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.
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

PURPOSE: Neuroendocrine (NE) cells of the prostate are considered to be involved in the pathogenesis of benign prostate hyperplasia (BPH). By a comparative analysis of NE cell density in BPH tissue of men who were either exposed to or not exposed to 5alpha-reductase inhibitor, we investigated the relationship between NE cells and BPH, and the effect of androgen deprivation on NE cells. MATERIALS AND METHODS: Prostate tissue specimens, obtained from 30 men by transurethral resection of the prostate or radical cystoprostatectomy, were used. Of the 30 patients, 10 had a prostate smaller than 25 ml (normal control), the other 20 had a prostate larger than 40ml, 10 of who had taken 5alpha-reductase inhibitor (finasteride) for 3 months before surgery (androgen blockade group), and 10 who had not (BPH group). The distribution of NE cells in the prostate was examined using the anti-chromogranin A (CgA) antibody, and the density of the CgA-positive cells was compared by an optical dissector method. Immunoblotting was performed using the neuron specific enolase (NSE) antibody. A Mann-Whitney U test was used in a statistical analysis. RESULTS: Most of the CgA-positive NE cells were localized between the acinar epithelial cells. The mean numbers of CgA-positive NE cells per acinus in the normal controls and the BPH groups were 1.67+/-0.78 and 4.45+/-2.54, respectively, and the difference was statistically significant (p<0.05). However, the mean number of CgA-positive NE cells in the androgen blockade group, was 4.93+/-2.17, which was similar to the BPH group. In a NSE immunoblotting study, a distinct band was observed in the BPH and androgen blockade groups, but the density of the band was higher in the androgen blockade group. CONCLUSIONS: Our results suggest that NE cells may be involved in the hyperplastic process of BPH. Inhibition of dihydrotestosterone, caused by the oral administration of the 5alpha-reductase inhibitor, failed to induce any significant change in the NE cells, probably due to the incomplete androgen blockade.
Administration, Oral ; Cell Count ; Dihydrotestosterone* ; Epithelial Cells ; Humans ; Hyperplasia ; Immunoblotting ; Male ; Neuroendocrine Cells* ; Phosphopyruvate Hydratase ; Prostate ; Prostatic Hyperplasia*

The objective of this study was to evaluate outcome for the patients of the intensive care unit, using APACHE III prognostic system. We prospectively collected the information of 429 patients in intensive care units at 2 tertiary care hospitals and 4 secondary care hospitals in PUSAN who had been admitted from December 1, 1993 to February 28, 1994. The results were as follows. 1. APACHE 111 scores were various from 0 to 173. But the distribution of the scores were similar between tertiary care hospitals and secondary care hospitals. 2. The mortality rate significantly increased as APACHE 111 score rised (P<0.001). Within the interval of same score, generally, the mortality of operative patients was higher in secondary care hospitals but in the case of nonoperative patients higher in tertiary care hospitals. 3. when the tertiary care hospitals compared with secondary for ratio of the predicted mortality rate to the actual mortality rate, there was little difference. 4. when we compared the 6 hospitals, one hospital had significantly better results and another hospital was significantly inferior (P<0.05).
APACHE* ; Busan ; Humans ; Intensive Care Units* ; Critical Care* ; Mortality ; Prospective Studies ; Secondary Care ; Tertiary Healthcare