We measured serum levels of CA-125 and Tissue polypeptide antigen(TPA) in 135 patients with pelvic tumors(129 benign pelvic tumors and 6 malignant ovarian tumors) preoperatively. Each tumor marker was measured by immunoradiometric assay. Serum CA-125 levels of 35.0U/ml, 65.0U/ml and TPA levels of 80.0U/ml, 100.0U/ml were determined as cut-off values. The results were evaluated by each tumor marker and two tumor markers coincidently. The results were as follows : (continue)
Humans ; Immunoradiometric Assay ; Biomarkers, Tumor

OBJECTIVE : The purpose of this study was to characterize the Rolandic fissure(Rf) and was to identify the Rf using the surface bony landmarks which can be usually exposed on craniotomy. METHODS : After morphological evaluation of the Rfs using 21 Korean adult formalin fixed cadavers, craniometric measurement was carried out from the surface bony landmarks of nasion, glabella, bregma, and lambda. RESULTS : The Rfs of both hemispheres did not show the mirror image. The Rfs ran forward and downward toward the sylvian fissure keeping the mean angle of 67degrees from mid-sagittal line as elongated S-shape in left and the elongated reverse S-shape in right hemisphere. Connections between the Rf and the longitudinal fissure and between the Rf and the sylvian fissure were found in 3 (7.1%) and 2 (4.8%) of 42 hemispheres, respectively. Most Rfs extended superiorly to 2-3mm lateral to the most superomedial surface of hemispheres and extended inferiorly to 3-5mm superior to the sylvian fissures. The mean distances from the nasion, glabella, bregma, and lambda to the most superomedial aspect of the Rf were 18.8+/-0.9cm, 16.6+/-0.8cm, 5.2+/-0.6cm, and 6.9+/-1.0cm, respectively. The mean distance measured between the Rf and the nasion using traditional method was 18.4+/-0.6cm. CONCLUSION : The distance between the Rf and the nasion roughly correspond within the range of mean 4 mm compared with that measured by the traditional measurement. These data may be more helpful to delineate the Rf after the placement of drapes for craniotomy.
Adult ; Cadaver ; Craniotomy ; Formaldehyde ; Humans

PURPOSE: Ugly ulcer and keloid formation of injection site has sometimes been a problem in Korea from the cosmetic point of view in intradermal vaccination. Since 3 or 4 years ago, multipuncture BCG vaccination has been used in Korea, there are no data and information about multipuncture BCG vaccination. We therefore performed this study to evaluate of conversion rate, complication and to make criteria of horizontal induration of Mantoux test instead of erythema to use criteria of positive Mantoux test in Japan. METHODS: 124 neonates who were born Kon-Kuk university hospital without family history of tuberculosis were given multipuncture BCG vaccination within 4 weeks after birth between Mar. and Oct. 1995. We observed change of local lesion for 1-3 months after BCG vaccination. All neonates tested a Mantoux test with 5TU of PPD 3 months after multipuncture BCG vaccination. RESULTS: 1) There was no significant difference in conversion rate of Mantoux test by feeding pattern. 2) There was no change of number of puncture site 1-3 months after BCG vaccination. 3) There was no ulcer in change of local lesion. Pusture, scab and redness was decreased 3 months after multipuncture BCG vaccination. Redness of all was replaced pigmentation. 4) The means+/-2SD of diameters of induration, erythema on Mantoux test were 10.4+/-3.0mm in horizontal induration, 13.2+/-4.2mm in horizontal erythema, 8.0+/-3.0mm in vertical induration, 10.9+/-3.5mm in vertical erythema. 5) Criteria for positive tuberculin reaction were diameters of induration, erythema : equal to or greater than 7mm of horizontal induration, equal to or greater than 5mm of vertical induration, equal to or greater than 10mm of horizontal and vertical erythema. 6) The positve conversion tuberculin rate were 87.8% in horizontal induration, 87.5% of vertical induration, 83.8% of horizontal erythema, 69.4% of vertical erythema. 7) Conversion rate of neonates immunized later 21 days after birth were significantly greater than neonates immunized within 21 days after birth. 8) There was no correlate Mantoux test conversion rate and strong reaction of local lesion. 9) There were no specific complication after multipuncture BCG vaccination. 10) There were no severe pain and irritability at multipuncture BCG vaccination. CONCLUSIONS: Multipuncture BCG is a good BCG vaccination that we can use with efficacious effect and slight local lesions instead of intradermal BCG vaccination.
Erythema ; Feeding Behavior ; Humans ; Infant, Newborn* ; Japan ; Keloid ; Korea ; Mycobacterium bovis* ; Parturition ; Pigmentation ; Punctures ; Tuberculin ; Tuberculosis ; Ulcer ; Vaccination*

