Corneoscleras were stored in 4 degrees C, 98% glycerin and were examined histologically at various storage periods. There were no remarkable pathologic changes in the stainability or arrangement of collagen fibers in stored corneoscleras from one month to 33 months. 12 eyes of 12 patients underwent tectonic or therapeutic keratoplasty with them. The integrity of the globe was maintained in all cases and vision improved in three cases without the second operation. One case achieved visual improvement by optical keratoplasty. In four cases, the vision may be improved by the second operation, such as optical keratoplasty and keratoprosthesis.
Collagen ; Corneal Transplantation ; Glycerol ; Humans

BACKGROUND: This study was undertaken to compare nosocomial infection rates between intensive care units of military and civilian hospitals. METHODS: From July to December 2000, we surveyed the intensive care unit of Armed Forces Capital Hospital (AFCH). We compared device use ratios and device-day infection rates with those of Korean Society for Nosocomial Infection Control (KOSNIC) and National Nosocomial Infections Surveillance (NNIS) system. RESULTS: During the period of study, 185 cases were admitted and 24 nosocomial infections were detected: 7 cases of pneumonia, 6 urinary tract, 3 blood stream, 3 cardiovascular system, 3 surgical site infections, 1 skin and soft tissue, and 1 central nervous system infection. Ventilator, urinary catheter and central venous catheter use ratios were 0.14 (95% confidence interval, 0.12-0.16), 0.58 (0.56-0.60) and 0.33 (0.31-0.35). The ratios of NNIS were 0.41, 0.67 and 0.50. Ventilator-, urinary catheter- and central venous catheter-day infection rates were 18.69(11.36-53.32), 6.65 (3.36-14.20) and 1.95 (1.44-9.92). However, the rates of KOSNIC were 9.93, 5.29 and 3.62. The rates of NNIS were 11.24, 6.14 and 5.55. CONCLUSIONS: In AFCH ventilators were used less frequently than NNIS, but more ventilator-associated pneumonia were developed than KOSNIC and NNIS.
Arm ; Cardiovascular System ; Central Nervous System Infections ; Central Venous Catheters ; Cross Infection* ; Hospitals, Military ; Humans ; Intensive Care Units* ; Critical Care* ; Military Personnel* ; Pneumonia ; Pneumonia, Ventilator-Associated ; Rivers ; Skin ; Urinary Catheters ; Urinary Tract ; Ventilators, Mechanical

IL-10 production by CD19(+)CD5(+) B cells was investigated, by determining the expression levels of CD19, a classical B cell marker. Peripheral mononuclear cells were stained with fluorescence-conjugated anti-CD5, anti-CD19, anti-IL-10, and Annexin V. Interestingly, IL-10-producing B cells were found to be localised within the CD19(low)CD5(+) B cell subset. Apoptotic changes were also observed mainly in CD19(low) cells among B cells. Thus, CD5(+) B cells should be classified as CD19(high) and CD19(low) cells, and the immunological significance of CD19 for the IL-10 production by CD5(+) B cells requires further studies.
Antigens, CD19/metabolism ; Antigens, CD5/metabolism ; Apoptosis/immunology ; B-Lymphocyte Subsets/cytology/*immunology ; Cell Separation ; Flow Cytometry ; Humans ; Interleukin-10/*biosynthesis

No abstract available.
Cell Line* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

This phase II study aimed to assess the clinical activity and toxicity of ifosfamide based regimen in patients with epithelial ovarian cancer, relapsed or refractory to cisplatin-containing combination chemotherapy. From July 1991 to June 1993, 18 patients with epithelial ovarian cancer, relapsed or refractory to cisplatin were treated as follows. Relapsed cases were treated with IP(ifosfamide 4,0g/m2 intravenously and cisplatin 60mg/m2 intravenously on day 1) regimen every 3-4 weeks. The regimen used in refractory cases was Et-I(etoposide 100mg/m2 intravenously on days 1 to 3 and ifosfamide 1.0g/m2 intravenously on days 1 to 5) regimen every 3 or 4 weeks. The uroprotectant mesna was concomitantly used. Responses and toxicities were evaluated according to the WHO Criteria. The overall response rate was 27.8%(5/18), including 2 complete response and 3 partial response. There were four episodes(22.2%) of grade 3, 4 myelosuppression, but no other grade 3, 4 non-hematologic toxicity. Salvage therapy with ifosfamide based regimen is a useful and well tolerated treatment strategy in selected patients with relapsed ovarian cancer.
Cisplatin ; Drug Therapy, Combination ; Humans ; Ifosfamide ; Mesna ; Ovarian Neoplasms* ; Recurrence ; Salvage Therapy

Acute epiglottitis is an inflammation of the epiglottis and adjacent structures. Although the incidence is extremely rare, acute epiglottitis is a life-threatening medical emergency and can cause sudden respiratory obstruction. Herein, we describe two cases of sudden death from epiglottitis and epiglottic abscess. A 39-year-old man and 66-year-old man died after suffering from shortness of breath. Autopsies revealed diffuse swelling and abscess formation in the epiglottis and neighboring structures. These cases emphasize the medicolegal importance of sudden death from acute epiglottitis and epiglottic abscess in adults.
Abscess* ; Adult* ; Aged ; Airway Obstruction ; Autopsy ; Death, Sudden* ; Dyspnea ; Emergencies ; Epiglottis ; Epiglottitis* ; Humans ; Incidence ; Inflammation

Ascending aortic aneurysm of the thorax is a condition characterized by an increase in the diameter of the ascending aorta between the aortic valve and the brachiocephalic artery. Most patients with ascending aortic aneurysm are asymptomatic and do not require treatment; the rates of dissection, rupture, and mortality are also low. In this report, we describe the autopsy findings in a case of sudden death due to acute myocardial infarction secondary to the previously asymptomatic, unruptured, and undissected aortic aneurysm of the thoracic ascending aorta extending to the sinus of Valsalva. The findings in this case emphasize the importance of preventive management of asymptomatic ascending aortic aneurysms, and possible mechanisms of sudden cardiac death in patients with uncomplicated ascending aortic aneurysm is also discussed.

