MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) is one of the mitochondrial encephalomyopathy, A rare disease caused by a disturbance of the mitochondrial chain of respiration. MELAS is confirmed by typical light and electron microscopic findings : "ragged red fibers" by modified Gomori trichrome stain on light microscope and numerous abormal mitochondria on electron microscope. We experienced a boy with the characteristic clinical and pathologic findings of MELAS. Our patient demonstrated bilateral basal ganglia calcifications and infarction at right parieto-occipital and thalamic areas on CT and MR We found that MRI was more sensitive and represented the infarcted lesions better than CT. Detection of cerebral insults of MELAS by MRI is important in making decision on patient treatment and also in predicion of the patient prognosis.
Acidosis, Lactic ; Basal Ganglia ; Brain Diseases ; Child* ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Encephalomyopathies ; Muscular Diseases ; Rare Diseases ; Respiration

OBJECTIVE: The purpose of this study was to determine the important factors affecting survival and pregnancy rate in frozen-thawed embryo transfer cycles. METHODS: we performed reprospective analysis in 738 cycles of frozen-thawed embryo transfers, in relation to the insemination methods, the freezing stage of embryo, patient's age, infertility factors and the origin of injected sperm in ICSI cycles. After conventional IVF or ICSI, the supernumerary PN stage zygotes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propandiol (PROH) as a cryoprotectant. RESULTS: The survival rates of thawed embryos were 69.3% (1585/2287) in conventional IVF group and 71.7&% (1645/2295) in ICSI group. After frozen-thawed embryo transfers, 27.0% (92/341) and 32.0% (109/341) of pregnancy rates were achieved in conventional IVF and ICSI group, respectively. There were no significant difference in the survival and pregnancy rates according to the insemination methods, the freezing stage and patient's age. However, the pregnancy rate (36.2%) of male factor infertility (22.9%). In ICSI group, the origin of injected sperm did not affect the outcome of frozen-thawed embryo transfer cycles. CONCLUSION: The present study demonstrates that acceptable clinical outcomes can be achieved after the transfer of frozen-thawed embryos regardless of the stage of embryos for freezing, the patient's age and the origin of injected sperm.
Embryo Transfer* ; Embryonic Structures* ; Freezing ; Humans ; Infertility ; Insemination ; Male ; Pregnancy Rate* ; Pregnancy* ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Survival Rate ; Zygote

Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%. According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification* ; Netherlands

PURPOSE: Our purpose was to deterrnine the efficacy of maternal corticosteroid therapy on the morbidity of premature infants between 26 and 31 weeks' gestation. METHOD: A total of 62 premature infants between 26 and 31 weeks gestation admitted to pediatric department of National Medical Center from Nov, 1990 to June 1996 were analyzed to evaluate the efficacy of prenatal corticosteroid therapy on the morbidity such as hyaline membrane disease, intreventricular hernorrhage, necrotizing enterocolitis, sepsis, neonatal death, days on ventilation and hospital days. RESULT: Among 62 women who delivered premature infants between 26 and 31 weeks, 22 received betamethasone before delivery and 40 did not. 1) The rate of hyaline membrane disease was less in the betamethasone group (41% vs. 70%, P<0.05). 2) The rate of intracranial hemorrhage was less in the betamethasone group (0 vs. 20%, P<0.05). 3) The days of ventilator care was less in the betamethasone group among survival cases (27+/-3.2 vs. 5.2+/-4.6, P<05). 4) Arnong 14 women who delivered at 26 to 28 weeks, 4 received betamethasone before delivery and 10 did not. The rate of neonatal death was less in the betamethasone group (o% vs. 80%, P<0.05). 5) Among 48 women who delivered at 29 to 31 weeks, 18 received betamethasone before delivery and 30 did not. The rate of hyaline membrane disease was less in the betamethasone group (39% vs. 73%, P<0.05). CONCLUSION: Betamethasone appears to reduce hyaline membrane disease, intraven- tricular hemorrhage, neonatal death and the morbidity significantly in premature infants between 26 and 31 weeks' gestation.
Betamethasone ; Enterocolitis, Necrotizing ; Female ; Hemorrhage ; Humans ; Hyaline Membrane Disease ; Infant, Newborn ; Infant, Premature* ; Intracranial Hemorrhages ; Pregnancy ; Sepsis ; Ventilation ; Ventilators, Mechanical

No abstract available.
Endometriosis* ; Female

Paragonimiasis is prevalent in Far East and a kind of endemic Korean disases. The primary site of humanparagonimiasis is the lung, but hte ectopic infection of lung fluke has been reported by many authors. Weexperienced one case of abdominal paragonimiasis in a 44 year old male with a complaint of left lowerquadrantpain. Physical examination, barium enema, and other data suggested the possibility of tumor originating from thewall of descending colon. (intramural tumor). Postoperative specimen taken from the solid tumorous lesion showedparasitic granuloma, characteristic of Paragonimus Westermani. Here, we report a case of very peculiar ectopicparagonimaisis involved descending colon wall simulating neoplastic tumor, and also review the literaturesbriefly.
Barium ; Colon ; Colon, Descending ; Enema ; Far East ; Granuloma ; Humans ; Lung ; Male ; Mesocolon ; Paragonimiasis ; Paragonimus westermani ; Physical Examination ; Trematoda

