OBJECTIVE: To investigate the response of hyperplastic endometrium to Medroxyprogesterone acetate according to the histologic types such as simple typical, complex typical and atypical hyperplasia. METHODS: A total of 79 patients with histologically proved endometrial hyperplasia were enrolled into this prospective study between March 1996 and May 1998. Patients without atypia were placed on a regimen of cyclic therapy with 10mg MPA orally, each day for 14days per month for 3 months. In the cases in which hyperplasia did not regress , MPA was increased to 20mg. Patients with atypical hyperplasia received continuous MPA therapy, 20mg orally each day for 3 month. All patients were followed up for a minimum of 3 months and a maximum of 1 year(mean 7 months). RESULTS: In patients with simple typical hyperplasia, 45 patients(80.4%) had regression, 11 patients(19.6%) had persistence and none had progression. In patients with complex typical hyperplasia, 10 patients(83.3%) had regression, 2 patients(16.7%) had persistence and none had progression. But, in patients with atypical hyperplasia 5 patients(45.4%) had regression, 4 patients(36.4%) had persistence and 2(18.2%) patients had well differentiated endometrial adenocarcinoma. There was no recurrence during the follow up. CONCLUSION: This data suggest that most women with typical hyperplasia respond to progestin therapy, but there is high failure rate of response to progestin therapy and risk of endometrial cancer in patients with atypical hyperplasia. If the young patient desires to preserve her fertility, then progestin therapy may be considered as primary treatment in patients with atypical hyperplasia. But older patients in whom fertility is not an issue, hysterectomy should be selected as treatment of choice for atypical lesion.
Adenocarcinoma ; Endometrial Hyperplasia* ; Endometrial Neoplasms ; Endometrium ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hyperplasia ; Hysterectomy ; Medroxyprogesterone Acetate ; Medroxyprogesterone* ; Prospective Studies ; Recurrence