BACKGROUND: Adenocarcinoma arising in the body or tail of the pancreas tends to be metastasized at the time of diagnosis, is mostly in inoperable stage, and poor in prognosis. In this study, we evaluated the adenocarcinoma arising in the body or tail of the pancreas and investigated the prognostic factors and ideal treatment. MATERIAL AND METHODS: We retrospectively analyzed 33 patients who were cytologically or histologically confirmed as adenocarcinoma in the body or tail of the pancreas at Samsung Medical Center from October 1994 to December 1999. RESULTS: The mean age of the patients in the resectable and unresectable groups were 63.4 and 60.6 year-old, respectively. The mean CA19-9 level was higher in unresectable group (5166.2u/ml), compared to the resectable group (964.7u/ml).(p=0.039) In the resectable group, the body was the most common location of the tumor, and in the unresectable patient group, the tail was more prevalent.(p= 0.021) The mean survival time of the resectable group was 15.1months. The univariate analysis of the resectale group showed that the age, sex, lymph node metastasis, chemotheraeutic modalities, radiotherapeutic modalities, and the location of tumor were not significantly related with the prognosis. In unresetable group, the mean survival time was 6.4months. The mean survival time were 3.3 months in patients over 60 year-old and 9.9 months in patients less than 60, showing statistically significant difference.( p=0.007) The mean survival time were 12.2 months and 3.4 months in patients who received the chemotherapy and who did not, respetively.(p=0.004) Evaluating the relationship between the extent of metastasis and survival, the mean survival length of single metastasis was 9.3 months, showing significantly higher survival length compared that of multiple metastasis.(p=0.027) Patient's sex, radiotherapeutic modality and location of the tumor were not significantly related with the prognosis. Multivariate analysis of prognostic factor showed that the patietnt's age (p=0,842), the extent of metastasis( p=0.458), and chemotherapeutic modality (p=0.078) were unrelated with prognosis. CONCLUSION: In adenocarcinoma arising in the body and tail of the pancreas, the CA19-9 level and tumor location could be utilized as indicating factors of the operability of the tumor. Age, sex, lymph node metastasis, and location of the adenocarcinoma are not significantly related with the survival length in both the resectable and unresectable groups. Also, in both groups, the chemotherapeutic and radiotherapeutic modalities were not related with the survival length.
Adenocarcinoma* ; Diagnosis ; Drug Therapy ; Humans ; Lymph Nodes ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Pancreas ; Prognosis* ; Retrospective Studies ; Survival Rate

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

Backgrouad & Aims: Cyclophosphamide, adriamycin and cisplatin(CAP) combination chemo- therapy improved the response rate in the treatment of advanced epithelial ovarian cancer, and it has been the gold standard. However, adriamycin is a rather toxic drug, and there is still confusion concerning the choice of adriamycin to be included in optimal regimen. The present study was designed to compare the activity and toxicity of combination regimens in advanced epithelial ovarian cancer between CAP and CTP which substitutes adriamycin with pirarubicin(THP- adriamycin). PATIENTS AND METHODS: From March 1995 to December 1997, 47 patients with FIGO stage III-IV epithelial ovarian cancer who were diagnosed after initial cytoreductive surgery were divided into two groups at random: (1) The case group were treated with CTP(500/40/50 mg/m2) as a first line chemotherapy. (2) The control group were treated with CAP(500/50/50 mg/m2) as that of case group. Clinical characteristics, response rates and toxicities according to Gynecologic Oncology Group criteria were compared between those treated with CAP and CTP respectively. RESULTS: Forty one patients out of 47 were evaluable and the number of patients in case and control group was 22 and 19 respectively. There was no significant differences in patient characteristics such as age, stage, histologic type between two groups. Clinical complete response rate was 50.0%(11/22) in patients treated with CTP regimen and 47.4%(9/19) with CAP regimen and there was no significant difference between two groups. Second look operation was undergone in 10 patients of CTP group and 7 patients of CAP group who showed clinical complete response and the pathologic complete response rate was 27.3%(6/22) with CTP and 21.1%(4/19) with CAP. The incidence of leukocytopenia of grade 3 or 4 was more frequently occurred in CAP group(52.6%, 10/19) than CTP group(22.7%, 5/22). There was no significant difference in the incidence of other toxicitied such as hepatic, renal and G-I toxicities. Suspicious cardiac toxicity according to the finding of EKG was seen in 15.8%(3/19) only with CAP regimen and all of them showed decreased cardiac function in gated blood pool scan. There were no significant differences in risponse rates between two groups, but the incidence of cardiac toxicity and leukocytopenia o f grade 3 or 4 was more frequently occurred in CAP group than CTP group. CONCLUSION : CTP regimen has comparable response rates to CAP regimen, with lower incidence of hematolohic and cardiac toxicity.
Cyclophosphamide* ; Cytidine Triphosphate ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination* ; Electrocardiography ; Humans ; Incidence ; Leukopenia ; Ovarian Neoplasms*