OBJECTIVES: This study was peformed to compare and measure the changes of corpus callosum of the schizophrenic patients with those of controls, to compare according to clinical symptoms, onset age. METHOD: Brain magnetic resonance imaging study was performed in 38 schizophrenic patients and 28 controls, and the authors measured cerebral area, anterior, middle, posterior callosal areas, vertical width, perpendicular width and maximal horizontal callosal length. The schizophrenic patients were assessed by the PANSS. To correct cerebral areas, ANCOVA was used with cerebral areas as covariants. And two-tailed t-test, ANOVA were used to compare callosal measurements according to subgroups. RESULTS: The schizophrenic patients, compared with controls, were significantly wider in posterior callosal area and thinner in anterior vertical width. The schizophrenic patients with prominent positive symptoms were significantly wider and thicker in middle callosal area, anterior middle vertical width than controls, and those with prominent negative symptoms were significantly thinner in posterior vertical width than those with prominent positive symptoms and wider in anterior area than controls. Early onset patients were significantly thicker in middle perpendicular area than controls. CONCLUSIONS: There were various controversial findings about corpus callosal pathology of the schizophrenic patients. This study, after correction of cerebral area, revealed increased sizes of several parts of callosal regions, and then it suggested neurodevelopmental abnormalities. And also significant differences in callosal regions according positive and negative symptoms suggested that these reflected the heterogeneities of schizophrenia.
Age of Onset ; Brain* ; Corpus Callosum ; Humans ; Magnetic Resonance Imaging* ; Pathology ; Schizophrenia

The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.
Adenoma, Pleomorphic ; Aged ; Cytosine ; Female ; Giant Cell Tumors ; Giant Cells ; Humans ; Korea ; Mixed Tumor, Malignant ; Monocytes ; Osteoclasts ; Parotid Gland ; Salivary Glands ; Stromal Cells

The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.
Adenoma, Pleomorphic ; Aged ; Cytosine ; Female ; Giant Cell Tumors ; Giant Cells ; Humans ; Korea ; Mixed Tumor, Malignant ; Monocytes ; Osteoclasts ; Parotid Gland ; Salivary Glands ; Stromal Cells

No abstract available.
Fetus* ; Humans ; Male* ; Mesothelioma*

OBJECTIVES: To clarify the clinicopathologic features of borderline malignancy of the ovary and analyze the treatment and survival characteristics through the study of our cases. Study METHODS: 102 patients with borderline tumors of the ovary, aged from 14 to 79 years, treated between 1982 and 1999 at Seoul National University Hospital, were analyzed retrospectively for clinicopathologic features. Most informations about stage, treatment modality and prognosis were obtained by hospital record or contacting patient with telephone. RESULTS: There were 77 patients (75.5%) with stage Ia, 5 stage Ib, 11 stage Ic, 4 with stage II and 5 with stage III by the classification of FIGO. 72 patients (70.6%) were mucinous type and 28 (27.5%) were serous type, 1 endometrioid type, 1 mixed. Total abdominal hysterectomy, bilateral adnexectomy, and omentectomy were performed in 43 (42.2%) patients and fertility saving surgery in 43 patients(cystectomy in 11 patients, USO in 32 patients). Twenty two patients (21.6%) were treated with postoperative adjuvant chemotherapy. The median duration of follow up was 54.0 months (1-204 months) and 6 patients developed recurrence after several years from the primary operation. The ten-year eumulative survival rate was 92.2% and the only independent prognostic factors evaluated by Cox analysis in regards to corrected survival were the FIGO stage (p=0.0197). There was no difference in the ten-year survival rate between surgery types - conservative surgery versus full surgical staging. And there was no difference in the 10-year survival rate between treatment groups - surgery only versus surgery followed by adjuvant chemotherapy. CONCLUSIONS: FIGO stage is the only independent prognostic factor in the borderline ovarian tumors. There was no difference in the 10-year survival rate of barderline ovarian tumors between surgery alone versus surgery followed by adjuvant chemothearpy. The slow clinical course, low recurrence rate and good prognosis in our patients explained again the reason for therapeutic approach relying on surgery alone.
Chemotherapy, Adjuvant ; Classification ; Female ; Fertility ; Follow-Up Studies ; Hospital Records ; Humans ; Hysterectomy ; Mucins ; Ovary* ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Telephone

PURPOSE: The Mesima-Ex is a kind of biologic response modifier, which is extracted from a mushroom called Phellinus linteus. Mesima-Ex consists of various chemical compounds which include protein bound polysaccharide, mucoprotein, triterpenoid, and quinones. Mesima-Ex exerts its antitumor effects by augmenting host immune response without any toxic side effects. In vitro study, Mesima-Ex seems to potentiates antibody dependent cell mediated cytotoxicity (ADCC) and cell mediated cytotoxicity (CMI) against tumor cells. We initiated this study to verify antitumor effects of Mesima-Ex as an antineoplastic agent. MATERIALS AND METHOD: Gastric cancer patients who underwent curative resection with normal hepatic and renal function were eligible. They were divided into two groups by random number table. One group (N=30: Mesima-Ex group) received postoperative adjuvant chemotherapy with 5-FU (500 mg/m2 weekly), adriamycin (40 mg/m2 every 3 weeks) and Mesima-Ex (6 cap daily per Os). Another group (N=37: control group) received 5-FU and adriamycin only without Mesima-Ex. NK (natural killer cell) activity, ADCC (antibody dependent cell mediated cytotoxicity), CD4 , and CD8 cells were measured and an analysis of disease free survival rate of the two study groups was performed. RESULTS: Sixty seven patients were enrolled in this study. Their median age was 55 years old. NK activity (basal activity: 25%) was enhanced significantly at the 2nd, and 4th months in the Mesima-Ex group (28.9%, 43.4%, p<0.05). ADCC was also enhanced from 37% to 42.1% at the 2nd month in the Mesima-Ex group (p<0.05). The control group did not show any significant change in NK activity or ADCC. The CD4 cell ratio was increased from 37% to 42.1% at the 2nd months in the Mesima-Ex group but not in the control group (p<0.05). There was no significant change in CD8 subsets (p>0.05). There were no toxic side effects more than grade III from Mesima-Ex administration. The two year disease free survival rate was higher in the Mesima-Ex group than that of the control group (77% vs 58%, p<0.05). CONCLUSION: Mesima-Ex can be used safely as an immunomodulator with standard chemotherapeutic agents for purpose of adjuvant chemotherapy. Mesima-Ex was effective in augmenting host immune response in vitro. The Mesima-Ex group showed a higher two year disease free survival rate than that of the control group.
Agaricales ; Antibody-Dependent Cell Cytotoxicity ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Doxorubicin ; Fluorouracil ; Humans ; Middle Aged ; Quinones ; Stomach Neoplasms*

Many studies have been reported on predicting factors in prognosis of acute carbon monoxide (CO) intoxication, which are different to the reports. These different results might be caused partially by the variable clinical courses in acute CO intoxication. This retrospective study was designed to investigate the predicting factors of each clinical course in acute CO intoxication. For this study, we evaluated retrospectively 103 admitted patients with acute CO intoxication. Among them, 11 patients (11%) remained as prolonged coma, 21 patients (20%) had developed delayed sequalae, and 71 patients (69%) lived without neurologic deficit. This study evaluated and analyzed predicting factors and its relative risk in prognosis at each course of acute CO intoxication with well-known possible factors. The results were as follows 1. The mental status of patient on admission was related to the concentration of blood CO. 2. The recovery of the mental state after 24 hours of admission was dependent on the exposure time of CO intoxication, the mental status on admission, blood pressure, fractional arterial pressure of CO2. 3. Prolonged coma had close correlation with the exposure time of CO intoxication, the mental status on admission, fractional arterial pressure of 02 0r CO2- 4. Delayed sequalae after recovery of the mental state were dependent on the mental status on admission, bradycardia, interval of the recovery of mental state (or recovery status of mentality within 24 hours). In conclusion, the prognostic factors of patients with acute CO intoxication may be different according to the clinical course of acute CO intoxication. Recovery of mentality in 24 hours of admission may be related to systemic blood pressure at admission which represents cerebral perfusion indirectly, and prolonged coma seems to be related to hypoxemia or hypercapnia on arterial blood gas study at admission which may contribute the profounding cortical damage. The initial mentality of patient on admission can not predict the delayed sequalae after acute CO inoxication, and more observation of patient for estimating the clinical status and the interval of mental recovery during admission, will be needed.
Anoxia ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Carbon Monoxide* ; Carbon* ; Coma ; Humans ; Hypercapnia ; Neurologic Manifestations ; Perfusion ; Prognosis* ; Retrospective Studies

