No abstract available.
GRB2 Adaptor Protein*

Gestational trophoblastic disease associated with the tubal pregnancy is uncommon, and the incidence has been described as 1/5000 tubal pregnancy. We have experienced a case of metastatic gestational trophoblastic disease(GTD) in the lung occuring with complete hydatidiform mole arising in tubal pregnancy. The patient was a 39-year-old, G4P2A2L2 woman with amenorrhea for 5 weeks. Ectopic pregnancy in the right fallopian tube was suspected on transvaginal ultrasonogram. A right adnexectomy was performed. The fallopian tube was markedly dilated and ruptured. The right ovary and a round hematoma had adhered to the external surface of the fallopian tube. On gross examination, no molar tissue was identified. On microscopic examination, the lumen of the dilated fallopian tube was filled with blood clots admixed with several chorionic villi showing hydropic swelling and marked proliferation of atypical trophoblasts. Proliferating syncytio-and cytotrophoblasts invaded the wall of the blood vessels of the fallopian tube and sheets of trophoblasts and some villi were identified in the lumen of blood vessels. Multiple pulmonary nodules thought to be metastatic nodules were identified in the chest X-ray and serum beta-HCG had increased 2 weeks later. This case indicates that a careful pathological examination in the ectopic pregnancy is mandatory, because tubal GTD is not clinically distinguishable from ordinary tubal pregnancy.
Pregnancy ; Female ; Humans ; Neoplasm Metastasis

Leydig cell tumor of the ovary is a very rare tumor which usually occurs in the postmenopausal age, and which is frequently associated with virilization. It has been classified as a lipid cell tumor due to the presence of intracytoplasmic lipids. However, since up to 25% of these tumors contain little or no lipid, the new term "steroid cell tumor" is proposed for this type of neoplasm. We report a case of Leydig cell tumor of the ovary in a 16 year old girl. The patient exhibited recently recognized hirsuitism and secondary amenorrhea. Physical examination revealed moderate obesity with moderate amounts of coarse hair over the whole body and a deepening of the voice. Testosterone and dehydroepiandrosterone sulfate levels were markedly elevated in the peripheral blood. Pelvic ultrasonography revealed a right ovarian tumor. The resected ovary showed a well demarcated, golden yellow to orange colored solid mass, measuring 7 cm on the cut surface. Microscopically, the tumor was composed of solid and diffuse sheets of tumor cells having abundant eosinophilic cytoplasm, and large round nuclei with frequent crystalloids of Reinke in the cytoplasm. To our knowledge this is the first case of Leydig cell tumor of the ovary in a young girl in the Korean literature.

The immunocompetence is important not only to kill the neoplastic cells but also to keep the neoplastic cells from growing further. T lymphocyte is plays the most important role in maintaining the tumor immunity efficiently. T lymphocyte has its specific functions depending in the subset of T lymphocytes. The author analyzed the T lymphocyte subsets in 31 brain tumor patients using anti-CD3, anti-CD4, anti-CD8 monoclonal antibodies and flow cytometry to determine the immunological status of brain tumor patients. All CD3, CD4 and CD8 subsets were reduced in both benign and malignant brain tumor patients but more signigicantly reduced in malignant tumor group. But in benign tumor group, the subtypes of T lymphocytes were not so different from those of normal healthy controls except the pituitary tumor patients, who showed the significant decrease in all the subtypes. In malignant tumor group, each subtype was signigicantly reduced and CD8 subtypes was markedly reduced in metastatic tumor patients, These analyses were considered to have the possibility to be contributable to planning the further immunotherapy and also the possibility to moniter the brain tumor patients clinically.
Antibodies, Monoclonal ; Brain Neoplasms* ; Brain* ; Flow Cytometry ; Humans ; Immunocompetence ; Immunotherapy ; Lymphocytes ; Pituitary Neoplasms ; T-Lymphocyte Subsets* ; T-Lymphocytes*

