Leiomyoma of vagina is relatively rare benign tumor. And majority of these lesions occur in labia major and anterior vaginal wall. The recurrence of this tumor is extremely rare and its cellular atypism, mitotic activity, tumor size and contour are known as important factors in its recutrence. A case of recutrent leiomyoma causing urinary frequency in vesicovaginal septum was reported with a brief review of literature.
Leiomyoma* ; Recurrence ; Vagina

BACKGROUND: The etiologies of ischemic cerebrovascular diseases are various-thrombosis or artery to artery embolism, cardiogenic embolism and lipohyalinosis. In the past embolic cerebral infarct was thought to occur uncommonly. But these days substantial portion of patients have been found to have potential embolic sources by transesophageal echo cardiography and carotid duplex doppler. As transesophageal echocardiography has a high yield for identification of potential sources of cardiac embolism in patients with ischemic cerbrovascular diseases, its use has been increasing. In Korea an increasing number of patients with ischemic cerebrovascular diseases have been examined by transesophageal echocardiography since 1990. But in all the previous studies transesophageal echocardiographic evaluation has been confined to the patients with high probability of embolic cerebral infarct. All kinds of ischemic cerebrovascular diseases patients have never been examined by transesophageal echocardiography and carotid duplex doppler and the prevalence of potential embolic sources in Korean ischemic cerebrovascular disease patients is not known. The aim of this study was to evaluate the prevalence of potential cardiovascular embolic sources by transesophageal echocardiography and carotid duplex doppler in unselected patients with ischemic cerebrovascular diseases. METHODS: We evaluated all kinds of ischemic cerebrovascular diseases patients admitted from 1994. 9. 1. until 1995 9. 31. to the Departments of Neurology and Internal Medicine of Kangnam General Hospital. We evaluated them by transesophageal echocardiography, carotid doppler, brain CT(or brain MRI). A significant carotid stenosis was defined as a duplex scandetected lesion producing at least 50% vessel narrowing. The following echocardiographic findings were defined prospectively as potential cardiac sources of embolism : atrial appendage or left atrial cavity thrombus, spontaneous echocardiographic contrast, atrial septal aneurysm, interatrial shunt, ventricular aneurysm, ventricular thrombus, myxomatous mitral valve and protruding atherosclerotic plaque in the ascending aorta or transverse aortic arch. RESULTS: Of 64 patients admitted during the study period, 30 were excluded(Three patients were critically ill, and twenty seven patients refused diagnostic work-up.). Thorough diagnostic work-up was performed in 34 patients. Transesophageal echocardiographic positive findings were present in six patients(17.6%). Of them four(4/34, 11.7%) had spontaneous echo contrast, two(2/34, 5.8%) had left atrial thrombi, one(1/34, 2.9%) had ascending aorta atheroma. Eleven patients(11/34, 32.3%) had abnormalities in carotid doppler study. Five patients(5/34, 14.7%) had abnormalities both in transesophageal echocardiography and carotid doppler study. CONCLUSIONS: The results suggest that among ischemic cerebrovascular diseases patients substantial portion of patients have potential embolic sources. The prevalence of potential embolic sources in Korea may be higher than previously expected. Because the relative small number of the patients studied make it difficult to generalize the results, further studies with a large number of patients are needed.
Aneurysm ; Aorta ; Aorta, Thoracic ; Arteries ; Atrial Appendage ; Brain ; Carotid Stenosis ; Critical Illness ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Hospitals, General ; Humans ; Internal Medicine ; Korea ; Mitral Valve ; Neurology ; Plaque, Atherosclerotic ; Prevalence ; Prospective Studies ; Thrombosis

