Even though malignant potential of vaginal intraepithelial neoplasia(VaIN) may be low, the prevalence is increasing and the mean age at diagnosis is decreasing. Various treatment options have been used for the eradication of ValN, but most effective standard protocol is not present because it is a rare disease. Laser vaporization was used to treat 7 patients with VaIN diagnosed at Department of Obstetrics and Gynecology, Seoul National University Hospital between 1992 to 1996. The patients were from 40 to 70 years of age with a mean 57 of years. All patients had a history of radical or simple hysterectomy, and final pathologic diagnosis were as follows : cervical cancer(n=5), cervical intraepithelial neoplasia(n=l), leiomyoma(n=l). Vaginal intrae-pithelial neoplasia(VaIN) was identified between 4 months and 8 years after first operation. All lesions were unifocal disease and found at the upper one third of the vagina. Treatment was performed with a CO2 laser unit and colposcope. Four(57%) out of seven patients had general anesthesia for the purpose of treatment. Patients were followed up for an average of 16.8 months with regular cytologic evaluation, colposcopy and biopsy. Failure of therapy was defined as evidence of intraepithelial neoplasia in any one of these three parameters. Only one patients showed persistent disease and the others remain free of disease. The success rate of therapy was 85.7%(6/7). (continue)
Anesthesia, General ; Biopsy ; Colposcopes ; Colposcopy ; Diagnosis ; Gynecology ; Humans ; Hysterectomy ; Laser Therapy ; Lasers, Gas* ; Obstetrics ; Prevalence ; Rare Diseases ; Seoul ; Vagina ; Volatilization*

BACKGROUND: The skin changes of X-linked recessive ichthyosis are cnused by the deficiency of the enzyme steroid sulfatase, which usually results from deletions of this gene in Caucasian populations. OBJECTIVE AND MEHTODS: To disgnose X-linked recessive ichthyosis and detect its carrier, we have investigated distinctive gene deletion and measured gene dosage of steroid sulfatase gene by southern blot hybridization in Korean patients with X-linked recessive ichthyosis. RESULTS: Patients from 8 of 9 unrelated families exhibited deletions, if the steroid sulfatase gene. Of 6 families showing a family history compatible with X-linked recessive inheritance, One family exhibited a normal pattern of hybridization. All but one family showed deletion of steroid sulfatase gene. All three patients lacking a fami1y history of the disease exhibited gene deletions. The ratio of the steroid sulfatsse specific band density to the Factor VIII specific band density was measured in 8 obligate carriers using a laser densitometer. The average ratio exhibited by the car riers was less than half that of normal women. Conclusian: These results suggest that the X-linked recessive ichth osis patient and its carrier can also be diagnosed and detected by Southern blot hybridization of steroid sulfatase gene in Korea.
Blotting, Southern* ; Diagnosis* ; Factor VIII ; Female ; Gene Deletion ; Gene Dosage ; Humans ; Ichthyosis* ; Korea ; Skin ; Steryl-Sulfatase ; Wills

A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

Objectives: The objective of the present study was to examine whether patients with severe depression and/or anxiety show a difference in the level of body awareness compared with that of healthy controls. Methods: Outpatients (n=100) with a diagnosis of moderate to severe depression and/or anxiety and 42 healthy controls were included in the study. Body awareness was assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA) scale, and other clinical characteristics like anxiety and depression were measured using the State-Trait Anxiety Inventory and Patient Health Questionnaire, respectively. The data were analyzed using ANCOVA, and statistically significant differences between the two groups in both the overall MAIA score and subscale scores were documented. Results: The overall MAIA scores of patients with depression and/or anxiety were significantly lower than that of healthy subjects. Specifically, the differences found in the subscales of trust, acceptance, attention-regulation, and return-to-body were significant, whereas the differences found in the subscales of notice and mind-to-body awareness were not. Conclusion These findings imply that the ability to monitor one’s own bodily sensations and to be aware of their connection with emotional states cannot serve as a marker for psychological well-being. Rather, it may be the aspects of attentional styles and attitudes toward bodily states that play a critical role in mental health. Further analyses examining the relationships between the subscales of body awareness and other psychological variables are deemed necessary.

