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

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

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*

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

Purpose: To compare changes in the swept-source (SS) anterior-segment optical coherence tomography (AS-OCT) parameters and intraocular pressure (IOP) control after lens extraction in various spectra of primary angle-closure disease (PACD). Methods: A total 92 eyes from 92 patients with PACD who underwent lens extraction were included in the study. All patients underwent IOP measurement preoperatively and at 1 day, 1 week, and 1, 3, and 6 months postoperatively. SS AS-OCT was performed in all subjects preoperatively and 1 month postoperatively. All participants were divided into two groups depending on the presence of glaucomatous optic disc or visual field damage (group A, PAC suspect or PAC; group B, PAC glaucoma). The changes in IOP and anterior chamber angle parameters of SS AS-OCT of each group were compared. Regression analysis was performed to find factors associated with the degree of IOP reduction after lens extraction. Results: Preoperatively, there was no significant difference in IOP between the two groups (16.3 ± 2.5 mmHg vs. 16.9 ± 3.2 mmHg, p = 0.297), but the number of glaucoma medications used was greater in group B (0.6 ± 1.0 vs. 2.0 ± 0.9, p < 0.001). Postoperatively, IOP was not significantly different, but the number of medications used was greater in group B (0.2 ± 0.7 vs. 0.9 ± 0.8, p < 0.001). Anterior chamber angle parameters including angle opening distance and trabecular-iris angle had a greater increase in group B after lens extraction. However, the residual iridotrabecular contact (ITC) index was significantly greater in group B (5.6 ± 7.0 vs 10.7 ± 12.1, p = 0.014). A greater change in the ITC index was related to a greater degree of IOP reduction (β coefficient, 0.429; p < 0.001). Conclusions Eyes with PAC glaucoma had a greater residual ITC index after lens extraction compared with eyes of other PACD spectrum and required a greater number of glaucoma medications to maintain a similar level of IOP.

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

In our previous study, we observed that hydrosalpingeal fluid (HSF) adversely effect mouswe embryo development and hatching. The aim of this study was to evaluate the effect of HSF as assessed by the blastocyst development rate (BDR) and by cell counting in vitro HSF was collected from nine patients undergoing salpingoneostomy to correct hydrosalpinx. Two-cell embryos were obtained from superovulated ICR mice. T6 medium and T6+/-0.4% bovine serum albumin were used as control media. T6 medium containing 10% or 50% HSF and 100% HSF from each patient were used as test media. Nine to 15 embryos were cultured in microdrops prepared from each of these media. To assess the total cell number within each blastocyst, the blastocysts were fixed and stained with Hoechst 33342 to facilitate cell counting. The mean BDR in two control media were 88.89% and 85.40%. The mean BDR in media containing 10%, 50%, 100% HSF were 85.87%, 89.58% and 75.57%, respectively (*: p<0.05). The overall mean cell count (+/-SEM) in control media were 87.6+/-9.65 and 90.12+/-11.38. The BDR was affected adversely only by 100% HSF and not in media containing 10% or 50% HSF. Mean cell counts were decreased significantly only in blastocysts cultured 100% HSF (63.8+/-13.66; p<0.01) but not in blastocysts cultured in 10% or 50% HSF (91.3+/-12.44 and 82.9+/-18.27, respectively). Thus, it is concluded that HSF has no embyotoxic effect but has a mildly negatively effect on embryonic growth and development.
Animals ; Blastocyst ; Cell Count ; Embryonic Development ; Embryonic Structures* ; Female ; Growth and Development ; Humans* ; Mice* ; Mice, Inbred ICR ; Pregnancy ; Serum Albumin, Bovine