Granulosa cell tumors are uncommon neoplasm of ovary that are characterized by their long natural history and for their tendency to recur years after an aparrent clinical cure. Endometrial cancer occurs in association with these tumor in at least 5% of cases and 25%-50% are associated with endometrial hyperplasia. In this study, we present a case of granulosa cell tumor of right ovary with endometrial cancer after left oophrectomy.
Endometrial Hyperplasia ; Endometrial Neoplasms* ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Natural History ; Ovary*

PURPOSE:To evaluate the role of unenhanced CT in diagnosing the acute appendicitis. METHOD AND MATERIALS: We retrospectively analyzed conventional contrast-enhanced abdominal CT scans of 197 normal patients and barium enemas of 26 out of the 197 patients. Additional unenhanced CT scans of right lower abdomen were performed on 30 patients who were suspected of having acute appendicitis;barium enema was performed in 26 patients. RESULTS: in the analysis of the conventional CT scans, we could detect 132(67%) normal appendicies. On barium enema of 26 out of 197 patients, abruptly narrowed appendix was visualized in 5 cases and luminal irregularity in 4 cases but all 26 cases showed normal appendix on CT. In the 30 cases of unenhanced CT, all appendicies were visualized. Among 12 Cases which were proved as acute appendicitis, barium enenma was done in 10 case;abruptly narrowed appendix was shown in 3 and luminal irregularity in 1. Among 18 cases which were diagnosed as normal appendix, nonvisualization of appendix' was in 1 case, abruptly narrowed lumen in 3, and luminal irregularity in 9. CONCLUSION:Unenhanced CT in the area of the cecum may be an effective and safe diagnostic tool for acute appendicitis.
Abdomen ; Appendicitis* ; Appendix ; Barium* ; Cecum ; Enema* ; Humans ; Phenobarbital ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVES: The purpose of this study was to investigate the risk factors in veterans for posttraumatic stress disorder and to find the correlation between the disorder and the characteristics of the variables. METHODS: We compared the risk factors in veterans between 40 diagnosed PTSD patients and 78 controls, using psychiatric by psychiatrists and measurement instruments such as CES, Mississippi scale, and BDI RESULTS: 1) There was statistically significant difference in prevalence on pre-military factor with regard to age at recruit(p<0.05) 2) PTSD on military factor was closely correlated with CES score(p<0.05) 3) There was statistically significant difference in PTSD on post-military factor with regard to occupation(p<0.05) 4) Scores of Mississippi scale, and BDI in PTSD were higher than those in control subjects(p<0.05, p<0.05) CONCLUSION: This results suggest that the likehood of developing PTSD in veterans depends on pre-military and post-military factors in addition to features of the trauma itself. Age of entry into the military, CES score, and occupation had statistically significant relationships with PTSD.
Humans ; Military Personnel ; Mississippi ; Occupations ; Prevalence ; Psychiatry ; Risk Factors* ; Stress Disorders, Post-Traumatic* ; Veterans*

Bone marrow transplantation has become an accepted treatment for malignancy(particulary leukemia and lymphoma), aplastic anemia, and certain inborn errors of metabolism. In addition to the problem of severe, prolonged myelosuppression, bone marrow transplantation is associated with several unusual complications. Among the complications such as GVHD, graft rejection, interstitial pneumonia and veno-occlusive disease, involvement of the gastrointestinal tract by GVHD is associated with high graft failure and mortality. Intestinal GVHD is usually manifest clinically as voluminous secretory diarrhea accompanied by abdominal cramping, ileus, nutritional depletion, and, at times, hemorrhage. We experienced a case of severe intestinal GVHD after allogeneic marrow transplantation for treatment of severe aplastic anemia. He received bone marrow from his elder sister, HLA-matched multiparous woman and suffered from large amount of watery diarrhea with skin rash 34 days after transplantation. 1n spite of prednisolone therapy the symptom was progressed. After sigmoidoscopic mucosal biopsy, intestinal GVHD was confirmed and we tried methylprednisolone pulse therapy. Skin lesion was improved but the amount of diarrhea was increased with intermittent abdominal cramping. We tried ALG(anti-lymphocyte globulin) and conservative management but the patient did not respond the therapy. He succumbed to pneumonia and acute respiratory insufficiency complicated with GVHD, 70days after transplantation.
Anemia, Aplastic* ; Biopsy ; Bone Marrow Transplantation* ; Bone Marrow* ; Colic ; Diarrhea ; Exanthema ; Female ; Gastrointestinal Tract ; Graft Rejection ; Hemorrhage ; Humans ; Ileus ; Leukemia ; Lung Diseases, Interstitial ; Metabolism, Inborn Errors ; Methylprednisolone ; Mortality ; Pneumonia ; Prednisolone ; Respiratory Insufficiency ; Siblings ; Skin ; Transplants

