OBJECTIVE: The patients of endometriosis may complain of dysmenorrhea, pelvic pain, and dyspareunia, but may be asymptomatic. We studied on the correlation between the pain and the psychologic stress, Also, we studied on the correlation between serum CA-l25 levels and the psychologic stress. METHODS: The data was obtained from il7 endometriosis patients. Psychological stress was studied with STAI(Stait-Trait Anxiety Inventory) and BDI(Beck Depression Inventory). We compared the degree of anxiety and depression according to existence of pain and the duration of pain. Also we examed the scores of STAI and BDI according to the level of serum CA-125. RESULTS: The pain group had more depression and anxiety, in comparison to the pain-free group. And the depression and anxiety significantly increased in long-term pain group. There was no correlation between the level of serum CA-125 and the depression,or axiety. CONCLUSION: The pain of endometriosis may play a role of pychological stress to the patients, so it seems to increase depression and anxiety.
Anxiety ; Depression ; Dysmenorrhea ; Dyspareunia ; Endometriosis* ; Female ; Humans ; Interleukin-7 ; Pelvic Pain ; Stress, Psychological*

Gonadotropin releasing hormone (GnRH) is believed to be pivotal hormone in hypothalamo-pituitary gonadal axis and the hypothalamus is believed as the exclusive organ producing GnRH and pituitary is for GnRH re ceptor until recently. Some reported the exptra-hypothalamic GnRH or extra-pituitary GnRH receptors from decades ago. The aims of this study are to confirm the existence of the GnRH receptor in bladder epithelial cancer cell, HT-1197 and HT-1376, and evaluated the possible role of the GnRH on cell cycle. The GnRH and GnRH receptor were detected by immunohistochemical staining and the effect of GnRH on cell cycle change in both cell line were studied by fluorescence activated cell sorter (FACS). The control cells were cultured at media supplemented with normal serum, and experimental group were cultured at media supplemented with charcoal stripped serum (CSS) which excluding peptide hormones except exogenous GnRH with different concentration. The GnRHs and GnRH receptors were detected at both cell lines and the cell cycle analysis showed that there were little difference in proportion of cell cycle among examined 10,000 cells in both cell lines, neither control nor experimental groups. This study shows that the GnRHs and GnRH receptors exist in bladder cancer cells and GnRH did not influence on the cell cycle progression. With this study, we suppose that the bladder cancer cells produce the GnRH and GnRH receptors and the role of the GnRF produced from the bladder cancer cells might be the autocrine rather than endo-or paracrine factor.
Axis, Cervical Vertebra ; Cell Cycle* ; Cell Line ; Charcoal ; Fluorescence ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Gonads ; Hypothalamus ; Peptide Hormones ; Receptors, LHRH ; Urinary Bladder ; Urinary Bladder Neoplasms

A 54-year-old woman with severe bullous pemphigoid (BP) associated with insulin dependent diabetes mellitus (DM), who showed unresponsiveness to conventional therapy with corticosteroids in combination of either cyclosporme or dapsone, was successfully treated with plasmapheresis followed each time by 3 successive days of pulse therapy of cyclophosphamide (500mg, intravenously). After six times of plasmapheresis, anti-basement membrane zone (BMZ) antibody titer decreased from 1:1280 to 1:40 and no new lesions developed at all. In severe refractory BP patients with uncontrolled DM, plasmapheresis is one of the valuable treatment modalities for a short period and the need for corticosteroids thus avoiding corticosteroid induced side effects. Herein we report a case of BP with uncontrolled DM who showed an excellent response to a low dose of corticosteroid and 150 mg oral azathioprine following plasmapheresis and cyclophosphamide pulse therapy.
Adrenal Cortex Hormones ; Azathioprine ; Cyclophosphamide* ; Dapsone ; Diabetes Mellitus ; Female ; Humans ; Insulin ; Membranes ; Middle Aged ; Pemphigoid, Bullous* ; Plasmapheresis*

Angioma serpiginosum is a rare vascular naevoid disorder due to progressive ectatic dilatation of capillaries in the papillary dermis. We report two cases of angioma serpiginosum. A 24-year-old woman presented with asymptomatic multiple deeply red macules arranged in a serpiginous pattern on the left posterior thigh. In the other case, an 8-year-old girl had asymptomatic red nonpalpable puncta that were grouped closely together in a linear pattern from the left lower abdomen to thigh. On the histopathological examination, both cases commonly showed grouped, dilated, ectatic vessels in the upper dermis. These clinical and histopathological findings were typical of angioma serpiginosum.
Abdomen ; Capillaries ; Child ; Dermis ; Dilatation ; Female ; Hemangioma* ; Humans ; Thigh ; Young Adult

BACKGROUND: The decision to institute mechanical ventilation for patients with COPD is very difficult. The accurate informaiton regarding weaning success and long-term survival will improve communication with patients and family and enhance informed consent. The aims of this study are to describe outcomes and identify variables associated with survival for patients experiencing mechanical ventilation with an acute respiratory failure of COPD. METHODS: The 53 cases of mechanical ventilation in the intensive care unit in the National Medical Center from 1989 to 1998 were included. Data were collected retrospectively from medical records. Weaning success rate and 3 month and 1 year survival rates were estimated. Factors associated with weaning success and survival were determined. RESULTS: Weaning success was 55%. For success group with 29 cases, 3 months survival rate was 61% and 1 year survival rate 37%. APACHE II scores in weaning success group were significantly lower than those in the failure group. Factors such as age, sex, comorbid-illnes, previous steroid use, causes of respiratory failure, RVH or arrhythmia on EKG, serum albumin level, arterial blood pH, PaO2, PaCO2, FEV1, duration of mechanical ventilation and steroid use during mechanical ventilation were not associated with weaning success. Only age and serum albumin level were associated with 3 month and 1 year survival. No COPD patients of age more than 75 years and serum albumin level less than 3g/dl had survived at 1 year after weaning success. CONCLUSION: While seaning success from mechanical ventilation can be predicted by APACHE IIscore in COPD patients, long-term outcomes of survivors may be influenced by nutritional status and age.
APACHE ; Arrhythmias, Cardiac ; Electrocardiography ; Humans ; Hydrogen-Ion Concentration ; Informed Consent ; Intensive Care Units ; Medical Records ; Nutritional Status ; Pulmonary Disease, Chronic Obstructive* ; Respiration, Artificial* ; Respiratory Insufficiency ; Retrospective Studies ; Serum Albumin ; Survival Rate ; Survivors ; Weaning

