Epidemiologic investigation was conducted on January, 1993 in Seoul to identify the cause of an infant methemoglobinemia. Field investigation of the area of outbreak, survey of household and family members, analysis of ground water, and blood tests of involved family members were performed. Following results were obtained. On analyzing the quality of the ground water on patients's household high levels of nitrate was found indicating contamination of water as the cause of a methemoglobinemia outbreak. On analyzing the quality of the ground waters on seven other places within the neighborhood five were contaminated by nitrate in concentration that exceeded the permissible limit implying presence nearby source of contamination. Sources of contamination were thought to be originating from human waste in conventional bathroom facilities, chicken manure used in nearby orchards and plant fields or fertilizers. But the results of water analysis with presence of bacteria or E.coli, concentration of potassium, phosphate and the past history of diarrhea among family members, chicken manure suggested the most possible source of contamination. To evaluate the health status of members in the neighborhood past history was reviewed revealing no prior existence of patient with cyanosis and 65 people in the neighborhood had normal levels of methemoglobin concentration in their blood. Conclusively, the ground water on patient's household was contaminated with nitrate and despite provision of adequate water supply, family members of the patient along with distrust in the water supply system had used ground water as their source of drinking water resulting of methemoglobinemia. Many suburban area of Seoul and country side thought to be having similar problems concerning contaminated ground water supply and dormant outbreak of patients as a result of the drinking of the contaminated water. Epidemiologic investigation and water analysis of ground waters are advised.
Bacteria ; Chickens ; Cyanosis ; Diarrhea ; Drinking ; Drinking Water ; Family Characteristics ; Fertilizers ; Groundwater ; Hematologic Tests ; Humans ; Infant* ; Manure ; Methemoglobin ; Methemoglobinemia* ; Plants ; Potassium ; Residence Characteristics ; Seoul ; Water ; Water Supply

PURPOSE: The chemical structure of tubulosine has been known since the mid-1960s. However, little is known about its biological and pharmacological functions. The aim of this study was to investigate the novel functions of tubulosine in cancer treatment, specifically in breast cancer. METHODS: An Unpaired (Upd)-induced Drosophila cell line and interleukin (IL)-6-stimulated human breast cancer cell lines were used to investigate the biological and pharmacological activities of tubulosine in vitro. To investigate the activities of tubulosine, we performed molecular and cellular experiments such as Western blot and reverse transcription polymerase chain reaction analyses, immunoprecipitation and terminal deoxynucleotidyl transferase dUTP nick end labeling assays, and immunofluorescence staining using breast cancer cell lines. RESULTS: Tubulosine exhibited anticancer activity in IL-6-stimulated human breast cancer cells. Moreover, tubulosine reduced the tyrosine phosphorylation level and transcriptional activity of signal transducer and activator of transcription (STAT) protein at 92E in Upd-induced Drosophila cells. Additionally, tubulosine suppressed IL-6-induced Janus kinase 2 (JAK2)/STAT3 signaling, resulting in decreased viability and induction of apoptotic cell death in breast cancer cells. Interestingly, inhibition of IL-6-induced JAK2/STAT3 signaling by tubulosine was associated with the blocking of IL-6 receptor (IL-6R) and glycoprotein 130 (gp130) binding. CONCLUSION: Tubulosine exhibits anticancer activity through functional inhibition of IL-6-induced JAK2/STAT3 signaling by targeting IL-6Rα/gp130 binding in breast cancer cells. These findings suggest that tubulosine may hold promise for the treatment of inflammation-associated cancers, including breast cancer.
Blotting, Western ; Breast Neoplasms ; Cell Death ; Cell Line ; DNA Nucleotidylexotransferase ; Drosophila ; Fluorescent Antibody Technique ; Glycoproteins ; Humans ; Immunoprecipitation ; In Vitro Techniques ; Interleukin-6 ; Interleukins ; Janus Kinase 2 ; Phosphorylation ; Phosphotransferases ; Polymerase Chain Reaction ; Receptors, Interleukin-6 ; Reverse Transcription ; STAT3 Transcription Factor ; Transducers ; Tyrosine

Fetus in fetu is a very rare congenital abnormality in which one vertebrate fetus is enclosed within the abdomen of another fetus. With advancing ultrasound imaging technique, a few case of prenatal diagnosis is reported recently. A case of fetus in fetu with 6 X 6 X 4 cm sized cystic mass in the fetal retroperitoneum was diagnosed prenatally using ultrasound and confirmed by ultrasound and computer tomogram after delivery. This mass was removed completely from delivered baby and finally confirmed fetus in fetu by pathologic examination. Solid portion in this mass was composed of vertebral organization with limb bud, well-developed organ system.
Abdomen ; Congenital Abnormalities ; Fetus* ; Limb Buds ; Prenatal Diagnosis* ; Ultrasonography ; Vertebrates

