No abstract available.
Rectal Prolapse*

No abstract available.
Female ; Meigs Syndrome*

BACKGROUND: It is generally accepted that most colorectal cancers develop from adenomas, so the detection and removal of them can reduce the incidence of colorectal cancers. Sigmoidoscopy is the effective tool for detecting and removing adenomatous polyps in the rectosigmoid region, but its major limitation is that sigmoidoscopy alone can not detect considerable portion of colorectal adenomas. METHODS: From October, 1996 to August, 1997, we performed 2017 sigmoidoscopies and 1683 colonoscopies. We analysed the anatomical distribution of adenomas and compared the detection rate of adenomas between two groups. In 32 cases, adenomas detected by sigmoidoscopy were followed by colonoscopy in less than 2 months. RESULTS: We found 125 cases of adenomas in 2017 sigmoidoscopies and 281 cases of adenomas in 1683 colonoscopies. In 281 cases of adenomas found by colonoscopy, 151 cases had rectosigmoid adenomas only and 25 cases had rectosigmoid and proximal adenomas, 105 cases had proximal adenomas only. The detection rate of adenomas by sigmoidoscopy was significantly lower than that by colonoscopy in the rectosigmoid region(6.1% vs. 10.5%, p=0.002). In 32 cases of adenomas found by sigmoidoscopy that were followed by colonoscopy, 7 cases of proximal adenomas and 6 cases of additional rectosigmoid adenomas were detected. CONCLUSION: Sigmoidoscopy cannot detect adenomas in the proximal colon beyond the sigmoid, it also can miss a significant portion of adenomas in the rectosigmoid.
Adenoma* ; Adenomatous Polyps ; Colon ; Colon, Sigmoid ; Colonoscopy ; Colorectal Neoplasms ; Incidence ; Mass Screening* ; Sigmoidoscopy*

BACKGROUND/AIMS: The caudal anesthesia for anal surgery is simple and effective. Also, it is relatively safe because there is no headache or other neurologic complications. But, during the operation under caudal anesthesia, the unwanted symptoms such as lower abdominal pain or hypotensive symptoms were experienced in some patients. These unwanted symptoms may occur due to anal and lower rectal dilatation. The precise mechanism is unknown. But we speculated that some sensory nerve endings in rectal submucosa may be involved in this mechanism. So, we think that it is possible to prevent or reduce these symptoms if we block these sensory nerve endings effectively with local anesthetics. Therefore, the aim of this study is to see whether the locally injected lidocaine can reduce or prevent the unwanted symptoms during anal surgery under caudal anesthesia. METHODS: There were 100 consecutive patients in this study who had hemorrhoidectomy with Jack-knife position under caudal anesthesia at our clinic. We divided evenly these 100 patients into two groups, injection and control groups(in each group, 50 patients were included.). In injection-group, We injected 10 cc(100 mg) of 1% lidocaine solution cir cumferentially into the lower rectal submucosa at the beginning of the operation. In control-group, we did not inject lidocaine solution initially, but the lidocaine injection was done during the operation in the same manner in the injection-group if the severe unwanted symptoms occurred. We used Parks-type retractor to dilate the anus and recorded the patient,s complaints. RESULTS: In injection-group, male to female ratio was 33:17, mean age was 42.1 years(20~69) and mean operation time was 38.3 minutes(15~80). In control-group, male to female ratio was 25:25, mean age was 43.7 years(17~65) and mean oeration time was 38.5 minutes(15~80). Lower abdominal pain was present in 11 patients(22%) among injection-group and in 37 patients(74%) among control-group(p=0.000). Hypotensive symptoms such as nausea, vomiting, sweating and dizziness were present in 1 patient(2%) among injection-group and in 8 patients(16%) among control-group(p=0.014). We injected lidocaine solution into lower rectal submucosa during the operation in 18 patients with severe symptoms among control-group. The effect of the injected lidocaine solution in 18 control patients was good in 13(72%) and fair in 5(28%). With regard to factors influencing the occurrence of symptoms, there was a tendency of higher occurrence in male, the younger-aged and the longer-operation groups. CONCLUSION: The lower rectal submucosal lidocaine injection reduced the unwanted symptoms such as lower abdominal pain and hypotensive symptoms during the anal surgery under the caudal anesthesia.
Abdominal Pain ; Anal Canal ; Anesthesia, Caudal* ; Anesthetics, Local ; Dilatation ; Dizziness ; Female ; Headache ; Hemorrhoidectomy* ; Humans ; Lidocaine* ; Male ; Nausea ; Sensory Receptor Cells ; Sweat ; Sweating ; Vomiting