The writers have conducted the investigation to assess the nutritional status of young rural Korean children aged form 0 to 4 years old in August 1971. The survey areas were Kaejong-myon, Daeya-myon, Okku-gun, Jeonra-bukdo, Korea. These survey areas were typical agriculture plain areas. The total numbers of children examined were 2,706 comprising 1,394 male and 1,312 female. the weight, height, and chest circumference of children were measured and means and standard deviations were calculated for each measurement. In addition, the nutritional status of each child was classified by the four levels of malnutrition and the Gomez classification. The examination of red blood cell count, haematocrit value, and intestinal parasite infection were carried out at the same time. In general, recent work tend to suggest that environment influences, especially nutrition, are of great importance than genetic background or other biological factors for physical growth and development. Certainly the physical dimensions of the body are much influenced by nutrition, particularly in the rapidly growing period of early childhood. Selected body measurements can therefore give valuable information concerning protein-calory malnutrition. Growth can also be affected by bacterial, viral, and parasite infection. For the field workers in a developing country, therefore, nutritional anthropometry appears to be of greatest value in the assessment of growth failure and undernutrition, principally from lack of protein and calories. In order to compare and evaluate the data obtained, the optimal data of growth from the offspring of the true well-fed, medically and socially protected are needed, So-called "Standards" that have been compiled for preschool children in Korea, However, are based on measurement of children from middle or lower socio-economic groups, sho are in fact, usually undernourished from six months of age onwards and continuously exposed to a succession of infective and parasitic diseases. So that, the Harvard Standards which os one of the international reference standards was used as the reference standards in this study. Findings of the survey were as follows: A. Anthropometric data: 1) Comparing the mean values for body weight obtained with the Korean standard weight of the same age, the rural Korean children were slightly haevier than the Korean standard values in both sexes. Comparing with the Japanese children values, the rural Koran children were slightly haevier in male and in the infant period of female but lighter in female of the period of 1 to 4 years old than Japanese children. 2) Comparing the mean values for height obtained with the Korean standard height of the same age, the rural Korean children were taller than the Korean standard values except the second half of infant period in both sexes. Comparing with the Japanese children, the rural Korean children were slightly smaller than Japanese children except the first half of infant period in both sexes. 3)Mean values of chest circumference of rural Korean children obtained were less than the Korean standard values of the same ages in birth sexes. B. Prevalence of Protein-Calory Malnutrition: Children examined were divided into two groups, i. e. , infant (up to the first birthday) and toddler (1 to $ years old). 1) Percentage of four levels of malnutrition: a) when the nutritional status of each child was classified (1) by body weight value, the percentages for male and female of children attained standard value, the percentages for male and female of children attained standard growth were 52.8%(infant 83.3%, toddler 44.4%) and 39.7%(infant 74.5%, toddler 30.5%), the first level of malnutrition were 31.9% (infant 13.7%,toddler 36.9%) and 31.7%(infant 15.3%, toddler 36.0%), the second level of malnutrition were 12.3%(infant 1.7%, toddler 15.3%) and 23.3% (infant 7.7%, toddler 27.5%), the third level of malnutrition were 2.7%(infant 0.7%, toddler 3.2%) and 4.6%(infant 1.8%, toddler 5.3%) the fourth level of malnutrition were 0.3% (infant 0.7%, toddler 0.2%) and 0.7%(0.7% for infant and toddler) respectively. (2)by height value, the percentages for male and female of children attained standard growth were 80.3%(infant 97.3%, toddler 75.6%) and 75.1%(infant 96.4%, toddler 69.5%), the first levels of malnutrition were 17.9%(infant 2.0%, toddler 22.3%) and 23.6%(infant 3.6%, toddler 28.8%), the second level of malnutrition were 1.2%(infant 0.3%, toddler 1.5%) and 1.1%(infant 0%, toddler 1.4%), the third level of malnutrition were 0.4%(infant 0.3%, toddler 0.5%) and 0.2%(infant 0%, toddler 0.3%), the fourth level of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 0% respectively. (3) By body weight in relation to height, the percentages for male and female of children attained standard growth were 87.9%(infant 77.6%, toddler 87.9%) and 78.2%(infant 77.4%, toddler 78.2%), the first level if malnutrition were 12.2%(infant 18.4%, toddler 10.6%) and 18.2%(infant 17.9%, toddler 18.3%), the second level of malnutrition were 1.9%(infant 3.3%, toddler 1.5%) and 3.0%(infant 3.3%, toddler 2.9%), the third level of malnutrition of malnutrition were 0.1%(infant 0.7%, toddler 0%)and 0.3%(infant 1.5%, toddler 0%) respectively. b) When the nutritional status of each child according to the mother's aged mother (31 to 40 years old) and old aged mother (41 years of above) was classified. (1) By body weight, among infants and toddlers, at each year of age, with increasing the mother's age, there was an increase in percentage of subjects underweight. This tendency of increasing percentage f underweight was more significant in the infant period than the toddler period. (2) By height value, no significant differences between each mother's age group were found. c) When the nutritional status of each child according to the birth rank, i. e. , lower birth rank(first to third) an higher birth rank(fourth of above) was classified. (1) By weight value, children of higher birth rank were slightly more often underweight than those of lower birth rank, but not significant. (2) By height value, no differences were found between children of lower and higher birth rank. 2) Gomez Classification: When the nutritional status of each child was classified a) By body weight value, the percentages for male and female of children, attained standard growth were 53.1%(infant 82.6%, toddler 44.9%) and 39.2%(infant 73.4%, toddler 30.1%), the first degree of malnutrition were 39.4%(infant 14.7%, toddler 46.2%) and 47.1%(infant 21.9%, toddler 53.8%), the second degree of malnutrition were 7.3%(infant 2.3%, toddler 8.6%) and 12.9%(infant 4.0%, toddler 15.2%), and the third degree of malnutrition were 0.2%(infant 0.3%, toddler 0.2%) and 0.8%(infant 0.7%, toddler 0.9%) respectively. b)By body weight value, the percentages for male and female of children, attained standard growth were 80.8%(infant 97.0%, toddler 76.3%) and 73.8%(infant 95.6%, toddler 68.0%), the first degree of malnutrition were 18.5%(infant 2.7%, toddler 22.9%) and 24.6%(infant 4.4%, toddler 30.0%), the second degree of malnutrition were 0.6%(infant 0.3%, toddler 0.7%) and 0.5%(infant 0.1%, toddler 0.7%), and the third degree of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 1.1%(infant 0%, toddler 1.3%) respectively. C. Results of clinical laboratory examination: 1) Red blood cells: The range of mean red blood counts for male and female were 3,538,000/m3 to 4,483,000/m3 respectively. The lowest red cell counts were seen at the age of 0-3 months for male and 1-2 months for female. 2) Haematocrit value: The ranges of haematocrit value of male and female were 35.1% to 38.8% and 34.7% to 38.8% respectively. The lowest haematocrit values were seen at the age of 2-3 months for male and 1-2months for female. 3)The prevalence rates of intestinal parasites for male and female children with Ascaris lumbricoides were 34.1%(infant 18.8%, toddler 38.1%) and 36.0%(infant 18.4%, toddler 40.7%), with Trichocephalus trichiuris were 6.8%(infant 2.9%, toddler 7.9%) and 9.0%(infant 3.0%, toddler 10.6%), with Hookworm were 0.3%(infant 0.5%, toddler 0.2%)and 0.3%(infant 0.5%, toddler 0.3%), with Clonorchis sinensis were 0.4%(infant 0%, toddler 0.5%) and 0.1%(infant 0%, toddler 0.1%)respectively.
Agriculture ; Ancylostomatoidea ; Anthropometry ; Ascaris lumbricoides ; Asian Continental Ancestry Group ; Biological Factors ; Body Weight ; Cell Count ; Child* ; Child, Preschool ; Classification ; Clonorchis sinensis ; Developing Countries ; Erythrocyte Count ; Erythrocytes ; Female ; Growth and Development ; Health Personnel ; Humans ; Infant ; Korea* ; Male ; Malnutrition ; Mothers ; Nutritional Status* ; Parasites ; Parasitic Diseases ; Parturition ; Prevalence ; Thinness ; Thorax ; Trichuris

