Intubation ; Ketorolac ; Laryngoscopy ; Microsurgery ; Nitrous Oxide ; Outpatients ; Pain, Postoperative ; Propofol* ; Succinylcholine ; Thiopental ; Vecuronium Bromide

PURPOSE: This study was undertaken to evaluate the treatment outcome and side effects of accelerated radiotherapy (RT) using concomitant boost for stage III non-small cell lung cancer (NSCLC). METHODS: Between April 1991 and December 1994, 102 patients with stage III NSCLC who had the favorable prognostic factors by CALGB criteria, were treated with concomitant boost radiotherapy. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment was administered concomitantly during the last 2 weeks with a dose of 13 Gy in 10 fractions. The interfraction interval was at least 6 hours. The total tumor dose was 66-70 Gy, given over 6 weeks. RESULTS: With 30 months median follow-up period for survivors, median survival was 15 months with 2 and 3-year overall survival rates of 34% and 19%, respectively. Thirty patients (29%) who had achieved complete remission after RT showed significantly better 2-year survival rates than those without complete remission (58% vs 22%, p 0.001). Local failure and distant metastases as the first or only failure occurred in 40 (44%) and 13 (14%), respectively, and ultimate local and distant failure rates were 45% and 29%, respectively. Although Grade IV esophageal complication of T-E fistula was observed in one patient, most patients with pulmonary complication showed mild, transient radiation pneumonitis. CONCLUSION: This result suggests that the treatrnent of stage III NSCLC with concomitant boost RT may improve survival rates without enhanced radiation induced toxicity compared with conventional RT. Further investigation of dose escalation by conformal radiotherapy of combining chemotherapy and accelerated RT is warranted.
Carcinoma, Non-Small-Cell Lung ; Drug Therapy ; Fistula ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiation Pneumonitis ; Radiotherapy* ; Radiotherapy, Conformal ; Small Cell Lung Carcinoma* ; Survival Rate ; Survivors ; Treatment Outcome

OBJECTIVE: We developed a Cocoon framework-based device independent electrocardiogram(ECG) Reporting System in order to support such various web devices as desktop Personal Computer(PC), Personal Digital Assistants(PDA) and SmartPhone. METHODS: ECG Reporting System, built in the Cocoon framework, consists of modules of ECG Report Module and ECG Image Module. Two modules publish the applied ECG Report to each different templates according to the requesting device. The method of framework-based development in this paper features a reduction of development costs and the robust stability of system. RESULTS: The medical staff may require patient ECG information in ubiquitous healthcare environment, ECG Reporting System supports their correct judgment and expeditious response by servicing ECG report of the patient according to the requesting device. CONCLUSION: The proposed system and concept in this paper may be a good solution for developing the point of care service system supporting various mobile devices.
Delivery of Health Care ; Electrocardiography* ; Humans ; Judgment ; Medical Staff ; Smartphone