OBJECTIVE: This study was performed to identify the prognostic factor for survival of patients with recurrent cervical cancer. METHODS: Sixty-eight patients were diagnosed as recurrent cervical cancer at the Seoul National University Hospital from January, 1988 to December, 1998. Recurrence was defined as new evidence of tumor after 6 months of disease free survival. Retrospective analysis was done in terms of clinical features and the Cox proportional hazard model was used to identify independent variables associated with an improved survival rate. Histopathologic types were distributed as follows; squamous cell carcinoma in 70.6%, adenocarcinoma in 11.8%, adenosquamous cell carcinoma in 11.8%, and small cell carcinoma in 1.5%. Distribution of FIGO stage was as follows; stage I in 25.0%, stage II in 66.2%, and stage III in 4.4%. Sites of recurrence were as follows; central pelvic recurrence in 44.1%, pelvic side wall recurrence in 11.8%, and distant metastasis in 44.1% and the most common site of distant recurrence was extrapelvic lymph nodes (29.4%). 29.4% of recurrences were observed within the first 12 months after initial therapy, 50.0% within 2 years and 64.7% within 3 years. RESULTS: Positive rate of SCC-Ag at initial diagnosis was 45.2% with cutoff value of 2.0 ng/ml. Positive rate of SCC-Ag at the diagnosis of recurrence was 60.0%. Overall response rate to the treatment was 29.1%. Complete response rate was higher in central pelvic recurrrence than pelvic side wall recurrence and distant metastasis (P = 0.002) and also higher in normal SCC-Ag level (< or = 2.0 ng/ml) at the diagnosis of recurrence than elevated level (P = 0.032). Cumulative survival rates of 1 year after recurrence was 66.8%, 2 year 36.7%, and 5 year 18.7%. Central recurrence showed higher cumulative survival rate than pelvic side wall or distant recurrence (P = 0.029). The patients with elevated SCC-Ag level at the time of diagnosis of recurrence showed lower cumulative survival rate than those with normal SCC-Ag level (P < 0.001). Cox proportional hazard model showed that SCC-Ag elevation at the time of diagnosis of recurrence retained significant values in predicting survival(OR = 2.56; 95% CI = [1.22-5.39]; P = 0.01). CONCLUSION: SCC-Ag elevation at the diagnosis of the recurrence is a strong independent prognostic indicator for survival of patients with recurrent cervical cancer.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Disease-Free Survival ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Uterine Cervical Neoplasms*

Basal cell carcinoma(BCC) and squamous cell carcinoma (SCC) are very prevalent neoplasms of the human skin. Ultraviolet radiation in sunlight is a well-established mutagen of the p53 gene and is one of basal cell carcinoma and squamous cell carcinoma. The newly-formed vascular network is important for neoplasms to grow beyond a size of about 1 mm2. Recent reports have suggested the hypothesis that a mutant p53 protein is closely related with capillary density. Immumohistochemistry for p53 protein and CD34 was performed in 20 cases of BCCs and 14 SCCs to evaluated the relationship between p53 protein and capillary density. The results were as follows:1. The microvessels stained by CD34 were mainly located in the interface of tumor cells and stroma. 2. There was no difference in the microvessel density according to the histologic types and age of the patients, but a higher microvessel density was noted in male patients. 3. The aggressive BCCs and the less-differentiated SCCs showed higher p53 immunostaining. 4. The mean microvessel density of cases showing strong positive immunostaining of the p53 gene(54.73+/-17.75) was higher than that of others(39.75+/-18.30). These results suggested that p53 protein expression and microvessel density are not related to the histologic types and age of the patients, but that differentiation and biologic behavior such as the infiltrating property of tumors and the microvessel density are closely related to p53 protein expression.
Capillaries ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Genes, p53 ; Humans ; Male ; Microvessels* ; Skin* ; Sunlight

The goal of the present study was to evaluate the diagnostic value of a joint distractor in arthroscopy in small-breed dogs. Sixty stifle joints, which were collected from thirty cadavers, were used in this study. To simulate different injuries, no medial meniscal tear, a full-thickness vertical longitudinal tear, a partial-thickness vertical longitudinal tear, full- and partial-thickness vertical longitudinal tears, or a peripheral detachment were created on the caudal horn of the medial meniscus of each stifle joint along with rupture of the cranial cruciate ligament. Each stifle joint then underwent arthroscopy with and without a joint distractor. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and correct classification rate (CCR) for the diagnosis of each type of medial meniscus pathology were calculated. For arthroscopy with and without a joint distractor, the Sn was 85% and 60%, the Sp was 96% and 92%, the PPV was 85% and 65%, the NPV was 96% and 90%, and the CCR was 94% and 86%, respectively. Arthroscopy is an effective diagnostic method for the assessment of medial meniscal pathologies in small-breed dogs, especially when performed with the aid of a joint distractor.
Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Cadaver ; Classification ; Diagnosis ; Dogs* ; Horns ; Joints* ; Menisci, Tibial ; Methods ; Pathology ; Rupture ; Sensitivity and Specificity ; Stifle ; Tears

