OBJECTIVE: To determne whether abnormal results of doble saeening tests for Down syndrome with MSAFP and free B-hCG are associated with adverse pregnancy outcome. METHODS: Between October 1994 and September 1997, 205 among 1731 who were screened had increased risk for Down screening program of CIS biointernational, Fetuses with Chromosomal abnormality or congenital anomalies and less than 35 years of maternal age were excluded from this study. Down syndrome screening test was performed between 14-22 weeks of gestation. RESULTS: Of 1731 women, 205 (13.4%) had increased Down syndrome risk. The pregnancy outcome of women with increased Down syndrome risk were compared with those of women without such risk There were no significant difference in the incidence of preterm labor (6[2.9%] vs 112[7.3%)), premature rupture of the membranes (2[0.9%] vs 56[3.6%]), pregnancy induced hypertension (2[0.9%] vs 36[2.3%]), abruptio placentae (0[0%] vs 2[0.1%]), low birth weight (2[0.9%] vs 21[1.3%]), oligohydramnios (4[1.9%] vs 10[0.6%]), intrauterine fetal death (0[0%] vs 2[0.1%]). CONCLUSION: False positive results of Down syndrome screening test in the 2nd trimester do not appear to be associated with adverse pregnancy outcome. But there are statistically significant increases of adverse pregnancy outcome in wemen with elevation of MSAFP or elevation of free B-hCG.
Abruptio Placentae ; Chromosome Aberrations ; Down Syndrome ; Female ; Fetal Death ; Fetus ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Mass Screening* ; Maternal Age ; Membranes ; Obstetric Labor, Premature ; Oligohydramnios ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

p27Kip1 has been recognized as a negative regulator of cell cycle. Reduced level of p27 expression is associated with development and aggressiveness of several human tumors. To investigate the role of p27Kip1 on progression of colorectal adenocarcinoma, we studied 40 cases of human colorectal adenocarcinomas for expression of p27Kip1 protein using an immunohistochemical method, and compared these results with known prognostic parameters of colorectal adenocarcinoma. Among 40 cases of colorectal adenocarcinomas, p27Kip1 expression was detected in the nuclei of tumor cells in 14 cases (35%). The expression rate of p27Kip1 protein was significantly lower in the cases with lymph node metastasis (25.8%) than in those without lymph node metastasis (66.6%) (p<0.05). But it did not correlate with other parameters such as tumor size, histologic grade, vascular invasion, and Ki-67 labeling index. The results suggest that reduced expression of p27Kip1 protein plays a role in biologically aggressive behavior of colorectal adenocarcinoma.
Adenocarcinoma* ; Cell Cycle ; Cyclin-Dependent Kinase Inhibitor p27* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Phytolaccae had been used as a pharmaceutical drug or food But nowadays, due to its toxicity, Phytolaccae is rarely used and cases of patients poisoned with it are seldom reported. The case presented here was of 43 year-old male who after ingesting extract of Phytolacca esculenta suffered from abdominal pain, diarrhea, nausea, vomiting, tachycardia, hypotension, pruritus, paresthesia, oliguria and azotemia. Kidney biopsy revealed tubular necrosis and some protein casts in tubular lumens. These findings suggested that acute renal failure was mainly caused by nephrotoxicity of Phytolacca extracts. Through continuous arteriovenous hemofiltration and two times of hemodialysis, he was completely recovered from acute renal failure. Other symptoms also disappeared by symptomatic management, but paresthesia of both lower extremities still remained. So we reported this case with a brief review of literature.
Abdominal Pain ; Acute Kidney Injury* ; Adult ; Azotemia ; Biopsy ; Diarrhea ; Hemofiltration ; Humans ; Hypotension ; Kidney ; Lower Extremity ; Male ; Nausea ; Necrosis ; Oliguria ; Paresthesia ; Phytolacca* ; Poisoning* ; Pruritus ; Renal Dialysis ; Tachycardia ; Vomiting

PURPOSE: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. METHODS: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. RESULTS: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. CONCLUSION: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.
Anesthesia ; Cooperative Behavior ; Curriculum ; Floors and Floorcoverings ; Humans ; Massage ; Surveys and Questionnaires ; Respiration ; Retrospective Studies ; Students, Nursing ; Women's Health

