In order to ascertain the status of health damage among Korean farmers who spray pesticides regularly in summer, blood and urine samples were collected for 88 volunteers during July to Septembei in 1990. Serum cholinesterase activity, parent compounds of pesticides in blood and urine, SGOT, SGPT, blood pressure, pulse rate were measured. The results were as follows ; 1. Mean cholinesterase activity after spraying pesticides was significantly lower than that before splaying. While proportion of abnormal cholinesterase activity (<1900U/L) group was 2.3% before spraying pesticides, tHe proportion of the group after spraying was 22.8% 2. Cholinesterase activity were decreased over 50% in 14.7% of the suhjects who can be classified into poisoning group 3. While pulse rate and blood pressure were slightly increased in poisoning group, those were significantly decreased in non-poisoning group. 4. Consecutive splaying of pesticide caused further reduction of cholinesterase activity, 5. Five parent compounds of pesticides frequently used during summer farming were analyzed using 106 blood samples. IBP in one sample and Isoprothiolane in four samples were detected. No parent compounds were detected in urine samples.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Cholinesterases* ; Heart Rate ; Humans ; Parents ; Pesticides ; Poisoning ; Volunteers

Small cell carcinoma of the gallbladder is a rare neoplasm with a high malignant potential, representing about 4% of all carcinomas in this organ. It predominantly develops in older women with cholelithiasis and deaths usually occur within a few months after the diagnosis. We report a case with a small cell carcinoma of the gallbladder with literature review. A case of 74-year-old woman with fever and abdominal pain for days was temporarily diagnosed as empyema of the gallbladder and received emergency cholecystostomy. 15 days later, she underwent cholecystectomy. Pathological examination of the gallbladder revealed small cell carcinoma. Of the immunohistochemical stains for neuroendocrine and other tumor markers, this tumor was positive for cytokeratin, NSE, lysozyme, gastrin,p53 and p16 and negative for CEA, chromogranin, synaptophysin, somatostatin, serotonin and ACTH. The small cell was partially originated from the common premobial cell with bidirectional differentiation. She died of cancer cachexia 2 months after initial operation.
Abdominal Pain ; Adrenocorticotropic Hormone ; Aged ; Cachexia ; Carcinoma, Small Cell* ; Cholecystectomy ; Cholecystostomy ; Cholelithiasis ; Coloring Agents ; Diagnosis ; Emergencies ; Empyema ; Female ; Fever ; Gallbladder* ; Humans ; Keratins ; Muramidase ; Neuroendocrine Tumors ; Serotonin ; Somatostatin ; Synaptophysin ; Biomarkers, Tumor

Hereditary breast carcinomas associated with BRCA1/2 mutations have unique clinicopathological and epidemiological characteristics. The objective of this study is to outline the prevalence, founder effect and clinicopathological characteristics of BRCA1/2 mutations for hereditary breast cancers from an analysis of reports recently published regarding Korean subjects. The prevalence of BRCA1 and/or BRCA2 mutations is 2.5-3.1% for sporadic breast cancers, 19.4-42.9% for familiar breast cancer patients with two or more affected first- and second- degree relatives with breast or ovarian cancers and 9.6-18.3% for early breast cancers. Common mutations for the Korean subjects were 2552delC, 3476insA, 4184del4, 5589del8, and 5615del111insA for BRCA1; and 7708C>T for BRCA2. These mutations were not found in Ashkenazi Jewish or Icelandic subjects. The proportion of estrogen or progesterone receptor (ER/PR) or ER/PR/HER2 triple negative status, basal-like phenotype as detected by immunohistochemical staining, and undifferentiated histological grade in Korean BRCA mutation subjects were higher than in subjects lacking BRCA1/2 mutations. Our review found that previous studies describing BRCA mutations among Korean subjects were limited. Since the clinicopathological, phenotypic and epidemiological characteristics of the BRCA1/2 mutations among Korean subjects are different from those among subjects from the Americas and Europe, more studies of hereditary or familial breast cancer including BRCA mutations must be conducted. A largescale prospective study called Korean Hereditary Breast Cancer Study (KOHBRA) was started from May 2007, and future information provided by the KOHBRA study will make a substantial contribution to solving the basic questions in etiology, individual susceptibility and clinicopathological characteristics for hereditary breast cancer among Korean subjects.
Americas ; Breast ; Breast Neoplasms ; Estrogens ; Europe ; Founder Effect ; Humans ; Iceland ; Ovarian Neoplasms ; Phenotype ; Prevalence ; Receptors, Progesterone

