We report CT and MR findings in tow cases of primary malignant melanoma of the vagina, one arising from cervicovaginal junction mimicking squamous cell carcinoma of the cervix and the other one recurring at vagina after resection. Two cases of malignant melanoma had high-attenuation on CT and high signal intensity on T1-weighted MR images and enhanced well after gadopentetate dimeglumine administration.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Gadolinium DTPA ; Melanoma* ; Vagina*

We report CT and MR findings in tow cases of primary malignant melanoma of the vagina, one arising from cervicovaginal junction mimicking squamous cell carcinoma of the cervix and the other one recurring at vagina after resection. Two cases of malignant melanoma had high-attenuation on CT and high signal intensity on T1-weighted MR images and enhanced well after gadopentetate dimeglumine administration.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Gadolinium DTPA ; Melanoma* ; Vagina*

No abstract available.
Carcinoma, Endometrioid*

Retroperitoneal tumors are relatively rare, accounting for 0.2% of all cancers; many different histologic types are present, and primitive retroperitoneal germ cell tumors constitute a small miniority of about 3%. Most primary extragonadal germ cell tumors (EGCTs) arise from the mediastinum of retroperitoneum in young males. The authors experienced a case of primary extragonadal mixed germ cell tumor with a 43-year-old woman complaining left lower abdominal pain. With the case report, a brief review was made.
Abdominal Pain ; Adult ; Female ; Germ Cells* ; Humans ; Male ; Mediastinum ; Neoplasms, Germ Cell and Embryonal*

Macrophage colony-stimulating factor (M-CSF) is known as one of the factors essential for osteoclast development. In the present study, we examined effects of M-CSF on the apoptotic pathway of osteoclast precursors and their underlying molecular mechanisms. Osteoclast precursors underwent apoptosis in the absence of M-CSF, even in the presence of receptor activator of NF-kB ligand (RANKL). Active caspase-3 and -9 were detected in the osteoclast precursors and treatments of precursors with their specific inhibitors (Z- DEVD-FMK and Z-LEHD-FMK) decreased the apoptosis. M-CSF decreased apoptosis in a dose-dependent manner with decreasing in active caspases-3 and -9 levels and up-regulating Bcl-XL. Those effects of M-CSF on inhibiting apoptosis of osteoclasts precursor by regulating anti-apoptotic signals was more effective when combined with RANKL. These results demonstrate that M-CSF acts as a survival factor for the osteoclast precursors. Furthermore, it is believed that the apoptosis of osteoclast precursors may be involved in the activation of caspase-9 and that M-CSF may promote their survival through Bcl-XL-induced inhibition of caspase-9 activation.
Animals ; Apoptosis/drug effects/physiology ; Carrier Proteins/pharmacology ; Caspases/antagonists & inhibitors/drug effects/metabolism ; Cell Survival/drug effects ; Cells, Cultured ; Cysteine Proteinase Inhibitors/pharmacology ; Enzyme Activation/drug effects ; Female ; Macrophage Colony-Stimulating Factor/*pharmacology ; Membrane Glycoproteins/pharmacology ; Mice ; Mice, Inbred ICR ; Oligopeptides/pharmacology ; Osteoclasts/*cytology/drug effects ; Proto-Oncogene Proteins c-bcl-2/drug effects/*metabolism ; Stem Cells/cytology/*drug effects ; Up-Regulation