OBJECTIVE: This study was designed to evaluate the efficiency of tumor markers level for early diagnosis of ovarian malignancy and for differentiation between benign and malignant ovarian tumors. MATERIALS AND METHODS: We determined preoperative serum tumor markers level in patients who were going to have an operation due to ovarian tumor in OB & GY Dept. of Chonnam University Hospital from April 1993 to September 1999. RESULTS: 1) The average values of serum tumor markers in patients with malingnant ovarian tumors were statistically higher than those of benign ovarian tumors. among malignant ovarian tumors, positive rate of all serum tumor markers was highest in epithelial ovarian carcinoma group. and among ovarian tumor markers, and positive rate of CA 125 was highest in epithelial ovarian carcinoma. 2) Dermoid cyst and endometioma were correlated to CA 19-9, CA 125 levels respectively. for malignant tumors, mucinous ovarian adenocarcinoma and non-mucinous ovarian adenocarcinoma were CA 19-9, CA 125 levels respectively. 3) Among ovarian tumor markers, CA 125 was the most in sensitivity and CA 72-4 was the most in specificity and diagnostic efficiency. 4) For postmenopausal women with ovarian tumors, elevated levels of at least one of the 4 tumor markers were present in the serum in 85.7% of the women who developed cancer, 62.5% of women with borderline, 27.8% of women with benign ovarian tumors. Conclusion; It is suggested that determination of serum tumor markers in patient suspected of ovarian tumor may be helpful to clinician for early diagnosis, differentiation between malignant and benign ovarian tumors.
Adenocarcinoma ; Dermoid Cyst ; Early Diagnosis ; Female ; Humans ; Jeollanam-do ; Mucins ; Sensitivity and Specificity ; Biomarkers, Tumor*

