OBJECTIVE: The purpose of this study is to evaluate the clinical usefulness of serum level of CA125 and CA19-9 to assess the severity of endometriosis. METHODS: The study was conducted on 80 patients with histologically diagnosed endometriosis and 20 patients in control group. Preoperative serum CA125 and CA19-9 levels were measured by immunoradiometric assay and the severity of disease was staged according to the revised American Fertility Society (1985) classification system. RESULTS: Both serum level of CA125 and CA19-9 in endometriosis patient (81.7+/-120.44 U/mL, 47.1+/-80.74 U/mL, Mean+/-SD) were higher than control group (10.8+/-6.48 U/mL, 11.7+/-8.82 U/mL, Mean+/-SD)(p=0.001, p=0.054). The serum CA125 level increased significantly according to stages (p=0.051), but serum CA19-9 level showed an increasing trend (p>0.05). With the cutoff value of CA125 with 35 U/mL and CA19-9 with 37 U/mL, overall positive rate for CA125, CA19-9, and CA125 combined with CA19-9 was 45.1%, 33.8%, and 52.5%. There was no difference between the positive rate with CA125 combined with CA19-9 (52.5%) and that with CA125 alone (45.1%)(p>0.05). With the cutoff value of CA125 with 15 U/mL and CA19-9 with 9 U/mL, overall positive rate for CA125, CA19-9, and CA125 combined with CA19-9 was 82.5%, 76.3%, and 92.5%, the positive rate with CA125 combined with CA19-9 (92.5%) was higher than that with CA125 alone (82.5%)(p=0.056). CONCLUSION: Because the positive rate with combined serum CA125 and CA19-9 level is not higher than that with serum CA125 alone for the severity assessment of endometriosis, it is recommended to use serum CA125 level alone.
Classification ; Endometriosis* ; Female ; Fertility ; Humans ; Immunoradiometric Assay

Synchronous multiple primary neoplasm is defined as more than 2 cancers are independently developed in one individual and are diagnosed simultaneously or within 6 months interval. The most common form of synchronous multiple primary neoplasm of female reproductive tract is that of uterine endometrium and ovary. Synchronous multiple primary neoplasm involving uterine cervix and endometrium is rare. Recently we experienced a case of synchronous multiple primary malignant neoplasm of the uterine cervix and endometrium. We report this case with revewing of other literature.
Cervix Uteri* ; Endometrial Neoplasms ; Endometrium* ; Female ; Humans ; Neoplasms, Multiple Primary ; Ovary

The acronym CHARGE (Coloboma, Heart defects, Atresia choanae, Retarded growth and development, Genital hypoplasia, and Ear abnormalities) was coined by Pagon et al. in 1981. The prevalence of CHARGE syndrome was estimated to be approximately 1/10,000 - 1/15,000. The cause of the CHARGE syndrome remains unknown but several observations support the role of genetic factors and a significantly higher paternal age at conception and several chromosomal abnormalities. The clinical spectrum of this multiple congenital anomaly and mental retardation is broad and variable, therefore the treatment of the CHARGE syndrome was not definitive and conservative. We hereby report, with reviewing other literature, a case of CHARGE syndrome diagnosed after delivery.
CHARGE Syndrome* ; Chromosome Aberrations ; Ear ; Fertilization ; Growth and Development ; Heart ; Intellectual Disability ; Nasopharynx ; Numismatics ; Paternal Age ; Prevalence

