Ovarian leiomyoma is a rare form of the ovarian mesenchymal neoplasm and about 50 cases have been reported in the literature. It is believed that many cases may go unnoticed because they are usually small in size and frequently mistaken for the more common fibroma or fibrothecoma. Its origin is still controversial and many possibilities are considered including the smooth muscle in the blood vessel wall of the hilum or the multipotential ovarian stromal cell. Herein we describe two cases of ovarian leiomyoma with its characteristic histologic finding.
Blood Vessels ; Female ; Fibroma ; Leiomyoma* ; Muscle, Smooth ; Ovary* ; Stromal Cells

No abstract available.
Pregnancy* ; Pyelonephritis*

In 2008, Korea has enacted new ordinances about the role of estheticians, but this law can be interpreted ambiguously, restricting hiring of estheticians in medical clinics. The purpose of the study is to obtain information about medical-esthetic systems in other countries. We have taken a survey of this object from 30 OECD & Asian countries, and the questionnaires returned from a total of 22 countries (Australia, Austria, Canada, Denmark, Finland, France, Germany, Hungary, Japan, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Spain, Switzerland, Turkey, United Kingdom, United States, Singapore, Israel, and Thailand), were used for the final analysis. The results are summarized as follows. In most countries, estheticians working independently deal with only healthy, normal skin. In most countries, estheticians working independently have no right to operate any medical instruments. In all 17 countries that returned the questionnaires medical clinics can employ estheticians, and only theses estheticians who belong to the medical clinics can handle the non-invasive medical instruments under the supervision of doctors. In 17 countries that have related legal regulations, nurses, under the control of doctors, can perform wider range of duties in various settings than estheticians. The survey concludes that the duties of estheticians are closely related with medical skin care services and estheticians can perform various non-invasive medical procedures only under the control of doctors. From consulting a variety of medical-esthetic systems in other countries, we propose that the estheticians be allowed to work in medical clinics to provide better medical services for the patients and to make more chances of employment for themselves.
Asian Continental Ancestry Group ; Austria ; Canada ; Denmark ; Employment ; Finland ; France ; Germany ; Great Britain ; Humans ; Hungary ; Israel ; Japan ; Jurisprudence ; Korea ; Netherlands ; New Zealand ; Norway ; Organization and Administration ; Portugal ; Questionnaires ; Singapore ; Skin ; Skin Care ; Slovakia ; Social Control, Formal ; Spain ; Switzerland ; Turkey ; United States

OBJECTIVE: This retrospective study presents our experience with respect to the clinical and angiographic outcomes of patients treated with stent-assisted coil embolization using Solitaire(TM) AB stents. MATERIALS AND METHODS: From March 2011 to December 2014, 50 patients with 55 wide-necked and/or complex intracranial aneurysms were evaluated. Four patients presented with an acute subarachnoid hemorrhage. Stent deployment was performed with a standard coiling procedure in 49 aneurysms. Three patients underwent bailout stenting, 2 patients were treated by temporary stenting and one patient was treated only by stenting without coiling for dissecting aneurysm. RESULTS: Successful placement of the Solitaire AB stent was achieved in all the cases. Based on the postprocedural angiographic results, a Raymond 1 was obtained in 32 (59%) of 54 aneurysms, excluded by one case of dissecting aneurysm, and a Raymond 2 in 13 (24%), and a Raymond 3 in 9 (17%). There was one thromboembolic (2%) and three hemorrhagic complications (6%). However, procedure-related morbidity or mortality was not found. Annual follow-up angiographic results from the embolization were obtained in 40 (74.1%) of 54 cases. These results were represented as Raymond 1 in 27 (67.5%), class 2 in 9 (22.5%), and class 3 in 4 (10%) cases. Angiographic improvement associated with progressive thrombosis of the aneurysm was obtained in 10 aneurysms. Four aneurysms were recanalized without requiring additional treatment. In-stent stenosis was found in one aneurysm, but stent migration was not seen on follow-up angiography. CONCLUSION: Stent-assisted coil embolization using the Solitaire AB stent for treating wide-necked and/or complex intracranial aneurysms was found to be safe and effective immediately post-embolization and after follow-up. Long-term follow-up will be required to identify the effect of the Solitaire AB stent on recanalization rates.
Aneurysm ; Aneurysm, Dissecting ; Angiography ; Constriction, Pathologic ; Embolization, Therapeutic* ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Mortality ; Retrospective Studies ; Stents ; Subarachnoid Hemorrhage ; Thrombosis

