OBJECTIVE: The purpose of this study was to analyze the clinical characteristics and prognosis of small cell uterine cervical carcinoma with neuroendocrine differentiation. METHODS: Patient's medical records were reviewed retrospectively who were diagnosed as small cell carcinoma of uterine cervix and were treated at Hanyang University Hospital between 1972 and 1997. RESULTS: Between 1972 and 1997, of 1164 patients who were diagnosed as invasive cervical cancer, there were 10 cases of small cell carcinoma of uterine cervix in the department of obstetrics and gynecology, Hanyang University Hospital. The incidence of small cell carcinoma in invasive cervical cancer was 0.9% (10/1164). Of 10 small cell carcinoma, seven(70%) were neuroendocrine types which were identified with several kinds of immunohistochemical stains (Chromogranin, Grimelius, and/or NSE). The age of these 7 patients ranged from 34 to 63 years (mean 49). Two were in stage Ib, 3 in stage lla, I in stage IIIb, and 1 in stage IVb. Patients with stage Ib-IIb (n 5) received 3-5 courses of neoadjuvant VBP chemotherapy (vinblastine, bleomycin and cis-platinum) followed by radical hysterectomy with pelvic and paraaortic node dissection. One IIIb patient was managed with concurrent chemo-radiation(3 cycles of cis-platinum & 5-FU) followed by 6 courses of chemotherapy. One IVb patient was treated by palliative chemotherapy with 8 cycles of VBP chemotherapy. Of 5 paticn(s who underwent surgery, none showed pelvic lymph node metastases. These 7 patients were folk>wed for 8 - 62 months (average: 20 months). During this period, 5 patients died of disease hetween 8 and 62 months later and 2 patients are still alive for 12 (stage Ib) and 26 months (stage Ib), respectively. In the contrary, of 3 patients without neuroendocrine differentiation, who underwent neoadjuvant VBP chemotherapy followed by radical hysterctomy with pelvic and paraaortic node dissetion or concurrent chemo-radiation, two stage IIb patients are still alive for 58 and 74 months, and one IIIb patient died of disease 12 months later. CONCLUSION: In summary, neuroendocrine differentiation seemed to adversely affect the prognosis and longterm survival of small cell carcinoma of uterine cervix. So, for this high risk group, more aggressive therapy would be need to improve outcome. However, as the number of patients were small in our study, further study with large number of patients are warranted.
Bleomycin ; Carcinoma, Neuroendocrine* ; Carcinoma, Small Cell ; Cervix Uteri* ; Cisplatin ; Coloring Agents ; Drug Therapy ; Female ; Gynecology ; Humans ; Hysterectomy ; Incidence ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Retrospective Studies ; Uterine Cervical Neoplasms

Endometriosis is a benign gynecologic disease that highly influences women of childbearing age. It is characterized by ectopic endometrial tissue. Primary umbilical endometriosis is a rare condition. It is a benign disease with endometrial tissue in an abnormal site in the navel. It may be accompanied with pain in the navel and a discolored bump. Among all locations with the potential for endometriosis, the navel has less than 1% incidence of primary umbilical endometriosis. In the present study, we reported a rare case of umbilical endometriosis revealed via a biopsy performed for a 49-year-old menopausal woman with the complaint of pain in the navel who underwent surgical excision and a biopsy after a scan.

To evaluate the risk and factors associated with seizure recurrence in children with epilepsy while receiving the adequate anticonvulsant treament, we studied 58 patients with newly diagnosed epilepsy who were followed prospectively for a median of 26 months (range 7 to 54). The results were as follows: 1) Forty-four of the 58 patients (75.9%) had recurrence of seizure. 2) The rate of recurrence according to type of seizure was observed to be 22 patients (68.8%) in generalized tonic-clonic seizure, 6 patients (85.7%) in simple partial seizure, 5 patients (83.3%) in complex partial seizure, 3 patients (100%) in mixed seizure, 2 patients (100%) in absence, 3 patients (100%) in infantile spasm, 1 patient (100%) in atonic seizure, 2 patients (50%) in secondary generalized seizure. There was no significant difference in the risk of recurrence observed among these seizure types. 3) The risk of recurrence varied according to the history of seizure, seizure recurrence was observed in 100% of the cases with history of neonatal seizure, 72.7% of the cases with febrile convulsion, and 73.3% of the cases with non-specific history. No significant difference was observed among these past history of seizure. 4) The rate of seizure recurrence according to electroencephalographic abnormalities did not differ significantly. Seizure recurrence was noted in 13 of the 18 patients with mildly disordered tracings (72.2%), 15 of the 20 patients with moderate abnormality (75.0%), and 12 of the 16 patients with severe abnormality (75.0%). 5) Recurrence rate according to cause of seizure was more significantly frequent in those with symptomatic epilepsy than in those with idiopathic type (100% vs 70.2%, p<0.05). 6) The frequency percentage of seizure recurrence by age groups of below 1 year, 1 to 3 years, 4 to 6 years, and above 6 years at onset of seizure were 100, 66.7, 57.1, and 72.7, respectively. The rate of seizure recurrence was significantly highest in patients aged below 1 year at onset of seizure. 7) There was significant difference in seizure recurrence between those with and without abnormalities as shown by neurologic examination (100% vs 70.8%, p<0.05). 8) There was no consistent difference in valproic acid serum levels between those who had a recurrence and those who did not. The patients receiving phenobarbital had significantly high serum levels of the phenobarbital in recurrent groups than those who had no recurrence. In conclusion, factors associated with an increased risk of seizure recurrence were early age at onset of epilepsy, symptomatic epilepsy, and neurologic abnormalities. We found no associations between risks of recurrence and types of epilepsy, or electroencephalographic abnormalities.
Anticonvulsants* ; Child ; Epilepsy ; Humans ; Infant ; Infant, Newborn ; Neurologic Examination ; Phenobarbital ; Prospective Studies ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile ; Spasms, Infantile ; Valproic Acid

