BACKGROUND & AIMS: Management of ovarian carcinoma presents most commonly by surgery and subsequent platinum-based chemotherapy, but most patients will have either residual or recurrent disease. Taxol, a new antimicrotubule agent, has been indicated as a salvage measure after failure of first-line or subsequent chemotherapy. The purpose of this study is to investigate the efficacy and toxicity of Taxol used as a salvage therapy. MATERIALS & METHODS: Between January 1994 and Jun 1996, 19 patients aged 38-64 years(median 52) with ovarian carcinoma were given Taxol-containing regimen. Taxol was administered at a dose of 135mg/m2 intravenously with cisplatin or carboplatin every 3 weeks. The patients who treated with Taxol only were received 175mg/m2 intravenously with same interval. The median treatment cycle was 6.6 cycles(range, 3 to 15 cycles). Patient's response were evaluated with tumor marker(CA-125) and CT or MRI before and after chemotherapy. Responses and toxicities were defined according to the Gynecologic Oncology Group criteria. (continue)
Carboplatin ; Cisplatin ; Drug Therapy* ; Humans ; Magnetic Resonance Imaging ; Ovarian Neoplasms ; Paclitaxel* ; Salvage Therapy*

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*

To achieve optimal decalcification in tissue and tissue preservation, we have tried magnetic field method and made some promising results. We used pulsed unipolar magnetic field obtained by rectification of 250 V-60 cycle, A.C. As a new method of bony decalcification, using 5% nitric acid, 10% formic acid and 10% formic acid+3% hydrochloric acid solutions, experimental groups were decalcified in the center of the magnetic field. The concentration of calcium ion in the decalcifying solution was measured by calcium-oxalate turbidity test by photometry method, and direct visualization of calcium radiopacity was obtained by soft X-ray view during the decalcification process. The pH change during decalcification was continuously checked and needle penetration method was also used. All the decalcification solution used in this study showed accelerated effect of bony decalcification in the strong magnetic field. Among them 5% nitric acid produced complete decalcification for the medium size bony specimen (less than 10x10x10 mm) within 24 hours, and the histologic feature was almost free of acid-chemical degeneration. The pH of all the decalcification solutions decreased in the strong magnetic field, maximum within 4~6 hours, and kept strong acidity throughout the decalcification procedure. After removal of the magnetic field the pH of all the decalcification solution returned to their original values after 24 hours. It was presumed that the cause of the accelerated decalcification in the magnetic field was due to combined effects of the rapid increase of acidity and the increased molecular resonance to stimulate the ionization of mineral elements.

An age-dependent cellular change of DNA contents in the testis of Sprague-Dawley rats was investigated by flow-cytometric method. Testicular cell suspensions at the age of 4, 5, 6, 7, 8, 10, 12, 16 and 26 weeks were prepared and stained with propidium iodide. The relative proportions in the number of mature and immature haploid (1n), diploid (2n), S-phase and tetraploid (4n) cells were calculated. The proportion in the number of mature haploid cells was sharply increased to the age of 10 weeks (about 38%), thereafter increased slightly to the level of 42% at the age of 26 weeks. The proportion of immature haploid cells was dramatically increased to the age of 6 weeks, then maintained at the level of 20 to 30% thereafter. The proportion of diploid cells was 64% at the age of 4 weeks, then decreased gradually through the age of 26 weeks. The proportion of S-phase cells was increased to the age of 4 weeks, then maintained at a plateau level to the age of 26 weeks. The proportion of tetraploid cells were about 26% at the age of 4 weeks, then decreased gradually to the age of 26 weeks. These results suggest that the proportions of testicular cells may depend on the age of the rat and that the flow cytometric method may be useful in the evaluation of the spermatogenic status with regard to accuracy and sensitivity.
Animals ; DNA/*analysis/genetics ; Diploidy ; Flow Cytometry/methods/veterinary ; Haploidy ; Male ; Rats ; Spermatogenesis ; Testis/chemistry/*growth & development

