Beta-fluoroethylacetate has been extensively used as the rodenticide in Korea. In some patients with acute poisoning, beta-fluoroethylacetate caused cerebellar dysfunction as a single and persistent neurologic sequela after a period of an acute neurological disorder which is characterized by mental deterioration, seizures, and respiratory failure. But there has been no report of pathological findings to explain neurological deficit. We tried to verify the histologic changes of the central nervous systems in beta-fluoroethylacetate poisoned rats. Silver staining(Gallyas) was used to evaluate the histology. In acute intoxication experiment with LD50(7mg/Kg), beta-fluoroethylacetate elicited acute onset of consciousness deterioration, generalized tonic-clonic seizures and large amplitude tremulous activity involving whole body with full recovery after 24 hours. There was no discernible pathologic change in CNS in acutely poisoned rats. However, when poisoned with sublethal dose(5mg/Kg) daily for five days, a moderate degree of nerve cell degeneration was found selectively in dentate nucleus, Purkinie cell layer, vestibulo-cochlear nucleus and striatum. This change was not seen in hippocampus, cerebral cortex or cerebellar cortex. These findings were well correlated with the previous reports of selective pathology in human 5-FU intoxication cases. Our preliminary results suggest that beta-fluoroethylacetate, a kind of cellular metabolism inhibitor may induce selective neuropathology mainly involving cerebellar output pathway in rats.
Humans ; Rats ; Animals ; Poisons

OBJECTIVE: In the human body the embryo initially gmws in the fallopian tube which is maintained in an 3-8% O2 concentration environment, and various substances such as growth factors and antioxidants present in tbe tubal fluid assists in maintaining a healthy environment for embryo development. But in IVF programs embryo cultures are conducted in incubators with 21.9% O2 and 5% CO2 condition, and such high oxygen concentrations have been reported to increase the production of oxygen free radicals within the embryo and is detrimental to the growth and development of the embryo. The objective of this study, therefore, is to determine the culture conditions which will decrease oxygen free radical production and thereby minimize the injury to the embryo. METHODS: Six to eight week old ICR strain mice embryos were cultured in 5% or 21.9% O2 conditions and in culture media to which inaement concentrations of superoxide dismutase (SOD) had been and the H2O2 concentration within the embryo, embryo developmental rate, and degree of fragmentation of the embryos was investigated. RESULTS: The control gmup embryos which were cultured in 21.9% O2 condition without addition of SOD showed developmental arrest at the 2-cell stage or fragmentation, while those cultured in 21.9% O2 condition with addition of SOD showed development to the blastocyst stage with deaeased fragmentation. In particular, the blastulation and fragmentation rates were the lowest in the group to which 500 IU/ml of SOD was added, but in the 5% O2 enviranment group many embryos reached the blastocyst stage and with no difference in frapnentation with or without addition of SOD. The HO relative intensity (120.5+/-20.2) within the embryos cultured in 21.9% O2 environment without SOD was significantly higher than that (56.8+/-10.8) of group with SOD (p<0.05). As showing that in the 5% O2 environment group without SOD it was 43.8+/-7.8 and in the group with SOD it was 37.3+/-5.4, the H2O2 concentration within embryos cultured in 5% 02 condition was significantly lower those that of 21,9% 02 environment regardless of SOD addition (p<0.05). CONCLUSION: The optimal oxygen concentration in incubator for mice embryo cultures is that which is similar to the 5% 0 concentration in vivo. When 20% 02 incubators are routinely used, the addition of SOD to the culture media will decrease the H2O2 concentration within the embryos with subsequent improvement in development. The optimal concentration which should be used is thought to be 500 IU/ml. It is suggested that the use of the above method in human IVF-ET programs will lead to improved embryo quality and enhanced pregnancy rates.
Animals ; Antioxidants ; Blastocyst ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Fallopian Tubes ; Female ; Free Radicals ; Growth and Development ; Human Body ; Humans ; Incubators ; Intercellular Signaling Peptides and Proteins ; Mice* ; Oxygen* ; Pregnancy ; Pregnancy Rate ; Superoxide Dismutase* ; Superoxides*

