OBJECTIVE: The aims of this study were to analyze the natural history of patients with pseudomyxoma peritonei originated from mucinous ovarian tumor, evaluate clinical and pathologic variables, and review our experience with available therapeutic modalities. METHODS: Six patients were treated for pseudomyxoma peritonei originating from mucinous ovarian tumor at Severance Hospital between 1990 and 1998. The data were collected retrospectively and all charts were reviewed RESULTS: The mean age at diagnosis was 51 years, and most common symptoms were abdominal distension. Pseudomyxoma peritonei was found in association with five mucinous ovarian tumors of borderline malignancy, and one ovarian mucinous adenoma. All patients underwent surgical staging and cytoreduction, three patients received postoperative adjuvant chemotherapy and, of these, two developed recurrence. With respect to survival, all patients were alive, four were alive and free of disease, two were alive with disease at the end point of study. CONCLUSION: Pseudomyxoma peritonei is commonly associated with borderline mucinous ovarian tumors, and is a frequently relapsing and protracted disease. But aggressive and repeated debulking surgery is recommended for long survival.
Adenoma ; Chemotherapy, Adjuvant ; Diagnosis ; Humans ; Mucins* ; Natural History ; Pseudomyxoma Peritonei* ; Recurrence ; Retrospective Studies

No abstract available.
Skin Diseases*

No abstract available.
Head* ; Orthognathic Surgery* ; Posture* ; Prognathism*

We report a case of drug eruption and liver damage due to diaminodiphenyl suIfone(DDS) ingestion in a 17-year-old female. This patient had taken DDS for 20 days, 100mg-200mg daily to treat an unknown skin disease. Thereafter, she had generalized erythematous eruption on whole body, icteric sclera and fever. Liver function test showed abnormality (SGOT 514 unit, SGPT 710 unit, alkarine phosphotase 4. 3 B.U., total biIirubin 7. Oml/dl, direct bilirubin 4. 8mg/dl). The adverse reactiions to DDS are gastrointestinal intolerance, hemolytic, anemia, methemoglobinemia, agranulocytoais, hepatitis, neuritis, psychosis and a skin rash described as a fixed drug eruption, erythema multiforme, exfoliative dermatitis and toxic epidermal necrolysis. In Korea, DDS has been used for the treatment of skin diseases of various types for a long time without prescription, especially in rural areas. This trend is a significant sociomediical problem in Korea.
Adolescent ; Alanine Transaminase ; Anemia ; Bilirubin ; Dermatitis, Exfoliative ; Drug Eruptions* ; Eating ; Erythema Multiforme ; Exanthema ; Female ; Fever ; Hepatitis ; Humans ; Korea ; Liver Function Tests ; Liver* ; Methemoglobinemia ; Neuritis ; Prescriptions ; Psychotic Disorders ; Sclera ; Skin Diseases ; Stevens-Johnson Syndrome

The clinical role of tumor markers to detect the extent of tumor invasion and recurrence in cervical cancer has been debated. To evaluate the chncal significance of SCC, CEA and TPA as tumor markers in cervical, we studied 744 patients weith cervieal cancer from June 1990 to Mey 1994. The cut-off val ues of SCC, CEA and TPA were 1.5 ng/ml, 4.5 ng/mi and 110 U/I respectively. Followings were the results. 1. The serum concentration and positive rates of SCC before therapy(567 cases) were 3,0+/-7.0ng/ml(40.4%) for stage I,8.7+/-13.9 ng/ml(71.6%) for stage II, 10.8+/-14.7 ng/ml(85.7%) for stage III, 23.9+/-24.3 ng/ml(94.7%) for stage IV, and 13.4+/-19.1 ng/ml(75.0%) for recurrent cancer. It was increased with advancing clinical stage(p<0.01). 2. The seum levels and positive rate of CEA before therapy(627cases) were 3.4+/-4.3 ng/ml (18%) for stage I, 7.1+/-12.3 ng/ml(37.2%) for stage II, 8.4+/-9.6 ng/ml(57.9%) for stage III, 15.4+/-22.2 ng/ml(52.6%) for stage IV, and 10.3+/-16.2 ng/ml(46.4%) for recurrent cancer. It was increased with advancing clinical stage from stage Ito stage III(p<0.01). 3. The serum concentration and positiceive rate of TFA before therapy(301cases) were 51.7+/-53.8 U/l(9.5%) for stage I, 105.3+/-108.8 U/l(32.3%) for stage II, 186.3%+/-159.8 U/l(50%) for stage III, 191.3+/-l06.2 U/I(63.6%) for stage IV, and 135.4+/-117.0 U/l(46.4%) for recurrent cancer. It was increased with advencing clinical stage(p<0.01). 4. In 64 patients{24.2%) with lymph node invasion of 265 patients treated by operation, the mean serum levels of SCC, CEA and TPA were higher than lymph node negative group(p<0.05). 5. The serum levels of SCCand CKA after therepy were 82.8% in sensitivity. 94.3% in specificity, 67.9% in positive predictive value, 97.4% in negative predictive value.
Humans ; Lymph Nodes ; Recurrence ; Sensitivity and Specificity ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