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

No abstract available.
Echocardiography* ; Heart Atria ; Thrombosis*

The majority of the cysts developed in pancreas are inflammatory pseudocyst but neoplastic cysts are rarely encountered Especially, mucinous cystadenoma which was begun and originated from epithelial cell of pancreatic duct is difficult to differentiate from pseudocysts by preoperative clinical, laboratory and radiologic findings. Mucinous cystadenoma has a malignant potentiality, so complete excision of cystadenoma is the treatment of choice. Recently, we experienced one case of mucionus cystadenoma in 37 year-old female, we report it with a review of the literature.
Adult ; Cystadenoma ; Cystadenoma, Mucinous* ; Epithelial Cells ; Female ; Humans ; Mucins* ; Pancreas* ; Pancreatic Ducts

Infective endocarditis (IE) is one of the major complications of the mitral valve prolapse (MVP) syndrome and usually involves mitral valve (MV) and its accessory apparatus. Left atrial (LA) mural endocarditis is a condition of rarely diagnosed and the most feasible mechanism is related to the impact of regurgitant jet that causes endothelial damage and retrograde microorganisms dissemination. Echocardiography is essential in diagnosis and treatment of IE but in mural endocarditis, it may be difficult to find vegetation by standard view of transthoracic echocardiography (TTE). We report a case of LA mural endocarditis which was diagnosed by transesophageal echocardiography (TEE) in a patient with MVP.
Echocardiography ; Echocardiography, Transesophageal ; Endocarditis ; Humans ; Mitral Valve ; Mitral Valve Prolapse

Traditionally, radical hysterectomy is the main surgical method for the treatment of early cervical carcinoma and always results in the loss of fertility. But, large numbers of young women are recently being diagnosed with cervical carcinoma and fertility preservation has become a concern. So, there has been a move towards more conservative approaches for the treatment of cervical carcinoma in recent years. Radical trachelectomy, which allows preservation of uterus but removes the cervix, parametrium and upper one third of the vagina, is a conservative but locally radical procedure. We performed radical abdominal trachelectomy with pelvic lymphadenectomy for two cases of invasive cervical carcinomas, which may be the first report in korea. One patient was 37 years old single women who had stage Ib cervical cancer and was disease free for 17 months after treatment. The other patient was 19 years old student who was also single and had stage IIa cervical cancer and was disease free for 14 months after treatment. We report the first two cases and review the literature on radical trachelectomy.
Adult ; Cervix Uteri ; Female ; Fertility ; Fertility Preservation ; Humans ; Hysterectomy ; Korea ; Lymph Node Excision* ; Uterine Cervical Neoplasms ; Uterus ; Vagina ; Young Adult

No abstract available.

PURPOSE: A consecutive series of 710 patients who underwent curative gastrectomy for carcinoma was studied with a special reference to the number or frequency of lymph node metastasis and the patient's prognosis. MATERIAL AND METHODS: Survival rates were calculated by the Kaplan-Meier method, and the difference between each group was evaluated statistically by the log-rank method. Follow-up was obtained for 709 patients (99.9%). RESULTS: According to the number of lymph nodal metastases, the five year survival rate for group 1 (1~3 positive nodes) was 50.9%; for group 2 (4~6 positive nodes), 56.7%; and for group 3 (more than 6 positive nodes), 12.0% (p<0.0001). According to the frequency of lymph node metastases, the five year survival rate for those with up to 25 per cent frequency of metastases was 47.5%; for those with up to 50 per cent frequency of metastases, 15.6%; and for those with greater than 50 per cent metastases, 6.3% (p<0.0001). According to the frequency of the regional lymph nodes (which include perigastric nodes along the lesser and greater curvatures, nodes located along the left gastric, common hepatic, splenic, and celiac arteries) metastasis, we categorized them as group 0 (N0: no metastasis), 1 (N1: metastasis in up to 25%), and 2 (N2: metastasis in greater than 25%). CONCLUSION: This subdivision could be successfully applied to the clinical evaluation of gastric carcinoma (five year survival rate for N0, 86.9%; for N1, 49.0%; and for N2, 10.7% (p<0.0001)) without difficulty in dividing certain lymph nodes into the correct location.
Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms* ; Survival Rate