Tolosa-Hunt syndrome (THS) is a clinical syndrome of painful ophthalmoplegia associated with an idiopathic inflammation in the superior orbital fissure or cavernous sinus. We report a 61-year-old woman with recurrent THS. She had been treated with steroids for the painful ophthalmoplegia. After a symptom-free period, she developed similar symptoms. The postcontrast brain MRI showed increased signal in the cavernous sinus, which was also seen in the previous MRI.
Brain ; Cavernous Sinus ; Female ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Middle Aged ; Ophthalmoplegia ; Orbit ; Steroids ; Tolosa-Hunt Syndrome*

BACKGROUND & AIMS: Management of ovarian carcinoma presents most commonly by surgery and subsequent platinum-based chemotherapy, but most patients will have either residual or recurrent disease. Taxol, a new antimicrotubule agent, has been indicated as a salvage measure after failure of first-line or subsequent chemotherapy. The purpose of this study is to investigate the efficacy and toxicity of Taxol used as a salvage therapy. MATERIALS & METHODS: Between January 1994 and Jun 1996, 19 patients aged 38-64 years(median 52) with ovarian carcinoma were given Taxol-containing regimen. Taxol was administered at a dose of 135mg/m2 intravenously with cisplatin or carboplatin every 3 weeks. The patients who treated with Taxol only were received 175mg/m2 intravenously with same interval. The median treatment cycle was 6.6 cycles(range, 3 to 15 cycles). Patient's response were evaluated with tumor marker(CA-125) and CT or MRI before and after chemotherapy. Responses and toxicities were defined according to the Gynecologic Oncology Group criteria. (continue)
Carboplatin ; Cisplatin ; Drug Therapy* ; Humans ; Magnetic Resonance Imaging ; Ovarian Neoplasms ; Paclitaxel* ; Salvage Therapy*

OBJECTIVE: The importance of surgico-pathologic staging in endometrial cancer to identify risk factors of the therapeutic and prognostic value has been recognized only recently. Recognition of subsets of patients should minimize treatment related morbidity and mortality for those patients with a good prognosis, while identifying patients who are at high risk for recurrence and therefore likely to benefit from adjuvant therapy. METHODS: This rettospective study was based on clinical review of 76 patients with endometrial cancer from 1983 through 1994 who underwent surgical treatment in Department of Obstettics and Gynecology at Seoul National University Hospital. All cases were restaged using the newly adopted FIGO surgical staging. Univariate and multivariate analysis were carried to compare the importance of prognostic variables. RESULTS: Significant prognostic factors in endometrial cancer were histologic subtype, depth of myometrial invasion, cervical invasion, parametrial invasion, adnexa metastasis, lymph node metastasis and peritoneal cytology(p<0.05). Age and histologic grade were not significant prognostic factors(p>0.05). Multivariate analysis showed that surgical stage and depth of myometrial invasion were important factors that predict recurrence(p<0.05). CONCLUSION: This study has yielded important information for therapeutic approach to endometrial cancer.
Endometrial Neoplasms* ; Female ; Gynecology ; Humans ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors ; Seoul

From Jan. 1984 to Dec. 1993, 46 patients with malignant germ cell tumor of ovary were identified in tumor registry of Seoul National University Hospital. The clinicopathologic features of these patients were reviewed. The mean age of patient was 21.6 years (range 1-54), and common presenting symptoms were abdominal mass (19/46), abdominal pain (9/46), abdominal distension (7/46), and epigastric discomfort (2/46) in order. Dysgerminoma was the most common histologic type (19/46, 41.3%), followed by endodermal sinus tumor (13/46, 28.2%), mixed germ cell tumor (6/46, 13/0%), embryonal carcinoma(5/46, 10.8%), immature teratoma(2/46, 4.3%), and chorio- carcinoma (1/46, 2.1%). Among 6 mixed germ cell tumors, dysgerminoma mixed with endodermal sinus tumor component was the most frequent combination. Fifty percent of patients were with FIGO stage I, and 26% with stage III. Overall two year disease free survival was 89.1%. Patients with dysgerminoma showed more favorable 2 year disease free survival (100%) than endodermal sinus tumor or mixed germ cell tumor (84.6%, 66.6% respectively). Patients age, disease stage, histologic type and future child-bearings should be considered in the management of malignant ovarian germ cell tumor. Multicenter prospective randomized studies are needed to identify the more rational treatment strateges of these rare malignant tumors.
Abdominal Pain ; Disease-Free Survival ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Seoul

