Chusid et al proposed diagnostic criteria of hypereosinophilic syndrome (HES) that remain valid today. These were, (1) a sustained peripheral blood eosinophil count of more than 1500/L present for longer than 6 months ; (2) no evidence of other apparent causes for eosinophilia, and (3) presumptive signs of parenchymal organ involvement. Any organ system may be affected in HES, but the most severe clinicopathological involvements are of the heart and nervous system. Although multiple organ systems may be involved, the most common cause of morbidity and mortality is cardiac involvement with extensive fibrous thickening of the endomyocardium and overlying thrombus. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocarditis by endomyocardial biopsy, with literature review.
Biopsy ; Edema* ; Eosinophilia ; Eosinophils* ; Heart ; Hypereosinophilic Syndrome ; Mortality ; Myocarditis* ; Nervous System ; Thrombosis

Chusid et al proposed diagnostic criteria of hypereosinophilic syndrome (HES) that remain valid today. These were, (1) a sustained peripheral blood eosinophil count of more than 1500/L present for longer than 6 months ; (2) no evidence of other apparent causes for eosinophilia, and (3) presumptive signs of parenchymal organ involvement. Any organ system may be affected in HES, but the most severe clinicopathological involvements are of the heart and nervous system. Although multiple organ systems may be involved, the most common cause of morbidity and mortality is cardiac involvement with extensive fibrous thickening of the endomyocardium and overlying thrombus. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocarditis by endomyocardial biopsy, with literature review.
Biopsy ; Edema* ; Eosinophilia ; Eosinophils* ; Heart ; Hypereosinophilic Syndrome ; Mortality ; Myocarditis* ; Nervous System ; Thrombosis

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*

Estimated incidence of round ligament varicosities in pregnancy is not known and often times it is confused with inguinal hernia due to their clinical similarities. When a patient is presented with inguinal mass especially in association with varicosity in the genital region or lower extremity, round ligament varicosity must be considered as a plausible diagnosis. Depiction of "bag of worms" on color Doppler ultrasonography is diagnostic of the round ligament varicosity and it is known to resolve spontaneously following delivery. We report a case of round ligament varicosities that was diagnosed at 29 weeks of gestation with a brief review of the literatures.
Hernia, Inguinal ; Humans ; Incidence ; Lower Extremity ; Pregnancy ; Round Ligament of Uterus ; Ultrasonography, Doppler, Color

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: To identify prenatal fetal sex and chromosomal aneuploidies by FISH using isolation of fetal nucleated RBCs. METHODS: peripheral blood samples was collected from 37 women between 11 and 24 weeks of gestation. we tried to enrich nucleated RBCs morphologically by Kleihaur-Betke staining after double gradient centrifugation and magnetic activating cell sorting (MACS) from maternal blood. Fluorescence in situ hybridization (FISH) analyses with CEP X and CEP Y probes for K-B positive nucleated RBCs were performed to detect whether fetal cells were existed among nucleated RBCs by observation of sex chromosomes. RESULTS: The average number of K-B positive nucleated RBCs separated from 10ml of maternal blood was 17.3 (+/-17.2) and the maximum number of nucleated RBCs was 54. We observed FISH signals in nucleated RBCs separated from 18 pregnant women, and Y probe signals were observed in 67.3% of nucleated RBCs separated from 10 pregnant women. CONCLUSION: We confirmed that separated nucleated fetal RBCs can be used to identify fetal sex and chromosomal aneuploidies by FISH. Since nucleated RBCs from maternal origin were not excluded, further studies are needed to overcome this limitation.
Aneuploidy ; Centrifugation ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Sex Chromosomes