OBJECTIVE: It is known that mouse embryos before implantation develop in a low oxygen environment of 3- 8% concentration and with antioxidant materials such as vitamins, antioxidant enzymes, ferrous binding proteins, and albumin in follicular and tubal fluids. However, the 20% oxygen culture condition with chemically defined media might be produce an abundance of ROS, and leads to developmental delay or developmental block in vitro. In this study, we attempt to elucidate the relationship between intracellular H2O2 production and embryo development in different oxygen culture conditions of mouse embryos. METHODS: Prenuclear embryos from C57BL/CBA Fl hybrid and ICR mouse were cultured in incubators which provided 5% carbon dioxide, 20% oxygen and 5% carbon dioxide, 5% oxygen. Measurement of H2O2 level in a embryo was performed with DCHFDA(2, 7 -dichlorodihydroflourescein diacetate)and analyzed with Quanti-cell 700, and the number of blastomeres was counted with DAPI( 4, 6'-diamidino-2-phenylindole). RESULTS: Oxygen concentration of the culture medias was significantly higher in the 20% oxygen environment compared to that of 5% oxygen environment. Culture of mice embryos in high oxygen condition leads to high HO concentrations at 2 cell stage and developmental delay or ""2-cell block"" regardless of the strain. But in a 5% oxygen environment, which is similar to in-vivo conditions HO production was suppressed continuously through out culture and development of embryos was definitely improved. CONCLUSION: These results suggest that there is a difference in the production of ROS or protective mechanism according to the mouse strains and stage of development, and it is thought that in-vitro culture in 5% oxygen environment provides stable in vivo equilibrium but in a 20% oxygen environment there is production of ROS which overcome the protective mechanism which leads to cellular damage and embryo developmental delay.
Animals ; Blastomeres ; Carbon Dioxide ; Carrier Proteins ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Female ; Incubators ; Mice* ; Mice, Inbred ICR ; Oxygen* ; Pregnancy ; Vitamins

Cyclooxygenase (COX) is an enzyme involved in the conversion of arachidonic acid to prostaglandins(PGs), and exists in two forms, COX-1 and COX-2. COX has been reported to be involved in early implantation by secretion of PGs which causes permeability of vessels and reaction of decidual cells around the implantation site. Recently, in mice and sheep studies, COX-1 and COX-2 expression in the endometrium has been reported to be different according to implantation and stages of the estrous cycle, but expression of COX-1 and COX-2 in human endometrium during the menstrual cycle has not yet been established. The purpose of this stuffy was to observe the variances of COX-1 and COX-2 expression by immunohistoehemical staining in endometrial samples obtained from human hysterectomy specimens and biopsies of women of reproductive age according to different stages of the menstrual cycle. Also, we attempted to observe COX-1 and COX-2 expression in the epithelial and stromal cells of the endometrium obtained during the mid-secretory phase, which were cultured separately. COX-2 showed a cyclic pattern of expression according to the different stages of the menstrual cycle and was strongly expressed particularly at the mid-secretory phase which corresponds to the time of implantation. However, COX-1 tended to be increased in the early proliferative, and mid- and late secretory phases, but was also expressed in the whole menstrual cycle showing no particular pattern. In the separately cultured cells COX-1 was expressed in epithilial cells and COX-2 in the stromal cells. The above results suggest that since COX-2 is expressed at the same time as implantation and cultured cells display a specific secretory pattern, COX-2 has inductive endocrine enzyme properties and has an important effect on endometrial cells during implantation. Also, COX-2 expression in endometrial cells may be utilized as a useful marker of endometrial maturation.
Animals ; Arachidonic Acid ; Biopsy ; Cells, Cultured ; Cyclooxygenase 1* ; Endometrium* ; Estrous Cycle ; Female ; Humans* ; Hysterectomy ; Menstrual Cycle ; Mice ; Permeability ; Prostaglandin-Endoperoxide Synthases ; Sheep ; Stromal Cells

