No abstract available.
Abdominal Pain* ; Vomiting*

Physostigmine has been used to counteract somnolence or coma induced by different types of pharmacological agent, such as anticholinergics, opioids, ketamine, tricyclic antidepressants and inhalational anesthetics. In this study, we have assessed the effect of physostigmine on arousal and respiration after 50% N2O-50% O2-enflurane general anesthesia under controlled condition such as no premedication, no neuromuscular blockade, same operative procedure and duration. Fifty healthy gynecologic patients scheduled for dilatation & curettage and cervical cone biopsy were divided randomly into two groups such as control group and physostigmine group. In physostigmine group, 0.02 mg/kg of physostigmine was administered intravenously at the end of operation. We evaluated the recovery time of pain response, eye opening on verbal command and orientation after the end of operation. We also checked the end-tidal enflurane concentration with SARACAP spectrometry. Blood pressure, pulse rate, respiration rate and tidal volume were checked at the end of operation and at the time of each recovery parameters returned. The results were as follows; first, pain response time was 5.1+/-2.4 min in control group compared with 3.5+/-2.1 min in physostigmine group. Second, on simple order to patients, eye opening time was 8.5+/-2.3 min in control group compared with 6.5+/-2.1 min in physostigmine group. Third, recovery of orientation to time, place and person was 9.7+/-2.8 min in control group compared with 7.5+/-2.1 min in physostigmine group. Fourth, there was no significant difference in respiratory parameters between the two groups. But there was no significant difference in end-tidal enflurane concentration between the two groups inspite of rapid recovery time in physostigmine group. In conclusion, 0.02mg/kg of physostigmine has the effect of early arousal after enflurane anesthesia without specific problems.
Analgesics, Opioid ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Antidepressive Agents, Tricyclic ; Arousal* ; Biopsy ; Blood Pressure ; Cholinergic Antagonists ; Coma ; Dilatation and Curettage ; Enflurane* ; Female ; Heart Rate ; Humans ; Ketamine ; Neuromuscular Blockade ; Physostigmine* ; Premedication ; Reaction Time ; Respiration* ; Respiratory Rate ; Spectrum Analysis ; Surgical Procedures, Operative ; Tidal Volume

OBJECTIVE: The purpose of this article is to assist in early diagnosis and treatment of ectopic pregnancy. METHODS: We analyzed clinical statistics of 401 patients, who visited Masan Samsung Hospital from January 1, 1998 to December 31, 2002, received treatment under diagnosis of ectopic pregnancy, and were comfirmed by histopathologic examination. RESULTS: During the index period, the occurrence rate of ectopic pregnancy was 1:16.5, with peak age of occurrence between 30 to 34 year-old (34.4%). Previous history of artificial abortion was noted in 76.1%, previous cesarean delivery in 17%, previous pelvic inflammatory disease in 15.7% and history of previous ectopic pregancy in 9.5%. Concerned to clinical manifestations, lower abdominal pain was reported in 93.3%, amenorrhea in 86.5%, and vaginal bleeding in 69.3%. Onset of clinical manifestation was 6-8 weeks from the last menstrual period in 39.7%, being the most common. As the implantation site, fallopian tube was affected in 95.3%, ovary in 3%, and cervix of the uterus in 1%. Total amount of intraperitoneal hemorrhage was less then 500 mL in 45.6%. As an operative treatment, salpingectomy of the affected side was conducted in 76.8%. Average lengths of hospital stay for laparoscopy versus laparotomy were 3.4 and 5.2 days, respectively. CONCLUSION: Ectopic pregnancy, as a common emergent disorders, requires continuous attention for women in reproductive age. With the aid of various diagnostic modalities, early diagnosis and treatment can reduce mortality and morbidity rates, and enhance future fetility.
Abdominal Pain ; Adult ; Amenorrhea ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Mortality ; Ovary ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic* ; Salpingectomy ; Uterine Hemorrhage ; Uterus

Urticaria pigmentosa is a form of urticaria characterized by abnormality of cutaneous mast cells. No prediction for either gender has been reported but it usually occurs in children. When it develops in an adult cutaneous manifestations often follows recalcitrant and persistent course. Though tendency of genetic inheritance with an autosomal dominant pattern has been suggested most of patients have no family history of mastocytosis. We report a case of adult-onset urticaria pigmentosa with references.
Adult ; Child ; Humans ; Mast Cells ; Mastocytosis ; Urticaria Pigmentosa* ; Urticaria* ; Wills

No abstract available.

Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Leukoplakia ; Mouth ; Neoplasm Recurrence, Local ; Neoplasms, Second Primary ; Prognosis ; Recurrence ; Tongue Neoplasms ; Tongue

OBJECTIVE: The frequency of CYP2C8 gene polymorphisms in Korean patients with epithelial ovarian cancer was identified and their association with toxicity and effect of the anticancer drug according to haplotypes was analyzed. METHODS: DNA was extracted from 57 epithelial ovarian cancer patients between January 2004 and March 2005. Genetic variations that are three common SNPs (CYP2C8*1D; -411T>C, CYP2C8*1C; -370T>G and CYP2C8*1B; -271C>A) by direct sequence analysis from 57 Korean women with epithelial ovarian cancer were observed. 33 patients who received debulking surgery, were diagnosed over FIGO state III, serous ovarian cancer were enrolled and received paclitaxel based chemotherapy. Among 33 patients 21 chemo-sensitive patients and 12 resistant patients were analyzed. Using these SNPs, We constructed haplotypes and haplotype pairs. CYP2C8 genotypes according to the clinical characteristics were analyzed and evaluated. RESULTS: Genetic analysis revealed the common SNPs' allele frequencies of -411T>C, -370T>G, and -271C>A were 0.3, 0.44, and 0.1. Two common SNPs allele frequency was similar to the data in Korean population substantially, but CYP2C8*1C frequency was more frequent in epithelial ovarian cancer patients and especially in FIGO stage III. Disease free interval in CYP2C8*1C homologous group was longer than others. CONCLUSION: CYP2C8*1C SNPs were detected more frequently in epithelial ovarian cancer patients and especially in FIGO stage III patients. CYP2C8*1C homologous patients had more longer disease free interval than others.
Cytochrome P-450 Enzyme System ; DNA ; Drug Therapy ; Female ; Gene Frequency ; Genetic Variation ; Genotype ; Haplotypes ; Humans ; Ovarian Neoplasms* ; Paclitaxel ; Polymorphism, Single Nucleotide ; Sequence Analysis

OBJECTIVE: Recently the existence of a CD4+CD25+ regulatory (Treg) population has been described in rodents and humans. It is unclear how the immune response cells interact to tumor cells effectively, but the malignant tumor cell growth was suppressed by the main effect of T lymphocytes and natural killer cells in experimental studies using various biologic response modifier. This study was performed to investigate the proportion of CD4+CD25high Tregs and expression of Foxp3 in Peripheral blood (PBL)s in patients with cervical, ovarian or uterine cancers. METHODS: Blood samples were collected from 10 healthy women and a total of 40 patients with gynecologic cancer at department of Obstetrics and Gynecology, Asan Medical Center, Seoul, Korea, from March 2005 to September 2005, were enrolled in study group. Information regarding patient history and tumor stage was recorded. They were diagnosed at same center at first, and never been treated any therapy. The population of CD4+CD25+high Tregs as a percentage of total CD4+cells was evaluated by flow cytometric analysis. We measured the proportion of Treg cell that co-express CD4 and CD25 in the peripheral blood lymphocytes form patients with either cervical, ovarian uterine cancer or carcinoma in situ of cervix. Expression of Foxp3 in the CD4+subsets defined by electrophoresis. RESULTS: The following tumor entities were included cervical cancer (n=10. 7 in stage I, 1 in stage II, 1 in stage III, 1 in stage IV); ovarian cancer (n=10. 4 in stage I, 0 in stage II, 5 in stage III, 1 in stage IV), ; uterine cancer (n=10. 9 in stage I, 0 in stage II, 0 in stage III, 1 in stage IV). In cervical cancer patient, ovarian cancer patients, uterine cancer patients and healthy women, the proportion of CD4+CD25high Tregs was 4.53% (SD 2.30), 6.89% (SD 7.81), 4.37% (SD 2.43) and 0.87% (SD 0.57) of the total CD4+cells respectively. The proportion of CD4+CD25+high T cells was significantly higher in cervical cancer patients (p=0.016), ovarian cancer patients (p=0.001) and uterine cancer patients (p=0.038) when compared with healthy women. But there was no significant difference in proportion of CD4+CD25+ Tregs comparing with healthy women. Expression of Foxp3 was significantly thicker in tumor-associated lymphocytes than control T cells by electrophoresis. CONCLUSION: In conclusion, our data suggested that the increase in frequency of regulatory T cells might play a role in modulation of the immune response against cervical, ovarian, uterine cancer could be important in design of immunotherapeutic approaches.
Carcinoma in Situ ; Cervix Uteri ; Chungcheongnam-do ; Electrophoresis ; Female ; Gynecology ; Humans ; Killer Cells, Natural ; Korea ; Lymphocytes* ; Obstetrics ; Ovarian Neoplasms ; Rodentia ; Seoul ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Uterine Cervical Neoplasms ; Uterine Neoplasms

