OBJECTIVE: Preterm birth is an important cause of infant death and morbidity but its pathophysiology still remains to be clear. The associations between preterm birth and the polymorphism of interleukin-1beta gene and interleukin-1 receptor antagonist gene have been suspected. And ethnic variations in the polymorphism of the genes were also reported. We decided to study polymorphisms of interleukin-1beta+3953 and interleukin-1 receptor antagonist in Korean pregnant women. METHODS: Patients were divided into 2 groups. Group 1 is the control group of 33 subjects with uncomplicated term delivery : group 2 is the case group of patients who had spontaneous preterm delivery. Polymorphisms were determined by polymerase chain reaction and restriction fragment length polymorphism analysis. RESULTS: There were significant differences in gestational age and birth weight between two groups (P<0.001). No significant differences were found in genotypic frequencies and allelic frequencies in interleukin-1beta+3953 between two groups. Interleukin-1 receptor antagonist gene had 5 alleles and the most frequent allele was IL1RN*1 (410bp), 66.7% in control group and 77.8% in case group. And significant differences were not found in genotypic frequencies and allelic frequencies between two groups, too. CONCLUSION: There were no significant differences in polymorphisms in interleukin-1beta +3953 and interleukin-1 receptor antagonist between term delivery group and preterm birth group.
Alleles ; Birth Weight ; Female ; Gestational Age ; Humans ; Infant ; Interleukin-1* ; Interleukin-1beta* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Pregnant Women ; Premature Birth*

OBJECTIVE: To evaluate the effectiveness of doxycycline as monotherapy for the treatment of acute pelvic inflammatory disease (AcPID) resistant with traditional combined regimen (TCR). METHODS: 128 patients were selected, who were diagnosed as AcPID from January 2003 to June 2004 and prescribed with medical treatment. Initially, TCR by cephalosporin, metronidazole, and aminoglycoside antibiotics was applied to all patients. 2-3 days later, the level of subjective pain or tenderness on pelvic examination was evaluated. If it is 30% or less than initial symptoms and signs, original regimen was prescribed (group I). If it is 30% more than initial symptoms and signs, we judged AcPID resistant with TCR and changed the antibiotic regimen with doxycycline (group II). Cure of AcPID was defined by no pain or tenderness. In this study, retrospective review about the result of medical treatment and clinical characteristics between two groups was done. RESULTS: Of the 128 patients, 94 (73.4%) was group I (46 inpatient and 48 outpatient) and 34 (26.6%) was group II (20 and 14). There were no significant differences in clinical characteristics except initial blood WBC count between group I and II. Initial blood WBC count was 11153+/-4393/microliter in group I and 9112+/-3483/microliter in group II (p<0.05). Positive rate of Chlamydia trachomatis using PCR was 9.4% (12/128) in all patients (group I:0%, II:35.3%). All patients of two groups were cured with TCR and doxycycline. CONCLUSION: Our data shows that doxycycline as monotherapy is effective to patients who are resistant with TCR for medical treatment of AcPID.
Anti-Bacterial Agents ; Chlamydia trachomatis ; Doxycycline* ; Female ; Gynecological Examination ; Humans ; Inpatients ; Metronidazole ; Pelvic Inflammatory Disease* ; Polymerase Chain Reaction ; Retrospective Studies

OBJECTIVE: Nitric oxide has a short half-life and is easily oxidized by nitrite, we can indirectly find out its activity by measuring the nitric oxide synthase in cells. The purpose of this study is to confirm the differences in the expression modes of eNOS in uterine endometrium and myometrium between the patients of uterine leiomyoma and the control group. METHODS: We defined the patient group as perimenopausal women who were diagnosed with uterine leiomyoma and underwent total hysterectomy, and the control group as the women who had no lesions in uterus. All of them were classified into proliferative phase and secretory phase by the Noyes standards and compared by immunohistochemical stain for eNOS. RESULTS: There is no significant differences between the patients of uterine leiomyoma and the control group statistically (endometrium P=0.319, myometrium P=0.264). The expression of eNOS in the vascular endothelial cells of the endometrium did not show significant differences statistically by menstrual cycle (proliferative phage P=0.549, secretory phage P=0.240). The expression of eNOS in the myometrium also did not show significant differences by menstrual cycle or by group statistically (proliferative phage P=0.279, secretory phage P=0.224). CONCLUSIONS: In this study, the expression of endothelial nitric oxide synthase was higher in the patients of uterine leiomyoma than in the control group, and during the secretory phase in menstrual period, but there was no statistical significance. We suppose that we can get statistically significant results if we have many cases of subjects.
Animals ; Bacteriophages ; Endometrium ; Endothelial Cells ; Female ; Half-Life ; Humans ; Hysterectomy ; Leiomyoma ; Menstrual Cycle ; Mice ; Myometrium ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type III ; Uterus