PURPOSE: Most epidemiological and clinical studies on BRCA1/ 2 mutations and the risk of breast cancer have been based on Western cohorts. There have been few such studies for Korean populations. The primary aim of this paper is to report the protocol of a Korean Hereditary Breast Cancer (KOHBRA) study. METHODS: The multi-centers registered in the Korean Breast Cancer Society are participating in the KOHBRA study. The objectives of the KOHBRA study till 2010 is to examine the prevalence of BRCA1/2 mutation and the prevalence of ovarian cancer among the high risk group of hereditary breast cancer patients and their families. This study is a prospective cohort study that recruited 2,250 subjects: 1) who were breast cancer patients with a family history of breast or ovarian cancers, 2) who were patients with a high risk of BRCA1/2 mutations (i.e. early onset, bilateral, male, multiple primary cancers), and 3) who had family members that were BRCA1/2 mutation carriers. The recruiting period will cover the 25th of May 2007 to the 24th of May 2010. Written informed consent is obtained at the time of enrollment. The family history and epidemiological data are obtained by a baseline questionnaire, the anthropometric data is measured and the clinical information is collected by chart-reviews by doctors. BRCA1/2 mutation testing and ovarian cancer screening are done. Blood samples are stored. Follow-up data are collected at 1, 3 and 5 yr after enrollment. RESULTS: Until now, 36 centers have joined the KOHBRA study and they are in the process of Institutional Review Board (IRB) approval. We expect to find the Korean founder mutation and to establish the Korean BRCA risk prediction model. Furthermore, the BRCA carrier cohort established from the KOHBRA study will be the groundwork to participate in an international study. CONCLUSION: The KOHBRA study will provide unique, important data to prove the etiology and natural history of Korean hereditary breast cancer. This study will be continued as genomic and proteomic epidemiological studies and future intervention studies for the prevention of hereditary breast cancer among Koreans.
Breast Neoplasms* ; Breast* ; Cohort Studies ; Epidemiologic Studies ; Ethics Committees, Research ; Follow-Up Studies ; Humans ; Informed Consent ; Male ; Mass Screening ; Natural History ; Ovarian Neoplasms ; Prevalence ; Prospective Studies ; Surveys and Questionnaires

PURPOSE: Growth patterns of colorectal carcinomas can be divided into polypoid growth (PG) and nonpolypoid growth (NPG). This study was intended to find characteristic clinicopathologic features and the expression status of p53, p21, and p16 with relation to growth patterns in colorectal carcinomas. METHODS: Sixty-one surgically resected colorectal carcinomas including 43 PG and 18 NPG carcinomas were reviewed in this study. Immunohistochemical stains for p53, p21, and p16 were done, and the results were analyzed with respect to growth patterns, and other prognosic parameters. RESULTS: PG carcinomas were significantly correlated with adenoma (p=0.0001), and with favorable histology group (p=0.04). On the contrary, NPG carcinomas were significantly correlated with unfavorable histology group (p=0.04). In NPG carcinomas, the frequency of positive expression of p53 was higher and the expression of p16 was lower than that of PG carcinomas. But there was no statistical significance (p=0.150, 0.210 respectively). The expression of p21 has no difference between NPG and PG carcinomas (p=0.953). CONCLUSIONS: As a result, it can be thought that the tendency of higher expression of p53 and lower expression of p16 in NPG carcinomas than in PG carcinomas may suggest more aggressive biologic behavior of NPG carcinomas.
Adenoma ; Colorectal Neoplasms* ; Coloring Agents ; Genes, Tumor Suppressor*

