OBJECTIVE: We report an investigation of cerebral blood flow(CBF) and the expression of p53 and p21 at peri-infarct area of focal cerebral infarction in rats. METHODS: Adult Sprague-Dawley male rats were used for the experiment. In Group 1(n=7), the right middle cerebral artery(MCA) was coagulated. In Group 2(n=11), the right MCA and common carotid artery(CCA) were coagulated, and the left CCA was occluded for 30 minutes. Cerebral blood flow was measured at two areas, 2mm and 8mm distal to the MCA coagulation site. The rats were killed after 24 hours. After immunohistochemical staining, the width of the p53 or p21 positive area was measured. The p53 and p21 positive glial cells were counted at the peri-infarct area adjacent to the infarction core in Group 2. RESULTS: A focal infarction was found invariably in Group 2. CBF's at 2 mm and 8 mm areas were 8.3+/-2.1, 36.4+/-4.2 in Group 1 and 0.0+/-0.0, 6.7+/-1.5ml/100g/min in Group 2, respectively. All of the measured CBF's except that of the 8mm site in Group 1 were significantly lower than preoperative level(p<0.001), which were between 20.8+/-4.5% and 16.3+/-3.3% of preoperative CBF. The ratio of p21 and p53 positive cells was 1.0+/-0.1. CONCLUSION: We could note that the expression of p53 and p21 was the highest at an adjacent peri-infarct area. The degree of CBF reduction is more responsible for infarction than CBF itself.
Adult ; Animals ; Cerebral Infarction* ; Humans ; Infarction ; Male ; Neuroglia ; Rats* ; Rats, Sprague-Dawley

PURPOSE: To investigate the outflow characteristics of silicone tubes with intraluminal stents used in membrane-tube (MT) type glaucoma shunt devices. METHODS: The silicone tubes used in MicroMT (internal diameter of 100 µm with a 7-0 nylon intraluminal stent) and Finetube MT (internal diameter of 200 µm with a 5-0 nylon intraluminal stent) were connected to a syringe-pump that delivered a continuous flow of distilled water at flow rates of 2, 5, 10, and 25 µL/min. The pressures and resistances of tubes were measured at a steady flow rate with full-length, half-length, and absence of intraluminal stents. RESULTS: The mean outflow resistance of the two types of tubes ranged from 3.0 ± 1.9 to 3.8 ± 1.7 mmHg/µL/min with a full-length intraluminal stent, 1.8 ± 1.1 to 2.2 ± 1.1 mmHg/µL/min with a half-length intraluminal stent, and 0.1 ± 0.0 to 0.2 ± 0.0 mmHg/µL/min without an intraluminal stent. Theoretically, for a physiologic state with a flow rate of 2 µL/min and episcleral venous pressure of 6 mmHg, the mean pressures of tubes were expected to be 13.2 ± 3.0, 10.5 ± 2.4, and 6.4 ± 0.2 mmHg in MicroMT with full-length, half-length, and absence of intraluminal stents, respectively, and 12.5 ± 3.9, 9.6 ± 2.4, and 6.2 ± 0.2 mmHg in Finetube MT with full-length, half-length, and absence of intraluminal stents, respectively. The pressure variance also decreased with intraluminal stent retraction (p < 0.01). CONCLUSIONS: The small diameter tubes of 100 and 200 µm internal diameters, with 7-0 and 5-0 nylon intraluminal stents, respectively, used in the MT-type glaucoma shunt device showed safe and effective outflow characteristics.
Glaucoma ; Hydrodynamics ; Intraocular Pressure ; Nylons ; Silicon ; Silicones ; Stents ; Venous Pressure ; Water

Infantile myofibromatosis is a rare neoplasm which occurs primarily in early infancy and arise in the various sites. A 4-year-old boy, who presented with painless soft scalp mass in the left temporoparietal region was diagnosed to have myofibromatosis and this case is presented with some literature reviews.
Child, Preschool ; Humans ; Male ; Myofibroblasts ; Myofibromatosis* ; Scalp

