A 55-year-old woman suffered from upper abdominal pain for two months and remained refractile against the anti-ulcer regimen. The palliative gastrectomy specimen revealed multiple shallow ulcerations on the thickened mucosal folds mainly in the antrum and body along the greater curvature where multiple, whitish nodules were found in the submucosa. Microscopically, individual submucosal nodules clearly corresponded to the necrotizing granulomatous vasculitis which were featured with diffuse fibrinoid necrosis of arterial walls accompanying granuloma formation and heavy infiltration of neutrophils, eosinophils, histiocytes and giant cells. Similar vasculitic lesions involved venules and arterioles. There were scattered vasculitic changes in the liver biopsy specimens and omentum. There were no clinical presentations or serological support of systemic involvement including systemic lupus erythematosus, Henoch-Schoenlein purpura, cryoglobulinemia or Churg-Strauss granulomatous vasculitis. We conclude that this is a hitherto undescribed primary necrotizing granulomatous vasculitis predominantly involving the stomach.
Abdominal Pain ; Arterioles ; Biopsy ; Cryoglobulinemia ; Eosinophils ; Female ; Gastrectomy ; Giant Cells ; Granuloma ; Histiocytes ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Middle Aged ; Necrosis ; Neutrophils ; Omentum ; Purpura, Schoenlein-Henoch ; Stomach* ; Ulcer ; Vasculitis* ; Venules

A 25-year-old man had been intermittently treated with topical steroid ointment for his eczematous lesions on the scrotum. One year later, a few hard nontender nodules were found with surrounding thickened lichenified skin on the previous lesions. Histopathologic examination of the skin revealed moderate acanthosis of the epidermis and multiple scattered calcified materials in the upper demis and within the hair follicle. We present this case, being considered a dystrophic calcinosis cutis due to local injury.
Adult ; Calcinosis* ; Epidermis ; Hair Follicle ; Humans ; Lupus Erythematosus, Discoid* ; Scrotum ; Skin

Cervicography is an adjunct method of cervical cancer screenign intended to complement papanicolaou smear. Cervicography involves obtaing and evalutionag a photographic image of the cervix.the purpose of this investigation was to evalute the efficacy of cervicography in cervicla cancer screening. Papanicolaou smear and cervigram data were obtainde for 169 patients who visited Department of Obstetrics and Gynecology, Chungnam Nationa University Hospital form September 1995 to march 1996. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen.the resunt wre as follows:1. the sensitivity and the specificity of cervicography was 78.8% and 86.3% respcetively. 2. the positive predictive value, negative predictive value, false negative rate, and false positive rate of cervicography were 71.9%, 90.15%, 13.7%, 21,2% respectively. 3. The sensitivity and the specifictiy of Papanicolaou smear was 84.6% and 92.3% respectivesly. 4. the positivie predictive value, negative predictive value, false negative rate, and false positive rate of Papanicoloau smear were 83.0%, 93.1%, 7.7%, 15.4% respecitively. 5. There was no significant difference between the sensitiviey and the specificity of cervicography and Papanicolaou smear (p=0.449, p=0.139) 6. When cervicography and Papanicolaou smear were used donjointly, the sensitivity was higher than for cervicography or Papanicolaou smear used alone (96.1% vs 78.8% p= 0.008, 96.1% vs 86.3%. p=0.047) However the specificity of the combined tests was lower than Papanicicolaou smear(80.3% vs 92.3% p=0.008). Cervicography is a useful method to detect cevical cancer. Howerver when cervigrams are used in conjuction with Papanicolaou smear, the detection rate of cervical cancer will be increased.
Chungcheongnam-do ; Complement System Proteins ; Early Detection of Cancer ; Female ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Cervicography is an adjunct method of cervical cancer screenign intended to complement papanicolaou smear. Cervicography involves obtaing and evalutionag a photographic image of the cervix.the purpose of this investigation was to evalute the efficacy of cervicography in cervicla cancer screening. Papanicolaou smear and cervigram data were obtainde for 169 patients who visited Department of Obstetrics and Gynecology, Chungnam Nationa University Hospital form September 1995 to march 1996. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen.the resunt wre as follows:1. the sensitivity and the specificity of cervicography was 78.8% and 86.3% respcetively. 2. the positive predictive value, negative predictive value, false negative rate, and false positive rate of cervicography were 71.9%, 90.15%, 13.7%, 21,2% respectively. 3. The sensitivity and the specifictiy of Papanicolaou smear was 84.6% and 92.3% respectivesly. 4. the positivie predictive value, negative predictive value, false negative rate, and false positive rate of Papanicoloau smear were 83.0%, 93.1%, 7.7%, 15.4% respecitively. 5. There was no significant difference between the sensitiviey and the specificity of cervicography and Papanicolaou smear (p=0.449, p=0.139) 6. When cervicography and Papanicolaou smear were used donjointly, the sensitivity was higher than for cervicography or Papanicolaou smear used alone (96.1% vs 78.8% p= 0.008, 96.1% vs 86.3%. p=0.047) However the specificity of the combined tests was lower than Papanicicolaou smear(80.3% vs 92.3% p=0.008). Cervicography is a useful method to detect cevical cancer. Howerver when cervigrams are used in conjuction with Papanicolaou smear, the detection rate of cervical cancer will be increased.
Chungcheongnam-do ; Complement System Proteins ; Early Detection of Cancer ; Female ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