Malignant mixed miillerian tumor (MMMT) was one of the rare uterine sarcoma. This tumor is composed of sarcoma and carcinoma. Primary MMMT in the peritoneum is among the rarest sites for MMMT. MMMT is highly malignant and the prognosis is grave due to frequent recurrence and metastasis. In the world literature, only 22 cases with primary MMMT of the peritoneum have been reported and most of these were single report. We report one case of primary MMMT in the peritoneum with a brief review.
Neoplasm Metastasis ; Peritoneum* ; Prognosis ; Recurrence ; Sarcoma

Microsatellites are short nucleotide repeat sequences present throughout the human genome. Alterations of microsatellites, comprising extra or missing copies of these se quences, have been termed microsatellite instability(MSI, genetic instability, replication errors, RER(+) phenotype). To date, at least four genes involved in DNA mismatch repair, hMSH2, hMLH1, hPMS1 and hPMS2, are thought to account for the observation of microsatellite instability in tumor from Hereditary nonpolyposis colorectal cancer (HNPCC) patients. The genetic defect responsible for the MIN+ phenotype in sporadic colorectal cancer, however, has yet to be clearly delineated. The purpose of this study was to determine the presence of MSI in sporadic cancer and to correlate its occurrence with clinicopathological parameters, we have studied six microsatellite loci by use of polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. We found that 20%(9 of 46 cases) sporadic colorectal cancers showed RER at two or several loci(RER+). Microsatellite instability was associated with location of the tumor in the proximal colon 66%(6 of 9 cases) and with poorly differentiated tumor phenotype 56%(5 of 9 cases). In order to better understand the role of somatic alterations within hMSH2 in the process of colorectal tumorigenesis, we examined the most conserved regions(codon 598~789) of this gene in nine patients with MIN spotadic colorectal cancer. 6 patient of RER(+) colorectal ca. patients had a polymorphism which was a T to C base change in the intron sequence at -6 position of the splice acceptor site at the 5'end of exon 13. This particular sequence variation is a polymorphism rather than a mutation which increase cancer susceptability. These data suggest that the genetic instability is detect ed in some colorectal cancers and play an important role in the pathogenesis of sporadic colorectal cancer.
Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Electrophoresis, Polyacrylamide Gel ; Exons ; Genome, Human ; Humans ; Introns ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Polymerase Chain Reaction ; RNA Splice Sites

BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

Multiple sclerosis (MS) is a diagnosis of exclusion and the lesions or objective findings should disseminate in space and time to diagnose MS. The diagnostic criteria of MS have continuously evolved overtime. The McDonald criteria were originally proposed in 2001, and the revised 2010 McDonald criteria have been used widely. Scientific advances in the past 7 years since 2010 induced the revised 2017 McDonald criteria. All revisions relied entirely on the available evidences, and not expert opinion. In this review, we will provide an overview of the way to diagnose MS and the 2017 McDonald criteria.
Diagnosis ; Expert Testimony ; Multiple Sclerosis