Advanced or complete atrioventricular (AV) block is frequently regarded as a cause of informed syncopal attacks even though escape rhythm is maintained. Torsades de pointes (TdP) may be a significant complication of AV block associated with QT prolongation. Maintaining ventricular rate over 70 beats/min is known to be important to normalize QT interval and to reduce the possibility of bradycardia-related TdP recurrence after pacemaker implantation. We report one case of syncopal attacks associated with TdP in a 70 year old female patient with advanced AV block and prolonged QT interval. She was referred to evaluate palpitation and syncope. Advanced AV block and QT interval prolongation were seen with electrocardiography, but junctional escape rhythm was maintained. Syncopal attacks occurred during temporary pacemaker insertion. Multiple episodes of nonsustained polymorphic ventricular tachycardia and TdP related to syncopal attacks were demonstrated by 24-hour Holter monitoring. A permanent pacemaker was implanted and ventricular rate was set over 70 beats/min resulting in no recurrence of TdP and syncope.
Atrioventricular Block* ; Electrocardiography ; Electrocardiography, Ambulatory ; Female ; Humans ; Recurrence ; Syncope* ; Tachycardia, Ventricular ; Torsades de Pointes* ; United Nations

Torsion of the adnexa is a well-known gynecologic cause of an acute surgical abdomen. Delay in diagnosis, inability to distinguish strangulation from necrosis, and fear of embolus dislodgement have made adnexectomy the accepted method of management of adnexal torsion. This condition occurs most commonly in the reproductive years, yet methods to preserve viable ovarian tissue have not been routinely used or evaluated. Therefore, in order to ascertain if color Doppler sonography(CDS) can detect adnexal viability, ultrasonography with CDS of the ovarian pedicle was performed in 27 patients in whom torsion of the ovarian tumor was confirmed surgically. We were able to identify a twisted vascular pedicle of the ovarian tumor by ultrasonography in 24 of 27 patients(88% detectability). In 10 patients in which pedicle arterial and venous blood flow was observed, the pathology specimens revealed normal, or edema with congestion, or early hemorrhage, but in the 9 cases where only arterial blood flow was observed or where there was no blood flow at all, pathology revealed hemorrhagic necrosis in all cases. In 5 cases where there was arterial blood flow the tumor was managed conservatively, either by detorsion or cytectomy, after which there was no cases of embolism or tumor recurrence during follow up ultrasonography. Normal follicular development and ovulation was also observed in these patients. In conclusion, for young women who are of child-bearing age in whom torsion of benign adnexal tumors is suspected, CDS should be conducted to detect torsion of the tumor and ascertain whether pedicle venous blood flow is present or not. If such blood flow is detected, the adnexa is considered to be viable and detorsion or cystectomy may be performed, thus preserving the ovary.
Abdomen ; Cystectomy ; Diagnosis ; Edema ; Embolism ; Estrogens, Conjugated (USP) ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Necrosis ; Ovary ; Ovulation ; Pathology ; Recurrence ; Ultrasonography

PURPOSE: There are several kinds of classificatian dealing with the staging of the gastric adenocarcinoma. However, such different staging systems pose difficulty in the inter- institutional or intemational comparison of the disease status and the treatment results. The purpose of this study is to evaluate each staging system and to assess the usefulness of the new UICC-TNM staging system (1997) for gastric adenocarcinoma. MATERIAL AND METHODS: We retrospectively analysed 473 cases of gastric adenocarcinoma who were operated at the Department of General Surgery, Hanyang University Hospital during the period from 1992 to 1996. Using these cases, we analyzed their cumulative 5-year survival rate according to three kinds of staging systems; old UICC-TNM staging system (1987), new UICC-TNM staging system (1997), and the Japanese staging system for gastric carcinoma (1993). RESULTS: The follow up rate was 94.3% and the median follow up period was 30.3 months. All of these three systems showed a statistically significant survival difference according to their different classifications. When the distribution of stage between old and new UICC-TNM staging system was compared, 95 cases (20.1%) were subjected to stage shifting, which involves 12.1% of up-staging and 8.4% of down-staging. Stage shifting was most prominent in stage IIIb (68.8%). The cumulative 5-year survival rate according to the new UICC-TNM staging system was 99.1% in stage Ia, 81.4% in stage Ib, 75.2% in stage II, 45.9% in stage IIIa, 21.0% in stage IIIb, and 19.4% in stage IV. CONCLUSION: We conclude that the new UICC-TNM staging system is simple, practically convenient, and highly reproducible, and it showed a statistically significant survival difference according to their staging classification.
Adenocarcinoma ; Asian Continental Ancestry Group ; Classification ; Follow-Up Studies ; Humans ; Retrospective Studies ; Survival Rate

