Until recently, the cervical pregnancy have been treated with surgery, usually hy- sterectomy, because of uncontrollable heavy vaginal bleeding. The development of sophisticated ultrasound which allows early diagnosis of cervical pregnancy and methotrexate chemotherapy opened up new therapeutic options in the management of this unusual but potentially life threatening complication of pregnancy which have been always a nightrnare for the gynecologist. We are reporting a case of cervical pregnancy diagnosed in 12 weeks of gestation. The patient was successfully treated with alternative administration of methotrexate (1 mg/kg, intramuscularly) and leucovorin (0.1 mg/kg, intramuscularly) without surgical intervention, in order to preserve both the uterus and fertility. Follow up was done with serum beta hCG and pelvic ultrasonography. Complete resolution of the cervical pregnancy was obtained at 50 days after starting methotrexate treatment. This case gave us the opportunity to review the recent literature on cervical pregnancy.
Drug Therapy ; Early Diagnosis ; Fertility ; Follow-Up Studies ; Humans ; Leucovorin* ; Methotrexate* ; Pregnancy* ; Ultrasonography ; Uterine Hemorrhage ; Uterus

The authors performed combined trabeculectomy-cataract extraction on eyes of 8 patients with coexisting glaucoma and cataract. Posterior chamber lens implantation was performed in 2 of 9 eyes. The follow-up period ranged from 6 to 12 months. Visual acuity was improved in 8 eyes. The mean intraocular pressure was reduced by approximately 53%, from 28 mmHg preoperatively to 13 mmHg postoperatively. No medications were required in 6 of the 8 eyes, but 2 needed one medication for adequate control of intraocular pressure, postoperatively. No greater incidence of complications were evident with the combined procedure, from that expected with routine cataract extraction or trabeculectomy alone.
Cataract Extraction* ; Cataract* ; Follow-Up Studies ; Glaucoma ; Humans ; Incidence ; Intraocular Pressure ; Trabeculectomy ; Visual Acuity

BACKGROUND: Melasma is an acquired, symmetrical hypermelanosis that occurs on sun-exposed areas of the skin. It has significant emotional and psychological effects on those affected with the condition. Melasma Quality of Life Scale (MELASQOL) is a specific questionnaire to identify the most impaired areas of melasma patient's life. OBJECTIVE: Our purpose of this study is to investigate the changing of MELASQOL after the treatment of melasma. METHODS: A total of 27 volunteers with melasma were enrolled in this 8-week treatment study. The patients were instructed to apply an arbutin-containing cream, once a day for 8 weeks. The assessment of outcomes included the colorimetric value (L*) and MELASQOL score. RESULTS: The arbutin-containing cream group increased more in the colorimetric values (L*) after the 8-week treatment (p<0.01). The MELASQOL score was decreased (p=0.02). No significant adverse reactions were observed. CONCLUSION: The treatment of melasma improves the QOL of melasma patients.
Humans ; Hyperpigmentation ; Melanosis ; Quality of Life ; Skin ; Surveys and Questionnaires

OBJECTIVES: A common problem with analyzing survey data involves incomplete data with either a nonresponse or missing data. The mail questionnaire survey conducted for collecting lifestyle variables on the members of the Korean Elderly Phamacoepidemiologic Cohort(KEPEC) in 1996 contains some nonresponse or missing data. The proper statistical method was applied to evaluate the missing pattern of a specific KEPEC data, which had no missing data in the independent variable and missing data in the response variable, BMI. METHODS: The number of study subjects was 8,689 elderly people. Initially, the BMI and significant variables that influenced the BMI were categorized. After fitting the log-linear model, the probabilities of the people on each category were estimated. The EM algorithm was implemented using a log-linear model to determine the missing mechanism causing the nonresponse. RESULTS: Age, smoking status, and a preference of spicy hot food were chosen as variables that influenced the BMI. As a result of fitting the nonignorable and ignorable nonresponse log-linear model considering these variables, the difference in the deviance in these two models was 0.0034(df=1). CONCLUSION: There is a lot of risk if an inference regarding the variables and large samples is made without considering the pattern of missing data. On the basis of these results, the missing data occurring in the BMI is the ignorable nonresponse. Therefore, when analyzing the BMI in KEPEC data, the inference can be made about the data without considering the missing data.
Aged ; Body Mass Index ; Humans ; Life Style ; Linear Models ; Postal Service ; Surveys and Questionnaires ; Smoke ; Smoking

