Primary sclerosing cholangitis is a chronic disease of unknown cause, characterized by inflammation and fibrosis of the biliary tree with diffuse multifocal stricture formation. With increasing knowledge of primary sclerosing cholangitis, it is now recognized that in the setting of inflammatory bowel disease, cholangiocarcinoma is a complication of primary sclerosing cholangitis. We recently experienced a case of 41 year old female patient who had Crohns disease associated with primary sclerosing cholangitis and cholangioearcinoma. We report a case of primary sclerosing cholangitis with cholangiocarcinoma with literature review.
Adult ; Biliary Tract* ; Cholangiocarcinoma* ; Cholangitis, Sclerosing* ; Chronic Disease ; Constriction, Pathologic ; Crohn Disease ; Female ; Fibrosis ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Pancreas*

Diabetic neuropathy is an axonal degenerative disease characterized by progressive axonal atrophy and reduced axonal transport. We were interested in the potential neuroprotective effects of nerve growth factor against diabetic neuropathies. To this aim we studied the effect of nerve growth factor on satellite cells, which might play a trophic role toward the related neuron, of the dorsal root ganglion in the streptozotocin-induced diabetic rats by electron in microscope . Diabetes was induced in rats by the streptozotocin. And recombinant human NGF was administrated everyday for 10 consecutive weeks. The results obtained are as follows : 1.In the diabetic induced group, the satellite cells revealed irregular nuclei.The neuron-satellite cell interface was more irregular and plicated than that of control. Large vacuoles and dense bodies were observed and no defects were in the ribosomes and rough endoplasmic reticulum. In the vacuoles, medium electron dense, fiber -like materials were occasionally observed. 2. In the experimental group of diabetic rats treated with NGF for 10 weeks, nucleus was round and the neuron-satellite interface was more regular. Vacuoles and dense bodies were less seen than diabetic rats. In the cytoplasm, many microtubules were observed. In these studies, we considered that streptozotocin induces changes of the satellite cell structure and NGF might improve cellular changes of the satellite cell exposed with streptozotocin.
Animals ; Atrophy ; Axonal Transport ; Axons ; Cytoplasm ; Diabetic Neuropathies ; Endoplasmic Reticulum, Rough ; Ganglia* ; Ganglia, Spinal ; Humans ; Microtubules ; Nerve Growth Factor* ; Neurons ; Neuroprotective Agents ; Rats* ; Ribosomes ; Streptozocin ; Vacuoles

Carcinoma of the fallopian tube accounts for less than 1% of all cancers of the female genital tract. The histology and behavior of fallopian tube cancer are simillar to ovarian cancer; thus evaluation and treatment are also essentially the same. Unlike ovarian cancer, fallopian tube cancer begins in a hollow viscus, and early lesions may be less likely to be associated with extensive intraperitoneal carcinoma. Two postmenopausal women presented with a pelvic mass. Pathologic examination of the resected specimens revealed primary adenocarcinoma of the fallopian tube. We have experienced two cases of fallopian tube cancer and reported with brief review of literature
Adenocarcinoma ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Humans ; Ovarian Neoplasms

PURPOSE: The detection of epileptogenic lesion plays an important role in the management of patients with partial epilepsy. Although the development of MRI improved the examination of cerebral hemispheres greatly, many patients with neocortical temporal lobe epilepsy (TLE) or extratemporal lobe epilepsy (extra-TLE) still show no lesion in conventional two-dimensional (2D) images. To increase the yield of MRI in those patients, we performed three-dimensional (3D) surface-projection rendering (SPR) of the cerebral hemispheres. METHODS: Conventional 2D MRI (T1, T2, FLAIR, thin slice SPGR) and 3D SPR were performed in 24 patients with neocortical TLE and extra-TLE, and 20 normal subjects. Sulcogyral patterns were evaluated blindly to clinical information. The locations of the epileptogenic zone, ictal onset zone (IOZ) and irritative zone (IRZ) were determined by intracranial EEG monitoring and epilepsy surgery. RESULTS: The 2D MRI identified epileptogenic lesions in five of the 10 neocortical TLE (50%) and five of the 14 extra-TLE (35.7%). 3D SPR revealed abnormal sulcogyral patterns in 9 of the 10 neocortical TLE (90%) and 9 of the 14 extra-TLE (64.3%). Cortical deformation zones with sulcogyral anomalies included the whole area of IOZ in 10 (55.5%) and IRZ in 6 (33.3%), overlapped with IOZ in 7 (38.9%) and IRZ in 11 (61.1%), were connected to IOZ in 1 (5.6%) and IRZ in 1 (5.6%). CONCLUSION: 3D SPR of volumetric MRI data can detect epileptogenic structural lesions of neocortical epilepsy that are not visible in the conventional 2D images.
Brain* ; Cerebrum ; Electroencephalography ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Temporal Lobe ; Humans ; Magnetic Resonance Imaging*