BACKGROUND/AIMS: To describe the toxicity profile of anti-neoplastic agents from real clinical settings, we analyzed spontaneously reported adverse events (AEs) using data from the adverse drug reaction (ADR) reporting system of the Korean Food and Drug Administration (KFDA). METHODS: Data were extracted from the nationwide spontaneous ADR reporting system of KFDA from July 2009 to December 2010. We extracted and analyzed data related to chemotherapy and identified unlabeled ADR that were not described in the package insert of the products. RESULTS: In total, 5,867 cases of antineoplastic agent-related AE reports were identified after excluding cases for duplication and cases assessed as 'unlikely' and 'unclassifiable', based on expert opinion. Of the patients with AEs, 52.4% were males and the median age was 56 years. In total, 460 AEs (7.8%) from 267 patients were reported as 'serious' AEs. The most common causative anti-cancer drug class was pyrimidine analogs (31.5%), followed by platinum compounds (19.9%), protein kinase inhibitors (10.8%), and taxanes (8.8%). The most common clinical manifestation of AEs was gastrointestinal toxicities (25.5%), followed by skin disorders (25.3%), and generalized reactions (14.3%). In total, 168 cases (2.9%) of unlabeled AEs were identified. Among these, 10 were reported as serious AEs. CONCLUSIONS: The most common causative class of antineoplastic agents was that of pyrimidine analogs. Gastrointestinal and dermatological toxicities were the most common clinical chemotherapy-related adverse events. Further investigation and monitoring to evaluate causality associated with unlabeled AEs identified in this analysis are needed.
Antineoplastic Agents ; Drug Toxicity ; Expert Testimony ; Humans ; Male ; Pharmacovigilance ; Platinum Compounds ; Product Labeling ; Protein Kinase Inhibitors ; Pyrimidines ; Skin ; Statistics as Topic ; Taxoids ; United States Food and Drug Administration

BACKGROUND/AIMS: To describe the toxicity profile of anti-neoplastic agents from real clinical settings, we analyzed spontaneously reported adverse events (AEs) using data from the adverse drug reaction (ADR) reporting system of the Korean Food and Drug Administration (KFDA). METHODS: Data were extracted from the nationwide spontaneous ADR reporting system of KFDA from July 2009 to December 2010. We extracted and analyzed data related to chemotherapy and identified unlabeled ADR that were not described in the package insert of the products. RESULTS: In total, 5,867 cases of antineoplastic agent-related AE reports were identified after excluding cases for duplication and cases assessed as 'unlikely' and 'unclassifiable', based on expert opinion. Of the patients with AEs, 52.4% were males and the median age was 56 years. In total, 460 AEs (7.8%) from 267 patients were reported as 'serious' AEs. The most common causative anti-cancer drug class was pyrimidine analogs (31.5%), followed by platinum compounds (19.9%), protein kinase inhibitors (10.8%), and taxanes (8.8%). The most common clinical manifestation of AEs was gastrointestinal toxicities (25.5%), followed by skin disorders (25.3%), and generalized reactions (14.3%). In total, 168 cases (2.9%) of unlabeled AEs were identified. Among these, 10 were reported as serious AEs. CONCLUSIONS: The most common causative class of antineoplastic agents was that of pyrimidine analogs. Gastrointestinal and dermatological toxicities were the most common clinical chemotherapy-related adverse events. Further investigation and monitoring to evaluate causality associated with unlabeled AEs identified in this analysis are needed.
Antineoplastic Agents ; Drug Toxicity ; Expert Testimony ; Humans ; Male ; Pharmacovigilance ; Platinum Compounds ; Product Labeling ; Protein Kinase Inhibitors ; Pyrimidines ; Skin ; Statistics as Topic ; Taxoids ; United States Food and Drug Administration

OBJECTIVE: The history of gestational diabetes (GDM) is a high risk for the development of type 2 diabetes mellitus (T2DM). The purpose of this study is to investigate the genetic association of LEP and LEPR gene polymorphisms and the development of T2DM in Korean women of history of GDM. METHODS: Women diagnosed as GDM during pregnancy from January 1992 to December 2002 were recruited. Those women with a T2DM at the time of study were classified as T2DM positive group, and without T2DM, as T2DM negative group. 2 genes (LEP and LEPR genes) and 8 SNPs (LEP-632G>A, +4950G>A, +4998A>C, and LEPR-141013T>C, -186A>G, +5193G>A, +7187A>C, +27265A>G) were selected. The TaqMan assay for genotyping and the statistical analysis for phenotypic and genetic factors between 2 groups were analyzed. RESULTS: A total of 54 women, T2DM positive (n=20) and T2DM negative (n=34) were enrolled. At the time of diagnosis of GDM, HbA1c, 50 g and 100 g oral glucose tolerance test, and insulin level were significantly associated between T2DM positive and negative groups (P<.05). In analysis of genetic risk to T2DM, the significant association related with any SNPs was not shown between T2DM positive and negative groups. CONCLUSION: In Korean women having past history of GDM, there was no relationship between 2 genes and the development to T2DM. To clarify a effect of candidate genes related with development of T2DM, there will need more samples and genes.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational ; Female ; Glucose Tolerance Test ; Humans ; Insulin ; Polymorphism, Single Nucleotide ; Pregnancy

