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Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

PURPOSE: The aim of this work was to evaluate nuclear histone acetylation level and total histone acetyltransferase (HAT) and deacetylase (HDAC) activity in ejaculated sperm and their relevance to conventional sperm parameters. MATERIALS AND METHODS: Thirty-three normozoospermic men were included in this study. Semen samples were processed by swim-up and then immunostained by six acetylation antibodies (H3K9ac, H3K14ac, H4K5ac, H4K8ac, H4K12ac, and H4K16ac). Our preliminary study verified the expression of HAT/HDAC1 in mature human sperm. From vitrified-warmed sperm samples, total HAT/HDAC activity was measured by commercially available kits. Nuclear DNA integrity was also measured by TUNEL assay. RESULTS: The levels of six acetylation marks were not related with conventional sperm parameters including sperm DNA fragmentation index (DFI) as well as HAT/HDAC activity. However, sperm DFI was positively correlated with HAT activity (r=0.038 after adjustment, p<0.02). HAT activity showed a negative relationship with HDAC activity (r=-0.51, p<0.01). Strict morphology was negatively correlated with acetylation enzyme index (=HAT activity/HDAC activity) (r=-0.53, p<0.01). CONCLUSION: Our works demonstrated a significant relationship of acetylation-associated enzyme activity and strict morphology or sperm DFI.
Acetylation ; Adult ; DNA Fragmentation ; Epigenesis, Genetic ; Histone Acetyltransferases/*metabolism ; Histones/*metabolism ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Protein Processing, Post-Translational ; Semen Analysis ; Spermatozoa/*metabolism

BACKGROUND: Cardiopulmonary exercise test is a useful test for the evaluation of the cardiovascular and respiratory systems. Obese subjects have an increased resting metabolic rate (VO2) compared to non-obese subjects and the increase is more marked during dynamic exercise, which results in the limitation of maximal exercise in obese subjects. In this study, the influence of the obesity and fat distribution on the maximal exercise capacity were evaluated. METHODS: Maximal exercise capacity was represented by maximam maximum oxygen uptake and VO2 max in the cardiopulmonary test. Obesity, total fat content and abdominal obesity(waist to hip ratio, WHR) were measured by bioelectrical impedence method. Total of 42 volunteers(male 22, female 20) were evaluated. RESULTS: 1) Weight to height ratio(mean±SD) was 110%±14.9% in men and 100±11.1% in women. 2) Fat ratio(mean±SD) was 23.3±5.2% in men and 27.55±3.9% in woman. 3) Waist to hip ratio(mean±SD) was 0.85±0.04 in men and 0.8±0.03 in woman. 4) In men, VO2max/min/Kg was negatively correlate with obesity, fat ratio, and abdominal fat distribution. 5) In woman, VO2max/Kg was negatively correlated with obesity and fat ratio, but did not show significant relationship with abdominal fat distribution. CONCLUSION: Obesity was a limiting factor for maximal exercise in both men and women. Abdominal obesity was a limiting factor for maximal exercise in men but its implication to women needs further evaluation.
Abdominal Fat ; Exercise Test* ; Female ; Hip ; Humans ; Male ; Obesity ; Obesity, Abdominal ; Oxygen ; Respiratory System

PURPOSE: To evaluate the risk of vertebral compression fracture (VCF) after conventional radiotherapy (RT) for colorectal cancer (CRC) with spine metastasis and to identify risk factors for VCF in metastatic and non-metastatic irradiated spines. MATERIALS AND METHODS: We retrospectively reviewed 68 spinal segments in 16 patients who received conventional RT between 2009 and 2012. Fracture was defined as a newly developed VCF or progression of an existing fracture. The target volume included all metastatic spinal segments and one additional non-metastatic vertebra adjacent to the tumor-involved spines. RESULTS: The median follow-up was 7.8 months. Among all 68 spinal segments, there were six fracture events (8.8%) including three new VCFs and three fracture progressions. Observed VCF rates in vertebral segments with prior irradiation or pre-existing compression fracture were 30.0% and 75.0% respectively, compared with 5.2% and 4.7% for segments without prior irradiation or pre-existing compression fracture, respectively (both p < 0.05). The 1-year fracture-free probability was 87.8% (95% CI, 78.2-97.4). On multivariate analysis, prior irradiation (HR, 7.30; 95% CI, 1.31-40.86) and pre-existing compression fracture (HR, 18.45; 95% CI, 3.42-99.52) were independent risk factors for VCF. CONCLUSION: The incidence of VCF following conventional RT to the spine is not particularly high, regardless of metastatic tumor involvement. Spines that received irradiation and/or have pre-existing compression fracture before RT have an increased risk of VCF and require close observation.
Colorectal Neoplasms* ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Incidence ; Multivariate Analysis ; Neoplasm Metastasis ; Radiotherapy ; Retrospective Studies ; Risk Factors ; Spinal Fractures ; Spinal Neoplasms ; Spine*

