PURPOSE: To report the case of a patient with large-angle hypertropia of an intramuscular hemangioma of the right superior rectus muscle (SR). METHODS: A 63-year-old man with progressive vertical deviation of the right eye for the past 6 months visited our strabismus department; his condition was not painful. An examination indicated that he had 60PD of right hypertropia at distance and near in primary gaze. Additionally, a significant limitation of his downgaze was noted. The right eye appeared mildly proptotic, and the upper and lower eyelids were slightly edematous. Corrected vision was 20/20 in both eyes. RESULTS: Orbital magnetic resonance imaging (MRI) studies revealed fusiform enlargement of the right superior rectus muscle, with prominent but irregular enhancement following gadolinium administration. Incisional biopsy revealed an intramuscular hemangioma in the superior rectus muscle with cavernous-type vessels. CONCLUSIONS: This case demonstrates that intramuscular hemangioma should be considered in the differential diagnosis of isolated extraocular muscle enlargement and unusual strabismus.
Strabismus/diagnosis/*etiology ; *Oculomotor Muscles ; Muscle Neoplasms/*complications/diagnosis ; Middle Aged ; Male ; Magnetic Resonance Imaging ; Humans ; Hemangioma/*complications/diagnosis ; Eye Neoplasms/*complications/diagnosis ; Disease Progression ; Diagnosis, Differential ; Biopsy

Antitumor effects of Bacillus Calmette-Guerin (BCG) against superficial urinary bladder cancer is known to be strong when BCG is directly infused into the bladder, but its immunological mechanisms are poorly understood. These experiments were performed to elucidate the effects of intralesional or systemic administration of BCG on the antitumor activity in murine transitional cell carcinoma (MBT-2) model and on the production of cytokines by the activated splenocytes or macrophages. ...continue...
Animals ; Bacillus ; Carcinoma, Transitional Cell ; Cytokines ; Immunotherapy* ; Macrophages ; Mice* ; Mycobacterium bovis* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

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

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

To investigate the developmental changes of human erythrocytes, adult and fetal erythrocyte membranes prepared from adult and cord blood were analyzed in regard to their proteins, glycoproteins, enzyme activities and glucose transport systems. 1. Adult and fetal erythrocyte membranes appeared to have the same major proteins and gl-ycoproteins in the electrophoretic pattern. 2. ATPase activity in adult erythrocyte membranes was lower than that of fetal erythrocyte membranes, whereas adult cholinesterase was higher. No significant change was observed in the activities of alkaline and acid phosphatases during development. 3. Glucose uptake was higher in fetal erythrocytes than in adult erythrocytes, suggesting some loss of glucose carrier system during devlopment. The results suggest that the major structural proteins in human erythrocyte membrane relatively unchanged while some functional proteins such as membrane enzymes and carrier proteins in transport systems are markedly changed during development.
Adenosine Triphosphatases ; Adult ; Carrier Proteins ; Cholinesterases ; Erythrocyte Membrane ; Erythrocytes* ; Fetal Blood ; Glucose ; Glycoproteins ; Humans* ; Membrane Proteins* ; Membranes* ; Phosphoric Monoester Hydrolases

OBJECTIVES: The aims of the study show the effect of cardiac disease of pregnant women on the perinatal complications and pregnancy outcomes. METHODS: From Jan. 2001 to Nov. 2005, 29 cases of pregnant women with cardiac disease were enrolled and classified by the NYHA (New York Heart Association) classes under the supervision of cardiologist and cardiothoracic surgeon. The average age of all cases is 29.9 years olds and it consists of 13 primigravida and 16 multigravida. For the examination of cardiac function during the pregnancy, the echocardiography was performed. We evaluated the cardiac disease of pregnant woman with the underlying causes, clinical manifestations during the pregnancy, delivery mode, gestational age at birth, birth weight, Apgar score and perinatal complication. RESULTS: All 29 cases with cardiac diseases are composed of 21 cases of NYHA class I (72.7%), 4 case of NYHA class II (13.7%) and 4 cases of NYHA class III (13.7%). There are 11 cases with congenital heart disease (37.9%), 6 cases with acquired heart disease (20.6%), 9 cases with arrhythmia (31.0%), and 3 cases with other cardiac disease (10.3%). Before the pregnancy, 6 cases of 11 cases with congenital heart disease and 5 cases of 6 cases with acquired heart disease performed the corrected cardiac surgery. Echocardiography was performed on 24 cases. It showed average ejection fraction in left ventricle of NYHA class I (13 cases) and NYHA class II, III (8 cases) were 61.5% and 52.6%, respectively. 7 cases of NYHA class I and 1 case of class II was done on the vaginal delivery. 14 cases of class I pregnant woman were performed the cesarean section according to obstetric indications but 3 cases of class II were performed the cesarean section for the prevention of cardiac risks. 4 cases of class III were performed the cesarean section according to obstetrics indications (2 cases) and for the prevention of cardiac risks (2 cases). For gestational age at birth, the average of NYHA class I was 38.1 weeks and the average of NYHA class II, III was 35.4 weeks. The average birth weight showed 3,022 gm in class I and 2,446 gm in class II and class III. Preterm birth were 3 cases (class II; 1 case, class III ; 2 cases). Low birth weight infant were 5 cases (class I; 3 cases, class II 2 cases). Intrauterine fetal death was a case (class I). Congenital abnormalities at birth were not observed in our study. Although no maternal mortality was observed, 2 cases of pulmonary edema caused by cardiomyopathy in NYHA class III and 1 case of Eisenmenger Syndrome caused by PDA in NYHA class II were developed during the labor. CONCLUSION: In this study, the majority of pregnant women with cardiac disease had the congenital heart diseases. It also showed that they can expect good perinatal outcomes by the adequate prenatal care including cardiac surgery before the pregnancy.
Apgar Score ; Arrhythmias, Cardiac ; Birth Weight ; Cardiomyopathies ; Cesarean Section ; Congenital Abnormalities ; Echocardiography ; Eisenmenger Complex ; Female ; Fetal Death ; Gestational Age ; Heart ; Heart Defects, Congenital ; Heart Diseases* ; Heart Ventricles ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Maternal Mortality ; Obstetrics ; Organization and Administration ; Parturition ; Pregnancy ; Pregnancy Outcome ; Pregnant Women* ; Premature Birth ; Prenatal Care ; Pulmonary Edema ; Thoracic Surgery