OBJECTIVES: In situ hybridization(ISH) is widely applied as an effective method to detect the positive signal in the preservation of histological architecture with high specificity. The purpose of this study is to evaulate the clinical availability of SISH(sand-witch in situ hybridization) using HBsAg mRNA probe in biopsy specimen of patients with chronic liver disease. METHODS: SISH was employed to detect the HBsAg mRNA & DNA in 127 cases of chronic liver diseases and the results were compared with those obtained by immunohistochemistry and enzyme immunoassay methods, RESULTS: The HBsAg mRNA & DNA by SISH and the HBsAg by immmunohistochemistry were detected in 94 cases(92.2%) and 86 cases(84.3%) of 102 HBsAg seropositive cases, respectively. The detection of HBsAg mRNA & DNA by SISH was identified in 8 cases of 25 HBsAg seronegative cases of chronic liver disease, and the HBsAg by immunohistochemistry in 1 case. The detection rates of HBsAg mRNA & DNA by SISH were 78.3% in chronic persistent hepatitis, 81.7% in chronic active hepatitis, 87.5% in liver cirrhosis, and 70.6% in hepatocellular carcinoma. The positive rates of HRsAg by immunohistochemistry were 56.5% in chronic persistent hepatitis, 71.8% in chronic active hepatitis, 87.5% in liver cirrhosis, and 52.9% in hepatocellular carcinoma. The detection of HBsAg mRNA & DNA by SISH is more sensitive than that of HBsAg by immunohistochemistry. CONCLUSION: SISH using HBsAg mHNA probe is a useful and sensitive method to detect HBV in chronic liver disease, and it is more sensitive than immunohistochemistry.
Biopsy ; Carcinoma, Hepatocellular ; DNA ; Hepatitis B Surface Antigens ; Hepatitis, Chronic ; Humans ; Immunoenzyme Techniques ; Immunohistochemistry ; In Situ Hybridization* ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; RNA, Messenger ; Sensitivity and Specificity

BACKGROUND/AIMS: The treatment for steroid-refractory acute graft versus host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) needs to be standardized. We report our clinical experience with etanercept for steroid-refractory acute GVHD. METHODS: Eighteen patients who underwent allo-SCT and presented with steroid-refractory acute GVHD at Ajou University Hospital were studied retrospectively. They were given 25 mg of etanercept subcutaneously twice weekly for 4 weeks. The clinical responses were evaluated with regard to the severity of acute GVHD. RESULTS: The median patient age was 43.5 years. Using nonparametric tests, etanercept had a down-grading effect on acute GVHD (p = 0.005), although no patient experienced complete remission. Partial responses were seen in 80%, 17%, and 57% of grade II to IV patients, respectively. Skin and gut GVHD were well controlled with etanercept, whereas hepatic GVHD was not. Four patients died of fatal infections. No factors affecting the clinical outcome of etanercept were identified. CONCLUSIONS: Etanercept has a modest effect on steroid-refractory acute GVHD after allo-SCT, with tolerable side effects.
Acute Disease ; Adult ; Aged ; Allografts ; Female ; Graft vs Host Disease/etiology/*therapy ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans ; Immunoglobulin G/adverse effects/*therapeutic use ; Immunosuppressive Agents/adverse effects/therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor/*therapeutic use ; Retrospective Studies ; Steroids/therapeutic use ; Young Adult

