No abstract available.
Estradiol* ; Female ; Menstrual Cycle* ; Superovulation*

Endometriosis of the rectum is unusual condition, since it represents an invasion of previously normal bowel by hormone-dependent nonmalignant cell from uterus of the same patient. It is estimated that the incidence of endometriosis is about 8-15% of reproductive women, of whom 3-34% show intestinal invasion of rectosigmoid colon, appendix, ileum, and cecum in order of decreasing frequency. Symptoms related bowel involvement may vary from none to complete intestinal obstruction. Because the mucosa is involved infrequently there is rarely rectal bleeding. X-ray and sigmoidoscopic studies are usually negative. It was not reported that colonic endometriosis was confirmed by endoscopic biopsy. Recently we experienced a case of rectal endometriosis which presented itself as a cyclic rectal bleeding with abdominal pain and diagnosed by colonoscopic biopsy.
Abdominal Pain ; Appendix ; Biopsy* ; Cecum ; Colon ; Colonoscopy ; Endometriosis* ; Female ; Hemorrhage ; Humans ; Ileum ; Incidence ; Intestinal Obstruction ; Mucous Membrane ; Rectum ; Uterus

BACKGROUND: To determine the prevalence of chronic fatigue syndrome and idiopathic chronic fatigue in Korea and to describe demographic, clinical, and psychological differences among those with chronic fatigue syndrome (CFS), those with idiopathic chronic fatigue, and healthy controls. METHODS: 1,526 persons aged 18-76 years who visited Korea university hospital health management center for general check-up between December 1998 and August 1999 were participated in the study. The questionnaire made according to the Centers for Disease Control and Prevention criteria was administered to the recruited persons and patients with chronic fatigue syndrome were diagnosed by questionnaire, physical examination and laboratory tests. The Korean version of the Center for Epidemiological Studies-Depression Scale (CES-D) was used to assess depression. RESULTS: Of the 1,526 persons studied, 433 (29.4 %) reported severe fatigue lasting at least 6 months. Of the 202 persons with unexplained chronic fatigue, 31 persons (2.0% of the study population) were classified as CFS cases. The prevalence of CFS was 2.81% in women, 1.49% in men respectively (p<0.05). When CES-D cut-off score of 25 was used, 30.43% of persons with CFS and 5.93% of persons without chronic fatigue had scores suggestive of depression. CFS patients had higher mean scores on CES-D than persons without chronic fatigue (p<0.05). CONCLUSION: Persons who met the criteria for chronic fatigue syndrome were found in 2.0%. The prevalence of chronic fatigue syndrome in our study were high, compared with previous studies in other countries. CFS patients had higher mean scores on CES-D than persons without chronic fatigue.
Centers for Disease Control and Prevention (U.S.) ; Depression ; Fatigue ; Fatigue Syndrome, Chronic* ; Female ; Humans ; Korea ; Male ; Physical Examination ; Prevalence* ; Surveys and Questionnaires

PURPOSE:Acute gastroenteritis is one of the causes of febrile seizures or benign seizures in children. This study was performed to find out the clinical characteristics and the prognosis of convulsions by acute gastroenteritis. METHODS:From January 2000 to December 2004, sixty five pediatric patients who suffered from convulsions due to acute gastroenteritis were classified into benign seizures (n=36) or febrile seizures(n=29) in Wonju Christian Hospital, Wonju College of Medicine, Yonsei University. We compared the age of onset, sex, the frequency and the duration of convulsions, blood electrolytes and peripheral white blood cell counts, findings of the cerebrospinal fluid examination, and the electroencephalograms between the two groups. In addition, we retrospectively analyzed their recurrence of convulsive diseases for 7 to 59 months after the first attacks. RESULTS:There was no difference of onset age, frequency and duration of convulsion between the two groups(P=0.12, P=0.83 and P=0.08). The types of convulsions were generalized seizures in both groups. There were 16 cases of positive responses to the antigen tests for stool rotavirus, and 12 of them(75%) belonged to the benign seizure group. And other laboratory findings were normal. During the follow-up period, 4 patients(11.1%) in the benign seizure group experienced febrile seizures, 2 patients(5.6%) benign seizures and 1 patient a generalized tonic-clonic seizure, whereas 3 patients(10.3%) in the febrile seizure group experienced simple febrile seizures. CONCLUSION:The comparative analysis between the benign seizure and the febrile seizure groups revealed no significant differences on the clinical characteristics except the number of positive responses to the rotavirus antigen tests in stool. And the recurrence rates of convulsions in both groups were similar with previous studies which showed no significant differences between the two groups.
Age of Onset ; Cerebrospinal Fluid ; Child ; Electroencephalography ; Electrolytes ; Follow-Up Studies ; Gangwon-do ; Gastroenteritis* ; Humans ; Leukocyte Count ; Prognosis ; Recurrence ; Retrospective Studies ; Rotavirus ; Seizures* ; Seizures, Febrile

