the ineidence of abdominal subcutaneous endometriosis is quite rare we have experienced one case of subcutaneous endometriosis. The typical clinical bistory and local findings of endometriasis enabk us to make the conect diagnosis. the treatment of choice is complete surgical excision of endometrial tissue and post operative medical therapy. This case was reported with a brief review of the comcemed literatures.
Diagnosis ; Endometriosis* ; Female ; Subcutaneous Tissue*

An umbilical omphalomesenteric duct polyp arises from remnants of the omphalomesenteric duct, which connects the midgut to the Yolk sac of the embryo and is closed completely at 7 weeks. Persistence of the omphalomesenteric duct shows various clinical manifestations of embryologic anomalies such as umbilical enteric fistula, Meckel's diverticulum or vitelline cysts. In particular, the umbilical omphalomesenteric duct polyp should be clinically discerned from persistent granulation tissue or pyogenic granuloma and attention should be given to external openings with discharge, which can be suggestive of underlying anomalies. We herein report an case of an umbilical omphalomesenteric duct polyp in a 10-year-old male who had no underlying anomalies.
Child ; Embryonic Structures ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Meckel Diverticulum ; Polyps* ; Vitelline Duct* ; Vitellins ; Yolk Sac

Cancer of the vulva accounts for approximately 0.5% of all gynecologic malignancies. At diagnosis, one-third of these cases is detected in an advanced stage (FIGO stages III, IV), and local extension of primary vulvar cancer may involve adjacent midline structures such as the clitoris, urethra, vagina, and anus. Initial surgical therapy of such locally advanced primary cancers may compromise the functional integrity of midline structures, necessitating ultraradical surgery including pelvic exenteration. In view of the relatively elderly age of the patients and the morbidity of this ultraradical dissection, concomitant chemoradiation therapy - that the efficacy had been proven in head and neck cancer, anal cancer has approached for patients with locally advanced vulvar cancer. We experienced a case of stage III vulvar cancer patient, who underwent concomitant chemoradiation therapy with 5-fluorouracil(FU) and cisplatin and who showed complete response. So, we report this case with brief review of the literatures.
Aged ; Anal Canal ; Anus Neoplasms ; Cisplatin ; Clitoris ; Diagnosis ; Female ; Head and Neck Neoplasms ; Humans ; Pelvic Exenteration ; Urethra ; Vagina ; Vulvar Neoplasms*

OBJECTIVES: The objective of this study was to identify the level of awareness regarding school-based suicide prevention programs in teachers who were in charge of the suicide prevention project, and to derive plans for future improvement. METHODS: A total of 582 teachers working in elementary, middle, and high schools across the country participated in this study. For the study, school-based suicide prevention programs were divided into four programs : curriculum-based program, staff in-service training, screening, and postvention ; the teachers' opinions regarding each program were then gathered by conduct of an online survey. RESULTS: The results indicated that participants chose the curriculum-based program as the most easily implementable program (65.6%), and postvention as the most difficult program to implement (52.9%). The curriculum-based program was implementable due to availability of procedure. Evasion of legal responsibility was significantly greater in postvention, making the program more desirable. Barriers to effective implementation include students' and parents' resistance to screening as well as time constraints in staff in-service training. CONCLUSION: These results suggest that a variety of preceding conditions must necessarily be prepared for successful implementation of each type of suicide prevention program. Policy implications and future directions are then discussed.
Humans ; Mass Screening ; Suicide*

BACKGROUND: Reference intervals need to be established according to age. We established reference intervals of hematology and chemistry from community-based healthy 1-yr-old children and analyzed their iron status according to the feeding methods during the first six months after birth. METHODS: A total of 887 children who received a medical check-up between 2010 and 2014 at Boramae Hospital (Seoul, Korea) were enrolled. A total of 534 children (247 boys and 287 girls) were enrolled as reference individuals after the exclusion of data obtained from children with suspected iron deficiency. Hematology and clinical chemistry analytes were measured, and the reference value of each analyte was estimated by using parametric (mean±2 SD) or nonparametric methods (2.5-97.5th percentile). Iron, total iron-binding capacity, and ferritin were measured, and transferrin saturation was calculated. RESULTS: As there were no differences in the mean values between boys and girls, we established the reference intervals for 1-yr-old children regardless of sex. The analysis of serum iron status according to feeding methods during the first six months revealed higher iron, ferritin, and transferrin saturation levels in children exclusively or mainly fed formula than in children exclusively or mainly fed breast milk. CONCLUSIONS: We established reference intervals of hematology and clinical chemistry analytes from community-based healthy children at one year of age. These reference intervals will be useful for interpreting results of medical check-ups at one year of age.
Breast Feeding ; Clinical Chemistry Tests/*standards ; Female ; Hematologic Tests/*standards ; Humans ; Infant ; Iron/*blood/standards ; Male ; Reference Values ; Republic of Korea

