Uterine torsion is defined as the mtation of more than 45 degrees around the long axis of the uterus or a rotation which is severe enough to produce symptoms. Torsion of the human pregnant uterus is a very rare complication. The diagnosis is problematic and is often made during a cesrean section due to inhibited labor. Torsion of the human pregnant uterus can be caused by myoma or other uterine abnormalities, ovarian cysts, adhesions, abnormal fetal presentations, or fetal abnormalities ( though no cause can be found in about 20% of cases ). Uterine torsion produces symptoms of varying severity depending on the degree of rotation, and duration of the pregnancy. High mortality rates for both mother and infant have been reported. We experienced one case of the torsion of term pregnant uterus and report this case with a brief review of the concerned literature.
Axis, Cervical Vertebra ; Diagnosis ; Female ; Fetus* ; Humans ; Infant ; Mortality ; Mothers ; Myoma ; Ovarian Cysts ; Pregnancy ; Uterus*

OBJECTIVE: A multistep process of gene alterations is required for tumor formation. p53 gene mutation is the most frequent and K-ras gene mutation places second in the gene abnormalities of non-small cell lung cancer (NSCLC). The effect by the mutations of the p53 and ras genes on clinical manifestation is still highly controversial. Little is known about the interaction between them in NSCLC. The present study was designed to investigate the effect by the mutations of the p53 tumor suppressor gene and K-ras oncogene on clinical manifestation, and the interaction between the mutations of two genes in the Korean NSCLC. METHODS: Fifty-eight patients were enrolled in this study who had been diagnosed as having NSCLC from stageI to stage III. They all had been alive for more than one month without any complication after curative resection. The paraffin-embedded lung tissues after resection were used to investigate the p53 expression by immunohistochemical staining, the mutations of the p53 and K-ras genes by polymerase chain reactionsingle strand conformation polymorphism (PCR-SSCP) and nucleotide sequencing. RESULTS: p53 protein was overexpressed in 25.9% by immunohistochemical staining. Overexpression was significantly more frequent in epidermoid carcinoma (p=0.01634). But there was no significant difference between the overexpression group and the negative expression group according to stage and survival. By PCR-SSCP analysis, the mobility shift of the p53 gene was found in 29.1%. There was no significant difference between the groups with and without mobility shift according to cell type, stage and survival. By nucleotide sequencing, p53 gene mutation was 37.9%. The locations of mutation were dispersed among numerous codons and the modes of mutation were also diverse. There was also no significant difference between the groups with and without mutation according to cell type, stage and survival. K-ras gene mutation was 24.1% and only in codon 12 by nucleotide sequencing. Although there was no significant difference between the groups with and without mutation according to cell type or stage, K-ras gene mutation carried a significantly worse prognosis in NSCLC (overall survival p=0.0391, disease-free survival p=0.0318). When the patients were divided into 4 groups according to p53 gene mutation and K-ras gene mutation, there was also no significant difference among any group according to cell type or stage. The prognosis became worse if K-ras gene mutation accompanied (overall survival p=0.0021, disease- free survival p=0.0166). Only the stage (p=0.0313) and K-ras gene mutation (p=0.0457) were significant prognostic factors by Cox regression test. An analysis in stage III showed the significantly shorter survival period in the patients with K-ras gene mutation. K-ras gene mutation, therefore, was confirmed as the independently significant prognostic factor separately from stage. CONCLUSION: p53 gene mutation had no clinical or prognostic significance because of scattered locations and diverse modes of mutation in contrast to K-ras gene mutation, which had a significantly negative effect on the prognosis of NSCLC. p53 and K-ras gene mutations were apparently independent genetic alterations which played different roles in the clinical manifestation and prognosis of NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Codon ; Disease-Free Survival ; Genes, p53 ; Genes, ras* ; Genes, Tumor Suppressor* ; Humans ; Lung ; Prognosis

OBJECTIVE: Clinical Assessment Interview for Negative Symptoms (CAINS) has recently been developed to improve measurement of negative symptoms in schizophrenia. We performed a multi-center study to validate the Korean version of the CAINS (CAINS-K) and explore potential cultural variation. METHODS: One hundred eighty schizophrenia patients diverse in demographic and illness profile were recruited from four centers in Korea. Along with the CAINS-K, the Scale for the Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS), Calgary Depression Scale for Schizophrenia (CDSS), a self-report measure of behavioral inhibition and activation (BIS/BAS) and neurocognitive tasks were administered to verify external validities. RESULTS: The CAINS-K showed high internal-consistency (0.92) and inter-rater reliability (0.77). Exploratory Factor Analysis replicated a two-factor structure of the original scale including motivation/pleasure and expression deficits dimensions. Korean patients tended to report lower pleasure compared to American patients in the prior study. The CAINS-K showed an adequate convergent validity with the SANS, negative symptoms of the BPRS, and BAS. A divergent validity was supported as the CAINS-K showed zero or only weak correlations with other symptoms of the BPRS, depression from the CDSS, and neurocognitive tasks. CONCLUSION: The CAINS-K demonstrated high internal consistency and adequate external validities, and is expected to promote studies on negative symptoms in Korean patients with schizophrenia.
Brief Psychiatric Rating Scale ; Depression ; Humans ; Korea ; Pleasure ; Schizophrenia

