Atrial septal defect is one of the most common congenital heart diseases in adult, of which absolute causes is not confirmed, but explained by multifactorial inheritance. In Korea, there has been no case report of atrial septal defect in identical twins in spite of some reports of atrial septal defect in relatives and twins in other countries. We present a first case of atrial septal defect in identical twins whose mother had no infection or medication history during pregnancy.
Adult ; Heart Diseases ; Heart Septal Defects, Atrial* ; Humans ; Korea ; Mothers ; Multifactorial Inheritance ; Pregnancy ; Twins ; Twins, Monozygotic*

PURPOSE: Bovine colostrum contains three times more immunoglobulin than human colostrums does. We investigated the effectiveness of administering Bovine colostrum combined with antibiotics in an animal model of ascending pyelonephritis. MATERIALS AND METHODS: Thirty female Sprague-Dawley rats were divided into 5 groups: the normal group, the non-treated control group, the Bovine colostrum administered group, the antibiotic treatment group and the combined administration of antibiotics and Bovine colostrums group. After anesthetizing, an inoculum of 1 x 10(8) colony forming units per ml of Escherichia coli (E. coli, ATCC 25922 strain) was instilled into the bladder through the urethra and the urethra was occluded for 4 hours. We began treatment with ciprofloxacin (15mg/kg, for 5 days, intramuscularly) alone or Bovine colostrum (6ml/kg, for 5 days, orally) alone or with combination treatment 72 hours after inoculation. The rats were sacrificed 4 weeks after infection. Both kidneys were examined pathologically. We carried bacterial culture examinations of the urine and the kidney tissue. RESULTS: As the results of examining the cultures of the urine and kidney tissues, no bacteria were cultivated in the antibiotics treatment group and the combined treatment group. 66.7% of the control group and 33.3% of the bovine colostrum treatment group had positive urine cultures and 66.7% of the control group and 41.7% of the bovine colostrum treatment group showed a positive reaction on the kidney tissue culture. The severity of pyelonephritis, as noted on the pathological examination, was highest in the control group. The combined treatment group had the lowest degree of infection among all the groups. CONCLUSIONS: The administration of bovine colostrum in combination with antibiotics can significantly reduce the inflammation associated with ascending pyelonephritis.
Animals ; Anti-Bacterial Agents* ; Bacteria ; Ciprofloxacin ; Colostrum* ; Escherichia coli ; Female ; Humans ; Immunoglobulins ; Inflammation* ; Kidney ; Models, Animal ; Pyelonephritis ; Rats ; Rats, Sprague-Dawley ; Stem Cells ; Urethra ; Urinary Bladder

OBJECTIVE: It is known that mouse embryos before implantation develop in a low oxygen environment of 3- 8% concentration and with antioxidant materials such as vitamins, antioxidant enzymes, ferrous binding proteins, and albumin in follicular and tubal fluids. However, the 20% oxygen culture condition with chemically defined media might be produce an abundance of ROS, and leads to developmental delay or developmental block in vitro. In this study, we attempt to elucidate the relationship between intracellular H2O2 production and embryo development in different oxygen culture conditions of mouse embryos. METHODS: Prenuclear embryos from C57BL/CBA Fl hybrid and ICR mouse were cultured in incubators which provided 5% carbon dioxide, 20% oxygen and 5% carbon dioxide, 5% oxygen. Measurement of H2O2 level in a embryo was performed with DCHFDA(2, 7 -dichlorodihydroflourescein diacetate)and analyzed with Quanti-cell 700, and the number of blastomeres was counted with DAPI( 4, 6'-diamidino-2-phenylindole). RESULTS: Oxygen concentration of the culture medias was significantly higher in the 20% oxygen environment compared to that of 5% oxygen environment. Culture of mice embryos in high oxygen condition leads to high HO concentrations at 2 cell stage and developmental delay or ""2-cell block"" regardless of the strain. But in a 5% oxygen environment, which is similar to in-vivo conditions HO production was suppressed continuously through out culture and development of embryos was definitely improved. CONCLUSION: These results suggest that there is a difference in the production of ROS or protective mechanism according to the mouse strains and stage of development, and it is thought that in-vitro culture in 5% oxygen environment provides stable in vivo equilibrium but in a 20% oxygen environment there is production of ROS which overcome the protective mechanism which leads to cellular damage and embryo developmental delay.
Animals ; Blastomeres ; Carbon Dioxide ; Carrier Proteins ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Female ; Incubators ; Mice* ; Mice, Inbred ICR ; Oxygen* ; Pregnancy ; Vitamins

