No abstract available.
Leukemia* ; Sweet Syndrome*

OBJECTIVES: The objective of this study was to identify the possible role of stem cell and myeloperoxidase (MPO) in the metabolic activation of styrene, hydroquinone and trichloroethylene, by investigating the effects of stem cell from umbilical cord blood and MPO on the frequency of sister chromatid exchange (SCE) and micronuclei (MN) induction in cultured human peripheral lymphocytes exposed to these chemicals. METHODS: Isolated lymphocytes from whole blood were cultured for 72 hours. The cells were treated with 1.50 mM styrene, 50 microM hydroquinone and 1.50 mM trichloroethylene dissolved with acetone (30 microl in total volume) at 24 hours after the beginning of culture. Control group was treated with acetone only. Immediately after adding these chemicals, 1.3X1 06 cells/ml and 2.6X1 06 cells/ml stem cell or 1.0 and 2.0 unit MPO with H2O2 (for substrate) were added to the cultures. Slides were stained with Giemsa's solution, and acridine orange for sister chromatid exchange, and for micronucleus analysis, respectively. RESULTS: The results were as follows: 1) Myeloperoxidase and stem cell did not significantly affect the frequencies of SCE or MN in the control group. 2) The frequency of SCE or MN with exposure to styrene did not different from control in the absence of stem cell or MPO. Sister chromatid exchange induced by styrene was significantly increased by adding stem cell or MPO in dose-dependent relationship. The frequency of MN induced by styrene significantly increased in the presence of 2.0 unit MPO. 3) The frequency of SCE was significantly increased with exposure to hydroquinone than acetone treated control in the absence of stem cell or MPO. Sister chromatid exchange induction by hydroquinone significantly increased dose-dependently in the presence of stem cell or MPO. There was a tendency of increase of the MN frequency induced by hydroquinone in the presence of stem cell or MPO, but not significant. 4) It was found that trichloroethylene itself did not increase SCE or MN frequency. Frequency of SCE induced by trichloroethylene was significantly increased with adding stem cell (low and high) and 2.0 unit MPO. Even though stem cell or MPO increased the frequency of MN of lymphocyte exposed to trichloroethylene, the difference was not significant. CONCLUSIONS: Authors found that the frequencies of both sister chromatid exchange and micronucleus induced by styrene, hydroquinone, and trichloroethylene were increased significantly with the treatment of stem cell or myeloperoxidase. It was suggested that myeloperoxidase may therefore play an important role in the metabolic activation of styrene, hydroquinone, and trichloroethylene and myeloperoxidase probably be involved in the myelotoxicity of these chemicals.
Acetone ; Acridine Orange ; Biotransformation ; Fetal Blood ; Humans ; Lymphocytes* ; Peroxidase* ; Siblings* ; Sister Chromatid Exchange* ; Stem Cells* ; Styrene* ; Trichloroethylene*

Silicone(polydimethylsiloxane) is a liquid polymer, widely used for medical purpose, especially breast augmentation and other cosmetic procedures, with a minimal tissue reaction and a high degree of thermal stability. Illegal injections of slilicone in human beings, however have been associated with many adverse effects, including migration of the silicone, skin hypopigmentation, granulomatous hepatitis, mastitis, human adjuvant disease (progressive systemic sclerosis, SLE, mixed connective tissue disease, rheumatoid Arthritis, Hashimoto's thyroiditis, morphea, etc.). Pulmonary involvement has rarely been mentioned in the literature. We experienced the unusual four cases of respirtory difficulty after injection of liquid silicone in the breast, vigina, uterus, hip. They were all young adult female and previously healthy, one of them died of the injection, and the others survived with health. Two patients were admitted because of dypena, cough, chest discomfort and bilateral pulmonary infiltration after injection of silicone. Transbrochial lung biopsy and autopsy disclosed numerous oil like materials filling the alveolar septal capillaries and marcrophages. High resolution C.T. disclosed multiple alveolar lesion in the peripheral lesion of both lung. Transbronchial lung biopsy, autopsy, high resolution C.T. lung scan disclosed abnormalities compatible with silicone fluid induced pulmonary embolism, which is followed by acute respiratory distress syndrome, especially after injection of liquid silicone in the vagina, uterus. The other patients had mild dypnea, cough, pulmonary function test initially showed mild restrictive pattern in one patient. Lung scan disclosed abnormalities compatible with silicone induced pulmonary embolism, after injection in the hip, breast. It is strongly suggested that illegal injection of slilicone fluid carries pulmonary problem and can induce acute pulmonary embolism followed by acute respiratory distress syndrome, especially after silicone injection in vigina and uterus surrounded by numerous blood vessels.
Arthritis, Rheumatoid ; Autopsy ; Biopsy ; Blood Vessels ; Breast ; Capillaries ; Cough ; Female ; Hepatitis ; Hip ; Humans ; Hypopigmentation ; Lung ; Mastitis ; Mixed Connective Tissue Disease ; Polymers ; Pulmonary Embolism* ; Respiratory Distress Syndrome, Adult ; Respiratory Function Tests ; Scleroderma, Localized ; Scleroderma, Systemic ; Silicones* ; Skin ; Thorax ; Thyroid Gland ; Thyroiditis ; Uterus ; Vagina ; Young Adult

