Leiomyosarcoma of small intestine is an uncommon tumor, comprising less than 20 percent of all primary malignant tumors of small intestine. Duodenal leiomyosarcoma is rare disease which amount to about 20 percent of all small bowel malignancy but potentially curable tumors often diagnosed at an advanced age, so its five-year survival following resection approximates 50% in reported series. Recently, several cases of leiomyosarcomas of duodenum were diagnosed by hypotonic duodenograhy in Korea. We experienced a woman with duodenal leiomyosarcoma that was diagnosed by endoscopic duodenal biopsy and received currative resection of the tumor(Whipple's operation). We report the case with review of the literatures.
Biopsy ; Duodenum ; Endoscopy ; Female ; Humans ; Intestine, Small ; Korea ; Leiomyosarcoma* ; Rare Diseases

PURPOSE: To compare standard laparoscopy-assisted Billroth I gastrectomies including standard lymph node dissection (LABIG) with hand-assisted laparoscopic surgery with the HandPort system (HALS) for the removal of early gastric cancers (EGC). METHODS: A prospective study was performed on 26 patients of EGC at Ewha Womans University Mok-Dong Hospital from July 1999 to August 2001. Seventeen patients (Group L) received LABIG using conventional laparoscopy-assisted methods and 9 patients received LABIG using HALS (Group H). We used staplers for the anastomosis, and a standard D2 lymph node dissection was done with ultrasonic shears or electrocautery. RESULTS: In group L, pathologic reports revealed 14 EGC (stage IA 14 cases), and 3 pm cancers (stage IB 1 case, II 2 cases). In group H, there were 9 early gastric cancers (stage IA 8 cases, IB 1 case). Significant differences (P<0.05) were present between group L and H in regards to the number of harvested lymph nodes (30.8 vs 18.9), estimated blood loss (462.1 vs 286.7 ml) and postoperative transfusion amounts (0.59 vs 0 unit). There were no differences in the mean operating time, distance from the lesion to the resection margin, postoperative leukocyte count, frequencies for pain control, wound size, time to diet, weight loss, serum protein, and postoperative hospital stay. Complications were present in 1 case in group L (enterocutaneous fistula) and 1 case in group H (gastric atony). There was one conversion to open surgery in group H. CONCLUSION: LABIG including standard lymph node dissections with both standard laparoscopic surgery and HALS were performed with equal outcome. The choice of surgical method depends on the characteristics of the lesion and the patient's physical factors.
Conversion to Open Surgery ; Diet, Reducing ; Electrocoagulation ; Female ; Gastrectomy* ; Gastroenterostomy* ; Hand-Assisted Laparoscopy* ; Humans ; Laparoscopy ; Length of Stay ; Leukocyte Count ; Lymph Node Excision ; Lymph Nodes ; Prospective Studies* ; Stomach Neoplasms* ; Ultrasonics ; Wounds and Injuries

No abstract available.
Goats* ; Skeleton*

No abstract available.
Goats* ; Mesencephalon* ; Periaqueductal Gray* ; Somatostatin*

Severely worn dentition causes various complications such as loss of tooth structure, discoloration, pulp complications and loss of function and aesthetics. In this case, the patient showed particularly severe attrition in the anterior teeth and lack of space for restoration. The amount of vertical dimension was determined based on the diagnostic wax up, and the patient’s adaptation was evaluated by using a removable occlusal splint for 6 weeks. Thereafter, the coordination of the muscular nervous system, aesthetics, temporomandibular joint were re-evaluated for 3 months by restoring the fixed provisional restoration. Through the above treatment process, the final restoration was completed with full mouth fixed prosthesis using monolithic zirconia, and functionally and aesthetically stable results were obtained.

Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

According to the functional matrix theory, Delaire proposes that individual occlusal plane was determined by variable effects of teeth, maxilla, mandible, cranium, cranial base and soft tissue matrix including the orofacial musculature. and that there is the ideal occlusal plane determined by the most proper spatial position of maxilla and mandible, functionally and esthetically. This study was designed to find out the relation between Delaire's ideal occlusal plane and muscle activity of masticatory muscles in individuals who have normal maxillo-mandibular relationships. Lateral cephalometric radiographs were taken and his/her individual occlusal plane and ideal occlusal plane were analyzed with Delaire's architectural and structural craniofacial analytic method. For evaluation of muscle activities of masticatory muscles, electromyography of anterior temporal muscle, superficial masseter muscle, and anterior belly of digastric muscle was recorded in fifty Korean normal Angle class I occlusion individuals. According to the average value of ideal occlusal plane, fifty normal Angle class I occlusion individuals were classified into three groups: Ideal occlusal plane group(I group), hyperrotation group(I+ group) and hyporotation group(I-group). The result of this study was as follows: 1. The results of Delaire's architectural and structural craniofacial analysis of lateral cephalography of the fifty Korean normal Angle class I occlusion individuals are that twelve persons(24%) have consistent or parallel with ideal occlusal plane and the average of angular difference was 1.22 degrees +/-3.69 degrees. 2. There is no significant difference in muscle activities of masticatory muscles during resting(p<0.05), but significant increases of muscle activity of ipsilateral anterior temporal and masseter muscle, contralateral anterior belly of digastric muscle during unilateral chewing and of anterior temporal and masseter muscle during bilateral clenching(p<0.05). 3. To find out the effect of the angular difference between Delaire's ideal occlusal plane and real occlusal plane to muscle activity, muscle activities of masticatory muscles were compared with three groups in each other; I group, I+ group and I-group. The results were no significant differences during resting, unilateral chewing and bilateral clenching.(p>0.05) 4. Although there is no significant differences of masticatory muscle activities among the three groups, the fact that increasing tendency of masseter muscle activity of ideal occlusal plane group(I+) than those of any other groups(I+ and I-) during bilateral clenching was noted. There is only the implication that occlusal plane makes some effects on masticatory muscle activities, espacially that of masseter muscle during bilateral clenching. In conclusion, the hypothesis that occlusal plane is one of the factors which affect the muscle activities of masticatory muscles and that anyone whose occlusal plane consistent with Delaire's ideal occlusal plane has an extraordinary functional advantage in masticatory muscle function cannot be proven with electromyography methods.
Dental Occlusion* ; Electromyography ; Malocclusion, Angle Class I* ; Mandible ; Masseter Muscle ; Mastication ; Masticatory Muscles* ; Maxilla ; Skull ; Skull Base ; Temporal Muscle ; Tooth

No abstract available.
Coal* ; Mortality* ; Pneumoconiosis*

In male reproducible health, fertility and IVF (in-vitro fertilization), semen analysis has been most important. Semen analysis can be divided into concentration, motional and morphological analysis of sperm. The existing method which was developed earlier to analyze semen concentrated on the sperm motility analysis. To provide more useful and precise solutions for clinical problems such as infertility, semen analysis must include sperm morphological analysis. But the traditional tools for semen analysis are subjective, imprecise, inaccurate, difficult to standardize, and difficult to reproduce. Therefore, with the help of development of microcomputers and image processing techniques, we developed a new sperm morphology analyzer to overcome these problems. In this study the agreement on percent normal morphology was studied between different observers and a computerized sperm morphology analyzer on a slide-by-slide basis using strict criteria. Slides from 30 different patients from the SNUH andrology laboratory were selected randomly. Microscopic fields and sperm cells were chosen randomly and percent normal morphology was recorded. The ability of sperm morphology analyzer to repeat the same reading for normal and abnormal cells was studied. The results showed that there was no significant bias between two experienced observers. The limits of agreement were 4.1%~-3.8%. The Pearson correlation coefficient between readers was 0.79. Between the manual and sperm morphology analyzer, the same findings were reported. In this experiments the slides were stained by two different methods, PAP and Diff-Quik staining methods. The limits of agreement were 7.2%~-5.7% and 6.0%~-6.3%, respectively. The Pearson correlation coefficients ware 0.76 and 0.91, respectively. The limits of agreement was tighter below 20% normal forms. In the experiments of repeatability, 52 cells stained by PAP and Diff-Quik staining methods were analyzed three times in succession. Estimating pairwise agreement, the kappa statistic for the pairs were 0.76, 0.81, 0.86, and 0.75, 0.88, 0.88 respectively. In this study it was shown that there was good agreement between manual and computerized assessment of normal and abnormal cells. The repeatability and agreement per slide of computerized sperm morphology analyzer was excellent. The computer's ability to classify normal morphology per slide is promising. Based on results obtained, this system can be of clinical value both in andrology laboratories and IVF units.
Andrology ; Bias (Epidemiology) ; Fertility ; Humans ; Infertility ; Male ; Microcomputers ; Semen ; Semen Analysis ; Sperm Motility ; Spermatozoa*

PURPOSE: To evaluate the correlation between nuclear density measured using the Pentacam(R) (Oculus Optikgerate GmbH, Wetzlar, Germany) Scheimpflug imaging system and phacoemulsification parameters. METHODS: The nuclear density was measured using maximal nuclear density with ImageJ, Pentacam(R) nucleus staging (PNS), average value and maximal value in lens densitometry. Intraoperatively, effective phaco time (EPT) and balanced salt solution (BSS) used were noted and compared with the nuclear density calculation methods. As an index of corneal endothelial cells, the changes in cell density (CD) were compared with the nuclear density. RESULTS: Regarding EPT, maximal nuclear density with ImageJ (r = 0.379, p < 0.01) and PNS (r = 0.367, p < 0.01) were correlated positively, but the other methods were not correlated. Concerning BSS used, maximal nuclear density with ImageJ (r = 0.279, p = 0.03) and PNS (r = 0.286, p = 0.04) were positively correlated, but the other methods were not correlated. The specular microscopy showed that as the nuclear density increased, the postoperative CD tended to decrease, but without statistical significance. CONCLUSIONS: Preoperative nuclear density measurements using maximal nuclear density with ImageJ or PNS were correlated with phacoemulsification parameters.
Cell Count ; Densitometry ; Endothelial Cells ; Microscopy ; Phacoemulsification*