The purpose of this study is to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal, umbilical cord serum, placenta and pregnancy outcomes. Venous bloods samples were drawn from 54 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth. And also, placental tissues were extracted. We investigated the difference of the iron status indices of maternal, umbilical cord serum and placental tissue between two gestational age group (PT group, NT group : preterm delivery and normal term delivery at 34.9wk and 39.0wk of mean gestational length, respectively) and also assessed correlations of iron status indices of maternal, umbilical cord serum and placenta tissue. And lastly, we related between birth weight and iron status indices of maternal, umbilical cord serum and placental tissue. The concentrations of maternal serum ferritin and of placental iron were significantly higher in PT group (32.1 +/- 21.1 ng/ml, 68.5 +/- 16.7microgram / g), than those of NT group (20.8 +/- 11.6 ng / ml, 53.2 +/- 17.4 microgram / g) respectively (p < 0.001). However the serum ferritin of umbilical cord were significantly higher in NT group (PT : 109.4 +/- 65.7 ng/ml, NT : 147.0 +/- 56.8 ng / ml) than those of PT group (p < 0.05). Our results showed that a negative association between birth weight (r=-0.361) and maternal serum ferritin and that a positive association between birth weight and umbilical cord serum ferritin (r=0.261). Despite not a significant difference, there was tendency that highest concentration of maternal serum ferritin was associated with the lowest birth weight. These findings indicate that birth weight of newborn is dependent of multiple factors such as maternal iron status during pre-pregnancy, body size, general nutritional status. Although for women who enter pregnancy with low iron stores, enough intakes of iron during pregnancy could produce undesirable pregnancy outcome. Therefore we suggest for successful pregnancy outcome and delivery differential iron supplementation program will be carried out individual pregnant women on the basis of pre-pregnancy nutritional status.
Birth Weight* ; Body Size ; Female ; Ferritins ; Fetal Blood ; Gestational Age ; Humans ; Infant, Newborn ; Iron* ; Nutritional Status ; Parturition* ; Placenta* ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Umbilical Cord*

Signet ring cell adenocarcinoma of the cervix is most commonly considered to be metastatic in origin. We describe one case of primary signet ring cell adenocarcinoma of the cervix occuring in 49-year-old patient. The lesion was located at the posterior lip of the cervix and about 3 cm in size. This case was parametrium thickening in pelvic examination and positive for HPV type 18. CCRT (concurrent chemoradiotherapy) was done for clinical FIGO stage II B adenocarcinoma of the cervix. The patient is alive for 6month since diagnosis and disappear lesion of the cervix. A upper gastroenteroscopy, colonoscopy, cystoscopy, intravenous pyelogram, abdominal pelvic CT, PET CT, mammogram were reported negative. Therefore we concluded this case for a primary cervical origin of signet ring cell adenocarcinoma of the uterine cervix.
Adenocarcinoma* ; Cervix Uteri* ; Colonoscopy ; Cystoscopy ; Diagnosis ; Female ; Gynecological Examination ; Humans ; Lip ; Middle Aged

Hantavirus pulmonary syndrome(HPS) is a systemic disease that is caused by a newly discorved and characterized virus of the Hantavirus genus, which is most frequently referred to as the sin nombre virus. The clinical syndrome resembles other hantavirus syndromes worldwide, except that it is characterized by a brief prodromal illness followed by rapidly progressive, noncardiogenic edema, and that it is more deadly than any previously recognized hantavirus infection. The clinical manifestations of HPS are characterized by four clinical phases prodrome, pulmonary edema and shock, diuresis, and convalescence. Mortality is greatest in the first 24 hours of the pulmonary edema and shock phase of the illness. These phases are strikingly similar to the clinical phases of Hemorrhagic fever with renal syndrome(HFRS) induced by Hantaan virus, except that HPS has not been associated with renal failure and Disseminated intravascular coagulation(DIC). We here report a case of hantavirus pulmonary syndrome developed in a 58 year-old man. He had a flu-like illness followed by the rapid onset of respiratory failure due to noncardiogenic pulmonary edema. HPS was diagnosed by clinical manifestations, identification of high titer antibody to Hantaan virus antigen and histologic finding of transbronchial lung biopsy (TBLB) specimen. The patient was treated with mechanical ventilation and initial corticosteroid pulse therapy resulting in successful outcome.
Biopsy ; Convalescence ; Diuresis ; Edema ; Fever ; Hantaan virus ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Humans ; Lung ; Middle Aged ; Mortality ; Pulmonary Edema ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Insufficiency ; Shock ; Sin Nombre virus

