BACKGROUND: Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model. METHODS: Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF). RESULTS: Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF. CONCLUSIONS: Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Acute Lung Injury* ; Animals ; Arrhythmias, Cardiac ; Bronchoalveolar Lavage ; Flecainide* ; Infusions, Subcutaneous ; Injections, Intraperitoneal ; Interleukin-8 ; Leukocytes ; Lung ; Lung Injury ; Models, Animal ; Neutrophils ; Rats ; Sepsis*

Uterine sarcomas are relatively rare tumors of mesodermal origin that constitute 2-6% of uterine malignancies. Uterine sarcomas include endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), malignant mixed m llerian tumor (MMMT) of both homologous and heterologous type, pure heterologous sarcomas, blood vessel sarcomas, and lymphoma. Endometrial stromal tumors are divided into three types: 1) endometrial stromal nodule, 2) low-grade stromal sarcoma or endolymphatic stromal myosis, and 3) endometrial stromal sarcoma. The low grade endometrial stromal sarcoma is very rare. It shows occasional local recurrence, which might arise from endometrial stroma, from adenomyosis, and rarely from endometriosis. We have experienced a case of low grade endometrial stromal sarcoma of the uterus in a 54-year-old woman, which is presented with a review of literatures.
Adenomyosis ; Blood Vessels ; Endometrial Stromal Tumors ; Endometriosis ; Female ; Humans ; Leiomyosarcoma ; Lymphoma ; Mesoderm ; Middle Aged ; Recurrence ; Sarcoma ; Sarcoma, Endometrial Stromal* ; Uterus*

No abstract available.
Abscess* ; Eosinophils* ; Humans ; Liver Transplantation* ; Liver* ; Living Donors* ; Transplants*

OBJECTIVE: The purpose of this study was to investigate the correlation between the cervicographic diagnoses and histologic diagnoses in patients with ASCUS cytologic diagnosis according to The Bethesda System. METHODS: This study was performed in outpatient clinic of Department of Obstetrics and Gynecology at Dankook University Medical Center from January 1, 2000 to July 31, 2000. Of the 120 patients who underwent both conventional Papanicolaou cervical cytologic test and cervicographic examination, 30 cases with ASCUS cytologic diagnosis were analyzed. Cervicographic diagnoses were compared with histologic diagnoses as a reference standard. RESULTS: Followings are the results summarized. 1. Age distribution was between 26 and 62. The mean age was 43.1 years. 2. The mean gravidity was 4.5 and the mean parity was 2.5. 3. There were 19 (63.3%) cervicographic diagnoses of Negative, 6 (20.0%) of Atypical, and 5 (16.7%) of Positive. Of the 5 Positive diagnoses, there were 3 cases of P0 and 2 cases of P1. 4. There were 1 (3.3%) histologic diagnosis of WNL, 23 (76.7%) diagnoses of cervicitis, 3 (10.0%) of LSIL, and 3 (10.0%) of HSIL. 5. Of the 19 cervicographic diagnoses of Negative, there were 17 histologic diagnoses of cervicitis, and 2 of LSIL. Of 6 cases of Atypical, there were 4 histologic diagnoses of cervicitis and 2 of HSIL. Of 5 cases of Positive, there were 3 histologic diagnoses of cervicitis, 1 of LSIL, and 1 of HSIL. 6. Cervicography for detecting LSIL or worse yielded sensitivity of 33.3%, specificity of 87.5%, positive predictive value of 40.0%, and negative predictive value of 84.0%. CONCLUSION: There was no statistical significance because of small data. Cervicography does not seem to replace conventional Papanicolaou cervical cytologic screening test or play an adjunctive role for detection of LSIL or worse in patients with ASCUS on cervical cytology. But a multicenter study with large data will be required to get the proper conclusion.
Academic Medical Centers ; Age Distribution ; Ambulatory Care Facilities ; Diagnosis ; Female ; Gravidity ; Gynecology ; Humans ; Mass Screening ; Obstetrics ; Parity ; Sensitivity and Specificity ; Uterine Cervicitis

