A clinical and histologic survey was done on 71 cases of basal cel carcinoma(BCC) filed at Department of Clinical Fathology, Kang Nam, Han Kang, and Kang Dong Sacred Heart Hospital during past 13 year s from 1979 to 1991. The results were summerized as follows: 1. Of all malignant skin tumors BCC accounted for 31.6%. The frequency of BCC in the total number of outpatients visiting the Department of Dermatology was 0.06%. 2. The ratio of men to women with HCC was 1:1.03. 83.8% of the pat.ients with BCC were older than the age of l0 years with the mean age of 56.9 years. 3. 83.8% of the BCC appared in the face, especially on the nose(25.4%), eyelid(20.3%). 4. On the basis of classification of Lever et al, the solid type(66.7% ) was the most com mon histologic pattern, followed by the adenoid(8.8%), pigmented(8.8%), and etc. By the classification of Farmer et al, the nodulocystic type(35.1% ) was the most common histologic pattern followed by infiltrative(31.6%), adenoid(8.8%), pigmented(8.8%), and etc. By the classification on Sexton et al, in the order of decreasing frequency, liistologic subtypes were the nodular(43.9%), mixed (22.8%), infiltrative(19.3%), supeficial(3.5%), morpheic(3.5%), and micronodular(3.5%).
Carcinoma, Basal Cell* ; Classification ; Dermatology ; Female ; Heart ; Humans ; Male ; Outpatients ; Skin

OBJECTIVE: Our purpose was to investigate urinary malondialdehyde (MDA), manganese superoxide dismutase (Mn-SOD) activity and polymorphism in placental tissues of women with preeclampsia and to evaluate oxidative stress in the pathophysiology of preeclampsia. METHODS: Urins and placental tissues were obtained from 20 normal and 20 preeclamptic women at 3rd trimester. Urinary MDA was assayed by an high performanance liquid chromatography (HPLC). The placental Mn-SOD activity was assayed by westen blotting and The placental Mn-SOD genotyping was assayed by PCR-RFLP. Data were analyzed statistically using Student's t-test and Chi-square test. RESULTS: 1) Urinary concentration of MDA was not significantly different in preeclampsia (4.43+/-2.37 ug/g) as compared with normotensive pregnancy (4.39+/-1.17 ug/g). 2) Preeclamptic women had similar Mn-SOD activity in placenta (1.04+/-0.04U/mL protein) as compared with normotensive pregnancy (1.44+/-0.34 U/mL protein). 3) No significant difference in the polymorphismthe of Mn-SOD genotype in placenta was observed between preeclampsia and normotensive pregnancy (X2=0.06, p>0.05) CONCLUSION: The findings in this study do not show that oxidative stress might be a pathogenetically relevent process causally contributing to the disease, and polymorphism in the Mn-SOD genotype in placenta do not seem to be risk factors for preeclampsia.
Chromatography, Liquid ; Female ; Genotype ; Humans ; Malondialdehyde ; Oxidative Stress ; Placenta ; Polymorphism, Genetic* ; Pre-Eclampsia* ; Pregnancy* ; Risk Factors ; Superoxide Dismutase* ; Superoxides*

OBJECTIVE: The purpose of this study was to determine which factors influence the likelihood of successful trial of labor, to evaluate the risks of VBAC and to evaluate the criteria of dystocia and the safety of VBAC. METHODS: This retrospective study was peformed based on 61 pregnant women who succeeded VBAC, 37 VBAC failure women, 100 nulliparas and 100 multiparas. RESULTS: In clinical characteristics, the parity, the number of previous cesarean section, gestational age, estimated fetal body weight by ultrasonography, and neonatal body weight had notable differences between the success and the failure group. In obstetric and historical factors, cervical effacement, dilation, and Bishop score at admission, spontaneous labor and method of induction of labor had differences. Among these factors, estimated fetal body weight by ultrasonography, cervical effacement and augmentation of labor using oxytocin were the most prognostic factors affecting the success of VBAC. In VBAC group, the duration of active-phase, second phase and total duration of labor were 313.5, 36.4 and 350.2 minutes, which were significantly shorter than nulliparas, but longer than multiparas. CONCLUSION: The trial of labor after cesarean section will decrease repeat operation, if it is performed under exact understanding of successful prognostic factors and the unique time length of labor. It will contribute to increase advantages for mother and economic benefits.
Body Weight ; Cesarean Section* ; Dystocia ; Female ; Fetal Weight ; Gestational Age ; Humans ; Mothers ; Oxytocin ; Parity ; Parturition* ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Trial of Labor ; Ultrasonography