BACKGROUND: Transforming growth factor (TGF)- has a large variety of biological functions, including the modulation of inflammation and the immune system, and is presumed to play important roles in repairing wounds and reducing scarring. The objective of this study is to examine the effects of TGF-1 on healing wounds and reducing scarring. We have also analysed the ability of the hemagglutinating virus of Japan (HVJ) liposome mediated antisense oligodeoxynucleotides (ODNs) to specifically inhibit wound-induced expressions of TGF-1 proteins and mRNA in the rat skin. METHODS: Skin wounds were created on the backs of 80 anesthetized rats. The first group of wounds, as the controls, was unmanipulated. The second group of wounds, as positive controls or an excessive scarring model, was injected with TGF-1 subcutaneously. The third group of wounds was injected with anti-TGF-1 antibody subcutaneously. The fourth group of wounds was injected with HVJ liposome mediated antisense ODNs for TGF-1 subcutaneously. The wounds of all groups were bisected and analysed histologically 5, 10, 15, 30, and 50 days after the wounds were made. RESULTS: All control wounds (TGF-1 or no injection) healed with scarring, whereas the wounds treated with the antibody or antisense ODNs healed with less scar formation compared to the control group. The wounds treated with the antibody or antisense ODNs had fewer macrophages, less collagen and fibronectin contents than the other wounds. Northern blotting and in situ hybridization analysis showed that wound sites treated with HVJ liposome mediated antisense ODNs for TGF-1 exhibited decreased levels of TGF-1 mRNA after injury. CONCLUSIONS: These findings suggest an important new approach to controlling scarring in normal wound healing, complementing the practice of adding exogenous growth factors to chronic wounds in the attempt to inhibit collagen deposition.
Animals ; Blotting, Northern ; Cicatrix* ; Collagen ; Complement System Proteins ; Fibronectins ; Genetic Therapy* ; Immune System ; In Situ Hybridization ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Liposomes ; Macrophages ; Oligodeoxyribonucleotides ; Oligoribonucleotides ; Rats ; RNA, Messenger ; Sendai virus ; Skin ; Transforming Growth Factor beta ; Transforming Growth Factors ; Wound Healing ; Wounds and Injuries

BACKGROUND/AIMS: In Korea, the prevalence of pancreatic cancer (PC) in general population has been reported as 7 in 100,000. However, that in diabetes mellitus (DM) has not been elucidated yet. This study was designed to estimate the prevalence of PC among DM patients, and characterize and compare the patients with DM with and without PC. METHODS: 5,082 patients (4,890 DM without PC, 78 PC with DM, and 114 PC without DM) were enrolled from Korea University Guro Hospital during a period of 4 years between January 2004 and January 2008. RESULTS: The prevalence of PC in DM patients was 1.6% and that of DM in PC patients was 40.6%. No significant differences in the clinical characteristics except HbAIc and ALP were observed between PC patients with DM and without DM. Among 78 PC patients with DM, DM was diagnosed in 19 (29.4%) and 29 (37.1%) patients concomitantly or within 2 years prior to the diagnosis of PC, respectively. Among the cases with recent onset DM (less than 2 years' duration), the disease duration of DM before the diagnosis of PC was less than 1 year in 14 patients (17.9%) and 1 to 2 years in 15 patients (19.2%). DM patients with PC were found to have significantly higher ALT, total bilirubin, and ALP levels than in DM patients without PC. CONCLUSIONS: The prevalence of PC in DM patients was 1.6% and was higher than in the general population. Recent onset DM was frequent in PC patients (less than 2 years' duration). We recommend close follow-up for at least 2 years in new-onset diabetes.
Aged ; Alanine Transaminase/blood ; Alkaline Phosphatase/blood ; Bilirubin/blood ; Diabetes Complications/diagnosis/*epidemiology ; Diabetes Mellitus/diagnosis/*epidemiology ; Female ; Hemoglobin A, Glycosylated/analysis ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/complications/diagnosis/*epidemiology ; Prevalence ; Time Factors