OBJECTIVES: The purpose of this study is to evaluate effects of patients' age, amenorrhea duration, motivation, purpose, regimen, side effects on compliance to hormone replacement therapy(HRT) Methods: Compliance to HRT was assessed in 258 postmenopausal women who began HRT in the Menopause Clinic of Hangang Sacred Heart Hospital, Hallym university. One hundred sixty nine women who had intact uterus received continuous combined therapy with 0.625 mg of conjugated equine estrogen (CEE) and 100 mg of micronized progesterone. Eighty nine women who were hysterectomized received only 0.625 mg of CEE. RESULTS: A total of 103 women (39.9%) reported that they continued HRT at least for one year. Continuation of HRT was significantly more common among women who started HRT becuase of recommendation by gynecologist after hysterectomy in our department (p< 0.05). A greater percentage of women who received only CEE without uterus continued HRT than women who received continuous combined therapy (p< 0.05). Duration of amenorrhea, reasons for taking HRT and side effects such as irregular bleeding or breast tenderness were not related to the continuation of HRT. CONCLUSION: Education of menopausal women about the benefit/risk and side effects of HRT may be critical in improving compliance.
Amenorrhea ; Breast ; Compliance* ; Education ; Estrogens ; Female ; Heart ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Menopause ; Motivation ; Progesterone ; Uterus

We performed a retrospective study of 12,307 patients who visited the emergency room of St. Paul's Hospital, secondary medical center, from January 1 to December 31,1996. The results were as follows : 1. Of 12,307 total patients, male to female ratio was 1.16:1 but after 7th decade, there were more female than male. And 3rd decade was the peak age group. 2. The majority o(patients visited our emergency room from noon to midnight (65% of total patients). 3. On average,33.7 patients visited our emergency room per day. Most patients visited on Sundays and other holidays(average 43.3 per day). 4. By monthly distribution, the patients Increased slightly during May, June, July, August and September. 5. Disease to injury ratio was 2.6:1. In disease, male to female ratio was 1 :1 and in injury, the male prominence had a the ratio 1.8:1 In 2nd decade, disease to injury ratio was higher (1.4:1) than that of other decade. And there were mostly disease patients in the group under 1 year old (19.2: 1). 6. Of 12,307 total patients,5,458 patients received only Intern's treatment (44.3%). In 3rd decade, the ratio of Intern's treatment was higher (54.4%). 7, The patients were categorized as follows, Infernal medicine 28.1%, Pediatrics 18.2fo, Orthopedic surgery 13.2%, Plastic surgery 7.4% etc. 8. Averaged admission rate was 25.3% and the rate of general surgery was the highest (49.5%). The rate of admission to intensive care unit (ICU) was 5.5% of total visiting patients and 21.8% of total admission patients. 9. The total patients transferred from other hospitals were 1152 (9.4%), 3.16 per day. The majority used non-emergency vehicles and only 8.5% of patients used the rescue service or ambulances. 10. The average transit time spent in the emergency room was 182 minutes. The longest was 246 minutes in March and the shortest 127 minutes in January.
Ambulances ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Intensive Care Units ; Male ; Orthopedics ; Pediatrics ; Retrospective Studies ; Surgery, Plastic

The frequency of stab wounds is gradually increasing and patients with stab wounds visit the hospital through the emergency room. Management options for patients with stab wound include mandatory exploration and selective observation, but recently many authors have emphasized the importance of selective conservation with development of diagnostic procedure and controversy still exists concerning the management of patients with stab wounds. We retrospectively analysed the clinical data of 78 patients with stab wounds who visited the emergency room of St. Paul's Hospital over 5 years from January 1 1992 to December 31 1996. The following results were obtained. 1) The most prevalent age group were the twenties & the thirties(58.9% of patient) and then most patients were of young age. The male to female ratio was 2.9: 1. 2) Most injuries occurred at night between 8p.m. and 4a.m.(61.5%) and during September injuries were most frequent. 3) The most common causes of stab wound were fighting(55.1%) followed by suicide (21.8%), then accidents including traffic accidents(16.7%) and robbery(6.4%). 4) The instruments most commonly used were knives(53.8%) and broken glass(28.2%). 5) Half of patients were drunk from alcohol and in 3 cases from an antipsychotic drug. 6) In 11 cases(14.1%), there were multiple wound sites and in 8 cases(10.3%) superficial wounds into subcutaneous fatty tissue. 7) According to stab wound sites, the extremities were wounded in 36 cases(46.2%), chest in 21 cases(26.9%), abdomen in 15 cases(19.2%) and neck in 7 cases(9.0%). 8) Emergency explorations were performed in 43 cases(55.1%) under general or regional anesthesia, which included neck in 4 cases(9.3%), chest in 3 cases(7.0%), abdomen in 11 cases(25.6%) and extremity in 25 cases(58.1%). In exploratory laparotomy, negative exploration rate was 18.2%. 9) Death occurred in 2 cases(2.6%). One died due to sepsis with multiple colon perforation and the other due to hypovolemic shock with Superior Vena Cava injury.
Abdomen ; Adipose Tissue ; Anesthesia, Conduction ; Colon ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Humans ; Laparotomy ; Male ; Multiple Trauma ; Neck ; Retrospective Studies ; Sepsis ; Shock ; Suicide ; Thorax ; Vena Cava, Superior ; Wounds and Injuries ; Wounds, Stab*