OBJECTIVE: To raise recognition and find out clinical characteristics about pubic bone separation relatively rarely reported. METHODS: Among the total of 40,475 mothers who had delivered livebirths of over 25 weeks gestation between January 1995 and December 2002, we assigned 40,401 mothers without pubic bone separation to control group I and 74 mothers with pubic bone separation to sample group I. We compared maternal age, gestational age, birth weight and parity between the two groups. To conduct subgroup analysis on mothers who had undergone normal vaginal delivery, we randomly selected 37 out of sample group I and assigned them to sample group II. We selected 1,073 out of control group I with a ratio of nullipara-to-multipara and assigned them to control group II. In subgroup analysis, we compared several risk factors between control group II and sample group II. Lastly, clinical characteristics of sample group I were analyzed by Student's T-test, chi-square test. RESULTS: There were no significant differences in maternal age, gestational age, birth weight and parity between control group I and sample group I. Moreover, there were no significant differences in maternal age, gestational age, parity, weight gain, duration of oxytocin use, BPD and labor duration between control group II and sample group II. But, the history of vacuum delivery, macrosomia and long second-stage labor duration were more notable in sample group II than control group II. The severity and distance of pubic bone separation were severe in cases of normal vaginal delivery than those of Cesarean section. CONCLUSION: In conclusion, it will enhance the diagnostic rate for pubic bone separation in perinatal period to widen the understanding of it's clinical characteristics.
Birth Weight ; Cesarean Section ; Female ; Gestational Age ; Humans ; Maternal Age ; Mothers ; Oxytocin ; Parity ; Pregnancy ; Pubic Bone* ; Risk Factors ; Vacuum ; Weight Gain

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin, and a major risk for persistent trophoblastic tumor. Partial hydatidiform moles appear to be a milder version of complete moles with both normal and cystic villi, focal trophoblastic hyperplsia, a fetus or indication of previous fetal existence, 69 chromosomes with a maternal contribution, and a malignant potential less than described for complete moles. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies. Due to advances in cytogenetics and ultrasonography, now permit the diagnosis of this pregnancy antenatally. However this unusual pregnancy has the risks of malignant change and severe medical complications, so it is a dilemma to decide continuation or termination of pregnancy. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 12 gestational weeks, and confirmed normal karyotype (diploid) of the coexistent fetus. A brief reviews of related literature was done.
Classification ; Cytogenetics ; Diagnosis ; Diploidy ; Female ; Fetus* ; Hydatidiform Mole* ; Hyperplasia ; Incidence ; Karyotype ; Pregnancy ; Trophoblastic Neoplasms ; Trophoblasts ; Ultrasonography

OBJECTIVE: To study perinatal outcomes in hyperemesis gravidarum (HG) patients as compared to normal pregnancy. METHODS: We performed retrospective analysis of pregnancy records of obstetric admission during 9-years period (between 1995 and 2003). We identified 77 women who admitted for control of HG after diagnosed as HG and delivered during the study period. Women treated as out-patients for hyperemesis and delivered at other hospital were excluded. Multiple gestation and stillbirth were also excluded from analysis. Subjects were stratified into groups of mild and severe HG according to the presence of at least one of the following criteria: ketonuria, increased hematocrit, and/or abnormal electrolytes. All patients without HG on whom records were available and who delivered during the study period were included as controls. Student T-test, chi square test, Kruskal-Wallis test and Mann-Whitney's U test were used. RESULTS: Among 77 women, 31 patients were diagnosed as having mild HG and 46 patients as having severe; 41205 patients were defined as controls. Maternal age, gravidity, maternal weight gain from preconception to delivery, maternal anemia were not significantly different between hyperemesis patients and control group. Mean birth weight, mean gestational age, neonatal sex ratio, Apgar score, delivery route were not significantly different. Pregnancy outcome variables and maternal characteristics for mild, severe HG and control group were also similar. CONCLUSION: Women with hyperemesis have similar maternal characteristics to the general population and have similar pregnancy outcomes. And there were no significantly difference between mild and severe hyperemesis patients.
Anemia ; Apgar Score ; Birth Weight ; Electrolytes ; Female ; Gestational Age ; Gravidity ; Hematocrit ; Humans ; Hyperemesis Gravidarum* ; Ketosis ; Maternal Age ; Outpatients ; Pregnancy ; Pregnancy Outcome ; Pregnancy* ; Retrospective Studies ; Sex Ratio ; Stillbirth ; Weight Gain

This study evaluated the degree and the frequency of cervical lesions after treatment with LEEP(loop electrosurgical excision procedure) in patients with abnormal Pap smears according to the presence or absence of high-risk HPV infection. From June 1994 to May 1997, eighty patients who showed CIN or chronic cervicitis on LEEP specimens were followed up with Pap smears. The histologic results and follow-up Pap smear data were analyzed. In all cases HPV test by Hybrid Capture assay was performed. Those with neoplastic lesion underwent follow-up Pap smears at least for 1 year with 3 month interval after LEEP. In HPV-positive group(N 38), 63.2% of the cases revealed neoplastic lesion(CIN) on final histologic evaluation, and in HPV-negative group(N 42) 54.8% of the cases did(p 0.26). HPV-positive group represented 25.0%(6/24) of abnormal Pap smear result on follow-up, which is higher than that of HPV-negative group(4.3%; 1/23), showing significant difference (p<0.05). There was a significant difference in the rate of neoplastic lesion developed during follow-up between resection margin-positive group and resection margin-negative group on LEEP(p 0,04). Also, HPV-positive group had significantly higher chance to show abnormal Pap smear results during follow-up(p 0.02). In conclusion, HPV test and margin status were shown to be useful parameters to predict the recurrence or persistence of CIN lesion treated by LEEP.
Follow-Up Studies ; Humans ; Recurrence ; Uterine Cervicitis