Monilethrix is a rare hereditary disorder of hair which was described by smith in 1879. The scalp hair is most frequently affected but the body or sexual hair are rarely affected. The affected hair shows periodic constrictions that break easily, so the hair could not grow more than a few millimetere long. It is thought that the node of the affected hair is normal and the thin internodal segment is deficient in hair matrix. Keratosis pilaris is generally an associated feature. We experienced a case of monilethrix with keratosis pilaris. The 4 years old male patient with monilethrix affected only scalp hair with keratosis. The family history was non-contributory.
Child, Preschool ; Constriction ; Hair ; Humans ; Keratosis* ; Male ; Monilethrix* ; Scalp

OBJECTIVES: Sleep disorders cause changes of autonomic nervous system (ANS) which affect cardiovascular system. Primary insomnia (PI) makes acceleration of sympathetic nervous system (SNS) tone by sleep deficiency and arousal. Obstructive sleep apnea syndrome (OSAS) sets off SNS by frequent arousals and hypoxemias during sleep. We aimed to compare the changes of heart rate variability (HRV) indices induced by insomnia or sleep apnea to analyze for ANS how much to be affected by PI or OSAS. METHODS: Total 315 subjects carried out nocturnal polysomnography (NPSG) were categorized into 4 groups - PI, mild, moderate and severe OSAS. Severity of OSAS was determined by apnea-hypopnea index (AHI). Then we selected 110 subjects considering age, sex and valance of each group's size [Group 1 : PI (mean age=41.50+/-13.16 yrs, AHI <5, n=20), Group 2 : mild OSAS (mean age=43.67+/-12.11 yrs, AHI 5-15, n=30), Group 3 : moderate OSAS (mean age 44.93+/-12.38 yrs, AHI 16-30, n=30), Group 4 : severe OSAS (mean age=45.87+/-12.44 yrs, AHI >30, n=30)]. Comparison of HRV indices among the four groups was performed with ANCOVA (adjusted for age and body mass index) and Sidak post-hoc test. RESULTS: We found statistically significant differences in HRV indices between severe OSAS group and the other groups (PI, mild OSAS and moderate OSAS). And there were no significant differences in HRV indices among PI, mild and moderate OSAS group. In HRV indices of PI and severe OSAS group showing the most prominent difference in the group comparisons, average RR interval were 991.1+/-27.1 and 875.8+/-22.0 ms (p=0.016), standard deviation of NN interval (SDNN) was 85.4+/-6.6 and 112.8+/-5.4 ms (p=0.022), SDNN index was 57.5+/-5.2 and 87.6+/-4.2 (p<0.001), total power was 11,893.5+/-1,359.9 and 18,097.0+/-1,107.2 ms2 (p=0.008), very low frequency (VLF) was 7,534.8+/-1,120.1 and 11,883.8+/-912.0 ms2 (p=0.035), low frequency (LF) was 2,724.2+/-327.8 and 4,351.6+/-266.9 ms2 (p=0.003). CONCLUSIONS: VLF and LF which were correlated with SNS tone showed more increased differences between severe OSAS group and PI group than other group comparisons. We could suggest that severe OSAS group was more influential to increased SNS activity than PI group.
Acceleration ; Anoxia ; Arousal ; Autonomic Nervous System ; Cardiovascular System ; Heart ; Heart Rate ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sympathetic Nervous System

