OBJECTIVE: Because endometriosis is difficult to diagnose and has a high recurrence rate after treatment, a reliable serum marker of endometriosis is necessary. Therefore, the aim of this study is to measure the serum levels of CA125 and CA19-9 in patients with endometriosis before and after treatment and during recurrence, and to assess the usefulness of these levels in the diagnosis, clinical follow up and prediction of recurrence in endometriosis. METHODS: Eighty-eight patients who visited the department of Obstetrics and Gynecology of Ewha Mokdong Hospital from January 1994 to December 1998 and were diagnosed as endometriosis by laparoscopy or explo-laparotomy were enrolled as subjects. A retrospective analysis of serum CA125 and CA19-9 levels at 1 month before and 3 to 6 months after initiation of treatment was done. RESULTS: The serum CA125 and CA19-9 levels of endometriosis group(81.0+/-252.5, 36.6+/-53.4 ; mean+/-2SD, U/ml) before treatment was significantly higher than control group(11.6+/-12.8, 9.4+/-8.6)(p<0.05). Overall sensitivity rate for CA125, CA19-9 levels and both was 53.4%, 42.9% and 64.3% respectively. The sensitivity rate for endometriosis, stage 3 and 4(85.4%, 55.0%) was significantly higher than that, stage 1 and 2(p<0.05). The serum CA125 level in endometriosis group showed a significant increment according to stages(p<0.05) while the serum CA19-9 level showed an increasing trend(p=0.055) and both levels decreased significantly after treatment(p<0.05). The serum CA125 level was also higher at recurrence after treatment(p<0.05). CONCLUSIONS: The serum CA125 and CA19-9 levels are a useful marker for diagnosing severity of disease, monitoring efficacy of treatment and predicting recurrence in endometriosis.
Biomarkers ; Diagnosis ; Endometriosis* ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Laparoscopy ; Obstetrics ; Recurrence ; Retrospective Studies

Development of drug resistance in tumors during treatment is a major factor limiting the clinical use of anticancer agents. When tumor cells acquire resistance to anticancer drug, they show cross-resistance to other antitumor agents. In the present study, SNU-1 cell was induced adriamycin 10-7 drug resistance, SNU-1/ADR, in vitro culture system. We got the doubling time and number for viability test during 96 hours by MTT assay. To investigate the cross resistance of various anticancer drugs in human stomach cancer cell SNU-1 and SNU-1/ADR, We compared IC50 (drug concentration of 50% reduction) and the relative resistance (RR). SNU-1/ADR was expressed multidrug resistant with vinblastine (RR;>31.62), vincristine (RR;29.50), dactinomycin (RR;21.37), epirubicin (RR;17.78), daunorubicin (RR;14.12), adriamycin (RR;7.76), and etoposide (RR;4.46), and other drugs, 5-fluorouracil, cisplatin, cyclophosphamide, methotrexate, and calarubicin, have not cross resistant with adriamycin. There was double minute chromosome in SNU-1/ADR by karyotyping although this change was not seen in SUN-1.
Antineoplastic Agents ; Cisplatin ; Cyclophosphamide ; Dactinomycin ; Daunorubicin ; Doxorubicin ; Drug Resistance ; Epirubicin ; Etoposide ; Fluorouracil ; Humans ; In Vitro Techniques ; Inhibitory Concentration 50 ; Karyotyping ; Metabolism* ; Methotrexate ; Stomach Neoplasms* ; Stomach* ; Vinblastine ; Vincristine

The funding acknowledgment in this article was omitted.

Myxofibrosarcomas (MFSs), which consist of multiple nodules with a variable cellular population in a myxoid matrix, are primarily located in subcutaneous tissue. Pleomorphic hyalinizing angiectatic tumors (PHATs) are rare soft-tissue tumors characterized by a proliferation of highly pleomorphic spindle or polygonal cells and abundant ectatic blood vessels in cellular or myxoid stroma. We present here an unusual case of a high-grade MFS with a PHAT-like appearance. A 67-year-old man presented with an asymptomatic subcutaneous mass in the right forearm. The tumor had myxoid, hypo-, and hypercellular areas with highly pleomorphic spindle or polygonal tumor cells that showed frequent mitoses and nuclear pseudoinclusions. Foci of punctuate necrosis and inflammatory infiltration were present throughout the tumor, and abundant ectatic, thick-walled vessels containing blood clots were noted. The tumor cells were immunohistochemically positive for vimentin but negative for CD34, S-100 protein, smooth muscle actin, desmin, and bcl-2.
Actins ; Aged ; Blood Vessels ; Desmin ; Forearm ; Humans ; Hyalin ; Mitosis ; Muscle, Smooth ; Necrosis ; S100 Proteins ; Sarcoma ; Subcutaneous Tissue ; Vimentin

