No abstract available.
Frontal Sinus*

Six cases of a rare variant of endocervieal adenocarcinoma (Adenoma maligum, AM) were collected for clinicopethologic analysis. The everage age of six patients was 49.3 years, and their chief com plaints were persis(ent mucid or watery discharge and intermittent vaginal spotting, The clinical im presaion was carcioma of The uterine cervix in faur out, of six cases. All except one were pathologically confirmed by initia1 biupey. two cases by colposcopic biopsies, two by cone biopsies, one by cone biopsy after suggested AM in calposcopic hiopsy. One case was incidentally found from hysterectnmised speeimen, which waas suspected as adennmyosis. On gross examination, the cervix usualty appeared either firm or indurated with thickening af the wall excepl one which was presented es a fungnting mass. The characteristic histologic feetures were ext,ensive arborizing endeervical glands with marked variation in size and shape, and the glands lined by mucin conyaining columnar epithelial cells with basal bland looking nuclei but with occasional cytologic atypia and rare mitose. The nenplasi.ic glands were characterized by deep stronml invasion be yond normal enddcervical glands, assosiated with loose edematous periglandular desmaplastic stromal reaction in moat cases. Immunohistochemical stainnings for carcinoembryonie antigen (CEA) revealed ey- toplasmic positivity in five cases. The clinical stage for all exeept one incidental case were : four Ib and one II b. In three cases, the radical hysterectomy with unilateral salpingooophorectomy plus dissection of bilateral pelvic and paraaortic lymph nodes was performed, and in one case radiotherapy was done prior to radical hysterectomy with bilateral salpingoophorectomy plus the dissection of left pelvic lymph nodes followed by chemotherapy. Total abdominal hysterectomy with bilateral salpingooophorectomy plus Burch's operation followed by radiation therapy was performed in on case. The remaining one case was treated with radiation therapy. Metastasis to the left obturator lymph node was discovered in one case with state IIb, and the patient expired 29 months after the radiotherapy. The remaining five cases are being carefully followed up. From our experience, we conclude that the early diagnosis of AM can be made based on comprehensive analysis concerning the clinical features, histopathological and immunohistochemical findings. The early diagnosis and proper therapy can lead to the better prognosis.
Adenocarcinoma ; Adenoma* ; Biopsy ; Cervix Uteri* ; Drug Therapy ; Early Diagnosis ; Epithelial Cells ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Metrorrhagia ; Mucins ; Neoplasm Metastasis ; Prognosis ; Radiotherapy

We retrospectively evaulated the frequency and risk factors of glaucoma after penetrating keratoplasty by reviewing charts of 96 patients(112eyes) who received the penetrating keratoplasty from May 1992 to Novermber 1995 at Chonnam Universty Hospital. Intraocular pressure was increased over 21mmHg in 18 eyes after surgery. Underlying disease of them were graft failure (5 eyes), bullous keratoplasty(5 eyes), corneal ulcer(5 eyes), trauma(3 eyes). Ten eyes(55.5%) were glaucomatous preoperatively. Eight eyes(44.4%) were phakic, 7 eyes(38.9%) aphakic, and 3 eyes(16.7%) pseudophakic. Ten eyes(55.5%) underwent only penetrating keratoplasty, 4 eyes(22.2%) vitrectomy at the time of penetrating keratoplasty, and 4 eyes(22.2%) combined cataract extraction. The eyes with previous history of glaucoma(19 eyes) had higher incidence of increased intraouclar pressure than those 93 eyes with no glaucoma history(P<0.0001). Aphakic eyes(21 eyes) had higher incidence of glaucoma than phakic eyes(80 eyes)(p<0.05).
Cataract Extraction ; Glaucoma* ; Incidence ; Intraocular Pressure ; Jeollanam-do ; Keratoplasty, Penetrating* ; Retrospective Studies ; Risk Factors ; Transplants ; Vitrectomy

