CT findings and comparison between clinical and CT staging were reviewed in 45 consecutive patients withbiopsy proven carcinoma of the cervix. CT was done for staging of primary untreted cercial cancer in 36 patientsand for diagnosis of recurrent cervical cancer or follow-up study 14 times in 9 patients . The results are asfollows; 1. As comparing with clinical staging in 36 cases, CT agreed with clinical stage in 19 cases (52.8%),upstaged in 10 cases(27.8%) and downstaged inn 7 cases (19.4%). 2. The main upstaged CT findings are detection ofunsuspected bladder or rectal invasion and paraaortic lymph node metastasis. Inadequate delineation ofintravaginal tumor was the leading causes of understage of CT than clinical one. 3. CT detected all 10 cases ofthe hydronephrosis shown by IVP and detected unsuspected bladder invasion in 3 cases. 4. CT was valuable in thediagnosis of recurrent tumor and follow-up study after treatment. 5. CT offeres distinct advantages over clinicalstaging and can be integrated into the present FIGO classification of uterine cervix carcinoma. CT can served asan initial radiological staging work-up of primary of recurrent cervical carcinoma.
Cervix Uteri ; Chungcheongnam-do ; Classification ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis ; Lymph Nodes ; Neoplasm Metastasis ; Urinary Bladder ; Uterine Cervical Neoplasms

The purposes of this study were to evaluate the diagnostic modalities of the acute rupture of anterior cruciate ligament(ACL) and to know the differences hetween complete and partial ACL rupture preoperatively, analyzing the methods of physical examimation and the clinical features in acutely injured patient. We analyzed the anterior drawer test, Lachman test, KT-2000 arthrometer, MRI findings and associated injuries in the 35 patients who were confirmed to have ACL rupture by arthroscopy of the knee joint, performed within a month after trauma. We divided the patients by arthroscopy into 2 groups: complete rupture group and the partial rupture group. Among the 35 cases of ACL rupture, there were 10 cases of partial rupture and 25 cases of complete rupture. The Lachman s test was the most sensitive method of the physical examinations in detecting acute ACL injuries, with 90% and 92% positive rate in each group retrospectively. KT-2000 arthrometer with more than 3mm side-to-side difference showed all positive findings except one. The findings of ACL rupture in MRI were discontinuity, increased signal intensity, ahnormal course of ACL fibers and so on. The sensitivity of MRI in diagnosing the acute injuries of ACL was 97.2% hut had difficulties in differentiating the complete from partial rupture. Associated injuries of the ACL injured knee were medial and lateral meniscus tear and medial collateral ligament injury. The diagnosis of acute ACL rupture was made possihle hy physical examinations and with use of the KT-2000 arthrometer and MRI was useful in detecting the ACL rupture or associated injuries but not in differentiating complete from partial rupture of the ACL.
Anterior Cruciate Ligament* ; Arthroscopy ; Collateral Ligaments ; Diagnosis* ; Humans ; Knee ; Knee Joint ; Magnetic Resonance Imaging ; Menisci, Tibial ; Physical Examination ; Retrospective Studies ; Rupture

Vascular ingrowth is essential for the survial of the graft tissue. The purposes of this study were to evaluate any changes in signal intensity of cqropreserved meniscal allograft with time in the magnetic resonance images(MRI) and to demonstrate the viability of the grafts. Eight patients underwent meniscal transplantation with cryopreserved allcgrafts using the bone block technique. MRIs of the knee were taken at 3 days, 3 weeks, 6 weeks, 3 month, 6 months. And I year after the implantation. A second-look arthroscopy and a small meniscal biopsy(sized 2mm x 2mm1 at the peripheral and central part of the meniscus were conducted at 3 months and 1 year. Three days after the operation, the signal intensity of the implanted meniscus revealed a homogenrous low signaJ intensity that could not be differentiated from that of' a contralateral normal meniscus. At 3 weeks, a high signal intensity appeared at the periphery of the meniscus. This signal, which did not communicate into the joint space, fuither intensified at 6 weeks. The high signal intensity of the meniscus, though still higher than that of the normal meniscus, decrexsed slightly at 3 months and continued to decrease progressively even a year after the implantation. The second-look arthroscopy revealed that the grafts were viable and that there was no tearing or shrinking of the meniscus. Cellular proliferation was also found at the central edge oi' the meniscus at 3 months. This cellular pattern differentiated from that of a nonmal meniscus in that the d stribution of cells was not in an even, but in a clonal pattem. The cellularity after a year, however, was sirnilar to that of normal meniscus except some area with deficiency of cells. It can be concluded that increased signal intensity of' the implanted meniscus with time indicates hypervascularity caused by vascular ingrowth, similar to the high signal intensity ot>tained from normal meniscus in young children. Increasecl signal intensity in the chronological postoperative MRls demonstrates the viability of the implanted cryopreserved meniscal allograft.
Allografts* ; Arthroscopy ; Cell Proliferation ; Child ; Humans* ; Joints ; Knee ; Magnetic Resonance Imaging* ; Transplants