PURPOSE: The purpose of this study is to evaluate the relationship between developmental lumbar spinalstenosis and its BMD value by using the single energy quantitative CT(SEQCT). MATERIALS & METHODS: Eighty normal volunteers(20-60years) were selected as a control group and 28 patients with developmental lumbar spinal stenosis were selected as a disease group. The two groups were divided into a younger (20-39years) and an older subgroup(40-60 years), and were further divided into male and female subgroups. All the cases showed no evidence of metabolic disease, fracture, herniated nucleus pulposus, degererative spondylosis, infectious disease, tumors orhad no history of absolute immobilization of more than two weeks. All underwent lumbar spine CT and SEQCT. We measured bone mineral density(BMD) at the cancellous bone of L1, 2, 3 and obtained the mean and its one standard deviation, and compared the data between each subgroup of the control and the disease group using ANOVA. RESULTS: There was a significant low BMD value in the younger male patient subgroup compared with the control subgroup(P<0.05). CONCLUSION: Developmental lumbar spinal stenosis in a young male may be a factor of decreasing BMD of the body of the spine.
Communicable Diseases ; Female ; Humans ; Immobilization ; Male ; Spinal Stenosis* ; Spine ; Spondylosis

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Audiometry ; Carpal Tunnel Syndrome* ; Condoms* ; Diagnosis ; Hand ; Mass Screening ; Median Nerve ; Neural Conduction ; Occupations ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Ulnar Nerve ; Vibration ; Wrist

PURPOSE: The purpose of this study was to provide basic data for injury prevention and rehabilitation program development of Taekwondo demonstration team by comparing lower extremity muscles function and proprioceptive senses of Taekwondo demonstration team with or without anterior cruciate ligament (ACL) injury. The subjects were ACL injured Taekwondo demonstration player group (ATD, n=13) who underwent ACL reconstruction and Kukkiwon Taekwondo demonstration player group (KTD, n=13) without injury history.METHODS: To evaluate the lower extremity muscles function, we measured the flexor-extensor muscle strength ratio and isokinetic muscle strength of the knee joint using a isokinetic muscle strength measuring device. In order to investigate the proprioceptive sensory function, position sense, and threshold to detection of passive motion was using a isokinetic muscle strength measuring device. The experiment was conducted on average 26 months after surgery.RESULTS: The results of this study are as follows. There was no significant difference between the two groups in the knee joint flexor-extensor ratio. But there was a significant difference in Knee joint flexion and extension strength between two groups at an angular velocity of 60°/sec, 180°/sec, and 300°/sec. and KTD group was higher than ATD groups (p=0.014, p=0.001, p=0.029, p=0.005, p=0.043, p=0.041, respectively). There was no significant difference between the two groups in the proprioceptive sensory test.CONCLUSION: The results of this study showed that the normal flexor to extensor ratio (50%–70%), But it was close to the injury risk level. Therefore, the training program for the improvement of the muscle strength and the imbalance of the strength of the lower extremity muscle function should be performed in both groups.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Education ; Knee Joint ; Lower Extremity ; Muscle Strength ; Muscles ; Program Development ; Proprioception ; Rehabilitation ; Sensation

OBJECTIVE: It is well known that X-ray induces follicular atresia, but the exact mechanism of atresia is not still unveiled completely. In addition, the role of macrophage related with clean-up the dead granulosa cells and other functions within the ovarian follicle is emphasized recently. The aim of this study is to assess the radiation-induced morphological changes of ovarian follicles and follicular macrophages. METHODS: 8 Gy X-ray irradiated on the 3-week old rats (Sprague-Dawley strain), sacrificed at 6, 12, and 24 hours after irradiation, and performed morphological studies with light and transmission electron microscopy, TUNEL, and macrophage immunohistochemistry. RESULTS: Follicular atresia increased significantly (p<0.01) at 6 hours after X-irradiation, and it was decreased significantly (p<0.01) at 12 and 24 hours after irradiation. X-ray induced chromatin condensation in the nucleus and nuclear fragmentation of granulosa cells, which were the typical features of apoptosis. Apoptotic granulosa cells were phagocytosed by the neighboring normal granulosa cells and the macrophages. During atresia of follicles, radioresistant granulosa cells were found in some follicles, which showed similar features morphologically with the granulosa cells of normal follicles. Macrophages were found both within the antrum and at the follicular granulosa layer. CONCLUSION: X-radiation induced follicular atresia by means of granulosa cell apoptosis, and radioresistant granulosa cells which have similar features morphologically with the granulosa cells of normal follicles were observed in some follicles. And the macrophages which phagocytose the apoptotic granulosa cells were located within the follicular antrum and at the follicular granulosa layer.
Animals ; Apoptosis ; Chromatin ; Female ; Follicular Atresia* ; Granulosa Cells ; Immunohistochemistry ; In Situ Nick-End Labeling ; Macrophages* ; Microscopy, Electron, Transmission ; Ovarian Follicle ; Radiation, Ionizing ; Rats