OBJECTIVE: To investigate the clinical efficiency of the cervical cerclage for preventing preterm birth in asymptomatic women who showed a shortened cervix at the second trimester ultrasound METHODS: From January 1996 to December 2005, we retrospectively reviewed the medical records of pregnant women who received routine second trimester ultrasound (16~24 gestational weeks) without abdominal pain or bleeding at Cheil general hospital. Women with a short cervical length < or =25 mm were classified into cerclage and expectant group. Women who received cervical cerclage within 1 week after detection of cervical shortening without any change of cervical length and shape were included in cerclage group. Primary outcome was the frequency of delivery before 34 weeks' gestation. Secondary outcome was the most important risk factor for preterm delivery in pregnant women with short cervix. Chi-square test, t-test, and multiple logistic regression analysis were used for statistical analysis. P<0.05 was considered statistically significant. RESULTS: The mean gestational age at ultrasound was 21.6 weeks' gestation. A total of 111 women had short cervix, including 26 that were treated by cerclage and 85 managed expectantly. The proportion of preterm delivery before 34 weeks' gestation was higher in the cerclage group [38% (10 of 26)] than that of the expectant group [20% (17 of 85)], but there was no significant difference (P=0.069). In the univariate analysis, funneling (38% vs 16%, P=0.012) and cervical length < or =15 mm (47% vs 15%, P=0.069) were associated with preterm delivery before 34 weeks' gestation. In the multiple logistic regression analysis, a cervical length < or =15 mm had an adjusted odd ratio of 3.7 (95% CI 1.3~10.6) for preterm delivery before 34 weeks's gestation. CONCLUSIONS: These data suggest that cerclage in asymptomatic woman with a short cervix in the second trimester ultrasound does not prevent preterm delivery before 34 weeks of gestation. Woman with extremely shortened cervical length < or =15 mm needs intensive management for prevention of preterm delivery.
Abdominal Pain ; Cerclage, Cervical ; Cervical Length Measurement ; Cervix Uteri ; Female ; Gestational Age ; Hemorrhage ; Hospitals, General ; Humans ; Logistic Models ; Medical Records ; Pregnancy ; Pregnancy Trimester, Second ; Pregnant Women ; Premature Birth ; Retrospective Studies ; Risk Factors

OBJECTIVE: To evaluate patients with adnexal masses that were managed surgically during pregnancy and their effect on fetal outcome. METHODS: The data were reviewed concerning pregnant women who required surgery at Samsung Cheil hospital between January 1996 to December 2001. Among 50,126 deliveries, 255 cases of ovarian tumors were evaluated for clinical aspects, histologic patterns, and obstetrics and fetal outcome. RESULTS: 1. The prevalence of ovarian mass in pregnancy was 0.5% (255 cases in 50,126 deliveries). 14 cases of malignant tumors were founded. 2. The maternal mean age was 28.7+/-3.6 years old, mean gavida was 1.8+/-1.1, and mean parity was 0.3+/-0.5. 3. The mean gestational weeks of diagnosis was 11.9+/-8.6 weeks. Prenatal operations were performed in 160 cases, and 95 cases of ovarian masses were operated at delivery time by cesarean section. 4. In the group of prenatal operation, preterm delivery and caesarian section rate were decreased at operation before 23 gestational weeks (P<0.05). 5. In 42 cases, Emergency operations were done. Mean delivery weeks was 36.7+/-7.2 weeks and was earlier than elective operation group (P<0.05). 6. The mean size of ovarian mass was 9.5+/-3.8 cm. The pathologic features of the 255 lesions were as follows: 98 benign cystic teratomas, 43 mucinous cystadenomas, 31 endometriomas, 20 serous cystadenomas, 14 simple cysts, 14 paraovarian cysts, 6 follicular cysts, 5 corpus luteal cysts, 5 theca luteal cysts, 3 hydrosalpinx, 2 fibromas, and 14 malignant tumors. 7. The 231 patients for whom the outcome of pregnancy was available, 18 (7%) gave birth before 37 weeks of gestation, while 3 (1.2%) experienced spontaneous abortions, 2 artificial abortions, and 1 hysterotomy. CONCLUSION: Most adnexal masses identified by sonography during pregnancy were small, simple cysts that did not pose a risk a pregnancy. However the percentage of malignant tumors or tumors of low malignant potential was 1.8 fold greater than previously reported. Surgical intervention at <23 weeks of gestation might have not been adverse outcomes.
Abortion, Spontaneous ; Cesarean Section ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Diagnosis ; Emergencies ; Endometriosis ; Female ; Fibroma ; Follicular Cyst ; Humans ; Hysterotomy ; Obstetrics ; Parity ; Parturition ; Pregnancy* ; Pregnant Women ; Prevalence ; Teratoma

