This report concerns a rare malignant smooth muscle neoplasm of the skin and the subcutaneous tissue, which was examined immunohistochemically and ultrastructurally. It occured in a 48-year-old female patient who had suffered from painful nodules on the left shoulder. The nodules were removed and diagnosed as a benign fibrohistiocytic tumor. One year after local excision, multiple nodules were detected by physical examination at the previous operation site. Grossly, thirteen well-defined small nodules had spread in the dermis and the subcutaneous tissue, of which nine were located from lower dermis to the subcutaneous tissue and four were in the subcutaneous tissue. Histologically, each nodule consisted mainly of epithelioid tumor cells having eosinophilic or clear plump cytoplasm and round to oval nuclei with small nucleoli, and some peripheral spindle tumor cells. The tumor cells were negative for PAS reaction with and without diastase digestion or alcian blue. Immunohistochemically, tumor cells were positive for smooth muscle actin and vimentin. Ultrastructurally, the tumor cells showed actin filaments and dense bodies in cytoplasm. This case was diagnosed as an epithelioid leiomyosarcoma of the skin and the subcutaneous tissue with local metastasis one year after local excision.
Actin Cytoskeleton ; Actins ; Alcian Blue ; Amylases ; Cytoplasm ; Dermis ; Digestion ; Eosinophils ; Female ; Humans ; Leiomyosarcoma* ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Periodic Acid-Schiff Reaction ; Physical Examination ; Shoulder ; Skin* ; Subcutaneous Tissue ; Vimentin

Herpes zoster oticus (Ramsay Hunt syndrome) is characterized by facial nerve paralysis associated with vesticular eruptions and cochleovestibular symptoms. Many evidences have supported that it is caused by the reactivation of latent varicella-zoster virus in the geniculate ganglion. Recently we experienced a case 49-year-old man presented severe vertigo and a vesicular eruptions of auricle and external ear canal. It is an unusual variant of herpes zoster oticus that involves only vestibular nerve without facial nerve palsy and hearing loss. We believe this case results from reactivation of latent varicella zoster virus in the vestibular ganglion and report with a review of literatures.
Dizziness ; Ear Canal ; Facial Nerve* ; Ganglion Cysts ; Geniculate Ganglion ; Hearing Loss ; Herpes Zoster Oticus* ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Middle Aged ; Paralysis* ; Vertigo ; Vestibular Nerve*

During the 6 year period, frorn May 1, 1989 to August 31, 1995, 40 cases of endometrial carcinoma were encountered at College of Medicine, University of Ulsan, Asan Medical Center. The purpose of this study is to investigate the patient's clinical characteristics and to correlate these findings with the there histopathologic results. The results were as follows : 1. There was an increasing tendency of endometrial carcinoma during 3-year time interval between May 1, 1989 and August 31, 1995. 2. Age distribution of the patients with endometrial cancer showed; 10% for the 31s ages<40, 27.5% for the 41.
Age Distribution ; Chungcheongnam-do ; Endometrial Neoplasms* ; Female ; Humans ; Ulsan

Diaphragm is though to play the most role in breathing and has a substantially greater proportion of slow oxidative and fast glycolytic fibers, and low proportion of fast oxidative fibers. The respiratory muscle, diaphragm, has the functional characteristics of slow speed of contraction, high resistance to fatigue and the ability to respond to intermittent ventilatory loads, for example of exercise. In the present study, the characteristics of the metabolism (depletion and repletion) of glycogen and the structural changes of diaphragm during depletion and repletion of glycogen were observed in rats. For comparison, the red gastrocnemius muscle which has a greater proportion of fast oxidative glycolytic (FOG) and slow oxidative (SO) fibers, and low proportion of fast glycolytic (FG) fiber, was also studied. The glycogen concentration of diaphragm in overnight fasted rats was 2.30+/-0.14mg/gm wet weight. The values of glycogen concentration at 60, 90 and 120minutes of treadmill exercise loaded rats was significantly decreased compared to that of the overnight fasted rats. There was no significant difference among the glycogen concentration of diaphragm at 60, 90 and 120minutes of exercises. The glycogen concentration of diaphragm was decreased to 1.12+/-0.17 from 2.30+/-0.14mg/gm wet weight by treadmill exercise. The glycogen depletion rats of diaphragm during exercise was faster than that of red gastrocnemius in both of the first 60minutes and 120minutes duration of exercise. The glycogen repletion of diaphragm after intragastric glucose administration by stomach tube was studied in control and exercise groups. The glycogen concentration was significantly increased after glucose administration in both of the control and exercise groups. All of the concentration of exercise group at 60, 120 and 180minutes after glucose administration was significantly higher than those of control group. In conclusion, one of the characterics of diaphragm in glycogen metabolism is fast glycogen depletion during exercise, and slowness of glycogen repletion after glucose ingestion in rats.
Rats ; Animals