Gastrointestinal (GI) dysfunction in Parkinson's Disease is common, but its pathophysiology is poorly understood. We performed esophageal manometry, radionuclide oropharyngeal and esophageal transit study in order to obtain the objective data of the frequency of dysphagia in the patients with Parkinson's and to evaluate the subjective symptoms and motor dysfunction of oropharynx and esophagus. Seventeen idiopathic Parkinson's disease patients(7 men and 10 women) and twenty age-matched controls were subjects for esophageal manometry , radionuclide oropharyngeal(O'IT) and esophageal transit study(ETT). Among 17 patients group, 10 patients were abnormal in esophageal manometry, and 14 were abnormal in radionuclide transit time(ETT). At the results of OTT & E'IT, there is significant difference between patient group and age-matched control group(contror group OTT ;2.64+1.9, ETT ;14.33+9.4 : patient group OTT ;34.21+ 71.6, ETT ; 115.98+116. Lsec) (P < 0. 05). However, there was no significant difference between those with complain of dysphagqa and those without complain of dysphagia. Moreover, there was no correlation among the results of O'IT & EIT, the findings of esophageal manometry, those with complain. Of dysphagia, and H-Y stage. In conclusion, it showed the oropharyngeal and esophageal dysfunction in most of Parkinson's disease patients, which was not related with the severity of dysphagia. The causable lesion of dysphagia involved diffusely throughout oropharynx, body of esophagus and lower esophageal sphincter. And, esophageal manometry and radionuclide transit study might be objective tools for evaluation of dysphagia. The relationship between motor dysfunction of oropharynx and esophagus and the severity of Parkinson's disease is remained to be clear.
Deglutition Disorders* ; Esophageal Sphincter, Lower ; Esophagus ; Humans ; Male ; Manometry ; Oropharynx ; Parkinson Disease*

Peripheral nervous system involvement is common in systemic vasculitis, occurring most frequently in the polyarteritis nodosa (PAN) group of disorders and in rheumatoid vasculitis. Within the polyarteritis nodosa group of systemic necrotizing vasculitides, three subgroups have been described: classic polyarteritis nodosa, Churg-Strauss syndrome, and an overlap syndrome. Three patients with evidence of systemic vasculitis and peripheral neuropathy were clinically and electrophysiologically investigated. All cases presented clinically with mononeuropathy multiples considered typical pattern of ischemic involvement of the peripheral nerve. The causes included polyarteritis nodosa, its Churg-strauss variant, and the overlap syndrome. Pain and weakness were frequent symptoms. Nerve conduction studies were abnormal In all cases. Necrotizing vasculitis was present as pathologic findings in two cases. All patients were treated with prednisolone alone or in combination with other immunosuppressive agents or with plasmapheresis.
Churg-Strauss Syndrome ; Humans ; Immunosuppressive Agents ; Mononeuropathies* ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Plasmapheresis ; Polyarteritis Nodosa ; Prednisolone ; Rheumatoid Vasculitis ; Systemic Vasculitis ; Vasculitis*

BACKGROUND: Acute pancreatitis is a fairly common abdominal disorder that can be easily confronted in the emergency department(ED) and is one of the most complex and clinically challenging of all abdominal disorders. Currently, there is no gold standard for the diagnosis of acute pancreatitis. We evaluated the usefulness of the actim Pancreatitis(R) rapid test, which has been recently developed in Europe, as a screening test of acute pancreatitis in our emergency department. METHODS: We prospectively studied the urinary trypsinogen-2 dipstick tests(actim Pancreatitis(R), Medix Biochemica, Kauniainen, Finland) of 200 patients with acute abdominal pain who were treated at our ED. All urine samples were collected from the patients within 12 hours of arrival at ED. We also measured serum amylase assay in the laboratory and compared the sensitivities and the specificities of the two test. Acute pancreatitis was diagnosed by authors according to standardized criteria. Abdominal USG or CT was performed when a patient with a normal serum amylase level had a typical clinical presentation. RESULTS: The actim Pancreatitis(R) rapid test was positive in 22 of the 25 patients with acute pancreatitis(sensitivity, 88.0 percent). The test was also positive in 6 of 175 patients without pancreatitis(specificity, 96.6 percent). The serum amylase assay had a sensitivity of 68.0 percent(with a cutoff value of 300 U per liter for the upper reference limit) and a specificity of 90.9 percent. But there were no statistical differences between the correlation coefficients of the two tests as diagnostic tool CONCLUSION: In patients with acute abdominal pain who are seen in the emergency department, the actim Pancreatitis(R) urinary dipstick test has a high degree of probability as a screening test for acute pancreatitis. Also it can easily and rapidly be use at the bedside.
Abdominal Pain ; Amylases ; Diagnosis ; Emergencies ; Emergency Service, Hospital ; Europe ; Humans ; Mass Screening* ; Pancreatitis* ; Prospective Studies ; Sensitivity and Specificity

