Colorectal cancer during pregnancy is rare but the trend for women to delay pregnancy until later in life may result in increased incidence of colorectal cancer during pregnancy. The most common symptoms are rectal bleeding, abdominal discomfort, abdominal distension, anorexia, nausea, vomiting, constipation, anemia and weight loss. Rectal bleeding, if it is occurred, is often attributed to hemorrhoids, a common finding of pregnancy and many of these symptoms are commonplace in normal pregnancy. This delays diagnosis of colorectal cancer during pregnancy and leads to more advanced stage and poor prognosis compared to the general population. We experienced a woman at 27 weeks gestation who complained of low abdominal distention and was diagnosed of sigmoid colon cancer and underwent cesarean section and hemicolectomy at 30 weeks gestation, so we present it with brief review of literature."
Anemia ; Anorexia ; Cesarean Section ; Colorectal Neoplasms* ; Constipation ; Diagnosis ; Female ; Hemorrhage ; Hemorrhoids ; Humans ; Incidence ; Nausea ; Pregnancy* ; Prognosis ; Sigmoid Neoplasms ; Vomiting ; Weight Loss

Purpose: This study was conducted to examine the effects of an educational program based on mobile SMS and counseling for colonoscopy in elderly people. Methods: The study utilized a non-equivalent control group with a non-synchronized design as a quasiexperimental research. The study subjects consisted of 72 elderly people (36 elderly people in the experimental group and 36 in the control group). Among the subjects, 49 were male (68.1%) and 23 were female (31.9%), and the age was 69.04± 6.14 years. Fortyfive subjects (62.5%) answered that they had underlying diseases, eight subjects (11.1%) had a family history of colon disease, and 61 subjects (84.7%) had undergone a colonoscopy. The experimental group was provided with an educational program based on mobile SMS and counseling when three days and one day before the test. The control group received verbal explanations using information sheet. The data were analyzed using descriptive statistics, the Chi-squares test, and the independent t-test with SPSS/WIN 21.0. Results Significant differences were found in bowel cleanliness scores (t= 3.60, p= .003) between the groups. No significant differences were seen between the groups in the sedation drug dosage (propofol (t= 1.02, p= .730), midazolam (t= 0.66, p= .380)) and time for colonoscopy (t= 1.08, p= .235). Conclusion: Based on the results of this study, an educational program based on mobile SMS and counseling for colonoscopy was proposed as an educational program before colonoscopy.

OBJETIVE: To investigate the efficacy of high infusion frequency of liquid nitrogen on pregnancy in human embryo after freezing and thawing. MATERIALS AND METHODS:: 150 infertile patients underwent 162 consecutive thawing-ET cycles. In the high infusion frequency group (Group A), 47 patients (50 cycles) underwent cryopreservation with high infusion frequency of liquid nitrogen. In the low infusion frequency group (Group B), 103 patients (112 cycles) underwent cryopreservation with low infusion frequency of liquid nitrogen. We analyzed the clinical characteristics, fertilization rates, development of embryo, good quality embryo ratio, implantation rates, and pregnancy rates between these two groups. RESULTS: There was no difference between the groups with regard to clinical characteristics (mean age, infertility duration, infertility factors, hormone profile), mean number of oocyte retrieval, fertilization rates, and mean embryo number of transfers. The survival rates in group A was 64.9% (228 of 350 embryos), and among the 228 embryos 190 embryos (83.3%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 65 (34.2%), 29 (15.3%), 35 (18.4%), and 37 (19.5%) of grades 1, 2, 3, and above 4, respectively. The survival rates in group B was 63.8% (482 of 755 embryos), and among the 482 embryos 465 embryos (96.5%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 106 (22.8%), 94 (20.2%), 89 (19.1%), and 112 (24.1%) of grades 1, 2, 3, and above 4, respectively. There was no difference in embryo quality change after the freezing-thawing procedure between the groups. Implantation rates (31.1% vs. 34.3%) were not significant. However hCG positive rates in group A (40%) were higher than group B, but not statistically significant. Clinical pregnancy rate (26% vs. 25.9%), on going pregnancy rates (>20 weeks) were not significant (26% vs. 25%). CONCLUSION: We compared embryo quality change, survival rates, and pregnancy rates between high infusion frequency group and low infusion frequency group and the results were similar between the two groups. Therefore, high infusion frequency of liquid nitrogen for cryopreservation is a worthy method to preserve in human embryos.
Cryopreservation ; Embryonic Development* ; Embryonic Structures* ; Female ; Fertilization ; Freezing* ; Humans* ; Infertility ; Nitrogen* ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate* ; Pregnancy* ; Survival Rate