PURPOSE: There are no clear-cut guidelines of how to treat patients who have failed after a tension-free midurethral sling (MUS) procedure. We describe our experience with repeat MUS procedures and transvaginal shortening of the previously implanted tape for those patients with an initially failed MUS procedure. MATERIALS AND METHODS: We reviewed the medical records of the patients who failed with their initial MUS procedure and then had a second operation. Of the 20 women, 14 patients had repeat MUS and another 6 patients underwent shortening of the implanted tape. Repeated MUS was done by either the retropubic or transobturator pathway. Shortening of the tape was done with a metal hemoclip to shorten the previously implanted tape. The preoperative characteristics and the intraoperative and postoperative data were assessed by reviewing the operative notes, medical records and office notes. RESULTS: The mean interval between the first and repeat procedures was 8.4 months (range: 1-48). The mean follow up time after the second operation was 29.9 months (range: 7-70). Seven patients underwent repeat MUS instead of tape shortening because the implanted tape had migrated or severe adhesions were noted on the intraoperative findings. Ten (71.4%) of 14 patients who underwent repeat MUS achieved full continence, while 4 patients (28.6%) had significant improvement. Of the patients with tape shortening, 4 (66.6%) achieved full continence, one (16.7%) improved and one (16.7%) was failed. CONCLUSIONS: Based on our limited experience, a repeat MUS sling procedure or tension revision of the tape might be an effective treatment for the patients with failed MUS.
Animals ; Female ; Follow-Up Studies ; Humans ; Medical Records ; Mice ; Reoperation ; Suburethral Slings* ; Treatment Failure ; Urinary Incontinence*

We retrospectively analyzed 29 patients with caudate hemorrhage, and evaluated the prognosis and the predictors of short-term and long-term outcomes. P With caudate hemorrhage showed better short-term outcome compared to those with intracerebral hemorrhages in general. However, the ciance re -ing was Rebleedmg, which had interval of less than 1 year in most cases, occurred mainly in patients with previous stroke. And this worsened the patients' outcome. Management of risk factors is critical. The prognostic factor influencing on the short-term outcome was the initial consciousness level and the long-term outcome could be anticipated through the evaluation of the neurologic status on the 30th day; subsequent improvement was expected in patients with mild abnormality, but not in those with moderate to severe disability.
Cerebral Hemorrhage ; Consciousness ; Hemorrhage* ; Humans ; Prognosis* ; Retrospective Studies ; Risk Factors ; Stroke

OBJECTIVE: To survey the clinical features, complications, prognostic factors and Five-year survival rates of 398 patients with invasive cervical cancer(stage Ib-IIb), subjected to radical hysterectomy and bilateral pelvic lymphadenectomy. METHODS: Medical records and pathologic reports were reviewed retrospectively on 398 cases, diagnosed and operated on during the period of Jan. 1988 - Dec. 1998. Five-year survival rates were estimated by the Kaplan-Meier method, and prognostic factors were assessed using Wilcoxon test. RESULTS: Of the 398 cases, 285 were in stage Ib(71.6%), 58 in stage IIa(14.5%), and 55 in stage IIb(13.8%). The mean age of patients was 48+/-9.9 years. Neoadjuvant chemotherapy was given to 200 patients(50.2%), Adjuvnat radiotherapy in 160 patients(40.2%) postoperatively. Operative complications occured in 121 patients(30%). Massive blood loss and bladder dysfuction were frequent complications(11.3% and 10.3%, respectively). Others were urinary tract infection(9.3%), wound infection(7.5%), lymphocyst(3.5%) and urinary tract fistula(0.7%), respectively. The Five-year survival rates for stage Ib, IIa, and IIb were 84.2, 82.8%, and 75.8%, respectively. Factors that affect the Five-year survival rates were cell type(small cell Vs other, P=0.0146), tumor size(< or = 3cm Vs >3cm, P=0.0425), depth of invasion( < or = 5gm Vs >5ne, P= 0.0007), response of chemotherapy(poor response Vs other, P= 0.0001), LN metastasis(1 Vs 2 Vs more, P=0.0001). CONCLUSION: Accumulating the clinical experience, we could improve results, reduce complications and speculated that the survival rates could be improved by neoadjuvant chemotherapy and/or adjuvant postoperative radiotherpy. Prospective randomized trials are needed to evaluate our approach and to be compared with concurrent chemoradiotherapy to definite its precise role in locally advanced cervical cancer.
Chemoradiotherapy ; Drug Therapy ; Humans ; Hysterectomy* ; Lymph Node Excision ; Medical Records ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Urinary Tract ; Uterine Cervical Neoplasms* ; Wounds and Injuries