Based on the review of literatures, this article discussed the frequency and timing of rebleeding after initial subarachnoid hemorrhage (SAH), and the risk factors and preventive strategy for rebleeding. In view of the active policy of early aneurysm surgery, the peak interval for rebleeding was the first 24 hours after the aneurysmal SAH. Patients with poor grades, ventricular drainage, angiography within 6 hours post-SAH, time interval between the last attack and admission, and reduced platelet function were proposed as a risk factor of rebleeding. Rebleeding from giant aneurysms occurred at a rate comparable to that associated with smaller aneurysm. The efficacy of short-term antifibrinolytic drugs was expected to minimize ultraearly rebleeding. When ventriculostomy is necessary, intracranial pressure should be maintained between 15 and 25 mmHg to minimize transmural pressure gradients. Securing ruptured aneurysm on an emergency basis remained open to debate.
Aneurysm ; Aneurysm, Ruptured ; Angiography ; Blood Platelets ; Drainage ; Emergencies ; Humans ; Intracranial Pressure ; Risk Factors ; Subarachnoid Hemorrhage* ; Ventriculostomy

OBJECTIVE: Topographic arrangement and morphometric pattern of cauda equina are studied. METHODS: In 10 adult formalin fixed cadavers, the entire dural sac of lumbosacral spine including extradural nerve roots was extracted. After paraffin fixation, serial cross section from sacral nerve roots to conus medullaris was performed. We investigated following structures at each disc level using a slide scanner after haematoxylin and eosin and Masson's trichrome stains: 1) location of filum terminale(FT), 2) arrangement of motor and sensory bundles, 3) morphometric characteristics of sensory bundles to motor bundle of each spinal nerve root. RESULTS: The FT was located in the dorsal half of midline at L2-3 disc level and in the most dorsal portion of midline from the L4-5 disc level and downward. All bundles of each nerve root showed an oblique arrangement. Motor bundle of each spinal nerve root was always located in the anterior or anteromedial portion of the corresponding sensory bundles. At L4-5 and L5-S1 disc levels, S1 to S4 nerve roots were arranged inverted V-shape centered FT. The sensory root was composed of several bundles whereas the motor root was always composed of a single bundle. The areas occupied by sensory bundles were larger than 2 to 4 times in S1-3 sacral nerve roots and 1.9 to 2.4 times in L3-5 lumbar nerve roots compared with those occupied by the corresponding motor roots. CONCLUSION: This study will be helpful to prevent the nerve root injury during the operation of cauda equina and predict postoperative complications.
Adult ; Cadaver ; Cauda Equina* ; Coloring Agents ; Conus Snail ; Eosine Yellowish-(YS) ; Formaldehyde ; Humans ; Paraffin ; Postoperative Complications ; Spinal Nerve Roots ; Spine

The sensitivity and specificity of ST segment change on ECG for detection of coronary artery disease(CAD) by pacing stress test were assessed. Among 28 cases with chest pain(mean age 52, M/F : 21/7), 10 patients had normal coronary angiographic finding(Group I), and 18 had coronary artery disease(Group II). Pacing stress test showed high specificity(100%), but low sensitivity(61%) for the diagnosis of CAD. Especially in patients with 1 vessel disease, the sensitivity was only 50%, and positive results were not attained unless there was at least 90% or more stenosis in any of the major branches(LAD, RCA or LCX). But in patients with multivessel disease, the sensitivity was much higher(83%). Lateral(V4-6) or inferior leads(2, 3, aVF) showed ischemic ST segment depression most commonly. Therefore one of the inferior lead and V5 may be a minimum requirement for monitoring pacing-induced ST segment changes. Time constant during isovolumic relaxation showed statistically significant prolongation after pacing only in CAD patient group, suggesting pacing-induced impairment of early left ventricular relaxation.
Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Depression ; Diagnosis* ; Electrocardiography ; Exercise Test ; Humans ; Relaxation ; Sensitivity and Specificity ; Thorax

PURPOSE: With the recent advent of surfactant replacement therapy, there is an increasing need for a rapid and reliable test to predict respiratory distress syndrome (RDS) immediately before or at birth. There are many investigations and methods for the detection of RDS in prenatal or postnatal period. The stable microbubble rating test (SMR-test) developed by pattle et al. is rapid and simple test performed on amniotic fluid and gastric aspirates which reflects the adequacy of pulmonary surfactant with higher diagnostic accuracy. To determine the relation of the SMR and surfactant derivatives [Surfacten : phospholipid (PL), Exosurf : dipalmitoyl-phosphatidyl choline (DPPC) concentration in vitro, author performed SMR test according to 15 groups of surfactant derivatives concentration by using modified Pattle's method. METHODS: Surfacten & Exosurf were diluted each concentration (0, 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 70, 80, 90, 100microgram/ml) by dilutional fluid. We enveloped test tube by paraffin paper for protection of evaporation. When we performed SMR test, we shaked test tube vigorously by Vlotex shaker. We performed SMR test according to 15 groups of Surfactant concentration by using modified Pattle's method. RESULTS: 1) The number of SMR according to 15 groups of surfactant derivatives concentration were 2, 1/mm2 in 4.2microgram/ml of PL and 3.1microgram/ml of DPPC, 279, 1104/mm2 in 83.3microgram/ml of PL and 61.8microgram/ml DPPC. 2) The regression curve of SMR and surfactant derivatives concentration showed statistically significant relation (p<0.005). CONCLUSION: The SMR test was a good method in estimation of surfactant concentration in vitro and also in diagnosis of RDS recognized as a surfactant deficiency.
Amniotic Fluid ; Choline ; Diagnosis ; Female ; Microbubbles* ; Paraffin ; Parturition ; Pulmonary Surfactants