Cytomegalovirus (CMV) infection is more frequent in immunocompromised patients those with acquired immunodeficiency syndrome (AIDS), malignant disease, steroid therapy. However, CMV can infect a healthy person who has normal immunity. Most cases of CMV infections are due to reactivation of latent virus. We report a case of cytomegalovirus colitis in a 73 years old woman who has congestive heart failure with normal immunity. Sigmidoscopy reveals cobble stone like mucosa and deep ulceration. CMV infection produces a cytomegalic cell containing a intranuclear inclusion, which is surrounded by clear halo in Hematoxylin-Eosin stain. Immunohistochemical stain for CMV reveals focal positive in cytoplasm and in nuclei of large cells. We diagnosed CMV colitis with histopathologic finding and immunohistochemistry through sigmoidoscopic mucosal biopsy.
Acquired Immunodeficiency Syndrome ; Aged ; Biopsy ; Colitis* ; Cytomegalovirus* ; Cytoplasm ; Female ; Heart Failure ; Humans ; Immunocompromised Host ; Immunohistochemistry ; Intranuclear Inclusion Bodies ; Mucous Membrane ; Ulcer

OBJECTIVE: This study was performed to identify pathologic and clinical risk factors that predicted survival in cervical cancer stage IB2 patients treated surgically. METHODS: The records of 52 patients with cervical cancer IB2 who underwent radical hysterectomy with pelvic lymph node dissection from 1997 to 2003 were reviewed retrospectively. Clinical and pathologic variables included age, tumor size (TS), histologic type, involvement of resection margin, parametrium invasion, lymph node metastasis (LN), lymph-vascular space invasion, depth of invasion, treatment modality and adjuvant radiation therapy (RTx). 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. RESULTS: In the present study, median follow up was 46.5 months. With regard to the 2-year disease free survival rate and the 5-year survival rate, univariate analysis revealed no significant differences in subgroups according to age, histologic type, resection margin, parametrium, lymph-vascular space invasion, depth of invasion and treatment modality. Tumor size (p=0.0024), lymph node metastasis (p=0.0007) and radiation therapy (p=0.0398) significantly affected the 2-year disease free survival rate in univariate analysis. They (TS: p=0.0001, LN: p=0.0023, RTx: p=0.0428) also significantly affected 5-year survival rate in univariate analysis. Tumor size (RR 35.87, CI 2.94-438.26, p=0.01) and lymph node metastasis (RR 16.6, CI 1.36-202.05, p=0.03) affected 5-year survival rate in multivariate analysis. CONCLUSION: In patients with cervical cancer stage IB2 who underwent operation regardless adjuvant radiation therapy, the important independent prognostic factors were tumor size and LN metastasis.
Disease-Free Survival ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Survival Rate ; Uterine Cervical Neoplasms*

BACKGROUND: The effectiveness of treatment of asthma has been assessed by lung function test, airway responsiveness and symptoms. But, they rarely capture the emotional and social impairment. Recently, questionnaires that reflect the quality of life (QOL) in asthma patients were developed. In this study, we evaluated the impairment on quality of life in Korean adult asthmatic patients cross-sectionally by using the QOL questionnaires of Juniper EF. METHODS: One hundred eighty nine adult patients with over 1 year history of asthma were enrolled. The patients were asked to choose the five most important daily activities among 40 daily activities which were important in Korea. The QOL questionnaire was composed of 32 items in 4 domains (activity, symptom, emotion and exposure to environmental stimuli) and the response option was scored on a 7-point scale. RESULTS: 45.5% of patients who participated in this study were men, and 48.3% had atopy. The disease severities of asthma evaluated by physician were mild intermittent (31%), mild persistent (35%), moderate persistent (21%) and severe persistent (12%). Among 40 items of general daily activities, 19 items were chosen by more than 20 patients. Among them, running, walking uphills, hurried movement were most impaired daily activities. The QOL of our asthma patients showed statistical difference on disease severity, control state and symptom status during the last 3 months. The QOL was not influenced by sex, age or atopy score. Occupational asthma showed the lowest score on QOL in all 4 domains. On grouping with medications, the group with oral steroid noted statistically lower scores of QOL in all domains. The QOL score of asthma was well correlated with average symptom attacks during the last 3 months. CONCLUSION: According to our study, rapid control of asthma and lowering of the diseaseseverity are essential for improvement of QOL. A QOL questionnaire in Korea should be ... (continue)
Adult ; Asthma ; Asthma, Occupational ; Humans ; Juniperus ; Korea* ; Male ; Quality of Life* ; Respiratory Function Tests ; Running ; Walking ; Surveys and Questionnaires