Anthrax in man is usually cutaneous, resulting from contact with materials derived from infected livestock. Internal organs are infrequently involved,. This report concerns a case of primary anthrax of intestine. The first case of primary anthrax of intestine is to our knowledge in Korea. The patient was a 14-year-old male who has complained of nausea, vomiting and acute abdominal pain. History was otherwise noncontributory except for ingestion raw meat of the dead cattle, one day before the onset of the disease. The cattle presumably died due to Bacillus anthracis in a village Bae-Ban Dong in the city of Kyung ju, Kyung Pook. Among 15 sufferers, 2 cases died 3 days later. Bacillus anthracis isolated from the raw beef, blood samples of two patients and throat culture of one patient. At laparotomy, the peritoneal cavity was full of serosanginous fluid. Right hemicolectomy including partial resection of ileum was done. The bowel was segmentally dilated, hemorrhagic and necrotic, especially at terminal ileum. The mucosa was edematous and largely ulcerated covered with greenish yellow exudate. The intense vascular congestion with hemorrhage and numerous colonization of bacteria were present through the entire wall. The organisms were large, gram-positive and PAS-negative bacilli in long chain. Bacterial emboli were scattered in lymphatics. The other feature was band like lymphoid cell infiltration in ulcer base and submucosal layer. Payer's patches were prominent and the germinal centers were necrotic. Interfollicular spaces exhibited aggregates of numerous atypical lymphoid cells. The cells were five times larger than resting lymphocytes and had several prominent nucleoli and abundant amphophilic cytoplasm. On immunohistochemical staining, most of atypical cells were positive for T-cell marker and Ki-I Ag. The mesenteric lymph nodes were enlarged, showing reactive feature, and the atypical cells were also demonstrated. The patient recovered completely.
Male ; Humans

OBJECTIVE: This study was performed to evaluate the usefulness of early operation in children with traumatic subdural hygroma. METHODS: The subjects were nine patients (Glasgow coma scale (GCS) score was below 10 and age was below 10 years old) who developed subdural hygroma after trauma between January 2000 to December 2002. Subduroperitoneal shunt was performed in one group and not performed in the other group. We analyzed the GCS score on admission and at 1 year after operation. Overall clinical results were evaluated retrospectively. RESULTS: Patients who underwent operation exhibited higher GCS scores at 1 year after trauma compared to those in the patients who were treated by conservative therapy(p<0.05). CONCLUSION: The early operation could be an effective treatment to children with subdural hygroma who showed delayed improvement of consciousness and to patients with hygroma that didn't decrease or was above moderate amount.
Child* ; Coma ; Consciousness ; Humans ; Lymphangioma, Cystic ; Retrospective Studies ; Subdural Effusion*

OBJECTIVE: To understand the difference of defecation physiology between postpartum and postoperative women. METHODS: Between July 1998 to April 1999, we performed defecogram and pudendal nerve motor latency to 31 women, who were 8 postoperative women, 9 post cesarean-section state women, and 14 normal vaginal delivery-state women. RESULTS: According to the defecogram results, only squeezing angles of the anorectal angle were significantly increased(96.0 vs 72.3, 74.9 degree) in normal vaginal delivery-state women compared to post cesarean-section state and postoperative women, but rest and evacuation angles were not. And to pudendal nerve latency, there were no statistically significant difference. CONCLUSION: We concluded that the pudendal plexus was damaged during labor, therefore its ability to control puborectalis muscle was damaged. So, the anorectal angles of squeezing of postpartum women were significantly increased, compared to those of post cesarean section women or postoperative women.
Cesarean Section ; Defecation* ; Female ; Humans ; Physiology* ; Postpartum Period* ; Pregnancy ; Pudendal Nerve*

OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.
Adenomyosis ; Endometrium ; Female ; Humans ; Hysterectomy* ; Leiomyoma ; Uterus

