Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

PURPOSE: Telomerase is a ribonucleoprotein enzyme that synthesizes telomeric DNA onto the ends of chromosomes, thereby preventing the replication-dependent shortening of those ends. This enzyme is essential for stability of eukaryotic chromosomes and may be necessary for cell immortalization. Telomerase activity is detected in a wide range of cancers of various tissues, and its expression may be a critical step in tumor progression. METHODS: The telomerase activity was measured using a telomeric repeat amplification protocol (TRAP) assay in 65 cases of breast cancers, 9 cases of fibroadenomas, and 7 cases of normal breast tissues. To compare the telomerase activity with cell cycle regulators, we measured the expression of the cyclin D1 and the p53 proteins by using immunohistochemical analysis. To compare the telomerase activity with traditional prognostic indicators, we measured the ER, PR, c-erbB-2 and ki-67 expression by using immunohistochemical analysis. Disease-free survival and overall survival in relation to telomerase activity were studied by using the Kaplan-Meier method. RESULTS: Telomerase activity was detected in 42 (64.6%) of the 65 breast cancers, 4 (44.4%) of the 9 fibroadenomas, and in none of the 7 normal breast tissues. There was no significant relationship between telomerase activity and cell cycle regulators such as cyclin D1 or p53. There was no statistical correlation between telomerase activity and tumor size, lymph nodal status, or histopathological prognostic parameters, such as ER, PR, p53, c-erbB-2 and ki-67, but a significant correlation was found (p=0.006) between telomerase activity and histologic grade. The telomerase activity was not significantly correlated with either the overall survival or the disease-free survival. CONCLUSION: These results suggest that telomerasemay play a role in the malignant transformation of breast tissue and that this enzyme was more activated in cancers of a poor histologic grade. However, the telomerase activity was not related to cell cycle regulators and traditional prognostic parameters. The possible significance of telomerase activity in breast cancer remains open to further investigation.
Breast Neoplasms* ; Breast* ; Cell Cycle* ; Cyclin D1 ; Disease-Free Survival ; DNA ; Fibroadenoma ; Ribonucleoproteins ; Telomerase*

No abstract available.
Cheilitis ; Lip ; Sialadenitis

PURPOSE: This study compared efficacy and safety of a colostomy and stent placement as a palliative management in obstructive colorectal cancer. METHODS: The patients underwent either a colostomy (16 patients) or endoscopic stent placement (14 patients). Patients with metastatic cancer and those who rejected surgery due to their advanced age and poor systemic state were enrolled in this study. RESULTS: The mean age of patients in the colostomy group (CG) and in the stent group (SG) was 61 and 66, respectively. The mean APACHE II score in the CG and SG was 4.5 and 6.9, respectively (P=0.026). The time to the first meal after the procedure was 3.8+/-1.7 days and 1.9+/-0.8 days in the CG and the SG, respectively (P=0.002). The frequency of analgesic injections after the procedure in the CG and SG was 3.7+/-2.8 and 0.2+/-0.4, respectively (P= 0.001). The mean hospital stay in the CG and the SG was 15.8+/-13.9 days and 7.0+/-3.5 days, respectively (P=0.026). The mean healthcare cost in the CG and SG was 6,085,000+/-3,959,683 won and 4,041,000+/-2,487,857 won, respectively (P=0.212). CONCLUSION: No serious complications occurred in the endoscopic stent group. There was a statistically significant difference between the two groups in the time to the first meal, the pain control frequency, and hospital stay after the procedure. Therefore, endoscopic stent placement might be a preferable option for the palliative treatment of patients with obstructive colorectal cancer.
APACHE ; Colorectal Neoplasms* ; Colostomy* ; Health Care Costs ; Humans ; Length of Stay ; Meals ; Palliative Care* ; Stents*

Vitamin K1 dermatitis is a cutaneous adverse reaction to vitamin K1, and this malady presents as an erythematous eczematoid patch or pseudoscleroderma. At first, liver disease was thought to be related to vitamin K1 dermatitis. However, it is no longer considered as being related to liver disease due to the increasing case reports of patients with vitamin K1 dermatitis and who are without liver disease. Type IV hypersensitivity reaction was suspected to be the cause of this reaction. This disease can be easily ignored because of its low incidence. We hereby report on a case of vitamin K1 dermatitis that was confirmed by a skin test.
Dermatitis ; Humans ; Hypersensitivity, Delayed ; Incidence ; Liver Diseases ; Skin Tests ; Vitamin K 1 ; Vitamins

Congenital laryngeal cleft is a rare anomaly, which can cause serious problems of airway and repeated aspiration pneumonia. It is due m failure of fusion of the posterior cricoid cartilage lamina. Dysphagia with aspiration of food is commonly seen w1h resultant bouts of pneumonia. Detection of an unsuspected minor cleft may be difficult, but the pediatrician should suspect the possibility of deft from the clinical features. This paper includes. a detailed case report of one patient with congenital laryngeal cleft and the review of literatures.
Cricoid Cartilage ; Deglutition Disorders ; Humans ; Pneumonia ; Pneumonia, Aspiration

Sclerotic fibroma is a rare skin neoplasm that can occur seen sporadically or in association with Cowden's disease. Clinically, it presents as asymptomatic flesh-colored or pinkish slow-growing papules or nodules with a wide anatomical distribution. We report a rare case of pedunculated type of sclerotic fibroma resembling soft fibroma, which has not been reported in Korea.
Fibroma ; Hamartoma Syndrome, Multiple ; Korea ; Skin Neoplasms