Fixation failure is a major complication of intertrochanteric fracture. The causes of fixation failure were assessed in a series of 80 patients with intertrochanteric fractures, which had been internally fixed with either a sliding hip screw or a Gamma interlocking nail. The overall rate of fixation failure was 16.3%, in which the cutting-out of the implant from the femoral head was the only cause of the instance. The cutting-out rate was influenced by the accuracy of fracture reduction, the position of implant placement within the femoral head, and the bone mineral density. Anatomical reduction and the central placement of implant within the femoral head showed the most excellent results compared to other treatment modalities. Age, gender, fracture type and a kind of fixation implant had no significant effect. Our results showed that the intertrochanteric fractures should be reduced as anatomically as possible and it is essential that the central placement of the implant within the femoral head be obtained.
Bone Density ; Head ; Hip ; Hip Fractures* ; Humans

BACKGROUND: The central physiological derangement of hemorrhagic fever with renal syndrome (HFRS) caused by hantaan virus (HTNV) is a vascular dysfunction, manifested by hemorrhage, impaired vascular tone and increased vascular permeability. Platelet activating factor (PAF), whose actions are mediated through a specific receptor, is a potent bioactive lipid. PAF has diverse biological functions in the vascular system, such as increasing vascular permeability, adhesion of leukocytes to the endothelium and reduction of cardiac output, which result in hypotension and shock. The goal of the present study was to investigate whether PAF is involved in the pathogenesis of HFRS. For this purpose, we evaluated the effect of HTNV on the expression of PAF receptor (PAF-R) and on the activity of PAF-acetylhydrolase (PAF-AH) instead of PAF because PAF is rapidly degraded by PAF-AH in vivo. MATERIALS AND METHODS: To evaluate the expression of PAF-R, we performed reverse-transcription PCR, western blot and FACS analyses using HTNV-infected human umbilical vein endothelial cells (HUVECs) and non-infected (control) HUVECs. In addition, we measured the activity of plasma PAF-AH in HFRS patients and normal healthy persons. RESULTS: The mRNA and protein expression of PAF-R was increased in HTNV-infected HUVECs compared with control HUVECs at 2 and 3 days post-infection (d.p.i.). FACS analysis showed that HTNV induced the surface expression of PAF-R in HUVECs from 2 d.p.i. The activity of plasma PAF-AH was 2.5-fold lower in HFRS patients than in normal healthy persons. CONCLUSION: Increased PAF-R expression by HTNV might increase the responsiveness to PAF in endothelial cells. Reduced PAF-AH activity in the blood of HFRS patients might delay PAF degradation. These results suggest that changes in PAF-R and PAF-AH by HTNV might influence to PAF activity and might be involved in the vascular dysfunction of HFRS.
Blood Platelets ; Blotting, Western ; Capillary Permeability ; Cardiac Output ; Endothelial Cells ; Endothelium ; Hantaan virus ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome ; Human Umbilical Vein Endothelial Cells ; Humans ; Hypotension ; Leukocytes ; Plasma ; Platelet Activating Factor ; Platelet Membrane Glycoproteins ; Polymerase Chain Reaction ; Receptors, G-Protein-Coupled ; RNA, Messenger ; Shock

No abstract available.
Acute Disease ; Aged ; Anti-Bacterial Agents/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Buttocks ; Debridement ; Diabetes Mellitus, Type 2/*complications/diagnosis ; Escherichia coli Infections/diagnosis/drug therapy/*microbiology ; Female ; Humans ; Microbial Sensitivity Tests ; Muscle, Skeletal/*microbiology/surgery ; Pyelonephritis/diagnosis/drug therapy/*microbiology ; Pyomyositis/diagnosis/*microbiology/therapy ; Tomography, X-Ray Computed ; Treatment Outcome