The purpose of this study is to investigate whether paraspinal muscle wasting occurs in association with chronic low back pain(LBP) and to know whether low back muscle exercise is effective for abating chronic low back pain. Cross sectional areas(CSA) of lumbar vertebral bodies and paraspinal muscles were measured using CT at the level of the fouth lumbar vertebral body in 37 patients(23 males 14 females) with acute low back pain and in 44 patients(20 males, 24 females) with chronic low back pin. The results were as follows; 1) The mean age of the patients with chronic LBP were higher than those with acute LBP. 2) The CSAs of L4 vertebral bodies were correlated significantly with body weight and the CSAs of L4 vertebral bodies, erector spinae and psoas muscles were larger in males than in females. 3) The volumes of the paraspinal muscles were significantly reduced in patients with chronic LBP compared to a cute LBP. These changes can cause erector spinae and psoas muscle weakness and disuse atrophy and thereby predispose to spinal instability and progressive dysfuction.
Back Muscles ; Body Weight ; Female ; Humans ; Low Back Pain* ; Male ; Muscular Atrophy ; Muscular Disorders, Atrophic ; Paraspinal Muscles* ; Psoas Muscles

OBJECTIVES: To investigate clinicopathologic findings of patients with small cell carcinoma of uterine cervix, and to evaluate the recurrence pattern and prognosis of patients with small cell carcinoma of the uterine cervix. Methods: From Jan. 1990, to Dec. 1997, 23 patients with small cell carcinoma of the uterine cervix were registered and followed-up at Korea Cancer Center Hospital. Clinical characteristics, survival of these patients were studied retrospectively. RESULTS: Among the 23 cases of small cell carcinoma of uterine cervix, 17 cases(74%) were of the neuroendocrine type (NE group), and 6 cases(26.0%) of the squamous cell type (SCC group). The median age, FIGO stage, and treatment modality were not significant difference between two groups. Pelvic lymph node metastases were found 53% in NE group, and 33% in SCC group, but there were not significant difference between two groups(p>0.05). Three patients showed distant metastases in NE group(bone 18%, bladder 9%), but there was no distant metastasis in SCC group. The 3 year survival rate was 50.0% in SCC group and 32.1% in NE group, but there were not statistical significance(p>0.05). Six patients showed recurrence after treatment (4/17 cases in NE group, 2/6 cases in SCC group). Recurrence sites were liver (3/6, 50%), and lung (2/6, 33%), brain (2/6, 33%), retroperitoneum (1/6, 17%), and axillae lymph node (1/6, 17%). CONCLUSION: This study showed neuroendocrine small cell carcinoma may have more aggressive than squamous small cell carcinoma, but there were not significant difference in prognosis between the two groups. Because of limitation of number of patients, further large scaled multicenter studies are needed.
Axilla ; Brain ; Carcinoma, Small Cell* ; Cervix Uteri* ; Female ; Humans ; Korea ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms

OBJECTIVE: Pulmonary metastasis from carcinoma of the uterine cervix is relatively rare, and their clinical outcomes are not still remain unknown. This study is to evaluate survival and prognostic factors in recurrent cervical cancer patients showing lung metastasis. METHODS: From Jan. 1993 to Dec. 1996, 53 recurrent cervical cancer patients showing lung metastasis, registered in Korea Cancer Center Hospital, were retrospectively evaluated with respect to their clinical characteristics, response rate to salvage therapy, survival and prognostic factors. RESULTS: Median age of patients at recurrence was 58 years, and median interval of initial diagnosis to recurrence was 17 months. The most common histologic type was squamous cell carcinoma(82%), followed by adenocarcinoma(6%), adenosquamous(6%), and others(6%). Response rate to salvage therapy was 47%(complete response rate 23.5%, partial response rate 23.5%), and median survival was 10 months(range 1-39). 3 year survival rate was 18%. Age, initial stage, initial tumor size, interval of recurrence and type of chemotherapeutic regimen were not significant prognostic factors, but squamous cell carcinoma antigen(SCC) level at recurrence and response to salvage therapy was significant(p=0.0087, p=0.0104). CONCLUSION: Survival of recurrent cervical cancer patients with lung metastasis was poor despite salvage therapy. Those patients who showed low SCC level at recurrence and good response to salvage therapy had favorable outcomes.
Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Female ; Humans ; Korea ; Lung* ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Survival Rate ; Uterine Cervical Neoplasms*