This paper reports our experiences in laparoscopically assisted surgical staging (LASS) to manage the patients with early-stage endometrial cancer. From March 1996 to March 1999, we performed LASS in 6 patients with clincal stage I adenocarcinoma of the endometrium. We performed laparoscopic-assisted vaginal hysterectomy (LAVH) with bilateral salpingo-oophorectomy (BSO) and intraoperative frozen-section (IFS) diagnosis. The depth of myometrial invasion, tumor differentiation, histologic types, cervical invasion, and adnexal involvement were determined by IFS diagnosis. Laparoscopic pelvic and/or para-aortic lymphadenectomies were performed based on the grade of the tumor and depth of myometrial invasion. One patient was discovered to have tumor metastases in pelvic peritoneum and uterosacral ligaments, and underwent only para-aortic lymphadenectomy for determining field of radiation therapy. 2 out of 5 patients only underwent LAVH with BSO and peroitoneal washing cytology. Three other patients underwent LAVH with BSO, peritoneal washing cytology and pelvic lymphadenectomy because they were identified by IFS diagnosis as intermediate risk group for nodal metastasis. The mean age of the patients was 46.4 years. Total length of the operation time ranged from 100 minutes to 305 minutes and the mean was 187.5 minutes. The mean hemoglobin decrement after the surgery was 0.9 gm/dl. No one recieved blood transfusion. The average number of pelvic and para-aortic lymph nodes removed were 16.7 and 18, respectively. After the surgery, the patients passed gas after an average of 2.0 days and urinated urine after an average of 3.8 days. No one had complication after LASS. Based on our experiences, LASS might be an alternative to the traditional surgical approach in patients with early-stage endometrial carcinoma.
Adenocarcinoma ; Blood Transfusion ; Diagnosis ; Endometrial Neoplasms* ; Endometrium ; Female ; Humans ; Hysterectomy, Vaginal ; Ligaments ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Peritoneum

We compared all frozen section examination of ovarian tumors during a 5 year period in our institute with permanent section diagnosis from paraffin sections. In this period, 604 ovarian tumors had frozen section examination. Final histologic diagnosis was divided into benign, low malignant potential and malignant. Sensitivity of frozen section diagnosis for malignant was 80 %, low malignant potential 73,1%, and benign 99.8%. Predictive value for malignancy was 98.5%, for low malignant potential 76.6%, and for benign disease 96.2%. Diagnostic problems occurred in huge tumors and low malignat potential mucinous tumors. Analysis of the 32 false negative(miss or under diagnosis) revealed that a sampling error was involved almostly. The cases of discrepancy between frozen section diagnosis and permanent section diagnosis, were 26/34 in mucinous tumors and 33/34 in huge size of tumors(more than 10cm). Although surgeons and pathologist are aware of the limitations of frozen section diagnosis of ovarian tumors, peroperative histologic examination can be worthwhile and prevent under or over treatment of ovarian malignancies.
Diagnosis* ; Frozen Sections* ; Mucins ; Paraffin ; Selection Bias

PURPOSE: Bilateral internuclear ophthalmoplegia (INO) has been reported mostly in bilateral medial longitudinal fasciculus (MLF) lesion. To report a case who presented with typical bilateral internuclear ophthalmoplegia (INO) with no brainstem lesion on brain MRI. METHODS: Case presentation. RESULTS: Seventy two year-old woman presented with bilateral marked adduction limitation and diplopia. Bilateral marked adduction limitation did not cross midline. Nystagmus occured in abducting eye. Elevation and depression were normal in duction. Transcranial doppler revealed moderated stenosis of right internal carotid artery and severe stenosis of left intracranial internal carotid artery. Brain MRI revealed focal old infarction of right corona radiata and circumscribed acute infarction at more upper level of corona radiata, however, no pathologic finding was identified in brainstem. Initial severe exotropia was improved to 30 PD exotropia in primary position. Adduction limitation was markedly improved 2 months later but bilateral horizontal nystagmus in abducting eye persisted
Brain Stem* ; Brain* ; Carotid Artery, Internal ; Constriction, Pathologic ; Depression ; Diplopia ; Exotropia ; Female ; Humans ; Infarction ; Magnetic Resonance Imaging ; Nystagmus, Pathologic ; Ocular Motility Disorders*

PURPOSE: We developed a novel method for measurement of hyperacuity and verified the utility thereof.METHODS: We developed a three-dimensional (3D) hyperacuity test using a 3D liquid crystal flat screen, a left- and right-image polarized display, and liquid crystal shutter glasses. We tested the technique in three groups: normal (n = 48), with cataracts (n = 14), and with macular disease (n = 35). We used a chart consisting of five dots and a reference line. Of the five dots, one was variably shifted from the other dots. A chart was presented to one eye and the reference line or blank image to the other eye; a subject scored positive when the dot in the unusual position was recognized.RESULTS: Hyperacuity was measured in terms of the reference line seen by the reference eye (RR), a blank image seen by the reference eye (RB), the reference line seen by the contralateral eye (CR), and a blank image seen by the contralateral eye (CB). All test scores were significantly lower when the reference line was seen than not (RR vs. RB and CR vs. CB; p < 0.01, respectively). For the RR and CR tests, no significant difference was apparent between the normal and cataracts group (p = 0.553, p = 0.494) but such differences were evident between the normal and macular disease groups (p = 0.028, p = 0.002). Also, visualization of the reference line by the reference and contralateral eyes did not differ (p > 0.05).CONCLUSIONS: Measurement of hyperacuity using our new method was not affected by media opacity but was significantly affected by macular disease. Presentation of a reference line facilitated hyperacuity assessment.
Cataract ; Eyeglasses ; Glass ; Liquid Crystals ; Methods