OBJECTIVE: The aim of this study was to compare vitrification optimization of mouse embryos using electron microscopy (EM) grid, cryotop, and thin plastic strip (TPS) containers by evaluating developmental competence and apoptosis rates. METHODS: Mouse embryos were obtained from superovulated mice. Mouse cleavage-stage, expanded, hatching-stage, and hatched-stage embryos were cryopreserved in EM grid, cryotop, and TPS containers by vitrification in 15% ethylene glycol, 15% dimethylsulfoxide, 10 microg/mL Ficoll, and 0.65 M sucrose, and 20% serum substitute supplement (SSS) with basal medium, respectively. For the three groups in which the embryos were thawed in the EM grid, cryotop, and TPS containers, the thawing solution consisted of 0.25 M sucrose, 0.125 M sucrose, and 20% SSS with basal medium, respectively. Rates of survival, re-expansion, reaching the hatched stage, and apoptosis after thawing were compared among the three groups. RESULTS: Developmental competence after thawing of vitrified expanded and hatching-stage blastocysts using cryotop and TPS methods were significantly higher than survival using the EM grid (p<0.05). Also, apoptosis positive nuclei rates after thawing of vitrified expanded blastocysts using cryotop and TPS were significantly lower than when using the EM grid (p<0.05). CONCLUSION: The TPS vitrification method has the advantages of achieving a high developmental ability and effective preservation.
Animals ; Apoptosis ; Blastocyst ; Dimethyl Sulfoxide ; Embryonic Structures ; Ethylene Glycol ; Ethylenes ; Ficoll ; Mental Competency ; Mice ; Microscopy, Electron ; Plastics ; Sucrose ; Vitrification

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

Ultrasound (US) elastography is a valuable imaging technique for tissue characterization. Two main types of elastography, strain and shear-wave, are commonly used to image breast tissue. The use of elastography is expected to increase, particularly with the increased use of US for breast screening. Recently, the US elastographic features of breast masses have been incorporated into the 2nd edition of the Breast Imaging Reporting and Data System (BI-RADS) US lexicon as associated findings. This review suggests practical guidelines for breast US elastography in consensus with the Korean Breast Elastography Study Group, which was formed in August 2013 to perform a multicenter prospective study on the use of elastography for US breast screening. This article is focused on the role of elastography in combination with B-mode US for the evaluation of breast masses. Practical tips for adequate data acquisition and the interpretation of elastography results are also presented.
Breast* ; Consensus ; Elasticity Imaging Techniques* ; Information Systems ; Mass Screening ; Ultrasonography*

BACKGROUND: Surgical site infection (SSI) is a potentially morbid and costly complication of surgery. While gastrointestinal surgery is relatively common in Korea, few studies have evaluated SSI in the context of gastric surgery. Thus, we performed a prospective cohort study to determine the incidence and risk factors of SSI in Korean patients undergoing gastric surgery. MATERIALS AND METHODS: A prospective cohort study of 2,091 patients who underwent gastric surgery was performed in 10 hospitals with more than 500 beds (nine tertiary hospitals and one secondary hospital). Patients were recruited from an SSI surveillance program between June 1, 2010, and August 31, 2011 and followed up for 1 month after the operation. The criteria used to define SSI and a patient's risk index category were established according to the Centers for Disease Control and Prevention and the National Nosocomial Infection Surveillance System. We collected demographic data and potential perioperative risk factors including type and duration of the operation and physical status score in patients who developed SSIs based on a previous study protocol. RESULTS: A total of 71 SSIs (3.3%) were identified, with hospital rates varying from 0.0 - 15.7%. The results of multivariate analyses indicated that prolonged operation time (P = 0.002), use of a razor for preoperative hair removal (P = 0.010), and absence of laminar flow in the operating room (P = 0.024) were independent risk factors for SSI after gastric surgery. CONCLUSIONS: Longer operation times, razor use, and absence of laminar flow in operating rooms were independently associated with significant increased SSI risk after gastric surgery.
Centers for Disease Control and Prevention (U.S.) ; Cohort Studies* ; Cross Infection ; Hair Removal ; Humans ; Incidence* ; Korea ; Multivariate Analysis ; Operating Rooms ; Prospective Studies* ; Risk Factors* ; Tertiary Care Centers