No abstract available.
Female ; Ovary* ; Ultrasonics*

OBJECTIVES: The purpose of this study was to assess the clinical features, microbiologic results, and the efficacy of perineal hygienic care of pediatric vulvovaginitis. METHODS: Forty-two unselected premenarcheal patients with symptoms or signs of vulvovaginitis who were attended the outpatient pediatric and adolescent gynecology clinic at Pundang CHA General Hospital from August 1997, to September 1999 were systematically interviewed and examined using a standardized format, studied microbiologically, and followed the efficacy of perineal hygienic measures prospectively. RESULTS: The median age of the patients was 4.8 years (range 2.9 years to 10.9 years). Vaginal complaints of 42 patients were discharge(79%), genital pain or irritation(31%), odor(17%), pruritus(14%), and vaginal bleeding(7%). On physical examination, vaginal discharge and vulvar erythema were noted in 17(40%) and 22(52%) patients, respectively. Aerobic bacteria or yeast excluding vaginal normal flora were found in 24 of 42 patients(57%). Convincing evidence of specific pathogens was found in 9 of 42 patients(21%) including one case of pinworm infestation. Isolated pathogens were H. influenza(3), S. pyogenes(2), K. pneumonia(2) and N. gonorrhea(1). No patients were found to have chlamydial infection or trichomoniasis. In 14 patients, risk factors were identified such as swimming(14%), bubble bath(5%), sexual abuse(5%), genital trauma(5%) and foreign body(2%). After two weeks instructions of perineal hygienic care, 26(62%) of 42 patients revealed complete resolution of symptoms and signs of vaginitis without antibiotics. Efficacies of perineal hygienic care were 94%(17/18) in the patients with normal flora alone, 60%(9/15) in the patients with organisms suspected for nonspecific infection and 0%(0/9) in the patients with specific pathogens(p<0.05). CONCLUSION: Majority(62%) of the pediatric patients with symptoms or signs of vulvovaginitis were cured with perineal hygienic care alone. And the efficacy of hygienic measure were higher in the patients without specific pathogens(79%, 26/33). Therefore, proper physical examination, microbiologic study and appropriate instructions of perineal hygienic care were more important than empirical antibiotic treatment in initial management of pediatric vulvovaginitis.
Adolescent ; Anti-Bacterial Agents ; Bacteria, Aerobic ; Enterobius ; Erythema ; Gynecology ; Hospitals, General ; Humans ; Outpatients ; Physical Examination ; Prospective Studies ; Risk Factors ; Vaginal Discharge ; Vaginitis ; Vulvovaginitis* ; Yeasts

Teratoma is very rarely developed in the third ventricle. We report a case of third ventricular mature teraroma in 12 year old boy with headache and precocious puberty. In TlWl and Gd-DTPA enhanced TlWl, the mass in the third ventricle showed mixed signal intensities with signal void and partial contrast enhancement. The tumor was confirmed as a mature teratoma including teeth and fatty tissue.
Adipose Tissue ; Child ; Gadolinium DTPA ; Headache ; Humans ; Magnetic Resonance Imaging* ; Male ; Puberty, Precocious ; Teratoma* ; Third Ventricle* ; Tooth

OBJECTIVE: SCC-Ag(Squamous Cell Carcinoma Antigen) is a tumor marker for patients with squamous cell carcinoma of the uterine cervix. It has shown that the SCC-Ag was well related with the response of cancer therapy and course of cervical cancer. The aim of this study is to investigate whether the presence of pelvic lymph node metstasis can be predicted by the measurement of the preoperative SCC-Ag levels in the patients with early staged squamous cell carcinoma of cervix. METHODS: The preoperative serum SCC-Ag levels were measured in 45 patients with stage I-II squamous cell carcinoma of cervix undergoing radical hysterectomy from September 1995 to December 1997. The serum SCC-Ag levels were analyzed for the clinicopathologic characteristics and other prognostic factors using univariate and multivariate analysis. RESULTS: The serum SCC-Ag levels of the patients exhibited pelvic lymph node metastasis were above 4.8ng/ml. An elevated preoperative serum SCC-Ag level, and tumor size were independent predictors for the presence of lymph node metastasis(p<0.01). CONCLUSION: The determination of the preoperative serum SCC-Ag levels provides a new prognostic factor in early staged cervical cancer.
Carcinoma, Squamous Cell* ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis* ; Uterine Cervical Neoplasms

No abstract available.
Anesthesia* ; Mediastinal Emphysema*

BACKGROUND :Although clinicopathologic differences have been described between Epstein-Barr virus (EBV)-positive and negative gastric adenocarcinomas, the pathogenetic basis for these differences remains unclear. In this study, efforts were made to confirm that expression of EBV-latent membrane protein (LMP1) and immunohistochemical characteristics of EBVpositive gastric adenocarcinomas. METHODS: We investigated genomic deletion, and RNA & protein expression of the EBV-LMP1, as well as immunohistochemical protein expression of transforming growth factor (TGF)-beta1, TGF-bata RII, p21, p16, E2F1, thymidylate synthase, and NF-kappaB in relation to EBV positive gastric adenocarcinoma. RESULTS: A total of 38 Epstein-Barr Virus Encoded RNA-positive and 80 negative gastric carcinomas were examined. A 30 bp DNA deletion in the EBV-LMP1 gene, initiating at codon 342, was detected in 94.4% of EBVpositive cases. By RT-PCR and western blotting, EBV-LMP1 mRNA and protein expressions were absent in all cases, re-gardless of DNA deletion. No significant differences in TGF-bata1, TGF-betaRII, p21, NF-kappaB, E2F1, or thymidylate synthase expression were identified. However, the decreased expression of p16 was found in 84.2% of EBV-positive carcinomas, relative to only 57.5% of EBV-negative tumors (p=0.024). CONCLUSION: EBV-LMP1 DNA deletion, mRNA and protein losses are highly prevalent in EBV-positive gastric adenocarcinoma among Korean patients, along with decreased p16 expression.
Adenocarcinoma* ; Blotting, Western ; Codon ; DNA ; Herpesvirus 4, Human* ; Humans ; Membrane Proteins* ; Membranes* ; NF-kappa B* ; RNA ; RNA, Messenger ; Stomach Neoplasms ; Thymidylate Synthase* ; Transforming Growth Factors*

