To assess the effectiveness of Magnetic Resonance Imaging (MRI) with endorectal surface coil in the ataging of carcinoma of the uterine cervix with emphasis on parametrial involvement. Thirty women with clinically and radiographically proven carcinoma of the uterine cervix were initially included for this study, but thirteen patients were excluded since the stages of tumors wore beyond stage IIa. CT and MR findings of the remaining seventeen patients were performed at Cheil General Hospital and compared a1ong with clinical findings with the special emphasis on the parametrial involvement by the tumor. Staging was assessed by CT and MRI, and the results were compared with the pathologic staging. Radiea1 abdominal hysterectomy with the pelvic and paraaortic lymphnode dissection was done to all sewenteen patients. The staging made primarily by CT and MRI was either stsge 1 or Ila, but MR images with endorectal surface coil was superior to CT in the visualization of depth of tumor infiltration, especially parametrial involvement. The determination of the depth of the tumor made by MR images showed statistically significant correlation with histologic evaluation(R =0.768, p<0.01). The accuracy rate for the evaluation of the parametrial invo1vement was 82.3% far CT and 94.1% for MRI with endorectal surface coil. The overall accuracy rate for tumor staging was 70.5% for clinical, 58.8% for CT and 82.3% for MR evaluation. The accurecy rate in evaluation of the pelvic and paraaortic lymphnode was 88.2% for CT, but the evaluation done by MRl was not adequate due to small FOV(field of view). In assessment of The steging of careinoma of the uterine cervlx, MR images with endorectal surface coil was superior to CT, especially in the evaluation of the parametrial involvement.
Cervix Uteri* ; Female ; Hospitals, General ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Neoplasm Staging

A 35 years old female patient was admitted to our neuro-pain clinic with symptoms of low back pain(L4, L5 level) radiated to both lower(L3, L4, L5 level) extremities that developed 6 years prior to admission. Upon initial physical examination, motor weakness or sensory deficit was absent. But on straight leg raising test, it was restricted to 60 degree in both lower extremities. Low back pain and radiating pain improved significantly after we performed epidural steroid injection. However on the next day of procedure the patient complaints more pain and started to experience severe pain during overnight for 3 days. On computer tomography(CT, L3-S1 level), we find suspicious lesion of herniated nucleus pulposus at L5-S1. Otherwise were within normal limits. Based on these symptoms, to find the other lesions, subsequently magnetic resonance imaging(MRI) was performed. Spinal tumor was seen at L2-3 level(2 2 4 cm). Neurosurgical surgery was recommended, and operation was performed. The patient was diagnosed to ependymoma after excision and cytologic studies. Even if one lesion was diagnosed, it must be put off until any other diseases or underlying cancer are ruled out. We report a patient with spinal cord tumor missed on CT, but revealed on MRI in the evaluation and management of herniated nucleus pulposus related(L5-S1) low back pain.
Adult ; Ependymoma ; Extremities ; Female ; Humans ; Leg ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Imaging ; Physical Examination ; Spinal Cord Neoplasms* ; Spinal Cord*

BACKGROUND: It is clinically important to know the distance of upper airway for airway management and respiratory care. The knowledge is useful for avoiding many possible complications due to endotracheal intubation by appropriate choice of endotracheal tube depth. METHODS: We investigated the distance from nose to carina according to the patient,s age, weight, height, sex with computed Tomography in 100 adults who had no anatomical abnormality of the upper airway, neck and head. RESULT: The length between upper incisor and vocal cord was 15.0+/-0.8 cm in male and 13.9+/-0.6 cm in female. The length between vocal cord and carina was 13.2+/-0.8 cm in male and 11.9+/-0.9 cm in female. The length between upper incisor and carina was 28.3 0.9 cm in male and 25.9+/-1.2 cm in female. The length between nose and vocal cord was 17.7+/-0.9 cm in male and 15.9+/-0.8 cm in female. The length between nose and carina was 30.9+/-1.2 cm in male and 27.9+/-1.3 cm in female. The distance of upper airway increased according to patient, s (n=100) height, weight and age(p<0.05). The distance of upper airway not increased according to female patient, s (n=36) age(p>0.05). CONCLUSION: The length between vocal cord and carina, nose and carina, incisor and carina increased according to patient, s (n=100) height, weight and age.
Adult ; Airway Management ; Female ; Head ; Humans ; Incisor ; Intubation, Intratracheal ; Male ; Neck ; Nose ; Vocal Cords

An endodermal sinus tumor is a malignant germ cell tumor that usually arises in the gonads, but on rare occasion occurs in extragonadal locations. Our case was that of a 3 year old girl who complained of a rapid growing orbital mass. On histologic examination it revealed the typical picture of an endodermal sinus tumor and it also disclosed a positive reaction for alphafetoprotein using an immunoperoxidase technique. An orbital exenteration was performed followed by chemotheraphy, but the patient died 5 months after the onset of the disease.

OBJECTIVE: To investigate the difference of gene expressions between leiomyoma and normal myometrial tissue was analzed by DNA Chip. METHODS: cDNAs retro-transcribed from equal quantities of mRNA derived from leiomyoma and corresponding normal myometrial tissue were labeled with Cy5 and Cy3 fluorescein as probes. The mixed probe was hybridized with two pieces of 3,066 double dot from a human dermal papilla cell cDNA library and scanned with a laser scanner. The acquired image was analyzed by ImaGene 3.0 software. Validation of gene expression was performed by reverse transcription-Polymerase chain reaction (RT-PCR) in 5 leiomyomas and corresponding normal myometrial tissues. RESULTS: Among many differentially expressed genes, genes with expression levels more than 3 times were found by comparing leiomyoma with corresponding normal myometrial tissue. One gene with expression levels lesser than 3 times in leiomyoma tissue compared to normal myometrial tissue was also detected. Although alterations of several genes, such as osteoblast specific factor 2, PAI-1 mRNA-binding protein, hydroxyacyl-Coenzyme A dehydrogenase/3-ketoacyl-Coenzyme A thiolase/enoyl-Coenzyme A hydratase alpha subunit (HADHA), p311, DEAD/H (Asp-Glu-Ala-Asp/His) box polypeptide 1 (DDX1), Hexokinase 1, 2 were identified in a significant high fraction of uterine leiomyoma compared to normal myometrial tissue. Cyr61 gene was shown to be markedly down-regulated in leiomyoma compared with the matched uterine myometrial control. I validated differential expression of genes by RT-PCR and demonstrated overexpression of OSF-2, HADHA, p311, DDX1, Hexokinase 1, 2. CONCLUSION: DNA chip techniques are effective in screening differential gene expression between leiomyoma tissue and normal myometrial tissue. These genes may be related to the genesis and development of uterine leiomyoma. Analysis of the human leiomyoma gene expression profile by DNA chip may be helpful gene diagnosis, treatment and prevention of this disease.
Diagnosis ; DNA* ; DNA, Complementary ; Fluorescein ; Gene Expression* ; Gene Library ; Hexokinase ; Humans ; Leiomyoma* ; Mass Screening ; Oligonucleotide Array Sequence Analysis* ; Osteoblasts ; Plasminogen Activator Inhibitor 1 ; RNA, Messenger ; Transcriptome

OBJECTIVE: To investigate the difference of gene expressions between leiomyoma and normal myometrial tissue was analzed by DNA Chip. METHODS: cDNAs retro-transcribed from equal quantities of mRNA derived from leiomyoma and corresponding normal myometrial tissue were labeled with Cy5 and Cy3 fluorescein as probes. The mixed probe was hybridized with two pieces of 3,066 double dot from a human dermal papilla cell cDNA library and scanned with a laser scanner. The acquired image was analyzed by ImaGene 3.0 software. Validation of gene expression was performed by reverse transcription-Polymerase chain reaction (RT-PCR) in 5 leiomyomas and corresponding normal myometrial tissues. RESULTS: Among many differentially expressed genes, genes with expression levels more than 3 times were found by comparing leiomyoma with corresponding normal myometrial tissue. One gene with expression levels lesser than 3 times in leiomyoma tissue compared to normal myometrial tissue was also detected. Although alterations of several genes, such as osteoblast specific factor 2, PAI-1 mRNA-binding protein, hydroxyacyl-Coenzyme A dehydrogenase/3-ketoacyl-Coenzyme A thiolase/enoyl-Coenzyme A hydratase alpha subunit (HADHA), p311, DEAD/H (Asp-Glu-Ala-Asp/His) box polypeptide 1 (DDX1), Hexokinase 1, 2 were identified in a significant high fraction of uterine leiomyoma compared to normal myometrial tissue. Cyr61 gene was shown to be markedly down-regulated in leiomyoma compared with the matched uterine myometrial control. I validated differential expression of genes by RT-PCR and demonstrated overexpression of OSF-2, HADHA, p311, DDX1, Hexokinase 1, 2. CONCLUSION: DNA chip techniques are effective in screening differential gene expression between leiomyoma tissue and normal myometrial tissue. These genes may be related to the genesis and development of uterine leiomyoma. Analysis of the human leiomyoma gene expression profile by DNA chip may be helpful gene diagnosis, treatment and prevention of this disease.
Diagnosis ; DNA* ; DNA, Complementary ; Fluorescein ; Gene Expression* ; Gene Library ; Hexokinase ; Humans ; Leiomyoma* ; Mass Screening ; Oligonucleotide Array Sequence Analysis* ; Osteoblasts ; Plasminogen Activator Inhibitor 1 ; RNA, Messenger ; Transcriptome

