Nonimmune hydrops fetals is defined as generalized edema of the fetal soft tissue in utero and may be associated with effusion in the serous cavities without hematologic evidence of isoimmunization. The most common demonstrable causes are cardiac anomalies, followed by chromosomal disorders, congenital malformations, alpha-thalassemia, and the twin-twin transfu-sion syndrome. We have experienced a case of nonimmune hydrops fetalis in identical twin which caused by congenital mitral valve insufficiency and disappeared spontaneously at 35 wks. Now we report a case of nonimmune hydrops fetalis that slowly and spontaneously imp-roved without interventions with a brief review of related literatures.
alpha-Thalassemia ; Chromosome Disorders ; Edema ; Humans ; Hydrops Fetalis* ; Mitral Valve Insufficiency ; Twins, Monozygotic*

No abstract available.
Amnion* ; Hydrocortisone* ; Pregnancy*

PURPOSE: The isoflavones in soy are likely to contribute to the historically low incidence of breast cancer among Asian women that consume traditional diets. A possible role of isoflavones in controlling the expression of cyclooxygenase-2 (Cox-2) has not previously been explored. In this study, the ability of the isoflavone, genistein, to regulate the expression of Cox-2 in breast cancer cells was evaluated. METHODS: The effects of genistein and NS-398, a Cox-2 inhibitor, were examined on the expression of Cox-2 at the mRNA level using the MDA-MB 231, and MCF-7 breast cancer cell-lines. RESULTS: In the MCF-7 cells, the Cox-2 mRNA could not be detected using RT-PCR. In the MDA-MB-231 cells, NS-398 and genistein were found to inhibit the Cox-2 mRNA expressions by 50 and 35~40%, respectively. CONCLUSION: These studies suggest that dietary isoflavonoids may contribute to the prevention or inhibition of breast cancer by inhibiting the Cox-2 expression.
Asian Continental Ancestry Group ; Breast Neoplasms* ; Breast* ; Cyclooxygenase 2* ; Diet ; Female ; Genistein* ; Humans ; Incidence ; Isoflavones ; MCF-7 Cells ; RNA, Messenger

A myxedema coma, representing the extreme feature of hypothyroidism is rare. Despite early vigorous treatment, a myxedema coma is associated with a mortality rate as high as 60%. Herein, a case of a myxedema coma, with severe hypoventilation, is described. When the patient arrived at the emergency room, she complained of dyspnea and general weakness, and was of a drowsy mental status. 7 days after admission, she was more confused and disoriented, and respiratory insufficiency had developed. Although levothyroxine was continued and her respiration improved, she still had a confused mentality and seizure developed. Despite medication her consciousness did not improve, so was discharged in despair by her family members. The respiratory abnormality with a myxedema coma is a depressed ventilatory response to hypercapnea, resulting in a decrease in alveolar ventilation, with progressive CO2 retention. An upper airway obstruction, especially during sleep, and neuromuscular dysfunction in breathing may be shown in hypothyroidism. Therefore, a myxedema coma, accompanied by severe hypoventilation, should be intensively treated with thyroid hormone replacement therapy and mechanical ventilatory support
Airway Obstruction ; Coma* ; Consciousness ; Dyspnea ; Emergency Service, Hospital ; Hormone Replacement Therapy ; Humans ; Hypothyroidism ; Hypoventilation* ; Mortality ; Myxedema* ; Respiration ; Respiratory Insufficiency ; Seizures ; Thyroid Gland ; Thyroxine ; Ventilation

Osteogenesis Imperfecta (OI) is a relatively rare hereditary disease, which is characterized by multiple bone fractures and spine scoliosis, due to the fragility of bone, and is often associated with blue sclerae, deafness and dentinogenesis imperfecta. Four types of OI can be distinguished, according to the clinical findings. Although mutations affecting type I collagen are responsible for the disease in most patients, the mechanism by which the genetic defects cause abnormal bone development remains to be fully understood. Here, the clinical characteristics of 10 OI patient cases are reported, with a review of the literature. All the cases, including 4 type I, 4 type III and 2 type IV, inherited OI as an autosomal dominant trait. All the subjects had multiple old fractures and decreased bone densities. In this study, the biochemical marker of bone formation, serum alkaline phosphatase, was found to be increased only in the pediatric OI patients, while the biochemical marker of bone resorption, urinary deoxypyridinoline, was increased in all cases. The mobility score was found to correlate with the severity of the type on diagnosis.
Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Development ; Bone Resorption ; Collagen Type I ; Deafness ; Dentinogenesis Imperfecta ; Diagnosis ; Fractures, Bone ; Genetic Diseases, Inborn ; Humans ; Osteogenesis Imperfecta* ; Osteogenesis* ; Sclera ; Scoliosis ; Spine

