Myometrial pregnancy developing in an previous cesarean section scar is the rarest of all ectopic pregnancy and provavly one of the most dangerous because of the risk of rupture and hemorrhage. For a young patient wanting to maintain her fertility, an earlier diagnosis and more conservative treatment are highly desirable. We present a case of an ectopic pregnancy embedded in the myometrium of a previous cesarean section scar in which the patient preserved her fertility through more noninvasive method, transvaginal ultrasound-guided Methotrexate injection.
Animals ; Cesarean Section* ; Cicatrix* ; Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Methotrexate* ; Mice ; Myometrium* ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

This study was performed for the comparison of the therapeutic efficiency between 6-month (2tHER/4HER) and 9-month (9HER) short-course chemotherapy under the programe conditions for pulmonary tuberculosis in terms of sputum AFB negative conversion rate, remedial interruption rate and cost effectiveness analysis. Two hundreds and ninty three patients treated with 9HER and 641 treated with 2HERZ/4HER had been discharged from 22 health centers in Seoul from May 1, 1993 to April 30, 1994. Seven hundreds and seventeen was subsequently analysed excluding 217 patients due to remedial interruption. The results: 1. Bacteriological negative conversion rate in 9HER regimen and 2HERZ/4HER regimen was 97.8% and 96.4% respectively (p>0.05). But the early treatment period, negative conversion rate in 2HERZ/4HER regimen was very higher than in 9HER regimen(p<0.01). 2. Remedial interruption rate for 9HER regimen and 2HERZ/4HER regimen was 34.1% and 13.6% respectively. The primary reason for the interruption was transfering to other clinics and this interruption was high within 3months. 3. Cost effectiveness for 2HERZ/4HER regimen was higher than 9HER regimen. The difference cost effectiveness ratio was 2.33 at the first sputum test and 1.69 at the last sputum test.
Cost-Benefit Analysis ; Drug Therapy* ; Humans ; Seoul* ; Sputum ; Tuberculosis, Pulmonary*

It is widely recognized that manipulation of body position takes advantage of the influences of gravity for improving oxygenation. The study aims to determine the effects of positioning(supine, prone, right lateral decubitus and left lateral decubitus positions) applied to the mechanically ventilatory acute respiratory failure patients on arterial oxygen partial pressure(PaO2), alveolar arterial oxygen tension difference(AaDO2), mean aterial pressure, peak inspiratory pressure and plateau pressure. Thirty two acute respiratory failure patients admitted to the medical intensive care unit at Kangnam St. Mary's Hospital, The Catholic University of Korea from March 1997 to January 1998, were divided into three groups by radiographic evidence of unilateral or bilateral lung disease. In group 1 with dominant right lung disease were twelve subjects, group 2 with dominant left lung disease had eight subjects and group 3 had twelve subjects with bilateral lung disease. The variables were measured in 30 minutes after each position of supine, prone, good lung down lateral decubitus and sick lung down lateral decubitus position. The position order was done at random by Latin squre design. The results are as follows; 1) With group 1 patients, the PaO2 in the left lateral decubitus and prone position were 126.8+/-30.8 mmHg and 106.7+/-36.8 mmHg, respectively(p=0.0001). 2) With group 2 patients, the PaO2 in the prone and the right lateral decubitus position were 121.7+/-44.7 mmHg and 118.5+/-31.7 mmHg, respectively (p=0.0018). 3) With group 3 patients, the PaO2 was 143.6+/-36.6 mmHg in the prone position (p=0.0001). 4) With group 1 patients, the AaDO2 in the left lateral decubitus and the right lateral decubitus position were 178.1+/-29.7 mmHg and 233.1+/-24.4 mmHg, respectively(p=0.0001). 5) With group 2 patients, the AaDO2 in the prone and the left lateral decubitus postion were 184.0+/-39.5 mmHg and 231.0+/-23.9 mmHg, respectively(p=0.0019). 6) With group 3 patients, the AaDO2 in the prone and the supine postion were 377.1+/-35.6 mmHg and 435.7+/-13.1 mmHg, respectively (p=0.0001). 7) There were no differences among the mean arterial pressure, peak inspiratory pressure and plateau pressure for each of the supine, prone, left lateral decubitus and right lateral decubitus position. The results suggest that oxygenation may improve in mechanically ventilatory patients with unilateral lung disease when the position is good lung dependent and prone, and patients with bilateral lung disease when the position is prone without any effects on the mean arterial pressure and airway pressure. It is suggested that body positions improve ventilation/perfusion matching and oxygenation need to be specified in patient care plans.
Arterial Pressure ; Gravitation ; Humans ; Intensive Care Units ; Korea ; Lung ; Lung Diseases ; Oxygen* ; Partial Pressure* ; Patient Care ; Prone Position ; Respiratory Insufficiency