OBJECTIVE: The reaccumulation of hematoma is one of the most frequent problems on the chronic subdural hematoma. The aim of this study is to determine the factors affecting the reaccumulation of hematoma and the reasonable site for the burr-hole trephination to achieve a low reaccumulation rate after burr-hole trephination and closed-system drainage METHODS: The authors studied 93 patients with chronic subdural hematoma in whom the location of burr-hole trephination was randomly placed and precisely determined on postoperative brain computerized tomographic scans or skull roentgenogram. Eighty five patients with chronic subdural hematoma were obtained with brain computerized tomographic scans the postoperative 3 day. The location of the burr-hole trephination, the location of subdural catheter tip, the maximum postoperative width of the subdural space, and the percentage of the ipsilateral subdural space occupied by air postoperatively were measured and analyzed the correlation with the postoperative reaccumulation rates. RESULTS: Patients with the parietal trephination had much more subdural air and a higher of chronic subdural hematoma reaccumulation than those with the frontal one. In addition, patients with residual subdural air on brain computerized tomographic scans obtained the postoperative 3 day also had a higher reaccumulation rate than those without subdural air collections. CONCLUSION: The incidence of postoperative subdural fluid reaccumulation can be reduced by the burr-hole trephination on the frontal convexity and by preventing subdural air accumulation during operation.
Brain ; Catheters ; Drainage* ; Hematoma ; Hematoma, Subdural ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Rabeprazole ; Skull ; Subdural Space ; Trephining*

A 69-year-old man, suffering from diabetes, presented with drowsiness and general weakness is reported. Brain computed tomography revealed low density subdural lesion in the left hemisphere. A single burr hole was trephined and purulent material with liquified hematoma was drained to reveal Klebsiella pneumoniae from the specimen culture. Due to the unexplained postoperative mental deterioration and high fever, the patient underwent abdominal sonography to reveal liver abscess and the same pathogen was also cultured from the liver abscess. This case was very rare in that Klebsiella pneumoniae implanted into the vascularized capsule of the chronic subdural hematoma by hematogenous bacteremia. When chronic subdural hematoma is present in an immunocompromised or in old age patient, the infected subdural hematoma might be considered as one of the differential diagnosis.
Aged ; Bacteremia ; Brain ; Diagnosis, Differential ; Empyema, Subdural ; Fever ; Hematoma ; Hematoma, Subdural* ; Hematoma, Subdural, Chronic ; Humans ; Klebsiella pneumoniae ; Liver Abscess ; Sleep Stages

BACKGROUND: The nasal mucosa is degenerated by inflammations, physical stimulations such as cessation of air flow, and other chemical stimulations. And it is regenerated regularly by newly differentiated cells. OBJECTIVES: In order to investigate the morphologic changes of the nasal mucosa and regenerating activities in sinusitis. MATERIALS AND METHODS: The authors made animal models of acute maxillary sinusitis by obstructing the natural ostium of maxillary sinus of rabbit and inoculating Staphylococcus aureus colonies. Each contralateral side was used as control. The rabbits were sacrificed after 1, 2, and 3 weeks. Morphologic changes of the nasal mucosa and regenerating activities of the olfactory mucosa were observed with Hematoxylin-eosin staining and immunohistochemistry using BrdU. RESULTS: Purulent sinusitis was developed in all rabbits. Light microscopy showed that nasal mucosa revealed inflammatory changes such as edema, inflammatory cell infiltration, goblet cell metaplasia, polypoid change, epithelial ulceration, and submucosal connective tissue proliferation. BrdU-labelled cells were observed mainly in the basal cell layer of the olfactory mucosa, and their numbers in the control sides were significantly higher than in the experimental sides. CONCLUSION: These results indicate that acute infection of the maxillary sinus induces inflammatory changes of both respiratory and olfactory mucosa of the nose and decreases the regenerating activity of olfactory mucosa.
Bromodeoxyuridine ; Connective Tissue ; Edema ; Goblet Cells ; Immunohistochemistry ; Inflammation ; Maxillary Sinus* ; Maxillary Sinusitis* ; Metaplasia ; Microscopy ; Models, Animal ; Nasal Mucosa* ; Nose ; Olfactory Mucosa ; Physical Stimulation ; Rabbits* ; Sinusitis ; Staphylococcus aureus ; Stimulation, Chemical ; Ulcer