Amyopathic dermatomyositis is defined by characteristic cutaneous manifestation of dermatomyositis without evidence of muscle involvement. There is no clinical difference between dermatomyositis and amyopathic dermatomyositis. Pulmonary involvement of dermatomyositis is so frequent than aggressive dianostic and therapeutic approach is needed. Early steroid or immunosuppresive treatment in pulmonary involvement of dermatomyositis gets better prognosis. Intravenous immunoglobulin treatment is an effective and safe alternative when the steroid or immunosuppresive treatment is ineffective or intolerable. We are reporting a case of amyopathic dermatomyositis with interstitial lung disease. This patient was improved with intravenous immunoglobulin treatment.
Dermatomyositis* ; Humans ; Immunoglobulins ; Lung Diseases, Interstitial* ; Prognosis

OBJECTIVE: To evaluate the correlation of HPV infection and E6 oncoprotein expression with carcinogenesis and prognostic role of cervical carcinoma METHODS: Paraffin embedded tissues were obtained from 35 invasive cervical carcinoma, 15 carcinoma in situ, 12 dysplasia of cervix and 20 patients with benign uterine disease as control. HPV type was determined by polymerase chain reaction using type specific primers. E6 oncoprotein expression was analyzed by immunohistochemical staining using C1P5 mouse monoclonal antibody. RESULTS: 1. The positivity of HPV type 16 PCR in invasive cervical carcinoma was 77.1% and it was significantly higher than carcinoma in situ(53.3%), cervical dysplasia(25%), and control (10%). But the positivity of HPV type 18 was not correlated between above groups. 2. The positivity of HPV type 16/18 in cervical carcinoma was not correlated to patient's age. 3. The positivity of HPV in cervical carcinoma was correlated to clinical stage of cervical carcinoma but the positivity of HPV in cervical dysplasia was not correlated to the degree of dysplasia. 4. The positivity of E6 oncoprotein expression was 77.1% in invasive cervical carcinoma, 66.7% in carcinoma in situ and 20% in control group. E6 oncoprotein was not decteted among the cases which negative was for HPV 16/18. The E6 oncoprotein expression in 35 cases of invasive cervical carcinoma was negative in 8, weakly positive in 7, positive in 12, and strong positive in 8 ases. But in 20 cases of normal control group, there was no case of strong positive or posirive E6 oncoprotein expression. 5. The E6 oncoprotein expression was significantly correlated to the clinical stage and lymph node metastasis. The incidence of lymph node metastasis increased and the stage became higher as the E6 oncoprotein expression increased. CONCLUSION: These results suggest that HPV is one of the most important factors in the carcinogenesis of cervical carcinoma and the E6 oncoprotein expression may be associated with biological aggressiveness of cervical carcinoma.
Animals ; Carcinogenesis ; Carcinoma in Situ ; Cervix Uteri ; Female ; Humans* ; Incidence ; Lymph Nodes ; Mice ; Neoplasm Metastasis ; Paraffin ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms* ; Uterine Diseases

The present study was performed to examine whether acupuncture can regulate the expression of cytokines that play important roles in wound healing and morphological changes in the burn wound healing of rats, such as transforming growth factor (TGF)-beta1, TGF-beta3, epidermal growth factor (EGF), and interleukin-6 (IL-6). Sprague-Dawley rats weighing 250~300 g were divided into two control groups and two experimental groups. Among the control groups, no-treatment group was classified as C and acupuntured group as Ca. Among the experimental groups, burned group (n = 6) was classified as B and acupunctured group after burn (n = 6) as Ba. The lumbar area of rats was burned 15 x 25 mm in size for 15~18 seconds with special small iron adapter and acupunctured at 5~7 mm in diameter and 1 cm in depth using 0.25 mm x 50 mm acupuncture needle for 20 minutes in wound area. Rats in group Ca were acupunctured once. Rats in group Ba were acupunctured every 12 hours 3 times. Rats were sacrificed at days 1, 3, 7, 15 and 20 after burn treatment. Morphological changes were examined by hematoxylin-eosin staining methods. The expression profiles of TGF-beta1, TGF-beta3, EGF and IL-6 were detected by immunohistochemical staining methods. The results we obtained were as follows: 1. In gross observation, the burn wounds were less odorous and cleaner in the acupunctured group (Ba) compared with those of no-acupuncture group (B). 2. Reepithelialization and formation of panniculus carnosus and granulation tissue were more prominent at days 3 and 7 in the acupunctured group Ba than group B. However, this difference was disappear at day 15. 3. In the muscle of group B, TGF-beta1 was observed after day7. However, in group Ba, TGF-beta1 was observed as early as days 1 and 3 and rapidly turnovered at day 7. 4. For TGF-beta3, both B and Ba groups showed similar results. 5. At day 3, EGF was observed in the subcutaneous tissue in both B and Ba groups. However, in day 7, EGF was rapidly decreased in Ba group compared with that of B. 6. For IL-6, both B and Ba groups showed similar results in epidermis, dermis, subcutaneous tissue and muscle. But, at day 3, IL-6 was rapidly decreased in theconnective tissue under the muscle in Ba group compared with that of B. These results suggest that acupuncture may improve the wound healing in the early stage by increasing the TGF-beta1 that is essential for the formation of extracellular matix and by decreasing EGF.
Acupuncture* ; Animals ; Burns* ; Cytokines ; Dermis ; Epidermal Growth Factor* ; Epidermis ; Granulation Tissue ; Interleukin-6* ; Iron ; Needles ; Odors ; Rats* ; Rats, Sprague-Dawley ; Skin ; Subcutaneous Tissue ; Transforming Growth Factor beta1* ; Transforming Growth Factor beta3* ; Transforming Growth Factors ; Wound Healing* ; Wounds and Injuries*

