OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

No abstract available.
B-Lymphocytes ; Lymphoma, B-Cell

PURPOSE: This treatment planning study was undertaken to evaluate the impact of beam angle configuration of intensity-modulated radiotherapy (IMRT) on the dose of the normal liver in hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The computed tomography datasets of 25 patients treated with IMRT for HCC were selected. Two IMRT plans using five beams were made in each patient; beams with equidistance of 72degrees (Plan I), and beams with a 30degrees angle of separation entering the body near the tumor (Plan II). Both plans were generated using the same constraints in each patient. Conformity index (CI), homogeneity index (HI), gamma index, mean dose of the normal liver (Dmean_NL), Dmean_NL difference between the two plans, and percentage normal liver volumes receiving at least 10, 20, and 30 Gy (V10, V20, and V30) were evaluated and compared. RESULTS: Dmean_NL, V10, and V20 were significantly better for Plan II. The Dmean_NL was significantly lower for peripheral (p = 0.001) and central tumors (p = 0.034). Dmean_NL differences between the two plans increased in proportion to gross tumor volume to normal liver volume ratios (p = 0.002). CI, HI, and gamma indices were not significantly different for the two plans. CONCLUSION: The IMRT plan based on beams with narrow separations reduced the irradiated dose of the normal liver, which would allow radiation dose escalation for HCC.
Carcinoma, Hepatocellular ; Humans ; Liver ; Radiotherapy, Intensity-Modulated ; Tumor Burden

Implant fixed prosthesis for the complete edentulous maxilla provides significant benefits in the aspects of functions and esthetics compared with the conventional denture. Implant supported fixed prosthesis are totally supported by implant, and thus stabilizes the prosthesis to the maximum degree as possible. Also, the improved retention and stability of fixed prosthesis enhance patients' psychological and psychosocial health. This clinical presentation describes a maxillary full arch implant-supported fixed prosthesis in complete maxillary edentulous patient who showed vertical and horizontal alveolar bone resorption in the anterior ridge. To rehabilitate the esthetics and proper lip support, the zirconia framework was fabricated and the pink porcelain was veneered to reproduce the natural gingival tissue. After 9 months of follow up, the restorations were maintained without complications and the patient was satisfied with the restoration both functionally and esthetically.
Alveolar Process* ; Bone Resorption ; Dental Porcelain ; Dentures ; Esthetics ; Follow-Up Studies ; Humans ; Lip ; Maxilla* ; Prostheses and Implants*

No abstract available.
Atrophy ; Pityriasis* ; Tinea Versicolor*

Purpose: Granular corneal dystrophy type 1 (GCD1) is a genetic disorder characterized by grayish-white granular deposits in the corneal stroma, typically manifesting before age 10. The specific characteristics of GCD1 in the Korea population remain insufficiently described. This study investigated the morphological features of GCD1 corneas with confirmed genetic mutations in this population. Methods: Medical records of GCD1 patients with the R555W mutation confirmed through transforming growth factor β induced (TGFBI) gene testing on oral epithelium or blood samples from 2005-2022, were analyzed. Corneal photographs obtained using a slit lamp biomicroscope were also examined. Results: The study group included 11 males and 19 females with an average age of 35.7 years, ranging from 3-70 years. All participants were heterozygotes. In 28 individuals (56 eyes, representing 93.3% of the total), there were signs of corneal deposit detachments, known as “drop-off”, observed in patients aged 6 years and above. Surface deposits reemerged at the peripheral margin of previous locations and expanded toward the center. The number and shape of opacities significantly changed with age, showing cycles of deposition and shedding. There were variations in the severity of opacities within the same family, particularly with advancing age, and distinct opacities extending into deeper stromal layers. Conclusions This study outlines the morphological characteristics of corneas in Korean GCD1 patients, based on corneal photograph analysis. These findings provide a basis for future comparative studies with GCD2 and may aid rapid clinical diagnosis based on clinical findings, prior to genetic testing confirmation.