OBJECTIVES: Our purpose was 1) to determine whether elevated maternal serum alpha- fetoprotein(MSAFP) predict increased risk of spontaneous preterm delivery and indicated preterm delivery; 2) to determine whether elevated maternal serum human chorionic gonadotropin(MSHCG) predict increased risk of preterm delivery. Methods: Between September 1995 and April 1998, 945 of 2105 pregnant women who received midtrimester MSAFP screening were identified and evaluated. 81 women with MSAFP levels of 2.0 MoM or more were included in the study group while 864 women with levels less than 2.0 MoM served as controls. Pregnancy outcome were obtained from hospital records and statistical analysis were performed. RESULTS: Women with elevated MSAFP levels showed an increased risk for preterm delivery(p<0.05), fetal growth restriction(p<0.05) and hypertensive disorders(p<0.05), but not for preterm premature rupture of membrane, fetal death in utero. There was a strong association between unexplained elevated MSAFP levels and spontaneous preterm delivery(p<0.05) but our study does not support an association between unexplained elevated MSAFP levels and indicated preterm delivery. There was no association between elevated MSHCG levels and preterm delivery regardless of MSAFP levels. CONCLUSION: We concluded that unexplained elevated levels of midtrimester MSAFP were associated with an elevated risk of spontaneous preterm delivery but not with a risk of indicated preterm delivery. Elevated MSHCG levels were not associated with a risk of preterm delivery and spontaneous preterm birth.
alpha-Fetoproteins* ; Chorion ; Extraembryonic Membranes ; Female ; Fetal Development ; Hospital Records ; Humans ; Mass Screening ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Premature Birth* ; Rupture

OBJECTIVES: To compare the diagnostic and prognostic performance of amniotic fluid white blood cell(AF WBC) count and amniotic fluid culture for the prenatal diagnosis of intrauterine infection and the prediction of neonatal outcomes in patients with preterm labor and intact membranes. Methods: Amniocentesis was performed in 75 patients with preterm labor and intact membranes, who delivered preterm neonates within 72 hours after amniocentesis. AF WBC was determined and amniotic fluid was cultured for aerobic and anaerobic bacteria as well as mycoplasma. The relations among placental histologic findings, perinatal outcome, AF WBC count, and AF culture were examined. Student t test, Mann Whitney U test, lamda2 test, Fisher's exact test, modified t test, and logistic regression analysis were used for statistical analysis. RESULTS: Microbial invasion of the amniotic fluid was more frequent in the patients with histologic chorioamnionitis than patients without histologic chorioamnionitis (28.9% vs 5.4%, p<0.05), and patients with histologic chorioamnionitis had significantly higher amniotic fluid white blood cell counts than those patients without such lesion (median 99, range 0-3024 cells/mm3 vs median 1, range 0-180 cells/mm3, p<0.01). Amniotic fluid white blood cell count (> or = 50cell/mm3) had a sensitivity of 55.3%(21/38) and a specificity of 94.6%(35/37) for the diagnosis of histologic chorioamnionitis and a sensitivity of 47.5%(19/40) and specificity of 90.9%(30/33) for the prediction of significant neonatal morbidity (defined as neonatal sepsis, respiratory distress syndrome, pneumonia, intraventricular hemorrhage, bronchopulmonary dysplasia, or necrotizing enterocolitis). These sensitivities were significantly higher than those of amniotic fluid culture (for histologic chorioamnionitis, 55.3% vs 28.9% ; for significant neonatal morbidity, 47.5% vs 25.0%, p<0.01 for each). CONCLUSION: Amniotic fluid WBC count is a more sensitive test for the prenatal diagnosis of intrauterine infection and for the prediction of significant neonatal morbidity than amniotic fluid culture in the patients with preterm labor and intact membranes.
Amniocentesis ; Amniotic Fluid* ; Bacteria, Anaerobic ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Diagnosis ; Female ; Hemorrhage ; Humans ; Infant, Newborn ; Leukocyte Count* ; Leukocytes* ; Logistic Models ; Membranes* ; Mycoplasma ; Obstetric Labor, Premature* ; Pneumonia ; Pregnancy ; Prenatal Diagnosis* ; Sensitivity and Specificity ; Sepsis