PURPOSE: We performed this study to evaluate the value as early markers predicting the acute rejection and differential diagnosis with other causes of renal dysfunction. METHODS: Immunohistochemical stains for HLA-DR, ICAM-1, IL-2 and IL-4 were performed on 44 cases of implantation biopsies which were divided into cases with acute rejection (R group, 14 cases) and cases without rejection episode (N group, 30 cases), and 45 gun biopsies for renal dysfunction which divided into cases diagnosed as rejection (A group, 28 cases) and cases diagnosed as other causes rather than rejection (B group, 17 cases). We analysed immunohistochemical results, various clinical datas such as age and sex of donor, living or cadaveric status of donor, the mean number of HLA-DR mismatch, age and sex of patient, serum creatinine level at post op 2 day for implantation biopsy and at the day on biopsy for renal dysfunction between above groups. RESULTS: 1) In 44 cases of implantation biopsies, positive immunohistochemical stains for HLA-DR were more frequent in R goup (71.43%) than in N group (26.66%). There was no significant difference of clinical datas and immunohistochemical stains for ICAM-1, IL-2 and IL-4. 2) In 45 cases of gun biopsies for renal dysfunction, immunohistochemical stains for HLA-DR were all positive in A group (100%) with higher rate of 3 stains (39.28%) than B group (positive; 70.58%, 3 ; 5.88%). Immunohistochmical stains for ICAM-1 were more frequently expressed in A group (100%) than B group (76.47%). Both stains revealed no significant difference according to the grades of rejection, disease other than rejection. There was no significant diffrence of immunohistochemical stains for IL-2 and IL-4, and clinical datas between two groups. CONCLUSION: We can conclude that the immunohistochemical stains for HLA-DR on implantation biopsies may predict the devepoment of the acute rejection and the immunohistochemical stains for HLA-DR and ICAM-1 on gun biopsies at the time of renal dysfunction may differentiate the reje.
Biopsy* ; Cadaver ; Coloring Agents ; Creatinine ; Diagnosis, Differential ; HLA-DR Antigens* ; Humans ; Intercellular Adhesion Molecule-1* ; Interleukin-2* ; Interleukin-4* ; Kidney Transplantation ; Living Donors ; Tissue Donors

PURPOSE: Numerous investigations have been conducted in order to determine the potential carcinogenic or chemopreventive activity of capsaicin. The aim of this study is to characterize the effects of capsaicin on colon cancer cells, and provide valuable information concerning the application of capsaicin in chemoprevention as well as for therapeutic purposes. METHODS: CoLo320DM and LoVo cells (human colon cancer cell line) were treated with capsaicin. In order to access cell viability and altered morphology, an MTT assay was performed and the cells were microscopically examined. Decreasing DNA staining was accessed by FACS. The cells were stained with FITC labeled annexin V and analyzed by FACS to detect cellular membrane alteration during apoptosis. The cells were stained with DiOC6(3) and Hydroethidine and analyzed by FACS in order to access ROS and dleta psi m. RESULTS: Capsaicin decreased cell viability in a dose-dependent manner. Capsaicin produced a cell morphology corresponding to the apoptotic features including cell shrinkage and chromatic condensation. Capsaicin treated cells induced a loss of nuclear DNA leading to hypoploidy in a dose-dependent manner. Cells were excluded by double staining with PI and FITC labeled annexin v and detected by FACS. We show that treatment of CoLo320DM, L0Vo cells with increasing concentrations of capsaicin parallel an increase in the percentage of red fluorescent cells (HE-->Eth) that reflect ROS hypergeneration and a decrease in the percentage of green fluorescent cells that reflect delta psi m disruption. CONCLUSION: These results clearly demonstrate that capsaicin-induced colon cancer cell death is apoptotic.
Annexin A5 ; Apoptosis* ; Capsaicin ; Cell Death ; Cell Line* ; Cell Survival ; Chemoprevention ; Colon* ; Colonic Neoplasms* ; DNA ; Fluorescein-5-isothiocyanate ; Humans* ; Membranes