In July 2010, we identified an outbreak of vancomycin-resistant enterococci (VRE) in our 26-bed neonatal intensive care unit. We performed an epidemiological investigation after clinical cultures of 2 neonates were positive for VRE. Identification, susceptibility testing, and molecular characterization were performed. Cultures of 3 surveillance stool samples of inpatients and 5 environmental samples were positive for VRE. All isolates were identified as Enterococcus faecium containing the vanA gene. Two distinct clones were identified by performing pulsed-field gel electrophoresis. The 2 clones exhibited different pulsotypes, but they represented identical Tn1546 types. Two sequence types, ST18 and ST192, were identified among all of the isolates with multilocus sequence typing. Our investigation determined that the outbreak in the neonatal intensive care unit was caused by 2 genetically different clones. The outbreak may have occurred through clonal spread and horizontal transfer of the van gene.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics ; Bacterial Typing Techniques ; Carbon-Oxygen Ligases/genetics ; DNA, Bacterial/analysis ; *Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Enterococcus faecium/drug effects/*genetics/isolation & purification ; Feces/microbiology ; Genotype ; Gram-Positive Bacterial Infections/diagnosis/epidemiology/*microbiology ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Male ; Multilocus Sequence Typing ; Vancomycin/pharmacology ; *Vancomycin Resistance

We report of case of one monozygotic twin sister with pituitary tumor and multiple endocrine neoplasia, type 1.The older sister, 31-year-old woman, had undergone Gamma Knife radiosurgery for prolactin producing pituitary microadenoma. Four years later, pancreatic insulinoma was detected, distal pancreatectomy and splenectomy were done. The younger sister, 31-year-old woman, had been operated for pancreatic insulinoma, 12 years ago. One year ago, hyperparathyroidism and pituitary macroadenoma were detected. Tumor removal was followed by Gamma Knife radiosurgery for residual tumor.
Adult ; Female ; Humans ; Hyperparathyroidism ; Insulinoma ; Multiple Endocrine Neoplasia* ; Neoplasm, Residual ; Pancreatectomy ; Pituitary Neoplasms ; Prolactin ; Radiosurgery ; Siblings ; Splenectomy ; Twins, Monozygotic*

Exercise-induced ischemic ST responses were analyzed in 36 patients who presented with chest pain and had exercise test and the results were compared with their coronary angiographic findings. Among 36 exercise test positives, the incidences of one-, two- and three vessel disease, and left main disease were 25%(9 cases), 30%(11 cases), 25%(9 cases) and 9%(3 cases), respectively. The incidence of multivessel disease(i.e., two-to three vessel disease or left main disease) in patients with ST depression > or =2.0mm was 72% and that in those with ST depression of 1.0-1.9mm was 45%. In patients with downsloping ST depression, the incidence of multivessel disease was significantly higher than that of one vessel disease(86% vs 14%, p<0.001). But both incidences of one vessel disease and multivessel disease were similar in patients with flat and slowly upsloping ST depression. More than two thirds of patients with ischemic ST depression appearing in the first 6 minutes of exercise or those lasting past 7 minutes in recovery were associated with multivessel disease. It is concluded that attention to depth, type, appearance time and duration of ST depression during exercise test is particularly helpful in detecting patients with advanced coronary disease.
Chest Pain ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Depression ; Electrocardiography* ; Exercise Test ; Humans ; Incidence