Strong corrosive acid is accidentally ingested by children or by psychiatric patients for the purpose of suicidal attempt. Late complications include chemical burn to pharyunx, perforation and stricture of upper gastrointestinal tract, respiratory insufficiencyand renal failure caused by hemoglobinuria following hemolysis. Acetic acid is difficult to ingestion large volume in a time because it is a strong irritant, provocating painful pharynx, and its autopsy case is rare. We report an autopsy case of acetic acid intoxication with acute disseminated intravascular coagulation (DIC) in several hours. We present pathogenesis of acetic acid intoxication and the associated forensic problems. A comatous 39-year-old female was admitted to emergency room 6 hours after she swallowed 90 gm of acetic acid. She was treated with gastric lavage but she was expired 9 hours after swallowing acetic acid. She was consulted to Department of Forensic Medicine of Kyungpook National University School of Medicine. She was grossly icteric and livor mortis was generally dark red. External wounds were 10 hemorrhagic lesions with 5 x 3.7cm and 3 x 2.8cm on the left arm and hand dorsum and facial abrasions. Internal gross examination revealed several purpural lesions in the gastric serosal surface and greater omentum. Microscopically, the stomach showed diffuse mucosal coagulation necrosis and intravascular hyalinized or fibrinoid thrombi in submucosal blood vessels. Liver showed necrosis of periportal area (zone I) and intracellular cholestasis around the central vein. Sections from renal tissue frequently show hemoglobin casts in the tubules and RBCs in the Bowman's capsules. Acetic acid of a remnant bottle, sampled blood and bloody necrotic tissues in the stomach were toxicologically examined in National Science Laboratory. The purity of ingested acetic acid is 98%, the concentration of acetic acid ion in blood is 734ppm and the content in gastric juice is 0.09%. In patients after acetic acid ingestion, DIC is most probably caused by procoagulants, produced by extensive acid-induced necrosis of the upper gastrointestinal tract. In this case, several purpural lesions were revealed on the arm, around facial abrasion and intravenous injection sites of the wrists. These are important to differentiate with contusion because she was battered before acetic acid ingestion. Purpurae in DIC are poorly demarcated, dark purple elevations with spreading margin but subcutaneous hemorrhage in contusion is grayish black or dark red with well demarcation (Table 2). But careful examination should be considered because traumatic hemorrhage is also exaggerated and mixed in DIC. (The Korean Journal of Legal Medicine)
Acetic Acid* ; Adult ; Arm ; Autopsy ; Blood Vessels ; Burns, Chemical ; Capsules ; Child ; Cholestasis ; Constriction, Pathologic ; Contusions ; Dacarbazine ; Deglutition ; Disseminated Intravascular Coagulation ; Eating ; Emergency Service, Hospital ; Female ; Forensic Medicine ; Gastric Juice ; Gastric Lavage ; Gyeongsangbuk-do ; Hand ; Hemoglobinuria ; Hemolysis ; Hemorrhage ; Humans ; Hyalin ; Injections, Intravenous ; Liver ; Necrosis ; Omentum ; Pharynx ; Postmortem Changes ; Purpura ; Renal Insufficiency ; Stomach ; Upper Gastrointestinal Tract ; Veins ; Wounds and Injuries ; Wrist

Aged ; Contrast Media ; adverse effects ; Electrocardiography ; Heart Arrest ; therapy ; Humans ; Male ; Myocardial Infarction ; therapy

The major complications of Meckel's diverticulum(MD) are bleeding, intestinal obstruction, infection, umbilical fistula and perforation. Although the relative incidences vary between authors, bleeding is the most common complication in children. The aim of our study is to show the symptomatic guideline for the diagnosis of the bleeding MD. Eight cases with bleeding MD which were operated upon at the department of Pediatric Surgery, Yeungnam University Hospital from April 1985 to April 2001 were reviewed. Half of the patients were under 2 years of age and all patients were male. All patients were preoperatively diagnosed by previous history of intestinal bleeding (melena, hematochezia) and 99mTc pertechnetate MD scan. Segmental resection and end-to-end anastomosis was performed in 6 patients and diverticulectomy in 2 patients. Heterotropic gastric mucosa was found in 6 patients. Postoperative complication was not observed in any cases. In conclusion, in any male children with obscure intestinal bleeding, especially less than 2 years of age, bleeding MD must be suspected. It seems to us that 99mTc pertechnetate MD scan is a useful tool to diagnose bleeding MD.
Child ; Diagnosis* ; Fistula ; Gastric Mucosa ; Hemorrhage* ; Humans ; Incidence ; Intestinal Obstruction ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Sodium Pertechnetate Tc 99m