OBJECT: To assess the relative risk of an adverse pregnancy outcome in women with a false-positive riskfor Down syndrome by prenatal screeen using triple markers(maternal serum alpha-fetoprotein[AFP], unconjugated estrio[uE3], and human chorionic gpna dotropin[hGC] levels) and age. METHODE: Case-Control study including sixity four women with false-positive screens for Down sydromeand a matched control group of 128 women whose screen indicated a risk for Down syndrome of less than1 :270. The risk for adverse pregnancy outcome was compared for the two groups,and the roles of maternal serum AFP, uE3, and hCG as predictors of adverse pregnancy outcome weredetermined. RESULT: Women with false-positive screen for Down syndrome were not significantly different from theirmatched controls in the incidence of preterm delivery (5% versus 2%), pretermpremature rupture of membrane(3% versus 0%), placental abruption(0% versus 1%),preeclampsia(3% versus 1%), small for gestational age newborns(5% versus 6%), and fetal demise after20 week's gestation(2% versus 0%). The occurrence of an adverse outcome in 7 of 64(11%) pregnancieswith a flase positive screen for Down syndrome was not different from that in 12 of 128(9%) matchedcontrol pregnancies.Only maternal age (odds ratio 1.19,95% cofidence interval 1.05~1.34, p < 0.005) was siginificantly associatedwith adverse outcome after controlling for the effects of maternal serum AFP, hCG and uF3. CONCLUSION: Althought the sample on this study, women with a false-positive screen for Down syndromedo not seem to be at increased risk for a adverse pregnancy outcome when compared to those with a negativescreen result. Among maternal age, maternal serum AFP, hCG, and uE3level, only maternal age seemed tobe a predictorof an adverse pregnancy outcome.
Biomarkers* ; Case-Control Studies ; Chorion ; Down Syndrome* ; Female ; Gestational Age ; Humans ; Incidence ; Maternal Age ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

OBJECT: To assess the relative risk of an adverse pregnancy outcome in women with a false-positive riskfor Down syndrome by prenatal screeen using triple markers(maternal serum alpha-fetoprotein[AFP], unconjugated estrio[uE3], and human chorionic gpna dotropin[hGC] levels) and age. METHODE: Case-Control study including sixity four women with false-positive screens for Down sydromeand a matched control group of 128 women whose screen indicated a risk for Down syndrome of less than1 :270. The risk for adverse pregnancy outcome was compared for the two groups,and the roles of maternal serum AFP, uE3, and hCG as predictors of adverse pregnancy outcome weredetermined. RESULT: Women with false-positive screen for Down syndrome were not significantly different from theirmatched controls in the incidence of preterm delivery (5% versus 2%), pretermpremature rupture of membrane(3% versus 0%), placental abruption(0% versus 1%),preeclampsia(3% versus 1%), small for gestational age newborns(5% versus 6%), and fetal demise after20 week's gestation(2% versus 0%). The occurrence of an adverse outcome in 7 of 64(11%) pregnancieswith a flase positive screen for Down syndrome was not different from that in 12 of 128(9%) matchedcontrol pregnancies.Only maternal age (odds ratio 1.19,95% cofidence interval 1.05~1.34, p < 0.005) was siginificantly associatedwith adverse outcome after controlling for the effects of maternal serum AFP, hCG and uF3. CONCLUSION: Althought the sample on this study, women with a false-positive screen for Down syndromedo not seem to be at increased risk for a adverse pregnancy outcome when compared to those with a negativescreen result. Among maternal age, maternal serum AFP, hCG, and uE3level, only maternal age seemed tobe a predictorof an adverse pregnancy outcome.
Biomarkers* ; Case-Control Studies ; Chorion ; Down Syndrome* ; Female ; Gestational Age ; Humans ; Incidence ; Maternal Age ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

OBJECTIVES: The purposes of this study were to determine the usefulness of transvaginal ultrasonographic assessment of the uterine cervix and to compare the diagnostic performance of ultrasonographic and digital examination of the cervix in predicting a successful induction of labor. STUDY DESIGN: One hundred-one singleton term pregnancies without ruptured membranes admitted for the labor induction were included in this study. Digital examination and transvaginal ultrasonography of the uterine cervix were performed at the time of admission. Cervical parameters evaluated included cervical length, presence of funneling, funnel length, and funnel width. Labor induction was underwent by prostaglandin E2 (PGE2) vaginal suppository and/or pitocin intravenous infusion. Outcome variable was a successful labor induction within 48 hours after beginning of the induction. RESULTS: The prevalence of induction failure was 10.9% (11/101). Receiver-operator characteristic (ROC) curve and multiple logistic regression analysis indicated a significant relationship between the successful induction of labor and cervical length <3.1 cm. The diagnositic indices of endocervical length was superior to those of Bishop's cervical score in predicting a successful induction of labor. In patients with cervical length <3.1 cm, the labor was induced successfully with fewer tablets of PGE2, less use of pitocin infusion, and shorter induction-delivery interval. CONCLUSION: Transvaginal ultrasonographical examination of the uterine cervix is more accurate than digital examination of the cervix in the prediction of a successful induction of labor in term gestation.
Cervix Uteri* ; Dinoprostone ; Female ; Humans ; Infusions, Intravenous ; Logistic Models ; Membranes ; Oxytocin ; Pregnancy* ; Prevalence ; Suppositories ; Tablets ; Ultrasonography