Myotonic dystrophy is the most common autosomal dominant myopathy in adults. Our patient, a 41 year-old female suffering from myotonic muscular dystrophy, developed upper thoracic myelopathy due to hypertrophy of the ligamentum flavum and the posterior longitudinal ligament. She had a typical hatchet face and ptosis with "head hanging forward" appearance caused by neck weakness. Motor weakness, sensory changes and severe pain below T4 level, along with urinary incontinence began 3 months ago. Genetic and electrodiagnostic studies revealed myotonic dystrophy type 1. Magnetic resonance imaging of the spine showed loss of cervical lordosis and spinal cord compression due to hypertrophied ligamentum flavum and posterior longitudinal ligament at T1 to T3 level. We concluded that her upper thoracic myelopathy was likely related to the thickness of the ligamentum flavum and posterior longitudinal ligament due to repetitive mechanical stress on her neck caused by neck muscle weakness with myotonic dystrophy.
Adult ; Animals ; Female ; Humans ; Hypertrophy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lordosis ; Magnetic Resonance Imaging ; Muscular Diseases ; Muscular Dystrophies ; Myotonic Dystrophy ; Neck ; Neck Muscles ; Spinal Cord Compression ; Spinal Cord Diseases ; Spine ; Stress, Mechanical ; Stress, Psychological ; Urinary Incontinence

PURPOSE: The survival after a pancreaticoduodenectomy, for a periampullary adenocarcinoma is limited. However, the improvement in perioperative management, and the development of interventional medicine have made the survival from that cancer favorable. Due to the anatomical proximity of periampullary tumors, surgeons perform same procedure. It is accepted that the outcome of periampullary cancers vary after resection. The purpose of this study was to evaluate the risk factors, and the differences in survival, from periampullary cancers according to the origin of the tumor. METHODS: From March 1992 to December 2000, 87 patients, with periampullary tumors, who underwent a pancreatico duodenectomy, were analyzed for the location of the tumor and the tumor status. Of the 87 patients, the 85 surviving more than 30 days were included in the statistic analysis. The survival was calculated using the Kaplan-Meier Method. The risk factors were also analyzed between the locations. RESULT: Of the 87 resected adenocarcinomas, 25 were pancreatic cancers, 30 distal CBD (common bile duct) cancers, 26 mpulla of Vater cancers and 6 duodenal cancers. The patients had a mean age of 60 (40~78) years. The total bilirubin, ALT, and CA 19-9 levels were statistically different for each cancer. There were no statistical differences between the cancer groups in operative methods, the amount of transfusion, postoperative hospital stay, and complications. The overall morbidity and mortality were 37 and 2%, respectively. The 5-year survival rates for the pancreatic, distal CBD, and Ampulla of Vater cancers were 9.6, 45.5, and 72.1%, respectively, was and were statistically significant (P<0.001). A univariate analysis of the 85 patients indicated that the predictors of long term survival included: a pathologic diagnosis of Ampulla of Vater cancer, absence of lymph node metastasis, tumor diameter<3 cm and complication. CONCLUSION: The factors influencing the survival were nodal metastasis, size of the tumor, age, and complications. The differences in the tumor biology will affect the survival, and although a pancreaticoduodenectomy remains the procedure of choice for periampullary tumors, adjuvant, or neoadjuvant, therapy for a pancreatic head tumor is especially needed.
Adenocarcinoma ; Ampulla of Vater ; Bile ; Bilirubin ; Biology ; Diagnosis ; Head ; Humans ; Length of Stay ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreaticoduodenectomy* ; Prognosis* ; Risk Factors ; Survival Rate

No abstract available.
Animals ; Female ; In Situ Hybridization ; Mice* ; Ovary*

Sixty patients with head and neck carcinoma were studied retrospectively to assess the impact of treatment on survival and local control rate by stage in the Dept of Radiation Therapy, Korea University Had Wha Hospital between March 1981 and March 1986. Prior to definite radiotherapy, patients were evaluated by physical examination and radiologic studies including hest, paryngogram and CT scan and then these patients were grouped according to the American Joint Committee(AJC) staging system. They were Treated with RT alone or postoperative irradiation to the dose of 7,200 cGy/8 weeks and 6,000 cGy/7 weeks respectively. The results were obtained and as follows; 1. overall male to female sex ratio was 3.6:1. The peak age of patients with head and neck cancer was 6th decade. 2. In all patients treated by RT, the ratio of squamous cell carcinoma to non-squamous cell carcinoma was 3.5:1 (60/77 patients). 3. The incidence according to the anatomic site of primary tumor was 22 cases in the larynx, 12 cases in PNS, 7 cases in nasopharynx, 6 cases in oropharynx, and 3 cases in hypopharynx. 4. According to AJC staging system, 4 cases were Stage I, 7 in Stage II, 19 in Stage III and 27 in Stage IV. 5. The overall incidence of cervical lymph node metastases was 43% and subdigatric and submaxillary triangle lymph nodes were the most frequent site of metastases. 6. Local control was achieved in 48% of patients treated by radio-therapy. 7. The lung was the most common site for distant metastases, comprising 4 cases among 7 cases in which distant metastases occurred. 8. The overall estimated 5-year survival rate was 43% in the head and neck cancer treated with radiotherapy by life-table analysis.
Carcinoma, Squamous Cell ; Female ; Head and Neck Neoplasms* ; Head* ; Humans ; Hypopharynx ; Incidence ; Joints ; Korea ; Larynx ; Lung ; Lymph Nodes ; Male ; Nasopharynx ; Neck ; Neoplasm Metastasis ; Oropharynx ; Physical Examination ; Radiotherapy* ; Retrospective Studies ; Sex Ratio ; Survival Rate ; Tomography, X-Ray Computed