To evaluate the relationship between spontancous diuresis and improvement of pulmonary function in respiratory distress syndrome, 15 premature neonates requiring mechanical ventilation for RDS, who admitted in NICU of Wonkwang University Hospital from January 1990 to June 1992, were studied. The results were as follows (results are mean+/-SEM) 1) Mean birth weight of study infants was 1.82+/-0.08Kg, and mean gestational age was 32.80+/-0.54 weeks. 2) The onset of diuresis occured at a mean age of 29.1+/-2.48 hours with maximum diuresis at a mean age of 41.9+/-1.8 hours 3) Mean urine output increased from 2.25+/-0.43ml/Kg/hr at the stage of pre 12 hours-onset of diuresis (p<0.001), then decreased 3.5+/-0.2ml/Kg/hr at the stage of after maximum diuresis (p<0.05). 4) After maximum diuresis, inspired oxygen gradient, peak inflating pressure, peak end expiratory pressure, mean airway pressure, and respiratory rate were decreased significantly (p<0.05), and alveolar-arterial oxygen gradient was decreased more significantly (p<0,01). So, We conclude that the pulmonary function was rapidly improving after maximum diuresis and these changes reflect the general principle used in ventilatory management of infants with RDS.
Birth Weight ; Diuresis* ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Oxygen ; Respiration, Artificial ; Respiratory Rate

The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 +/- 21.2 micrometer in length and 11 +/- 0.6 micrometer in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.
Aged ; Animals ; Fatal Outcome ; Humans ; Immunocompromised Host ; Larva ; Male ; Sputum ; Strongyloides/growth & development/*isolation & purification ; Strongyloidiasis/*etiology ; Superinfection/*parasitology

A retrospective clinical study on 63 cases of intussusception in infants and children, who were admitted to the department of pediatrics and surgery from May, 1974 to Feb. 1978, was done. The prognosis of this disease is dependent upon early diagnosis and treatment but the causatio of this disease is not clear yet. It is a relatively common disease and we think it is worthwhile to analyze our won cases. The results were : 1. Among 63 cases, 37 were admitted to the department of pediatrics and 36 were admitted to the department of GS. 2. In age distribution, 85% of the patients were under 1 year of age and the peak incidence was 3~9 months of age. 3. Male was predominant than female. Male to female ratio was 2.8:1 4. The 58.8% of the patients were above 50 percentile of body weight comparing with Korean standard data. 5. In the aspect of the etiology, 96.9% of the cases were idiopathic and only 3.1% of the cases had organic causes. 6. The 4 cardinal symptoms were abdominal pain(93.7%), vomiting(90.%), bloodymucous stool(80.1%) and abdominal mass(74.6%) 7. Among the cases, colocolic type was 33.3%, ileocolic type was 22.2% and ileocecal type was 20.6% 8. The 71.4% of the cases were reduced successfully by barium enema. 9. Recurrence rate was 4.8%.
Age Distribution ; Barium ; Body Weight ; Child* ; Early Diagnosis ; Enema ; Female ; Humans ; Incidence ; Infant ; Intussusception* ; Male ; Pediatrics ; Prognosis ; Recurrence ; Retrospective Studies

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Physical Examination

OBJECTS: The purpose of this study was to evaluate the relative usefulness of the morphologic scoring system and spectral doppler ultrasonographic analysis in differentiating between benign and malignant adnexal masses. METHODS: All patients scanned between July 1995 and June 1998 with sonographically identified and pathologically confirmed adnexal masses formed the study group. The adnexal masses were scored as benign or malignant on the basis of their sonographic appearance. Specific categories included inner wall structure, wall thickness, septal structure, and echogenicity. Women whose morphologic findings were suspicious for malignancy underwent doppler sonography. A threshold pulsatility index of 1.0 and resistance index of 0.4 were used to differentiate benign from malignant lesions. The findings were correlated with the presence of malignancy. RESULTS: Two hundred fifty one patients formed the study group; 215 patients were benign and 36 patients were malignant pathologically. Using the morphologic scoring system, 31 of the 36 malignant masses were classified as suggestive of malignant tumor, and 147 of the 215 benign masses were classified as not suggestive of malignant tumor (sensitivity, 86%; specificity, 68%; positive predictive value, 31%; negative predictive value, 97%). Doppler velocimetry was performed on a total of 62 patients, 19 patients with malignant tumors and 43 patients with benign tumors. A mean PI value of 0.85 and RI value of 0.52 for malignant tumors and mean PI value of 2.00 and RI value of 0.75 for benign tumors was shown. The PI value was significantly lower (p 0.001) in malignant than that of in benign masses, but RI value was not significant (p 0.184). The sensitivity and specificity in the detection of malignancy combined with doppler velocimetry was 86% and 67%, respectively. CONCLUSION: Doppler velocimetry studies did not add substantially to the prediction of malignancy using the morphologic scoring system.
Diagnosis* ; Female ; Humans ; Rheology ; Sensitivity and Specificity ; Ultrasonography

No abstract available.
Carotid-Cavernous Sinus Fistula* ; Facial Bones* ; Humans

No abstract available.
Cheek* ; Humans ; Psychotic Disorders*