BACKGROUND: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. MATERIAL AND METHOD: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male : female=18 : 7, mean age 43.2+/-18.6 years) and 23 patients with isolated mitral endocarditis (Group II, male : female=10 : 13, mean age 43.2+/-17.1 years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patientsdeveloped mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II. The preoperative left ventricular ejection fraction for each group was 60.8+/-8.7% and 62.1+/-8.1% (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was 37.2+/-23.5 (range 9~123) months. RESULT: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and 100%, 84.9%, and 84.9% for Group II patients, respectively. CONCLUSION: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.
Aortic Valve ; Aortic Valve Insufficiency ; Atrial Fibrillation ; Bicuspid ; Cardiac Output, Low ; Echocardiography ; Endocarditis* ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; Hemorrhage ; Humans ; Male ; Microwaves ; Mitral Valve Insufficiency ; Mortality ; Postoperative Complications ; Stroke Volume ; Survival Rate

Desmoid tumor is a infrequent, but particular type of fibromatosis (dysplastic lesion of connective tissue), usually originating in the fascial sheath or musculoaponeurotic tissue of the body. It is characterized by its propensity for slow, incessant growth and by its nonmetastastic but locally aggressive behavior. While rarely associated with this tumor, morbidity and mortality occur when there is encroachment on vital structures. Because of the scarcity of data, the relatively small number of patients and the pathological resembrance to low-grade fibrosarcoma, desmoid tumor may be easily misdiagnosed and wrong conclusions regarding its biological behavior may be drawn. Also, the optimal treatment for this tumor remains controversial. At present, the most successful method of control of desmoid tumor is complete excision with a clear margin of normal tissue surrounding the tumor. To better delineate the natural history and the result of managing patients with this disease, we have reviewed all patients with desmoid tumor treated at our hostital from 1985 to 1996, and the following results were obtained : The male-to-female ratio was 1 : 2.7, and a childbearing-aged female preponderance was present like most reports. Seven of 22 patients(32 %) developed local recurrence. The recurrence of desmoid tumor was not related to patient's sex/age, location/size of the tumor, and previous operative history. Even though desmoid tumor is not pathologically malignant, it should be regarded as clinical malignancy and be treated by wide excision with pathologically-proven safe resectional margin.
Female ; Fibroma ; Fibromatosis, Aggressive* ; Fibrosarcoma ; Humans ; Mortality ; Natural History ; Recurrence

OBJECTIVE: We investigated the prevalence of depressive symptom and effect of family support on depressive symptom among high school students in Jeju Island, Korea. METHODS: The study subjects were 711 high school students consisting of 403 males and 308 females of three high schools in urban Jeju Island and the data was gathered using self-reporting questionnaires consisting of BDI, sociodemographic factors, health behavior and family support, etc. RESULTS: The prevalence of depressive symptom in high school students in Jeju Island is 17.7% in total, 17.1% in male, 18.5% in female. Multiple logistic regression analysis revealed that the family support had significantly effect on depression after controlling other confounding variables including age, sex, socioeconomic state, parent's marital statue, body image satisfaction, academic achievement, time spend with parents to build a relationship, and mother's education year. CONCLUSION: Family support was found to be a significant correlate of depressive symptom high school students in Jeju Island. Variety of supports to enhance family cohesion and family relation including sociocultural and political policies and program would be needed to reduce the risk of having depressive symptom and suicide ideation among high school students in Jeju Island.
Achievement ; Body Image ; Confounding Factors (Epidemiology) ; Depression ; Family Relations ; Female ; Health Behavior ; Humans ; Korea ; Logistic Models ; Male ; Parents ; Prevalence ; Surveys and Questionnaires ; Suicide