Malignant Mixed Mullerian tumors(MMMTs) are unusual neoplasms occumng mostly in the uterus and, ralely, they arise in the ovary. The clinical features of malignant mixed mullerian tumor of the ovary are similiar to other ovarian malignancies. The clinical course is rapidly progressive and fatal. The optimal treatment modalities has remained elusive. The most reliable prognostic criterion is the initial tumor stage and the overall survival was poor. We experienced two cases of malignant mixed miillerian tumor of the ovary, so we report these cases with a brief review of the concerned literatures.
Female ; Ovary* ; Respiratory Sounds ; Uterus

Purpose: Initial conservative treatment with selective endovascular or surgical intervention has shown successful outcomes in the treatment of spontaneous isolated superior mesenteric artery dissection (SISMAD). However, the benefits of antithrombotic therapy as a part of conservative treatment have not been clarified. This study aimed to investigate the clinical course of SISMAD patients and determine differences in clinical outcomes between the antithrombotic and noantithrombotic groups. Methods: We retrospectively reviewed 79 cases of SISMAD that were treated conservatively from January 2004 to December 2019 at Chonnam National University Hospital. Clinical outcomes, including the length of hospital stay, pain resolution time, image remodeling, and maximal remodeling time, were compared between the antithrombotic and noantithrombotic groups. Results: There were 30 patients in the no-antithrombotic group and 49 patients in the antithrombotic group. There was no significant difference in clinical characteristics between the 2 groups, except for dyslipidemia (P = 0.011). The follow-up period (32.6 months vs. 14.6 months, P = 0.009) and imaging follow-up period (31.6 months vs. 13.9 months, P = 0.011) were longer in the antithrombotic group than in the no-antithrombotic group. The length of hospital stay (5.1 days vs. 7.7 days, P = 0.002) was significantly shorter in the no-antithrombotic group than in the antithrombotic group because patients in the antithrombotic group required longer hospitalization for warfarin titration. Conclusion In patients with SISMAD, conservative treatment without antithrombotic therapy may have clinical benefits such as decreased length of hospital stay compared with conservative treatment with antithrombotic therapy.

OBJECTIVE: To measure gynecologic resources required to care for women who have unscheduled vaginal bleeding while using hormone replacement therapy. MATERIALS AND METHODS: Between January 1996 to December 1998, women presenting with abnormal withdrawal bleeding on HRT were identified and associated clinic visits and gynecologic procedures were recorded during a mean follow-up of 2 years. RESULTS: Among women using cyclic HRT, 28.9% had> OR =1 visit for unscheduled vaginal bleeding 8.7% had> OR =1 endometrial biopsy. Among women using continuous combined HRT, 19.3% had> OR =1 visit for unscheduled vaginal bleeding and 6.4% had> OR =1 endometrial biopsy. The gynecologic procedures used in women using cyclic HRT were 20% of reassurance, 50% of ultrasonograpy, 30% of endometrial biopsy and in women using continuous combined HRT were 50% of reassurance, 16.6% of ultrasonograpy, 33.3% of endometrial biopsy. The results of endometrial biopsy were reported all the benign condition. CONCLUSION(S): Unscheduled vaginal bleeding markedly decreased after 12 months of therapy in women using continuous combined HRT but did not decline among those using cyclic HRT.
Ambulatory Care ; Biopsy ; Female ; Follow-Up Studies ; Hemorrhage ; Hormone Replacement Therapy* ; Humans ; Uterine Hemorrhage*

PURPOSE: This study demonstrated that apoptosis induced by mycophenolic acid (MPA) is mediated by mitochondrial membrane potential transition (MPT) changes in Jurkat cells. METHODS: Cell viability and MPT changes were measured by flow cytometry. Western blotting was performed to evaluate the expression of Bcl-2 family proteins, Bid, truncated Bid (tBid), cytochrome c, voltage dependent anion channel (VDAC), poly ADP-ribose polymerase (PARP), and protein kinase C-delta (PKC-delta). The catalytic activity of caspase-9 and -3 was also measured. RESULTS: Cell viability was decreased in time- and dose-dependent manners. Bcl-2 protein expression was decreased, but Bax protein expression was identified. A decreased Bcl-XL /Bcl-XS ratio was also noted. The expression of tBid protein also increased in a time-dependent manner in Jurkat cells treated with MPA. While normal MPT appeared as orange fluorescence, abnormal MPT corresponded to green fluorescence. Green fluorescence increased as orange decreased in the MPA-treated cells. Significantly increased concentrations of MPA induced the release of cytosolic cytochrome c. MPA also augmented the catalytic activity of caspase-9 and caspase-3 in Jurkat cells. Our findings demonstrated that MPA-induced apoptosis is mediated by MPT changes accompanied by decreased Bcl-XL expression and the appearance of tBid protein. The release of cytosolic cytochrome c from mitochondria and increased catalytic activity of caspase-9 and caspase-3 were observed in MPA-treated Jurkat cells. CONCLUSION: These results suggest that mitochondrial dysfunction caused by MPA induces human T lymphocyte apoptosis.
Adenosine Diphosphate Ribose ; Apoptosis ; bcl-2-Associated X Protein ; BH3 Interacting Domain Death Agonist Protein ; Blotting, Western ; Caspase 3 ; Caspase 9 ; Cell Survival ; Citrus sinensis ; Cytochromes c ; Cytosol ; Flow Cytometry ; Fluorescence ; Humans ; Jurkat Cells ; Lymphocytes ; Membrane Potential, Mitochondrial ; Mitochondria ; Mitochondrial Membranes ; Mycophenolic Acid ; Protein Kinase C-delta ; Proteins