OBJECTIVE: The fears and side effects of a prolonged hormone replacement therapy on the postmenopausal symptoms reinforce a growing interest about alternatives. The present study was performed to investigate whether black cohosh root extract (BCRE) can be used or not as an alternative to hormone replacement therapy (HRT) in order to relieve postmenopausal symptoms. MATERIAL & METHODS: Randomized, double-blind prospective clinical trial examined the effects of BCRE and HRT on Kupperman index, biochemical bone markers, lipid profiles, and side effects in 74 women with postmenopausal symptoms. Treatments included placebo (Festal(R)) (n=12), BCRE (Feramin(R)) (n=32) and HRT (Premarin(R)) (n=30) for 3 months. Kupperman index, biochemical bone markers (osteocalcin and deoxypyridinoline), and lipid profiles (total cholesterol, triglyceride and HDL-cholesterol) were measured at 0, 1 and 3 months. Side effects were checked at 3 months. RESULTS: BCRE was significantly effective in lowering of Kupperman index as much as HRT at two control times (1 month: p<0.05, 3 months: p<0.001). It also showed slightly favorable effects on biochemical bone markers and lipid profiles but not statistically significant. Fewer side effects were seen in BCRE than HRT. CONCLUSION: BCRE appears to be a safe and effective alternative to HRT for early postmenopausal symptoms and may be especially useful in women with intolerances or contraindications to traditional HRT.
Cholesterol ; Cimicifuga* ; Female ; Hormone Replacement Therapy* ; Humans ; Prospective Studies ; Triglycerides

OBJECTIVE: The fears and side effects of a prolonged hormone replacement therapy on the postmenopausal symptoms reinforce a growing interest about alternatives. The present study was performed to investigate whether black cohosh root extract (BCRE) can be used or not as an alternative to hormone replacement therapy (HRT) in order to relieve postmenopausal symptoms. MATERIAL & METHODS: Randomized, double-blind prospective clinical trial examined the effects of BCRE and HRT on Kupperman index, biochemical bone markers, lipid profiles, and side effects in 74 women with postmenopausal symptoms. Treatments included placebo (Festal(R)) (n=12), BCRE (Feramin(R)) (n=32) and HRT (Premarin(R)) (n=30) for 3 months. Kupperman index, biochemical bone markers (osteocalcin and deoxypyridinoline), and lipid profiles (total cholesterol, triglyceride and HDL-cholesterol) were measured at 0, 1 and 3 months. Side effects were checked at 3 months. RESULTS: BCRE was significantly effective in lowering of Kupperman index as much as HRT at two control times (1 month: p<0.05, 3 months: p<0.001). It also showed slightly favorable effects on biochemical bone markers and lipid profiles but not statistically significant. Fewer side effects were seen in BCRE than HRT. CONCLUSION: BCRE appears to be a safe and effective alternative to HRT for early postmenopausal symptoms and may be especially useful in women with intolerances or contraindications to traditional HRT.
Cholesterol ; Cimicifuga* ; Female ; Hormone Replacement Therapy* ; Humans ; Prospective Studies ; Triglycerides

Spontaneous Infarction of fibroadenoma of the breast is very uncommon and may lead to difficulties in clinical and pathological diagnosis. Most reported cases occured in young women during pregnancy or lactation. This report describes imprint cytologic features of an infarcted fibroadenoma in a 19-year-old young woman without evidence of pregnancy. The smears revealed many individually scattered degenerated or necrotic epithelial or spindle stromal cells and naked nuclei on dirty necrotic background. A few sheets of cohesive uniform epithelial cells and a few fragments of stromal cells were also present. Most of the epithelial cells had pyknotic and hyperchromatic nuclei, however, cellular atypism such as pleomorphism, prominent nucleoli or mitosis were not present. Though the necrotic ductular and glandular outline of this case may bear a superficial resemblance to adenocarcinoma, obvious cytologic atypia or mitosis, even in the necrotic areas, were not present.
Adenocarcinoma ; Breast* ; Diagnosis ; Epithelial Cells ; Female ; Fibroadenoma* ; Humans ; Infarction* ; Lactation ; Mitosis ; Pregnancy ; Stromal Cells ; Young Adult