PURPOSE: The most important prognostic factors in gastric cancer are depth of invasion and lymph node metastasis. Therefore, the prognosis for serosa and lymph node negative gastric cancer is favorable. However, there is no general agreement on the prognostic factors in this subset of patients. This study was undertaken to evaluate the prognostic significances of venous invasion (VI), lymphatic invasion (LI), and perineural invasion (NI) in T1 and T2 gastric cancer without lymph node involvement. MATENRIALS AND METHODS: We retrospectively evaluated 206 patients with T1 and T2, lymph node negative gastric cancer who underwent a curative resection from 1989 to 1993 at Kangnam St. Mary's Hospital, Seoul, Korea. The Chi-square test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and the Cox regression method was used to evaluate independent prognostic significance. RESULTS: The rate of VI, LI and NI correlated well with the depth of tumor invasion. The rates of VI (+) for T1 vs T2 was 0% vs 5.1%, of LI (+) was 5.6% vs 26.8%, and of NI (+) was 1.6% vs 26.8% in NI (+). There were 13 recurrent cases, 10 cases out of the 13 were T2 gastric cancers, and the recurrence rate was higher in LI (+) andNI (+) cases than in LI (-) and NI (-) cases. The 5-year survival rates were 93.4% in LI (-) cases, 77.4% in LI (+) cases, 92.5% in NI (-) cases, 74% in NI(+) cases, 95.9% in LI (-) NI (-) cases, and 73.9% in LI (+) NI (+) cases. Multivariate analysis demonstrated that simultaneous LI and NI was the only significant factor influencing the prognosis. CONCLUSION: These results suggest that simultaneous lymphatic and perineural invasion may be an independent prognostic factor in patients with T1 and T2 gastric cancer without lymph node metastasis.
Humans ; Korea ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Serous Membrane ; Stomach Neoplasms* ; Survival Rate

To determine the difference of the results induced by preoperative dialysis, we analyzed the medical records of the patients who had undergone pars plana vitrectomy (PPV) for the treatment of proliferative diabetic retinopathy (PDR). Of 65 patients (74 eyes) in total, there was the functional success (FS: final visual acuity> or =0.04) in 58 (78.4%), visual improvement of 2 lines or more (VI) in 55 (74.3%), central visual efficiency of 20% or more (VE) in 42 (56.8%), and anatomical success (AS) in 62 eyes (83.8%). The dialysis group with 16 patients(19 eyes) showed FS in 12 (63.2%), VI in 11 (57.9%), VE in 10 (52.6%), and AS in 14 eyes (73.7%). The non-dialysis group with 49 patients (55 eyes) showed FS in 46 (83.6%), VI in 44 (80.0%), VE in 32 (58.2%) and AS in 48 eyes (87.0%). There was more or less difference between the dialysis and non-dialysis group in AS, VI, VE and AS, but it was not significant on the statistics. Accordingly, there may not be significant effect of dialysis on the result of PPV for the treatment of PDR.
Diabetic Retinopathy ; Dialysis* ; Humans ; Medical Records ; Vitrectomy*