We report a case of idiopathic hypertrophic spinal pachymeningitis in a 56-year-old woman who complained of a tingling sensation and progressive weakenss of both legs since 6 months prior, and then was unable to walk for 1 week. Magnetic resonance imaging showed a low signal intensity of dural and epidural mass in the T7-T11. The mass was concentrically compressing the spinal cord and extending to the paraspinal area through the intervertebral foramina. Total laminectomy from T7 to T12 and mass removal were done. The mass was composed of markedly thickened dura mater. Microscopic examination showed fibrous thickening with hyalinization and infiltration of chronic inflammatory cells, mainly lymphocytes. Idiopathic hypertrophic spinal pachymeningitis is a rare disease causing progressive paraparesis that can resemble other disorders associated with spinal compression.
Dura Mater ; Female ; Humans ; Hyalin ; Laminectomy ; Leg ; Lymphocytes ; Magnetic Resonance Imaging ; Meningitis* ; Middle Aged ; Paraparesis ; Rare Diseases ; Sensation ; Spinal Cord

BACKGROUND: Aplastic anemia is an uncommon disease characterized by marrow hypocellularity, resulting in a reduction of the counts of circulating red blood cells, neutrophils, and platelets. The etiology of aplastic anemia remains unknown in the majority of cases. An association of aplastic anemia with pregnancy has been reported but the strength of such a relationship remains somewhat controversial. OBJECTIVE: To evaluate the association of aplastic anemia with pregnancy and the optimal management of patients with aplastic anemia during pregnancy. METHODS: This retrospective study was done by review of medical records of 18 patients with aplastic anemia, of whom 8 patients were diagnosed before pregnancy and 10 patients were diagnosed during pregnancy, who had a total of 25 pregnancies after the diagnosis from January, 1990 to October, 1997 at the Seoul National University Hospital, RESULTS: The incidence of aplastic anemia during pregnancy was one in 806 persons(18/14, 507) in this study. During pregnancy, the circulating blood cell levels decreased in all pregnancies. In all 7 cases that showed a relapse during pregnancy the remission occurred following the termination of pregnancy. 12 patients presenting with severe aplastic anemia during pregnancy had poorer hematological improvement than patients with mild aplastic anemia after termination of pregnancy. CONCLUSION: In all patients with aplastic anemia during pregnancy the circulating blood cell levels decreased. The successful outcome in these cases illustrates the benefit of modern supportive care in the management of such patients. The present observations suggest that a pregnancy which occurs during the long-term remission of aplastic anemia may be allowed to progress to birth.
Anemia* ; Anemia, Aplastic ; Blood Cells ; Bone Marrow ; Diagnosis ; Erythrocytes ; Female ; Humans ; Incidence ; Medical Records ; Neutrophils ; Parturition ; Pregnancy ; Pregnant Women* ; Recurrence ; Retrospective Studies ; Seoul

The characteristics of the expiratory nasal flow consist of three parts - amount, content and shape. By far, most reports are confined only to the nasal resistance, nasal pressure, temperature, humidity and gas concentration of the expiratory nasal flow. There are few reports on the shape of the expiratory nasal flow. We aimed to visualize the expiratory nasal flow and to see whether there is any correlation between the shape of the expiratory nasal flow and the shape of the external nose. For each seven normal adult males and females, the shape of the expiratory flow was checked with infrared imaging thermometer placed on the frontal and sagittal planes. We also measured the external nasal indices and compared them with the shape of the nasal flow. We could see the shape of the expiratory nasal flow through the infrared imaging thermometer in real time. The mean of the angles formed by each side of the expiratory nasal flows on the frontal plane was 39 degrees, and the frontal angle showed good correlation with the shape of the external nose. The real-time visualization of the expiratory nasal flow, conducted with the infrared imaging thermometer, was an absolutely non-invasive technique and may be used to investigate nasal functions.
Adult ; Female ; Humans ; Humidity ; Male ; Nose ; Thermometers