OBJECTIVES: To investigate whether endometrial proteins with molecular weight(MW) of 92 kilodalton(kDa) may be a specific antigen involved in autoimmunity in endometriosis and to evaluate the efficacy of enzyme-linked immunosorbent assay(ELISA) in determining antiendometrial antibodies, compared with Western blot. METHODS: Sera of forty-eight patients with endometriosis, 21 patients with normal control patients, 7 patients with Mayer-Rokitansky-Kustner-Hauser(MRKH) syndrome and cord sera of 22 male neonates(experimental controls) were tested for the presence of antibodies against endometrial proteins by Western blot and ELISA. All statistics were performed by Fishers exact teast and Student's t-test. RESULTS: Fourteen(29.1%), 18.8%, and 33.3% of sera from patients with endometriosis had immunoglobulin (IgG) antibodies that were reactive against endometrial proteins of MW of 71, 92, 103 kDa while any sera from experimental controls did not show any reactivity against these antigens. Overall, threr were specific IgG antiendometrial antibodies detectable by Western blot in 56.3% of patients with endometriosis and in a normal eontrol patient. The binding activities of serum IgG to endometrial proteins were higher in patients with endometriosis than other groups. Circulating IgG antiendometrial antibodies were detected by ELISA in 54.3% of 35 patients with endometriosis and in 2 normal control patients. The concordance rate between ELISA and Western blot in determining the presence of antiendometrial antibodies was 78.3%. CONCLUSIONS: Ninety-two kDa endometrial protein is a specific antigen eliciting IgG responses in endometriosis. ELISA may be an useful method in screening autoimmune endometriosis.
Antibodies* ; Autoimmunity ; Blotting, Western* ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin G ; Immunoglobulins ; Male ; Mass Screening

BACKGROUND: Onychomycosis is one of the most prevalent fungal diseases in the general population. However, treatment is of limited effectiveness and must be administered for long periods of time. Systemic antifungal agents are associated with adverse effects. OBJECTIVE: We evaluated the clinical efficacy and safety of a 1,064-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser with amorolfine nail lacquer to treat onychomycosis. METHODS: The 128 patients were randomly divided to 2 groups: 64 in the experimental group were treated with 1,064-nm Nd:YAG laser therapy and amorolfine nail lacquer; the other 64 were in a control group treated with topical amorolfine lacquer monotherapy. The laser treatment was 4 sessions at 4-week intervals and amorolfine lacquer was applied once a week for 16 weeks. Efficacy was assessed as response rate from standardized photographs with ImagePro®Plus (Media Cybernetics, Inc., USA) analysis, microscopic examination, and subjective evaluation. RESULTS: At 16 weeks, the experimental group showed a significantly higher cumulative cure rate than the control group (71.88% vs. 20.31%, p<0.0001). Clinical therapeutic effects were linked to patient satisfaction. The percent of “very satisfied” or “satisfied” responses was higher in the test group than the control group (81.25% vs. 23.44%). The treatment regimen was well tolerated, with transient discomfort observed in the test group. CONCLUSION: The 1,064-nm Nd:YAG laser with amorolfine nail lacquer was effective and safe for treating onychomycosis. This therapy should be considered an alternative treatment, especially for patients with contraindications to systemic antifungal agents.
Antifungal Agents ; Cybernetics ; Humans ; Lacquer* ; Laser Therapy ; Onychomycosis* ; Patient Satisfaction ; Therapeutic Uses ; Treatment Outcome ; Yttrium*