Objective : The breast-feeding rate has decreased in Korea despite of the active encouraging effort of breast-feeding for the last 10 years. So we investigated the factors that are related to breast-feeding failure. METHOD: 1807 specific questionares of mothers who visited the six university hospitals in Seoul from October 1993 to December 1995 were analysed by ANOVA and multiple logistic regression using SAS program. RESULTS: 1) Exclusive breast-feeding rate for the first 6 months was 20.0%. The factors of breast feeding success were antenatal plan for breast-feeding, the first successful breast-feeding and breast-feeding in the hospital after delivery (P<0.01). 2) The duration of breast-feeding was 5.2+/-4.4 months. It was significantly longer in the first successful breast-feeding (P<0.01). The earlier the first breast-feeding, the longer the breast-feeding duration (P<0.01). 3) The breast feeding rate for the first feeding after delivery was significantly higher in normal delivery (46.5%) and the rooming-in (57.4%) than in Cesarean section (37.1%) and the nursery (39.1%) (P<0.01). 4) The first time of breast-feeding was 64.8+/-62.8 hours after delivery and was significantly earlier in the local clinic, normal delivery and rooming-in than in the hospital, Cesarian section and the nursery (P<0.01). The first breast-feeding was successful in 46.9% and was significantly higher in antenatal education (P<0.01). 5) The reasons for the breast-feeding failure within postnatal one month were the insufficient milk (37.1%), the physician' s recommendation (18.8%), the inverted nipple (12.1%), the baby's poor suckling power (10.5%) and thin breast-milk (7.0%). The reasons to switch the successful breast-feeding to formula-feeding before 6 months of age were the return to work (25.1%), the convenience of formula-feeding (17.4%), the excellency of formula (10.0%) and maternal conveniency (6.2%). 6) The reasons to consider the breast milk insufficient were too frequent feeding with crying (38.7%) and poor sleeping with irritability (19.0%). The reasons to consider the breast milk thin were the loose stool (51.1%) and watery nature of breast milk (48.9%). The effort to increase the breask milk was present in 68.2%. The most frequent effort was to increase the maternal intake (67.6%) instead of the frequent baby' s suckling (25.6%). 7) Persons who recommended to stop breast feeding were family members 62.7%, pediatricians 25.5%, obstetricians 10.7%, nurses 1.1%. The maternal diseases to stop breast feeding by physician such as mastitis (11.1%), hepatitis B (4.9%) and tuberculosis (2.5%) were relatively appropriate. But the baby' s diseases such as jaundice (29.9%), loose stool (22.2%) and vomiting (2.8%) were inappropriate. CONCLUSIONS: To increase the breast-feeding rate, we recommend the antenatal plan for breast-feeding, the early breast-feeding as soon as possible and the exclusive breast-feeding in the hospital after delivery. The mothers should make an effort to increase the breast milk by frequent suckling. The physicians should be better prepared to assist the breast-feeding mothers and monitor continuously to resume even after the temporary hold of breast-feeding.
Breast Feeding ; Cesarean Section ; Crying ; Female ; Hepatitis B ; Hospitals, University ; Humans ; Jaundice ; Korea ; Logistic Models ; Mastitis ; Milk ; Milk, Human ; Mothers ; Nipples ; Nurseries ; Pregnancy ; Prenatal Education ; Return to Work ; Seoul ; Tuberculosis ; Vomiting

OBJECTIVE: To determne whether abnormal results of doble saeening tests for Down syndrome with MSAFP and free B-hCG are associated with adverse pregnancy outcome. METHODS: Between October 1994 and September 1997, 205 among 1731 who were screened had increased risk for Down screening program of CIS biointernational, Fetuses with Chromosomal abnormality or congenital anomalies and less than 35 years of maternal age were excluded from this study. Down syndrome screening test was performed between 14-22 weeks of gestation. RESULTS: Of 1731 women, 205 (13.4%) had increased Down syndrome risk. The pregnancy outcome of women with increased Down syndrome risk were compared with those of women without such risk There were no significant difference in the incidence of preterm labor (6[2.9%] vs 112[7.3%)), premature rupture of the membranes (2[0.9%] vs 56[3.6%]), pregnancy induced hypertension (2[0.9%] vs 36[2.3%]), abruptio placentae (0[0%] vs 2[0.1%]), low birth weight (2[0.9%] vs 21[1.3%]), oligohydramnios (4[1.9%] vs 10[0.6%]), intrauterine fetal death (0[0%] vs 2[0.1%]). CONCLUSION: False positive results of Down syndrome screening test in the 2nd trimester do not appear to be associated with adverse pregnancy outcome. But there are statistically significant increases of adverse pregnancy outcome in wemen with elevation of MSAFP or elevation of free B-hCG.
Abruptio Placentae ; Chromosome Aberrations ; Down Syndrome ; Female ; Fetal Death ; Fetus ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Mass Screening* ; Maternal Age ; Membranes ; Obstetric Labor, Premature ; Oligohydramnios ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture