Perinatal infection is the leading cause of fetal and neonatal mortality and is directly related to childhood morbidity. Perinatal infections cause abnormal growth, delayed development, and many other clinical pro blems in newborns. In particular, TORCH syndrome can cause serious fetal and neonatal health problems through vertical infection, and timely diagnosis and treatment through regular antenatal examinations are important. There are no therapeutic options or vaccines for parvovirus or cytomegalovirus. Therefore, prevention is the most important method. In the case of toxoplasmosis, prenatal education is important because it can be prevented through hygiene management, although there are therapeutic drugs. Syphilis has a high preva­lence, so early diagnosis is important. Rubella and varicella zoster infections can lead to fatal results in vertical transmission to the fetus. Therefore, preconception vaccination should be performed.Women with herpes simplex, which has a high prevalence in the community, need to be mindful when choosing a childbirth method by evaluating the infection through regular prenatal care to prevent vertical infection. Seasonal flu is rarely transmitted vertically to the fetus, but the morbidity and mortality risk to the mother is higher than that of the general population. Thus, prevention through vaccination is important.Lastly, coronavirus disease 2019 (COVID-19) infection has yet to be well studied, although the mother's mor­bidity and mortality are similar to those of the general population and there is no evidence of vertical in­fection. Since the findings of the effects on the mother and fetus are limited, transmission should be pre­vented through social distancing and personal hygiene practices.

Purpose: This study investigated levels of childbirth fear and related prenatal factors (self-confidence for childbirth, prenatal depression, knowledge about childbirth, and spousal support) among pregnant women in South Korea. Methods: A correlational study design was used to explore levels of childbirth fear and related prenatal factors in 200 pregnant women over 28 weeks of gestation. A self-administered questionnaire was used to measure fear of childbirth and related factors, such as self-confidence for childbirth, prenatal depression, knowledge about childbirth, and spousal support. Results: One-third of the pregnant women were aged 35 years and older. Sixty-one percent of women were nulliparae, but only 26.0% had experienced prenatal education. The mean score for fear of childbirth was 66.99 out of 165. The prevalence of fear of childbirth was 72.0%, and childbirth fear was severe in 26.5% of the participants and moderate in 45.5%. Fear of childbirth was negatively related to self-confidence (r=.45, p<.001), but positively related to prenatal depression (r=.21, p=.002). Two significant predictors were found to explain the fear of childbirth. Higher self-confidence for childbirth was associated with less severe fear of childbirth (β=–6.49, p<.001), while higher prenatal depression was associated with more severe fear of childbirth (β=2.08, p=.038). Conclusion The level of fear of childbirth was higher among pregnant women with lower self-confidence and higher prenatal depression. Reasonable evidence should be provided for implementing prenatal and childbirth classes to reduce pregnant women’s depression and to increase their confidence.

Purpose: This study investigated levels of childbirth fear and related prenatal factors (self-confidence for childbirth, prenatal depression, knowledge about childbirth, and spousal support) among pregnant women in South Korea. Methods: A correlational study design was used to explore levels of childbirth fear and related prenatal factors in 200 pregnant women over 28 weeks of gestation. A self-administered questionnaire was used to measure fear of childbirth and related factors, such as self-confidence for childbirth, prenatal depression, knowledge about childbirth, and spousal support. Results: One-third of the pregnant women were aged 35 years and older. Sixty-one percent of women were nulliparae, but only 26.0% had experienced prenatal education. The mean score for fear of childbirth was 66.99 out of 165. The prevalence of fear of childbirth was 72.0%, and childbirth fear was severe in 26.5% of the participants and moderate in 45.5%. Fear of childbirth was negatively related to self-confidence (r=.45, p<.001), but positively related to prenatal depression (r=.21, p=.002). Two significant predictors were found to explain the fear of childbirth. Higher self-confidence for childbirth was associated with less severe fear of childbirth (β=–6.49, p<.001), while higher prenatal depression was associated with more severe fear of childbirth (β=2.08, p=.038). Conclusion The level of fear of childbirth was higher among pregnant women with lower self-confidence and higher prenatal depression. Reasonable evidence should be provided for implementing prenatal and childbirth classes to reduce pregnant women’s depression and to increase their confidence.

PURPOSE: The aim of the present study was to elucidate the clinicopathological significance and diagnostic accuracy of immunohistochemistry (IHC) for determining the mesenchymal epidermal transition (c-MET) expression in patients with gastric cancer (GC). MATERIALS AND METHODS: The present meta-analysis investigated the correlation between c-MET expression as determined by IHC and the clinicopathological parameters in 8,395 GC patients from 37 studies that satisfied the eligibility criteria. In addition, a concordance analysis was performed between c-MET expression as determined by IHC and c-MET amplification, and the diagnostic test accuracy was reviewed. RESULTS: The estimated rate of c-MET overexpression was 0.403 (95% confidence interval [CI], 0.327~0.484) and it was significantly correlated with male patients, poor differentiation, lymph node metastasis, higher TNM stage, and human epidermal growth factor receptor 2 (HER2) positivity in IHC analysis. There was a significant correlation between c-MET expression and worse overall survival rate (hazard ratio, 1.588; 95% CI, 1.266~1.992). The concordance rates between c-MET expression and c-MET amplification were 0.967 (95% CI, 0.916~0.987) and 0.270 (95% CI, 0.173~0.395) for cases with non-overexpressed and overexpressed c-MET, respectively. In the diagnostic test accuracy review, the pooled sensitivity and specificity were 0.56 (95% CI, 0.50~0.63) and 0.79 (95% CI, 0.77~0.81), respectively. CONCLUSIONS: The c-MET overexpression as determined by IHC was significantly correlated with aggressive tumor behavior and positive IHC status for HER2 in patients with GC. In addition, the c-MET expression status could be useful in the screening of c-MET amplification in patients with GC.
Diagnostic Tests, Routine ; Humans ; Immunohistochemistry* ; Lymph Nodes ; Male ; Mass Screening ; Neoplasm Metastasis ; Receptor, Epidermal Growth Factor ; Sensitivity and Specificity ; Stomach Neoplasms* ; Survival Rate

Black staining of the teeth in children and adolescents does not cause pain or serious illness, but it can be socially debilitating for esthetic reasons. Black staining is easily removed through periodic professional mechanical tooth cleaning and ultrasonic scaling, but it can easily recur within few months. Using essential oil-containing mouth rinses diluted at 50% twice per day could prevent the black staining from returning after it is removed, reducing the need for mechanical treatments and improving esthetics.

Perivascular epithelioid cell tumor (PEComa) is a very rare mesenchymal tumor with a distinctive morphology and immunophenotype. PEComas usually harbor TSC2 alterations, although TFE3 translocations, which occur in MiT family translocation renal cell carcinoma and alveolar soft part sarcoma, are also possible. We recently experienced a case of PEComa with TFE3 expression arising in the breast. An 18-year-old female patient presented with a right breast mass. Histologically, the tumor consisted of epithelioid cells with alveolar structure and showed a diffuse strong expression of HMB45 and TFE3. TSC2 was preserved. Melan A and smooth muscle actin were negative. To our knowledge, this is the first Korean case of PEComa of the breast that intriguingly presented with TFE3 expression.
Actins ; Adolescent ; Breast ; Carcinoma, Renal Cell ; Epithelioid Cells ; Female ; Humans ; MART-1 Antigen ; Muscle, Smooth ; Perivascular Epithelioid Cell Neoplasms ; Sarcoma, Alveolar Soft Part

Diffuse pulmonary ossification is a rare entity which was reported just a case in Korea, defined as "wide spread heterotropic bone formation within the lung parenchyme", and it's pathogenesis remains unclear. Generally, diffuse pulmonary ossification is diagnosed by autopsy because most of case is asymptomatic, and classified as either nodular and dendriform diagnosed pathologic examination. We reviewed a case of diffuse dendriform pulmonary ossification with spontaneous pneumothorax.
Autopsy ; Korea ; Lung ; Lung Diseases, Interstitial ; Osteogenesis ; Pneumothorax