PURPOSE: To investigate the changes of corneal nerve innervation and sensitivity after corneal tattooing. METHODS: Twelve New Zealand rabbits were divided into two groups of six subjects each. Tissue marking dye or balanced-salt solution was injected into the corneal stroma in one eye of each subject. Corneal nerve innervation was observed at 3 days and 1, 2, 3, 4, and 6 weeks postoperatively and compared with that of the opposite eyes. Corneal sensitivity was evaluated at 1, 2, and 3 days and 1, 2, 3, 4, and 6 weeks postoperatively and compared to the preoperative values in the same subjects. RESULTS: The ratios of corneal nerve density of the study eyes to those of the control fellow eyes were 1.09 in the central area and 1.06 in the peripheral area in subjects injected with tissue marking dye, and 1.11 and 1.23, respectively, in subjects injected with balanced salt solution, which showed no difference between the two groups. The corneal nerve density tends to increase at 3 days postoperatively (p=0.125), but no significant change was found thereafter. Corneal sensitivity assessed using the Cochet-Bonnet esthesiometer was 2.13+/-0.48 cm preoperatively. At three days postoperatively, it was 2.50+/-0.48 cm in subjects injected with tissue marking dye and 2.33+/-0.26 cm in subjects injected with balanced salt solution. It was significantly increased at 3 days postoperatively (2.42+/-0.36 cm, p=0.031), but there were no significant changes at 7 days or more postoperatively. CONCLUSIONS: Corneal nerve density increased at 3 days after corneal tattooing, and this effect is thought to be related to early postoperative hypersensitivity.
Corneal Stroma ; Hypersensitivity ; Nerve Regeneration* ; Rabbits ; Tattooing*

OBJECTIVE: We designed this study to understand the physiologic effects and secretory pattern of IGF-I and IGF-II in human serum and changes in expression of IGF-I and IGF-II in human ovarian tissues during menstrual cycle, and to know which one is more important on human ovarian function between IGF-I and IGF-II, related to FSH, LH and estradiol. METHODS: IGF-I, IGF-II, FSH, LH and estradiol levels were measured in 80 serum samples by ELISA from normal reproductive women. We also examined the immunohistochemical staining of the IGF-I and IGF-II in the ovarian tissues of 14 normal reproductive women. The mean age was 35.6+/-9.15 years-old, ranged from 20 to 45. The average menstrual cycle was 27 to 29 days. RESULTS: 1. The average serum concentration of IGF-I was 204.43+/-50.92 ng/mL, and that of IGF-II was 1381.56+/-292.56 ng/mL. 2. The regular pattern or relationship on serum IGF-I and IGF-II concentrations were not observed (P=0.19). 3. To cross-correlation of serum concentrations of FSH, LH, estradiol and IGF-I, IGF-II, IGF-II was thought to effect on human ovarian menstrual cycles, affected by action of FSH (P=0.048). 4. In the normal reproductive ovaries, we observed immunohistochemical staining for IGF-I in primary, secondary, mature follicle, corpus luteum and stroma, but not in corpus albicans. 5. In the normal reproductive ovaries, we observed immunohistochemical staining for IGF-II in primary, secondary, mature follicle, and corpus luteum but not in corpus albicans and stroma. 6. Stronger immunohistochemical staining was observed in ovaries for IGF-II, rather than IGF-I. CONCLUSION: IGF-I and IGF-II were produced by ovarian tissues, and participated in ovarian folliculogenesis according to menstrual cycles by paracrine, autocrine functions. IGF-II, rather than IGF-I, was thought to effect greater on human ovarian menstrual cycles, affected by action of FSH.
Corpus Luteum ; Enzyme-Linked Immunosorbent Assay ; Estradiol ; Female ; Humans ; Immunohistochemistry ; Insulin-Like Growth Factor I* ; Insulin-Like Growth Factor II ; Menstrual Cycle* ; Ovarian Follicle ; Ovary