PURPOSE: Out-of-hospital cardiac arrest is an extensive public health problem, so cardiopulmonary resuscitation (CPR) has been widely taught to lay communities. However, little research has been done to assess attitude and reluctance to performing CPR in Korea. The present study clarified the basic factors affecting attitude and reluctance towards resuscitation in Seoul, Korea. METHODS: Using a telephone survey of a randomly selected sample of Seoul citizens, we questioned 1,007 subjects over a 2 week period in November 2006 on their prior training, knowledge, and awareness of resuscitation. The survey questions sought to clarify basic aspects of knowledge and attitude towards CPR, as well as to gather demographic information. RESULTS: Forty-five percent of subjects had previously been taught CPR. Of these, 70% had been taught more than two years previously. While sixty-nine percent indicated a general willingness to performed CPR on a stranger, only 6.8% responded that they definitely would perform CPR. In addition, only 3.3% were able to remember the correct compression- to-ventilations ratio for adult CPR. Of the 314 respondents who were unwilling to performed CPR, 44.3% gave as their reason the risk involved in a deteriorating situation, while 33.1% cited a lack of CPR knowledge. The factors most related to CPR performance and reluctance were male (odds ratio=1.997, p=0.048), prior CPR education (odds ratio=1.798, p=0.001), and accuracy of CPR knowledge (odds ratio=1.983, p=0.001). CONCLUSION: Although general awareness of CPR among the Korean community is high, practical knowledge relating to the performance of basic CPR is poor. This suggests that present community CPR educational strategies had limited efficacy.
Adult ; Cardiopulmonary Resuscitation ; Surveys and Questionnaires ; Humans ; Korea ; Male ; Out-of-Hospital Cardiac Arrest ; Public Health ; Resuscitation ; Telephone

OBJECTIVE: To determine pathologic variables associated with overall survival and disease free survival of patients with endometrial cancer. METHODS: Survival of 81 endometrial cancer patients treated with primary surgery between January 1997 and December 2003 at our center was compared about various histopathologic variables. All patients underwent complete surgical staging including pelvic +/- paraaortic lymph node dissection. Survival analyses were performed by the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by Cox's proportional hazards model using likelihood-ratio statistics based on the conditional parameter estimate (Conditional). RESULTS: With regard to disease free survival, univariate analysis revealed no significant differences in subgroups according to age category, grade and adjuvant radiotherapy. However, significant differences in disease free survival were found between stage I+II and stage III, and between endometrioid type and the others type. Among these significant subgroups, the Cox-proportional hazards model showed that stage was the only independent prognostic factor. There were no significant differences in the overall survival of patients in subgroups according to age category and adjuvant radiotherapy. But, significant differences in overall survival were found in subgroups according to stage, histology and grade. Multivariate analysis revealed that stage was the only independent significant adverse prognostic effect. CONCLUSION: Our results showed that only stage was an independent prognostic factor of disease free survival and overall survival in endometrial cancer patients.
Disease-Free Survival ; Endometrial Neoplasms* ; Female ; Humans ; Lymph Node Excision ; Multivariate Analysis ; Proportional Hazards Models ; Radiotherapy, Adjuvant

Heterotopic pregnancy with coexistiong intrauterine and extrauterine pregnancy, is a rare event in natural pregnancy. However, in recent years, the increase in the incidence of pelvic inflammatory disease and use of assisted reproductive technology had led to an increase in the frequency of heterotopic pregnancy. When the diagnosis of heterotopic pregnancy is delayed, maternal mortality and morbidity may be increased, and unwanted loss of intrauterine pregnancy may occur. Therefore, the early diagnosis of heterotopic pregnancy is clinically important, and clinicians have to consider the possibility of heterotopic pregnancy and conduct careful and thorough evaluation if suspected. We experienced a case of heterotopic pregnancy in a woman in the absence of the known risk factors. She underwent underwent spontaneous abortion of intrauterine pregnancy at postoperative 4th day, after laparoscopic salpingectomy for left tubal pregnancy. We report this case with brief review of literature.
Abortion, Spontaneous ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Incidence ; Maternal Mortality ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal* ; Reproductive Techniques, Assisted ; Risk Factors ; Salpingectomy