PURPOSE: Drining of Nitrate-contaminated water has been the most common cause of acquired methemoglobinemia. We had cyanotic infant diagnosed as methemoglobinemia caused by feeding with powdered formula mixed with nitrate-contaminated ground water. METHODS: We had done epidemiologic investigation to identify the cause of an infant's methemoglobinemia. Analysis of ground water and blood test of involved family members and neighbors were performed RESULTS: Analysis of the 8 household ground water revealed high level of nitrate(29837 ppm), indicating contamination of water as the cause of methemoglobinemia. We had done blood tests to evaluate the methemoglobin level of 65 people in the neighborhood ; among them, there was no infant and we could not find another cyanotic case of methemoglobinemia. They had normal blood level of methemoglobinemic concentration. CONCLUSIONS: If ground water will be used for drinking water, especially for formula water, epidemiologic investigation and analysis of ground waters should be recommended.
Drinking Water ; Family Characteristics ; Groundwater* ; Hematologic Tests ; Humans ; Infant ; Methemoglobin ; Methemoglobinemia* ; Residence Characteristics

PURPOSE: The prognostic factors influencing the survival rate in patients with renal cell carcinoma were evaluated. MATERIALS AND METHODS: An analysis was performed on 102 patients with renal cell carcinoma who underwent a radical nephrectomy from January 1995 to June 1999. The survival rate according to each prognostic factor such as the 1997 TNM stage, the size, cell type and nuclear grade of the tumor and the presence of symptoms at the point of diagnosis, age and gender, and tumor location was analyzed using the Kaplan-Meier method. The statistics was determined by the log-rank test of a univariate analysis and the Cox proportional hazards model of multivariate analysis. RESULTS: Univariate analysis showed that the TNM stage, size and nuclear grade of tumor, and the presence of symptoms at the point of diagnosis had a significant influence on survival rate of patients with renal cell carcinoma. The tumor cell type, age and gender, the location of the tumors had little statistical significance. Multivariate analysis showed that a distant metastasis was the most significant prognostic factor followed by nuclear grade of the tumor cell, T stage, the presence of symptoms at the point of diagnosis, and lymph node metastasis in this order. CONCLUSIONS: The TNM stage, nuclear grade of the tumor and the presence of symptoms at diagnosis are important prognostic factors in renal cell carcinoma. Analyzing these prognostic factors will be useful as a treatment modality, follow up and prognosis of patients with renal cell carcinoma.
Carcinoma, Renal Cell* ; Cell Size ; Diagnosis ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Proportional Hazards Models ; Survival Rate

PURPOSE: The purpose of this study was to determine whether the functions and longevity of unicompartmental knee arthroplasty (UKA) are influenced by such patient factors as gender, age, height, weight and the body mass index (BMI) based on a comparative study of the cases. MATERIALS AND METHOD: Among the patients who underwent a UKA using an Oxford(R) phase 3 prosthesis, 154 cases (male: 13 cases, female: 141 cases) were categorized into two groups by their gender, age, height, weight and BMI, and they were followed-up for at least 5 years after operation. Their mean age, height, weight and BMI were 61.6 years, 154.5 cm, 61.9 kg and 25.9 kg/m2, respectively, and the mean follow-up period was 6 years 7 months. Clinical assessments were done using the Knee Society Score rating system. RESULTS: The average knee and function scores improved from 55.9 and 54.9 preoperatively to 87.9 and 82.4 at the last follow-up, respectively, and the mean range of knee motion improved from 129.7degrees to 133.5degrees. The postoperative knee score, function score and range of knee motion improved significantly in all the groups. The group younger than 60 years old had better function scores preoperatively and the group of taller than 155 cm had a larger range of knee motion postoperatively, but there were no other significant difference. The cumulative survival rate of the implant was 93.3%, and there was no significant difference of the survival rate of the implant according to gender, age, height, weight, and BMI. CONCLUSION: The clinical results of UKA were satisfactory in all the groups regardless of gender, age, height, weight and BMI with a mean of 6 years 7 months follow-up, and there were no significant differences on comparison between each group. Therefore, the mid-term clinical results of UKA using an Oxford phase 3 prosthesis are not influenced by these patient factors.
Arthroplasty ; Body Mass Index ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Longevity ; Osteoarthritis ; Prostheses and Implants ; Survival Rate ; Ursidae