BACKGROUND AND OBJECTIVES: Many studies have established risk factors for cardiovascular diseases. The Duke treadmill score has gained widespread acceptance for prognosis and diagnosis in cardiac diseases. Recently, changes in heart rate during and after exercise have also been studied to predict the prognosis of cardiac diseases. We examined the relationship between the incidence of cardiovascular events and exercise capacity, achievement of 85% maximal predicted heart rate (MPHR) or heart rate recovery (HRR) after a routine exercise treadmill test. SUBJECTS AND METHODS: We studied 88 patients with chest pain who were over the age of 30. They were referred for exercise treadmill test for assessment of chest pain and underwent symptom-limited, exercise test with a cool down period of 30 seconds. HRR was defined as the difference in heart rate between peak exercise and 1 minute after exercise. Delta heart rate (DHR) was defined as the difference in heart rate between resting and peak exercise. Other parameters in the exercise test were also measured. RESULTS: Cardiovascular events were found in 13 of the 88 patients. In the events group, age, peak heart rate in exercise, ST depression, maximal exercise capacity, HRR, DHR and achievement of 85% MPHR were all significant variables. There was a favorable prognosis in the patients with a value of HRR >22 beats/minute and a value of DHR >83 beats/minute. Even after adjusting for age, sex, ST depression and left ventricular hypertrophy, the parameters of maximal exercise capacity, HRR, DHR, and achievement of 85% MPHR remained predictive prognostic factors in cardiovascular events. CONCLUSION: Parameters in exercise treadmill test, such as maximal exercise capacity, HRR, DHR and achievement of 85% MPHR, appear to provide additional information and are important variables associated with the prediction of risk in cardiac events.
Cardiovascular Diseases* ; Chest Pain ; Depression ; Diagnosis ; Exercise Test* ; Heart Diseases ; Heart Rate* ; Heart* ; Humans ; Hypertrophy, Left Ventricular ; Incidence ; Prognosis ; Risk Factors

OBJECTIVE: The authors present cases of cyst formation after gamma knife radiosurgery for arteriovenous malformation. METHODS: One hundred seventy eight arteriovenous malformation patients were treated with Gamma knife radiosurgery from October, 1994 to October, 2002. Six patients developed cyst after Gamma knife radiosurgery after a mean of 46.5 months(range, 11-62 months). Male to female ratio was 5: 1 and mean age was 19.7 years(range, 15-24 years). RESULTS: The mean marginal dose was 22.7Gy(range, 10-25Gy) and mean volume was 22.4cm3(range, 1.9-80.3cm3). Initial symptoms were hemorrhage in three, seizure in two and headache in one. Symptom after cyst formation was motor weakness in three patients, asymptome in three patients. The locations of the cyst were basal ganglia in two, parietal in two, occipital in one, parietooccipital in one. Ventriculoperitoneal shunt was performed in one, Ommaya's reservoir insertion in one, craniotomy and removal of cyst and then Ommaya's reservoir insertion after 8 months in one and no treatment was given in three. CONCLUSION: Cyst formation after Gamma knife radiosurgery for arteriovenous malformation may occur. However, symptomatic cysts can be effectively treated with Ommaya's reservoir insertion, or cystoperitoneal shunt and in some cases, excision is needed.
Arteriovenous Malformations ; Basal Ganglia ; Craniotomy ; Female ; Headache ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations* ; Male ; Rabeprazole ; Radiosurgery* ; Seizures ; Ventriculoperitoneal Shunt

A nationwide survey on radiation safety management in Korean animal hospitals was conducted. By 2013, 53 radiation generators were registered as veterinary medical devices (41 X-ray generators and 12 computed tomography scanners). Additionally there were six approved laboratories for radiation equipment and protection facility, and five approved laboratories for radiation exposure of employees, respectively. By March 2013, 2,030 out of 3,829 animal hospitals operated radiation-generating devices. Among these devices, 389 (19.2%) out of 2,030 were not labeled with the model name and 746 (36.7%) were not labeled with production dates. Thus, most veterinary X-ray generators were outdated (42.6%) and needed replacements. When periodic inspections of 2,018 animal hospitals were performed after revision of the Veterinarians Act in 2011, the hospitals were found to be equipped with appropriate radiation generators and protection facilities. Among 2,545 employees exposed to radiation at the hospitals, 93.9% were veterinarians, 4.3% were animal nurse technicians, and 18% held other positions. Among 169 employees supervised by administrators, none of those had a weekly maximum operating load that exceeded 10 mA.min. This study suggests that the radiation safety management system of animal hospitals was general good.
Administrative Personnel ; Animals ; Hospitals, Animal* ; Humans ; Korea ; Safety Management* ; Veterinarians