Incisional hernias occur in <1% of women undergoing operative laparoscopy and are mostly limited to trocar sites > or =10 mm. Bowel herniation through 5 mm trocar site is more uncommon than that of 10 mm trocar site. So we present a case of small bowel herniation through a 5mm trocar site with a brief review of literature.
Female ; Hernia ; Humans ; Laparoscopy ; Surgical Instruments*

Placenta increta is rare, but life-threatening complication of pregnancy characterized by invasion of placenta villi into the underlying myometrium. Placenta increta is usually diagnosed in the third trimester and is associated with significant blood loss and uterine perforation or rupture as well as an increased risk of infection. It also has been described as a complication of selective pregnancy termination and spontaneous pregnancy loss in the second trimester and rarely in the first trimester. We report a case of placenta increta which was presented as uterine mass after dilatation and curettage (D and C) due to missed abortion in the first trimester.
Abortion, Missed ; Animals ; Dilatation and Curettage ; Female ; Humans ; Mice ; Myometrium ; Placenta Accreta* ; Placenta* ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Rupture ; Uterine Perforation

CA 125 is a high molecular weight glycoprotein expressed in the cell surface of some derivatives of embryonic coelomic epithelium. It presents in over 80% of non-mucinous epithelial ovarian carcinomas and it also occurs in the serum of healthy males and females at low concentrations (<35 IU/mL). Serum CA 125 concentration may also be moderately elevated in several benign conditions, such as pelvic inflammatory disease, uterine fibroids, pregnancy, spontaneous abortion with chromosomal abnormality, and especially in endometriosis. However serum CA 125 concentration is seldom over 100 IU/mL in endometriosis. In this paper, we present a patient with bilateral ovarian endometrioma associated with abnormally high serum CA 125 level (>1,000 IU/mL) and after excision of the ovarian tumor, the CA 125 levels returned to normal. Our case further emphasizes the association of high levels of CA 125 with benign gynecologic conditions and we discussed the possible explanations for this abnormal elevation of CA 125 levels.
Abortion, Spontaneous ; Chromosome Aberrations ; Endometriosis* ; Epithelium ; Female ; Glycoproteins ; Humans ; Leiomyoma ; Male ; Molecular Weight ; Pelvic Inflammatory Disease ; Pregnancy

OBJECTIVES: We aimed to evaluate the effect of geographic units of analysis on measuring geographic variation in medical services utilization. For this purpose, we compared geographic variations in the rates of eight major procedures in administrative units (districts) and new areal units organized based on the actual health care use of the population in Korea. METHODS: To compare geographic variation in geographic units of analysis, we calculated the age-sex standardized rates of eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, caesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan) from the National Health Insurance database in Korea for the 2013 period. Using the coefficient of variation, the extremal quotient, and the systematic component of variation, we measured geographic variation for these eight procedures in districts and new areal units. RESULTS: Compared with districts, new areal units showed a reduction in geographic variation. Extremal quotients and inter-decile ratios for the eight procedures were lower in new areal units. While the coefficient of variation was lower for most procedures in new areal units, the pattern of change of the systematic component of variation between districts and new areal units differed among procedures. CONCLUSIONS: Geographic variation in medical service utilization could vary according to the geographic unit of analysis. To determine how geographic characteristics such as population size and number of geographic units affect geographic variation, further studies are needed.
Angioplasty, Balloon, Coronary ; Arteries ; Cesarean Section ; Delivery of Health Care ; Female ; Hip ; Hysterectomy ; Korea ; Magnetic Resonance Imaging ; National Health Programs ; Population Density ; Pregnancy ; Small-Area Analysis ; Transplants