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*

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

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 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

OBJECTIVE: To evaluate the recent trend of indication for pregnancy termination. METHOD: From 1993 to 2000, 1,087 cases of termination out of 61,842 cases of deliveries in Samsung cheil hospital were analyzed. We reviewed retrospectively the data-base and charts of delivery, and analyzed the indication for pregnancy termination. RESULTS: Among 61,842 cases of deliveries, indications of pregnancy termination were fetal structure anomalies in 399 cases (0.7%), IUFD in 261 cases (0.4%), PROM in 215 cases (0.4%), chromosomal anomalies in 138 cases (0.2%), anhydroamnios in 32 cases (0.05%), rubella infection of mother or fetus in 24 cases (0.04%), and others in 20 cases (0.03%). Autopsy was performed in 242 cases of fetal anomalies (60.7%), 116 cases of UIFD (44%), and 59 cases of fetal chromosomal abnormalities (43%). The cases of chromosomal anomaly as indication of termination increased and rubella infection of mother or fetus decreased recently, and it is statistically significant r=0.95(P=0.00) and r=-0.73(P=0.04). The fetal weight terminated due to PROM is significantly decreased (Y=517-26 x year P=0.002). CONCLUSION: The indications of termination for fetal chromosomal abnormalities were increased, but for rubella infections were decreased. In cases of PROM, the terminated fetal weight were significantly decreased. However, no change was observed in cases of fetal anomaly, IUFD,and PROM.
Autopsy ; Chromosome Aberrations ; Fetal Weight ; Fetus ; Humans ; Mothers ; Pregnancy ; Retrospective Studies ; Rubella

OBJECTIVE: The objective of this study was to evaluate the safety and timing of the surgery and fetal outcome of pregnancy complicated by a persistent adnexal mass that was required surgical intervention METHODS: We retrospectively reviewed 171 cases of adnexal masses during pregnancy that were required surgery at Samsung Cheil Hospital and Women's Healthcare Center between 1996 to 2001. We analysed medical records for characteristics of tumor, indication and timing of surgery and the effect of pregnancy outcome. Adverse pregnancy outcome is defined as preterm delivery, spontaneous abortion, intrauterine fetal death and perinatal death. The obtained data were analysed using t-test and Fisher's exact test by SPSS. RESULTS: The incidence of adnexal masses during pregnancy that required surgical management was 1 in 292.3 live births. A malignant tumor or a tumor of low malignant potential was found in 7% of cases. A total of 43 patients underwent surgery under emergency condition, 31 (72%) of which were done due to torsion. There were 14 preterm delivery, 3 spontaneous abortion, 1 intrauterine fetal death, 1 perinatal death and 2 artificial abortion in this study. There was a significant difference in adverse pregnancy outcome between elective and emergency group (7/118 [5.9%] versus 11/43 [25.6%] P=.001), and surgery group that before 20 week's gestation and those of after 20 week's gestation (12/145 [8.3%] versus 6/16 [37.5%] P=.004). CONCLUSION: When necessary and feasible, surgery should be scheduled for the early portion of the second trimester, when organogenesis is complete and most spontaneous abortion have occurred, but before later risks of technical difficulties and premature labor. Also we recommend early diagnostic evaluation and immediate surgical intervention of adnexal masses as problematic adnexal mass diagnosed during pregnancy to prevent the risk of emergency surgery associated with adnexal complication (torsion, rupture and hemorrhage) and the risk of delayed diagnosis of malignancy.
Abortion, Spontaneous ; Delayed Diagnosis ; Delivery of Health Care ; Emergencies ; Female ; Fetal Death ; Humans ; Incidence ; Live Birth ; Medical Records ; Obstetric Labor, Premature ; Organogenesis ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnancy* ; Retrospective Studies ; Rupture

The purpose of this study was to determine whether the levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placenta growth factor (PlGF) are altered during the second trimester in the plasma of women who subsequently develop preeclampsia. We performed a case-control study to compare the levels of sFlt-1 and PlGF in the preeclamptic (n=46) and normal pregnant women (n=100). The maternal plasma levels of sFlt-1 and PlGF were measured by enzyme-linked immunosorbent assay. The sFlt-1 levels were significantly higher in the preeclamptic women than in normal controls (p<0.001), while the PlGF levels were significantly lower (p<0.001). In normal controls, sFlt-1 levels were positively correlated (r=0.27, p=0.008), whereas, in the preeclamptic women, those were negatively correlated with the PlGF levels (r=-0.423, p=0.005). Furthermore, the log[sFlt-1/PlGF] ratio was significantly higher in the preeclamptic women than in normal controls (p<0.001). The receiver operating characteristic curve revealed a specificity of 78% with a diagnostic sensitivity of 80.4%; the optimal cut-off value of the log[sFlt-1/PlGF] ratio was 1.4 (95% CI 0.756-0.910, p<0.001). Preeclampsia showed a strong association with increased levels of sFlt-1 and decreased levels of PlGF in the second trimester maternal plasma. Accordingly, the sFlt-1/PlGF ratio may provide early prediction of subsequent development of preeclampsia.
Adult ; Biological Markers/metabolism ; Case-Control Studies ; Female ; Humans ; Immunoassay ; Middle Aged ; Placenta/metabolism ; Pre-Eclampsia/*diagnosis/*metabolism ; Pregnancy ; Pregnancy Proteins/*biosynthesis ; Pregnancy Trimester, Second ; ROC Curve ; Sensitivity and Specificity ; Vascular Endothelial Growth Factor Receptor-1/*biosynthesis

OBJECTIVE: To evaluate the relationship between increased nuchal translucency (NT) and abnormal pregnancy outcomes. METHODS: From January 1999 to December 2001, The 298 fetuses of increased nuchal translucency (>or=2.5 mm) in period of 10-14 weeks gestation were reviewed retrospectively. Amniocentesis and high resolution ultrasonography during second trimester were done for all cases. We analyzed septation within NT, karyotypes, structural anomalies, and adverse pregnancy outcomes such as spontaneous abortion, intrauterine fetal death and preterm delivery. RESULTS: The mean age of the patients was 30.5 +/- 3.5 years. The mean gestational age and CRL were 12.5 +/- 0.95 weeks and 6.5 +/- 1.15 mm. We observed 18 (6%) cases of abnormal karyotypes. 7/46 (15.2%) fetuses with internal septation had abnormal karyotype and 11/252 (4.4%) fetuses without internal septation had abnormal karyotype (p=0.013). Among the 280 fetuses with normal karyotype, 8 (2.8%) fetuses had structural anomalies and 18 (6.4%) fetuses had adverse pregnancy outcomes. The chromosomal abnormality and structural anomaly were significantly increased in the group of nuchal translucency thickness above 3.5 mm (p=0.001). CONCLUSION: Increased nuchal translucency is related with chromosomal abnormality and abnormal pregnancy outcomes.
Abnormal Karyotype ; Abortion, Spontaneous ; Amniocentesis ; Chromosome Aberrations ; Female ; Fetal Death ; Fetus ; Gestational Age ; Humans ; Karyotype ; Nuchal Translucency Measurement* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Retrospective Studies ; Ultrasonography