The purpose of this paper is to review the colonoscopic fingings of twenty two patients with colonic tuberculosis which were diagnosed by colonoscopic finding, histopathology, and follow-up observation after antituberculosis chemotherapy at Pusan National University Hospital from January 1992 to December 1994. The results were as follows: 1) The male to female ratio was 1: 1.2, and the average age of the patients was 39.4 years with a slight predominance in women. The age of peak incidence was the 4th decade 40.9%). 2) Abdominal pain(95%), diarrhea(63%), and weight loss(50%) were the most common clinical findings. Others were constipation, melena, and palpable abdominal mass. The location of the pain was right lower abdomen, epigastrium, central abdomen, and left lower abdomen in decreasing order. 3) Hematologic findings showed decrease in hemoglobin level, increase in ESR, and positive CRP(61.5%). The white blood cell counts were mostly normal. 4) The stool examination showed positive occult blood in 7 cases among 18 cases (38.9%). Acid-fast bacteria was observed in stool of one case. 5) On colonoscopy, the lesion sites were ileoeecal valve(75%), ascending colon(72.7 %), terminal ileum(52.6%), cecum(42.9%), transverse colon(31.8%), descending colon (27.3%), sigmoid colon(9%), and rectum(9%) in decreasing order of frequency. Most of them involved ileocecal area. 6) On colonoscopy, the shape of ulcer revealed circular(41%), fusion(36%), and irregular pattern(18%). It found skipped area in 9 cases, pseudopolyp in 8 cases, patency of ileocecal valve in 5 cases, and severe deformity of ileocecal valve in 6 cases. 7) Microscopic finding of biopsy specimens revealed noncaseating granulomatous inflammation in 12 cases, and nonspecific ulcerative inflammation in 10 cases. In conclusion the diagnostic yield may be greatly enhanced by obtaining multiple target biopsies frorn tbe deep portion of the ulcer bed and margins. Judged from the colonoscopic finding and clinical improvement after antituberculosis chemotherapy, more accurate diagnosis can be acquired.
Abdomen ; Bacteria ; Biopsy ; Busan ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Congenital Abnormalities ; Constipation ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Ileocecal Valve ; Incidence ; Inflammation ; Leukocyte Count ; Male ; Melena ; Occult Blood ; Tuberculosis* ; Ulcer

The pattern of periodic sharp wave complexes (PSWC) was widely accepted as the most characteristic electroencepalographic(EEG) abnormality in Creutzfeldt-Jakob disease (CJD) although it may be lacking in prodromal and terminal stages. The EEG abnormalities are often asymmetric. We compared PSWC with 18F-FDG PET and brain MRI finding to know the signifcance of PSWC. All the patients had typical clinical courses and symptoms of CJD. Three patients were pathologically verified. Three patients were in full stage and two in terminal stage of CJD. We analysed PSWC in digital EEG and compared the regions of maximal PSWC amplitudes with 18F-FDG PET and brain-MRI finding in regard to lateralization and localization. Regarding lateralization, the maximal amplitudes of PSWC were observed over left frontal area in two patients and over right frontal region in three. Three patients in full stage had PET hypometabolism in the same hemisphere as PSWC were lateralized. Their brain MRI showed abnormal basal ganglia intensities but no sever brain atrophy. Two patients in terminal stage had PSWC lateralized in right frontal region but in PET one had left frontoparietal and the other bilateral global hypometabolism. Their brain-MRI showed severe cortical atrophy in the same hemisphere as PET hypometabolism was observed. Regarding all patients in full or terminal stage had maximal PSWC in frontal region, which were not consistent with PET and MRI findings. Cortical lesions in MRI were well corresponding with PET hypometabolism but not with PSWC. These results suggest that PSWC could reflect the hemisphere with more CJD activities in full stage, but could not localize the region where PET and MRI showed abnormalities, suggesting that the generation of PSWC could be related with the involvement of subcortical structures in CJD.
Atrophy ; Basal Ganglia ; Brain ; Creutzfeldt-Jakob Syndrome* ; Electroencephalography ; Fluorodeoxyglucose F18 ; Humans ; Magnetic Resonance Imaging