This study was carried out to determine the accuracy of Doppler echocardiography for predicting the pulmonary arterial pressure from right ventricular systolic time intervals in 52 patients with ventricular septal defect. The diagnosis of ventricular septal defect was made by cardiac catheterization and angiocardiography at Dong San hospital, Keimyung University during the period of one year from jan. 1988 to Dec. 1988. Doppler measurements of acceleration time (AT), right ventricular ejection time (RVET), right ventricular preejection period (RPEP), AT/RVET, and RPEP/AT were compared with pulmonary arterial pressure (PAP), measured by cardiac catheterization. The patients were divided into 3 groups : PAP< or =30mm Hg, PAP 31-59mm Hg, PAP??0mm Hg. The following results were obtained. 1) In the groups of PAP< or =30mm Hg, AT was 0.12+/-0.01sec, AT/RVET was 0.47+/-0.07 and RPEP/AT was 0.50+/-0.05. 2) In the groups of PAP> or =60mm HG, AT was 0.06+/-0.01sec. AT/RVET was 0.28+/-0.05. RPEP/AR was 1.51+/-0.21. As the level of PAP increased, Doppler AT, AT/RVET and RPEP/AT showed significant change(P<0.001). 3) The Doppler AT showed relative high correlation(r=-0.76) with PAP measured by cardiac catheterization in all group. 4) The Doppler AT/RVET showed correlation(r=-0.70) with PAP. 5) The Doppler RPEP/AT showed high correlation(r=0.91) with PAP. The Doppler echocardiography was easy to apply in all age groups, and was found useful for detecting pulmonary hypertension in ventricular septal defect and for the follow-up check of the patients. It may help to determine the optimal time for surgery and evaluation of the treatment.
Acceleration ; Angiocardiography ; Arterial Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Systole

No abstract available.
Amenorrhea* ; Female

The purpose of this study was to develop, implement and evaluate a nutrition education program for middle aged men at a worksite. To be read easily, induce interest, and selected at need, seven 6-page leaflet aets were developed, which was the most preferable from chosen by the subjects. The contents of leaflet set were [Changing life style], [Good food habit],[Weight control and diet],[Cardiovascualr disease and diet], [Alimentary disease and diet],[Diaabetes and diet],and [Liver disease and diet]. Nutrition education was provided for 61 middle aged men(30 professors, 31 office workers) at a worksite from 40 mins to one hour. And the level of nutrition knowledge and nutrition attitude were tested to evaluate the effects of the nutrition education program with a developed leaflet set before and after nutrition education. After the nutrition deucation. the nutrition knowledge score had increased significantly at p<0.001, from average 9.3 point to 11.4 point. The level of nutrition knowledge was increased significantly at p<0.001, and the prevalence of misconceptions and the uncertainty of knowledge were decreased significantly at p<0.05. There was a significant difference between professors and office workers both before and after the program. Also, there was a significant increase in the attitude about nutrition score after the program and this means that the subjects were flexibly more open minded about nutrition than before(from 39.9 point, at p<0.001). The difference in the nutrition attitude score between professors and office workers was not significant both before and after the nutrition deucation. The developed leaflet set was evaluated very positively in understanding, interest, timing, and usage by the subjects.
beta-Aminoethyl Isothiourea ; Education* ; Humans ; Male ; Middle Aged* ; Prevalence ; Uncertainty ; Workplace*

17alpha-hydroxylase and 17,20-lyase are enzymes encoded by the CYP17A1 gene and are required for the synthesis of sex steroids and cortisol. In 17alpha-hydroxylase deficiency, there are low blood levels of estrogens, androgens, and cortisol, and resultant compensatory increases in adrenocorticotrophic hormone that stimulate the production of 11-deoxycorticosterone and corticosterone. In turn, the excessive levels of mineralocorticoids lead to volume expansion and hypertension. Females with 17alpha-hydroxylase deficiency are characterized by primary amenorrhea and delayed puberty, with accompanying hypertension. Affected males usually have female external genitalia, a blind vagina, and intra-abdominal testes. The treatment of this disorder is centered on glucocorticoid and sex steroid replacement. In patients with 17alpha-hydroxylase deficiency who are being raised as females, estrogen should be supplemented, while genetically female patients with a uterus should also receive progesterone supplementation. Here, we report a case of a 21-year-old female with 17alpha-hydroxylase deficiency who had received inadequate treatment for a prolonged period of time. We also include a brief review of the recent literature on this disorder.
Adrenocorticotropic Hormone ; Amenorrhea ; Androgens ; Corticosterone ; Estrogens ; Female ; Genitalia ; Humans ; Hydrocortisone ; Hypertension ; Male ; Mineralocorticoids ; Progesterone ; Puberty, Delayed ; Steroid 17-alpha-Hydroxylase* ; Steroids ; Testis ; Uterus ; Vagina ; Young Adult