OBJECTIVE: To investigate whether patterns of dysphagia were associated with the location of the brain lesion and clinical factors in subacute stroke patients. METHOD: One hundred and seventy-eight first-ever subacute stroke patients who underwent videofluoroscopic swallowing study (VFSS) from January 2006 to April 2012 were enrolled in the present study. Swallowing-related parameters were assessed by VFSS. The location of brain lesions were classified into the cortical, subcortical, and brain stem. The degree of cognitive impairment and the independency of activities of daily living were assessed by the Korean version of mini-mental status examination and Korean version of modified Barthel index (K-MBI). Aphasia and hemineglect were assessed by Korean version of Western aphasia battery and line bisection test. These data were collected via retrospective chart review. RESULTS: A reduced laryngeal elevation and prolonged pharyngeal delay time were associated with brain stem lesion. Other swallowing parameters were not associated with lesion topology. Pyriform sinus residue was associated with the presence of aphasia and low K-MBI scores. Prolonged pharyngeal delay time was associated with the patient's age, type of stroke and brain stem lesion. CONCLUSION: Pyriform sinus residue was associated with clinical factors such as aphasia and K-MBI scores rather than with the location of brain lesion. However, reduced laryngeal elevation and prolonged pharyngeal delay time were predominant in brain stem lesions.
Activities of Daily Living ; Aphasia ; Brain Stem ; Brain* ; Deglutition Disorders ; Deglutition* ; Humans ; Pyriform Sinus ; Retrospective Studies ; Stroke*

OBJECTIVE: To investigate the morphometric characteristics of the pituitary gland and diaphragma sellae in Korean adults. METHODS: Using the 33 formaline fixed adult cadavers (23 male, 10 female), the measurements were taken at the diaphragma sellae and pituitary gland. The authors investigated the relationship between dura and structures surrounding pituitary gland, morphometric aspects of pituitary gland and stalk, and morphometric aspect of central opening of diaphragma sellae. RESULTS: The boundary between the lateral surface of pituitary gland and the medial wall of cavernous sinus was formed by the thin dural layer and pituitary capsule. The pituitary capsule adherent tightly to the pituitary gland was observed to continue from the diaphragma sellae. Mean width, length, and height of the pituitary gland were 14.3 +/- 2.1, 7.9 +/- 1.3, and 6.0 +/- 0.9 mm in anterior lobes, and 8.7 +/- 1.7, 2.9 +/- 1.1, and 5.8 +/- 1.0 mm in posterior lobes, respectively. Although all dimensions of anterior lobe in female were slightly larger than those in male, statistical significance was noted in only longitudinal dimension. The ratio of posterior lobe to the whole length of pituitary gland was about 27%. The mean thickness of pituitary stalk was 2 mm. The diaphragmal opening was 5 mm or more in 26 (78.8%) of 33 specimen. The opening was round in 60.6% of the specimen, and elliptical oriented in an anterior-posterior or transverse direction in 39.4%. CONCLUSION: These results provide the safe anatomical knowledge during the transsphenoidal surgery and may be helpful to access the possibility of the development of empty sella syndrome.
Adult ; Cadaver ; Cavernous Sinus ; Diaphragm ; Empty Sella Syndrome ; Female ; Formaldehyde ; Humans ; Male ; Pituitary Gland

PURPOSE: Dioctahedral smectite is an alumina silicate of phyllitic structure and absorbs bile acid in the intestine, forming a non-absorbable complex preventing enterohepatic circulation. The purpose of this study is to clarify the value of dioctahedral smectite and the adequate dosage, in combination with phototherapy, as well as to confirm whether it shortens the duration of hospitalization and to compare dioctahedral smectite with cholestyramine. METHODS: Total 45 full-term neonate with a total bilirubin level greater than 12 mg/dl were studied. The neonate were randomly divided into three groups : 1) Only phototherapy group (A) 2) 3.0 g/day dioctahedral smectite with phototherapy group (B) 3) 1.0 g/kg/day cholestyramine with phototherapy group (C). RESULTS: The mean serum bilirubin level of group B and C decreased significantly compared to group A at 48, 72 and 96 hours after the beginning of the study. The duration of phototherapy and hospitalization significantly decreased in group B and C. CONCLUSION: The data revealed that oral administration of dioctahedral smectite not only increased the efficacy of phototherapy, but also shortened the duration of phototherapy and can substitute for cholestyramine.
Administration, Oral* ; Aluminum Oxide ; Bile ; Bilirubin ; Cholestyramine Resin* ; Enterohepatic Circulation ; Hospitalization ; Humans ; Hyperbilirubinemia, Neonatal* ; Infant, Newborn ; Intestines ; Jaundice, Neonatal ; Phototherapy* ; Silicates