OBJECTIVE: The purpose of this study was to compare the umbilical artery blood gas analysis and assess the relationship between fetal oxygenation and placenta to birth weight ratios in preeclampsia and small for gestational age. METHODS: We compared the results of umbilical artery blood gas analysis and placenta to birth weight ratio in group of preeclampsia (N=28), group of small for gestational age (N=15), group of large for gestational age (N=15), and controls (N=24). And we also divided all of them into 3 groups by placenta to birth weight ratio at birth, <0.2 (N=25), 0.2-0.25 (N=39) and >0.25 (N=18). We compared umbilical artery gas analysis in each groups. RESULTS: The placenta to birth weight ratio in PE was significantly lower than control group (p<0.05). Umbilical artery pO2 and O2 saturations in each group of preeclampsia and small for gestational age were significantly lower than group of large for gestational age and controls (p<0.05). But we could not find any differences in other umbilical artery blood gas analysis (pH, pCO2, HCO3-). Umbilical artery pO2 and O2 saturations of higher placenta to birth weight ratio were stepwise lower than those of lower placenta to birth weight ratio but, pCO2 of higher placenta to birth weight ratio was stepwise lower than those of lower placenta to birth weight ratio. But there was no significant difference. CONCLUSION: Our data suggested that fetal oxygenation is significant determinant of fetal growth from small for gestational age and preeclampsia. And it may be related to placental implantaton and growth.
Birth Weight* ; Blood Gas Analysis* ; Fetal Development ; Gestational Age* ; Oxygen ; Parturition* ; Placenta* ; Pre-Eclampsia* ; Umbilical Arteries*

Multiple epiphyseal dysplasia (MED) is a clinically and genetically heterogeneous chondroplasia, characterized by delayed development of the ossification centers and, deformities of the extremities that involve only the epiphysis and result in mild short stature. Mutations in the cartilage oligomeric matrix protein (COMP) gene are most commonly found, and most of the mutations are located in the calmodulin-like repeats and the C-terminal domain. We report a Korean kindred of?12 family members with MED in four generations who were found to have a novel mutation in the COMP gene. A pedigree showed early onset osteoarthritis requiring arthroplasty that was an autosomal dominant inherited trait. Radiological examinations demonstrated the presence of osteochondral defects in the medial femoral condyles, and the knee and hip joints showed variable degrees of precocious degenerative changes. Mutation analysis of the COMP gene in the proband and five other affected family members identified a novel missense mutation, c.1280G>C (p.Gly427Ala) in exon 12, which was not found in three unaffected family members. Direct sequencing of the COMP gene may yield pathogenic mutations in dominantly inherited MED cases, and may provide opportunities of carrier detection among high-risk family members, leading to genetic counseling for early diagnosis and intervention before the onset of complications.
Achondroplasia ; Arthroplasty ; Cartilage ; Congenital Abnormalities ; Early Diagnosis ; Epiphyses ; Exons ; Extracellular Matrix Proteins ; Extremities ; Family Characteristics ; Genetic Counseling ; Glycoproteins ; Hip Joint ; Humans ; Knee ; Mutation, Missense ; Osteoarthritis ; Osteochondrodysplasias ; Pedigree

OBJECTIVE: The aim of this study is to assess the correlation of progesterone challenge test (PCT) and endometrial thickness as a primary screening test for endometrial pathology in postmenopausal women prior to hormonal replacement therapy (HRT). METHODS: 92 postmenopausal women were measured serum estradiol (E2) level, endometrial thickness by transvaginal ultrasonography, and followed by PCT before HRT. And we compared the results of PCT with endometrial thickness and E2 levels. RESULTS: Women with a positive result of PCT in 32% of case and 75.9% of positive test showed endometrial thickness 4 mm or more. However 60.3% of negative test showed endometrial thickness 4 mm or more. This resulted in a PPV=76%, NPV=40%, sensitivity=37%, and specificity=78%. Mean serum E2 was significantly higher in patient with positive PCT but serum E2 showed no positive correlation with endometrial thichness (CI 95%, P Biopsy ; Estradiol ; Female ; Humans ; Mass Screening ; Menopause ; Pathology ; Progesterone* ; Ultrasonography

Uterine leiomyomas are the most common benign uterine tumor. They may be subserosal, intramural, or submucosal in location within the uterus or located in the cervix, in the broad ligament, or on a pedicle. But leiomyoma of the round ligament of the uterus is a rare condition occurring predominantly in premenopausal middle-age women, which is usually single and unilateral. In 50% of patients, they are associated with similar lesion of the uterus. Recently we have experienced a case of large cystic myxoid leiomyoma of the round ligament of the uterus misdiagnosed as an ovarian tumor in 32 year-old multiparous woman. We report this case with a brief review of literatures.
Adult ; Broad Ligament ; Cervix Uteri ; Female ; Humans ; Leiomyoma* ; Round Ligament of Uterus* ; Uterus