PURPOSE: To determine the characteristics of benign breast calcifications on mammogram. MATERIALS AND METHODS: Benign breast calcifications on mammograms of 25 patients, which were confirmed by needle localization and excisional biopsy(15 cases), cytology(1 case), or follow-up study(9 cases), were retrospectively analysed according to size, shape, number, distribution, and density. RESULTS: The size of benign breast calcifications was uniform in 4 cases (16%), and variable in 21 cases (84%). The shape of calcifications was round or oval in 18 cases(72%), linear or branching pattern in 6 cases (24%), and irregular in 1 case(4%). The number of calcifications was 2-5 in 7 cases(28%), and over 6 in 12 cases(48%). The distribution of calcifications was focal in 13 cases(52%) and diffuse in 12 cases(48%). The density of calcification was homogenous in all 25 cases(100%). CONCLUSION: Analysis of number, shape, size, and distribution is helpful for the diagnosis of benign breast calcifications. However the homogenous density of the calcification is suggested to be the most helpful criterion for the diagnosis of benign breast calcifications.
Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Needles ; Retrospective Studies

OBJECTIVES: Previous studies have shown the relationship between recognition of facial expressions and psychiatric symptoms. This study investigated how healthy young adults recognize neutral faces and which psychological distresses and symptoms relate to their recognition of neutral faces. METHODS: One hundred forty-three healthy volunteers participated in this study. We used neutral facial pictures, selected from the Japanese and Caucasian Facial Expressions of Emotion (JACFEE) photo set, to evaluate participants' facial expression recognition and the State-Trait Anxiety Inventory, Beck Depression Inventory, Toronto Alexithymia Scale, Conner-Davidson Resilience Scale, and Temperament and Character Inventory (TCI) to measure and examine their psychological characteristics. RESULTS: There were significant positive correlations between the recognition rate of neutral expressions as contempt and trait-anxiety level (r=0.21 ; p=0.01) and depression (r=0.20 ; p=0.02). This contempt-recognition was significantly negatively correlated with resilience score (r=-0.22 ; p=0.01) and the TCI self-directedness subscale (r=-0.29 ; p=0.00). Also, the TCI's harm avoidance subscale score was significantly positively correlated with the contempt recognition rate (r=0.21 ; p=0.01). CONCLUSION: These finding suggests recognition of neutral faces as contempt may be related to psychological distress, including trait and temperament characteristics. This negative bias toward neutral emotion (expressions) may affect interpersonal relations and social functioning in a healthy population.
Affective Symptoms ; Anxiety ; Asian Continental Ancestry Group ; Bias (Epidemiology) ; Depression ; Facial Expression ; Humans ; Interpersonal Relations ; Polymethacrylic Acids ; Temperament ; Young Adult