Genome-wide association studies (GWASs) facilitated the discovery of countless disease-associated variants. However, GWASs have mostly been conducted in European ancestry samples. Recent studies have reported that these European-based association results may reduce disease prediction accuracy when applied in non-Europeans. Therefore, previously reported variants should be validated in non-European populations to establish reliable scientific evidence for precision medicine. In this study, we validated known associations with type 2 diabetes (T2D) and related metabolic traits in 125,850 samples from a Korean population genotyped by the Korea Biobank Array (KBA). At the end of December 2020, there were 8,823 variants associated with glycemic traits, lipids, liver enzymes, and T2D in the GWAS catalog. Considering the availability of imputed datasets in the KBA genome data, publicly available East-Asian T2D summary statistics, and the linkage disequilibrium among the variants (r2 < 0.2), 2,900 independent variants were selected for further analysis. Among these, 1,837 variants (63.3%) were statistically significant (p < 0.05). Most of the non-replicated variants (n = 1,063) showed insufficient statistical power and decreased minor allele frequencies compared with the replicated variants. Moreover, known variants showed <10% genetic heritability. These results could provide valuable scientific evidence for future study designs, the current power of GWASs, and future applications in precision medicine in the Korean population.

Purpose: To report the effect of removal of a central descemet membrane on the endothelial function, morphology, and clinical symptoms of eyes with Fuch’s endothelial dystrophy. Methods: From August 2019 to January 2021, patients with Fuch’s endothelial dystrophy, i.e., with confluent, central corneal guttae and cataracts that required surgery, underwent phacoemulsification, intraocular lens implantation, and central descemet membrane stripping. To evaluate the effect of descemet stripping only (DSO), visual acuity and intraocular pressure were measured, and corneal pachymetry, slit-lamp and specular microscopy, and anterior segment optical coherence tomography performed, before surgery and at 1, 7, and 30 days and 3 and 6 months after surgery. Results: Seven patients (10 eyes) were included. Visual acuity improved from 1.01 ± 0.40 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.33 ± 0.22 logMAR 6 months after surgery (p = 0.008). The mean central corneal thickness decreased from 578.50 ± 36.88 μm preoperatively to 568.50 ± 48.61 μm 6 months after surgery; the difference was not significant (p = 0.507). The endothelial cell count increased significantly from 663.80 ± 356.40/mm2 preoperatively to 1,082.00 ± 274.46/mm2 6 months after surgery (p = 0.043). Conclusions DSO can serve as a useful alternative when corneal transplantation is not possible in patients with Fuch’s endothelial dystrophy, but treatment efficacy and safety require further evaluation.

Purpose: To analyze the change in the weekly incidence of epidemic keratoconjunctivitis (EKC) per 1,000 outpatients during the coronavirus disease 2019 (COVID-19) pandemic by comparing the mean weekly proportion of EKC of 2020 with that from 2016 to 2019. Methods: Using data from the Korea Disease Control and Prevention Agency for 2016-2020, we analyzed the weekly proportion of EKC per 1,000 outpatients. The data were also analyzed according to age, semester and vacation periods, region, and social distancing stages. For the Daegu data, we also analyzed the effects of social distancing in an area. Results: The mean weekly proportion of EKC per 1,000 outpatients in 2020 was lower than in previous years for all ages (2016-2019 19.77 ± 7.17‰, 2020 7.28 ± 2.97‰; p < 0.001). During the semester, the mean difference between 2016-2019 and 2020 was significant, particularly for preschool children. In Daegu, the weekly proportion of EKC per 1,000 outpatients during the extra 12-18 weeks of social distancing was significantly lower (2016-2019, 18.78 ± 6.61‰; 2020, 8.94 ± 2.92‰; p < 0.001). Conclusions The public health interventions implemented during the COVID-19 outbreak not only reduced the prevalence of COVID-19 but also reduced the prevalence of EKC. Therefore, maintaining hygiene principles and standard precautions may help prevent EKC.

OBJECTIVE: To assess the advantages, disadvantages, applicability, and complications of operative laparoscopy in ovarian pathologic lesions. MATERIALS AND METHODS: A retrospective case series which compares 354 patients who had laparoscopic surgery at Ajou University Hospital from June, 1994 to September, 2001 for ovarian pathology. RESULTS: The patient's ages ranged from 13 to 77 years, and their mean age was 30.9 years. Most of the lesions were less than 7 cm in size and unilateral. The operations performed were cystectomy in 225 cases (63.6%), salpingooophorectomy, oophorectomy, salpingectomy and fenestration or biopsy in order. Operative times were between 10 and 240 minutes (mean: 74.2 minutes). Pathologic examinations of unilateral ovarian tumors were performed in 305 cases. The most common pathology of unilateral ovarian tumor was teratoma (107/305, 35.1%), endometrioma and cystadenoma in order. Malignancies were found in 4 cases including borderline malignancy (1.3%). Pathologies of bilateral ovarian tumor were endometrioma (31/41, 75.6%), teratoma, and fibroma in order. Postoperative hospital stays were from 0 days to 19 days (mean: 2.5 days). There were 7 surgical complications including 3 vessel injury related hematomas, 1 abscess formation, and 3 exploratory laparotomy. CONCLUSIONS: We concluded that operative laparoscopy was useful in surgery of ovarian lesions, if there are carefully selected patients, standard procedures, and skilled laparoscopic surgeons.
Abscess ; Biopsy ; Cystadenoma ; Cystectomy ; Endometriosis ; Female ; Fibroma ; Hematoma ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Operative Time ; Ovariectomy ; Pathology ; Retrospective Studies ; Salpingectomy ; Teratoma

OBJECTIVE: To determine the effects of hCG on extracellular ATP induced apoptosis in cultured human luteinized granulosa cells (hLGCs) METHODS: The addition of various concentrations of ATP (0, 0.1, 0.25, 0.5, 0.75 mM) and 5 IU hCG to luteinized granulosa cells obtained during in vitro fertilization ovum pickup procedures. After culture for 24 hours, purinoceptor activity and functional changes in mitochondria were measured by patch clamp, flow cytometry, and confocal microscopy. RESULTS: Calcium imaging with fura-2 revealed that ATP elevated [Ca2+]i by mobilizing intracellularly stored Ca2+. A patch clamp study showed that ATP exerted its effect by initially binding to the P2Y type purinoceptor, as evidenced by the ATP-evoked outward Ca2+-activated K+ current. Probing mitochondria with JC-1, a mitochondrial transmembrane potential-sensitive dye, revealed that ATP induced mitochondrial depolarization in a concentration-dependent manner. A quantitative flow cytometric analysis with Annexin V showed that apoptotic cells were increased in number in proportion to the concentration of ATP, having 18.57% of apoptotic cell populations in the presence of 0.75 mM ATP compared to 7.88% in the control. Moreover, treatments with human chorionic gonadotropin (hCG) at 5 IU reversed both the ATP-induced mitochondrial depolarization and apoptosis (18.57 vs 6.32%). CONCLUSION: Taken together, these results indicate, first, extracellular ATP recognized by the P2Y type purinoceptor on h-LGCs increases the intracellular Ca2+. Second, the increased intracellular Ca2+ triggers the apoptotic cascade by acting at least, in part, on mitochondria. Third, hCG reverses the ATP-induced apoptosis, raising a possible clinical implication of hCG in the treatment of degeneration of granulosa cells such as follicular atresia.
Adenosine Triphosphate* ; Annexin A5 ; Apoptosis* ; Calcium ; Chorionic Gonadotropin ; Female ; Fertilization in Vitro ; Flow Cytometry ; Follicular Atresia ; Fura-2 ; Granulosa Cells* ; Humans* ; Lutein* ; Microscopy, Confocal ; Mitochondria ; Ovum ; Receptors, Purinergic