OBJECTIVE: To show the patterns of changes in biochemical markers of bone turnover and ultrasound bone mineral density (BMD) during pregnancy and postpartum in Korean women. METHODS: We conducted a prospective study between February 2004 and February 2005. Forty-one healthy singleton pregnant women were included. We used quantitative ultrasonography for BMD measurement which is advantageous to pregnant women because it is radiation-free and it provides very accurate BMD that correlates highly with BMD measured by conventional dual energy x-ray absorptiometry. We measured marker of bone resorption (beta-Crosslaps), bone formation [total alkaline phosphatase (ALP), osteocalcin (OC)], total calcium, phosphorus and parathyroid hormone (PTH) during and after pregnancy. RESULTS: During pregnancy, BMD slightly decreased in the third trimester. Bone resorption marker (beta-Crosslaps) increased steadily during pregnancy and immediate postpartum. Markers of bone formation (ALP, osteocalcin) increased from late pregnancy. Total calcium decreased slightly as bone resorption peaks in second trimester. PTH and phosphorus increased steadily throughout pregnancy and postpartum. CONCLUSION: Pregnancy is characterized by high bone turnover in Korean women with resorption preceding formation.
Absorptiometry, Photon ; Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Resorption ; Calcium ; Female ; Humans ; Osteocalcin ; Osteogenesis ; Parathyroid Hormone ; Phosphorus ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnant Women ; Prospective Studies

The purpose of this study is to compare perinatal outcomes of twin pregnancies complicated by gestational diabetes (GDM) with those unaffected by GDM. A total of 1,154 twin pregnancies who delivered at Cheil General Hospital, between January 1998 and December 2002 were recruited to participate in a retrospective analysis. Out of these twin pregnancies, 37 women were had GDM. Four pregnancies exposed to GDM were excluded due to the loss of medical records; therefore 33 twin pregnancies exposed to GDM were enrolled. We matched the GDM pregnancies with pregnancies unaffected by GDM in a 1:2 ratio; therefore there were 33 GDM/66 without GDM who delivered during the study period. Our findings show that there were no significant differences including birth weight, Apgar score, respiratory distress syndrome, meconium aspiration pneumonia, transient tachypnea of new born, hyperbilirubinemia, hypoglycemia, hypocalcemia and congenital anomalies. Therefore, well controlled GDM may not increase perinatal complications in twin pregnancies. Careful pregnancy management and fetal surveillance in twin pregnancies is important to decrease perinatal complications and maintain a sound pregnancy and healthy offspring.
Twins ; Treatment Outcome ; Retrospective Studies ; Pregnancy, Multiple ; Pregnancy Outcome ; Pregnancy ; Humans ; Female ; Diseases in Twins ; Diabetes, Gestational/*pathology/*therapy ; Adult

OBJECTIVE: The purpose of this study was to determine the independent factors that predict neonatal birthweight and find the relationship between maternal weight gain and neonatal birthweight in women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM). METHODS: Forty-six women with GDM and one hundred fifty women with NGT were included in the study. All subjects had singleton pregnancies and no medical diseases that may affect the fetal growth and were certain of gestational age by early ultrasonography. Maternal weight at each prenatal visit was recorded and neonatal anthropometic measurement was done within 2 days of birth. RESULTS: The average rate of weight gain (kg/week) in NGT was lowest during the first trimester (0.09 +/-0.10), peaked during the second trimester (0.52+/-0.14), and slowed after 34 gestational weeks (0.46+/-0.26). In women with GDM, the average rate of weight gain was also lowest during the first trimester (0.18+/-0.23), but it was twofold higher compared with women with NGT. There was a significant decrease of the rate of weight gain after 28 gestational weeks in women with GDM. Total weight gain during pregnancy was 3.4 kg less in women with GDM. Neonatal birthweight was correlated with maternal weight gain and the rate of weight gain during 14-27 and 28-33 weeks in NGT. However, birthweight was correlated with maternal weight gain and the rate of weight gain during the first trimester and 14-27 weeks in GDM. CONCLUSION: This result suggests that the women with GDM who have greater weight gain during the first and the second trimester have a increased risk of excessive fetal growth. Thus strict glycemic control during pregnancy is needed especially in these women.
Diabetes, Gestational* ; Female ; Fetal Development ; Gestational Age ; Glucose* ; Humans ; Parturition ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Ultrasonography ; Weight Gain*

