Vaginal clear cell adenocarcinoma is a very rare malignant disease and it has been known to be associated with in utero exposure to DES. We expreienced a case of clear cell adenocarcinoma of the cagina in 40 years ole woman, and present the case with a brief review of related literatures.
Adenocarcinoma, Clear Cell* ; Female ; Humans ; Vagina*

Vaginal clear cell adenocarcinoma is a very rare malignant disease and it has been known to be associated with in utero exposure to DES. We expreienced a case of clear cell adenocarcinoma of the cagina in 40 years ole woman, and present the case with a brief review of related literatures.
Adenocarcinoma, Clear Cell* ; Female ; Humans ; Vagina*

No abstract available.
Candidiasis* ; Paget Disease, Extramammary* ; Vulva

No abstract available.
Longevity* ; Scrub Typhus*

For the diagnosis of upper gastrointestinal (GI) lesions, magnification method is usually used in conjunction with chromoscopy, enabling the endoscopist to view subtle mucosal patterns in exquisite detail. Recently published datas have shown that magnifying endoscopy might be a valuable adjunct for the diagnosis, detection, and characterization of inflammatory and neoplastic lesions of the upper GI tract. It is also proven to be an useful surveillance protocol in identifying dysplastic epithelium or early cancer within a segment of Barrett's esophagus. Possible indications for magnifying endoscopy in upper GI tract include screening and surveillance of Barrett's esophagus, defining the extent of esophageal and gastric adenocarcinoma, detecting synchronous/metachronous gastric and esophageal cancers, diagnosing Helicobacter pylori infection, and recognizing minimal mucosal changes in gastroesophageal reflux disease. By grading the quality of evidence for the currently published trials, it is clear that the majority are case series, case reports, and/or observational studies without randomization, control, or blinding. Moreover, other evidence-based criteria such as independent, blind comparisons of magnifying endoscopy with a standard method which evaluates this technology in an appropriate spectrum of patients to whom the test may be applicable, and standardizing methodology would be crucial before magnifying endoscopy becomes a standard procedure in clinical practice. In the future, a uniform classification system for staining and magnifying patterns should be devised and observer agreement should be tested. Futher studies then could be performed based upon consistent, validated, and standardized terminologies and criteria.
Diagnosis, Differential ; Duodenal Diseases/pathology ; Endoscopy, Gastrointestinal/*methods ; Esophageal Diseases/pathology ; Gastrointestinal Diseases/*pathology ; Humans ; Image Enhancement/*methods ; Stomach Diseases/pathology ; Upper Gastrointestinal Tract/pathology

No abstract available.
Compartment Syndromes*

PURPOSE: A new compressed sensing technique by iterative truncation of small transformed coefficients (ITSC) is proposed for fast cardiac CINE MRI. MATERIALS AND METHODS: The proposed reconstruction is composed of two processes: truncation of the small transformed coefficients in the r-f domain, and restoration of the measured data in the k-t domain. The two processes are sequentially applied iteratively until the reconstructed images converge, with the assumption that the cardiac CINE images are inherently sparse in the r-f domain. A novel sampling strategy to reduce the normalized mean square error of the reconstructed images is proposed. RESULTS: The technique shows the least normalized mean square error among the four methods under comparison (zero filling, view sharing, k-t FOCUSS, and ITSC). Application of ITSC for multi-slice cardiac CINE imaging was tested with the number of slices of 2 to 8 in a single breath-hold, to demonstrate the clinical usefulness of the technique. CONCLUSIONS: Reconstructed images with the compression factors of 3-4 appear very close to the images without compression. Furthermore the proposed algorithm is computationally efficient and is stable without using matrix inversion during the reconstruction.
Magnetic Resonance Imaging, Cine*