The purpose of this study was examine the general characteristics of relapsed pulmonary tuberculous patients (i.e. age, sex, weight, occupation, previous forms of treatment, drug sensitivity, and the frequency of relapse) in order to improve future treatments of tuberculosis as well as to perpetuate health education. The data was obtained from the medical records of 186 relapsed pulmonary tuberculosis patients who were registered for treatment at various public health officers in Seoul during the year of 1994. The major findings obtained from the study were as follows; l) The male to female ratio of relapsed pulmonary tuberculous patients was about 7:3, more specifically 23.7% of the men and 30.9% of the women were between 20 and 29 years of age. 2) Comparing initial less aggravated states to relapsed states, patients with minimal x-ray findings later proved moderately advanced X-ray findings. Furthermore, patients with negative sputum AEB findings later proved positive sputum AFB findings. 3) of the l86 patients studied, 91.9% suffered, relapse and 8.1% suffered 2 or more relapses. Of the patients who suffered at least 1 relapse, 54.8% received short-term treatment, 26.9% received long-term treatment, and 18.3% received treatment of an unknown during their initial tuberculosis treatment periods. 4) Fifty five point four percent of the patients had no reaction to the drug treatment(not available), 25.9% of the patients had sensitive reaction to the drug treatment, 18.7% of the patients had resistant reaction to the drug treatment. Drug resistance was higher in patients to exhibited positive X-ray findings as well as in patients that exhibited positive sputum findings furthermore, patients receiving treatment of an unknown nature(35.5%) exhibited higher drug resistance than those receiving short-term treatment(13.6%) and long-term treatment(l7.0%). 5) Of the 160 patients who suffered relapses, 8.8% suffered a relapse within 1 year after treatment and 91.2% suffered a relapse at least 1 year after treatment. Furthermore, our study showed that women, under 30, who received short-term treatment and encounterd complications during their primary treatment suffered relapses faster than any other groups studied. In addition, minimal X-ray findings and sputum AFB findings were not correlated to the time relapse occurred. Therefore, the greater efforts are needed to prevent relapsed pulmonary tuberculosis.
Drug Resistance ; Female ; Health Education ; Humans ; Male ; Medical Records ; Occupations ; Public Health* ; Recurrence ; Seoul* ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

Zonula occludens (ZO) proteins serve as scaffolding proteins that provide structural support at cell junctions and the cytoplasmic surface, acting as bridges between integral membrane proteins and the cytoskeleton. In addition to their structural functions, they also regulate cell growth and proliferation. Recent studies have shown that ZO proteins are involved in various diseases, including cancer. Specifically, ZO proteins influence the growth and development of cancer cells in the tumor microenvironment. These proteins perform various functions in the tumor microenvironment through processes such as angiogenesis, inflammatory responses, epithelial-mesenchymal transition, and interactions with mesenchymal stem cells. The mechanisms of these actions may vary depending on the type of cancer and environmental conditions. Ongoing research explores several signaling pathways involving ZO proteins. These insights suggest that new therapeutic approaches may be considered to slow down cancer growth and development within the tumor microenvironment. Despite continuing research on the cellular and in vivo roles of ZO proteins, the current understanding of how these signaling mechanisms function within the tumor microenvironment in vivo remains limited. In this review, we introduce the characteristics and regulatory mechanisms of ZO proteins in the cancer microenvironment, explore their potential to suppress cancer cell environments, and examine their roles in vivo.

Zonula occludens (ZO) proteins serve as scaffolding proteins that provide structural support at cell junctions and the cytoplasmic surface, acting as bridges between integral membrane proteins and the cytoskeleton. In addition to their structural functions, they also regulate cell growth and proliferation. Recent studies have shown that ZO proteins are involved in various diseases, including cancer. Specifically, ZO proteins influence the growth and development of cancer cells in the tumor microenvironment. These proteins perform various functions in the tumor microenvironment through processes such as angiogenesis, inflammatory responses, epithelial-mesenchymal transition, and interactions with mesenchymal stem cells. The mechanisms of these actions may vary depending on the type of cancer and environmental conditions. Ongoing research explores several signaling pathways involving ZO proteins. These insights suggest that new therapeutic approaches may be considered to slow down cancer growth and development within the tumor microenvironment. Despite continuing research on the cellular and in vivo roles of ZO proteins, the current understanding of how these signaling mechanisms function within the tumor microenvironment in vivo remains limited. In this review, we introduce the characteristics and regulatory mechanisms of ZO proteins in the cancer microenvironment, explore their potential to suppress cancer cell environments, and examine their roles in vivo.

Zonula occludens (ZO) proteins serve as scaffolding proteins that provide structural support at cell junctions and the cytoplasmic surface, acting as bridges between integral membrane proteins and the cytoskeleton. In addition to their structural functions, they also regulate cell growth and proliferation. Recent studies have shown that ZO proteins are involved in various diseases, including cancer. Specifically, ZO proteins influence the growth and development of cancer cells in the tumor microenvironment. These proteins perform various functions in the tumor microenvironment through processes such as angiogenesis, inflammatory responses, epithelial-mesenchymal transition, and interactions with mesenchymal stem cells. The mechanisms of these actions may vary depending on the type of cancer and environmental conditions. Ongoing research explores several signaling pathways involving ZO proteins. These insights suggest that new therapeutic approaches may be considered to slow down cancer growth and development within the tumor microenvironment. Despite continuing research on the cellular and in vivo roles of ZO proteins, the current understanding of how these signaling mechanisms function within the tumor microenvironment in vivo remains limited. In this review, we introduce the characteristics and regulatory mechanisms of ZO proteins in the cancer microenvironment, explore their potential to suppress cancer cell environments, and examine their roles in vivo.