BACKGROUND/AIMS: This study compared the results of cyclooxygenase-2 (COX-2) expression in inflammatory bowel disease and tuberculous colitis as evident by immunochemical staining and real time polymerase chain reaction (PCR). METHODS: Patients with ulcerative colitis (n=18), Crohn's disease (n=7), tuberculous colitis (n=7) and 10 normal controls were included. Biopsied colonic mucosa was simultaneously used for immunohistochemical staining and real time PCR. RESULTS: Patients with inflammatory bowel disease and tuberculous colitis showed high COX-2 expression by both methods compared to the normal controls. In Crohn's disease patients, the real time PCR value correlated well staining grade; this correlation was not evident in ulcerative colitis patients. In real time PCR, grossly normal colonic mucosa in ulcerative colitis also showed higher expression of COX-2 than normal mucosa. CONCLUSIONS: Real time PCR value of COX-2 is more representative of inflammation state in inflammatory bowel disease than the value from immunohistochemical staining.
Colitis ; Colitis, Ulcerative ; Colon ; Crohn Disease ; Cyclooxygenase 2 ; Humans ; Immunohistochemistry ; Inflammation ; Inflammatory Bowel Diseases ; Mucous Membrane ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction

BACKGROUND/AIMS: A two-year, prospective, nationwide multicenter study was undertaken to evaluate the effect of Helicobacter pylori eradication on the development of reflux esophagitis (RE) and gastroesophageal reflux disease (GERD) symptoms in the Korean population. METHODS: In total, 1,489 subjects without RE were enrolled at the outpatient clinics of 12 tertiary hospitals nationwide, and 452 subjects underwent follow-up (F/U) for 2 years to evaluate the development of RE and GERD symptoms. RESULTS: RE was found in 33 subjects (7.3% of 452 subjects) and 14 subjects (7.3% of 192 subjects) during the first and second year of F/U, respectively. H. pylori status was not associated with the development of RE. RE was found in six (9.0%) of 67 H. pylori-negative patients, in 26 (11.2%) of 233 eradicated subjects and in eight (7.0%) of 114 noneradicated subjects (p=0.532). Multivariate analysis showed that age > or =60 years (odds ratio [OR], 7.11; 95% confidence interval [CI], 1.92 to 26.41), alcohol consumption (OR, 4.43; 95% CI, 1.03 to 19.19) and F/U cholesterol levels > or =200 mg/dL (OR, 5.03; 95% CI, 1.32 to 19.17) were significant risk factors for the development of RE. There was no significant difference in the development of GERD symptoms or weight according to H. pylori status during the 2-year F/U. CONCLUSIONS: Eradication of H. pylori did not affect the development of reflux esophagitis or GERD symptoms among patients in outpatient gastroenterology clinics in South Korea.
Alcohol Drinking ; Ambulatory Care Facilities ; Cholesterol ; Esophagitis, Peptic ; Follow-Up Studies ; Gastroenterology ; Gastroesophageal Reflux ; Helicobacter ; Helicobacter pylori ; Humans ; Multivariate Analysis ; Outpatients ; Prospective Studies ; Republic of Korea ; Risk Factors ; Tertiary Care Centers

Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.

Purpose: Docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP) regimen is frequently used to treat early and locally advanced human epidermal growth factor receptor 2 (HER2)–positive breast cancer (BC) in neoadjuvant setting. However, large-scaled real-world evidence did not exist. Materials and Methods: We retrospectively reviewed medical records of patients with early or locally advanced HER2-positive BC who underwent neoadjuvant TCHP followed by curative surgery at Samsung Medical Center between January 2016 and August 2020. Results: Of 447 patients, 316 (70.7%) received breast-conserving surgery and 131 (29.3%) received total mastectomy. In terms of neoadjuvant chemotherapy response, pathologic complete response (pCR) and residual cancer burden (RCB) score were analyzed. The rate of pCR was 64% a class of RCB 0 was observed in 65% of cases, RCB class I in 12%, RCB class II in 14%, and RCB class III in 2%. The 3-year event-free survival rate was 90.6%, BC with pCR occurred in 92.8%, and BC with non-pCR in 86.3% (p=0.016). In terms of distant metastasis, the 3-year distant recurrence-free survival rate was 93.5%; BC with pCR occurred in 95.9% and BC with non-pCR in 89.2% (p=0.013). Mucositis (85.2%), pain (83.2%), and diarrhea (70.5%) were the most common non-hematologic adverse events. In terms of hematologic adverse events, anemia (89.9%) was the most commonly observed adverse events followed by thrombocytopenia (29.8%). Conclusion Neoadjuvant TCHP therapy had a pCR rate of 64% and a 3-year event-free survival of 90% in real world experience. In terms of toxicity profile, anemia was frequently observed and adequate management including occasional transfusion was required.