The purpose of this study was to elucidate the effects of Hwangyun, Hwangyunhaedogtang, and Kumeunhwa on the lymphocyte activity in allergic contact dermatitis induced by contact allergen 1-chloro-2,4-dinitrobenzene (DNCB) of Balb/c mouse. For examination of a contact hypersensitivity, MEST (mouse ear swelling test) and lymphocyte proliferation assay measured by [(3)H]-methylthymidine incorporation were done. Cytokine mRNA in the draining lymph node cells were examined by RT-PCR. Contact hypersensitivity was more effectively induced by 0.25% DNCB treatment than 1% DNCB treatment. Local lymph node cell proliferation from DNCB-sensitized mouse was most highly elicitated with 100 ug/ml DNBS stimulation in vitro. The cytokine profiles of lymph node cells from DNCB-sensitized and DNBS-stimulated mouse were strong expression of IL-2 and IFN-r, weak expression of LT and IL-4, and no expression of IL-6 and IL-10. This lymphocyte proliferation was significantly inhibited in mice administered Korean medical drug for 10 days and sensitized with DNCB at day 5 (88.22%, 65.14%, and 52.29% in Hwangyun, Hwangyunhaedogtang, and Kumeunhwa, respectively). But Kumeunhwa was not effective in the inhibition of lymphocyte proliferation when administered after DNCB-sensitization. The cytokine expressions were also inhibited especially IL-2 and IFN-r in Hwangyun administered- mice. These inhibitions of lymphocyte activity by Korean medical drugs were also observed when stimulated with ConA (1 ug/ml). Conclusively, immune responses of contact hypersensitivity induced by DNCB are involved in local lymph node T cells mainly Th1 type cells, and Korean medical drugs especially Hwangyun suppressed allergic contact dermatitis via inhibition of the activity of these cells.
Animals ; Cell Proliferation ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Dinitrochlorobenzene ; Ear ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Lymph Nodes ; Lymphocytes* ; Mice ; RNA, Messenger ; T-Lymphocytes

BACKGROUND: In patients with mitral stenosis, the degree of pulmonary hypertension is expected to be related to the severity of mitral valve obstruction. However, some patients with severe mitral stenosis do not develop reactive pulmonary hypertension. MATERIALS AND METHODS: We evaluated 34 patients with symptomatic mitral stenosis undergoing percutaneous mitral valvuloplasty by clinical, echocardiographic, and invasive hemodynamic(cardiac cathrterization) data. Prevalvuloplasty data were available in 34 subjects[mean age 38+/-9 year ; women 74% ; NYHA class 1 (6 patients), class 2 (17 patients), class 3 (7 patients), class 4 (4 patients) ; in electrocardiography, NSR(23 patients), Atrial fibrillation(11 patients)]. RESULTS: 1) The pulmonary vascular bed gradient was significantly correlated with pulmonary vascular resistance(r=0.91), mean pulmonary artery pressure(r=0.82), transmitral mean pressure gradient(r=0.64) and mitral valve area(r=-0.48). The pulmonary vascular resistance was significantly correlated with mena pulmonary artery pressure(r=0.77), transmiral mean pressure gradient(r=0.61) and mitral valve area(r=-0.54), NYHA functional classification(r=0.36). However, the pulmonary vascular bed gradient and pulmonary vascular resistance was not significantly correlated with age, sex, cardiac output, the severity of mitral regurgitation and mean left atrial pressure. 2) The mean pulmonary artery pressure was significantly correlated with mean left atrial pressure(r=0.80), transmitral mean pressure gradient(r=0.72) and mitral valve area(r=-0.47). 3) When patients were divided into those with a pulmonary vascular bed gradient > 12mmHg and Atrial Pressure ; Cardiac Output ; Echocardiography ; Electrocardiography ; Female ; Heart Diseases ; Humans ; Hypertension, Pulmonary* ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Pulmonary Artery ; Vascular Resistance

No abstract available.
Embryonic Development* ; Female ; Humans* ; Pregnancy ; Serum Albumin*