PURPOSE: To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. MATERIALS AND METHODS: lnterictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Bath positive images showing ictal hypoperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hypoperfusion, hypoperfusion-plus, combined hypoperfusion-hypoperfusion, and focal hypoperfusion only. RESULTS: The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hypoperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hypoperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hypoperfusion alone was seen only in mesial TLE while lateral temporal hypoperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hypoperfusion in the neighboring brain regions where ictal discharges propagated. CONCLUSION: Hypoperfusion as well as hypoperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanisrn of ictal hypopertusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.
Baths ; Brain ; Epilepsies, Partial* ; Epilepsy ; Epilepsy, Temporal Lobe ; Humans ; Incidence ; Pathology ; Perfusion* ; Sclerosis ; Seizures ; Tomography, Emission-Computed, Single-Photon*

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases

Small incision cataract surgery has many advantages such as less induced corneal astigmatism, fast visual recovery, and fast rehabilitation. We had implatned the newly developed Staar AA-4203 foldable silicone IOL in the ag of 100 cataractous eye and followed for at least 3 months (3-0 months, mean 6 months). Silicone IOLs were implanted using a specific injector through 4mm scleral pocket incision after continuous circular capsulorhexis and bimanual phacoemulsification. The lenses were centered well in 99% of eyes. Tear of anterior capsule occurred in one eye (1%), and tear of both anterior and posterior cassule occurred in another one eye (1%) during IOL implatation. The IOL was displaced into the vitreous in the latter eye, which was reoperated. The preoperative and postoperative cornedal astigmatism at 1 day, 1 month, 2 month and 3 month was -O.14 +/- 0.83 D of with the rule astigmatism (WTR), -0.55 +/- 1.06 D of WTR, -0.28 +/- 0.91 D of WTR, -0.07 +/- 0.81 D of WTR, and O.01 +/- 0.84 D of against the rule astigmatism respectively. Uncorrected VA of 1.0 was 35% at postoperative 1 day, 52% at 1 month, 48% at 2 month. Corrected VA of 1.0 was 65% at postoperative 1 day, 87% at 1 month, 88% at 2 month. Inflammatory reaction in the anterior chamber and vitreous had subsided within one or two months without any complications in 99% of eyes. Fibrinous membrane on the suface of IOL occurred in 2 eyes (2%), one of which caused grave sequelae. The results, although it showed early postoperative results, reflected that the above silicone foldable IOL fitted to the small incision cataract surgery guaranteed us the safety and fast visual recovery.
Anterior Chamber ; Astigmatism ; Capsulorhexis ; Cataract ; Fibrin ; Membranes ; Phacoemulsification ; Rehabilitation ; Silicones*

No abstract available.
Diuretics*

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*

The issues concerning the disability evaluating system in Korea are controversial to say the least. Evaluating systems are so complicated that they continually cause confusion to medical examiners even though they must evaluate patient's medical status accurately, objectively and reasonably to provide adequate compensation for patients. However, controlling associations or educating curricula for disability evaluation are not in place. This study investigates the impending problems of disability evaluation in Korea and discussed what should be done to improve the situations. Social environments, evaluating standards, examiners' capability and education are reviewed in an effort to present an adequate proposals to Korean medical examiners.
Compensation and Redress ; Coroners and Medical Examiners ; Curriculum ; Disability Evaluation ; Humans ; Hypogonadism ; Korea ; Mitochondrial Diseases ; Ophthalmoplegia ; Social Environment