We report here on a case of a neurogenic tumor of the neck with an uncertain origin on the preoperative evaluation. A 67-year-old woman with a palpable mass in the left side of the neck was referred to our hospital. The mass had slowly grown over 7 years and her dyspnea had gradually become more severe over the recent 6 months. Computerized tomography and magnetic resonance imaging showed an 8 cm sized solid mass that abutted the trachea and the esophagus without invasion, but the origin of the mass was not clearly identified. During surgical exploration, we identified that the tumor was located in the esophageal muscle layer. Immunohistochemical staining revealed that the tumor cells were positive for S-100 protein, which confirmed a diagnosis of schwannoma.
Aged ; Diagnosis ; Diagnosis, Differential* ; Dyspnea ; Esophagus ; Female ; Humans ; Magnetic Resonance Imaging ; Neck ; Neurilemmoma ; S100 Proteins ; Thyroid Gland ; Trachea

PURPOSE: To review diagnostic procedure, clinical stage, age distribution, treatment of endometriosis in adolescents. MATERIAL AND METHOD: We retrospectively reviewed medical records of 39 adolescent girls(11-21) admitted to Yonsei University College of Medicine between 1990 and 1999. We identified 39 patients who underwent laparotomy or laparoscopy and was diagnosed as having endometriosis. Endometriosis was classified according to the Revised American Fertility Society Classification(AFS). The chief symptoms leading to diagnosis, clinical stage, age distribution, and treatment modality were reviewed. RESULTS: Average age of menarche was 14.2, and the interval after the menarche was 5.9 years. The chief symptoms leading to diagnosis were chronic pelvic pain(27%), acute pelvic pain(21%), palpable pelvic mass(21%), dysmenorrhea(18%). Laparoscopy was performed in 20 patients(51%). The majority of the patients(44%) presented with stage II, 4(10%) with stage I, 11(28%) with stage III, and 7(18%) with stage IV. GnRH agonists(64.1%), expectant managements(25.7%), OCPs(5.1%) and danazol(5.1%) were used after surgery. CONCLUSION: Adolescents with chronic pelvic pain have a high rate of endometriosis and should be promptly referred to a gynecologist to diagnose the etiological lesion of pelvic pain and initiate appropriate therapy.
Adolescent* ; Age Distribution ; Diagnosis ; Endometriosis* ; Female ; Fertility ; Gonadotropin-Releasing Hormone ; Humans ; Laparoscopy ; Laparotomy ; Medical Records ; Menarche ; Pelvic Pain ; Retrospective Studies

Botryomycosis is a rare, chronic and suppurative di- sease that is often mistaken clinically and histologically for a fungal infection, because the histologic feature shows a cluster of bacteria found within an eosinophilic matrix or capsule, giving the appearance of granules mimicking the sulfur granules of actinomycosis. Staphy- lococcus aureus is the most common organism cultured from lesions of botryomycosis, but other bacteria have also been isolated and implicated, including Psudomonas aeruginosa, E. coli, Proteus spp., Bacillus spp.. In some case, multiple pathogenic bacteria were found on cul ture. This disease has two patterns of organ involve ment. The more common type is cutaneous type, which involves the skin, subcutaneous soft tissue, muscle and bone. The other is visceral type which involves the lungs, liver, tongue, orbit, bowel, brain, kidney or pros tate. We report a case of brain and pulmonary botry omycosis in a 60 year-old man, who have early lung cancer. Botryomycosis was diagnosed by brain mass removal, PCNA and bronchoscopy, and lung cancer was detected incidentally by bronchoscope. The patient was treated with the Penicillin G after operation of brain mass, and right pneumonectomy was done.
Actinomycosis ; Bacillus ; Bacteria ; Brain ; Bronchoscopes ; Bronchoscopy ; Eosinophils ; Humans ; Kidney ; Liver ; Lung Neoplasms* ; Lung* ; Middle Aged ; Oceans and Seas ; Orbit ; Penicillin G ; Pneumonectomy ; Proliferating Cell Nuclear Antigen ; Proteus ; Skin ; Sulfur ; Tongue

OBJECTIVE: Leiomyomas of the bladder and urethra in women is very rare. We present five cases of histologically proven the female urethral and bladder leiomyomas identified over a 15-years period at our institution, together with review of the literature focused on the symptom and proper management. METHODS: Five women pathologically confirmed bladder or urethral leiomyoma were reviewed by the medical record, retrospectively. RESULTS: One patient with bladder leiomyoma was asymptomatic, but four patients with urethral leiomyoma had a palpable mass on physical examination. The leiomyomas posited laterally were less symptomatic than other leiomyomas posited medially, and the symptoms were especially obstructive ones. All of them were removed by excision, and any complication or recurrence was not occurred. CONCLUSION: Leiomyomas of the bladder and urethra are rare and associated with variable symptoms depending on their locations and sizes. It is not necessary immediate operation except to excessive bleeding or acute complete obstruction. Complete excision followed by histological examination is the most reliable means of distinguishing leiomyoma from other more common and usually malignant tumors of the genitourinary tract.
Female* ; Hemorrhage ; Humans ; Leiomyoma* ; Medical Records ; Physical Examination ; Recurrence ; Retrospective Studies ; Urethra* ; Urinary Bladder*