Fetus in fetu is an very rare condition in which a vertebrate fetus is incorporated within its twin. Although a number of cases were reported at 3rd trimester of gestation or postnatally, the authors present a retroperitoneal fetus in fetu with 9 x 7 x 6 cm sized cystic mass that was diagnosed at 2nd trimester using ultrasonography and confirmed on a computed tomography scan after birth. The mass was successfully excised postnatally and consistent with a fetus in fetu by pathological confirmation. Solid mass was surrounded by a fluid-containing sac and showed highly ordered organogenesis around an axial vertebral column.
Diagnosis* ; Fetus* ; Humans ; Organogenesis ; Parturition ; Pregnancy ; Spine ; Ultrasonography ; Vertebrates

OBJECTIVE: Intrauterine growth is influenced by multiple factors like genetic, nutritional, environmental and hormonal factors. As birth weight is reported to be related to perinatal morbidity and mortality, we aimed to compare umbilical cord blood adiponectin, IGF-I, IGFBP-1, insulin and leptin levels between small for gestational age (SGA) and appropriate for gestational age (AGA) neonates at birth to investigate the influence of these factors on birth weight and ponderal index. METHODS: We investigated retrospectively 30 pregnant women with SGA and 30 pregnant women with AGA who delivered at Ewha Womans University Hospital and their babies from January 2007 to December 2007. Fetal umbilical cord venous blood adiponectin, IGF-I, IGFBP-1, insulin and leptin levels from SGA and AGA neonates were obtained at the time of delivery. The definition used to identify cases of SGA was individual birth weight ratio of less than 10th percentile and the definition of ponderal index (PI) was [BW (g)/ (height (cm))3]x100. RESULTS: Umbilical cord blood adiponectin, IGF-I and IGF/IGFBP ratio were significantly lower (P<0.05) in SGA than AGA. And umbilical cord blood IGFBP-1 were significantly higher (P<0.05) in SGA than AGA. But there was no significant difference in umbilical cord blood insulin and leptin levels between SGA and AGA neonates. Positive correlation was noted between adiponectin and IGF-I, IGF/IGFBP ratio, insulin and leptin. Negative correlation was noted between adiponectin and IGFBP-1, IGF-I and IGFBP-1. On multiple regression analysis, adiponectin and IGF-I were significant factors associated with body weight (BW), but only IGFBP-1 was significant factor associated with PI. CONCLUSION: These results suggest that fetal adiponectin, IGF-I, IGFBP-1 may have an important role in regulation of intrauterine growth and we will expect that evaluation of adiponectin and IGF-I in SGA may be helpful in prediction of neonatal outcome, and IGFBP-1 may be useful in diagnosis of asymmetric intrauterine growth retardation (IUGR).
Adiponectin ; Birth Weight ; Body Weight ; Female ; Fetal Blood ; Fetal Growth Retardation ; Gestational Age ; Humans ; Infant, Newborn ; Insulin ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor I ; Leptin ; Parturition ; Pregnant Women ; Retrospective Studies ; Umbilical Cord

Apert Syndrome is a kind of developmental disorder characterized by the craniosynostosis by synostosis of the coronal suture, bilateral symmetric syndactyly of the limbs (mitten-like hands and feet), midfacial hypoplasia, and variable degree of mental retardation. In 1894, Wheaton did the first description, and in 1906, it was named by Apert. Apert Syndrome is a rare autosomal dominent disorder and the prevalance at birth is estimated from 1:100000 to 160000. This syndrome is developed by the result of a mutation in the fibroblast growth factor receptor 2 gene (FGFR 2) located at 10q25.3-26. In familial cases, diagnosis in the first trimester sometimes has been made. But In sporadic cases, mostly it has been diagnosed in the second or third trimester by ultrasonography. In Korea, Apert syndrome is so rare, and it has not yet been reported that Apert syndrome is defined by prenatal molecular diagnosis with ultrasonographic detection. We present a case of prenatal molecular definitive diagnosis of Apert syndrome suspected strongly by ultrasonographic finding with a brief review of literature. Mother of affected fetus was transferred to our hospital at 31(2) weeks' gestation due to abnormal fetal ultrasound finding of severe polyhydroamnios and bilateral syndactyly of hands detected at 26(3) weeks' gestation. We suspected Apert syndrome by fetal ultrasonographic finding, and then confirmed Apert syndrome by DNA analysis of fetal amniocyte from therapeutic amnioredution at 31(4) weeks' gestation.
Acrocephalosyndactylia* ; Craniosynostoses ; Diagnosis* ; DNA ; Extremities ; Female ; Fetus ; Hand ; Humans ; Intellectual Disability ; Korea ; Mothers ; Parturition ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Receptor, Fibroblast Growth Factor, Type 2 ; Sutures ; Syndactyly ; Synostosis ; Ultrasonography

Twin reversed arterial perfusion (TRAP) sequence is a unique complication of monochorionic twinning, in which normal pump or donor twin paradoxically perfuses the recipient or acardiac twin through arterial- arterial anastomoses. This results in reversed flow of poorly oxygenated blood through the recipient twin and is usually associated with partial or complete lack of heart development. The pump twin has a mortality rate of 50% as a result of high-output heart failure, preterm labor, and polyhydramnios. We present here a case of twin reversed arterial perfusion (TRAP) sequence complicated by severe polyhydramnios during the second trimester. The blood supply to acardiac twin was interrupted successfully at 25 weeks of gestation by injecting 1.5 mL of absolute alcohol into the intra-abdominal portion of the single umbilical artery, under ultrasound guidance. Serial ultrasound showed normal growth and normal amniotic fluid volume in normal pump twin, but arrest of growth in femur length and decrease in amniotic fluid volume in acardiac twin. The normal pump twin was delivered at 384 weeks of gestation and had uneventful neonatal course.
Amniotic Fluid ; Ethanol ; Female ; Femur ; Heart ; Heart Failure ; Humans ; Mortality ; Obstetric Labor, Premature ; Oxygen ; Perfusion* ; Polyhydramnios* ; Pregnancy ; Pregnancy Trimester, Second ; Single Umbilical Artery ; Tissue Donors ; Ultrasonography