PURPOSE: Heptaplatin (SKI-2053 R) is a new platinum analogue, with a better toxicity profile than cisplatin, and has antitumor activity even in cisplatin resistant cell lines. 5-fluoruracil (5-FU) has shown synergy with platinum compounds. This phase II trial was designed to determine the efficacy and toxicities of heptaplatin/ 5-FU (5-fluorouracil) for treating stomach cancer. MATERIALS AND METHODS: Thirty-two patients with advanced, measurable gastric adenocarcinomas were enrolled in this trial. The treatment consisted of heptaplatin, 400 mg/m2/day (1 hour IV infusion), on day 1 and 5-FU, 800 mg/m2/day (12 hours IV infusion), on days 1 to 5. The cycles were repeated every 3 weeks. RESULTS: Of the 26 evaluable patients, 9 had partial responses and 1a complete response (overall response rate, 38%; 95% confidence interval, 19~57%). The median response duration was 23 weeks (range: 4~60 weeks). The median time to progression was 26 weeks (range: 3~68 weeks). The grades III-IV toxicities were mostly hematological toxicities: leucopenia was observed in 11 patients (35%) and thrombocytopenia 4 (13%). No definite neuropathy was observed. Grade I-II nephropathy was also noted: grade I high BUN/creatinine levels occurred in 5 patients (16%), grade II proteinuria 2 (6%), grade I proteinuria 5 (16%). Neutropenic fever developed in 5 patients (16%) and 1 died of pneumonia in a neutropenic state. CONCLUSION: This study suggests that the regimen of Heptaplatin/5-FU should be effective and have a favorable toxicity profile for the patients suffering with advanced stomach cancer.
Adenocarcinoma ; Cell Line ; Cisplatin ; Drug Therapy ; Fever ; Fluorouracil ; Humans ; Leucovorin* ; Platinum ; Platinum Compounds ; Pneumonia ; Proteinuria ; Stomach Neoplasms* ; Stomach* ; Thrombocytopenia

BACKGROUND: The question of which dialysis modality should be recommended to end-stage renal disease (ESRD) patients with a history of coronary artery disease (CAD) is encountered frequently in clinical practice, and the answer is still controversial. We tried to explore the patient's survival difference by the dialysis modality in incident ESRD patients with CAD. METHODS: We retrospectively analyzed survival differences by dialysis modality in 56 new ESRD patients with preexisting CAD (HD: PD=30: 26) at yearly intervals with Poisson regression from September 1994 to February 2000. We also investigated the predictors of mortality with multivariate analysis by time-dependent Cox regression. RESULTS: There were no significant differences in age, sex, diabetes, co-morbidity, severity of CAD on commencement of dialysis between HD and PD patients with CAD. Cardiovascular deaths were observed in only HD group. In the CAD group, the relative risk (RR) of mortality in HD patients was equal or higher than that in PD patients for the first 3 years, but RR became lower in HD patient after 3 years. The significant predictors of mortality in CAD group were age, diabetes, arrhythmia and history of cardiac arrest at the time of dialysis initiation. CONCLUSION: When we choose a dialysis modality in incident ESRD patient with preexisting CAD, we could consider an early survival benefit of PD over HD and integrated dialysis approach as a treatment option in this patient group. Further investigation including control group is needed to evaluate in the multicenter, large-scaled manner.
Arrhythmias, Cardiac ; Coronary Artery Disease* ; Coronary Vessels* ; Dialysis* ; Heart Arrest ; Humans ; Kidney Failure, Chronic* ; Mortality ; Multivariate Analysis ; Retrospective Studies