Meckel-Gruber syndrome is a quite rare congenital disorder, characterized by posterior encepalocele, cleft palate and lip, polycystic kidneys, hepatic fibrosis with bile duct proliferation, and postaxial polydactyly and syndactyly. We experienced an autopsy case of M eckel-Gruber syndrome in a second baby of 28 year-old woman. At 26 weeks of gestation, congenital anomaly was detected on ultrasonographic examination and the pregnancy was terminated. Familial history was not noted.
Pregnancy ; Female ; Humans

VDT syndrome has been understood as the outocme of the computerized socio-economic cultures in this modern age. It affects many workers on larious visual functions as well as affecting some general health conditions including neurologic, circulatory, and musculosckeletal system. We conducted series of investigations to evaluate the influence of VDT work on the physiologic functions using objective ocular examinations on VDT workers with non-VDT workers as controls. Prolongation of near point decreased accommodation amplitude, myopic shift of refractive condition, and decreased amout of tear formation were significantly indicative in the VDT workers' group. The above functional disturbances can significahtly, deteriorate not only working effeciency but general physical condition if appropriate measures are not provided quickly. Therefore, it is firmly suggested that a comprehensive epidemiological study should be implemented aimed at ImprovIng working situations for VDT workers.
Asthenopia ; Epidemiologic Studies ; Tears

BACKGROUND: REM sleep behavior disorder (RBD) commonly occurs in old-age group and shows very good response to clonazepam. However, clonazepam can aggravate or even precipitate sleep-disordered breathings (SDBs) that is highly prevalent among elderly people. Melatonin has been known to be effective in RBD treatment and is much less likely to increase the airway resistance. The aim is to document the efficacy of melatonin therapy in RBD with co-existing significant SDB. METHODS: We recruited consecutive patients who have both RBD and significant SDB (apnea-hypopnea index, AHI>15) confirmed by nocturnal polysomnography. Melatonin was started at the dose of 0.5 mg/night and increased according to the clinical response. Successful response is defined when symptoms are free or reduced in frequency more than 90% and any physical injury or violence should not be present. RESULTS: Eleven among 16 RBD patients were eligible and enrolled (eight male, median age 69 years, range 54-89). All had significant obstructive sleep-disordered breathings (mean AHI = 28.8, range 22.6-35.2). Melatonin was prescribed(dosage 2-8 mg/night, treatment duration, 7-35 months). Nine patients showed successful response (2-8 mg/night) but two showed unsatisfactory response to 6 mg or 8 mg/night. Two of nine patients with favorable response complained of mild sleepiness. CONCLUSIONS: Melatonin can be effective for controlling RBD with co-existing SDB. Effective dosage range is variable without intolerable adverse effect.
Aged ; Airway Resistance ; Clonazepam ; Humans ; Male ; Melatonin* ; Polysomnography ; REM Sleep Behavior Disorder* ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Sleep, REM* ; Violence