No abstract available.
Dysgerminoma*

BACKGROUND: The development of androgenetic alopecia is thought to be caused by increased androgen action on the hair follicles in the genetically predisposed person. Although most reports about dehydroepiandrosterone sulfate(DHEA-S) and total testosterone in female androgenetic patients are within normal limits, there are some controversies about comparing the mean values of the patients with those of the normal control group. OBJECTIVE: The purpose of this study was to compare the mean value of plasma DHEA-S and total testosterone of the patients with those of normal controls according to their ages, and evaluate relations between hormone levels and clinical type and hyperandrogenic symptoms(HAS). METHOD: We examined 60 female patients with androgenetic alopecia for clinical types, symptoms, family histories, and other systemic diseases. The mean value of the patients were compared with those of 42 normal controls according to ages, clinical types, and HAS. RESULTS: 1. Forty two cases(70.0%) were Ludwig type I, 16 cases(26.7%) were type II, 2 cases(3.3%) were type III. 26 cases(43.3%) were between 20-29 years, 19 cases(31.7%) were between 30-39 years. 2. Common age of onset was between 20-29years(23 cases, 38.3%) and below 19 years old(21 cases, 35.0%). 3. There were 32 cases(53.3%) who showed HAS and seborrhea was the most common symptom (20 cases). 4. There were 33 cases(55.0%) who showed a family history and the father was the most common relative(19 cases). Family history of first degree relative was 31 cases(51.7%). 5. Plasma DHEA-S levels of both patients and control group were all within normal limits, and there were no significant differences in the mean values between the patients ( 1633.03+/-736.31 ng/ml) and normal controls(1764.72+/-690.94 ng/ml). There were also no difference between the patients and controls according to their ages. 6. In total testosterone, 7 out of 60 patients and 3 out of 42 normal controls were beyond the normal limit and there were no significant differences in the mean values between the patients(0.548+/-0.386 ng/ml) and normal controls(0.563+/-0.501 ng/ml). There were also no differences between the patients and controls according to their ages. 7. There was no significant difference in the mean value of DHEA-S and total testosterone among type I, types II & III, and normal controls. 8. There was no significant difference in the mean value of DHEA-S and total testosterone among patients with HAS, without HAS, and normal controls. CONCLUSION: There were no significant differences in the mean values of plasma DHEA-S and total testosterone between the patients and normal controls and no significant differences in the mean values of hormone levels according to clinical type and HAS.
Age of Onset ; Alopecia* ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Dermatitis, Seborrheic ; Fathers ; Female* ; Hair Follicle ; Humans ; Plasma ; Testosterone*

Air embolism can occur during central venous catheter removal. We encountered a patient diagnosed with cerebral air embolism associated with the removal of an internal jugular venous catheter. The patient was 65 years old and was admitted to the intensive care unit due to pneumonia. He had a catheter placed in the right internal jugular vein. Five days thereafter, the catheter was removed in semi-Fowler's position using the Valsalva maneuver. Immediately after the catheter removal, the patient became pale, felt dyspneic, lost consciousness and exhibited seizure activity. A neurological examination, revealed left upper arm (grade I) and lower leg paralysis (grade II) as well as left facial palsy. A brain computed tomogram showed that, air was trapped in the cavernous sinus. In diffusion weighted magnetic resonance imaging, signal changes were reported in the right frontal cortex, indicating acute cerebral infarction. Hyperbaric oxygen therapy and ventilatory support with synchronized intermittent mandatory ventilation mode was applied. Twenty days thereafter, consciousness and motor functions were recovered completely except for mild weakness of the upper arm (grade IV).
Arm ; Brain ; Catheters ; Cavernous Sinus ; Central Venous Catheters ; Cerebral Infarction ; Consciousness ; Diffusion ; Embolism, Air ; Facial Paralysis ; Humans ; Hyperbaric Oxygenation ; Intensive Care Units ; Intracranial Embolism ; Jugular Veins ; Leg ; Magnetic Resonance Imaging ; Neurologic Examination ; Paralysis ; Pneumonia ; Seizures ; Valsalva Maneuver ; Ventilation

