Intussusception is rare in adult and usually caused by organic lesions, although there is a singnificant numbeof so-called idiopathic cases. The diagnosis of intussusception have been made by pali abdomen, barium enema andsmall bowel series. But recently ultrasound and CT make a contribution to diagnose intussusception. CT is not theprimary means for evaluation a gastrointestinal tract abnormality but also provides yaluable informations inevaluating disorders affecting the hollow viscera of the alimentary tract. CT image of intussusception demonstratea whirl like pattern of bowel loops separated by fatty stripe correlating to the intestinal walls. Abdominal ultrasonogram was used as the initial diagnostic test in 2 cases out of total 4 cases, with abdominal mass ofunknown cause. It revealed a typical pattern, composed of a round or oval mass with central dense echoes andperipheral poor echoes. We report 4 all cases of intussusception in adult who were performed by CT and/orultrasound. All cases were correlated with barium enema examination and/or surgical reports.
Abdomen ; Adult ; Barium ; Diagnosis ; Diagnostic Tests, Routine ; Enema ; Gastrointestinal Tract ; Humans ; Intussusception ; Ultrasonography ; Viscera

BACKGROUND/AIMS: This study was conducted to examine the relationship between family history of type 2 diabetes (T2DM) and risk of developing gestational diabetes mellitus (GDM) in Korean women. METHODS: We performed a 100-g oral glucose tolerance test in 858 pregnant women who had abnormal glucose tolerance in 50-g oral glucose challenge. In addition, we reviewed the incidence of T2DM in the parents and siblings and analyzed the association between the familial history of T2DM and the risk of GDM. RESULTS: Of the 858 subjects, 427 were normal, and 431 were diagnosed with GDM. Compared with women with no family history of T2DM, women with first degree family history of T2DM displayed higher risk of T2DM (odd ratio: parent only 1.91, sibling only 6.24, any 2.27). CONCLUSIONS: The risk of developing GDM was significantly increased in Korean women with a family history of T2DM in first-degree relatives.
Adult ; Cluster Analysis ; Diabetes Mellitus, Type 2/*genetics ; Diabetes, Gestational/diagnosis/*genetics ; Female ; Genetic Predisposition to Disease ; Glucose Tolerance Test ; Humans ; Korea ; Male ; Parents ; Pregnancy ; Risk Factors ; Siblings

BACKGROUND: Preoxygenation is a standard anesthetic technique using 100% oxygen for the prevention of hypoxia during the induction of anesthesia. Measuring end-tidal oxygen is the most useful indicator for determining the end-point of preoxygenation. We studied the effects of preoxygenation between pregnant and non-pregnant patients during 5 min of tidal volume breathing. METHODS: Non-pregnant women who were scheduled for general surgery (Group I, n = 25) and pregnant women who were scheduled for elective cesarean section (Group II, n = 20) were explained the technique of preoxygenation, which was conducted with 100% oxygen during 5 min of tidal volume breathing. End-tidal oxygen concentration was measured at 10 sec intervals for 5 min, simultaneously. RESULTS: Group II showed significantly higher end-tidal oxygen concentration than Group I from 30 sec to 170 sec during preoxygenation (P < 0.05). The mean time required for end-tidal oxygen concentration > or =90% was 110.0 +/- 31.7 sec for Group II and 152.8 +/- 34.5 sec for Group I. Therefore, Group II showed a significantly shorter time than Group I (P < 0.05). CONCLUSIONS: We concluded that the time for complete preoxygenation was shorter in pregnant patients compared to non-pregnant patients.
Anesthesia ; Anoxia ; Cesarean Section ; Female ; Humans ; Oxygen ; Pregnancy ; Pregnant Women ; Respiration ; Tidal Volume

GTP-Binding Proteins ; Receptors, Thyrotropin-Releasing Hormone ; Thyrotropin-Releasing Hormone*

