BACKGROUND: Striatocapsular infarction involves the territory of the large lateral striate branches of the middle cerebral artery sparing the overlying cortex. Two kinds of angiographic findings of the striatocapsular infarction have been reported previously: one with a complete occlusion of the M1 segment and the other without. However, the clinical features and outcomes in relation to the magnetic resonance angiographic (MRA) findings remain unknown. In the present study, we evaluated the clinical outcomes in patients with striatocapsular infarctions according to the MRA findings. METHODS: Twenty-two consecutive patients with striatocapsular infarctions who were admitted to the Chosun University Hospital between July 1998 and June 2000 were included in the study. Striatocapsular infarction was confirmed by magnetic resonance imaging (MRI) and MRA. The patients were divided into two groups based on MRA findings. Ten patients with occluded MCA were included in group A, and the remaining 12 patients with normal or stenotic MCA were categorized as group B. We compared their clinical characteristics and outcomes at 3-months post-stroke. RESULTS: Only 1 out of 12 patients in group B and 6 out of 10 patients in group A showed cortical symptoms and signs. Patients in group A tended to have more severe disability and a worse prognosis than those in group B. CONCLUSIONS: The MRA findings may help clinicians to better predict the clinical outcomes after striatocapsular infarctions. (J Korean Neurol Assoc 19(5):452~456, 2001)
Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Prognosis

Primary progressive aphasia (PPA) is an uncommon neurodegenerative syndrome characterized by a progressive deterioration of language, while nonverbal cognitive and other neurological functions of PPA are relatively preserved for a longer period. However, it still remains unclear whether PPA represents a distinct diagnostic entity or a precursor of global dementia syndrome. We report PPA cases that presented with a slowly progressive language dysfunction without disturbing other daily living activities for several years. Repeated neuropsychological tests revealed progres-sive deterioration of executive aspects of language and mild memory dysfunction, although their receptive language and nonverbal cognitive functions were relatively preserved. The imaging of the brain showed prominent atrophic changes in the left perisylvian and the adjacent temporal region. In considering the mild cognitive decline accompanied by language deterioration, we conclude that in these cases it is clinically heterogenous and may be parts of a spectrum of focal forms of non-Alzeimer type dementia.
Activities of Daily Living ; Aphasia, Primary Progressive* ; Brain ; Dementia ; Memory ; Neuropsychological Tests

OBJECTIVE: To compare the age of menarche, changing patterns of the menstrual characteristics in adolescent girls between 1988 and 1998. METHODS: A survey was undertaken for 1,500 highschool girls and compare with those of pervious study for 5,000 middle and highschool girls performed by same author in 1998 by means of questionnaire. RESULTS: During a decade, the mean menarcheal age decreased from 13.5+/-1.0 to 12.7+/-1.0 years(p=0.001). Gynecologic age, Body mass index were associated with age of menarche in both 1988 and 1998. The interval of menstruation was 30.6 3.5dyas in 1998 and shortened compared with 32.1+/-6.3 days in 1988(p=0.001). The duration of menstruation was lengthened in 1998 than in 1988(6.1+/-1.1 days vs 5.8+/-2.2 days, p=0.001). The incidence of irregular cycle(28.2% vs 58.2%, p=0.001), dysmenorrhea(73.9% vs 77.8%, p=0.001), and secondary amenorrhea(16.2% vs 27.2%, p= 0.001) decreased in 1998 compared with those of 1988. The incidence of agonies about menstruation was also decreased in 1998 than in 1988(26.2% vs 69.1%, p=0.001). The most common agony about menstruation in 1988 was irregular cycle(28.4%), but dysmenorrhea( 64.3%) in 1998. CONCLUSIONS: From the above results, the mean age of menarche was advanced since last decade but most of the adolescent girls still have suffered from dysmenorrhea.
Adolescent* ; Body Mass Index ; Dysmenorrhea ; Female ; Humans ; Incidence ; Menarche ; Menstruation ; Surveys and Questionnaire