OBJECTIVE: The purpose of this study was to evaluate the relationship between the visual acuity and visual evoked potentials of the amblyopia patients and normal persons for the demonstration of the visual disability. METHOD: We performed visual evoked potential study, in 49 eyes of the 43 amblyopia patients and in 76 eyes of 38 normal young adults. Our study was carried out to evaluate the relationship of the visual acuity with N1, P1, N2, P2 latency, P1-N2 amplitude and to compare the latency of N1, P1, N2, P2, and P1-N2 amplitude in amblyopia patients and normal young adults. RESULTS: The mean values of N1, P1, N2, P2 latency were prolonged in amblyopia patients compared to normal young adults (p <0.05). There was no correlation between the visual acuity and P1 latency (p> 0.05), but significant correlation was noted between the visual acuity and P1-N2 amplitude (p <0.05). CONCLUSION: These results showed prolonged latency of N1, P1, N2, P2 in amblyopia group as well as significant correlation between visual acuity and P1-N2 amplitude in both groups. So, P1 latency and P1-N2 amplitude are good parameters in evaluating the visual disability.
Amblyopia* ; Evoked Potentials, Visual* ; Humans ; Visual Acuity ; Young Adult

BACKGROUND: Mean platelet volume (MPV) increases when platelets are activated, and it is known to increase in migraine patients. The aim of this study is to investigate whether there is a difference in MPV or platelet count between migraine patients with (MA) and without aura (MO).METHODS: Migraine patients were recruited from the out-patient department of a hospital between January 2012 and June 2017. Patients were divided into MA and MO groups. Platelet count and MPV were compared between groups, and the frequency of comorbidities such as ischemic stroke and cardiovascular disease, was investigated in both groups.RESULTS: Of the 123 patients, 46 were classified as MA, and 77 were classified as MO. The MPV of the MA group was significantly higher than that of the MO group (8.92±0.17 fL, 6.32±0.28 fL, respectively) (P=0.034). However, platelet count showed no significant difference between groups. Cardiovascular disease and ischemic stroke incidences were significantly higher in the MA group than in the MO group (ischemic stroke: 15.2%, 7.8%, respectively, P=0.027; cardiovascular disease: 10.9%, 6.5%, respectively, P=0.018).CONCLUSION: Mean platelet volume was significantly greater in the MA group than in the MO group. This may be related to the pathophysiological differences between the two conditions.
Cardiovascular Diseases ; Comorbidity ; Epilepsy ; Humans ; Incidence ; Mean Platelet Volume ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Outpatients ; Platelet Activation ; Platelet Count ; Stroke

Objective: The primary objective of this study was to examine the associations among emotion regulation strategies, interoceptive awareness, and psychological distress measures—namely, depression, anxiety, and somatization. Additionally, we aimed to explore the predictive power of various facets of interoceptive awareness in determining the severity of symptoms for each mental disorder. Methods: A cohort of 130 outpatients diagnosed with depression/anxiety disorder were recruited, and 20 subjects exhibiting incomplete responses were excluded from the dataset, leading to a final sample size of 110 outpatients. The clinical symptoms were measured by Patient Health Questionnaire-9, State–Trait Anxiety Inventory Form Y, and Symptom Checklist-90-Revised, and the usage of emotion-regulation strategies and interoceptive awareness was assessed with Emotion Regulation Questionnaire and Multidimensional Assessment of Interoceptive Awareness (MAIA), respectively. A hierarchical regression analysis was performed to examine whether emotion-regulation strategies and interoceptive awareness explain the statistically significant variance in each of the symptoms. Results: In the depression model, cognitive reappraisal, accept, and attention regulation showed significant associations, while in the anxiety model, cognitive reappraisal, attention regulation, trust, and notice emerged as significant factors. Lastly, cognitive reappraisal and attention regulation were found to be significant contributors to the final model for somatization. Conclusion The inclusion of MAIA subscales improved the predictive ability of the regression model, highlighting the independent association between interoceptive awareness—particularly attention regulation—and clinical symptoms of anxiety and depression. Additionally, the study underscores the relevance of considering the specific pathological context when implementing interventions, as evidenced by the positive associations between the accept subscale and depression and between the notice subscale and anxiety, respectively.