OBJECTIVE: The aim of this study was to correlate histologic type with the clinico-pathologic features of endometrial carcinoma. METHODS: A retrospective review was performed of 158 patients with endometrial cancer who had treated surgically at Cheil General Hospital between Jan. 2000 and Dec. 2003. Histologic findings after operation were divided two groups (endometrioid group vs. non-endometrioid group) then compared to each other groups. Clinico-pathologic factors were reviewed, compared and statistically analyzed. RESULTS: Endometrioid group was 112 cases (70.9%) and non-endometrioid group was 46 cases (29.1%). Non-endometrioid group was mucinous; 5 (3.2%), UPSC; 6 (3.8%), clear Cell; 2 (1.3%), mixed; 32 (20.3%), adenosquamous; 1 (0.6%). Non-endometrioid group showed older (p=0.0003) and higher proportion of menopausal women (p=0.0017) than Group 1. But menopause mean age were not diffent between two group. Abnormality in Pap smear and thickness of endometrium (TVS) were not diffent between two group. Non-endometrioid group were significantly associated with higher grade (p=0.0000), deeper myometrial invasion (p=0.0030), larger tumor size (p=0.0006), Lympho-vascular invasion (p=0.0486) and higher recurrence rate (p=0.0369) CONCLUSION: This study revealed non-endometrioid group was significantly associated with older age, menopause status, advanced pathologic features at surgical staging, and high recurrence rate.
Endometrial Neoplasms* ; Endometrium ; Female ; Hospitals, General ; Humans ; Menopause ; Mucins ; Recurrence ; Retrospective Studies

This study was carried out in order to compare the effects in different surgeries using mesh in pelvic organ prolapse patients whose leading points were C. Thirty-nine patients were categorized into 3 groups: group A pelvic reconstruction with hysterectomy; group B hysterectomy prior to pelvic reconstruction; and group C pelvic reconstruction with uterus preserved. At first visit, POP-Q stage was determined, and age, BMI, admission days, operation time, post-operative stage and complications were observed and results were analyzed and compared. All patients who were operated upon converted to stage one month following the operation, and no further change was observed except in one patient. Group admission days were not significantly different, but tended to be lower in group C. Group average operation times between 'group A and B' and 'group A and C' were statistically different. No significant difference was observed in post-operative complications between the groups, but 3 members of group A developed erosion, whereas no erosion occurred in groups B and C. Pelvic reconstruction using mesh is a highly efficient method of treating pelvic organ prolapse. Improvements in stage and post-operative complications were not significantly different in the groups. However, uteropexy showed a shorter operation time, fewer admission days, and less erosion due to mesh than conventional pelvic reconstruction with hysterectomy.
Adult ; Aged ; Aged, 80 and over ; Comparative Study ; Female ; Humans ; Middle Aged ; Pelvis/surgery ; Reconstructive Surgical Procedures/*methods ; Retrospective Studies ; *Surgical Mesh ; Uterine Prolapse/*surgery ; Visceral Prolapse/*surgery

OBJECTIVE: Burch operation has been effective method for the treatment of stress incontinence. Burch operation is a well-accepted procedure for treating stress urinary incontinence secondary to urethral hypermobility without intrinsic sphincter deficiency and is the reference standard with which other procedures are compared. This study is to evaluate the effectiveness of the Choi's hook in laparoscopic Burch operation. METHODS: This study included 47 patients who had undergone laparoscopic Burch operation from October 2000 through March 2005. Of these 47 patients, 27 patients underwent traditional laparoscopic Burch operation (Group 1) and 20 patients underwent laparoscopic Burch operation with Choi's Hook on anchoring the endopelvic fascia to the Cooper's ligament (Group 2). RESULTS: The mean age of patients of Group 1 was 55.6+/-9.37 years of age and that of Group 2 was 56.0+/-5.93 years of age. There is no difference in the mean age of patients (P>0.05). The mean operating time was 90.5+/-15.32 minutes for Group 1 and 38.5+/-10.14 minute for Group 2. The mean operating time was shorter in Group 2 than Group 1 (P<0.05). There was no difference in recurrence rate and complication rate between Group 1 and Group 2 (P>0.05). CONCLUSION: We performed laparoscopic Burch operation with the Choi's Hook on anchoring the endopelvic fascia to the Cooper's ligament. When we compared traditional laparoscopic Burch operation with laparoscopic Burch operation with Choi's Hook, we could shorten the operation time using the Choi's Hook.
Fascia ; Humans ; Ligaments ; Recurrence ; Urinary Incontinence