OBJECTIVE: To evaluate the role of nitric oxide(NO) in fetal growth. METHOD: We measured umbilical vein serum NO in preeclampsia by Stuehr method and evaluated the association with the fetal birth weight and compared with normal pregnancy and twin pregnancy. RESULTS: 1. The umbilical vein serum nitrite concentration in preeclampsia was higher than that of the normal pregnancy (p<0.005). 2. Umbilical vein serum nitrite concentration of FGR(fetal growth restriction) baby group was higher than that of the non-FGR group in preeclampsia (p<0.005). 3 Umbilical vein serum nitrite concentration of larger baby group was higher than that of the smaller baby group in twin pregnancy but statistically not significant (p>0.005). 4. There were no significant differences of umbilical vein serum nitrite concentration between twin pregnancy and normal single pregnancy group (p>0.005). CONCLUSION: These results suggest that the increased nitric oxide production in the umbilical vein may be a compensatory response to improve blood flow and fetal growth in preeclampsia.
Birth Weight ; Fetal Development* ; Nitric Oxide* ; Pre-Eclampsia* ; Pregnancy ; Pregnancy, Twin ; Umbilical Veins*

Prostaglandins which are produced from amnionic cells are known to play a major role in uterine contraction and cervical dilatation in human. Recently it is reported that aspirin increases the expression of PGHS-1 and PGHS-2 in trophoblast cells from placenta. We examined here the changes of immunoreactive prostaglandin H synthase (PGHS) level by aspirin in cultured cells from amniotic fluid and human amnionic WISH cells. PMA (10-7 M), an activator of protein kinase C increased the induction of PGHS-2 in both cells with or without fetal calf serum. PGHS-2 protein was also increased significantly by 10-4 M aspirin at 6 hours in both cells in the presence of serum but it was not increased in the absence of serum. The expression of PGHS-1 protein was enhanced by asprin but not by PMA in the absence of serum. Other anti-inflammatory drugs such as acetaminophen, indomethacin, dexame- thasone, and mefenamic acid increased the PGHS-2 protein level in WISH cells. PMA-induced PGHS-2 expression in WISH cells was not decreased by aspirin, on the contrary, the level was increased additively. Our results show that the increased expression of PGHS in amnion cells or other amniotic fluid cells by aspirin and other several anti-inflammatory drugs is through an unidentified effect rather than feedback effect by depletion of prostaglandin.
Acetaminophen ; Amnion* ; Amniotic Fluid ; Aspirin* ; Cell Line* ; Cells, Cultured* ; Cyclooxygenase 2 ; Female ; Humans ; Indomethacin ; Labor Stage, First ; Mefenamic Acid ; Placenta ; Pregnancy ; Prostaglandin-Endoperoxide Synthases* ; Prostaglandins ; Protein Kinase C ; Trophoblasts ; Uterine Contraction

No abstract available.
Lung*

The authors observed a case of malignant mixed germ cell-sex cord stromal tumor occuring in a 43-year-old woman. A laparotomy perfomed on August 3, 1994, revealed a large roughly round, partially ruptured tumor in the right ovary. The tumor mass weighed 330 gm and its dimensions were 11X9X8 cm. Tumors composed of germ cells and sex cord stroma intimately associated togther are very rare. Interest in these gonadal tumors that are distinct from gonadoblastoma has mouted in recent years. The tumor behaves in a benign clinical course and occurs predominantly in female infats and children with normal 46.XX karyoytype. This tumor differs from gonadobalstoma in its histologic pattern, absence of regresive changes, lack of association with other neoplastic germ cell elements, and occurrence in normal gonads.Histologically, the mass was characterized by an intimate admixutr of germ cells and sex cord stromal cells. The lesion had many predominant setoli tuble formations and lipid cell changes. But it lacked Call-Exner like bodies, calcification and byalinization that charaterize gonadoblastomas. Typical areas of dysgemonoma and endodermal sinus tumor were also present the patient subsequelty received chemotherapy(blemycin,etoposied, and cisplatin administered in 5cycles), The patient was symptom free two yares after surgery and chemotherapy.
Adult* ; Child ; Cisplatin ; Drug Therapy ; Endodermal Sinus Tumor ; Female ; Female* ; Germ Cells ; Gonadoblastoma ; Gonads ; Humans ; Laparotomy ; Ovary* ; Stromal Cells

OBJECTIVE: The purpose of this study was to identify chemoresistance and prognosis differences between recurrent micropapillary serous ovarian carcinoma (MPSC) and serous ovarian carcinoma. METHODS: The Extreme drug resistance (EDR) assay was performed in 13 recurrent micropapillary serous ovarian carcinoma and 56 recurrent serous ovarian carcinoma. RESULTS: Mean age of MPSC and Serous ovarian cancer were 41.1 and 58.0 respectively (p<0.05). Etoposide and Doxil were the two least resistance chemotherapeutic agents to recurrent MPSC but the most resistance agents to recurrent serous ovarian cancer. Taxol and cisplatin were the two most resistance agents to MPSC. The mean follow up was 42 months (range 1-173) The five-year overall survival rate of MPSC and serous ovarian carcinoma were 71.6% and 33.9% respectively. The mean survival were 136 months in MPSC compared with 72 months in serous ovarian carcinoma (p<0.035). CONCLUSION: In this retrospective analysis, MPSC showed very different in EDR results and favorable prognosis compare to serous ovarian carcinoma.
Cisplatin ; Drug Resistance ; Etoposide ; Follow-Up Studies ; Ovarian Neoplasms ; Paclitaxel ; Prognosis* ; Retrospective Studies ; Survival Rate

PURPOSE: Ventricular late potentials have been shown to predict malignant ventricular arrhythmia and sudden cardiac death in patients with myocardial infarction and cardiomyopathy. Low amplitude and high frequency potentials at the end of the QRS complex can be detected on the body surface using signal-averaged electrocardiogram(SAECG). This study determines the age-related criteria of SAECG parameters and age-related differences. METHODS: SAECGs were obtained in 58 healthy children in five age groups(<1mo, 1-11mo, 1-5yr, 6-11yr, and 12-15yr). Three orthogonal leads(X, Y, Z) triggered with R-waves were amplified. In all recordings, a minimum of 250 beats were averaged after filtering with a 40Hz high- pass filter and 250Hz low-pass filter with noise level less than 0.7microvolt. RESULTS: The filtered QRS(f-QRS) duration was low, and the root mean square amplitude of terminal 40ms of f-QRS(RMS40) was high before 6years of age. The duration of low amplitude signal under 40microvolt(LAS) and late duration(LD) changed little during childhood. The criteria for significant ventricular late potential were as follows : f-QRS>98ms, RMS40<105microvolt, LAS>27ms, and LD>40ms for <1mo; f-QRS>109ms, RMS40<98microvolt, LAS>20ms, and LD>49ms for 1-11mo; f-QRS>114ms, RMS40<33microvolt, LAS>33ms, and LD>39ms for 1-5yr; f-QRS>112ms, RMS40<39 microvolt, LAS>30ms, and LD>45ms for 6-11yr; f-QRS>117ms, RMS40<18microvolt, LAS>37ms, and LD>30ms for 12-15yr. RMS40 and LAS correlated with f-QRS duration(r=-0.75, and 0.45 respectively, P<0.05), suggesting that these parameters are associated with ventricular muscle thickness and ventricular conduction time. CONCLUSION: Age-related differences in SAECG parameters may be due to ventricular muscle thickness and ventricular conduction time. This should be considered for the evaluation of ventricular late potential.
Arrhythmias, Cardiac ; Cardiomyopathies ; Child* ; Death, Sudden, Cardiac ; Electrocardiography* ; Humans ; Myocardial Infarction ; Noise

Hemangiopericytoma is a rare mesenchymal neoplasm, accounting for about 1% of vascular tumor. Hemangiopericytoma is known to be derived from the vascular pericyte and occurs most commonly lower extremities, pelvis and retroperitoneum. Surgical radical excision is the treatment of choice. Because of malignant features of hemangiopericytoma, long term and close follow-up is important. We report a case of successfully resected retroperitoneal hemangiopericytoma.
Accounting ; Follow-Up Studies ; Hemangiopericytoma ; Lower Extremity ; Pelvis ; Pericytes

OBJECTIVE: To investigate the histologic features of the uterus and adnexae extirpated from gender identity disorder (GID) patients that received depot androgen injection. METHODS: We reviewed the histologic findings of the uterus and adnexae removed from sixteen GID patients, who had taken depot androgen injection for 5~168 months. RESULTS: Fourteen patients (87.5%) showed the atrophied epithelium of exocervix and all of 16 patients (100%) showed the atrophy of endometrium. Seven patients (43.7%) showed multiple cystic follicles in the ovarian cortex and 6 patients (37.5%), 3 patients (18.7%) showed corpus albicans and corpus luteum, respectively. CONCLUSIONS: Exogenous androgen induced atrophy of cervix and endometrium. This effect was more prominent in the endometrium. In addition, PCO-like histologic features were observed in the ovary.
Atrophy ; Cervix Uteri ; Corpus Luteum ; Endometrium ; Epithelium ; Female ; Gender Identity* ; Humans ; Ovary ; Uterus*

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. A range of factors including tuberculous infection, beryllium exposure, and cold climate have been implicated in the pathogenesis of the condition. A 45-year-old woman presented with a 4-month history of an asymptomatic eyelid swelling and multiple erythematous papules on the neck. Histological examination of the neck, orbital soft tissue, and lacrimal gland was consistent with sarcoidosis. Ziehl−Neelsen stains and polymerase chain reactions (PCRs) for tuberculosis on the skin biopsy specimens were negative. However, the orbital soft tissue specimen was positive for non-tuberculous mycobacteria (NTM) PCR. The patient was finally diagnosed with sarcoidosis associated with NTM. Treatment with systemic steroid and hydroxychloroquine was started, resulting in an improvement of skin lesions. We herein report a case of sarcoidosis associated with NTM infection with review of the literature, as only little is known regarding the role of mycobacteria in sarcoidosis.

Background: Vulvar pruritus is a common complaint among women presenting to dermatologists. However, few studies have analyzed the dermatologic conditions that cause it. Objective: This retrospective study aims to evaluate the clinical features and causes of pruritic skin lesions of the female external genitalia. Methods: This study included 161 female patients with vulvar pruritus between 2008 and 2018 at CHA Bundang Medical Center. Data were collected by reviewing the electronic medical records retrospectively. The age, diagnosis, and histopathologic findings of the patients were reviewed. Results: The patients’ mean age was 49 years. On physical examination, 71.4% of patients (n=115) had definite skin lesions, and 28.6% (n=46) had ‘vulvar pruritus without skin rash’. The most common diagnostic category, confirmed by skin biopsy, was inflammatory dermatoses (53.4%, n=86), including lichen sclerosus et atrophicus, lichen simplex chronicus, nonatopic eczema, atopic eczema, and psoriasis. Moreover, 7.5% of patients (n=12) were diagnosed with infectious diseases, including candidiasis, herpes simplex virus, syphilis, and scabies; 5.6% (n=9) were diagnosed with neoplastic diseases, including vulvar intraepithelial neoplasia, squamous cell carcinoma, extramammary Paget’s disease, and Bowen’s disease. Conclusion The causes of vulvar itch are vast, and often, multiple causes coexist simultaneously. Therefore, it requires a systemic approach to establish the correct diagnosis. Dermatologists should actively participate in the diagnosis and treatment.