To study the clinical characteristics and treatment results of childhood soft tissue sarcoma, the retrospective study was performed on 67 patients with soft tissue sarcoma, experienced at the Department of Pediatrics, Seoul National University Hospital from January, 1982 to July, 1990. The median age of 67 soft tissue sarcoma patients was 4 years 5 months and age distribution showed that 0-4 year age group was most common (55.2%). The sex ratio of male to female was 1.2:1. There were 3 cancers among relatives of soft tissue sarcoma patients, including one cancer among first-degree relatives. As for pathological classification, rhabdomyosarcoma (67.1%) was the most common childhood soft tissue sarcoma, followed by malignant Schwannoma (8.9%), extraskeletal Ewing's sarcoma (6.0%), infantile fibrosarcoma (4.5%), malignant fibrous histiocytoma (3.0%), malignant hemangiopericytoma (3.0%), and there were 1 case each of angiosarcoma, leiomyosarcoma, synovial sarcoma, malignant mesenchymoma and mesenchymal chondrosarcoma. The median age of 45 rhabdomyosarcoma patients was 3 years 8 months and age distribution showed that 0-4 year age group was most common (64.5%). Twenty three patients were male and 22 were female. The histologic subtype of rhabdomyosarcoma was embryonal type in 38 patients (84.5%), alveolar type in 5 patients (11.1%) and unclassified type in 2 patients (4.4%). As for primary site of soft tissue sarcomas, the most frequent site was the head and neck region (32.8%) including parameningeal region (13.4%) and orbit (6.0%), followed by extremities (20.9%), trunk (19.4%), retroperitoneum and pelvis (11.9%), urogenital region (7.5%), perineum and perianal region (4.5%) and other region (3.0%). As for primary site of 45 rhabdomyosarcoma cases, the most frequent site was also the head and neck region (37.8%). The most common initial symptom of soft tissue sarcoma patients was mass (68.7%). As for Intergroup Rhabdomyosarcoma Study clinical grouping system of 67 soft tissue sarcoma patients, clinical group III (58.2%) was most common, followed by clinical group II(20.9%), IV (14.9%) and I (6.0%). Of 10 cases of clinical group IV with distant metastasis, lung (8 cases) was the most common metastaic region and other metastatic regions were bone, kidney, liver and bone marrow. As for IRS clinical grouping system of 45 rhabdomyosarcoma patients, clinical group III was most common (68.9%). Of 6 cases of clinical group IV, lung (5 cases) was also the most common metastatic region, followed by kidney and liver. From 1982 to 1985, chemotherapy was done with pulse VAC or pulse VAdrC-VAC regimen based on IRS-I and IRS-II. From 1986, patients in clinical group I and II received vincristine and actinomycin-D for 1 year and patients in clinical group III, IV and II with alveolar histologic subtype(unfavorable histologic group) received vincristine, actinomycin-D, adriamycin, cyclophosphamide and cisplatinum based on IRS-III. Radiation therapy was administered to patients in clinical group II, III and IV. Of 67 cases of soft tissue sarcoma, 54 case were eligible for treatment analysis. The 3 year disease free survival (DFS) of all 54 cases was 54.1%, 3 year DFS of clinical group I and II was 83.9%,3 year DFS of clinical group III and IV before 1986 was 35.7% and after 1986 was 48.2%. Of 45 cases of rhabdomyosarcoma, 41 cases were eligible for treatment analysis. The 3 year DFS of all 41 cases was 49.1%,3 year DFS of clinical group I and II was 87.5%,3 year DFS of clinical group III and IV before 1986 was 27.2% and after 1986 was 45.0%. Patients in clinical group I and II who had no gross residual tumor after primary surgical excision had best prognosis with 3 year DFS approximating 90% with only 2 drugs regimen, significantly better than patients in clinical group III and IV with 3 year DFS below 50% even after intensifying chemotherapy since year 1986. This analysis suggests that total surgical removal is very important for improving prognosis and should be undertaken where possible in all patients without distant metastasis. Treatment results also showed that after year 1986 with intensification of chemotherapy, 3 year DFS of clinical group III and IV as well as early toxic deaths increased, and after lowering doses of chemotherapeutic agents of regimen 35 of IRS-III, treatment results improved much. Therfore to improve prognosis of patients with gross residual tumor after surgical excision of biopsy and patients with distant metastasis at diagnosis, intensified multiagent chemcherapeutic regimen with adequate dose modification should be done to lower early toxic deaths.
Age Distribution ; Biopsy ; Bone Marrow ; Chondrosarcoma, Mesenchymal ; Classification ; Cyclophosphamide ; Diagnosis ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Extremities ; Female ; Fibrosarcoma ; Head ; Hemangiopericytoma ; Hemangiosarcoma ; Histiocytoma, Malignant Fibrous ; Humans ; Kidney ; Leiomyosarcoma ; Liver ; Lung ; Male ; Mesenchymoma ; Neck ; Neoplasm Metastasis ; Neoplasm, Residual ; Neurilemmoma ; Orbit ; Pediatrics ; Pelvis ; Perineum ; Prognosis ; Retrospective Studies ; Rhabdomyosarcoma ; Sarcoma* ; Sarcoma, Ewing ; Sarcoma, Synovial ; Seoul ; Sex Ratio ; Survival Rate ; Vincristine

No abstract available.
Child* ; Drug Therapy ; Humans

No abstract available.
Child* ; Humans ; Incidence* ; Leukemia*