For evaluating the reproductive performances of GTD patients, we found 115 cases of GTD patients, 77 HM and 38 GTT, who became pregnant after the completion of treatments and follow-up period. The results of this study suggest subsequent pregnancies after the completion of treatments may promise normal reproductive outcomes regardless of the chemotherapy.
Drug Therapy ; Follow-Up Studies ; Gestational Trophoblastic Disease* ; Humans ; Pregnancy

PURPOSE: To evaluate the mammographic and clinical findings of nonpalpable breast cancer. MATERIALS AND METHODS: In 28 of 607 breast cancer patients examined between January 1994 and April 1997, lesions werenonpalpable. We retrospectively analyzed the mammographic, clinical and pathologic features of 25 patients (28lesions) whose mammograms we obtained. RESULTS: Among these 25 patients (28 lesions) screening was abnormal in22; other symptoms were bloody nipple discharge(n=4), and nipple eczema(n=2). The patients were 34-62 (mean 52)years old. Invasive ductal carcinoma(n=13), DCIS(ductal carcinoma in situ, n-12), Paget's disease (n=2), andLCIS(lobular carcinoma in situ, n=1) were found during surgery. Six of 28 lesions(21%) showed evidence of axillarynodal metastasis;the majority arose from the upper outer quadrant of the breast (n=21). The mammographic findingswere mass (50%), (and mass with microcalcification, 11%); microcalcification(29%); asymmetrical density(14%); andnormal (7%). According to the mammographic density of breast parenchyma, the major finding in the low densitygroup(N1+P1) was mas (9/9), and in the high density group(P2+DY) was microcalcification (12/19). CONCLUSION: Themost common mammographic findings of nonpable breast cancer were mass (50%) and microcalcification(29%). Itsfeatures varied according to the mammographic density of breast parenchyma;mass was the main finding in the lowdensity group and microcalcification in the high density group.
Breast Neoplasms* ; Breast* ; Carcinoma in Situ ; Humans ; Mass Screening ; Nipples ; Retrospective Studies

PURPOSE: To evaluate the results of peeling of internal limiting membrane (ILM) for the treatment of diabetic macular edema with severe hard exudates. METHOD: We analyzed the records of the patients who had macular edema with severe hard exudates, underwent pars plana vitrectomy combined with indocyanine green (ICG)-assisted ILM peeling, and then were followed more than 4 months postoperatively. RESULTS: In 6 patients, 10 eyes, mean age was 60.2 years and follow-up period was 7.3 months. In all eyes, a attached posterior hyaloid was shown, and hard exudates and macular edema began to decrease within 1 week after operation. Visual acuity was less than 0.1 in 6 eyes before operation, in 3 eyes by the best visual acuity during follow-up period and in 4 eyes on the final examination, and 0.15 or better in 2 eyes, 6 eyes and 5 eyes, respectively. According to the best visual acuity, there was improvement in 8 eyes and no change in 2 eyes, and according to the final visual acuity, improvement in 6 eyes, no change in 3 eyes and deterioration in 1 eye. CONCLUSIONS: ICG-assisted ILM peeling would be helpful for the treatment of diabetic macular edema with severe hard exudates.
Exudates and Transudates* ; Follow-Up Studies ; Humans ; Indocyanine Green ; Macular Edema* ; Membranes* ; Visual Acuity ; Vitrectomy

Ovary is one of the organs in which angiogenesis occurs during ovarian cycle. Angiogenesis is associated with angiogenic factor like acidic fibroblast growth factor, basic fibroblast growth factor and transformation growth factor. Therefore, we performed this study to identify the distribution and mRNA expression of angiogenin, new potential angiogenic factor, in ovary of Korean native cattle by immunohistochemistry and in situ hybridization. Angiogenin immunoreactivity and mRNA expression were observed in endothelial cells, fibroblast and vascular smooth muscle cells. However, we could not observed angiogenin immunoreactivity and mRNA expression in primordial ovarian follicle. In follicular epithelial cells of primary ovarian follicle, weak angiogenin immunoreactivity and mRNA expression were observed. Follicular epithelial cells, theca interna and externa in secondary ovarian follicles, showed angiogenin immunoreactivity, while follicular epithelial cells did the weak mRNA expression. Angiogenin immunoreactivity and mRNA expression were observed in follicular epithlial cells, theca interna and oocyte in tertiary ovarian follicle. The corpus luteum showed strong immunoreactivity and mRNA expression but atretic follicle weak. However, these angiogenin immunoreactivity and mRNA expression became to be weaker during regression. These results suggest that angiogenin may play a role as not only an angiogenic factor but a growth factor in ovary.
Angiogenesis Inducing Agents ; Animals ; Cattle ; Corpus Luteum ; Endothelial Cells ; Epithelial Cells ; Female ; Fibroblast Growth Factor 1 ; Fibroblast Growth Factor 2 ; Fibroblasts ; Immunohistochemistry ; In Situ Hybridization ; Menstrual Cycle ; Muscle, Smooth, Vascular ; Oocytes ; Ovarian Follicle ; Ovary* ; RNA, Messenger* ; Theca Cells