BACKGROUND: The bispectral index, a parameter of electroencephalography (EEG) and a tool for the measurement of sedative state has been used in general anesthesia and for the assessment of sedative degree in intensive care units. The adverse effects of inhalation agents are various although hepatic toxicity, renal toxicity, postoperative nausea, and vomiting have been reported. This study was designed to evaluate the adverse effect of inhalation agents. METHODS: Forty-four adult patients scheduled for thyroidectomy under general anesthesia were randomly assigned to one group with a BIS below 40 (BIS40 group, n = 23) or to a group with a BIS from 50 to 60 (BIS60 group, n = 21). Hgb, WBC count, PLT count, renal function, and liver function were measured pre-and post-operatively (after 24 hrs). The degree of postoperative nausea and vomiting were estimated using the Rhodes Index of Nausea, Vomiting and Retching (RINVR) in postoperative 6 hrs, 12 hrs and 24 hrs. RESULTS: The amount of fentanyl used during the operation were greates in the BIS60 group than in the BIS40 group for adequate analgesia, and the preoperative and postoperative values of Hgb, WBC count, PLT count, AST, ALT, ALP, s-BUN, and s-creatine were not significantly different between the BIS40 and BIS60 groups. 6 hrs, 12 hrs and 24 hrs post-operatively no differences were observed between groups by RINVR in terms of nausea and vomiting. CONCLUSIONS: The adverse effect of an inhalation agent appears not to be related to its concentration when sevoflurane with BIS monitoring are used to reduced the amount of agent inhaled.
Adult ; Analgesia ; Anesthesia* ; Anesthesia, General ; Electroencephalography ; Fentanyl ; Humans ; Inhalation ; Intensive Care Units ; Liver ; Nausea ; Postoperative Nausea and Vomiting ; Thyroidectomy ; Vomiting

PURPOSE: We proposed a multi-physiological signals based real-time intelligent triggering system(MITS) for Cardiac MRI. Induced noise of the system was analyzed. MATERIALS AND METHODS: MITS makes cardiac MR imaging sequence synchronize to the cardiac motion using ECG, respiratory signal and second order derivative of SPO2 signal. Abnormal peaks due to arrhythmia or subject's motion are rejected using the average R-R intervals and R-peak values. Induced eddy currents by gradients switching in cardiac MR imaging are analyzed. The induced eddy currents were removed by hardware and software filters. RESULTS: Cardiac MR images that synchronized to the cardiac and respiratory motion are acquired using MITS successfully without artifacts caused by induced eddy currents of gradient switching or subject's motion or arrhythmia. We showed that the second order derivative of the SPO2 signal can be used as a complement to the ECG signals. CONCLUSION: The proposed system performs cardiac and respiratory gating with multi-physiological signals in real time. During the cardiac gating, induced noise caused by eddy currents is removed. False triggers due to subject's motion or arrhythmia are rejected. The cardiac MR imaging with free breathing is obtained using MITS.
Arrhythmias, Cardiac ; Artifacts ; Complement System Proteins ; Electrocardiography ; Magnetic Resonance Imaging* ; Noise ; Respiration

BACKGROUND: To observe the clinical features and the outcomes from diagnostic work-up in definite multiple sclero-sis (MS) which was diagnosed by using a Poser's criteria. METHODS: We retrospectively evaluated 43 cases who were diagnosed as multiple sclerosis in Seoul National University Hospital by using Poser's criteria from January 1st, 1991 to December 30th , 1995. Among the 43 cases, 35 patients were classified to definite MS group, clinically or laboratory supported. We analyzed age, sex, initial symptom, age of onset, duration between initial symptom and definite MS diagnosis, total numbers of recurrence and symptoms, CSF profile, evoked potential study, follow-up duration and the MRI findings of the definite MS patients. RESULTS: Of 35 cases who were diagnosed as definite MS, 15 patients were male and 20 patients were female. The mean age of onset was 34.6 years, the mean duration between initial symptom onset and diagnosis of definite MS was 16.9 months, and the mean follow-up duration was 34.8 months. The most common site of initial involvement was spinal cord (24 cases), and then optic nerve (5 cases), brain stem (4 cases), and cerebrum (2 cases) were followed. Thoracic spinal cord (24 lesions) was more frequently involved than cervical cord (18 lesions). Moreover 32 cases (91.4%) had at least one time of spinal cord involvement and there is a tendency that the proportion of double spinal cord lesion is increasing with the number of spinal cord recurrence. CONCLUSIONS: Spinal cord involvement in multiple sclerosis is the most common symptom and double spinal cord involvement in MRI is frequently observed. We think that it would be the characteristics of the multiple sclerosis in Korea.
Age of Onset ; Brain Stem ; Cerebrum ; Diagnosis ; Evoked Potentials ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis* ; Optic Nerve ; Recurrence ; Retrospective Studies ; Seoul ; Spinal Cord