PURPOSE: Henoch-Schonlein purpura nephritis(HSPN) accompanied by nephrotic syndrome(NS) is known to have a poor prognosis and effective treatment is still controversial, even though both corticosteroids and immunosuppresant have been used for therapy. Cyclosporine A(CsA) is a well known immunosuppresant and widely used in renal transplantation and glomerular diseases especially steroid resistant. The aims of this study was to evaluate the therapeutic effect of CsA and to compare CsA with previously reported our data of rifampin(RFP) and azathioprine(AZA) in children with HSPN accompanied by NS. METHODS: 37 HSPN patients with NS confirmed by renal biopsy were selected. Of these, 17 patients were treated with CsA(5 mg/kg/day) for 6-8 months, 7 children were treated with RFP(10-20 mg/kg/day) for 9-12 months and 13 patients were treated with AZA(2 mg/kg/day) for 8 months. Along with these regimens, low dose oral prednisolone(0.5-1 mg/kg, qod) was also used. Sequential renal biopsy was done in all patients 1 month after termination of treatment. RESULTS: Complete remission rate of nephrotic syndrome was 5S.8% in CsA, 57.1% in RFP and 38.4% in AZA group after 17, 22, 11 months of mean follow-up period. Overall remission rate including partial remission was 88.2% in CsA, 85.7% in RFP and 84.6% in AZA group. Disappearance rate of hematuria was 58.8% in CsA, 57.1% in RFP and 46.2% in AZA group. Improvement of grade of clinical status was observed in 17 out of 17 CsA, 7 out of 7 RFP and 10 out of 13 AZA group. Improvement of pathologic class on sequencial renal biopsy was shown in 5 CsA(29.4%), none RFP(0%) and 2 AZA group(12.4%). Improvement on histologic immune-deposition was seen in 15 CsA(88.2%), 6 RFP(85.9%) and 4 AZA group(30.8%). CONCLUSION: In conclusion, Both CsA and RFP treated groups showed better result in complete remission rate of nephrotic syndrome and significant inprovement of histologic immune-deposition compared with AZA treated group(p=0.004). So, we recommend CsA and RFP rather than AZA for immunosuppresant treatment in HSPN with nephrotic syndrome.
Adrenal Cortex Hormones ; Biopsy ; Biopsy, Fine-Needle* ; Breast* ; Child ; Cyclosporine ; Diagnosis* ; Follow-Up Studies ; Hematuria ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Nephrotic Syndrome ; Prognosis ; Purpura, Schoenlein-Henoch

Irritable bowel syndrome (IBS) is a very common functional gastrointestinal disorder characterized by abdominal pain or discomfort with bowel habit changes. However, its pathogenesis and pathyphysiology have been poorly understood. There were many robust functional and anatomical evidences in Korea for visceral hypersensitivity, low-grade inflammation and immunologic alterations, brain-gut interaction and genetic factors in the development of IBS. The link between pathophysiologic changes and gastrointestinal symptoms would be the strong basis for the relevance of target therapy in this condition. The ROME III criteria represent the current gold standard for the identification of characteristic and supportive symptoms of IBS and for the categorization of IBS patients into symptom-based subgroups with exclusion of organic diseases. There were some limitations in use of Rome III criteria in the clinical practice and research fields. Test of Rome III are needed, especially in Korea.
Abdominal Pain ; Aluminum Hydroxide ; Carbonates ; Gastrointestinal Diseases ; Humans ; Hypersensitivity ; Inflammation ; Irritable Bowel Syndrome ; Korea ; Rome

A 62-year-old woman without vascular risk factors presented with left-sided weakness and numbness. Magnetic resonance imaging (MRI) brain depicted acute right hemispheric infarcts in the cortical and subcortical white matter. Initial MR angiography (MRA) showed large thrombus at the right carotid bifurcation. Valvular atrial fibrillation (vAF) with severe tricuspid regurgitation (TR) was found on two-dimensional echocardiography. Serial follow-up computed tomography angiography (CTA) or MRA at 3, 9, and 15 days after anticoagulation alone showed complete resolution of the thrombus with no neurological deterioration. Our case suggests that prompt institution of anticoagulantion alone may result in radiologic resolution of the thrombus with improvement in patient’s clinical status.
Carotid Arteries

The double-chambered right ventricle is congenital or acquired cardiac anomaly, which is characterized by aberrent hypertrophied muscular bands that divide the right ventriclar cavity into two different pressure chamber. This anomaly can complicate the natural history of patient with isolated ventricular septal defect. We experienced two cases of cases of acquired DCRV, which confirmed by two separate cardiac catherterization and angiography. The purpose of this report is to show that the aberrant muscular bands may be nonobstructive in early infancy and that the obstructive effect is developed with time as the bands become progressively more hypertrophied.
Angiography ; Heart Septal Defects, Ventricular ; Heart Ventricles* ; Humans ; Natural History

To investigate the pathogenesis of the duodenal ulceration produced by mepirizole (1-(4-methoxy-6-methyl-2-pyrimidinyl)-3-methyl-5-methoxypyrazole) in rat, the effects of various concentraion and sorts of antiulcer drugs and truncal vagotomy on the mepirizole (200 mg/kg of body weight) induced duodenal ulcers were observed morphologically, and after mepirizole administration (200 mg/kg), amount and acidity of gastric jucie were measured sequently. The results were as follows: 1) In the control group of fasting for 24 hours after mepirizole administration only, duodenal ulcers were developed in all animals with 21.5+/-5.8 mm2 of ulcer index, perforation rate was 15%, and mortality rate was 0%. But lesions of the stomach were hemorrhagic and erosive with erosion index of 3.8+/-1.6 mm2. 2) The antiulcer drugs were significantly inhibited duodenal ulceration and gastric erosion produced by mepirizole although the inhibition effects were different. 3) After truncal vagotomy, duodenal ulcer and gastric erosion induced by mepirizole were also significantly inhibited. 4) On the gastric analysis, decrease of amount, increase of acidity, and decrease of concentration of gastric juice were observed after administration of mepirizole compared with nontreated normal group. Above findings suggest that the pathogenesis of the duodenal ulceration by mepirizole is the action of gastric acid on the duodenal mucosa with breakdown of defence mechanisms of the duodenum.
Animals ; Mortality

A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
Actins ; Aneuploidy ; Coloring Agents ; Common Bile Duct ; Dendritic Cells, Follicular ; Herpesvirus 4, Human ; Immunohistochemistry ; Keratins ; Liver ; Lung ; Lymph Nodes ; Maxillary Sinus ; Membranes ; Muramidase ; Muscle, Smooth ; Myofibroblasts* ; Prognosis ; Recurrence ; S100 Proteins ; Thigh ; Urinary Bladder ; Vimentin