OBJECTIVE: To evaluate the accuracy of combined transvaginal ultrasound and beta-hCG discriminatory zone for diagnosing intrauterine pregnancy, abortion, and ectopic pregnancy in early abnormal pregnancy. METHODS: Initial ultrasound findings and beta-hCG level were compared with final pregnancy outcome in 164 early pregnant women who visit our hospital with vaginal bleeding or abdominal pain. The sensitivity, specificity, and predictive value by the combination of two diagnostic tools were calculated. Statistic analysis of collected data used x2 of SPSS(9.0). RESULTS: Of 90 women with normal outcome, 64(71.1%) had a gestational sac 5mm, and in 47 cases, the hCG level was above 1,800 mIU/ml. Transvaginal ultrasound was non-diagnostic in 47(28.6%) of 164 women, and especially, 43(53.1%) of 81 cases with beta-hCG levels below 1,800 mIU/ml. The portion of accurate ultrasound diagnosis was significantly higher in women above 1,800 mIU/ml (85.5%, 71 of 83 cases) compard with levels below 1,800 mIU/ml (37.0%, 30 of 81 cases) : P < 0.001; Relative Risk(RR) 2.31; CI 95%. Sensitivity of transvaginal ultrasound diagnosis of intrauterine pregnancy, abortion, and ectopic pregnancy was 90.2%, 79.3%, and 66.7% in women who presented with beta-hCG levels above 1,800 mIU/ml, and 41.0%, 23.5%, and 75% below 1,800 mIU/ml, respectively. And, negative predictive value was 83.9%, 89.7%, and 98.8% in each of intrauterine pregnancy, abortion, and ectopic pregnancy above 1,800 mIU/ml, and 64.6%, 60%, and 97.3% below 1,800 mIU/ml, respectively. CONCLUSIONS: The sensitivity, specificity, and predictive value of transvaginal ultrasound for diagnosing abnormal early pregnancy were poor except cases of ectopic pregnancy when beta-hCG levels were low than discriminatory zone. Ultrasound impressions were well related with beta-hCG levels.
Abdominal Pain ; Diagnosis ; Female ; Gestational Sac ; Humans ; Pregnancy Outcome ; Pregnancy* ; Pregnancy, Ectopic ; Pregnant Women ; Sensitivity and Specificity ; Ultrasonography* ; Uterine Hemorrhage

OBJECTIVE: To develop an immunoassay system for the rapid measurement of beta-hCG in serum sample, we designed an immunochromatographic assay-based one-step assay that uses two monoclonal antibodies to beta-hCG as a sandwich pair. METHODS: The assay system is composed of a test strip housed within a cartridge for sample application and a laser-fluorescence scanner for quantification. The strip contains a sample pad, an absorption pad, and a nitrocellulose membrane where a capture antibody is immobilized and antigen-antibody reaction occurs. Ten L of serum was added to 60 L of detector solution, and the mixture was loaded onto the well of the sample pad on the cartridge. After incubation for 12 min, the cartridge was scanned for quantification with the laser-fluorescence scanner. RESULTS: No cross-reactivity was observed between beta hCG antibodies and other pituitary hormones. The calibration curve displayed linearity (R2=1) at concentrations of 0-1,000 IU/L. Intra- and interassay imprecisions were determined with serum samples to be their CVs within <6% and <7%, respectively. Analytical recovery was 103-108.4% in serum samples at three different concentrations. There was high correlation between beta-hCG concentrations measured by Boditech system and those measured by Abbot AxSYM system. CONCLUSION: The new fluorescence assay system is a convenient and fast method and can be used as a good tool for detection and quantification of beta-hCG in serum samples. Furthermore, the portable system allows us to perform the tests on a sampling site in any places without bringing the samples to a laboratory.
Absorption ; Antibodies ; Antibodies, Monoclonal ; Antigen-Antibody Reactions ; Calibration ; Chorionic Gonadotropin ; Collodion ; Fluorescence* ; Immunoassay ; Immunochromatography* ; Membranes ; Pituitary Hormones

