We report a case of postpartum choriocarcinoma from a 23-year old primiparous woman which was preceded by fetal anemia and intrauterine fetal death at 37 weeks' gestation. It has not been previously described in Korean literatures. The placenta, weighing 550 gm, contained multiple intervillous thrombi with laminated fibrin residue and pale cut curface. Histologic evidence of choriocarcinoma was not found in the placenta or in any fetal organs at autopsy, but large number of nucleated red blood cells and immature hemopoietic cells in the fetal capillaries of the placenta suggested the presence of fetal anemia. It was assumed that feto-maternal transfusion might had played a major role of fetal anemia and death.
Female ; Infant, Newborn ; Humans

Tailgut cyst is a rare congenital anomaly arising in the retrorectal space. Malignancy arising from the tailgut cyst is very rare. We experienced a case of adenocarcinoma arising from the tailgut cyst. The findings of this rare tumor are bony destruction of the sacrum on plain radiograph, a cystic mass on ultrasound, a low attenuation mass with calcification and enhancement on CT, and a multiseptated cystic mass containing solid component on MRI.
Adenocarcinoma* ; Magnetic Resonance Imaging ; Sacrum ; Ultrasonography

PURPOSE: Recent studies suggest that the symptomatic improvement in benign prostatic hyperplasia significantly related with transition zone volume (TZV). The purpose of this study was to determine the clinical significance of TZV and transition zone index (TZI) in changes of prostate volume (PV) and clinical parameters following finasteride therapy. MATERIALS AND METHODS: 140 patients over 50 years of age with symptomatic benign prostatic hyperplasia were treated with finasteride (5mg/d) for 12 months and underwent transrectal ultrasound evaluation of PV and TZV prior to initiating therapy and after 12 months. Patients were grouped according to the results of PV (> OR =40ml or <40ml), TZI (> OR =0.45 or <0.45) and PSA level (> OR =2.5 or <2.5). The responders was determined as improvement in peak flow rate more than 3mL/sec. RESULTS: PV decreased by 14.11% in patients with TZI less than 0.45, while the decrease was 19.25% for men with TZI greater than 0.45 (p<0.01). In addition, PV was significantly decreased by 16.72% in patients with PV less than 40cc and TZI greater than 0.45 (p<0.01). PV decreased by 17.37% in patients with PSA less than 2.5, while the decrease was 18.92% in men with PSA greater than 2.5. In responders, only TZI was significantly different among PSA, PV and TZI (p<0.05). CONCLUSIONS: Treatment effect of finasteride on symptomatic benign prostatic hyperplasia patients was increased in proportion to enlarged PV, increased TZI, increased PSA. TZI was a useful proxy for predicting clinical outcomes in initiating finasteride therapy on benign prostatic hyperplasia.
Finasteride* ; Humans ; Male ; Prostate ; Prostatic Hyperplasia* ; Proxy ; Ultrasonography

Hospitals have been very susceptable to changes in external environment. Accordingly, they have been experiencing great financial difficulty due to low insurance rates and increasing competition. As a remedy, hospitals have attempted to use computer in a strategic manner. Such system is called strategic information system (SIS) , and order communication system (OCS) is an example of SIS in hospital setting. While OCS has known to be effective in reducing waiting time for outpatients, many hospitals are reluctant to introduce this system mainly because there are no real data or methods for justifying the cost of the system. Cost-benefit analysis has been traditionally used for such purpose, but this method deals with limited portion of benefits and therefore not very useful for analyzing the economic feasibility of SIS. In this paper, information economics tools which expand cost with value was used to analyze the economic feasibility of OCS. To assist the analysis, financial simulation model was developed using simulation package, called IFPS (Interactive Financial Planning System).
Cost-Benefit Analysis ; Humans ; Information Systems ; Insurance ; Outpatients

Richter's syndrome is generally accepted taht lymphoma or leukemia of low grade malignancy, during their course, may alter both their morphologic and clinical appearance and evolve into highly malignant neoplasia. The pathogenesis is not clear, however, dedifferentiation by the emergence of a new clone of cells of higher maligancy similar to the blastic transformation in chronic myelocytic leukemia is suggested as possible mechanism. A case of Richter's syndrome is described. This 45 year old female had been diagnosed as chronic lymphocytic leukemia by absolute peripheral lymphocytosis 5 months before, developed sudden severe abdominal pain and was received segmental resection of ileum under the clinical impression of intestinal perforation with peritonitis. Histologically, the ulcer margin was diffusely infiltrated by polymorphic cells composed of large atypical cells having vesicular nuclei, multinucleated giant cells and Reed-Sternberg like cells admixed with mature lymphocytes. These atypical and multinucleated cells of the paraffin section showed strong monoclonal immunoreactivity for IgG and lambda light chain by PAP method and was interpreted as malignant lymphoma, diffuse, large cell, immunoblastic, polymorphous.
Female ; Humans

Superoxide dismutase(SOD), catalase and glutathione peroxidase and the levels of lipid peroxide were assayed in erythrocytes and synovial fluid isolated from 17 patients with osteoarthritis of the knee joints and 7 with healthy knee joints as a control groups. In the erythrocytes, SOD, catalase and glutathione peroxidase activities were significantly increased in osteoarthritis compared with normal control groups, but the changes of malonyldialdehyde level was not significant. The activity of SOD in synovial fluid was significantly decreased in osteoarthritis compared with normal control groups, but catalase activity was significantly increased in synovial fluid of osteoarthritis. This result suggested that the increament of antioxidant enzymes in erythrocytes were probably due to increased production of oxygen radicals in osteoarthritis. In osteoarthritis, knee joints might be injured more easily by oxygen radicals because of decreased activity of SOD in synovial fluid of osteoarthritis.
Catalase ; Erythrocytes ; Glutathione Peroxidase ; Glutathione ; Humans ; Joints ; Knee Joint ; Knee ; Malondialdehyde ; Osteoarthritis ; Osteoarthritis, Knee ; Reactive Oxygen Species ; Superoxide Dismutase ; Superoxides ; Synovial Fluid

No abstract available.
Sinusitis*

No abstract available.
Ascites* ; Gallbladder* ; Ultrasonography*

No abstract available.

BACKGROUND: Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 µg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). METHODS: Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 µg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. RESULTS: No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. CONCLUSIONS: For patients under general anesthesia receiving dopamine at 10 µg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Dopamine* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Jugular Veins ; Saphenous Vein ; Vascular Resistance ; Veins*