PURPOSE: Primary culture of the cavernous smooth muscle cells from corpus cavernous tissues is known to be difficult, mainly because of contamination with fibroblasts. We applied a new method for better isolation of rat penile smooth muscle cells (RPSMCs) from rat corpus cavernosum tissue for reliable ex vivo research on erectile dysfunction. MATERIALS AND METHODS: With the use of 8-week-old adult male Sprague-Dawley rats, ex vivo migrations of rat cavernous tissue were measured by penis and aortic ring assay by use of a Matrigel-based D-valine-modified culture method. The expression of alpha-smooth muscle actin (alpha-SMA) and platelet/endothelial cell adhesion molecule (PECAM)-1 in the RPSMCs was determined by standard immunofluorescent staining and immunoblotting. The expression patterns of phosphodiesterase (PDE) family mRNA in RPSMCs were compared with patterns in rat aortic smooth muscle cells (RASMCs) by use of quantitative real-time reverse transcription polymerase chain reaction. RESULTS: Immunocytochemical staining showed greater alpha-SMA-positive and PCAM-1-negative fluorescence. Moreover, whereas the expression of alpha-SMA was detected in the RPSMCs, that of PECAM-1 was not. The levels of PDE1A, PDE1B, PDE1C, PDE2A, PDE3A, PDE4A, PDE4B, PDE4C, PDE4D, and PDE5A mRNA in the RPSMCs were about 3.2-, 4.4-, 3.4-, 29.0-, 3.5-, 2.8-, 2.9-, 6.1-, 45.0-, and 6.0-fold the corresponding expression in RASMCs. CONCLUSIONS: We developed a two-stage tissue culture method utilizing a Matrigel-based sprouting culture system to facilitate stromal cell sprouting and an adherent culture system using D-valine to eliminate the contamination of fibroblasts into the smooth muscle cells.
Actins ; Adult ; Animals ; Antigens, CD31 ; Caves ; Cell Adhesion ; Collagen ; Drug Combinations ; Erectile Dysfunction ; Fibroblasts ; Fluorescence ; Humans ; Immunoblotting ; Laminin ; Male ; Muscle, Smooth ; Muscles ; Myocytes, Smooth Muscle ; Penile Erection ; Penis ; Primary Cell Culture ; Proteoglycans ; Rats ; Rats, Sprague-Dawley ; Reverse Transcription ; RNA, Messenger ; Stromal Cells

BACKGROUND: Cerebral white matter change (WMC) is usually seen in stroke patients. This study was aimed at determining whether there might be a relationship between the extent of WMC and whether to control hypertension or not and the frequency of previous stroke lesion. Stroke subtypes were also analyzed to elucidate WMC distribution. METHODS: We investigated demographic features, vascular risk factors, subtypes, and WMC in 339 ischemic stroke patients over forty years of age who had brain MRI from the Hallym Stroke Registry between January 1998 and December 2001. In hypertension, it was divided into with therapy and with no therapy. In frequency of previous stroke lesion, we subdivided the patients into three groups by number of frequency: 0, 1, and >or=2. Stroke subtypes were classified into large artery atherosclerosis (LAA), small artery occlusion (SAO), cardioembolism (CE), and stroke of undetermined etiology (SUE). WMC was quantitatively estimated by subdividing into 5 grades (0~IV). RESULTS: Age, female, hypertension, previous stroke lesion, and SAO correlated significantly with prevalence of WMC (p<0.001, =0.002, <0.001, <0.001 and <0.001, respectively). In hypertension, there was significant difference between normotensive and hypertensive (p=0.001). But there was no statistical difference between with therapy and with no therapy (p>0.05). In previous stroke lesion, it showed significant difference between 0 and (1 and >or=2) (p<0.001) and between 1 and >or=2 (p<0.001). In subtype, CE also correlated significantly with prevalence of WMC as well as SAO than LAA (p<0.001). CONCLUSIONS: WMC seen in patients with stroke is related with small-vessel disease and is mainly affected by age, female, hypertension, and previous stroke lesion.
Arteries ; Atherosclerosis ; Brain ; Female ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Prevalence ; Risk Factors* ; Stroke*

BACKGROUND: Sensitive skin has been described as a skin type showing higher reactivity than normal skin and developing exaggerated reactions when exposed to internal stimulants and external irritants. The lactic acid sting test is widely accepted as a marker of skin sensitivity and employed for the selection of subjects experiencing invisible sensory irritation. OBJECTIVE: To carry out an epidemiological study to assess the prevalence and possible related factors of sensitive skin in a regional population, and to examine the relationship between sensitive skin and subjective irritation using the lactic acid sting test. METHODS: A total of 514 people responded to self-assessment questionnaires composed of questions about the self-perception, related factors, symptoms and signs of sensitive skin. We assessed subjective irritation using the lactic acid sting test in 54 volunteers. RESULTS: The results are summarized as follows: 1. The incidences of self-reported sensitive skin were 55.7% for women, 38.9% for men and 51.0% for all responders. 2. The family history and seasonal variation of sensitive skin were significantly more common in sensitive skin group. 3. The face especially the cheek area was the most sensitive portion of body, cosmetics were common irritants. 4. The lactic acid stinging scores were significantly higher in the sensitive skin group. CONCLUSION: Our survey indicated that sensitive skin is a common problem for people and a complex problem with genetic, individual, environmental implications and the lactic acid sting test is a valuable method to define skin sensitivity.
Bites and Stings* ; Cheek ; Epidemiologic Studies ; Female ; Humans ; Incidence ; Irritants ; Lactic Acid* ; Male ; Patient Selection ; Prevalence ; Seasons ; Self Concept ; Self-Assessment ; Skin* ; Volunteers ; Surveys and Questionnaires