Malignant Mixed Mullerian tumors(MMMTs) are unusual neoplasms occumng mostly in the uterus and, ralely, they arise in the ovary. The clinical features of malignant mixed mullerian tumor of the ovary are similiar to other ovarian malignancies. The clinical course is rapidly progressive and fatal. The optimal treatment modalities has remained elusive. The most reliable prognostic criterion is the initial tumor stage and the overall survival was poor. We experienced two cases of malignant mixed miillerian tumor of the ovary, so we report these cases with a brief review of the concerned literatures.
Female ; Ovary* ; Respiratory Sounds ; Uterus

OBJECTIVE: Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been limitation because of the low sensitivity and high false negative rate in the detection of preclinical or clinical disease of the cervix. This study was performed to explore the usefulness of Hybrid Capture System HPV DNA test as a diagnostic method of the cervical cancer. METHODS: Cervical cytology and Hybrid Capture System 1 (HCS1) HPV DNA test were performed in 1,023 women who visited Gynecologic Oncology Clinic in Guro Hospital, Korea University Medical Center. HPV DNA were retested by HCS1, HCS2 and Polymerase Chain Reaction(PCR), in randomly selected 200 women to compare these DNA tests. RESULTS: While the sensitivity and specificity of cervical cytology in detection of cervical lesion were 71.2% and 89.5%, those of HCS1 HPV DNA test were 63.0% and 86.9% respectively. There was significant difference in detection of cervical precancerous lesions between HCS1 and HCS2 (P<0.05), but not between HCS2 and PCR (P=0.14). And the sensitivity and specificity were improved with combining cytology and HCS1 HPV DNA test(82.2%, 86.9%~). CONCLUSION: HCS HPV DNA test may be considered as a useful adjunctive test with cervical cytology in cervical cancer screening.
Academic Medical Centers ; Cervix Uteri ; DNA ; Female ; Human Papillomavirus DNA Tests* ; Humans ; Korea ; Mass Screening* ; Mortality ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

No abstract available.
Classification* ; Uterine Cervical Neoplasms*

Respiratory bronchiolitis-associated interstitial lung disease has been described among current or former smokers and has features consistent with interstitial lung disease. Symptoms include cough, dyspnea on exertion. Lung pathology is characterized by the accumulation of pigmented macrophages within respiratory bronchioles and adjacent air spaces associated with mild thickening of the peribronchiolar interstitium. It must be separated from the other interstitial lung disease because of marked differences in treatment and prognosis. Recently we experienced a case of respiratory bronchiolitis -associated interstitial lung disease in a 48-year-old man. As far as we know, this is the first case in Korea.
Bronchioles ; Bronchiolitis ; Cough ; Dyspnea ; Humans ; Korea ; Lung ; Lung Diseases, Interstitial* ; Macrophages ; Middle Aged ; Pathology ; Prognosis ; Smoking

Ceramide, a product of sphingomyelin hydrolysis, is now recognized as an intracellular lipid messenger, which mediates the effects of extracellular agents on cellular growth, differentiation and apoptosis. Recently, ceramide has been implicated in the regulation of phospholipase D (PLD). In this study, we examined the effects of ceramide on the activity and mRNA level of PLD during apoptotic process in FRTL-5 thyroid cells. C2-ceramide (N-acetyl sphingosine) induced apoptosis in FRTL-5 thyroid cells. Fluorescent staining showed that ceramide induced the typical features of apoptosis including condensed or fragmented nuclei. DNA fragmentation was also observed by agarose gel electrophoresis. Flow cytometric cell cycle analysis showed more clearly that ceramide induced apoptotic cell death in FRTL-5 thyroid cells. The treatment of FRTL-5 thyroid cells with thyroid-stimulating hormone (TSH) resulted in an increased PLD activity in a dose- and time-dependent manner. However, the TSH-induced increase in PLD activity was down-regulated within 2 h after ceramide treatment. Furthermore, the levels of PLD mRNA were found to be decreased throughout apoptotic process as inferred by reverse transcription-polymerase chain reaction. However, the decreases in PLD mRNA levels were not correlated with those in PLD activities after ceramide treatment. Taken together, these data suggest that ceramide inhibits the PLD activity in an early apoptotic phase and down-regulation of the levels of PLD mRNA may be implicated in apoptotic process in FRTL-5 thyroid cells.
Animal ; Apoptosis/drug effects* ; Cells, Cultured ; DNA Fragmentation ; Enzyme Activation/drug effects ; Flow Cytometry ; Gene Expression Regulation, Enzymologic/drug effects ; Phospholipase D/metabolism* ; Phospholipase D/genetics ; RNA, Messenger/genetics ; Rats ; Rats, Inbred Strains ; Sphingosine/pharmacology ; Sphingosine/analogs & derivatives* ; Thyroid Gland/enzymology ; Thyroid Gland/drug effects* ; Thyrotropin/pharmacology