BACKGROUND AND OBJECTIVES: The protective effect of angiotensin converting enzyme (ACE) inhibitor against ischemia/reperfusion injury has been demonstrated in animal models, however the effect of AT1 receptor antagonist is contradictory. The present study was designed to investigate the myocardial protective effects of the AT1 receptor antagonist irbesartan during myocardial ischemia/reperfusion in vivo. MATERIALS AND METHODS: Sprague-Dawley rats were subjected to a 45-minute left coronary artery ligation followed by a 2-hour re-perfusion. An inert vehicle (group I:n=14) or irbesartan (50 mg/kg/day:group II, n=12) was administered for 3 days before coronary occlusion. The ratio of the myocardial infarct area to the ischemic area at risk was assessed through triphenyltetrazolium chloride staining. Apoptosis was evaluated by analyzing DNA fragmentation and TdT-mediated dUDP nick end labeling staining. Western blot analysis was performed for MAP Kinases (ERK1/2 and p38) and Bcl-2 and Bax. RESULTS: The ratio of the infarct area to the ischemic area at risk of group II was smaller than that of group I (42.6+/-2.7% vs. 64.1+/-4.6%;p<0.005). Agarose gel electrophoresis revealed discrete DNA laddering in the ischemic zone of group I, however DNA ladder formation was attenuated in group II. The expressions of ERK1 MAPK and Bcl-2 were increased in the ischemic area of group II compared to that of group I. CONCLUSION: AT1 receptor antagonist was effective in reducing myocardial reperfusion injury in vivo. This effect can at least be partially attributed to the attenuation of cardiomyocyte apoptosis, and this anti-apoptotic effect appears to be related to the increased expression of Bcl-2 and alterations in MAP kinase signaling.
Angiotensin II* ; Angiotensins* ; Animals ; Apoptosis ; Blotting, Western ; Coronary Occlusion ; Coronary Vessels ; DNA ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Ligation ; MAP Kinase Signaling System ; Models, Animal ; Myocardial Infarction ; Myocardial Ischemia* ; Myocardial Reperfusion Injury ; Myocytes, Cardiac ; Peptidyl-Dipeptidase A ; Phosphotransferases ; Rats* ; Rats, Sprague-Dawley ; Receptors, Angiotensin ; Reperfusion Injury* ; Reperfusion*

Leptomeningeal carcinomatosis (LMC) is rare metastatic form of gastric cancer. Most cases are diagnosed in the final stage after multiple distant metastasis. An 84-year-old woman was admitted with melena, headache and vomiting. Esophagogastro-duodenoscopy showed an ulceroinfiltrating lesion at the stomach (Borrmann class III), and biopsy revealed a signet ring cell carcinoma. The abdominal-pelvic CT showed no evidence of metastasis. A sudden decrease of consciousness was noted, but the brain CT showed no active lesion while the brain MRI revealed enhancement of leptomeninges. A lumbar puncture was performed and the cerebrospinal fluid study revealed malignant neoplastic cells. With family consent, no further evaluation and treatment were administered and she died six weeks after the diagnosis of gastric cancer. We report an extremely rare case of a patient who initially presented with neurologic symptoms, and was diagnosed LMC from advanced gastric cancer without any evidence of metastasis in abdomen and pelvis.
Abdomen ; Aged, 80 and over ; Biopsy ; Brain ; Carcinoma, Signet Ring Cell ; Cerebrospinal Fluid ; Consciousness ; Diagnosis ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Melena ; Meningeal Carcinomatosis* ; Neoplasm Metastasis ; Neurologic Manifestations ; Pelvis ; Spinal Puncture ; Stomach ; Stomach Neoplasms* ; Vomiting

Herein, we present a case of coexisting neuroendocrine carcinoma and conventional adenocarcinoma (collision tumor) in the ampulla of Vater, which has seldom been reported in the literature. A 51-year-old man presented with a month history of jaundice. MRCP disclosed about 1.9x1.8 cm sized heterogeneously enhancing mass in ampulla of Vater, causing obstructions of distal common bile duct. He underwent pylorus-preserving pancreaticoduodenectomy under the diagnosis on ampulla of Vater cancer. Pathologically, sections on the ampulla of Vater showed conventional ductal adenocarcinoma extended and collided with poorly differentiated neuroendocrine carcinoma. In conclusion, we hereby presented a case of coexisting neuroendocrine carcinoma and conventional adenocarcinoma in the ampulla of Vater.
Adenocarcinoma* ; Ampulla of Vater* ; Carcinoma, Neuroendocrine* ; Common Bile Duct ; Diagnosis ; Humans ; Jaundice ; Middle Aged ; Pancreaticoduodenectomy