BACKGROUND: Residual pleural thickening is frequently seen following treatment for tuberculous pleurisy, and pleural decortication is performend occasionally in patients with severe residual pleural thickening. However, predictive factors for the development of residual pleural thickening are uncertain at the initial diagnosis of the tuberculous pleurisy. Therefore, the purpose of this study was to identify the associated factors for residual pleural thickening at initial diagnosis. METHODS: We separated 63 patients diagnosed as tuberculous pleurisy into two groups; group 1 consisted of patients without residual pleural thickening and group 2 comprised patients with residual pleural thickening at the end of tuberculous pleurisy treatment. We analyzed the clinical characteristics, radiological findings, pleural biopsy and characteristics of pleural fluid between group 1 and group 2. RESULTS: The study population and clinical symptoms of the two groups were not significantly different and the duration of symptoms before treatment and the peripheral WBC were similar between the two groups. The presence of pulmonary tuberculosis, pleural fluid loculation or the amount of pleural effusion sid not differ significantly between the thwo groups. The incidence of positive AFB staining(group 1 : 8%, group 2 : 38%) and granuloma(group 1 : 30%, group 2 : 62%) on pleural biopsy specimens was significantly higher in group 2 than in group 1. Pleural fluid WBC and differential count, adenosine deaminase level, pH, preotein level or glucose level did not differ between the two groups. However, group 2 had higher LDH levels (1370±208mg/dl) than group 1 (860±71mg/dl, p<0.05). CONCLUSION: In tuberculous pleurisy, patients with residual pleural thickening following treatment demonstrated a higher incidence of posivive AFB staining and granuloma on the pleural biopsy specimens or higher LDH level in the pleural fluid than patients wihtout residual pleural thickening From these results, we speculate that the amonut of tuberculous bacilli and granuloma are probably correlated with residual pleural thickening in the tuberculous pleurisy.
Adenosine Deaminase ; Biopsy ; Diagnosis ; Drug Therapy* ; Glucose ; Granuloma ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Pleural Effusion ; Pleurisy* ; Sudden Infant Death ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

PURPOSE: To report a case of Miller Fisher syndrome in a pediatric patient with gastroenteritis associated with seroconversion of Campylobacter jejuni titer during the development of neurological symptoms and positive anti-GQ1b IgG. CASE SUMMARY: An 8-year-old male patient visited our clinic with bilateral ophthalmoplegia, diplopia, and ptosis of the right upper lid. He had experienced gastroenteritis one week previous, and antibodies to Campylobacter jejuni were detected in his plasma. Ophthalmic examination revealed a corrected visual acuity of 20/20 in both eyes. Ocular motor examination revealed limitations in all positions of gaze. Neurologic examination demonstrated areflexia and ataxia. The serologic anti-GQ1b IgG test was positive. Intravenous immunoglobulin and steroid pulse therapy were started. Extraocular movement, ptosis, and ataxia gradually improved after one month of treatment. CONCLUSIONS: We confirmed a case of Miller Fisher syndrome in a pediatric patient with bilateral ophthalmoplegia, ptosis, and a positive anti-GQ1b antibody test.
Antibodies ; Ataxia ; Campylobacter jejuni ; Child ; Diplopia ; Gastroenteritis ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Male ; Miller Fisher Syndrome* ; Neurologic Examination ; Ophthalmoplegia ; Plasma ; Visual Acuity

OBJECTIVE: Metastatic dissemination of epithelial ovarian carcinoma is thought to be mediated via tumor cell exfoliation into the peritoneal cavity, followed adhesion to and invasion through the mesothelium which overlies the contents of the peritoneal cavity. MMP-2 is secreted as a zymogen, the activation of which has been associated with metastatic progression in human ovarian cancer cell lines. METHODS: We have utilized short-term cultures to analyze the effect of specific extracellular matrix proteins, type I collagen. RESULTS: Culturing Caov-4 ovarian cell line on type I collagen led to a significant increase in conversion of the MMP-2,72kD to the MMP-2,66kD, and MT-MMP expression. MT-MMP expression correlates with expression and activation of MMP-2 during malignant progression. Altered MT-MMP expression in ovarian cell lines might contribute to MMP-2 activation, which facilitates invasion of these tumors. CONCLUSION: In summary, we found increased expression of MT-MMP that correlated with increased level of activated MMP-2 and cellular counts in chemoinvasion assay in Caov-3 cell line. But no significant increases in Skov-4 cell line on type I collagen. Conclusion: These data suggest that type I collagen induces MMP-2 activation in part by up-regulation of MT-MMP expression but has a more complicated mode of action involving additional processes.
Cell Line* ; Collagen Type I ; Epithelium ; Extracellular Matrix Proteins ; Humans ; Matrix Metalloproteinases* ; Membranes* ; Ovarian Neoplasms* ; Peritoneal Cavity ; Up-Regulation