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

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

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

No abstract available.
Female ; Ovary* ; Ultrasonics*

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

Intravenous urography is very important in the detection of pathological conditions of the urinary tract, but the presence of intestinal gas shadows may be very confusing in the interpretation of urograms. There is considerable difference of opinion regarding the desirability of preparing patients for excretory urography. we obtained clinical impression and statistical results that intestinal gas was increased with prolonged duration after last diarrhea, also with sleeping after last diarrhea. So we attempted one new method of preparation in which employed 30cc, of castor oil for catharsis two times at night before examination and next morning 6:00 a. m. and result was compared with other methods. A total of 300 cases, for the most in-patients, consisted of 6 groups, were studied in this report. All patients had nothing by mouth after midnight until the X-rays were completed and pyelograms usually were taken in the morning. Following methods of preparation were studied. Group 1 : 60 cc. castor oil at bed time. Group 2 : 60 cc. castor oil at 4:00 a. m. Group 3 : 30 cc. castor oil at bed time and 30 cc. at 6:00 a. m. Group 4 : 60 cc. castor oil at bed time and enema in the morning. Group 5 : No cathartics and enema. Group 6 : Dulcolax 2 tablets at bed time. The X-ray films were graded as A) excellent B) good C) fair D) poor by three or more examiners. Group 3. afforded best result. We believed that result was due to prevention of intestinal fermentation by ingestion of castor oil at bed time and passage of swallowed air before X-ray examination by repeated ingestion at 6:00 a. m. A larger series of cases over a longer period of time, for more accurate statistical study, is warranted.
Bisacodyl ; Castor Oil ; Catharsis ; Cathartics ; Diarrhea ; Eating ; Enema ; Fermentation ; Humans ; Mouth ; Statistics as Topic ; Tablets ; Urinary Tract ; Urography* ; X-Ray Film

The standard iron-chelator deferoxamine is known to prevent the growth of coagulase-negative staphylococci (CoNS) which are major pathogens in iron-overloaded patients. However, we found that deferoxamine rather promotes the growth of coagulase-positive Staphylococcus aureus. Accordingly, we tested whether deferiprone, a new clinically-available iron-chelator, can prevent the growth of S. aureus strains as well as CoNS. Deferiprone did not at least promote the growth of all S. aureus strains (n=26) and CoNS (n=27) at relatively low doses; moreover, it could significantly inhibit the growth of all staphylococci on non-transferrin-bound-iron and the growth of all CoNS on transferrin-bound iron at relatively high doses. At the same doses, it did not at least promote the growth of all S. aureus strains on transferrin-bound-iron. These findings indicate that deferiprone can be useful to prevent staphylococcal infections, as well as to improve iron overload, in iron-overloaded patients.
Deferoxamine/pharmacology ; Humans ; Iron/metabolism ; Iron Chelating Agents/*pharmacology ; Iron Overload/metabolism ; Microbial Sensitivity Tests ; Pyridones/*pharmacology ; Staphylococcus/*drug effects/growth & development ; Staphylococcus aureus/drug effects/growth & development ; Transferrin/metabolism