BACKGROUND: Carcinoma of the uterine cervix is a theoretically preventable disease because its precursor lesions can be detected by cervical Papanicolau smears and appropriately treated, Although cervical cytology screening programmes have resulted in the redution of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. The focus of criticism has been the false-negative Pap smear, and the false-negative Pap smear is the major quality issue currently facing the physicians. To reduce the false-negative rate of Pap smear, it is essential to improve the accuracy of Pap smear. But false-negative rate of Pap smear has been reported variously. OBJECTIVE: This study was undertaken to evaluate accuracy of Pap smear by study false-negative and false-positive rate of Pap smear and to determine whether false-negative and false-positive rate had any correlations with clinical factors. STUDY DESIGN: The study population was comprised of 346 women, who were undertaken gynecologic operation at the Department of Obstetrics & Gynecology at Hanyang University hospital between March, 1997 and April, 1998. All patients were taken Pap smear before operation. In 93 women of these, preoperative diagnosis were cervical intraepithelial neoplasia and carcinoma in situ of uterine cervix, and in 253 women of these, preoperative diagnosis were benign disease as uterine myoma or adenomyosis, etc. All of their surgical specimen were examined. Pap smear, pathology, medical charts of all patients were reviewed retrospectively, and false-negative rate and false-positive rate were calculated. Clinical factors that associated with false-negative and false-positive rate were evaluated. Fishers exact test and Pearson chi-square test were used of statistical analysis, RESULTS: False-negative rate of Pap smear was 7.2%, false-positive rate was 4.6%, corresponding rate with histology was 88.2%. Sensitivity and specificity of PAP smear were 87.0% and 97.0% respctively. According to gross finding of uterine cervix, erosion was 46.6% in cervical intraepithelial neoplasia, 67.8% in carcinoma in situ, 66.6% in microinvasive carcinoma of uterine cervix and 55.3% of 103 erosion findings was cervical intraepithelial neoplasia, carcinoma in situ or microinvasive carcinoma. 23.1% of cervical lesion were normal gross finding. Menopause was associated with false-negative rate and previous vaginal infection history, previous cervical minor operation, delivery mode, contraception method, pelvic inflammatory disease history, vaginal bleeding at Pap smear and gross finding of cerbix were not associated. There were no clinical factors that were associated with false-positive rate. CONCLUSION: Compared with other reports, false-negative rate(7.2%) and false-positive rate(4.6%) of Pap smear was lower and corresponding rate(88.2%) was higher in Hanyand university hospital. Because of higher false-negative rate in menopausal women, it need more careful to take and interpretate Pap smear in these group.
Adenomyosis ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Contraception ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Leiomyoma ; Mass Screening ; Menopause ; Mortality ; Obstetrics ; Pathology ; Pelvic Inflammatory Disease ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Hemorrhage

OBJECTIVE: Proopiomelanocortin (POMC) gene is involved in various neuroendocrine reproductive activities and its principal areas of expression are hypothalamus and pituitary gland. However, as it is known as low copy gene, detection of its expression by in situ hybridization is challenging. This study was to examine the degree of basal expression of POMC mRNA and anatomic localization of its expression in rat hypothalamus and pituitary gland as a preliminary study for related reproductive endocrine researches. METHODS: Hypothalamus and pituitary gland of ovariectomized female Spraque-Dawley rat (weight: 250-300 g) was obtained by decapitation with preservation of POMC mRNA by cardiac perfusion of 4% paraformaldehyde. Then, coronal sections of hypothalamus and horizontal sections of pituitary gland were made after paraffin embedding. For in situ hybridization, 35S-labeled antisense RNA probe was used and after in situ hybridization reaction and serial washing procedure, detection of its signal was made by emulsion autoradiography of slide and dark field microscopic examination was done for photographic documentation. Anatomic localization of various nucleus of hypothalamus was done by method proposed by Paxinos and Watson1. RESULTS: Strong expression signal of POMC mRNA was detected in the intermediate lobe of pituitary gland. Less strong, but evenly distributed signals were also detected in the anterior lobe of pituitary gland. In hypothalamic sections, entire area of arcuate nucleus from rostral to caudal direction (between bregma -2.80 mm to bregma -4.30 mm area) showed clear and strong signal of POMC mRNA expression. CONCLUSION: Though POMC gene is known as low copy gene, its basal mRNA expression in pituitary gland and hypothalamus in ovariectomized rat were detectable by in situ hybridization technique. As subpopulation of arcuate nucleus are under complex differential regulation, this in situ hybridization model would be helpful for understanding the effects of various regulatory factors on expression of POMC gene in the specific anatomic area of hypothalamus and pituitary gland.
Animals ; Arcuate Nucleus ; Autoradiography ; Decapitation ; Female ; Humans ; Hypothalamus* ; In Situ Hybridization* ; Paraffin Embedding ; Perfusion ; Pituitary Gland* ; Pituitary Gland, Anterior ; Pituitary Gland, Intermediate ; Pro-Opiomelanocortin* ; Rats* ; RNA, Antisense ; RNA, Messenger

Since 1970, the group B streptococcus(GBS) has been a significant cause of neonatal sepsis in the West. Two distinct forms of disease occur in neonates. Early-onset disease which occurs within 7 days after birth is characterized by respiratory distress, apnea, shock, pneumonia, and occasionally meningitis. Late onset disease usually occurs at 3-4 weeks of age(ranging from 7 days to 3 months) and presents occult bacteremia or meningitis. The GBS is thought to be a rare causative agent for neonatal sepsis in Korea. Lately, we experience a case of early-onset GBS sepsis who died at 3rd day of life. We present this case with brief review of literatures.
Apnea ; Bacteremia ; Humans ; Infant, Newborn ; Korea ; Meningitis ; Parturition ; Pneumonia ; Sepsis* ; Shock

No abstract available.
Abortion, Spontaneous* ; Female ; Humans ; Incidence* ; Pregnancy