The authors report two cases of high cervical spinal chordomas that were removed via the median labiomandibular glossotomy(MLG) approach. One patient was a 62-year-old female in whom an extradural chordoma was found at the level of C3 vertebra with huge prevertebral extension, and causing dyspnea and dysphagia; the other was a 47-year-old female, found to be suffering from a chordoma of C2 vertebral body, which was found incidentally. After removal of the tumors, ventral instrumented fusions were performed in both patients, who showed good recoveries with only minor complications. The MLG approach is radical, and rarely performed by neurosurgeons, but for treatment of an expanded high cervical lesion that needs ventral surgery and seems to be inaccessible via the conventional transoropharyngeal or anterolateral retropharyngeal route, it should be considered. The authors discuss the clinicopathological characteristics of spinal chordomas and general considerations of the MLG approach to high cervical lesions, and briefly describe the surgical techniques involved in this approach.
Chordoma* ; Deglutition Disorders ; Dyspnea ; Female ; Humans ; Middle Aged ; Spine

In order to observe the effects of Nicotine and NNK on cultured human gingival fibroblast, several factors were examined including mutagenicity, the number of cells attached culture plate surface through MTT test, the abundance of collagen & collagenase in mRNA level and collagenolytic activity in extracellular matrix. The results were as follows; 1. Regardless of the co-existence of S9, Nicotine did not show the mutagenicity by itself and NNK by itself showd the same result; However, dose related mutagenicity was shown in NNK with S9. 2. The number of fibroblasts attached cultured plate surface was measured by MTT procedure. The number of cells in Non-smokers increased at all time periods as compared to those of smoker. 3. Non-smoker's fibroblast treated by NNK or Nicotine was dose-dependently decreased in the number of cells when compared to untreated control. In higher dose, Nicotine showed the cellular toxicity , but NNK did not. 4. No change in the abundance of mRNA for proalpha1 and proalpha2 was shown in Nicotine treated group but in gingival fibroblasts following treatment with NNK, the abundance of mRNA for proalpha1, but not proalpha2 collagen was decreased. 5. The abundance of mRNA for collagenase was decreased when NNK was treated but no change occurred in Nicotine treated group. 6. The effect of NNK and Nicotine in collagenolytic activity showed that ,collagenase activity exclusively react to type I collagen, was increased in both group, but gelatinase exclusively react to type IV collagen was not influenced at all. Collagenase activity of smoker's fibroblast was also increased as much as Nicotine and NNK group. The findings suggest that both of Nicotine and NNK lead gingival fibroblast to decrease in the abundance of collagen. And it seems to be that Nicotine and NNK have independent pathway toward the gingival fibroblast.
Humans

Purposes : Nitric oxide (NO) is classified as toxic gas in native states, but in most biologic systems NO acts as a messenger molecule. NO is known as endothelium derived relaxing factor that modulates tone of vascular smooth muscle. Inhaled NO has been reported to act as a selective pulmonary vasodilator and we expect that NO inhalation can be used as a successful treatment modality in the management of persistent pulmonary hypertension of the newborn. We used the newborn piglet to create acute hypoxic pulmonary hypertension and examined the hemodynamic effect of inhlaled NO and dose-response characteristics in different concentrations of NO in this model. The aims of this study were to investigate the feasibility and safety of administering NO to a neonatal model and to get a useful informations about clinical applications of administering NO. METHODS: Nine 2-to 9-d-old piglets with an average weight of 3.1+/-0.86kg were anesthetized, intubated and instrumented in order to measure the hemodynamic variables. NO in nitrogen in a concentration of 800 ppm in 47 liter sylinder was obtained and injected into the inspiratory line of a time-cycled pressure-limited neonatal ventilator after reducing of pressure using 3 staged regulator. Gas mixture in downstream of the injection site was analyzed for NO and NO2 using electrochemical analyzer. Statistical analyses were done using with SAS software ver. 6.04. RESULTS: Baseline hemodynamic parameters in normoxic breathing such as mean systemic arterial pressure, mean pulmonary arterial pressure, systemic vascular resistance, pulmonary vascular resistance and cardiac index were 79+/-18mmHg, 16+/-4mmHg, 0.20+/-0.09mmHg, mL-1, min, kg, 0.04+/-0.02mmHg, mL-1, min, kg, and 399+/-201mL/min/kg respectively. Inhaling 20 and 80 ppm NO during ventilation at FIO2 0.21 did not produce any significant changes in hemodynamic indices. Pulmonary hypertension was induced by reducing the fraction of inspired oxygen to 0.10 to 0.15 and arterial oxygen saturation between 35 and 45%. The hypoxic challenge caused a significant increase in pulmonary arterial pressure, pulmonary vascular resistance and the ratio of pulmonary to systemic vascular resistance of 105% (P<0.001), 92% (P<0.02), 72% (P<0.01) respectively. Systemic arterial pressure increased by 20% (P<0.05), but systemic vascular resistance and cardiac index were not changed significantly. Inhaled NO was then administered in concentrations of 10, 20, 40, 80, and 100 parts per million in random order. All concentrations of NO were associated with a rapid decrease in pulmonary arterial pressure and pulmonary vascular resistance (P<0.02, P<0.001). The ratios of pulmonary to systemic vascular resistance decreased with all levels of inhaled NO (P<0.05). There was no significant difference between the different doses of NO in their effects. There was no significant increase in circulating methemoglobin, and the NO2 levels in the inspiratory limb of ventilator never exceeded 1.5 ppm. Plasma nitrite and nitrate increased in a dose-dependent manner (P<0.05). CONCLUSIONS: In acute hypoxic pulmonary hypertension induced newborn piglets NO inhalation with all the varying concentrations led to reduction of pulmonary arterial pressure promptly and safely without significant increase of methemoglobin and NO2 levels.
Animals ; Arterial Pressure ; Endothelium-Dependent Relaxing Factors ; Extremities ; Hemodynamics* ; Humans ; Hypertension, Pulmonary* ; Infant, Newborn* ; Inhalation* ; Methemoglobin ; Muscle, Smooth, Vascular ; Nitric Oxide* ; Nitrogen ; Oxygen ; Plasma ; Respiration ; Vascular Resistance ; Ventilation ; Ventilators, Mechanical