OBJECTIVE: To determine the changes of nitric oxide production in preeclampsia, the concentration of nitric oxide metabolite, nitrite, was measured in umbilical vein after perfusing plasma from normal pregnant women and preeclamptic pregnant women. MATERIAL AND METHOD: 15 normal and 15 preeclamptic umbilical cords were obtained at the time of cesarean section. Two pieces of umbilical cord in equal length(20 cm in length) were prepared from each umbilical cord. Two pieces of umbilical cord were connected in parallel in a perfusion chamber. One piece of umbilical cord was perfused sequentially for 20-minutes' interval with the perfusates in the order of cord buffer, cord buffer including 15% normal pregnant serum, 15% normal pregnant serum with histamine(10-5mol/L), 15% normal pregnant serum with calcium ionophore A23187(5 mol/L) and the other one was perfused exactly same way using 15% preeclamptic serum instead of 15% normal pregnant serum. All the perfusates used were gassed with 95% O2 and 5% CO2 and warmed to 37degree C. Perfusates were collected in eppendorf tube and freezed at -70degree C until assayed. NO was measured by means of Greiss reaction. one way ANOVA and paired t-test were used where appropriate and p-value < 0.05 was considered significant. RESULTS: NO production in normal umbilical cords was not different regardless of perfusate. Although adding histamine and calcium ionophore, the NO production was slightly increased but statistically not significant in both groups. NO production in preeclamtic umbilical cords was significantly increased with 15% preclamptic serum(15% normal serum vs. 15% preeclamptic serum; 0.060+/-0.016microgram/ml/min vs 0.075+/-0.014microgram/ml/min, p<0.05). CONCLUSION: The preeclamptic sera may not affect the production of NO in the human umbilical vein endothelial cells. The biologic significance of increased NO production in preeclamptic umbilical cord with perfusing preeclamptic serum is unknown, but it might be compensation for the vasoconstriction of preeclampsia.
Calcium ; Cesarean Section ; Compensation and Redress ; Female ; Histamine ; Human Umbilical Vein Endothelial Cells ; Humans ; Nitric Oxide* ; Perfusion ; Plasma ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Umbilical Cord ; Umbilical Veins ; Vasoconstriction

The general intensive care unit of Presbyterian Medical Centar was opened in 1965 with 3 beds and expanded to 17 heds in 1981. Generally, the type of I.C.U. is multidisciplinary and intensive care often means a combination of recovery room service and intensive therapy. Here, we have analyzed clinically 4, 986 LC.U. patients admitted between Jan. 1986 and Dec. 1990. to obtain a better guide and management in the I.C.U.. The results were as follows I) Total number of patients for 5 years was 4,986; 1,071 patients in 1986, 1,102 patients in 1987, 1,012 patients in 1988, 952 patients in 1989, 849 patients in 1990. The ratio of male to female patients was almost 2: 1. 2) Total admission days in the I.C.U. was 26,892 days and average patient stay being 5.5 days. The average age for 5 years was 50.9 year-old-age. 3) The majority of the patients(3,526 cases, 70%) stayed in the I.C.U. less than 5 days The number of patients staying more than 9 days increased from 127 cases(12%) in 1986 to 155 cases (18%) in 1990 4) The group representing the highest number of patients admitted was in the 50 to 59 year-old-age group. About 60% of the patients admitted were in the 40 to 69 year-old-age groups and the highest mortality rate occurred in the 70 to 79 year-old-age group(24.4%). 5) The number of the patients admitted to the department of internal medicine, which was the highest among all departments, was 3,564 caaes. Mortality rate was highest in the department of pediatric. 6) During 5 years, overall mortality rate was 21.9%(1,091 cases) inclusive of the hopeless-dis-charged patients. 7) Liver cirrhosis & variceal rupture of esophagus was the commonest disease. Mortality rate WS8 highest in leukemia(50%) & lymyhoma(50%) and lowest in acute renal failure(0%). 8) After putting into operation of nation-wide medical. insurance scheme, average patient stay and average age were increased. From the above results, it can be concluded that average admission days, average age and patients staying more than 9 days in the I.C.U. increased annually.
Esophagus ; Female ; Humans ; Insurance ; Intensive Care Units* ; Critical Care* ; Internal Medicine ; Liver Cirrhosis ; Male ; Mortality ; Protestantism ; Recovery Room ; Rupture

Rhytisma lonicericola was identified as a tar spot fungus on Lonicera sp. in 1902, and has since been recorded on several species of Lonicera in China, Japan, and Korea. Most of the previous records of R. lonicericola have been based on a list of disease occurrences in the absence of any formal morphological identification or molecular analyses. Using six newly obtained specimens collected in the past 2 years, we confirmed the tar spot fungus found on L. japonica in Korea as R. lonicericola based on morphological examinations and molecular phylogenetic analyses. This fungus was distinguished from R. xylostei, another tar spot fungus on Lonicera, by ascospore size and geographical distributions. We present detailed mycological information and, for the first time, DNA sequence data useful for the identification of R. lonicericola.