Minimally invasive techniques for various cardiac disease are widely accepted in these days. We report a successful case of reoperative mitral valve replacement approached successfully by a small right parasternal incision.
Heart Diseases ; Mitral Valve* ; Reoperation ; Surgical Procedures, Minimally Invasive

PURPOSE: Reconstruction for post-radiation scar on periorbital area including upper eyelid takes consider of eyelid function and cosmetic results. It is a challenging procedure to reconstruct the severe radiation induced scars deformities on face around the orbital area in terms of its complicated anatomy and restoration of cosmetic social function. The authors report a reconstruction case of radiation induced severe facial deformities with scars including upper lid and periorbital area using evidence based plastic surgical techniques such as newly designed lower lid orbicularis oculi myocutaneous transposition flap, lateral canthopexy, skin graft, composite graft, fat graft, acellular dermal matrix graft, Z-plasty focusing on cosmetic and functional result. METHODS: A 18 year-old female patient had right upper facial deformities caused by radiation induced wide scars around the right periorbital, upper lid and temporal area after treatment for hemangioma at age of 1. She also showed right facial palsy on forehead, and hypoplasia of left ala nasi. The patient suffered from skin atrophy, wide scar formation, scar contractures on right periorbital area, severe lagophthalmos on right eye, right frontal facial palsy, and small hypoplastic left ala nasi. At the first operation, release of scars and full thickness skin graft, reposition of asymmetric right eyebrow caused by facial palsy using Z-plasty, correction of temporal depression using acellular dermal matrix (AlloDerm(R)) graft, and auricular composite graft for left ala nasi reconstruction were performed. And after 4 months follow-up, the second operations were performed including lower orbicularis oculi muscle transposition flap for upper lid lagophthalmos, lateral canthopexy, and fat graft. RESULTS: Lower lid orbicularis oculi muscle transposition flap and all grafts were successfully survived. After 3 weeks follow-up, she showed good looking facial appearance and facial symmetry, and there were no complications. CONCLUSION: For post-radiation facial scar reconstruction, it showed a better cosmetic outcome using flap transfer rather than skin graft. The newly designed lower eyelid orbicularis oculi muscle transposition flap, canthopexy, fat graft give a good result for reconstruction of radiation induced scars of upper eyelid and periorbital deformities.
Acellular Dermis ; Atrophy ; Cicatrix* ; Congenital Abnormalities ; Contracture ; Depression ; Eyebrows ; Eyelids ; Facial Paralysis ; Female ; Follow-Up Studies ; Forehead ; Hemangioma ; Humans ; Orbit* ; Skin ; Transplants

Background and Objectives: We analyzed surgical outcomes, perioperative complications, and mortality in head and neck squamous cell carcinoma (HNSCC) in patients who underwent curative surgery following neoadjuvant immunotherapy.Subjects and Method The records of 36 HNSCC patients who underwent curative surgery with neoadjuvant immunotherapy and 69 HNSCC patients who received neoadjuvant chemotherapy were analyzed. Results: The average operation time was 315 minutes, and the average bleeding volume was 167 cc. The average length of hospital stay was 21 days. When evaluating surgical margin status, we found 24 patients (66.6%) who exhibited a negative margin. We found no case where surgery was impossible due to progression of the lesion during neoadjuvant immunotherapy. Compared to the neoadjuvant chemotherapy group, neoadjuvant immunotherapy group showed acceptable perioperative safety and complication profile. The postoperative complication rate was 19.4% in the neoadjuvant immunotherapy group and 13.0% in the neoadjuvant chemotherapy group (p=0.386). There were no serious complications during the recovery period after surgery or instances of death due to complications. Conclusion In HNSCC patients, there was no increase in the incidence of complications or mortality related to curative surgery after neoadjuvant immunotherapy.

Rifampin is one of the first line drugs for treating tuberculosis, but it might be associated with serious adverse effects, including renal failure. We report here on a case of a 57-year-old patient who developed Henoch-Shonlein purpura during antituberculosis therapy that included rifampin. The patient converted to negative on the AFB smear for tuberculosis two weeks after the initial administration of antituberculosis medication. After treatment for 60 days, this patient was diagnosed with Henoch-Shonlein purpura by the purpura lesion on the lower legs, the leukocytoclastic vasculitis, the renal impairment and the pathological examination. After stopping rifampin, the skin lesions disappeared in about 10 days and his renal function gradually improved. This case study showed that Henoch-Schonlein purpura can be caused by rifampin during antituberculosis therapy and we recommend that the use of rifampin should be restrained when clinical symptoms of Henoch-Shonlein purpura are observed.
Acute Kidney Injury ; Humans ; Leg ; Middle Aged ; Purpura ; Purpura, Schoenlein-Henoch ; Renal Insufficiency ; Rifampin ; Skin ; Tuberculosis ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous