Use of oral hypoglycemic agents during pregnant women with type 2 diabetes is controversial due to safety issues. Recently, randomized controlled trials support short-term safety of glyburide and metformin for the treatment of gestational diabetes mellitus. However, long-term safety data are not available. Moreover, use of oral hypoglycemic agents, except for metformin and glyburide, during pregnancy were limited to a few case reports. We report the case of a pregnant woman with type 2 diabetes unintentionally exposed to metformin and voglibose in addition to lercanidipine and bisoprolol during fetal organogenesis. The patient was continuously exposed to oral agents because we were not aware of her pregnancy until 22 weeks of gestation. After pregnancy was confirmed, we replaced oral hypoglycemic agents with insulin and discontinue betablockers. Delivery occurred without maternal or fetal complications.
Bisoprolol ; Diabetes, Gestational ; Female ; Glyburide ; Humans ; Hypoglycemic Agents ; Insulin ; Metformin* ; Organogenesis ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women*

Female ; Follow-Up Studies ; Humans ; Male ; Mandibular Condyle ; Mouth ; Prognosis ; Surgery, Plastic

PURPOSE: To explore the expressions of P53 and phosphorylation-H2AX in varicocele-induced rat testes. MATERIALS AND METHODS: A total of 16 adult male Sprague-Dawley rats underwent an operation; 12 underwent an experimental varicocele and 4, as controls, were sham-operated. Groups of 4 varicocele-induced rats underwent a left orchiectomy after 2 or 3 weeks, or both orchiectomies after 4 weeks. The sham-operated rats underwent both orchiectomies after 4 weeks. Sections of both testes from each animal were studied. The changes in the expressions of P53 and phosphorylation of H2AX were determined using immunohistochemistry and western blot. RESULTS: Immunohistochemical staining of the left testes in the varicocele- induced rats showed that the expressions of P53 and phosphorylation of H2AX had not begun 2 weeks postoperatively, but remarkable results were observed after 3 and 4 weeks. Both testes of the varicocele-induced rats showed the expressions of P53 and phosphorylation of H2AX after 4 weeks, with the left testes being more distinctive in immunohistochemical staining compared to the right. Western blot of the left testes in the varicocele- induced rats also showed unclear expressions of P53 and gamma-H2AX after 2 weeks. Considerable distinction was seen after 3 and 4 weeks compared to the control group. CONCLUSIONS: Our results suggest that experimental varicocele is associated with increased sperm DNA damage. These changes may be related to abnormal spermatogenesis.
Adult ; Animals ; Blotting, Western ; DNA Damage ; Germ Cells* ; Humans ; Immunohistochemistry ; Male ; Orchiectomy ; Phosphorylation* ; Rats* ; Rats, Sprague-Dawley ; Spermatogenesis ; Spermatozoa ; Testis ; Varicocele*

PURPOSE: To evaluate the treatment outcomes of the three-dimensional conformal radiotherapy (3D-CRT), in conjunction with induction chemotherapy, for the treatment of stage III non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Between November 1998 and March 2003, 22 patients with histologically proven, clinical stage III NSCLC, treated with induction chemotherapy, followed by 3D-CRT, were retrospectively analyzed. There were 21 males (96%) and 1 female (4%), with a median age of 68.5 (range, 42~79). The clinical cancer stages were IIIA and IIIB in 41 and 59%, respectively. The histologies were squamous cell carcinoma, adenocarcinoma and others in 73, 18 and 9%, respectively. Twenty patients (91%) received induction chemotherapy before radiation therapy. The majority of the chemotherapy regimen consisted of cisplatin and gemcitabine. Radiation was delivered with conventional anteroposterior/ posteroanterior fields for 36 Gy, and then 3D-CRT was performed. The total radiation dose was 70.2 Gy. The median follow-up period was 17 months (range, 4~59 months). RESULTS: The median overall survival was 19 months. The two and four-year overall survival rates were 37.9 and 30.3%, respectively. The median progression-free survival was 21 months. The two and four-year progression-free survival rates were 42.1 and 21%, respectively. The prognostic factors for overall survival by a univariate analysis were age, histology and T stage (p<0.05). Acute radiation toxicities, as evaluated by the RTOG toxicity criteria, included two cases of grade 3 lung toxicity and one case of grade 2 esophagus toxicity. CONCLUSIONS: The radiation dose could be increased without a significant increment in the acute toxicities when using 3D-CRT. It also seems to be a safe, well- tolerated and effective treatment modality for stage III NSCLC.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Cisplatin ; Disease-Free Survival ; Drug Therapy ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Lung ; Male ; Radiotherapy, Conformal* ; Retrospective Studies ; Survival Rate

Two cases of redundant nerve root syndrome of cauda equina in patient was described. The general clinical features were the intermittent neurologic claudication with improvement at rest, low back pain of long duration and radicular pain in one or both legs, sensory & motor change in one or both legs. Myelography revealed a partial to complete block with characteristic serpentine filling defects above or below the block simulating a vascular malformation. One case was associated with lumbar H.N.P and the other cases were associated with L-H.N.P and pseudospondylolithesis. In addition to, we reviewed the literature of redundant nerve root syndrome of the cauda equina.
Cauda Equina* ; Humans ; Leg ; Low Back Pain ; Myelography ; Vascular Malformations

Eagle's syndrome is a condition that causes a dull, atypical neuralgic pain in the oropharyx, head and neck, often referred to the ear and the mastoid region in association with elongation of the styloid process of the temporal bone. Most people with abnormal styloid process have no symptoms. Recently, we have experienced a case of eagle's syndrome in a 38 year old woman. She had been suffered from sore throat, mild headache, and pharyngeal discomfort when swallowing and turning the head to the right side. It was successfully treated with surgical shortening of the styloid process via transpharyngeal approach under the general anesthesia, and then her symtom was relieved without complication.
Adult ; Anesthesia, General ; Deglutition ; Ear ; Female ; Head ; Headache ; Humans ; Mastoid ; Neck ; Pharyngitis ; Temporal Bone

Elastic Tissue ; Humans ; Hyperplasia ; Joints ; Mandibular Condyle ; Osteoarthritis ; Rabbits

Due to an extreme shortage of cadaveric kidneys, many centers in Japan successfully performed ABO-incompatible kidney transplantations using plasmapheresis, splenectomy and immunosuppression. Recently, a protocol including anti-CD20 monoclonal antibody (rituximab) and antigen-selective immunoadsorption has been used for ABO-incompatible transplantation in Europe. In Korea, ABO-incompatible kidney transplantation has been rarely performed. We report an experience of successful ABO-incompatible kidney transplantation using plasmapheresis and rituximab. The patient was a 32-yr-old female suffering from chronic renal failure, and her blood type was O, Rh+. The donor was her husband, and his blood type was B, Rh+. A combination therapy including 5 times of plasmapheresis starting from 10 days before transplantation with 2-day interval, intravenous gammaglobulin, rituximab at 2 weeks before transplantation and potent immunosuppression successfully decreased the titers of anti-A and anti-B antibodies to 1:2 and 1:1, respectively. The kidney transplantation was successful without any sign of hyperacute or acute rejection.
*ABO Blood-Group System ; Adult ; Antibodies, Monoclonal/*therapeutic use ; *Blood Group Incompatibility ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; *Kidney Transplantation ; Plasmapheresis ; Transplantation Conditioning

Chronic osteomyelitis is often considered difficult to treat and may lead to refratory condition in oral and maxillofacial region. Clinical features of chronic osteomyelitis includes pain, swelling, pus discharge, and radiographic change. There are many kinds of treatment of chronic osteomyelitis. One of the most important factors in treating osteomyelitis are removal of infectious foci and administration of massive antibiotics. Recently we reviewed 29 patients with chronic osteomyelitis who visited in our department and treated successfully with our treatment protocols, consisting of surgical intervention and intravenous antibiotics for 2 weeks, and followed by oral antibiotics for 6 weeks. It is concluded that combination of surgical intervention and antibiotic therapy are sufficient to treat the chronic osteomyelitis in oral and maxillofacial region.
Anti-Bacterial Agents ; Clinical Protocols ; Humans ; Osteomyelitis* ; Suppuration

We report here a case of inguinal sparganosis, initially regarded as myeloid sarcoma, diagnosed in a patient undergone allogeneic hematopoietic transplantation (HSCT). A 56-year-old male patient having myelodysplastic syndrome was treated with allogeneic HSCT after myeloablative conditioning regimen. At day 5 post-HSCT, the patient complained of a painless palpable mass on the left scrotum and inguinal area. Pelvic magnetic resonance imaging and computed tomography revealed suspected myeloid sarcoma. Gun-biopsy was performed, and the result revealed eosinophilic infiltrations without malignancy. Subsequent serologic IgG antibody test was positive for sparganum. Excisional biopsy as a therapeutic diagnosis was done, and the diagnosis of sparganosis was confirmed eventually. This is the first report of sparganosis after allogeneic HSCT mimicking myeloid sarcoma, giving a lesson that the physicians have to consider the possibility of sparganosis in this clinical situation and perform adequate diagnostic and therapeutic approaches.
Animals ; Diagnosis, Differential ; Hematopoietic Stem Cell Transplantation ; Humans ; Larva ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelodysplastic Syndromes/complications/surgery ; Republic of Korea ; Sarcoma, Myeloid/diagnosis ; Scrotum/parasitology/*pathology ; Sparganosis/parasitology/*pathology/radiography ; Sparganum/*immunology/isolation & purification ; Tomography, X-Ray Computed ; Transplantation, Homologous