Tailgut cysts (TGCs) are rare congenital cysts that occur in the retrorectal or presacral spaces. Although most tailgut cysts have been reported as benign, there have been at least 9 cases associated with malignant change. We report herein on an unusual case of a 40-year-old woman with a carcinoembryonic antigen (CEA) -producing adenocarcinoma arising within a TGC who underwent surgical resection and local radiation therapy. Despite the complete resection, metastatic adenocarcinoma developed five months after surgery. CEA-producing adenocarcinoma from a TGC is extremely rare and only two cases, including this case, have been reported in the English medical literature. Besides CEA, the serum levels of CA 19-9 became markedly elevated in this patient. Given that the serum CEA level decreased to the normal range after complete resection of tumor and that the tumor recurrence was associated with a rebound of the CEA serum level, our case shows that serial measurements of serum CEA can be used for treatment planning and for assessing the patient's treatment response for this rare disease.
Adenocarcinoma/blood/pathology/*therapy ; Adult ; CA-19-9 Antigen/blood ; Carcinoembryonic Antigen/*blood ; Cysts/blood/pathology/*therapy ; Female ; Hamartoma/blood/pathology/*therapy ; Humans ; Rectal Neoplasms/blood/pathology/*therapy ; Sacrococcygeal Region

OBJECTIVES: To assess the ability of risk of malignancy index (RMI) 1 to discriminate between benign and malignant pelvic masses. METHODS: Between January 2007 and December 2010, 547 women with pelvic masses were evaluated. Their medical records are reviewed here retrospectively. The sensitivity, specificity and positive and negative predictive values of the cancer antigen (CA) 125 level, ultrasound findings and menopausal status in the prediction of malignant pelvic masses were calculated and compared individually or combined using the RMI 1. RESULTS: The receiver operating characteristic (ROC) curves of CA 125, the ultrasound score and the RMI 1 were all found to be relevant predictors of malignancy. ROC analysis of the RMI 1, CA 125 serum levels, ultrasound score and menopausal status showed areas under the curves of 0.795, 0.782, 0.784 and 0.594, respectively. The RMI 1 was found to be statistically significantly correlated with menopausal status (P = 0.001), while not statistically significantly correlated with CA 125 (P = 0.628) or the ultrasound score (P = 0.541). The RMI 1 at a cut-off of 150 - with a sensitivity of 77.9%, specificity of 81.1%, positive predictive value of 51.7% and negative predictive value of 93.4% - showed the highest performance in determining the malignant tendency of pelvic masses. CONCLUSION: Accepting a RMI 1 cut-off value of 150 results in statistically more significant diagnostic criteria than menopausal status for the discrimination of benign and malignant pelvic masses.
Discrimination (Psychology) ; Female ; Humans ; Medical Records ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

Tuberculous peritonitis in pregnancy is a rare form of extrapulmonary tuberculosis that is not easily diagnosed. The clinical presentations of tuberculous peritonitis are usually non-specific and mimic those of other diseases, such as ovarian malignancy or chronic liver disease, and this non-specificity can cause diagnostic delays and complications. The authors report the case of a 31-year-old primigravida woman who presented with uncontrolled fever, dyspnea, elevated liver enzymes, and mild abdominal distension at 13+2 weeks of gestation. At 14+2 weeks, a therapeutic abortion was conducted and tuberculous peritonitis was confirmed by laparoscopic excisional biopsy of peritoneal nodules and histopathologic examination. The patient recovered on antituberculosis therapy and abdomen and chest follow up radiographic findings have confirmed improvement.
Abdomen ; Abortion, Therapeutic ; Adult ; Biopsy ; Dyspnea ; Female ; Fever ; Follow-Up Studies ; Humans ; Liver ; Liver Diseases ; Peritonitis ; Peritonitis, Tuberculous* ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy* ; Thorax ; Tuberculosis