A sarcomatoid carcinoma of the gastrointestinal tract is a very rare tumor. Only limited cases have been reported in the literature. The tumor is more malignant than the usual adenocarcinoma of the gastrointestinal tract. Typically, when discovered, a sarcomatoid carcinoma of the small intestine is already in a late stage of disease with a rapidly progressive course. The survival rate is markedly lower than for adenocarcinomas. Here, we report the case of a 63-year-old male patient who was referred from the Gastroenterology Department of Chonnam University Hospital. He had been suffering from a sudden onset of painless jaundice, and from weight loss for one month. The operation at our hospital was performed under a diagnosis of periampullary cancer. Whipple's operation was carried out on Dec. 14, 1998. Pathology confirmed the diagnosis of a sarcomatoid carcinoma of the duodenum. This article presents that case of a sarcomatoid carcinoma of the duodenum with a brief review of the literature.
Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastroenterology ; Gastrointestinal Tract ; Humans ; Intestine, Small ; Jaundice ; Jeollanam-do ; Male ; Middle Aged ; Pathology ; Survival Rate ; Weight Loss

BACKGROUND: Iron deficiency is one of the commonest nutritional diseases in young children, which influences cognitive performance and motor development. For the diagnosis of iron deficiency in infants, we evaluated several parameters obtained during the test of routine complete blood count. METHODS: A total of 192 full-term infants were studied. They were aged from 6 to 12 months, who visited Boramae Hospital from Aug 2002 to Oct 2004 according to their routine check up schedules. Venous blood was drawn to determine hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, hemoglobin content (CH), hemoglobin content of reticulocyte and red cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For iron status, iron, total iron binding capacity and ferritin were determined. The normal, iron deficiency, and iron deficiency anemia groups were defined on the basis of Hb level of 11 g/dL, transferrin saturation of 20%, and/or ferritin level of 12 microgram/L. RESULTS: The significant predictors of iron deficiency state were CH (P<0.001) and RDW (P=0.035). Infants with CH < or = 26 pg could be diagnosed as having an iron deficiency state with 80% sensitivity and 86% specificity. CONCLUSIONS: CH can be used as a new parameter to diagnose an iron deficiency state in infants with the advantage of cost saving and avoiding additional blood sampling. However the reference range should be established before clinical testings and the parameter should be generalized to other automatic analyzers.
Anemia, Iron-Deficiency ; Appointments and Schedules ; Blood Cell Count ; Child ; Cost Savings ; Diagnosis ; Erythrocyte Indices ; Ferritins ; Humans ; Infant* ; Iron* ; Reference Values ; Reticulocytes ; Sensitivity and Specificity ; Transferrin

OBJECTIVE: This study was performed to identify the prognostic factor for survival of patients with recurrent cervical cancer. METHODS: Sixty-eight patients were diagnosed as recurrent cervical cancer at the Seoul National University Hospital from January, 1988 to December, 1998. Recurrence was defined as new evidence of tumor after 6 months of disease free survival. Retrospective analysis was done in terms of clinical features and the Cox proportional hazard model was used to identify independent variables associated with an improved survival rate. Histopathologic types were distributed as follows; squamous cell carcinoma in 70.6%, adenocarcinoma in 11.8%, adenosquamous cell carcinoma in 11.8%, and small cell carcinoma in 1.5%. Distribution of FIGO stage was as follows; stage I in 25.0%, stage II in 66.2%, and stage III in 4.4%. Sites of recurrence were as follows; central pelvic recurrence in 44.1%, pelvic side wall recurrence in 11.8%, and distant metastasis in 44.1% and the most common site of distant recurrence was extrapelvic lymph nodes (29.4%). 29.4% of recurrences were observed within the first 12 months after initial therapy, 50.0% within 2 years and 64.7% within 3 years. RESULTS: Positive rate of SCC-Ag at initial diagnosis was 45.2% with cutoff value of 2.0 ng/ml. Positive rate of SCC-Ag at the diagnosis of recurrence was 60.0%. Overall response rate to the treatment was 29.1%. Complete response rate was higher in central pelvic recurrrence than pelvic side wall recurrence and distant metastasis (P = 0.002) and also higher in normal SCC-Ag level (< or = 2.0 ng/ml) at the diagnosis of recurrence than elevated level (P = 0.032). Cumulative survival rates of 1 year after recurrence was 66.8%, 2 year 36.7%, and 5 year 18.7%. Central recurrence showed higher cumulative survival rate than pelvic side wall or distant recurrence (P = 0.029). The patients with elevated SCC-Ag level at the time of diagnosis of recurrence showed lower cumulative survival rate than those with normal SCC-Ag level (P < 0.001). Cox proportional hazard model showed that SCC-Ag elevation at the time of diagnosis of recurrence retained significant values in predicting survival(OR = 2.56; 95% CI = [1.22-5.39]; P = 0.01). CONCLUSION: SCC-Ag elevation at the diagnosis of the recurrence is a strong independent prognostic indicator for survival of patients with recurrent cervical cancer.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Disease-Free Survival ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Uterine Cervical Neoplasms*