Lesch-Nyhan syndrome is a rare X-linked recessive metabolic disorder characterized by developmental delay, hyperuricemia, choreoathetosis, spasticity, mental retardation, and compulsive self-injurious behavior. This disorder results from a complete deficiency of the purine salvage enzyme, hypoxanthine-guanine phosphoribosyltransferase (HGPRT). This syndrome is often misdiagnosed to cerebral palsy and clinical manifestations are usually related to the degree of enzyme deficiency. Complete HGPRT deficiency presents with severe specific neurologic manifestation and nephrolithiasis leading to fatal kidney damage. This report highlighted the importance of clinical awareness leading to early diagnosis and therapy for prevention of the self mutilation and renal failure, even if we couldn't inhibit the progression of neuro-psychotic symptoms.
Cerebral Palsy ; Early Diagnosis ; Hyperuricemia ; Hypoxanthine Phosphoribosyltransferase ; Intellectual Disability ; Kidney ; Lesch-Nyhan Syndrome* ; Muscle Spasticity ; Nephrolithiasis ; Neurologic Manifestations ; Renal Insufficiency ; Self Mutilation ; Self-Injurious Behavior

A 37-year-old female presented to our hospital with a history of bleeding episodes (excessive bleeding after tooth extraction, gum bleeding, easy bruising, and excessive menstruation) and severe thrombocytopenia (2,000/µL). She had no family history of bleeding tendency or thrombocytopenia. No peripheral lymphadenopathy or splenomegaly was noted. The patient's white blood cell count was normal; hemoglobin was 9.7 g/dL. A peripheral blood smear showed markedly decreased platelets, with occasional giant or large platelets. Bone marrow examination found increased megakaryocytes. The patient also complained of hearing difficulty; a hearing test indicated sensory-neural hearing impairment. Her thrombocytopenia was refractory to treatment with glucocorticosteroids, intravenous gamma-globulin, and danazol. In the 13 years following her initial presentation, the patient required anti-hypertensive treatment, a hearing-aid for progressive hearing loss, and started maintenance kidney dialysis. Her clinical history of refractory thrombocytopenia, progressive hearing impairment, and renal failure suggested myosin heavy chain 9 gene-related congenital syndrome (Epstein syndrome), which was confirmed by the presence of a heterozygous deletion mutation, c.221_223del, (p.Lys74del) in peripheral leukocyte deoxyribonucleic acid.
Adult ; Bone Marrow Examination ; Danazol ; Dialysis ; DNA ; Female ; gamma-Globulins ; Gingiva ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Tests ; Hemorrhage ; Humans ; Kidney ; Leukocyte Count ; Leukocytes ; Lymphatic Diseases ; Megakaryocytes ; Myosin Heavy Chains ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Sequence Deletion ; Splenomegaly ; Thrombocytopenia* ; Tooth Extraction

OBJECTIVE: The aim of this study was to examine whether the presence of anti-ribonucleoprotein (anti-RNP) antibodies at diagnosis is associated with systemic lupus erythematosus (SLE) flares in newly diagnosed patients during the first year of follow-up. METHODS: The medical records of 71 newly diagnosed SLE patients without other concomitant autoimmune disease, serious infection, or malignancy were reviewed retrospectively. SLE flares were defined according to the SLE Disease Activity Index 2000. Patients were divided into 2 groups according to the presence or absence of anti-RNP, and variables were compared between the groups. RESULTS: During the first year of follow-up, SLE patients with anti-RNP at diagnosis more frequently presented with mucosal ulcers (p=0.003), rash (p=0.001), and arthritis (p=0.007), compared to those without anti-RNP. The SLE flare incidence was remarkably higher in patients with anti-RNP than in those without anti-RNP (62.5% vs. 23.1%, p=0.001). SLE patients with anti-RNP at diagnosis had a significantly higher risk of ever experiencing a SLE flare during the first year of follow-up, compared to those without anti-RNP (odds ratio=8.250). CONCLUSION: In conclusion, SLE patients with anti-RNP at diagnosis were more than 8-fold more likely to experience an SLE flare during the first year of follow-up.
Antibodies ; Arthritis ; Autoimmune Diseases ; Diagnosis* ; Exanthema ; Follow-Up Studies* ; Humans ; Incidence ; Lupus Erythematosus, Systemic* ; Medical Records ; Retrospective Studies ; Ulcer