PURPOSE: The cognitive and psychosocial morbidity of medically refractory epilepsy is considerable. Epilepsy surgery can play a important role in these patients. We investigated the clinical manifestations and the surgical outcome of our patients with medically refractory epilepsy. METHODS: We studied 27 patients under 15 years old who had epilepsy surgery at Samsung Medical Center between March 1995 and December 2001 retrospectively. RESULTS: The median age at first unprovoked seizure was 6 years, the median age at surgery was 11.02 years and duration of follow-up was 14 months to 7 years 2 months. Complex partial seizure was the most common type of seizures. Interictal and ictal discharges were lateralized in 66.7% and 81.5%, respectively. MRI showed abnormal findings in 23 patients and the cortical dysplasia was the most common pathologic finding. As per surgical outcomes, 77.8% of the patients became seizure free. Among patients with temporal lobe epilepsy(TLE), seizure free rate was 92.3% whereas patients with extratemporal lobe epilepsy(ETLE) showed 64.3% seizure free rate. All patients with TLE with focal lesions became seizure free. Patients with focal lesions which were concordant with findings of EEG, SPECT, and PET showed excellent surgical outcomes. However, patients with no focal lesion in MRI and discordant preoperative examinations showed poor outcomes. CONCLUSION: The results of epilepsy surgery in our patients were quite satisfactory. Good surgical outcome can be expected when the decision of surgery is made based on a good correlation among clinical, neuroradiological, and other preoperative examinations.
Adolescent ; Child ; Electroencephalography ; Epilepsy* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Retrospective Studies ; Seizures ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon

Essential thrombocythemia, a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets and increased incidence of thrombosis and hemorrhage. Essential thrombocythemia may cause frequent vascular thrombosis, but it can be a rare cause of acute ischemic heart diseases such as acute myocardial infarction without atherosclerosis, unstable angina and angina pectoris. We report a case of essential thrombocythemia complicated by acute myocardial infarction. A patient with a previous history of vascular thrombotic complications (such as transient ischemic attack and deep vein thrombosis) was managed with 2.8 million units of intravenous urokinase, antiplatelet agent, ACEI, antianginal medications and hydroxyurea. There were clinically remarkable improvements and no further episodes of thrombotic ischemic vascular complications, including acute myocardial infarction.
Angina Pectoris ; Angina, Unstable ; Atherosclerosis ; Hemorrhage ; Humans ; Hydroxyurea ; Incidence ; Ischemic Attack, Transient ; Myeloproliferative Disorders ; Myocardial Infarction* ; Myocardial Ischemia ; Thrombocythemia, Essential* ; Thrombocytosis ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins

BACKGROUND AND OBJECTIVES: Studies on the stability of atheromatous plaques, as a determinant of the cause of complications, have been reported. Among the functional features of plaques related with vulnerability, inflammation has emerged as a leading cause of clinical presentation. The purpose of this study was to find the source of the inflammatory response in the patients with acute myocardial infarction (AMI). SUBJECTS AND METHODS: Patients with AMI, whose lesion of in either the left anterior descending artery (LAD group, n=13) or the right coronary artery (RCA group, n=11), were selected. The levels of interleukin-6 (IL-6) and P-selectin were measured in blood from the aortic root (A), great cardiac vein (G) and peripheral vein (V). The control group (n=15) included patients with either stable or variant angina. RESULTS: The levels of IL-6 were 4.77+/-6.0 (A), 11.32+/-7.8 (G) and 4.39+/-5.0 pg/mL (V) in the LAD group, and 3.64+/-2.1 (A), 6.05+/-4.9 (G) and 3.84+/-3.2 pg/mL (V) in the RCA group. Unrelated to the infarction related artery, the level of IL-6 in the great cardiac vein was significantly increased in patients with AMI. The percentages of platelet expressed P-selectin were 6.03+/-7.0 (A), 8.14+/-8.1 (G) and 8.83+/-7.9 (V) in the LAD group and 6.46+/-8.4 (A), 5.80+/-6.0 (G) and 5.91+/-6.9 (V) in the RCA group. CONCLUSION: These findings suggest that the generalized inflammatory response is activated across the coronary vascular bed in patients with AMI, regardless of the infarction related artery site. Therefore, systemic therapy, as well as local management for vulnerable plaque, would be required.
Arteries ; Blood Platelets* ; Coronary Vessels ; Humans ; Infarction ; Inflammation ; Interleukin-6 ; Myocardial Infarction* ; P-Selectin ; Plaque, Atherosclerotic ; Platelet Activation* ; Veins

For the article: Park CG, Ahn JC, Hong SJ, et al. Efficacy of Irbesartan on Left Ventricular Mass and Arterial Stiffness in Hypertensive Patients. Korean J Intern Med 2006;21:103-108. The 6th author's name was misspelled as Sung Mi Park. The correct spelling is Seong Mi Park.