OBJECTIVE: The purpose of this study is to evaluate the clinicopathologic characteristics of the torsion of the ovarian tumor in postmenopausal women. METHODS: We reviewed the medical records of 20 postmenopausal patients with a postoperative diagnosis of torsion of the ovarian tumor in Department of Obstetrics and Gynecology, Hanyang University Hospital from January 1989 to December 1998. RESULTS: The postmenopausal patients with torsion of the ovarian tumor constitute 20/94 (21.3%) of all adnexal torsion patients encountered during this period. The mean (+/-SD) age of the 20 patients was 63.5+/-9.0 years, with a range of 52-90 years. The mean time since menopause was 16.5+/-10.3 years, with a range of 1-39 years. The mean parity was 5.4+/-2.0 (range of 3-10). Lower abdominal pain (65%) was the most frequently presenting symptom, palpable mass(20%) or diagnosed mass(15%) being the second. But, in 20% of cases there was no lower abdominal pain. The torsion occurred at the right side in 11cases (55%) and at the left side in 9 cases. The most frequent degree of torsion was those cases that was rotated twice (720 degrees). The neoplasms undergoing torsion ranged in diameter between 5cm and 30cm and the most prevalent size was 6 to 10 cm (8 cases). Most of the patients (17cases) were treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy. The tumors that produce torsion varied histologically and the most common type was cystic teratoma (in 5 cases), simple cyst(in 3 cases), serous cystadenoma(in 2 cases), mucinous cystadenoma(in 2 cases). CONCLUSIONS: In our study, ovarian tumor torsion occurring in postmenopausal patients constituted approximately 20% of all torsion patients, therefore adnexal torsion should be considered when a postmenopausal woman presents with lower abdominal pain. When torsion is diagnosed, total abdominal hysterectomy and bilateral salpingo-oophorectomy is the usual treatment for postmenopausal patients. Histologically, in more than 90% of cases, the tumors that produce torsion were benign. If cancer is evident, more extensive surgery is required.
Abdominal Pain ; Diagnosis ; Female ; Gynecology ; Humans ; Hysterectomy ; Medical Records ; Menopause ; Mucins ; Obstetrics ; Parity ; Teratoma

OBJECTIVES: Intrauterine growth restriction(IUGR) accounts for significantiy increased perinatal mortality and neonatal morbidity rates. The Purpose of this study is to investigate the association between some of the risk factors and the incidence of fetal growth restriction. PATIENTS AND METHOD: The retrospective survey of obstetric records of 2188 mothers, who delivered between July, 1995 and June, 1998, was carried out in Hanyang University Kuri Hospital, with the following inclusion criteria: Korean, singleton pregnancy with live birth and a gestational age of more than 32 weeks. RESULTS AND CONCLUSION: 1) The incidence rate for IUGR was 4,7% during the period of 1995 through 1998. 2) 41.2% of IUGR was due to unknown causes, 58.8% of IUGR was due to known. Among known causes the maternal factor was 40.2%, the placenta factor was 14.7%, and the fetal anomaly was 4%. 3) Among maternal factors, pregnancy induced hypertension was the most common cause. 4) The incidence of IUGR was higher in primiparous women and in female babies. 5) The IUGR group showed lower Apgar scores at 1 and 5 minutes than control group,
Female ; Fetal Development ; Fetal Growth Retardation ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Live Birth ; Mothers ; Perinatal Mortality ; Placenta ; Pregnancy ; Retrospective Studies ; Risk Factors

OBJECTIVE: This study was done to assess long-term survival and risk factors for recurrence after neoadjuvant chemotherapy and radical hysterectomy for locally advanced cervical cancer patients. METHODS: Between August 19S3 and May 1990, 80 cervical cancer stage IB-IIB patients with tumor diameter 4cm or more received neoadjuvant VBP chemotherapy and radical hysterectomy. After follow-up more than 10 years for these patients, survival rate and risk factors for recurrence were analyzed. RESULTS: Seventy eight of SO patients were followed for 10 years. During this period, 20,5% patients(16/78) had recurrences and all of them died of recurrence. Five and 10 year survival rates were 82%(64/78) and 79.4%(62/78), respectively. High risk factor for recurrence was pelvic lymph node invasion. However, clinical stage, initial tumor mass size, number of neoadjuvant chemotherapy, clinical response, or residual tumor size were not clinically significant risk factors for recurrence. Initial tumor size was correlated with pelvic lymph node metastasis. In recurrent patients, site of recurrence was not different according to pelvic lymph node status. For node positive patients, combination of chemotherapy and radiation seemed to be more effective in reducing recurrence compared to chemotherapy or radiation only. CONCLUSION: For locally advanced stage IB-IIB cervical cancer patients who received neoadjuvani chemotherapy and radical hysterectomy, pelvic lymph node metastasis was high risk factor for recurrence and initial tumor size was closely correlated with pelvic lymph node invasion even after neoadjuvant chemotherapy.
Drug Therapy* ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Recurrence* ; Risk Factors* ; Survival Rate ; Uterine Cervical Neoplasms*