Postoperative pain may be associated with shallow breathing, inability to cough, and reduction in spirometric values which lead to restrictive pattern of ventiltion with hypoxemia and/or hypercapnea. Therfore postoperative pain should be maneged by using appropriate methods. To investigate the analgesic effect of interpleural block with 0.25% or 0.375% bupivacaine hydrochloride, 30 patients were randomly divided into one of three groups(saline group, 0.25% bupivacaine group and 0.375% bupivacaine group). In the saline group, 0.9% saline with 1: 200, 000 epinephrine(0.5 ml/kg) was injected into the pleural cavity via the chest drainage tube, either 0.25% or 0.375% bupivacaine with 1: 200,000 epinephrine(0.5 ml/kg) was injected with the same manner of the saline group in the bupivacaine groups, respectively. Respiratory parameters(minute volume, tidal volume, respiratory rate, forced vital capacity, incentive spirometric volume, cough score, deep inspiratory score), numeric pain rating score and hemodynamic changes were measured before anesthetic induction, 10 minutes before the study drug injection, 30 and 60 minutes after the study drug administration, respectively. Postoperative respiratory parameters were decreased at l0 minutes before the drug injection compared to the preanesthetic values in all groups. There were no statistically significant differences of all parameters after the drug administration among three groups. There was a tendency of improvement in the respiratory parameters after the drug injection in saline and 0.25 % bupivacaine groups and a greater tendency of improvement of respiratory parameters and numeric pain rating score in 0.375% bupivacaine group than the other groups. Only one case of tachycardia was developed in the saline group. These results suggest that the postoperative pain after thoracotomy is not appropriately manged by using the interpleural block with 0.25% or 0.375% bupivacaine hydrochloride (0.5 ml/kg) administrated via the drainage tube of the chest.
Anoxia ; Bupivacaine* ; Cough ; Drainage ; Hemodynamics ; Humans ; Motivation ; Pain, Postoperative ; Pleural Cavity ; Respiration ; Respiratory Rate ; Tachycardia ; Thoracotomy* ; Thorax ; Tidal Volume ; Vital Capacity

No abstract available.
Pregnancy*

In removable partial dentures, abutment teeth are essential for support, maintenance, and stability of partial dentures, and are an important factor in the fabrication of functional dentures. If the number of periodontally sound abutments is sufficient and they are located on both sides, it will be easy to manufacture functional dentures with good support, maintenance, and stability. But on the contrary, if the number of teeth is insufficient or if they are located on one side, it is biomechanically disadvantageous and relatively difficult to make functional denture. On the other hand, recently, implant-supported removable dentures, which reinforce the three elements of maintenance, support, and stability by using implant surveyed crown, have been frequently selected as treatment plans.In particular, by adding an implant surveyed crown when only a small number of residual teeth remain, mastication efficiency, esthetics, patient comfort, and pronunciation can be improved. In this case, bilateral posterior extension partial denture was fabricated using implant surveyed crown as abutments by placing implants in the premolars area opposite to the residual tooth unilaterally in the mandible. As a result, the asymmetry of the abutment was resolved, and the maintenance and stability of the denture was achieved.

OBJECTIVES: Among non-pharmaceutical measures for preventing cognitive impairment, involving in social activities is known to be very effective. We tried to examine the correlation between social activity and cognitive function. METHODS: This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. All the subjects completed the study questionnaire which included demographic characteristics, current and past history of illnesses, drug history, Korean version of Mini Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale, and Beck Anxiety Inventory. We checked the time consumed in each 9 social activities through the checklist. RESULTS: On multiple logistic regression analysis, the total time spent in social activities wasinversely associated with the K-MMSE score after adjusting confounding variables like age, sex, education level, depression, anxiety and vascular risk factor (beta=-0.041, p=0.024). On the other hand, correlation was found between K-MMSE score and time spent in participating in religious party (beta=0.053, p=0.003) as well as time spent in elder's university (beta=0.040, p=0.025) after adjustingage, sex, education, depression, anxiety and vascular risk factor. CONCLUSION: Our results suggest that involving in quality social activities might be more effective in improving cognitive function than spending longer total time in any social activity.
Aged ; Anxiety ; Cognition ; Cohort Studies ; Confounding Factors (Epidemiology) ; Depression ; Hand ; Humans ; Logistic Models ; Surveys and Questionnaires ; Risk Factors