BACKGROUND AND OBJECTIVES: The restoration of infarct-related coronary artery (IRA) patency in acute myocardial infarction (AMI) linked to a significant improvement in survival. Because of microvascular and cellular injury, patent IRA does not always represent successful reperfusion. With progress of myocardial ischemia, standard 12 lead ECG shows evolutional changes of ST-segment, R wave and Q wave. But their relations to myocardial perfusion were uncertain. METHODS: Total 41 patients of the first anterior wall AMI were enrolled and serial ECGs were taken to measure sum of ST-segment elevation (sigma ST), sum of Q wave (sigma Q), sum of R wave (sigma R), and QRS score (QRSs) proposed by Selvester in each patients before thrombolytic therapy (i), after coronary angiography at 90 minutes of thrombolytic therapy (a), and before discharge (d). Myocardial contrast echocardiography was performed within 10 days of AMI to estimate opacification score (OS) and opacification index (OI) in segments of LAD territory. We investigate the relation between evolution of ECG changes and perfusion status of infarcted myocardium. RESULTS: 1) There was no relation between OI and sigma ST, but sigma R and QRSs showed significant relation with OI before discharge (r=0.59, - 0.33, p<0.05, respectively), post thrombolytic therapy (r=0.51, - 0.61, p<0.05), and baseline ECG (r=0.53, - 0.51, p<0.05). 2) The number of segments with OS (0.5) showed no singificant relation to the degree of sigma ST and sigma Q, but number of segments with OS (0) showed singinficant relation to that of sigma R and QRSs (r of sigma Ri, sigma Ra, sigma Rd vs number of segments with OS (0)= - 0.59, - 0.66, - 0.43, p<0.05, QRSi, QRSa, QRSd vs number of segments with OS (0)=0.58, 0.58, 0.57, p<0.05). CONCLUSION: These findings suggest that the ECG changes of R wave and QRS scores could be useful markers of perfusion state in thrombolytic era.
Coronary Angiography ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Humans ; Myocardial Infarction* ; Myocardial Ischemia ; Myocardium ; Perfusion* ; Reperfusion ; Thrombolytic Therapy

BACKGROUND: Increased aortic stiffness measured by pulse wave velocity (PWV) and left ventricular hypertrophy (LVH) are independent risk factors of cardiovascular events in hypertensive patients. We have conducted a prospective study to examine the effects of the angiotensin II receptor antagonist (irbesartan) on PWV and LVH in hypertensive patients. METHODS: A total of 52 untreated hypertensive patients (age:53.3+/-8.0 yrs) were enrolled; they had no evidence of associated cardiovascular complications. Blood pressure, heart rate, aortic PWV and left ventricular mass index (LVMI) by 2-D echocardiography were measured at baseline and after irbesartan treatment (150 mg or 300 mg/day) at 12 weeks and 24 weeks. RESULTS: Blood pressure was significantly decreased after 12 weeks and 24 weeks of treatment compared to baseline (SBP: 134.6+/-13.3 mmHg, 134.0+/-11.0 mmHg vs 163.7+/-13.8 mmHg p<0.001, DBP: 86.0+/-10 mmHg, 83.07 mmHg vs 102.4+/-9.6 mmHg p<0.001, respectively) without significant change in heart rate. LVMI decreased at 12 weeks and at 24 weeks after treatment compared to baseline (from 145.5+/-35.1 g/m2 at baseline to 137.5+/-35.4 g/m2 at 12 weeks, p=0.017 and 135.3+/-35.4 g/m2 at 24 weeks, p=0.008). Aortic PWV was decreased after irbesartan treatment at 12 weeks (from 9.6+/-2.8 m/sec to 8.7+/-3.1 m/sec at 12 weeks, p=0.064) and at 24 weeks (from 9.6+/-2.9 m/sec to 7.7+/-2.1 m/sec at 24 weeks, p=0.007). CONCLUSIONS: Long-term treatment with irbesartan may reduce arterial stiffness and regression of LVH in hypertensive patients. The pleiotropic effects of irbesartan, further decreasing PWV without change of BP between 12 and 24 weeks of treatment, may have favorable vascular effects on arterial stiffness and LVH.
Tetrazoles/*therapeutic use ; Prospective Studies ; Middle Aged ; Male ; Hypertrophy, Left Ventricular/*prevention & control ; Hypertension/*drug therapy/pathology/physiopathology ; Humans ; Female ; Biphenyl Compounds/*therapeutic use ; Aorta/*drug effects/physiopathology ; Angiotensin II Type 1 Receptor Blockers/*therapeutic use ; Aged ; Adult