We measured serum CA19-9 from March 1990 to June 1992 in 63 cases of normal controls, 56 cases or bladder cancer, 32 cases of renal cell carcinoma, 8 cases of prostatic carcinoma, 4 cases of penile cancer. 2 cases of testicular cancer and 3 cases of carcinoma of gastrointestinal tract with metastasis to the retroperitoneum. The results of this study were that serum levels of CA19-9 in urinary bladder cancer, renal cell carcinoma and prostatic carcinoma were statistically significant. However, sensitivity was low, 14. 29% for urinary bladder cancer, 18.75% for renal cell carcinoma. 12.5 % for prostatic carcinoma and specificity was 95.2%. In renal cell carcinoma, there was no change in serum level between stages. However there was a statistically significant difference (p<0.05) between low stage(A, B) and high stage(C, D) urinary cancers. We suggest that serum CA19-9 levels cannot be used as a screening test or prognosis indicator in tumors of the genitourinary tract ; however it can be helpful in differentiating between low and high stage urinary bladder cancers.
Carcinoma, Renal Cell ; Gastrointestinal Tract ; Male ; Mass Screening ; Neoplasm Metastasis ; Penile Neoplasms ; Prognosis ; Sensitivity and Specificity ; Testicular Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urogenital Neoplasms*

We managed the two cases of small cell carcinoma of prostate, which has been reported only 20 cases in the world literature. It has not been reported in our country. It`s prognosis is very poor and it may have neurosecretory manifestation. Small cell carcinoma of the prostate combined with adenocarcinoma or previous history of adenocarcinoma is found in 50% cases. The diagnosis was established by pathologic findings with special stain (neuron specific enolase) and electromicroscopic examination.
Adenocarcinoma ; Carcinoma, Small Cell* ; Diagnosis ; Prognosis ; Prostate*

The phenomenon of multiple primary malignant tumors in one patient synchronously or metachronously is no more curiosity. So, careful follow up study and early diagnosis of those lesions, based on an awareness of the possibility of the second cancer, will substantially increase the survival of these patients. We collected nine cases of multiple primary cancers according to Moertel's classification histologically proved and treated from 1985 to l992 at Kosin Medical Center. The results were as follows; 1. The average age of the patients was 60.9 years with dominance in seventh decade 2. The male to female ratio was 7: 2 with significant dominance in male. 3. The synchronous to metachronous ratio was 6: 3, in metachronous cases the average time interval between 1st and 2nd cancers was 122 months. 4. In 6 cases of synchronous cancers, there were penile cancer and hepatoma, renal cell carcinoma and bladder cancer, prostatic cancer and bladder cancer, bladder cancer and colon cancer, and prostatic cancer and lung cancer. In 3 cases of metachronous cancers, there were bladder cancer and uterine cervical cancer, bladder cancer and stomach cancer, and renal cell carcinoma and synovial sarcoma. 5. In 3 cases of metachronous cancers, adjuvant therapy was performed in 2 cases after operation including one case of chemotherapy and another case of radiotherapy.
Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Classification ; Colonic Neoplasms ; Drug Therapy ; Early Diagnosis ; Exploratory Behavior ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Male ; Neoplasms, Second Primary ; Penile Neoplasms ; Prostatic Neoplasms ; Radiotherapy ; Sarcoma, Synovial ; Stomach Neoplasms ; Urinary Bladder Neoplasms ; Uterine Cervical Neoplasms

OBJECTIVE: This study was carried out to evaluate the distribution and clinical features of patients with degenerative change of the mandibular condyle. METHODS: Six thousand and seventy patients with TMD (temporomandibular disorder) were selected for this study, who had complete initial clinical records and radiographs. Panorama and TMJ panorama radiographs were used to screen the degenerative change in the condyle, and the patients were divided into DJD (degenerative joint disease) and non-DJD groups. RESULTS: The distribution and clinical features of the two groups were compared. Out of the total number of patients, 31.7% were in the DJD group, and 68.3% were in the non-DJD group. The portion of females was larger in the DJD group (80.8%) than in the non-DJD group (67.5%), and the DJD group had high prevalence in the second and third decades. Lack of incisal contact, retrusive chin, facial asymmetry, and mouth opening limitation were the chief complaints of the patients who had positive relation to DJD. CONCLUSION: Patients with an orthodontic treatment history, CO-CR discrepancy and crepitation were at possible risk of having DJD.
Chin ; Facial Asymmetry ; Female ; Humans ; Joints ; Mandibular Condyle* ; Mouth ; Prevalence ; Temporomandibular Joint ; Temporomandibular Joint Disorders