Pulmonary hamartoma is uncommon benign tumor-like malformation, which comprises abnormal mixing of the normal components of the lung i.e., cartilage, fat, smooth muscle or respiratory epithelium. The majority occurs in fourth and fifth decades of life, but extremely rare in the pediatric age. Pulmonary hamartoma is clinically classified to endobronchial and intrapulmonary hamartoma. The majority of the pulmonary hamartomas have no clinical symptoms and are detected incidentally by routine chest roentgenograms. But definite diagnosis should be necessary, because of its difficulty to differentiate from malignant and inflammatory lesions. We report a case of intrapulmonary hamartoma which was detected by routine chest roentgenogram check up and diagnosed by fine needle aspiration biopsy and pathological examination with the review of the literature.
Biopsy ; Biopsy, Fine-Needle ; Cartilage ; Child ; Diagnosis ; Hamartoma* ; Humans ; Lung ; Muscle, Smooth ; Respiratory Mucosa ; Thorax

Ocular disturbances related to cranial nerve lesion or increased intracranial pressure are well known in cryptococcal meningitis, but internuclear ophthaloplegia is very rare and only two cases have been reported to our knowledge. We report the third patient of internuclear ophthalmoplegia in cryptococal meningitis. The internuclear ophthalmoplegia in our case persisted for one year with a demonstrable lesion in brain MRI, in contrast to the other cases in which intranuclear ophthalmoplegia was transient and no responsible lesion was observed.
Brain ; Cranial Nerves ; Cryptococcosis* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Cryptococcal ; Ocular Motility Disorders ; Ophthalmoplegia

Previous studies showed that whole body vibration could prevent bone resorption and stimulate new bone formation. The aim of this study is to detect and track effect of whole body vibration for osteoporotic bone of OVX rats. 12 Female rats were used and allocated into 5 group, CON, SHAM, WBV 17, WBV 30 and WBV 45. Rats except SHAM group were ovariectomised to induce osteoporosis. Rats in WBV groups were stimulated whole body vibration at magnitude of 1 mm(peak-peak) and frequency 17 Hz, 30 Hz and 45 Hz, repectively, for 8 weeks (20 min, 5 days/week). The 4th lumbar in rats were scanned at a resolution of 35 micrometer at baseline, before stimulation, and 8 weeks by In-vivo Micro-CT. To detect and track changes of morphological characteristics in lumbar trabecuar bone of rats, structural parameters were measured and calculated from acquiring images. In the results, changes of structural characteristics of WBV group were smaller than those of CON group. Loss of quantity of trabecular bone in WBV 45 was the least. In contrast, that in WBV 17 was the biggest. These results showed that reasonable whole body vibration beneficially affected osteoporotic bones. In addition to, whole body vibration was likely to be substituted partly for drug treatment.
Animals ; Bone Resorption ; Female ; Humans ; Osteogenesis ; Osteoporosis ; Rats* ; Vibration*

Isolated cranial neuropathies involving the facial nerve are very rare manifestations of pontine infarction, and have not been described in paramedian pontine infarction. We report a 67-year-old woman who developed sudden and long-lasting right facial nerve paralysis accompanied by transient ipsilateral abducens nerve palsy. Brain magnetic resonance imaging showed two discrete simultaneous infarctions in the right inferior paramedian pontine area, which seemed to correspond to the facial nerve fascicle and the abducens nerve fascicle, respectively. Paramedian pontine infarction can be one of the causes of facial nerve palsy and present as an isolated or predominant sign.
Abducens Nerve Diseases* ; Abducens Nerve* ; Aged ; Brain ; Cranial Nerve Diseases ; Facial Nerve ; Female ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Paralysis

Benedikt syndrome is characterized by ipsilateral ophthalmoplegia with contralateral hemichorea due to a midbrain lesion. A 67-year-old male with Benedikt syndrome underwent corpectomy at L1 and anterolateral interbody fusion at T12-L2 due to pathologic bursting fracture at L1 involving multiple myeloma. He had a history of traumatic subarachnoid hemorrhage and subdural hemorrhage 8 months before surgery. Magnetic resonance image of the brain revealed intracranial hemorrhage from thalamus to midbrain. Target controlled infusion with propofol and remifentanil were administered for anesthetic induction and maintenance and close hemodynamic and neurologic monitoring led to successful anesthetic management.
Aged ; Anesthesia ; Brain ; Hematoma, Subdural ; Hemodynamics ; Humans ; Intracranial Hemorrhages ; Male ; Mesencephalon ; Multiple Myeloma* ; Ophthalmoplegia ; Propofol ; Spine* ; Subarachnoid Hemorrhage, Traumatic ; Thalamus

Migraine equivalents include cyclic vomiting, acute confusional states, and benign paroxysmal vertigo. Cyclic vomiting is characterized by recurrent, sometimes monthly, boults of severe vomiting that may be so intense dehydration and electrolyte abnormalities occur, particularly in an infact. We experienced a 3-year-old girl who showed manifestations of cyclic vomiting and abdominal pain. We report this case with a review of related literatures.
Abdominal Pain ; Child, Preschool ; Dehydration ; Female ; Humans ; Migraine Disorders* ; Vertigo ; Vomiting