To investigate cellular proliferation pattern of pterygial tissue, eleven paraffin sections through two normal conjunctiva, six primary and three recurrent pterygia were studied immunohistochemically by finding epithelial cells and subepithelial fibroblasts staining patterns as defined by monoclonal antibody for proliferating cell nuclear antigen(PCNA). The results showed similar epithelial cellular proliferation patterns in normal conjunctiva, primary and recurrent pterygia. But scattered patches of fibroblasts in subepithelial connective tissue staining positive with PCNA were found only in recurrent pterygium. Our results suggest that primary pterygium is not a disorder of excess cellular proliferation, but a proliferation of fibroblasts in subepithelial connective tissue have a role in pathogenesis of recurrent pterygium.
Cell Proliferation ; Conjunctiva ; Connective Tissue ; Epithelial Cells ; Epithelium ; Fibroblasts ; Paraffin ; Proliferating Cell Nuclear Antigen ; Pterygium*

Reconstruction of the nasal alar may be challenging due to the complex nature of multiple cosmetic units and functional considerations, including maintenance of valvular competency. Reconstructive options include various flaps or graft repairs, depending on the subunit involvement and the size of the defect. Linear closures may be suitable for small defects, while bilobed flaps, melolabial flaps, and forehead flaps may be considered for moderate to large defects involving partial and full-thickness defects of the ala.
Congenital Abnormalities* ; Forehead ; Transplants

We herein report a case of occupational contact urticaria syndrome induced by cefotiam di-hydrochloride in a nurse. She had generalized pruritic wheals accompanied by palpitations and tachypnea during the preparation of cefotiam solution. A scratch patch test with cefotiam di-hydrochloride, a major component of cefotiam ingredient showed multiple erythema and wheals within 5 minutes, accompanied by palpitations and tachypnea. No delayed type reaction was observed. Based on her clinical history and scratch test result, we diagnosed her condition as contact urticaria syndrome caused by cefotiam.
Cefotiam* ; Erythema ; Patch Tests ; Tachypnea ; Urticaria*

PURPOSE:Insulin-like growth factor-I(IGF-I) is an essential anabolic factor for postnatal rat brain development and IGF-I expression is highly abundant during the first 21 days, critical growth period. Hypoxic-ischemic brain insults occurring during the perinatal period result in neuronal necrosis and permanent brain damage. To investigate the regulation of the action of IGF-I in response to such a hypoxic insult, we examined the gene expression of IGF-I and IGFBP-5 during the first 72 hr after hypoxic-ischemic injury in immature rat brain. METHODS:Ligation of the right carotid artery of 7-day-old rats was followed by 2 hour exposure to 8% oxygen to produce severe hypoxic brain damage. Using reverse transcriptase-polymerase chain reaction(RT-PCR), the expression of IGF-I mRNA and IGFBP-5 mRNA was determined in both hypoxic and control brains at post 1, 4, 12, 24, 48 hr and 72 hr after hypoxic-ischemic insult. RESULTS:The IGF-I mRNA and IGFBP-5 mRNA expression of hypoxic brain were not different from those of controls at 1 hr of recovery but IGF-I mRNA expression was decreased rapidly at post 4 hr, this decrease more pronounced at 12 hr of recovery. IGF-I mRNA and IGFBP-5 mRNA expression were increased at 48 hr and 24 hr of recovery, respectively and both IGF-I mRNA and IGFBP-5 mRNA expression showed similar level of controls at 72 hr of recovery. CONCLUSION: Out findings suggest that IGF-I play a important role in both neuronal loss and repair process following hypoxic-ischemic brain injury and IGFBP-5 is also strongly involved in the repair of damaged brain tissue by mediating IGF-I action. (J Korean Soc Pediatr Endocrinol 2003;8:56-63)
Animals ; Brain Injuries* ; Brain* ; Carotid Arteries ; Gene Expression ; Hypoxia, Brain ; Insulin-Like Growth Factor Binding Protein 5 ; Insulin-Like Growth Factor I ; Necrosis ; Negotiating ; Neurons ; Oxygen ; Rats* ; RNA, Messenger*