PURPOSE: Generalized peritonitis caused by a free perforation of gastric cancer is a rare condition, which occurs in 1~4% of all gastric cancer patients. To assess the characteristics of the patients and investigate the optimal treatment of choice, the data from 51 patients previous recent 10 years were retrospectively analyzed. METHODS: Between 1988 and 1997, 51 patients underwent surgical treatment for perforated gastric cancer. The clinicopathological features and survival rates of the resected group (n=39) and the non-resected group (n=12) were analyzed. RESULTS: The incidence was 0.78% and the mean age was 57 years. The most common tumor location was in the lower 1/3 in the resected group (n=21, 53.8%) and in the upper 1/3 in the non-resected group (n=6, 50%). Borrmann type 3, the poorly differentiated type, and a positive serosa invasion were more common in both groups. Liver and peritoneal metastases were observed in 2 cases (5.2%) and 7 cases (14.3%) in the resected group, and 4 cases (33.4%), and 3 cases (25%) in the non-resected group, respectively. Resectability found in 76.5%: 27 cases of a subtotal gastrectomy and 12 cases of a total gastrectomy. A limited lymph node dissection (D0, D1) was performed in 14 cases (35.9%) and an extended dissection (D2, D3) was performed in 25 cases (64.1%). The 5-year survival rate of stage I was 80%, 40% in stage II, 14% in stage III and 0% in stage IV, and the overall 5 year survival rate was 20.5% in the resected group and 0% in the non-resected group. The depth of invasion, lymph node metastasis and tumor stage significantly influenced the survival rate of the patients. CONCLUSION: Because a perforation of the gastric cancer may develop in every stage, surgeons must take care of these patients by the same way as with non-perforation cases.
Gastrectomy ; Humans ; Incidence ; Liver ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Peritonitis ; Retrospective Studies ; Serous Membrane ; Stomach Neoplasms* ; Survival Rate

A phenotypically normal couple was referred for cytogenetic evaluation due to three consecutive first-trimester spontaneous abortions. Chromosomal analysis from peripheral blood was performed according to standard cytogenetic methods using G-banding technique. The husband's karyotype was normal. The wife's karyotype showed a balanced complex chromosome rearrangement (CCR) involving chromosomes 9,14, and 13. There were three breakpoints: 9p21.2, 14q21, and 13q12.2. The karyotype was designated as 46, XX, t (9;14;13)(p21.2;q21; q12.2). Fluorescence in situ hybridization (FISH) analysis with chromosome-specific libraries of chromosomes 9,14, and 13 was performed to confirm this rare chromosome rearrangement. The result of FISH coincided with that obtained by standard cytogenetic techniques.
Abortion, Habitual/*genetics ; Adult ; Case Report ; *Chromosome Aberrations ; *Chromosomes, Human, Pair 13 ; *Chromosomes, Human, Pair 14 ; *Chromosomes, Human, Pair 9 ; Female ; Human ; In Situ Hybridization, Fluorescence ; Pregnancy

The right and left hemispheres of the brain play somewhat different roles but help each other perform higher cortical functions. A 43 year-old right-handed woman was admitted due to a intraventricular hemorrhage followed by hydro-cephalus. A brain MRI revealed an intraventricular hemorrhage in the lateral, 3rd, and 4th ventricle and the hemorrhage in the lateral ventricle was compressing the genu of the corpus callosum. When asked to draw the face of a clock, she placed the numbers in reverse order (counter clockwise) when performing the task with her right hand, whereas the same task performed by the left hand was normal. In addition, when she wrote out simultaneously with right and left hands , she wrote Korean words in their mirror image with her left hand . When she wrote Chinese characters, she performed better with her right hand. These findings revealed some aspects of interhemispheric interaction in processing the images of a clock, and the orthographic lexicon of Korean and Chinese characters.
Adult ; Asian Continental Ancestry Group ; Brain ; Corpus Callosum ; Female ; Hand ; Hemorrhage* ; Humans ; Hydrocephalus* ; Lateral Ventricles ; Magnetic Resonance Imaging