PURPOSE: Ibuprofen is a non steroidal anti-inflammatory drug used for treating fever and pain including headache, arthralgia, and back pain. There is scarce information on the safety of ibuprofen associated with fetal anomaly when used early in pregnancy. Epidemiology studies have suggested that use of NSAIDs, including ibuprofen, during pregnancy may increase the risk of cardiac defects and gastroschisis. The aim of the study was to evaluate fetal outcomes among pregnant women who were unintentionally exposed to ibuprofen in early pregnancy. METHODS: Total 381 pregnant women who were unintentionally exposed to ibuprofen during early pregnancy were prospectively followed up. In addition, 643 age and gravity matched pregnant women not exposed to any potential teratogenic agent during pregnancy were recruited as controls. Patients were followed-up until delivery or loss to follow-up. Newborns were examined in order to identify any major congenital malformation. RESULTS: Mean age of exposed women was 31.2+/-3.4 years, with a mean number of previous pregnancies of 2.3+/-1.2 and mean gestational weeks at exposure of 4.4+/-2.2. All gestations were confirmed by ultrasonography. Of exposed women, 17 (5.6%) had spontaneous abortions, 16 were on- going pregnancies, 1 had an intra-uterine fetal death, 21 artificial abortion and 55 cases were lost to follow-up. Therefore, 271 pregnancies unintentionally exposed to ibuprofen were evaluated, each delivering a singleton baby. Three babies had congenital anomalies: one had unilateral hydronephrosis, another baby was born with a unilateral inguinal hernia. The last baby was born with unilateral kidney dysplasia with megaureter. In the control group, 6 babies were born with major malformations [1.11% vs. 1.31% (P=0.552, OR: 0.841, 95% CI: 0.2 to 3.4)]. CONCLUSION: These preliminary results suggest that the ibuprofen may not be a major human teratogen.
Abortion, Spontaneous ; Anti-Inflammatory Agents, Non-Steroidal ; Arthralgia ; Back Pain ; Female ; Fetal Death ; Fever ; Follow-Up Studies ; Gastroschisis ; Gravitation ; Headache ; Hernia, Inguinal ; Humans ; Hydronephrosis ; Ibuprofen ; Infant, Newborn ; Kidney ; Lost to Follow-Up ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnant Women ; Prospective Studies

PURPOSE: There is a dearth of information on maternal drug exposure during lactation. The Korean Mothersafe Professional Counseling Center launched helpline to provide information and clinical consultation service on drug safety during lactation as well as in pregnancy. Here, we reviewed our 5 years' experience of counseling with drug exposed breastfeeding mothers. METHODS: The questionnaires were given to drug exposed breastfeeding mothers from January 2005 to April 2010 who contacted our helpline and follow-up survey data was collected by phone call. The questionnaires included lists of symptoms that exposed mothers experienced and that was observed in their infants, as well as demographic questions and questions about lactation. RESULTS: A total of 278 mothers completed the survey and lactational exposure was estimated. Majority of them reported that their infants and themselves never experienced serious side effects of drugs during lactation. Only 3 (1.1%) babies reported side effects and 20 (7.2%) mothers reported decreased production of breast milk. Two hundred thirty two (83.5%) mothers continued breastfeeding after counseling. Lactation was stopped temporarily in 20 (7.2%) mothers and permanently in 26 (9.3%) mothers. CONCLUSION: Most of the drugs exposed during lactation did not cause serious side effects to infants and mothers. As many drugs have inadequate data to assure safety, the clinician is left with a dilemma as to where the balance of risks and benefits lie with respect to the mother and her baby. The author expect that analyses of these counseling will contribute to provide practical answers to clinicians as well as exposed mothers and to establish correct breastfeeding practice.
Breast Feeding ; Counseling ; Female ; Follow-Up Studies ; Humans ; Infant ; Lactation ; Milk, Human ; Mothers ; Pregnancy ; Surveys and Questionnaires ; Risk Assessment