INTRODUCTION: This study examined the effect of autogenous tooth bone used as a graft material for bone regeneration in an artificial bony defect of minipigs. MATERIALS AND METHODS: Four healthy minipigs, weighing approximately 35-40 kg, were used. Four standardized artificial two-walled bony defects, 5 mm in length and depth, were made on the bilateral partial edentulous alveolar ridge on the mandible of minipigs, and autogenous tooth bone was augmented in the right side as the experimental group. On the other hand, only alloplastic bone graft material HA was grafted with the same size and manner in the left side as the control group. All minipigs were sacrificed at 4 weeks after a bone graft and evaluated histologically by Haematoxylin-eosin staining. The specimens were also evaluated semi-quantitatively via a histomorphometric study. The percentage of new bone over the total area was evaluated using digital software for an area calculation. RESULTS: All specimens were available but one in the left side (control group) and two in the right side (experimental group) were missing during specimen preparation. The amount of bone formation and remodeling were higher in all experimental groups than the control. The mean percentage area for new bone in the experimental and control groups was 43.74+/-11.96% and 30.79+/-2.93%, respectively. CONCLUSION: Autogenous tooth bone is a good alternative to autogenous bone with the possible clinical feasibility of an autogenous tooth bone graft in the reconstruction of bony defects.
Alveolar Process ; Bone Regeneration ; Hand ; Mandible ; Osteogenesis ; Regeneration ; Swine, Miniature ; Tooth ; Transplants

OBJECTIVES: The aim of the present study was to evaluate the effect of fluoride mouthrinse with low pH on the surface microhardness of artificial incipient carious enamel. METHODS: Firstly, the concentration of sodium fluoride and pH values were measured in commercially available mouthrinse. Secondly, DOCTOR Clean & Fresh(R) (Jang In Pharm, co., LTD. KOREA) with 0.02% sodium fluoride and pH value below pH 4.0 was selected as the experimental group, 0.02% sodium as the positive control group and distilled water as the negative control group. Enamel samples of n vine teeth (n=36) were divided into the three groups respectively and treated with the mouthrinse solutions for 3 and 20 minutes. The surface microhardness (Vickers hardness number, VHN) was measured with microhardness tester before and after the treatments. RESULTS: The average pH of DOCTOR Clean & Fresh(R) was 3.45+/-0.00, and it was acidic enough to cause tooth erosion. The difference of surface microhardness (DeltaVHN) before and after the 20 minute treatment was statistically significant among the groups: DOCTOR Clean & Fresh(R) (12.77+/-2.25 DeltaVHN), distilled water (0.24+/-0.75 DeltaVHN), 0.02% sodium fluoride solution (-0.62+/-1.62 DeltaVHN) (P<0.05). The DOCTOR Clean & Fresh(R) group with low pH showed greater changes on the surface microhardness of the carious enamel than those of other groups (P<0.05). CONCLUSIONS: It is suggested that the mouthrinse with low pH can reduce the surface microhardness of incipient carious enamel.
Dental Enamel ; Fluorides ; Hardness ; Hydrogen-Ion Concentration ; Sodium ; Sodium Fluoride ; Tooth ; Tooth Erosion ; Water

Thyroid imaging is indicated to evaluate congenital hypothyroidism during newborn screening or in cases of a palpable thyroid mass in children and adolescents. This pictorial essay reviews the ultrasonography (US) of thyroid diseases in children and adolescents, including normal thyroid gland development, imaging features of congenital thyroid disorders (dysgenesis, [aplasia, ectopy, hypoplasia], dyshormonogenesis, transient hypothyroidism, thyroglossal duct cyst), diffuse thyroid disease (Grave's disease, Hashimoto's thyroiditis, and suppurative thyroiditis), and thyroid nodules. The primary imaging modalities for evaluating thyroid diseases are US and radionuclide scintigraphy. Additionally, US can be used to guide aspiration of detected nodules.
Adolescent ; Child ; Congenital Hypothyroidism/diagnosis/*ultrasonography ; Female ; Graves Disease/diagnosis/ultrasonography ; Hashimoto Disease/diagnosis/ultrasonography ; Humans ; Hypothyroidism/diagnosis/*ultrasonography ; Infant, Newborn ; Male ; Thyroid Dysgenesis/diagnosis/ultrasonography ; Thyroid Nodule/embryology/*ultrasonography ; Thyroiditis/diagnosis/*ultrasonography

PURPOSE: The purpose of this study was to identify the quality of life in colorectal cancer patients with chemotherapy-induced peripheral neuropathy. METHODS: A total of 93 patients were recruited in the cross-sectional survey design. Quality of life in colorectal cancer patients were measured by European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 and CIPN20. RESULTS: In the QLQ C30, the mean score of the global health status was 59.41, the functional scale was 73.29 and symptom scale was 26.72. In CIPN20, the mean score of sensory scale was 32.70, autonomic scale was 22.88 and motor scale was 16.12. In the QLQ C30, the global health status showed significant differences according to surgery (p=.027) and the functional scale, and the symptom scale showed significant differences according to gender (p=.046, p=.020) and nonpharmacologic intervention (p=.001, p=.009). The CIPN20, the sensory scale showed significant differences according to age (p=.006), DM (p=.005), grade of CIPN (p=<.001) the status of chemotherapy (p=.001) and nonpharmacologic intervention (p=.010). CONCLUSION: The level of quality of life in colorectal cancer patients with peripheral neuropathy was relatively low. There is a need for developing a nursing intervention for colorectal cancer patients to improve their quality of life and to decrease chemotherapy-induced peripheral neuropathy.
Colorectal Neoplasms ; Cross-Sectional Studies ; Humans ; Peripheral Nervous System Diseases ; Quality of Life