PURPOSE:Acute gastroenteritis is one of the causes of febrile seizures or benign seizures in children. This study was performed to find out the clinical characteristics and the prognosis of convulsions by acute gastroenteritis. METHODS:From January 2000 to December 2004, sixty five pediatric patients who suffered from convulsions due to acute gastroenteritis were classified into benign seizures (n=36) or febrile seizures(n=29) in Wonju Christian Hospital, Wonju College of Medicine, Yonsei University. We compared the age of onset, sex, the frequency and the duration of convulsions, blood electrolytes and peripheral white blood cell counts, findings of the cerebrospinal fluid examination, and the electroencephalograms between the two groups. In addition, we retrospectively analyzed their recurrence of convulsive diseases for 7 to 59 months after the first attacks. RESULTS:There was no difference of onset age, frequency and duration of convulsion between the two groups(P=0.12, P=0.83 and P=0.08). The types of convulsions were generalized seizures in both groups. There were 16 cases of positive responses to the antigen tests for stool rotavirus, and 12 of them(75%) belonged to the benign seizure group. And other laboratory findings were normal. During the follow-up period, 4 patients(11.1%) in the benign seizure group experienced febrile seizures, 2 patients(5.6%) benign seizures and 1 patient a generalized tonic-clonic seizure, whereas 3 patients(10.3%) in the febrile seizure group experienced simple febrile seizures. CONCLUSION:The comparative analysis between the benign seizure and the febrile seizure groups revealed no significant differences on the clinical characteristics except the number of positive responses to the rotavirus antigen tests in stool. And the recurrence rates of convulsions in both groups were similar with previous studies which showed no significant differences between the two groups.
Age of Onset ; Cerebrospinal Fluid ; Child ; Electroencephalography ; Electrolytes ; Follow-Up Studies ; Gangwon-do ; Gastroenteritis* ; Humans ; Leukocyte Count ; Prognosis ; Recurrence ; Retrospective Studies ; Rotavirus ; Seizures* ; Seizures, Febrile

Ehlers-Danlos syndrome type IV (EDS IV) is a hereditary disorder of the connective tissue, characterized by easy bruising, thin skin with visible veins, and spontaneous rupture of the large arteries, uterus, or bowel. EDS IV is caused by mutations of the gene for type III procollagen (COL3A1), resulting in insufficient collagen production or a defect in the structure of collagen. EDS IV can have fatal complications such as the rupture of great vessels or organs, which can cause hemorrhaging and sudden unexpected death. Here, we report a case of a 43-year-old female who collapsed after a struggle with a neighbor. In this patient, the bifurcation of the bilateral common iliac artery ruptured, with no evidence of trauma, inflammation, or atherosclerosis. Genetic analysis of COL3A1 showed the presence of a c.2771G>A (p.Gly924Arg) mutation, which may be associated with EDS IV. The forensic pathologist should consider the possibility that the spontaneous visceral or arterial rupture was caused by EDS IV. Genetic analysis is not currently a routine procedure during autopsy. However, in this case, we suggest that the patient possibly had an underlying EDS IV condition, and we recommended family members of the deceased to seek genetic analysis and counseling.
Adult ; Aortic Rupture* ; Arteries ; Atherosclerosis ; Autopsy ; Collagen ; Collagen Type III ; Connective Tissue ; Counseling ; Ehlers-Danlos Syndrome* ; Female ; Humans ; Iliac Artery ; Inflammation ; Rupture ; Rupture, Spontaneous ; Skin ; Uterus ; Veins

PURPOSE: Vascular smooth muscle cells (VSMCs) migration and proliferation are important for neointimal formation after arterial injury. Migration of VSMCs requires degradation of basement membrane and extracelluar matrix surrounding the cell, and there is increasing evidence that VSMCs produce extracelluar matrix-degradating proteinases, such as matrix metalloproteinases (MMPs) after arterial injury. To assess the role of MMPs in VSMCs proliferation, migration and intimal thickening, we measured the expression of MMP-2 and MMP-9 in the balloon-injured rat aorta model. METHOD: Twenty-five male Sprague-Dawley rats weighting of 250~300 gm were underwent aortic intimal denudation with 2F balloon catheter. Aorta was harvested at various time intervals of 1, 3, 5, 7, 21 days and then analyzed the MMP expression used by gelatin zymography. Intimal hyperplasia caused by balloon injury was confirmed by microscopic examination. RESULT: MMP-2 (72 kD) was constitutively expressed in the normal aorta and was not increased substantially after injury. But the expression of 62 kd forms, which is activated form of MMP-2, was significantly increased during the period of 5 through 7 days after injury (P<0.05). The expression of MMP-9 (92 kD) was significantly increased at 1st day after injury and diminished thereafter (P<0.05). CONCLUSION: These results suggest that activated MMP-2 (62 kD) and MMP-9 (92 kD) may play an important role in VSMCs migration and formation of intimal hyperplasia after arterial injury. And the activated form of MMP-2 (62 kD) seems to be involved mainly in degradation of basement membrane and matrix.
Animals ; Aorta* ; Basement Membrane ; Catheters ; Gelatin ; Humans ; Hyperplasia* ; Male ; Matrix Metalloproteinases* ; Muscle, Smooth, Vascular ; Peptide Hydrolases ; Rats* ; Rats, Sprague-Dawley