BACKGROUND: The HER-2/neu proto-oncogene (also known as c-ErbB-2) encodes a 185 kD transmembrane glycoprotein with intrinsic tyrosine kinase activity. Many studies revealed the correlation between the aberrant overexpression of HER-2/neu oncogene and poor prognosis of the malignant tumors such as breast, stomach, colon, lung cancers. But the significance of HER-2/neu oncogene overexpression as a prognostic factor in ovarian cancer remains controversial. OBJECTIVE: The aims of this study were to assess the prevalence of HER-2/neu oncogene amplification by polymerase chain reaction(PCR) and to evaluate the prognostic significance of HER-2/neu oncogene overexpression in terms of chemo-responsiveness and survival rate. MATERIALS AND METHODS: This study included 32 patients with advanced ovarian cancers(24 epithelial ovarian cancers, 2 Brenner tumors, 2 malignant mixed miillerian tumors, 2 granulosa cell tumors, 1 struma ovarii, 1 Krukenberg tumor). All patients had underwent staging laparotomy, and postoperative adjuvant chemotherapy with platinum-based combination chemotherapy. PCR was performed using tissues preserved in liquid nitrogen at the time of debulking operation. Overexpression of HER-2/neu oncogene was defined as being equal to or greater than 1.5 a.u. We analyzed whether the HER-2/neu overexpression correlated with chemoresponsiveness and 5-year survival rate(5-YSR). RESULT: HER-2/neu oncogene amplification was present in all of the ovarian cancers(32/32). Significant overexpression[gene copy number(GCN) > or =1.5 a.u.] was present in 13 of 32 ovarian cancers(41%) and 12 of 24 epithelial ovarian cancers (50%). The clinical response rate to chemotherapy in high copy group(GCN > or = 1.5 a.u.) was 67%(8/12) and that of low copy group(GCN<1.5 a.u.) was 92%(11/12)(p>0.05). Pathologic response rate to chemotherapy was 0%(0/5) and 50%(3/6), respectively(p>0.05). 5-YSR was 8% in high copy group and 25% in low copy group, but this difference was not statistically significant(p=0.17). CONCLUSION: HER-2/neu overexpression might be a poor prognostic factor, but this difference was not definitely elucidated by satistical analytsis in this study. Larger scaled prospective randomized study is needed to define the prognostidc significance of the HER-2/neu overezpression in ovarian cancer.
Breast ; Brenner Tumor ; Chemotherapy, Adjuvant ; Colon ; Drug Therapy ; Drug Therapy, Combination* ; Glycoproteins ; Granulosa Cell Tumor ; Humans ; Laparotomy ; Lung Neoplasms ; Nitrogen ; Oncogenes* ; Ovarian Neoplasms* ; Polymerase Chain Reaction ; Prevalence ; Prognosis ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Stomach ; Struma Ovarii ; Survival Rate

Spontaneous rupture of the bile duct is an exceedingly rare and usually recognized fatal cause of peritonitis and intraabdominal sepsis. Several reports of isolated cases have demonstrated its rarity in the absence of operative trauma or severe injury. Perforation of the biliary system occurs most frequently in the gall bladder, which perforation of the hepatic duct is less common, being described mainly in infants, but extremely rarely in adults. The diagnosis of the spontaneous rupture of the bile duct depends on meticulous clinical examination and imaging investigation. The basic principles of treatment are to stop the bile leakage, evacuate the extravasated bile, apply decortication of the encapsulated fluid collection and provide adequate drainage. We report on a patient with spontaneous perforation of the right hepatic duct who presented with abdominal pain, jaundice and fever. Exploratory surgery showed proximal common bile duct obstruction with right hepatic duct perforation.
Abdominal Pain ; Adult ; Bile ; Bile Ducts ; Biliary Tract ; Common Bile Duct ; Diagnosis ; Drainage ; Fever ; Hepatic Duct, Common* ; Humans ; Infant ; Jaundice ; Peritonitis ; Rupture, Spontaneous* ; Sepsis ; Urinary Bladder