PURPOSE: Incidental parathyroidectomy is the most common and unexpected consequence of a total thyroidectomy. It can cause hypocalcemia symptoms such as muscle cramping and even seizures. We conducted this study to compare several factors including the preservation rate of parathyroid glands during both a bilateral axillo-breast approach endoscopic thyroidectomy (BABA) and a conventional open thyroidectomy (CT) for papillary thyroid carcinomas. METHODS: We retrospectively reviewed the medical records of 299 papillary thyroid cancer patients who had a total thyroidectomy between January 2008 and December 2011. We grouped the patients into two groups: BABA (n=70) and CT (n=229). We analyzed age, tumor size, operation time, the number of preserved and removed parathyroid glands, amount and duration of seroma drainage, pain score, hypocalcemia symptoms, and serum total calcium level in both the BABA and CT groups. RESULTS: We observed a younger age (under 45 years old) (P=0.000), smaller tumor size (P=0.000), longer operation time (P=0.000), larger amount of drainage (P=0.000), longer duration of drainage (P=0.007), and larger pain score (P=0.000) in the BABA group. Of the 70 patients that received an endoscopic thyroidectomy, we preserved all four parathyroid glands in 56 patients (78.6%). Of the 229 patients that received an open thyroidectomy, we preserved all four parathyroid glands in 141 patients (61.6%, P=0.004). CONCLUSION: BABA results in more extensive tissue damage over a longer period of time than CT. However, BABA was an excellent method for preserving parathyroid glands when compared with CT for thyroid carcinoma. Thus, it seems to be feasible performing BABA when it matches the indications.
Calcium ; Drainage ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Medical Records ; Methods ; Muscle Cramp ; Parathyroid Glands* ; Parathyroidectomy ; Retrospective Studies ; Seizures ; Seroma ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*

PURPOSE: The optimal sequence of chemotherapy (CT) and radiotherapy (RT) remains uncertain although both can reduce breast cancer recurrence after breast-conserving surgery (BCS). The current study was performed to evaluate whether concurrent RT with CT increases chemotherapy-associated toxicities. METHODS: Two hundred and thirty-eight patients with stage I and II breast cancers were prospectively allocated concurrent CT and RT (N=133) or sequential CT and RT (N= 105) after BCS. In the sequential group, the RT was started after completion of 3 cycles of CT with an additional 3 cycles of CT delivered after the RT. All patients underwent intravenous CMF chemotherapy composed of cyclophosphamide (500 mg/m2), methotrexate (50 mg/m2) and 5-FU (500 mg/ m2), every 3 weeks for 6 cycles following surgery. RESULTS: There were no significant differences between the two groups with regard to the grade 3 or 4 hematologic toxicities during chemotherapy or in abnormal liver enzyme elevation. Radiation related adverse effects, such as moist desquamation and pneumonitis symptom, were no different between the two groups. During the median 42 month follow-up period, range 16- to 60 months, 18 (13.5%) and 20 (19.1%) patients in the concurrent and sequential groups had systemic recurrences of breast cancer. The disease-free survival and local recurrence rates were no different between the two groups. CONCLUSION: Concurrent CT and RT were not associated with an increased toxicity and reasonable cosmetic results were achieved in this current study. The current study indicates that concurrent RT with CT after BCS is a feasible treatment modality, with the advantage of a shortening treatment time.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant* ; Cyclophosphamide ; Disease-Free Survival ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Humans ; Liver ; Mastectomy, Segmental* ; Methotrexate ; Pneumonia ; Prospective Studies ; Radiotherapy* ; Recurrence

BACKGROUND: Immunomodulators enhancing MHC-restricted antigen presentation would affect many cellular immune reactions mediated by T cells or T cell products. However, modulation of MHC-restricted antigen presentation has received little attention as a target for therapeutic immunoregulation. Here, we report that lectins isolated from mushroom Fomitella fraxinea enhance MHC-restricted exogenous antigen presentation in professional antigen presenting cells (APCs). METHODS: Lectins, termed FFrL, were isolated from the carpophores of Fomitella fraxinea, and its effects on the class I and class II MHC-restricted presentation of exogenous ovalbumin (OVA) were examined in mouse dendritic cells (DCs) and mouse peritoneal macrophages. The effects of FFrL on the expression of total MHC molecules and the phagocytic activity were also examined in mouse DCs. RESULTS: DCs cultured in the presence of FFrL overnight exhibited enhanced capacity in presenting exogenous OVA in association with class I and class II MHC molecules. FFrL increased slightly the total expression levels of both class I (H-2K(b)) and class II (I-A(b)) MHC molecules and the phagocytic activity of DCs. Antigen presentation-enhancing activity of FFrL was also observed in macrophages isolated from mouse peritoneum. CONCLUSION: Lectins isolated from the carpophores of Fomitella fraxinea increase MHC-restricted exogenous antigen presentation by enhancing intracellular processing events of phagocytosed antigens.
Agaricales* ; Animals ; Antigen Presentation* ; Antigen-Presenting Cells ; Dendritic Cells ; Immunologic Factors ; Lectins* ; Macrophages ; Macrophages, Peritoneal ; Mice ; Ovalbumin ; Ovum ; Peritoneum ; T-Lymphocytes