OBJECTIVE: To determine whether cyclooxygenase (COX)-1 and COX-2 are expressed differentially during the whole gestational period in the pregnant human uterine cervix and if they are involved in the process of labor. METHODS: Nine patients were matched for obstetrical history and maternal age were divided into an abortion group who aborted between 13 and 16 weeks(n=3), a preterm group who delivered between 20 and 37 weeks(n=3), and a term group who delivered between 37 and 42 weeks of gestation(n=3). Immediately after vaginal delivery cervical biopsy samples were obtained and immunohistochemically stained for COX-1 and COX-2 and the degree of staining was evaluated by H-scoring system. RESULTS: Expression of COX-1 and COX-2 was found in epithelial and stromal cells of uterine cervical tissues of preterm and term group. The immunohistochemical expression of COX-1 and COX-2 was strongest in the term group compared to the preterm group in stromal cells(HSCORE : 2.0 vs. 4.0 ; 2.0 vs. 3.0), and in epithelial cells(HSCORE : 1.0 vs. 3.0 ; 1.0 vs. 3.0). CONCLUSION: Although small amount of the groups were investigated, in the pregnant human uterine cervix, COX-1 and COX-2 are found to be expressed, and both shows the strongest expression in term cervical tissue. It is suggested that the uterine cervix, under the control of prostaglandins, is actively involved in the process of labor, and it is thought that the role of COX-1 and COX-2 is more important in parturition process with advancing gestational age.
Biopsy ; Cervix Uteri* ; Cyclooxygenase 1* ; Cyclooxygenase 2 ; Female ; Gestational Age ; Humans* ; Maternal Age ; Parturition ; Pregnancy ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Stromal Cells

Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.
Angiography ; Femoral Artery* ; Fractures, Bone ; Groin ; Humans ; Leg ; Transplants ; Vascular System Injuries

This paper describes that invasive aspergillosis was found in oral cavity, especially in lower molar periodontium in a immunocompromised 34-year-old woman who had been admitted in hemato-oncology with the diagnosis of acute myeloid leukemia. Antifungal therapy and surgical excision of involved teeth, bone and gingiva were the treatment of choice. After treatment infected area was healed very well. We would like to report our case because we could not find any paper reporting on invasive aspergillosis occurring in lower molar periodontium.
Adult ; Aspergillosis* ; Diagnosis ; Female ; Gingiva ; Humans ; Leukemia, Myeloid, Acute ; Molar* ; Mouth ; Periodontium ; Tooth

Foreign bodies of the upper gastrointestinal tract are usually discovered in children, persons with esophageal disease, prisoners with a purpose of secondary gain, and mentally disturbed or disabled individuals. In adults, accidentally or intentionally ingested foreign bodies such as dentures, coins, corks, toothbrush, needles, and nails are reported. To our knowledge, there has been one case of gastric bezoar caused by glue ingestion that was removed by surgical operation in Korea. However, there has been no case report of esophageal foreign body caused by glue ingestion neither in Korea nor elsewhere. We report a case of a man with a history of chronic glue inhalation, who ingested glue with suicidal intent, that was solidified from the upper esophagus to the stomach. It was successfully removed by therapeutic endoscopy.
Adhesives* ; Adult ; Bezoars ; Child ; Dentures ; Eating* ; Endoscopy ; Esophageal Diseases ; Esophagus ; Foreign Bodies* ; Humans ; Inhalation ; Intention ; Korea ; Needles ; Numismatics ; Prisoners ; Prisons ; Stomach ; Upper Gastrointestinal Tract

PURPOSE: This descriptive study was conducted to identify the use of complementary and alternative therapies, and the perception and attitudes toward CAT in Korean adults. METHODS: The 1,010 study subjects were recruited from ten regions in South Korea. Data were collected from July to September, 2004. RESULTS: The 43.2% of the sample(n=436) had an experience of using CAT. The subjects using CAT was more likely to have high score in the CAT perception compared to the subjects with no experience of CAT(p=.001). The primary source of information about CAT was mass media(59.7%). The 52.4% of the sample answered that CAT was supplementary and the 27.7% answered CAT was applicable to chronic pain or musculoskeletal disorders. Subjects(34.8%) pointed out that the greatest problem was no scientific informant in the use of CAT. The primary reason of using CAT was to maintain their health or to prevent disease(44.0%), and the 59.0% of the subjects responded that CAT was effective. Majority of subjects were satisfied with CAT(63.3%) and experienced no side effects of CAT(90.6%). CONCLUSION: This study suggests that professional counseling and education for CAT is needed for Korean public as well as the research approach to test the effects of CAT.
Adult* ; Animals ; Cats ; Chronic Pain ; Complementary Therapies* ; Counseling ; Education ; Humans ; Korea

Primary leptomeningeal melanomas(PLMs) are rare aggressive central nervous system(CNS) tumors without systemic foci. It can be very difficult, however, to clearly distinguish PLMs from those that have metastasized. We report a case of malignant leptomenigeal melanoma occurring in the right temporal convexity of a 77-yearold woman. Almost all malignant CNS melanomas in the old are secondary to the cutaneous melanoma and can cause diverse neurological manifestations; certain clinical findings of the presented case-namely, the patient's age, vague neurologic findings and absence of cutaneous lesions -are therefore interesting. Thorough clinical checkups, including whole-body bone scan, whole spine MRI, abdominal ultrasound, and tumor marker studies to find extracranial lesions revealed no abnormalities. Based on these clinical findings, we suppose-though are not certain-that the tumor of the presented case is a PLM.
Female ; Humans ; Magnetic Resonance Imaging ; Melanoma* ; Neurologic Manifestations ; Spine ; Ultrasonography

BACKGROUND: Topical steroid treatment induces diverse local Wand systemic adverse effects. Several approaches have been tried to reduce the steroid-induced adverse effects. Simultaneous application of physiological lipid mixture is also suggested. OBJECTIVE: Novel vehicles for topical glucocorticoids formulation were evaluated for the efficacy of reducing side-effects and the drug delivery properties of desonide, a low potency topical steroid. METHODS: Transcutaneous permeation and skin residual amount of desonide were measured using Franz diffusion cells. The in vivo anti-inflammatory activity was evaluated using murine model. RESULTS: Topical steroids formulation containing desonide, in either cream or lotion form, were prepared using multi-lamellar emulsion (MLE), and conventional desonide formulations were employed for comparison. MLE formulations did not affect the anti-inflammatory activity of the desonide in phobol ester-induced skin inflammation model, compared with conventional formulations. While the penetrated amounts of desonide were similar for all the tested formulations at 24 hours after application, the increased lag time was observed for the MLE formulations. Interestingly, residual amount of desonide in epidermis was significantly higher in lotion type MLE formulation. Steroid-induced adverse effects, including permeability barrier function impairment, were partially prevented by MLE formulation. CONCLUSION: Topical desonide formulation using MLE as a vehicle showed a better drug delivery with increased epidermal retention. MLE also partially prevented the steroid-induced side effects, such as skin barrier impairment.
Desonide ; Diffusion ; Epidermis ; Glucocorticoids ; Inflammation ; Permeability ; Retention (Psychology) ; Skin ; Steroids

In this study, we evaluated feasibility of applying MTV (Metabolic Target Volume) to respiratory gated radiotherapy for more accurate treatment using various SUV (Standard Uptake Value) from PET images. We compared VOI (Volume of Interest) images from 50%, 30% and 5% SUV (standard uptake volume) from PET scan of an artificial target with GTV (Gross Tumor Volume) images defined by percentage of respiratory phase from 4D-CT scan for respiratory gated radiotherapy. It is found that the difference of VOI of 30% SUV is reduced noticeably comparing with that of 50% SUV in longitudinal direction with respect to total GTV of 4D-CT image. Difference of VOI of 30% SUV from 4D-PET image defined by respiratory phase from 25% inhalation to 25% exhalation, and GTV from 4D-CT with the same phase is shown below 0.6 cm in maximum. Thus, it is better to use 4D-PET images than conventional PET images for applying MTV to gated RT. From the result that VOI of 5% SUV from 4D-PET agrees well with reference image of 4D-CT in all direction, and the recommendation from department of nuclear medicine that 30% SUV be advised for defining tumor range, it is found that using less than 30% SUV will be more accurate and practical to apply MTV for respiratory gated radiotherapy.
Exhalation ; Inhalation ; Nuclear Medicine ; Positron-Emission Tomography

PURPOSE: There is an increasing incidence of mortality among trauma patients; therefore, it is important to analyze the trauma epidemiology in order to prevent trauma death. The authors reviewed the trauma epidemiology retrospectively at a regional emergency center of Korea and evaluated the main factors that led to trauma-related deaths. MATERIALS AND METHODS: A total of 17007 trauma patients were registered to the trauma registry of the regional emergency center at Wonju Severance Christian Hospital in Korea from January 2010 to December 2012. RESULTS: The mean age of patients was 35.2 years old. The most frequent trauma mechanism was blunt injury (90.8%), as well as slip-and-fall down injury, motor vehicle accidents, and others. Aside from 142 early trauma deaths, a total of 4673 patients were admitted for further treatment. The most common major trauma sites of admitted patients were on the extremities (38.4%), followed by craniocerebral, abdominopelvis, and thorax. With deaths of 126 patients during in-hospital treatment, the overall mortality (142 early and 126 late deaths) was 5.6% for admitted patients. Ages > or =55, injury severity score > or =16, major craniocerebral injury, cardiopulmonary resuscitation at arrival, probability of survival <25% calculated from the trauma and injury severity score were independent predictors of trauma mortality in multivariate analysis. CONCLUSION: The epidemiology of the trauma patients studied was found to be mainly blunt trauma. This finding is similar to previous papers in terms of demographics and mechanism. Trauma patients who have risk factors of mortality require careful management in order to prevent trauma-related deaths.
Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cause of Death ; Child ; Child, Preschool ; Emergency Service, Hospital ; Female ; *Hospital Mortality ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Injury Severity Score ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Survivors ; Wounds and Injuries/*epidemiology/*mortality ; Young Adult

We report a case of 29-year-old, morbidly obese, diabetic primigravida who had undergone previously primary percutaneous coronary intervention with stent placement for an inferior wall myocardial infarction at 10 weeks of gestation. She remained asymptomatic with medication during the remainder of her pregnancy, but preoperative echocardiography revealed left ventricular dilation and a restrictive diastolic dysfunction with a preserved ejection fraction (46%). She developed acute pulmonary edema associated with hypertension after an elective Cesarean delivery under continuous epidural anesthesia despite the meticulous restriction of fluid.
Adult ; Anesthesia, Epidural ; Cesarean Section ; Echocardiography ; Female ; Humans ; Hypertension ; Inferior Wall Myocardial Infarction ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Pregnancy ; Pulmonary Edema ; Stents