Choriocarcinoma is an aggressively growing and widely metastasizing tumor that originates from trophoblastic cells. A primary gastric choriocarcinoma (PGC), however, is very rare. A 76-year-old female patient visited the emergency department of Wonkwang University Hospital with abdominal discomfort and melena. Esophagogastroduodenoscopy revealed a huge ulceroinfiltrative mass lesion with blood clots on the boundary between the greater curvature side and the posterior wall side of the stomach lower body. CT showed a 3-cm exophytic mass lesion with heterogeneous enhancement, an ulcer lesion at the posterior wall side of the stomach lower body, and multiple enlarged lymph nodes at the splenic artery and left gastric artery nodal stations. She underwent a radical subtotal gastrectomy with a D2 lymph node dissection. The final diagnosis was PGC coexisting with adenocarcinoma based on the pathology results. This paper reports a rare case of primary gastric choriocarcinoma coexisting with adenocarcinoma and discusses the characteristics of this neoplasm with reference to the literature.
Adenocarcinoma ; Aged ; Arteries ; Choriocarcinoma ; Chorionic Gonadotropin ; Diagnosis ; Emergency Service, Hospital ; Endoscopy, Digestive System ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Melena ; Pathology ; Pregnancy ; Splenic Artery ; Stomach ; Trophoblasts ; Ulcer

Choriocarcinoma is an aggressively growing and widely metastasizing tumor that originates from trophoblastic cells. A primary gastric choriocarcinoma (PGC), however, is very rare. A 76-year-old female patient visited the emergency department of Wonkwang University Hospital with abdominal discomfort and melena. Esophagogastroduodenoscopy revealed a huge ulceroinfiltrative mass lesion with blood clots on the boundary between the greater curvature side and the posterior wall side of the stomach lower body. CT showed a 3-cm exophytic mass lesion with heterogeneous enhancement, an ulcer lesion at the posterior wall side of the stomach lower body, and multiple enlarged lymph nodes at the splenic artery and left gastric artery nodal stations. She underwent a radical subtotal gastrectomy with a D2 lymph node dissection. The final diagnosis was PGC coexisting with adenocarcinoma based on the pathology results. This paper reports a rare case of primary gastric choriocarcinoma coexisting with adenocarcinoma and discusses the characteristics of this neoplasm with reference to the literature.
Adenocarcinoma ; Aged ; Arteries ; Choriocarcinoma ; Chorionic Gonadotropin ; Diagnosis ; Emergency Service, Hospital ; Endoscopy, Digestive System ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Melena ; Pathology ; Pregnancy ; Splenic Artery ; Stomach ; Trophoblasts ; Ulcer

Paragangliomas (PGs) of the thyroid are very rare tumors. Based on the medical literature, thyroid PGs invariably affected women and they were always thought to be benign, and they have always been mistaken for other more common lesions. We report here on the first case of PG of the thyroid in a 45-year-old man in Korea. Ultrasonographically, the tumor showed hypoechoic features. Microscopically, the tumor showed the typical zellballen pattern. The small to medium-sized tumor cells contained moderate amounts of finely granular eosinophilic cytoplasm and round to oval nuclei with fine chromatin. The tumor invaded the thyroid capsule and the extrathyroidal tissue with vascular and perineural invasion. Immunohistochemically, the tumor showed positivity for chromogranin, S-100 protein, CD56a, and synaptophysin and negativity for calcitonin, thyroglobulin, galectin-3, p53, CK19, and EMA. The Ki-67 labeling Index was 10%. We concluded that our case has a high potential of metastasis, and a close follow up would be important.
Female ; Male ; Humans