Testicular tumors were reported sporadically in Korea. Seminomatous germ cell tumor is the most frequent tumor in the testis and it is treated highly effectively with irradiation and/or chemotherapy according to stage. Herein we report a relatively rare case of seminoma developed in abdominal cryptorchid testis of 28 years old male. which was treated with PVB chemotherapy after cytoreductive surgery. Histopathological examination revealed seminoma of stage II B(T3N2MO) by M.D. Anderson hospital classification Postoperative PVB chemotherapy was performed and the tumor was completely remitted at follow up study for 4 years.
Adult ; Classification ; Cryptorchidism ; Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Male ; Neoplasms, Germ Cell and Embryonal ; Seminoma* ; Testicular Neoplasms ; Testis*

PURPOSE: We measured the BMD of elderly patients with osteoporotic hip fracture in order to understand the relationship between BMD of each sites and hip fracture occurrence or the types, and also to suggest a reference point for starting an osteoporosis treatment program. MATERIALS AND METHODS: From July 2007 to February 2010, we investigated total 147 elderly osteoporotic hip fracture patients over 65 years. For control group, 80 patients who were over 65-year-old and did not have any fracture were selected. BMD was compared at each site between each groups statistically. RESULTS: In the comparison of femur intertrochanter and neck fracture groups, BMD of femur neck and trochanter areas and L2, L3 areas were significantly less in intertrochanteric fracture group. In the analysis according to the classification of intertrochanteric fracture, BMD of intertrochanter and Ward's triangle area were significantly less in unstable fracture group than stable one. Each of the fracture threshold of intertrochanteric and neck fracture group was -1.10 and -1.36 of the T-score in proximal femur, and -1.40 and -1.40 of the T-score in lumbar vertebrae. CONCLUSION: To examine the BMD of both proximal femur and lumbar vertebrae areas is helpful to predict the hip fracture occurrence and the type of hip fracture. And for the prevention of hip fracture in elderly patients over 65 years, we propose that the aggressive treatment of osteoporosis should be started to prevent fracture for patients with a T-score less than -1.40.
Aged ; Bone Density ; Femur ; Femur Neck ; Hip ; Humans ; Lumbar Vertebrae ; Neck ; Osteoporosis

Ganglioneuromas have their origin in neural crest and are found along the path of the sympathetic chain from the base of the skull to the pelvis, including the adrenal medulla. Clinically, ganglioneuromas may be incidentally found or detected secondarily by pressure effects on adjacent structures. Endocrine activity is rare among ganglioneuromas. Symptoms and signs such as hypertension, profuse perspiration, cutaneous flushing, rash, pallor, polyuria, and diarrhea are well documented. Recently we experienced a case of ganglioneuroma arising from the retroperitoneal sympathetic chains in a 46 year-old-female and, herein, report with review of the literatures.
Adrenal Medulla ; Diarrhea ; Exanthema ; Flushing ; Ganglioneuroma* ; Hypertension ; Neural Crest ; Pallor ; Pelvis ; Polyuria ; Skull

Fibrous dysplasia is a benign fibro-osseous lesion originally described by Lichtenstein in 1938. Currently, three general subtypes of disease are recognized: monostotic, polyostotic, and McCune-Albright syndrome. Fibrous dysplasia is not rare, with the incidence report being about 5% to 7%. Common sites of fibrous dysplasia are the skeletal system including long bones, ribs, craniofacial bones, and the pelvis. However, fibrous dysplasia is rare in the nasal cavity, especially involving the turbinate. In the review of literature over the past 50 years, we were able to discover only 4 cases in which the fibrous dysplasia involved inferior turbinate, with all of them being the polyostotic form found around the sinuses. There were only 4 cases in which monostotic fibrous dysplasia involved the middle turbinate, but none the inferior turbinate. We present this case, with a review of the relevant literature, as the first report on monostotic fibrous dysplasia of the inferior turbinate.
Fibrous Dysplasia, Monostotic ; Fibrous Dysplasia, Polyostotic ; Incidence ; Nasal Cavity ; Pelvis ; Ribs ; Turbinates