Traditionally, preeclamptic women who meet established criteria for severe disease aredelivered expeditiously. Although delivery is always appropriate thrapy for the mother, itmay not be for the fetus remote from term. The purpose of this investigation was to evaluatethe differences of pregnancy and neonatal outcome of severe preeclampsia and normalpregnancy, especially before 34 weeks gestational age, and to determine whether aggressiveor expectant management of severe preeclampsia before 34 weeks is more beneficial tomaternal and fetal outcome. A hundred and twenty consecutive pregnancies complicated bysevere preeclampsia and a hundred and twenty normal pregnancies were stuided.The results were as follows:1. The incidence of severe preeclampsia was 3.9%(130 of 3328). The 26~30 year oldage group was most common, 43%(52 patients).2. In case of study between severe preeclamptic patients and normal pregnant patient,there was no differences regarding gestational age at delivery, birth weight, cesarean sectionrate, incidence of RDS, perinatal death. The 1min/5 min Apgar scores of severe preeclampsiais significantly lower than control group(6/7 vs 7/8, p < 0.05). Neonates with SGA(small for gestational age) were found in 29% neonates of patients with severe preeclampsia,which is significantly higher than normal pregnancy group(6%, p < 0.05).3. There was no significant difference between expectant(n=10) and aggressive(n=21)management group less than 34 weeks gestation regarding the gestational age of admissionand delivery, blood pressure, proteinuria, serum creatinine, hemoglobin, hematocrit, pletelets,liver enzymes, and LDH. Only the prolongation of gestational age in the expectant managementgroup is significantly higher than in the aggressive management group(7 vs 2 days,p < 0.05).4. The neonatal and pregnancy outcome of expectant(n=10) and aggressive managementgroup(n=15) were as follow: The birth weight in the expectant management groupis lower than in the aggressive management group(1316.7+/-668.8g vs 1576.2+/-428.7 g, p < 0. 05). The incidence of SGA in the expectant management group is higher than in theaggressive management gorup(50% vs 27%, p=not significant). There was no significant differencebetween expectant and aggressive management group regarding the 1 min/ 5 minApgar score, the cesarean section rate, and the frequency of respiratory distress syndrome,cerebral hemorrhage, renal failure, sepsis, DIC of neonates.
Birth Weight ; Blood Pressure ; Cesarean Section ; Creatinine ; Dacarbazine ; Female ; Fetus ; Gestational Age ; Hematocrit ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn ; Mothers ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Proteinuria ; Renal Insufficiency ; Sepsis

Uterine anomalies have been reported in 4% of women with infertility and in up to 15% of those with recurrent abortion. One of the major intrauterine disorder associated with infertility and recurrent abortions is intrauterine septum, The reproductive outcome of 41 patients of intrauterine septum (7 complete, 34 incomplete) with repeated abortions or infertility was assessed after the uterine septotomy. 5 of 7 patients with comlete uterine septum undergone uterine septotomy (3; hysteroscopic metroplasty, 2; abdominal metroplasty) had total 6 pregnancies and all of them had live biths. 28 patients with incomplete uterine septum got the hysteroscopic intrauterine septotomy and the viable pregnancy rate was 62% (3 ongoing pregnancies, 13 live biths of total 26 pregnancies). 6 patients with incomplete uterine septum had not the operation and 5 patients had 5 live births after total 6 pregnancies with 1 spontaneus abortion. Even though, the number of cases were small, the live birth rate in the group of septotomy of the patients of complete uterine septum (100%, 6/6) was higher than that in the group of not-done (50%, 1/2). The live birth rate in the group of not-done of the patients with incomplete uterine septum (83%, 5/6) was higher than that in the group of hysteroscopic uterine septotomy (62%, 16/26), but 5 of 6 had short uterine septal length (<1 cm), 1 had 1.5 cm septal length in the group of not-done. All the patients with successful pregnancy outcome had no other co-factors at the diagnostic laparoscopy, but the 5 primary infertility patients with no live birth even after treatment (all were with incomplete septum; 3 undergone hysteroscopic septotomy, 2 not-done with one abortion) had other co-factors such as endometriosis, peritoneal or tubal facor. In conclusion, hysteroscopic uterine septotomy would be useful for the patients with habitutal abortion or infertility and more advanced managemnet protocols should be applied to the patients having other co-factors if there was no pregnancy even after the uterine septotomy.
Abortion, Habitual* ; Endometriosis ; Female ; Humans ; Hysteroscopy* ; Infertility* ; Laparoscopy ; Live Birth ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate