Polycystic ovary syndrome is characterized by symptoms of oligomenorrhea, amenorrhea, infertility, hirsutism and obesity. It is known that the women with such diseases would have higher risks to coronary heart diseases, hypertension, DM and endometrial cancer later on, Known risk factors of endometrial cancer are nullipara, late menopause, obesity, DM, unopposed estrogen, tamoxifen treatment, and atypical endometrial hyperplasia ect. 75% of endometrial cancer occurs in age over 50 and 4% of endometrial cancer occurs in age under 40. Particulary endometrial cancer concurrent polycystic ovary syndrome occurs usually in people under age 40 and is commonly well differentiated cell type and is related to good prognosis. We experienced a case of endometrial cancer with polycystic ovary syndrome, who was early dignosed, presented with infertility and got an operation in our hospital, and report this case with a brief review of literature.
Amenorrhea ; Coronary Disease ; Endometrial Hyperplasia ; Endometrial Neoplasms* ; Estrogens ; Female ; Hirsutism ; Humans ; Hypertension ; Infertility ; Menopause ; Obesity ; Oligomenorrhea ; Polycystic Ovary Syndrome* ; Prognosis ; Risk Factors ; Tamoxifen

PURPOSE: To evaluate the levels of vascular endothelial growth factor (VEGF) in the vitreous of patients with proliferative diabetic retinopathy (PDR) and to find any correlation between clinical and fundus findings, grade of PDR, post-operative complications and surgical outcomes. METHODS: Using ELISA, the vitreous concentration of VEGF was measured in 74 patients with PDR who had undergone vitrectomy and in 13 control patients. RESULTS: The pre-operative levels of VEGFin the vitreous of the PDR patients was significantly increased compared with those of the control and with the post-operative levels. The pre-operative VEGF concentration in the vitreous of the PDR patients was correlated with the duration of diabetes and the severity of proteinuria, but not with the type of diabetes, level of HbA1c, hypertension and BUN/creatinine levels. The severity of PDR was also correlated with pre-operative VEGF levels, especially in NVD, NVE and NVI, but was not correlated with vitreous hemorrhage and fibrous proliferation elsewhere. There was negative correlation with the severity of retinal detachments. The vitreous levels of VEGF in PDR were significantly lower in those who had received previous laser photocoagulation than in those who did not. The VEGF levels were also significantly elevated in patients who developed NVI or NVG in the post-operative period. The changes of visual acuity after vitrectomy in the PDR patients were not correlated with vitreous levels of VEGF. CONCLUSIONS: These results show that VEGF is related to intraocular angiogenesis, progression of PDR and post-operative complications such as NVI or NVG, and that panretinal photocoagulation could prevent the progression of PDR.
Diabetic Retinopathy* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypertension ; Light Coagulation ; Proteinuria ; Retinal Detachment ; Vascular Endothelial Growth Factor A* ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Suicidal smothering is distinctly uncommon, especially when caused by winding strips of adhesive tape around the head to cover the nose and mouth. The authors report a very unusual case in which the deceased, a 43-year-old woman, was found with gray adhesive tape wrapped 8 times around the head and strictly obstructed nose and mouse and 2 times around neck. Clear distinction between the homicidal and suicidal smothering by means of multiple loops of adhesive tape is often impossible on the basis of the anatomical findings alone. An accurate evaluation of circumstances, a thorough post-mortem examination, inspection of the scene are extremely important in such cases. We reports a case of suicidal smothering by means of multiple loops of adhesive tape with brief review of literature.
Adhesives* ; Adult ; Animals ; Autopsy ; Female ; Head ; Humans ; Mice ; Mouth ; Neck ; Nose ; Suicide ; Wind

Oriental hump nose is characterized by mild degree of the hump, broad dorsum, low nasal height and drooping tip. Therefore, conservative humpectomy followed by either tip-plasty or augmentation rhinoplasty yields more satisfactory results than classical Joseph's nasal hump reduction. However, the degree of the hump as well as the length of the nose can be affected by the height of the nasal root. That is, if the nasal root is too low, the hump nose may stand out and the nose will seem longer than the actual measurements. We think that it is important to consider the height of the nasal root in the course of the nasal hump reduction. During the last 2 year periods, we have classified twenty eight patients with hump nose into three groups, low(group A: 7 patients), moderate(group B: six patients) and high(group C: fifteen patients), based on the nasal root height. Each group went through different operative procedures according to their nasal root height and favorable results were obtained.
Humans ; Nose ; Rhinoplasty ; Surgical Procedures, Operative

PURPOSE: To evaluate the visual and anatomical outcomes for neovascular age-related macular degeneration with submacular hemorrhage after intravitreal injections of tenecteplase (TNK), anti-vascular endothelial growth factor (VEGF) and expansile gas. METHODS: This study was a retrospective clinical case series following 25 eyes of 25 patients. All patients received a triple injection using 0.05 mL TNK (50 µg), 0.05 mL anti-VEGF and 0.3 mL of perfluoropropane gas. Retreatment with anti-VEGF was performed as needed. Preoperative and postoperative best-corrected visual acuity and central retinal thickness were analyzed. RESULTS: The mean logarithm of the minimum angle of resolution of best-corrected visual acuity improved significantly from 1.09 ± 0.77 at baseline to 0.52 ± 0.60 at 12 months (p < 0.001). The mean central retinal thickness also improved significantly from 545 ± 156 at baseline to 266 ± 107 at 12 months (p < 0.001). A visual improvement of 0.3 logarithm of the minimum angle of resolution unit or more was achieved in 15 eyes (60%). During the 12 postoperative months, an average of 4.04 intravitreal anti-VEGF injections was applied. CONCLUSIONS: A triple injection of TNK, anti-VEGF, and a gas appears to be safe and effective for the treatment of submacular hemorrhage secondary to neovascular age-related macular degeneration.
Acute Disease ; Aged ; Aged, 80 and over ; Female ; Fibrinolytic Agents/administration & dosage ; Fluorescein Angiography ; Fluorocarbons/*administration & dosage ; Follow-Up Studies ; Fundus Oculi ; Humans ; Intravitreal Injections ; Macula Lutea/*diagnostic imaging ; Male ; Middle Aged ; Retinal Hemorrhage/diagnosis/*drug therapy ; Retrospective Studies ; Tissue Plasminogen Activator/*administration & dosage ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity

PURPOSE: Acute dysbarism is a potentially lethal injury associated with environmental medicine. Therefore, prompt treatment, including transportation of victims, is important for the best prognosis. The aim of this study was to examine transportation routes of patients with acute dysbarism for the best prognosis in Korea. METHODS: Geography of South Korea was analyzed using the geographic information system (GIS). The study examined two scenarios using transportation analysis, which relies on a GIS base and pressure variation during air and ground transportation. Given the practical assumptions, we propose some heuristic transportation routes based on the simulation of altitude, transportation time, and availability of related factors. RESULTS: Currently, transportation by ground to the treatment facilities always passes high altitude areas above 152 feet. Also, available helicopters for air transportation could not approach the treatment facilities due to the limitation of flying distance and insufficiency of medical staff and treatment equipment. Altitude variation and delayed time were identified during the period of transportation by ground from Ganneung or Incheon to Tongyoung. Heuristic algorism through the above facts recommends air transport along coasts as the best method for transportation from Ganneung or Incheon to Tongyoung. CONCLUSION: In Korea, transportation by ground was not expected to result in the best prognosis for patients with acute dysbarism. Transportation by air should be considered first as the method of transportation. Also, for the best treatment of patients with acute dysbarism, additional treatment facilities need to be established in the west coast region.
Aircraft ; Altitude ; Decompression Sickness ; Diptera ; Environmental Medicine ; Foot ; Geographic Information Systems ; Geography ; Geography, Medical ; Humans ; Incheon ; Korea ; Medical Staff ; Prognosis* ; Transportation of Patients ; Transportation*

The incidence of duodenal diverticulum found incidentally during upper gastrointestinal roentgenographicexamination varies between 2% and 5%. The majority of cases occur along the medial aspect of the second portion of the duodenum, within 2.5cm of the ampulla of Vater. The majority of duodenal diverticula are asymptomatic, but insome cases, complications such as diverticulitis, hemorrhage, perforation, and fistula formation occur in thethird and fourth portions of the duodenum. We describe a case of giant diverticulum of the transverse duodenum,revealed by UGI and angiography, massive gastrointestinal bleeding in a 80-year-old patient.
Aged, 80 and over ; Ampulla of Vater ; Angiography ; Diverticulitis ; Diverticulum* ; Duodenum* ; Fistula ; Hemorrhage* ; Humans ; Incidence

PURPOSE: To assess the usefulness of Gd-DTPA MRI in the evaluation of the characteristics of intracranial meningiomas and in the correlation with their histopathologic pattern. MATERIALS AND METHODS: We retrospectively analyzed the Gd-DTPA MRI findings in 22 cases of histologicalty-proven intracranial meningiomas. The images were assessed for signal intensity, internal texture, peritumoral edema, and enhancement characteristics. Computed tomograms were obtained in 18 cases and compared with MRI findings. RESULTS: Tl-weighted images were not particularly useful for discriminating pathologic subtype, but signal intensity on T2-weighted images were relatively well correlated with histopathologic findings. A heterogeneous texture produced by tumor vascularity, calcification, cystic foci, hemorrhagic necrosis, or psammoma body was relatively well shown on Gd-DTPA Tl-weighted image compared with that on T1- or T2-weighted image. Gd-DTPA Tl-weighted images revealed a dural tail sign in 19 cases(83%). Angioblastic type was slightly hypointense on Tl-weighted image and markedly hyperintense on T2-weighted image. Psammomatous type and firboblastic type were isointense on both T1- and T2-weighted image. Fibroblastic type was more densely enhanced than the other. The transitional, atypical, and papillary types showed tendency of heterogeneous enhancement. CONCLUSION: Gd-DTPA MRI was a useful imaging modality in evaluation of the characteristics of meningiomas and correlated well with the pathologic patterns.
Edema ; Fibroblasts ; Gadolinium DTPA* ; Magnetic Resonance Imaging* ; Meningioma ; Necrosis ; Retrospective Studies

PURPOSE: The purpose of this study was to compare the linear sintering behavior of presintered zirconia blocks of various densities. The mechanical properties of the resulting sintered zirconia blocks were then analyzed. MATERIAL AND METHODS: Three experimental groups of dental zirconia blocks, with a different presintering density each, were designed in the present study. Kavo Everest(R) ZS blanks (Kavo, Biberach, Germany) were used as a control group. The experimental group blocks were fabricated from commercial yttria-stabilized tetragonal zirconia powder (KZ-3YF (SD) Type A, KCM. Corporation, Nagoya, Japan). The biaxial flexural strengths, microhardnesses, and microstructures of the sintered blocks were then investigated. The linear sintering shrinkages of blocks were calculated and compared. RESULTS: Despite their different presintered densities, the sintered blocks of the control and experimental groups showed similar mechanical properties. However, the sintered block had different linear sintering shrinkage rate depending on the density of the presintered block. As the density of the presintered block increased, the linear sintering shrinkage decreased. In the experimental blocks, the three sectioned pieces of each block showed the different linear shrinkage depending on the area. The tops of the experimental blocks showed the lowest linear sintering shrinkage, whereas the bottoms of the experimental blocks showed the highest linear sintering shrinkage. CONCLUSION: Within the limitations of this study, the density difference of the presintered zirconia block did not affect the mechanical properties of the sintered zirconia block, but affected the linear sintering shrinkage of the zirconia block.
Cyclic N-Oxides ; Zirconium

BACKGROUND: Almost every study of rib fractures in the elderly show associated injuries resulting in admission to thoracic or cardiovascular surgery. In Korea, no studies have compared these elderly patients with younger patients. METHODS: This study is based on patients who were diagnosed as having rib fracture at the Emergency Department of the Seoul Medical Center from March 2013 to April 2011. The medical records and radiological examinations of 192 cases were reviewed. Two groups were created-older than 65 years and younger than 64 years. Comparisons were made between the two groups including place of injury, time of injury, associated injuries, and the final result in the Emergency Department. RESULTS: The final patient sample size was 192. The elderly group had 142 patients with the average age being 48.77+/-9.70 years and 75.4% males. The young group had 50 patients with the average age at 75.90+/-7.21 years and 25% males. The most common place of injury was road (p=0.007) in the young group and home (p=0.002) in the elderly group. The most common mechanisms of injury were slipping (47.4%), traffic accidents (18.2%), falling (14.1%), and assault (9.4%). Falling was more prevalent in the young group than in the elderly group (p=0.011). Rib fractures occurred at night (p<0.001), on Saturdays, on Sundays, and in the winter in the young group and in the morning(p=0.002), on Mondays, on Fridays, and in the winter in the elderly group. Associated injuries, in descending order, were chest, limb, head, and spine. CONCLUSION: This study found that several selected factors of an injury-place, mechanism, time, and associated injuries, differ by age.
Accidents, Traffic ; Aged ; Emergency Service, Hospital* ; Extremities ; Head ; Humans ; Korea ; Male ; Medical Records ; Rib Fractures* ; Sample Size ; Seoul ; Spine ; Thorax