BACKGROUND: As health screening examinations are becoming more popular, increasing number of patients are found to have hematuria. In case of isolated microscopic hematuria, when to refer these patients to urologists for cystoscopy to find bladder cancer has been a matter of debate. METHODS: From January 1998 to May 2004, 287 patients older than 50 years of age visited our clinic for the evaluation of hematuria. Of these patients, 50 isolated asymptomatic microscopic patients underwent cystoscopy for the evaluation of bladder cancer. Additionally, 275 patients were retrospectively analyzed who had been found to have urologic malignancy during the same period. RESULTS: There were 50 patients (9 men, 41 women) with asymptomatic isolated microscopic hematuria who agreed to undergo cystoscopy examinations. Cystoscopic findings included normal in 41 patients, benign prostatic hyperplasia in 2 patients, cystitis in 2 patients, ureterocele in 1 patient, bladder neck contracture in 1 patient, urethral stricture in 1 patient, bladder diverticulum in 1 patient and ureter stone in 1 patient, but no bladder cancer was detected. In retrospective analysis, among 22 patients with bladder cancer and initial asymptomatic microscopic hematuria, one patient was found to have bladder cancer by cystoscopy after negative findings on radiologic examinations and urine cytology. CONCLUSION: Cystoscopy in patients with asymptomatic isolated microscopic hematuria to diagnose bladder cancer seems to be limited in the cost and efficacy aspect in the current study. A prospective multicenter study is needed establish the criteria for cystoscopy in these patients.
Contracture ; Cystitis ; Cystoscopy* ; Diverticulum ; Hematuria* ; Humans ; Male ; Mass Screening ; Neck ; Prostatic Hyperplasia ; Retrospective Studies ; Ureter ; Ureterocele ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder Neoplasms

About 90% of primary gastrointestinal lymphomas originate from the B-cell and less than 10% from the T-cell. In respect of anatomical location, the stomach is the most common site of gastrointestinal lymphomas followed by the ileum, colon, and rectum. However, esophagus and duodenal lymphomas are infrequently involved. Primary T-cell lymphoma of the duodenum is not common and peripheral T-cell lymphoma of the duodenum is very rare. In Korea, there has been no case report of peripheral T-cell lymphoma which simultaneously involved the stomach and duodenum. In this report, we present a case of primary peripheral T-cell lymphoma of the duodenum and stomach. A 63-year-old man was hospitalized complaining of weight loss of 15 kg and dyspepsia for 2 months. Esophagogastroduodenoscopy showed a large annular infiltrative lesion in the descending portion of the duodenum. At the posterior side of the upper body of the stomach, an ill-defined, broad, flat, and infiltrative lesion was also noted. Microscopic examination of the biopsy specimen showed that atypical bizzare lymphocytes infiltrated the mucosa of the duodenum and stomach. The lymphocyte was positive for CD3, CD5 and negative for CD20, CD23, and CD56 by immunohistochemistry. We made a diagnosis of primary peripheral T-cell lymphoma of the stomach and duodenum. We report a case of peripheral T-cell lymphoma of the stomach and duodenum with a review of the literature.
B-Lymphocytes ; Biopsy ; Colon ; Diagnosis ; Duodenum* ; Dyspepsia ; Endoscopy, Digestive System ; Esophagus ; Humans ; Ileum ; Immunohistochemistry ; Korea ; Lymphocytes ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Middle Aged ; Mucous Membrane ; Rectum ; Stomach* ; T-Lymphocytes ; Weight Loss

PURPOSE: Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study was to compare the retention rate of CPR skills in laypersons between the two hands-only and conventional CPR training methods. METHODS: Participants were randomly assigned to one of the two training groups: The hands-only CPR group with 80 minutes of training or the conventional CPR group with 180 minutes of training. The CPR skills for each participant were evaluated at the end of the training session and at 3 months thereafter, using the Resusci Anne® manikin with a skillreporting software. RESULTS: A total of 252 participants completed the training sessions; of which, 125 participants were in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in the average compression rate (p=0.015), average compression depth (p=0.031), and proportion of adequate compression depth (p=0.011). Contrastingly, there were no differences with respect to the retention of skills in the conventional CPR group after 3 months. CONCLUSION: The conventional CPR training appears to be more effective with respect to retention of chest compression skills compared with hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training remains poor.
Cardiopulmonary Resuscitation* ; Education* ; Heart Arrest ; Manikins ; Retention (Psychology) ; Thorax ; Ventilation