PURPOSE: Periventricular leukomalacia(PVL) is associated with the characteristic neurologic sequale of spastic diplegia or quadriplegia, and cortical blindness. So early diagnosis of PVL in the neonatal period is of importance because of the prognostic implications of this lesion. Novotny et al reported that Positive Rolandic Sharp waves(PRS) on the EEGs was a marker of PVL because most infants who had excessive PRS on their EEGs also had PVL on their neurosonography. PRS were present in most neonates at a time when neurosonography showed periventricular echodense lesions, prior to the appearance of cystic PVL. Therefore, the appearance of excessive PRS on the EEG is very useful for the early detection of PVL. The aim of this study is to assess the relationship between the PVL and PRS on the EEGs, to observe the appearance timing of PRS on the EEGs, and to evaluate the risk factors of later neurologic sequale. METHODS: Among the neonates admitted to the Sowha Childern's Hospital between 1989 and June 1993, 25 neonates with cystic PVL on neurosonography or CTscan were the study group. Control group were the age-matched 20 neonates who were admitted at the same time of study period. We reviewed the neurosonographic findings, EEG features, and charts retrospectively. RESULTS: 1) Excessive PRS were observed in 20 cases of study group(80%), whereas 1 case in control group(5%)(p<0.001). 2) The frequency of PRS was not affected by the abnormality of EEG background activity. 3) The frequency of PRS in a 10 minutes epoch was 14.5+11.1 in the study group, whereas 1.57+1.96 in the control group(p<0.001). 4) In most neonates, PRS were present at a time when the neurosonography showed periventricular echodense lesion or cystic PVL. 5) In a follow-up neurosonography, 12 among 17 neonates with localized PVL were normalized and only 5 cases had ventriculomegaly. Whereas, all of 5 extensive PVL had the sequale of ventriculomegaly or cerebral atrophy. 6) In a follow-up neurologic examination, the poorer sequale including spastic diplegia or quadriplegia was associated with the larger, the more extensive, and the subcortical PVL. CONCLUSIONS: 1) Excessive PRS were significantly more observed in the study group than in the control group(p<0.001). 2) The frequency of PRS was not affected by the abnormality of EEG background activity. 3) The prognosis of the neonates with PVL was depended on the size, extent, and location of the PVL rather than the presence or frequency of PRS.
Atrophy ; Blindness, Cortical ; Cerebral Palsy ; Early Diagnosis ; Electroencephalography ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Leukomalacia, Periventricular* ; Neurologic Examination ; Prognosis ; Quadriplegia ; Retrospective Studies ; Risk Factors

It is well established that mast cell proliferation and maturation are regulated by two principle cytokines, IL-3 and the c-kit ligand stem cell factor (SCF). Previous reports have demonstrated that bone marrow-derived IL-3-dependent mast cells exhibit the characteristic apoptosis on removal of IL-3. To know how the number of mast cells is controlled, we observed the effects of nitric oxide (NO) on the murine bone marrow-derived cultured mast cells (BMCMC). Apoptosis was measured by the analysis of flow cytometric data and electrophoretic evidence of DNA fragmentation. Our data showed that sodiurn nitroprusside (SNP)-a NO releasing substance- induced apoptosis in BMCMC. Cell cycle analysis showed that the number of the G,/G, and S phase decreased markedly, while the percentage of cell in G,/M phase was increased. Also, SNP alone induced cell death, whereas SNP in combination with SCF markedly decreased cell death of BMCMC. SNP-induced apoptosis was partially inhibited by the treatment of BMCMC with SCF. Our results suggest that NO might have sorne role in the regulation of the number of mast cells.
Apoptosis ; Bone Marrow* ; Cell Cycle ; Cell Death ; Cytokines ; DNA Fragmentation ; Interleukin-3 ; Mast Cells* ; Nitric Oxide* ; Nitroprusside ; S Phase ; Stem Cell Factor

The congenital long-QT syndrome (LQTS) is characterized by recurrent syncope, prolonged QT intervals, QT interval lability, polymorphic ventricular tachycardia, and sudden death. We report a case of congenital long QT syndrome in a 28-day-old male infant who presented with syncope, bradycardia with 2: 1 pseudo-atrioventricular block and a markedly prolonged QT inteval. One episode occured after crying and degenerated into ventricular fibrillation and terminated after cardioversion. A VVI type cardiac pacemaker was implanted. Subsequently, the infant's heart rate was over 110/min and 2: 1 AV block and any other arrhythmia were absent. The infant recovered from the accompanied pneumonia and sepsis and was discharged 47 days after adrnission. However, 13 days after discharge, the infant returned to our hospital ER with syncope. Ventricular fibrillation ceased after cardioversion. Despite medication with propranolol, ventricular tachycardia persisted. The infant expired the day after he was discharged against medical advice.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Bradycardia ; Crying ; Death, Sudden ; Electric Countershock ; Heart Rate ; Hospitals ; Humans ; Infant ; Long QT Syndrome ; Male ; Pneumonia ; Propranolol ; Sepsis ; Syncope ; Tachycardia, Ventricular ; Ventricular Fibrillation