OBJECTIVE: The aim of the present study was to evaluate changes of vascular endothelial growth factor levels in maternal circulating blood during normal pregnancies and examine their relationship with maternal platelet counts. METHODS: The 33 subjects were selected from healthy normotensive women from the antenatal clinic at Korea University Medical Center, Guro Hospital. Blood samples for VEGF were taken at 7 to 8 weeks' gestation, 16 to 18 weeks' gestation, 24 to 26 weeks' gestation, 30 to 32 weeks' gestation, 37 to 41 weeks' gestation. Serum and plasma were extracted from all samples, and VEGF concentrations were measured in duplicates by competitive enzyme immunoassay. The 23 of them, the platelet counts were performed with an automated blood Coulter counter. RESULTS: Serum VEGF levels during normal pregnancies were mean 6.73 ng/mL at 7-8 weeks' gestation, 7.88 ng/mL at 16-18 weeks' gestation, 7.18 ng/mL at 24-26 weeks' gestation, 8.42 ng/mL at 30-32 weeks' gestation, 14.03 ng/mL at 37-41 weeks' gestation. Plasma VEGF levels were mean 5.50 ng/ mL at 7-8 weeks' gestation, 7.23 ng/mL at 16-18 weeks' gestation, 7.98 ng/mL at 24-26 weeks' gestation, 7.35 ng/mL at 30-32 weeks' gestation, 14.05 ng/mL at 37-41 weeks' gestation. The trends in the mean VEGF levels were similar between serum and plasma, with stable levels until 30 to 32 weeks' gestation, and then the levels were increased. There was no significant difference between serum VEGF levels and plasma VEGF levels (p=0.236) and no correlation between circulating VEGF levels and platelet counts. CONCLUSION: Our data suggests that platelets may not be the origin of elevated VEGF levels in normal pregnancies because there was no correlation between VEGF levels and platelet counts.
Academic Medical Centers ; Blood Platelets* ; Female ; Humans ; Immunoenzyme Techniques ; Korea ; Plasma ; Platelet Count* ; Pregnancy* ; Vascular Endothelial Growth Factor A*

PURPOSE: To assess the value of preoperative ultrasonography (US) - guided skin marking for the investigation of cervical lymph node (LNs) metastasis in papillary cancer patients who had not undergone evaluation of cervical LNs at the initial diagnosis. METHODS: We evaluated cervical lymph nodes in 40 patients with papillary thyroid cancer. Ultrasonography wasperformed just prior to surgery. The shape, echogenicity, size, and location of lymph nodes were noted and the location of lymph nodes was marked on the skin surface with a pen under ultrasound guidance. The retrieved lymph nodes underwent intraoperative frozen section analysis to plan the extent of surgery. RESULTS: One hundred thirty two LNs were detected on preoperative US, 1087 LNs were surgically removed. Of 40 patients, 28 patients had lymph node metastasis. The cystic appearance, the presence of calcifications, hyperechogenicity and the absence of an echogenic hilum were significantly greater in malignant LNs than in benign LNs (P< 0.001). Among these, the cystic appearance and the presence of calcifications showed a very high specificity and seemed to be the most reliable in indicating malignant LNs. CONCLUSION: In papillary thyroid cancer patients, preoperatively ultrasound-guided localization of cervical LNs with skin marking shows good potential to determine surgical extent. Ultrasound features of LNs help in the selection of the node to remove with intraoperative frozen section analysis.
Diagnosis ; Frozen Sections ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Sensitivity and Specificity ; Skin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Ultrasonography

PURPOSE: Tamoxifen has been prescribed as a very effective hormonal agent not only for the treatment of breast cancer, but also for the prevention of the disease. The development of resistance to tamoxifen is one of the most important obstacles to hormonal therapy of breast cancer. HER2 or EGFR expression has been reported to be associated with the development of tamoxifen resistance. This study was performed to evaluate the effect of HER2 and EGFR inhibition on tamoxifen resistance using tamoxifen-resistant breast cancer cells (T47D:A18/4-OHT cells). METHODS: Tamoxifen-resistant T47D:A18/4-OHT cells were established by long-term treatment of 1micrometer 4-hydroxytamoxifen on T47D:A18 human breast cancer cells. The effect of HER2 and EGFR inhibition was investigated by the use of a cell proliferation assay with treatment of trastuzumab, a monoclonal antibody to the extracellular domain of the human HER2 receptor, and ZD1839, an ERFR tyrosine kinase inhibitor. RESULTS: In contrast to T47D:A18 cells, T47D:A18/4-OHT cells showed estrogen-independent proliferation and partial regulation by treatment with tamoxifen. With a single treatment of trastuzumab or ZD1839, T47D:A18/4-OHT cell growth was reduced to 77.8% (P=0.15) or 74.4% (P=0.034) respectively, as compared to untreated cells. Combinational treatment with 1 nM estradiol resulted in a further reduction of T47D:A17 cell proliferation by 83.6% (P=0.002) for trastuzumab and 77.7% (P=0.047) for ZD1839, as compared to the single treatments. CONCLUSION: Tamoxifen resistance could be partially regulated by inhibition of HER2 or EGFR in T47D:A18/4-OHT cells, especially in combination with a low dose of estradiol. This effect may provide an important clue to overcome tamoxifen resistance in the treatment of breast cancer.
Antibodies, Monoclonal, Humanized ; Breast ; Breast Neoplasms ; Cell Proliferation ; Estradiol ; Humans ; Protein-Tyrosine Kinases ; Quinazolines ; Tamoxifen ; Trastuzumab

It is well known that the amplification of the HER2 gene is closely associated with poor prognosis of breast cancer. However, there is controversy about the clinical significance of HER2 according to lymph node status in breast cancer. The aim of this study was to identify the differences in the prognostic significance of HER2 gene amplification according to the stages of breast cancer. We prepared a tissue array for fluorescence in situ hybridization (FISH) with breast cancer specimens from the surgery in 1994 to 1999. Total 338 cases of breast cancer were enrolled and the median follow-up period was 6.3 yr. The detection rates of HER2 gene amplification were as follows: 10.3% in stage I, 22.3% in stage II, and 43.8% in stage III. On survival analyses HER2-positive groups showed worse prognosis in stage III of breast cancer, but not in stage I or II. Multivariate analyses with a Cox-regression model also revealed that HER2 amplification was an independent prognostic factor only in stage III breast cancer. Regarding HER2 gene amplification as a prognostic factor of breast cancer, the clinical significance of the gene was found to be confined to advanced breast cancer.
Adult ; Aged ; Breast Neoplasms/*genetics/mortality/*pathology ; Disease Progression ; Female ; Follow-Up Studies ; Gene Amplification ; Genes, erbB-2/*genetics ; Humans ; *In Situ Hybridization, Fluorescence ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Tumor Markers, Biological/genetics

PURPOSE: HER2 is a 185-kDa transmembrane protein, which shares a considerable homology with the epidermal growth factor receptor. The over-expression of HER2 has been reported to be associated with a poor clinical outcome in breast cancer. In clinical practice and research studies, immunohistochemistry (IHC) and fluorescence in-situ hybridization (FISH) have commonly been used for the detection of HER2. The aim of this study was to evaluate the prognostic significance of HER2 according to the results of IHC and FISH for HER2. METHODS: IHC and FISH were performed on the same breast cancer specimens from 388 Korean patients, with a mean follow-up duration of 59.8 months, with survival analyses were made according to the results of the HER2 detection methods; A0485 Ab (DAKO, Denmark) and the HER2 test kit (DAKO HerceptTest(TM), Denmark) for IHC, and the HER2 FISH kit (Vysis Inc., Downers Grove, Ill) for FISH were used. RESULTS: The IHC showed HER2 over-expression rates of 34.8% and 26.8% by the A0485 antibody and HercepTest, respectively. The rate of HER2 amplification by FISH in the same specimen was 25.8%. HER2 was confirmed as an independent prognostic factor by multivariate analyses regardless of the detection methods. In the survival analyses, according to the IHC results for HER2, only the 3+ scoring group in the positive results was associated with a poor survival. However, the positive group in the FISH test revealed a significantly worse survival than the FISH-negative group. CONCLUSION: For the prediction of survival of patients with breast cancer, the FISH test would be more useful than IHC, especially in the 2+ scoring IHC cases.
Breast Neoplasms* ; Breast* ; Fluorescence ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Prognosis ; Receptor, Epidermal Growth Factor ; Survival Analysis*

PURPOSE: HER2 is a 185-kDa transmembrane protein, which shares a considerable homology with the epidermal growth factor receptor. The over-expression of HER2 has been reported to be associated with a poor clinical outcome in breast cancer. In clinical practice and research studies, immunohistochemistry (IHC) and fluorescence in-situ hybridization (FISH) have commonly been used for the detection of HER2. The aim of this study was to evaluate the prognostic significance of HER2 according to the results of IHC and FISH for HER2. METHODS: IHC and FISH were performed on the same breast cancer specimens from 388 Korean patients, with a mean follow-up duration of 59.8 months, with survival analyses were made according to the results of the HER2 detection methods; A0485 Ab (DAKO, Denmark) and the HER2 test kit (DAKO HerceptTest(TM), Denmark) for IHC, and the HER2 FISH kit (Vysis Inc., Downers Grove, Ill) for FISH were used. RESULTS: The IHC showed HER2 over-expression rates of 34.8% and 26.8% by the A0485 antibody and HercepTest, respectively. The rate of HER2 amplification by FISH in the same specimen was 25.8%. HER2 was confirmed as an independent prognostic factor by multivariate analyses regardless of the detection methods. In the survival analyses, according to the IHC results for HER2, only the 3+ scoring group in the positive results was associated with a poor survival. However, the positive group in the FISH test revealed a significantly worse survival than the FISH-negative group. CONCLUSION: For the prediction of survival of patients with breast cancer, the FISH test would be more useful than IHC, especially in the 2+ scoring IHC cases.
Breast Neoplasms* ; Breast* ; Fluorescence ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Prognosis ; Receptor, Epidermal Growth Factor ; Survival Analysis*