Zonula occludens (ZO) proteins serve as scaffolding proteins that provide structural support at cell junctions and the cytoplasmic surface, acting as bridges between integral membrane proteins and the cytoskeleton. In addition to their structural functions, they also regulate cell growth and proliferation. Recent studies have shown that ZO proteins are involved in various diseases, including cancer. Specifically, ZO proteins influence the growth and development of cancer cells in the tumor microenvironment. These proteins perform various functions in the tumor microenvironment through processes such as angiogenesis, inflammatory responses, epithelial-mesenchymal transition, and interactions with mesenchymal stem cells. The mechanisms of these actions may vary depending on the type of cancer and environmental conditions. Ongoing research explores several signaling pathways involving ZO proteins. These insights suggest that new therapeutic approaches may be considered to slow down cancer growth and development within the tumor microenvironment. Despite continuing research on the cellular and in vivo roles of ZO proteins, the current understanding of how these signaling mechanisms function within the tumor microenvironment in vivo remains limited. In this review, we introduce the characteristics and regulatory mechanisms of ZO proteins in the cancer microenvironment, explore their potential to suppress cancer cell environments, and examine their roles in vivo.

Zonula occludens (ZO) proteins serve as scaffolding proteins that provide structural support at cell junctions and the cytoplasmic surface, acting as bridges between integral membrane proteins and the cytoskeleton. In addition to their structural functions, they also regulate cell growth and proliferation. Recent studies have shown that ZO proteins are involved in various diseases, including cancer. Specifically, ZO proteins influence the growth and development of cancer cells in the tumor microenvironment. These proteins perform various functions in the tumor microenvironment through processes such as angiogenesis, inflammatory responses, epithelial-mesenchymal transition, and interactions with mesenchymal stem cells. The mechanisms of these actions may vary depending on the type of cancer and environmental conditions. Ongoing research explores several signaling pathways involving ZO proteins. These insights suggest that new therapeutic approaches may be considered to slow down cancer growth and development within the tumor microenvironment. Despite continuing research on the cellular and in vivo roles of ZO proteins, the current understanding of how these signaling mechanisms function within the tumor microenvironment in vivo remains limited. In this review, we introduce the characteristics and regulatory mechanisms of ZO proteins in the cancer microenvironment, explore their potential to suppress cancer cell environments, and examine their roles in vivo.

BACKGROUND: Extracellular sulfatases (Sulfs), sulfatase 1 (Sulf1) and sulfatase 2 (Sulf2), play a pivotal role in cell signaling by remodeling the 6-O-sulfation of heparan sulfate proteoglycans on the cell surface. The present study examined the effects of Sulfs on angiotensin II (Ang II)-induced hypertensive mediator expression and vascular smooth muscle cells (VSMCs) proliferation in spontaneously hypertensive rats (SHR). METHODS: Ang II receptors, 12-lipoxygenase (12-LO), and endothelin-1 (ET-1) messenger RNA (mRNA) expressions in SHR VSMCs were analyzed by real-time polymerase chain reaction and Western blotting. VSMCs proliferation was determined by [³ H]-thymidine incorporation. RESULTS: Basal Sulfs mRNAs expression and enzyme activity were elevated in SHR VSMCs. However, Sulfs had no effect on the basal or Ang II-induced 12-LO and ET-1 mRNA expression in SHR VSMCs. The inhibition of Ang II-induced 12-LO and ET-1 expression by blockade of the Ang II type 2 receptor (AT₂ R) pathway was not observed in Sulf1 siRNA-transfected SHR VSMCs. However, Sulf2 did not affect the action of AT₂ R inhibitor on Ang II-induced 12-LO and ET-1 expression in SHR VSMCs. The down-regulation of Sulf1 induced a reduction of AT₂ R mRNA expression in SHR VSMCs. In addition, the inhibition of Ang II-induced VSMCs proliferation by blockade of the AT₂ R pathway was mediated by Sulf1 in SHR VSMCs. CONCLUSION: These findings suggest that extracellular sulfatase Sulf1 plays a modulatory role in the AT₂ R pathway that leads to an Ang II-induced hypertensive effects in SHR VSMCs.
Angiotensin II* ; Angiotensins* ; Arachidonate 12-Lipoxygenase ; Blotting, Western ; Down-Regulation ; Endothelin-1 ; Heparan Sulfate Proteoglycans ; Hypertension ; Muscle, Smooth, Vascular* ; Rats, Inbred SHR* ; Real-Time Polymerase Chain Reaction ; Receptor, Angiotensin, Type 2* ; RNA, Messenger ; Sulfatases