The present study was performed to examine whether acupuncture can regulate the expression of extracellular matrix proteins that play important roles in burn wound healing of rat, such as fibronectin, type I and IV collagens, and laminin. Sprague-Dawley rats weighing 250~300 g were divided into 4 groups such as normal control group (C), only acupuncture treatment group (Ca), burn treatment group (B), and a group for acupuncture treatment after burn (Ba). We burned 15x25 mm in size for 15~18 seconds at lumbar area of rats with special iron adapter and acupunctured at 5~7 mm in diameter and 1 cm in depth using 0.25 mm x 50 mm acupuncture needle for 20 minutes in wound area. Rats in group Ca were acupunctured once, and rats in group Ba were acupunctured every 12 hours 3 times. Rats sacrificed at days 1, 3, 7, 15 and 20 after burn treatment. Histological changes were examined by azan staining methods and expression profiles of fibronectin, type I and IV collagens, and laminin were detected by immunohistochemical staining methods. The results we obtained were as follows: 1. At day 1, fibers in epidermis, dermis and subcutaneous tissue in both groups B and Ba were not observed. However groups B and Ba exhibited fibers stained mildly and moderately, respectively, in muscle and connective tissues. At day 20 , the level of fiber in group B which was comparable to group C was less than that of in B group. 2. At day 3, fibronectin in group Ba was observed in the muscle. At days 15 and 20, fibronectin was increased in epidermis and dermis of group Ba compared with those of group B. 3. Type I collagen in subcutaneous tissue was observed at days 1, 3 and 7 in both groups B and Ba. However type I collagen was observed only in group Ba at day 15. In the epidermis of group Ba, type I collagen was observed at day 3 and maintained until day 20, while observing only at day 20 in group B. 4. For type IV collagen, both groups B and Ba showed similar results. 5. For laminin, both groups B and Ba showed similar results except the 7th day results. However after day 15, laminin was stained moderately and mildly in groups Ba and B, respectively. These results suggest that acupuncture may improve the burn wound healing by increasing fibronectin and type I collagen.
Acupuncture* ; Animals ; Burns* ; Collagen Type I ; Collagen Type IV ; Collagen* ; Connective Tissue ; Dermis ; Epidermis ; Extracellular Matrix Proteins ; Fibronectins* ; Iron ; Laminin* ; Needles ; Rats* ; Rats, Sprague-Dawley ; Skin ; Subcutaneous Tissue ; Wound Healing* ; Wounds and Injuries*