OBJECTIVE: The purpose of this study is to assess the relationship between the oligohydramnios and umbilical venous blood EPO levels and nRBC counts, and to investigate the significance of oligohydramnios as intrauterine hypoxic marker in AGA and SGA fetuses. METHODS: EPO and nRBC were measured in 217 singletons with a gestational age of 32 to 42 weeks at delivery. The subjects were divided into 4 groups: group 1 (AGA with normal amniotic fluid volume, n=129), group 2 (AGA with oligohydramnios, n=15), group 3 (SGA with normal amniotic fluid volume, n=57) and group 4 (SGA with oligohydramnios, n=11). EPO levels and nRBC counts in group 2, 3 and 4 were compared to those in group 1 using Mann-Whitney U-test. Relationship between EPO and nRBC was assessed using linear regression analysis. In addition, relationship between results of umbilical venous blood gas analysis and EPO/nRBC was assessed using the same method. P-values less than 0.05 were considered statistically significant. RESULTS: EPO levels and nRBC counts in AGA with oligohydramnios (group 2) were not significantly different from those in AGA with normal amniotic fluid volume (group 1). EPO levels in SGA with normal amniotic fluid volume (group 3) were significantly higher than those in AGA with normal amniotic fluid volume (group 1). EPO levels and nRBC counts in SGA with oligohydramnios (group 4) were significantly higher than those in AGA with normal amniotic fluid volume (group 1). There was significant positive correlation between EPO and nRBC. Parameters obtained from the umbilical venous blood gas analysis were more related with nRBC than EPO. CONCLUSION: Oligohydramnios was significant intrauterine hypoxic marker in SGA fetuses. However, the results of this study suggested that the influence of oligohydramnios on antenatal fetal condition might be less severe in AGA fetuses than in SGA fetuses. Moreover, it was likely that nRBC had stronger association with pathologic hypoxia than EPO did.
Amniotic Fluid ; Anoxia ; Blood Gas Analysis ; Erythroblasts* ; Erythropoietin* ; Female ; Fetus* ; Gestational Age* ; Linear Models ; Oligohydramnios ; Parturition* ; Pregnancy

OBJECTIVE: Recently, selective termination is employed in multifetal pregnancies, in the presence of an abnormal fetus, or in the complication of twin pregnancies. The purpose of this study is to evaluate effectiveness, safety of the tailored selective termination in multifetal pregnancies. METHODS: This study was retrospective and involved six cases. Indication of termination were 3 cases of structural anomalies (anencephaly, encephalocele, body stalk anomaly), 1 case of chromosomal anomaly (21 trisomy) and 2 cases of monochorionic twin complications (acardiac twin, twin to twin transfusion syndrome). RESULTS: We used KCL injection in 4 cases, they were all confirmed dichorionic twin, and in 2 cases of monochorionic twin, we used alcohol ablation of intra-abdominal umbilical artery in 1 case, and radiofrequency ablation of the cord in 1 case. CONCLUSION: All procedures were successful, and all normal infants were delivered in 3rd trimester. Tailored selective termination in 2nd trimester is effective and safe in abnormal multifetal pregnancies.
Catheter Ablation ; Encephalocele ; Female ; Fetofetal Transfusion ; Fetus ; Humans ; Infant ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy, Twin* ; Retrospective Studies ; Umbilical Arteries

OBJECTIVE: The aim of this study were to examine the serum level of estradiol, estriol, progesterone, oxidized LDL in preeclamtic patients and to evaluate the protective effects of estrogen and progesterone against lysophosphatidylcholine (LPC) induced cell death in Human umbilical vein endothelial cells (HUVECs). METHODS: We analysed the serum level of estradiol, estriol, progesterone, oxidized LDL in patients with preeclampsia and control. We used LPC to induce cell death in HUVECs. For cytotoxic assay, we did LDL assay for cell death and Resazurin assay for cell viability. HUVECs were exposed to various concentrations of LPC, LPC+estrogen, LPC+progesterone and we did cytotoxic assay. RESULTS: The serum estradiol, estriol were lower in the preeclamptic patients (P<0.05). Oxidized LDL were higher in the preeclamptic patients(P<0.05). LPC induced cell death in a concentration-dependant manner. Estrogen or progesterone inhibited LPC-induced cell death in a concentration-dependant manner (P<0.05). CONCLUSION: Estrogen and progesterone attenuated LPC-induced cytotoxicity. The results suggest that Oxidized LDL induced endothelial damage in preeclampsia may be induced by low serum estradiol, estriol and progesterone levels and prevented by estrogen and progesterone addition.
Cell Death ; Cell Survival ; Estradiol ; Estriol ; Estrogens* ; Human Umbilical Vein Endothelial Cells ; Humans ; Lysophosphatidylcholines ; Pre-Eclampsia ; Progesterone*