We report herein a case of gastric undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. A 57-year-old man was referred after a gastroscopy for anemia evaluation. Gastroscopy revealed an approximately 3 cm ulcerofungating mass occupying the greater curvature of stomach body. Biopsy results revealed a poorly differentiated adenocarcinoma. Left gastric lymph node was enlarged, but there were no evidence of distant metastasis on the abdominal CT. He underwent a radical subtotal gastrectomy and gastroduodenostomy with dissection of the enlarged lymph nodes. Postsurgical histological examination revealed an undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. Immunohistochemical staining revealed that the tumor cells were focal positive for AFP, anti-hepatocyte antibody.
Adenocarcinoma ; Anemia ; Biopsy ; Carcinoma ; Endodermal Sinus Tumor ; Gastrectomy ; Gastroscopy ; Lymph Nodes ; Neoplasm Metastasis ; Stomach ; Yolk Sac

OBJECTIVE: The study assessed the immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted cervical cancer vaccine in healthy Korean women aged 15-25 years. METHODS: Phase IIIB, double-blind, randomised (2:1), multi-centre trial was conducted in Korea from June 2007 to March 2008. The study enrolled 225 women in the HPV (N=149) and placebo (N=76) groups who received three doses of HPV-16/18 AS04-adjuvanted vaccine or placebo (aluminium hydroxide) administered intramuscularly at 0, 1, and 6 months and were followed until one month post-dose 3. Serum samples were collected pre-vaccination and one month post-dose 3. Safety and reactogenicity data were collected throughout. RESULTS: In this trial, 208 women completed the study (141 in HPV group; 67 in placebo group). At month 7, all initially seronegative women had seroconverted for HPV-16 and HPV-18 antibodies with anti-HPV-16 and anti-HPV-18 geometric mean titres of 9,351.4 El.U/mL (95% CI, 8,145.5 to 10,735.8) and 4204.1 El.U/mL (95% CI, 3,626.5 to 4,873.6), respectively. Initially seropositive women showed similar increase in geometric mean titre levels. Compliance to the three dose vaccination course was 95.3% in HPV and 89.5% in placebo group. Solicited local (pain) and general (fatigue, myalgia or headache) symptoms were commonly reported in both groups. Three serious adverse events were reported (two in HPV group; one in placebo group), all unrelated to vaccination by the investigator; all recovered. CONCLUSION: The HPV-16/18 AS04-adjuvanted vaccine was highly immunogenic with a clinically acceptable safety profile in Korean women. This study was in line with previous global studies in Europe, North America, and Brazil. (ClinicalTrials.gov number, NCT 00485732.)
Aged ; Antibodies ; Brazil ; Compliance ; Europe ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Korea ; North America ; Uterine Cervical Neoplasms ; Vaccination