The feature of congenitial hand anomalies is multiple and complex. Polydactyly and syndactyly is one of the most common congenital anomalies of the upper limb. The statistical analysis of these anomaly is the basic study of congenital hand anomalies. However, the number of reports is small. The purpose of this study is to compare and analyze objective data and make a nation-wide statistical report on polydactyly and syndactyly. We used data from the National Health Insurance Corporation for reviewing polydactyly and syndactyly. We reviewed 3 years of data from 1998 to 2000 focusing on age, the number of operations, male to female ratio, the duration of hospital care and cost. The number of operations for polydactyly was 694 cases and for syndactyly was 574 cases. Therefore we may assume that polydactyly occurs 1:910 births and syndactyly occurs 1:1101 births. The duration of hospital care for polydactyly was 12 days and for syndactyly was 17 days. The full cost for the correction of polydactyly was 770,000 won and syndactyly was 1,220,000 won. The ratio of polydcatyly and syndactyly was 1.12:1. The operation for polydactyly and syndactyly was performed between the age of 1 and 2 in most cases. Male to female ratio of polydactyly was 1.14 :1 and syndactyly was 1.39:1. This study will be helpful to find appropriate treatment for congenital hand anomalies.
Female ; Hand ; Humans ; Male ; National Health Programs* ; Parturition ; Polydactyly* ; Syndactyly* ; Upper Extremity

Coil migration is an extremely rare but hazardous complication of aneurysmal coil embolization. Only 1 case report has described coil migration following endovascular exclusion to gastrointestinal (GI) tract. We report the experience of a case of colon penetration caused by embolization coil placed for internal iliac aneurysm. A 66-year-old man visited the Emergency Department for hematochezia that had persisted for 3 months. Stent insertion and coil embolization of left internal iliac artery aneurysm had been performed on the patient 18 months ago. Colonoscopy was performed. It suggested penetration of sigmoid colon by embolization coil and diverticulum. Angiography revealed extravasation of contrast media at left internal iliac artery. Covered stent deployment was done in the left internal iliac artery. One week after the stent insertion, the patient underwent anterior resection, aneurysm resection, and coil removal. The patient recovered without complications. He was discharged at 2 weeks after the operation.
Aged ; Aneurysm ; Angiography ; Colon* ; Colon, Sigmoid ; Colonoscopy ; Diverticulum ; Embolization, Therapeutic ; Emergency Service, Hospital ; Endovascular Procedures ; Extravasation of Diagnostic and Therapeutic Materials ; Gastrointestinal Hemorrhage ; Humans ; Iliac Aneurysm* ; Iliac Artery ; Intestinal Perforation ; Stents

Background: Spontaneous pneumopericardium is a very rare condition. Spontaneous pneumothorax and pneumomediastinum have been reported to be associated with an idiopathic pulmonary fibrosis (IPF). However, spontaneous pneumopericardium has not yet been reported in association with IPF. Here we report a case of spontaneous pneumomediastinum and pneumopericardium in a patient with acute exacerbation of IPF with a review of the relevant literature.
Humans ; Idiopathic Pulmonary Fibrosis* ; Mediastinal Emphysema* ; Pneumopericardium* ; Pneumothorax

PURPOSE: Mycophenolic acid (MPA) is the active agent of mycophenolate mofetil (MMF), which is an immunosuppressive drug. MPA is a selective inhibitor of inosine monophosphate dehydrogenase. The aim of this study was for demonstrate that mycophenolic acid induces apoptosis in human Jurkat cells via the generation of reactive oxygen species (ROS). METHODS: The cells were cultured in the presence or absence of MPA. Flow cytometric analysis was performed after propidium iodide staining. Western blotting for caspase 3, Bcl-2 and Bax proteins was also performed. RESULTS: MPA decreased the viability of Jurkat cells in a dose- and time-dependent manner. The MPA induced apoptotic cell death displayed nuclear fragmentation and sub G0/G1 phase arrest in the Jurkat cells. The expression of caspase-3 proteases in the MPA treated-Jurkat cells increased in a time-dependent manner. Treatment with MPA resulted in increased ROS generation in the Jurkat cells. There was a decreased expression of Bcl-2 and an increased expression of Bax protein in the MPA treated Jurkat cells. CONCLUSION: This result suggests that MPA-induced cytotoxicity is associated with a direct increase of both ROS generation and the expression of Bax protein.
Apoptosis ; bcl-2-Associated X Protein ; Blotting, Western ; Caspase 3 ; Cell Death ; Humans ; Inosine Monophosphate ; Jurkat Cells ; Mycophenolic Acid ; Oxidoreductases ; Peptide Hydrolases ; Propidium ; Reactive Oxygen Species