PURPOSE: To test the hemodynamic and biochemical sequences of secondary cerebral energy failure after acute reversed hypoxic ischemic brain insult (HI) can be reproduced in newborn piglets. METHODS: Fifteen anesthetized, ventilated newborn piglet (<3 day) were studied. Eight (HI) were induced transient HI by breathing 8% oxygen and complete occlusion of bilateral common carotid arteries for 30 minutes followed by reoxygenation and reperfusion. Seven (control) were given a sham operation. Both groups were maintained for 48 hours with intensive care and monitoring of cerbral hemodynamics and [delta Cyt aa3] using near infrared spectroscopy (NIRS). Finally, brain cortex was harvested and determined activities of Na+, K+/-ATPase, level of conjugated dienes, ATP and phosphocreatine (PCr) biochemically. RESULTS: No changes took place in the 48-hour control group. In HI group, PaO2, pH, and MABP decreased, and heart rate, glucose, lactate level in blood and lactate level in CSF increased during acute HI. These variables subsequently returned to normal with time. In continuous NIRS monitoring, [delta Cyt aa3] were not changed in the control group. But in HI group [delta Cyt aa3] decreased significantly in acute HI and then normalized with resuscitation but gradually decreased and was significantly lower than control group at 48 hours. Cerebral Na+, K+/- ATPase activity and ATP, PCr level of experimental group significantly decreased compared to control group. Cerebral level of conjugated dienes were not significantly different between both group. CONCLUSION: We successfully reproduced secondary cerebral energy failure after acute HI in thenewborn piglet and this animal model may be useful for testing cerebroprotective strategies.
Adenosine Triphosphatases ; Adenosine Triphosphate ; Animals ; Anoxia ; Brain ; Carotid Artery, Common ; Glucose ; Heart Rate ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Critical Care ; Ischemia ; Lactic Acid ; Models, Animal ; Oxygen ; Phosphocreatine ; Polymerase Chain Reaction ; Reperfusion ; Respiration ; Resuscitation ; Spectroscopy, Near-Infrared* ; Spectrum Analysis

BACKGROUND: Fungus ball should always be considered in the differential diagnosis of chronic or recurrent sinusitis resistant to adequate medicinal treatment. MATERIALS AND METHODS: From January 1, 1995, to September 31, 1997, 32 patients were diagnosed with fungus ball based on the pathologic confirmation. We reviewed the 32 patients from the diagnostic point of view, evaluating clinical symptoms, signs, computerized tomography (CT) findings, and operative findings. We also reviewed five cases of clinical misdiagnosis, in which pathologic confirmation failed to identify fungus despite operative and radiologic findings suggesting its presence. RESULTS: Among 32 patients, 19 cases (59%) were suspected prior to surgery as having fungus ball. Eleven cases (34%) were suspected only upon historical and physical examination. CONCLUSION: A high index of suspicion is necessary for the diagnosis of fungus ball. A pathologic confirmation is necessary for a definite diagnosis.
Diagnosis* ; Diagnosis, Differential ; Diagnostic Errors ; Fungi* ; Humans ; Nose ; Physical Examination ; Sinusitis