OBJECTIVES: To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. METHODS: From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of 6~9 weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. RESULTS: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. CONCLUSION: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.
Abortion, Spontaneous ; Apgar Score ; Birth Weight ; Diabetes, Gestational ; Female ; Fetal Death ; Gestational Age ; Gestational Sac ; Humans ; Incidence ; Intubation ; Membranes ; Obstetric Labor, Premature ; Placenta Previa ; Pre-Eclampsia ; Pregnancy ; Pregnancy Reduction, Multifetal* ; Pregnancy, Multiple ; Pregnancy, Twin* ; Reproductive Techniques, Assisted ; Rupture ; Triplets ; Ventilation

OBJECTIVES: To investigate the role of TGF (Transforming growth factor-beta) involved in the paracrinic communication during decidualization between UEC (uterine epithelial cells) and USC (uterine stromal cells), we have employed a co-culture system composed of human endometrial epithelial and stromal cells in defined hormonal conditions. DESiGN: in the co-culture, endometrial epithelial cells cultured in the matrigel-coated cell culture insert are seeded on top of the endometrial stromal cells cultured within a collagen gel. The co-culture was maintained for 48 hours under the following hormonal conditions: progesterone dominant condition (100 nM P4 and 1 nM E2) or estrogen-dominant condition (100 nM E2 and 1 nM P4). 10 ng/ ml HGF and/or 10 ng/ml TGF-beta1 are added. METHODS: RT-PCR is utilized to detect mRNAs quantitatively. Enzyme-linked immunosorbent assay (ELiSA) and immunohistochemical staining are utilized to detect proteins in the tissue. RESULTS: Prolactin mRNA is expressed in the co-cultured stromal cells under the progesterone dominant condition. TGF-beta1 and its receptors are expressed in both the co-cultured epithelial and stromal cells irrespective of the steroid present, which is in contrast with no or negligible expression of TGF-beta1 or its receptor in cells separately cultured. Both estrogen and progesterone significantly elevate the concentration of hepatocyte growth factor (HGF) in the conditioned medium of the co-culture with the value of 4,325 pg/ml in E2-dominant and 2,000 pg/ml in P4-dominant condition compare to 150 pg/ ml in no hormone. in separately cultured stromal cells, administration of HGF induces the expression of TGF receptor 1 in both hormonal conditions, but induction of TGF receptor 2 is only manifest in the P4-dominant condition. Administration of TGF-beta and HGF directly induce the decidualization marker prolactin mRNA in separately cultured stromal cells. CONCLUSION: it is likely that steroid hormones induces prolactin mRNA indirectly by promoting the cell to cell communication between the stromal and the epithelial cells. TGF-beta and HGF are two possible paracrine mediators in the human endometrial decidualization.
Cell Communication ; Cell Culture Techniques ; Coculture Techniques ; Collagen ; Culture Media, Conditioned ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Estrogens ; Hepatocyte Growth Factor ; Humans* ; Progesterone ; Prolactin ; RNA, Messenger ; Stromal Cells ; Transforming Growth Factor beta ; Transforming Growth Factor beta1