PURPOSE: HER-2/neu oncogene is known to play a part in the process of carcinogenesis, while the biological characteristics of HER-2/neu oncoprotein include regulating cell growth and increasing the reproductionability of a tumor. The extracelluar domain (ECD), whose molecular weight is between 95 and 105 kD among the HER-2/neu oncoprotein structures, is proteolyzed and separated from the cell surface by metalloproteases and goes into the blood stream where it starts circulation. Since monoclonal antibody was developed for the serum HER-2/neu ECD, it's now possible to measure HER-2/neu ECD in the serum with the immunoassay method. The measurement of serum HER-2/neu ECD is used for prognosis of metastatic breast cancer and for testing the treating effect of trastuzumab (Herceptin(R)), a target agent for the patients positive to the HER-2/neu receptor. In Korea there is no report on the accurate reference range of serum HER-2/neu for healthy women. The purposes of this study were to measure the serum HER-2/neu ECD in healthy Korean women, analyze the reference range. METHODS: The subjects of the study include 200 healthy Korean women with 50 from each in their twenties, thirties, forties, and fifties. As for methodology, the HER-2/neu in the serum separated from their blood was measured. The serum HER-2/neu level was measured quantitatively with the recently developed ADVIA Centaur(R) automated immunoassay analyzer and ADVIA Centaur(R) HER-2/neu assay reagent. With the measurement, you can use the sandwich immunoassay and direct chemiluminescence technique for two monoclonal antibodies for the epitopes located in the serum HER-2/neu ECD. The reference ranges were calculated based on the mean +/- 2 SD. RESULTS: One of the 200 healthy subjects was excluded from analysis for having the highest value of serum HER-2/neu (23.1 ng/ml), and the data of total 199 were used for analysis. The analysis results indicated that the minimum value was 3.5 ng/mL, the maximum value 14.5 ng/mL, the mean 8.6 ng/mL, average 8.77 ng/mL, and SD 1.61 ng/mL. The reference range of the 199 subjects's serum HER-2/neu measurements was calculated by the mean +/- 2 SD. Since the mean +/- SD of their HER-2/neu measurements was 8.8 +/- 1.6 ng/mL, the reference range was 5.6~12.0 ng/mL. The reference ranges for the age groups were 6.1~10.9 ng/mL, 5.3~11.4 ng/mL, 5.0~12.6 ng/mL and 6.3~12.6 ng/mL for the twenties, thirties, forties and fifties, respectively. The reference ranges for the age groups were analyzed statistically and there was statistical difference (p= 0.002) between fifties and twenties or thirties. The upper limit level of the reference range of serum HER-2/neu in healthy Korean women was 12.0 ng/mL. CONCLUSION: The results suggest that the reference range of serum HER-2/neu in healthy Korean women is 6.1~10.9 ng/mL, 5.3~11.4 ng/mL, 5.0~12.6 ng/mL and 6.3~12.6 ng/mL for the twenties, thirties, forties, and fifties, respectively. There is no significant difference between the twenties, thirties, forties, each other. According to analyzed statistically, there is difference between fifties and twenties or thirties (p= 0.002), but there is no statistically significant difference between forties and fifties.
Antibodies, Monoclonal ; Breast ; Breast Neoplasms ; Carcinogenesis ; Epitopes ; Female ; Humans ; Immunoassay ; Korea ; Luminescence ; Metalloproteases ; Molecular Weight ; Oncogenes ; Population Characteristics ; Prognosis ; Reference Values* ; Reproduction ; Rivers ; Trastuzumab

BACKGROUND AND OBJECTIVES: Myocardial bridge is congenital coronary anomaly and cause myocardial ischemia by milking effect. The general study of myocardial bridge is to be weak, so we examined a clinical study of myocardial bridge. MATERIALS AND METHOD: This study included 36 bridge cases out of 1048 patients who underwent coronary angiography due to chest pain from Jan. 1993 to Jul. 1998. Angiographic film, medical records and interview by telephone were reviewed retrospectively. Total follow-up duration was mean 27 months (1 month to 62 months). RESULTS: Incidence of myocardial bridges diagnosed by angiography was 3.4%. Angiography showed normal in 32, 1 vessel disease in 3 and 2 vessel disease in one patient. Mean reference diameter was 2.97+/-0.36mm, bridge diameter was 2.75+/-0.33mm in diastole, 1.12+/-0.47mm in systole. Myocardial bridge length was 12.50+/-7.44mm, mean % diameter stenosis was 59.26+/-17.7%. Myocardial bridge location was 80.6% in mid LAD and 13.9% in mid & distal LAD and 5.5% in distal LAD. There was no statistically significant correlation with sex, risk factor of coronary heart disease, resting electrocardigraphy, treadmill test, diameter and angulation of coronary artery, clinical symptom in the severity of myocardial bridge. But the severity of myocardial bridge correlated with bridge length(r=.5033). CONCLUSION: Clinical outcomes of bridge patients were relatively good during the mean follow up periods of 27 months. Myocardial bridge was more severe in younger age and longer bridge length.
Angiography ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Diastole ; Exercise Test ; Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Milk ; Myocardial Ischemia ; Retrospective Studies ; Risk Factors ; Systole ; Telephone