PURPOSE: To determine whether correlation exists between anxiety/depression and the advent/ progression of the disease in glaucoma patients. We compared the degree of anxiety and depression among 3 groups which consist of glaucoma patients, cataract patients, and healthy individuals. METHODS: Between July 1, 1999 and December 31, 1999, a written survey was conducted on three groups of people-glaucoma patients, cataract patients, and healthy individuals, who visited Dankook University Hospital's Ophthalmology Outpatient Depatment. Each group consists of 25 people. The Spielberg's State-Trait Anxiety Inventory (STAI) was employed to quantify the degree of anxiety. STAI consists of 40 questions; 20 questions were designed to measure State Anxiety (STAI-S) and 20 questions to measure Trait Anxiety (STAI-T). In each question, the participants were asked to give scores of 1 to 4. In order to measure the degree of depression, Beck Depression Inventory (BDI) was employed which consists of 21 questions with a 0 to 3 scoring scale for each question. RESULTS: In glaucoma patient group, the average STAI-S score was 44.76+/-13.64, STAI-T score 43.92+/-11.66, and BDI score 15.72+/-10.16. The obtained score was significantly higher compared to cataract patient group (34.64+/-9.17, 34.84+/-10.76, 8.44+/-6.80) and normal group (35.56+/-7.30, 34.52+/-7.70, 8.76+/-4.92) and such findings implied that the degree of anxiety and depression was significantly higher in glaucoma patient group. The severity of intraocular pressure, visual field, visual acuity, and cup to disc ratio did not seem to be correlated with anxiety and depression. DISCUSSIONS: In glaucoma patients, a psychological self training in daily life, in addition to surgical or medical treatment, which can help reduce anxiety and depression can be a useful complement to the conventional treatment modalities.
Anxiety* ; Cataract ; Complement System Proteins ; Depression* ; Glaucoma* ; Humans ; Intraocular Pressure ; Ophthalmology ; Outpatients ; Visual Acuity ; Visual Fields

BACKGROUND: Histological differentiation, status of hormonal receptors, size of tumor, and status of axillary lymph nodes are known prognostic factors in breast cancer. Recently, the DNA ploidy and the S-phase fraction have been considered as relating to parameters affecting the prognosis of cancer patients. METHODS: The authors measured the DNA ploidy and the S-phase fraction and evaluated their significance as prognostic factors in breast cancer. Their correlation with tumor size, lymph-node involvement, pathologic differentiation, status of hormonal receptors, menopause, and survival duration were also analyzed. The DNA ploidy and the S-phase fraction were checked with an FAC scan (Becton Dikinson, U.S.A.) and a cell fit (Becton Dikinson, U.S.A.) using the fresh breast-cancer tissue from 104 patients. RESULTS: The ploidy analysis showed that 32% of the tumors were diploid and 68% were aneuploid. There was significance in the pathologic differentiation, but no significance in the other prognostic factors. The median S-phase fraction was 8.9%, and it was used as a cutoff point. Forty-nine percent (49%) of the tumors were greater than 8.9%, and 51% were less than it. There was significance in the status of hormonal receptors. There was no significance in the relation between these factors and the disease-free survival rate. CONCLUSIONS: Even though these results suggest that the DNA ploidy and the S-phase fraction determined by using flow cytometry are not clinically useful independent prognostic factors, it will be necessary to measure them in a large number of patients and then follow those patients so that a multivariate survival analyses can be performed to evaluate the clinical significance of these factors.
Aneuploidy ; Breast Neoplasms* ; Breast* ; Diploidy ; Disease-Free Survival ; DNA* ; Female ; Flow Cytometry ; Humans ; Lymph Nodes ; Menopause ; Ploidies* ; Prognosis

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme ; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization ; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially In continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions. Quality in terms of accessibility and continuity highly varied among institutions. To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.
Accreditation ; Consumer Participation ; Cooperative Behavior ; Delivery of Health Care ; Education ; Financial Management ; Health Resources ; Humans ; Information Systems ; Korea* ; Occupational Health Services* ; Occupational Health* ; Primary Health Care ; Quality Improvement ; Questionnaires ; Social Welfare ; World Health Organization

A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a 4x3x2.5 cm fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.
Abdominal Pain ; Child ; Constipation ; Diagnosis, Differential ; Emergencies ; Enema ; Fecal Impaction ; Feces ; Humans ; Ileum ; Intestinal Obstruction ; Intestine, Small ; Laxatives ; Male