BACKGROUND: Dendritic cell (DC)-based cancer immunotherapy is studied for several years. However, it is mainly derived from autologous PBMC or leukapheresis from patient, which has limitations about yield and ability of DC production according to individual status. In order to solve these problems, inquiries about allogeneic DCs are performed but there are no preclinical trial answers for effect or toxicity of allogeneic DC to use for clinical trial. In this study, we compared the anti-tumor effect of allogeneic and autologous DCs from mouse bone marrow stem cells in mouse metastatic melanoma model. METHODS: B16F10 melanoma cells (5 x 10(4)/mouse) were injected intravenously into the C57BL/6 mouse. Therapeutic DCs were differentiated from autologous (C57BL/6: CDC) or allogeneic (B6C3F1: BDC) bone marrow stem cells with GM-CSF, SCF and IL-4 for 13days and pulsed with B16F10 tumor cell lysate (Blys) for 18hrs. DC intra-peritoneal injections began on the 8th day after the tumor cell injection by twice with one week interval. RESULTS: Anti-tumor response was observed by DC treatment without any toxicity especially in allogeneic DC treated mice (tumor burden score: 2.667+/-0.184, 2.500+/-0.463, 2.000+/-0.286, 1.500+/-0.286, 1.667+/-0.297 for saline, CDC/unpulsed-DC: U-DC, CDC/Blys-DC, BDC/U-DC and BDC/Blys-DC, respectively). IFN-gamma secretion was significantly increased in allogeneic DC group stimulated with B16F10 cell lysate (2,643.3+/-5,89.7, 8,561.5+/-2,204.9. 6,901.2+/-141.1 pg/1 x 10(6) cells for saline, BDC/U-DC and BDC/Blys-DC, respectively) with increased NK cell activity. CONCLUSION: Conclusively, promising data was obtained that allogeneic DC can be used for DC-based cancer immunotherapy.
Animals ; Bone Marrow ; Dendritic Cells ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Immunotherapy ; Interleukin-4 ; Killer Cells, Natural ; Leukapheresis ; Melanoma* ; Mice ; Neoplasm Metastasis* ; Stem Cells

BACKGROUND: Tumor cell lysate has been considered as a preferential antigen source for the therapeutic dendritic cell pulsing. Our experiences with in vivo study with animal tumor model indicate the tumor cell lysate dependent differential effect of DC therapy. Our previous data show that MC38 lysate pulsed-DC induced stronger ag-specific immunity than CT26 lysate pulsed-DC in vitro. In this study we tried to reveal the mechanism for differential induction of ag-specific immunity of different colon cancer cell lysate pulsed-DCs. METHODS: MC38 and CT26 cell lines were prepared as lysate by freezing-thawing procedure. Tumor cell antigenicity was confirmed by detecting the surface expression of MHC I/II & B7.1/2 molecules. IL-10, IL-12 and TGF-beta in the tumor cell lysate were detected by ELISA and the presence of heat shock proteins were analysed by western blotting. RESULTS: The secretion of IL-10, a immune-inhibitory cytokine was about 470% higher in CT26 lysate than in MC38. Hsp 70 was detected only in the MC38 lysate but not in the CT26. On the other hand, Hsp 60 and 90 expression were not different in two colon cancer cell lysates. CONCLUSION: In two different colon caner cell lysate, immune inhibitory IL-10 (higher in CT26) and Hsp70 (MC38 superiority) were differentially expressed. These data indicate that higher ag- specific immunity induction by MC38 lysate pulsed-DC may due to the expression of hsp70 and lower secretion of IL-10, a immune-inhibitory cytokine than CT26 lysate. The significance of other cytokine and the surface marker expression will be discussed.
Animals ; Blotting, Western ; Cell Line ; Colon ; Colonic Neoplasms ; Dendritic Cells ; Enzyme-Linked Immunosorbent Assay ; Hand ; Heat-Shock Proteins ; Interleukin-10 ; Interleukin-12 ; Transforming Growth Factor beta

OBJECTIVE: There are various surgical approaches to far-lateral lesions in the L5-S1 intervertebral space. Of these is the validity of a paramedian tangential approach is being investigated in this study. METHODS: A retrospective study was conducted on 25 patients who had been diagnosed as having a far-lateral L5-S1 disc herniations, osteophyte, costal process hypertrophy, and had undergone a paramedian tangential approach from November 1999 through December 2003. The degree of symptoms and improvement were compared via the visual analog pain scale, before and after surgery. RESULTS: This study included 4 males and 21 females with a mean age of 62+/-11.8 years old. The average follow-up period after surgery was 8.2+/-2.7 months. The visual analog pain scale taken before surgery was 6.7+/-1.1 points, while the post-surgical scale was 2.4+/-0.9 points showing a significant decrease (p<0.05). There were no complications that developed during surgery. CONCLUSION: A paramedian tangential approach is less invasive in the soft tissue than that of the median approach. This approach may effectively reduce nerve root compression and expand intervertebral foramens, and is devoid of the risk of spinal instability after surgery. The authors suppose that a paramedian tangential approach is quite an effective technique to relieve compression in the far-lateral L5-S1 intervertebral space.
Female ; Follow-Up Studies ; Humans ; Hypertrophy ; Male ; Osteophyte ; Pain Measurement ; Radiculopathy ; Retrospective Studies