BACKGROUND: Joint symptoms frequently occur in the course of antituberculous chemotherapy and tend to be ignored and overlooked, but in some cases, they are often very troublesome in obstructing ordinary life. Joint symptoms that develop during antituberculous chemotherapy need to be understood, but there are few materials describing them systematically. METHOD: This study enrolled 33 patients with tuberculosis treated with first line antituberculous agents for more than 6months. In the course of treatment, joint symptoms not associated with specific cause, such as pre-existing joint disease or trauma, were investigated and compared with those of the asymptomatic group, We confirmed the incidence of joint symptoms and factors associated with them. RESULTS: Nineteen of 33 patients (58%) had joint symptoms. Joint symptoms developed 1.9±1.4 months after the beginning of chemotherapy and lasted for 3.6±2.5 months. IN 18 of 19 symptomatic patients, multiple joints were involved : shoulder(10 patients, 53%), knee(10,53%), finger(6,32%). Joint symptoms were expressed as pain(19 patients, 100%), stiffness(7,37%) and/or swelling (3,16%). Fourteen patients (74%) took analgesics to relieve their symptoms and in 2 patients, antituberculous agents were discontinued because of the severity of their symptoms. The symptoms seem to be caused by agents other than pyrazinamide, but it was very difficult to identify the definite causative agent. In age, sex, underlying disease and serum uric acid level, no significant differences were noted between the two groups. CONCLUSIONS: Although joint symptoms are common during antituberculous chemotherapy, their development is difficult to predict. Because some joint symptoms can become very bothersome, the physician should pay close attention to these symptoms.
Analgesics ; Arthralgia ; Drug Therapy* ; Humans ; Incidence ; Joint Diseases ; Joints* ; Pyrazinamide ; Tuberculosis ; Uric Acid

BACKGROUND: Partial unilateral lentiginosis (PUL) is a rare pigmentary disorder characterized by grouped multiple lentigines on otherwise normal skin that histologically have the typical features of lentigo. This entity has been only rarely reported in the Korean population. OBJECTIVE: The purpose of this study was to evaluate clinical and histopathologic characteristics, association with other disorders, and differential diagnosis of PUL. METHODS: We reviewed our experiences of thirteen cases of PUL which had been collected in our dermatology clinic during the 6-year period between 1993 and 1998. RESULTS: Twelve patients were female and one was male. In 3 patients the lesions appeared after the age of 20 years. Ten patients had the lesions on the upper part of the body, the neck being the most common location. No bias was shown in terms of the side of the body affected. Cafe-au-lait macules (one to three) were found in six patients, axillary freckles were observed in two. Histopathologic examination of biopsy specimens commonly showed hyperpigmentation of the basal layer, elongation of rete ridges, and an increased number of melanocytes. There ,was no evidence of associated disorders or family history. CONCLUSION: Based on this data, we confirmed that PUL is a benign, idiopathic lentiginosis with no commonly associated abnormalities. Furthermore, we believed that PUL is not uncommon in Korean people.
Bias (Epidemiology) ; Biopsy ; Dermatology ; Diagnosis, Differential ; Female ; Humans ; Hyperpigmentation ; Lentigo ; Male ; Melanocytes ; Melanosis ; Neck ; Skin

Advances in multimodal treatment using radiation and chemotherapy, more sophicated diagnostic, radiologic methods, and newer reconstructive surgical techniques have led to aggressive surgical treatment of chondrosarcoma of the pelvis. Recently, good results have been reported in even high grade chondrosarcoma of the pelvis with surgery with/without adjuvant therapy. From January 1984 to June 1992, ten patients with chondrosarcoma of the pelvis were treated. Their average age was 40(18 to 55). Location of the lesion were ilium(5), periacetabular lesion(1), ischiopubic region(1) and sacrum(3). Nine cases were conventional type and one was dedifferentiated type. Surgical resection was done for nine patients, with which radical margin in one, wide margin in four, marginal margin in one and intralesional margin in three. Postoperative radiotherapy(6000-7000cGy during 6-7week) was done for five patients of having wide(1), marginal(1) or intralesional(3) surgical margin. One patient took radiotherapy only after biopsy. The average follow-up period was 2 years and 9 months(1 year to 6 years 1 month). Six patients wer continuously disease free(CDF) or disease free(DF). One patient is alive with disease(AWD). Three patients died of disease(DOD). With Kaplan-Meier's method, 5-year actuarial survival rate for total 10 cases was 60%, for operated group(9 cases) 66.7% and for operated conventional group(8 cases) 80%. With wider resection margin, better survival could be achieved.
Biopsy ; Chondrosarcoma ; Combined Modality Therapy ; Drug Therapy ; Follow-Up Studies ; Humans ; Methods ; Pelvis ; Radiotherapy ; Survival Rate

No abstract available.

No abstract available.
Synostosis*