The majority of cystic lesions of the pancreas are psudocysts and a small fraction neoplastic. Failure to recognize the true nature of neoplastic cyst will lead to an incorrct treatment strategy. Ultrasonography, computerized tomography and angiography were used to distingish these lesions, but diagnostic value of ERCP is in controversy. To evaluate the diagnostic value of ERCP in cystic lesions of the pancreas, we analysed 33 cases of pancreatic cystic lesions (pseudocyst 18 cases, retention cyst 3 cases and cystic, neoplasm l2 cases) between Apr. 1985 and June 1993. In 18 cases of pseudocysts, ERP findings were communication with cyst in 8 cases (44.4%), chronic pancreatitis in 8 cases (44.4%), obstruction in 4 cases (22.2%) and displscement of pancreatic duct in 2 cases (11.1%), and ERC findings, which were perfomed in 8 cases, showed cholangitis in 3 cases (37.5%), CBD stone in 2 cases (25%), mass effect in 1 case (12.5%) and normal in 2 cases (25%). There was no communication with the cyst and pancreatic duct, except two mucinous ductal ectasia, in 12 cases of cystic neoplasms, and the other findings were displacement of pancreatic duct in 4 cases (33.3%), obstruction in 2 cases (16.7%) and normal in 4 cases (33.3%). ERC findings of cystic neoplasm were almost normal (85.7%) except 1 case of cholangitis. In conclusion, ERCP findings of pseudocysts were communication with pancreatic duct, chronic pancreatitis and biliary tract abnormality. In contrast, ERCP findings of cystic neoplasms were displacement or obstruction of pancreatic duct without communication and chronic pancreatitis, and biliary tract abnormality were rare.
Angiography ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Dilatation, Pathologic ; Mucins ; Pancreas ; Pancreatic Cyst* ; Pancreatic Ducts ; Pancreatitis, Chronic ; Ultrasonography

Peliosis hepatis is characterized by the presence in the liver of blood-filled cavities, which may or may not be lined with sinusoidal cells. The individual cysts or cavities usually do not exceed several centimeters in diameter. The cysts are typically continuous with adjacent, more normal sinusoids, and they sometimes can be seen in continuity with hepatic venous tributaries. The lesion is usually diagnosed by gross or microscopic examination. When suspected, it can be diagnosed by percutaneous liver biopsy. In the past, peliosis hepatis is primarily associated with wasting diseases, such as tuberculosis, malignancy, and chronic suppurative infection. However, recently peliosis hepatis is seen most commonly in association with the administration of anabolic steroids or HIV infection. We report a case of peliosis hepatis that is diagnosed by peritoneoscopic live biopsy and not associated with known disease.
Biopsy* ; HIV Infections ; Laparoscopy ; Liver* ; Peliosis Hepatis* ; Steroids ; Tuberculosis ; Wasting Syndrome

Azithromycin* ; Doxycycline* ; Scrub Typhus*

No abstract available.
Humans ; Hydronephrosis* ; Radioisotope Renography*

PURPOSE: Thyroid disease is the most common endocrine disease in childhood. Thyroid hormone has critical effects on growth and development, especially in childhood. We survey the prevalence, sex and age distribution, symptoms and thyroid function states of thyroid diseases in childhood. METHODS: Three hundred ninety one children who were diagnosed as having thyroid disease at department of pediatrics, St. Mary's hospital from Jan. 1987 to Dec. 1998 enrolled in this study. RESULTS: 1) The ratio between male and female patients was 1: 5.3. Age distribution was puberty, school age and infancy in their order of frequency. 2) The results of thyroid function tests showed normal function in 210 cases (53.7%), increased function in 95 cases(24.3%), and decreased function in 86 cases (22%). 3) Simple goiter, Graves disease, and chronic lymphocytic thyroiditis were the most common diseases in euthyroid, hyperthyroid, and acquired hypothyroid state, respectively. 4) The most common sign and symptom was goiter in euthyroid(100%), hyperthyroid(98.8%) and acquired hypothyroid state(96.2%). Forty of 68 cases(58.8%) with congenital hypothyroidism were detected by neonatal screening. CONCLUSION: Simple goiter, chronic lymphocytic thyroiditis and Graves disease were common acquired thyroid diseases in childhood, and goiter is the most common clinical manifestation in acquired thyroid disease. Recently, increasing number of congenital hypothyroidism was detected by neonatal screening test.
Adolescent ; Age Distribution ; Child ; Congenital Hypothyroidism ; Endocrine System Diseases ; Female ; Goiter ; Graves Disease ; Growth and Development ; Hashimoto Disease ; Humans ; Infant, Newborn ; Male ; Neonatal Screening ; Pediatrics ; Prevalence ; Puberty ; Thyroid Diseases* ; Thyroid Function Tests ; Thyroid Gland*

Angiogenesis is an essential requirement for development, progression, and metastasis of malignant tumors. Vascular endothelial growth factor (VEGF) is one of the important angiogenic factors. Recently the role of angiogenesis has been known in premalignant lesions. This study was performed to determine whether the angiogenesis and VEGF expression were increased in association with histological grade of cervical intraepithelial neoplasia (CIN) and to see the relationship between the angiogenesis and VEGF. Immunostainings for factor VIII and VEGF were performed on 52 cases of cervical neoplasia (12 cases of CIN I, 11 cases of CIN II, 15 cases of CIN III, 7 cases of microinvasive squamous cell carcinoma, and 7 cases of invasive carcinoma) and 5 cases of normal cervix. The results showed a significant increase of microvessel count from normal cervix through CIN grades to invasive squamous cell cacinoma. VEGF expression was increased in proportion to the CIN grades. There was no significant correlation between microvessel count and VEGF expression. In conclusion, the tumor angiogenesis is an early event in tumorigenesis of uterine cervix. In addition, no significant relationship between the microvessel count and VEGF expression in CIN suggests the possibility of other growth factors affecting mainly angiogenesis of premalignant lesion of uterine cervix.
Angiogenesis Inducing Agents ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Factor VIII ; Female ; Intercellular Signaling Peptides and Proteins ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*