Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

Syphilitic granulomatous pancreatitis is an extremely rare condition,and can occur in the generalized acquired syphilitic patient in tertiary or secondary phase. The most serious problem with granulomatous pancreatic lesion is clinical or radiological misdiagnosis as cancer. We experienced a case of syphilitic granulomatous pancreatitis arising in 54 year old female patient. She was treated for syphilis 20years ago. But she and her husband are still strong positive to VDRL and TPHA. On abdominal computed tomography and endoscopic pancreatico- duodenography, there was an obstructive mass of low density in the distal common bile duct or pancreatic head. Under the preoperative diagnosis of pancreatic head carcinoma, Whipple's operation was done. On gross examination, the pancreas was fibrotic, and the common bile duct was well preserved without tumor mass. Microscopically, numerous intralobular noncaseating epithelioid cell granulomas with multinucleated giant cells are identified. They surround thick-walled, small to medium sized arteries and involve vascular wall with luminal narrowing or obliteration, which are characteristic findings of the syphilitic granuloma. The remaining parenchyme shows fibrosis, acinar atrophy or destruction with dense infiltration of lymphohistiocytes, plasma cells with granuloma formation. Although the Warthin-Starry stain reveals no spirochetes, the serologic result and pathologic findings are compatible with syphilitic granulomatous pancreatitis.
Female ; Humans

No abstract available.
Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Kidney Transplantation*

No abstract available.
Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Kidney Transplantation*

BACKGROUND: This study was performed to examine the relationship between alcohol consumption and obesity according to facial flushing in Korean males. METHODS: The 1,198 men in this study were divided into four groups according to the amount of alcohol they consumed: non-drinkers (ND), lower moderate drinkers (LM, < or =7 standard drinks per week), higher moderate drinkers (HM, 7 to 14 drinks per week), and heavy drinkers (HD, >14 drinks per week). They were also separated into two groups according to facial flushing: non-flushers and flushers. Obesity and abdominal obesity were defined as body mass index of 25 kg/m2 or higher and waist circumference of 90 cm or higher, respectively. RESULTS: In LM and HM groups without flushing, the risks of obesity and abdominal obesity were not significantly increased compared to those of non-drinkers. However, in the HD group without flushing, those risks were significantly increased [OR, 1.55; confidence interval (CI), 1.01 to 2.40, and OR 1.63; CI 1.02 to 2.58, respectively]. In the LM group with flushing, those risks were not significantly increased. However, in HM and HD groups with flushing, the risks of obesity and abdominal obesity were significantly increased (OR, 2.10; CI, 1.07 to 4.16, and OR, 2.06; CI, 1.05 to 4.06, respectively, in HM; and OR, 2.16; CI, 1.08 to 4.34, and OR, 2.50; CI, 1.26 to 4.98, respectively, in HD). CONCLUSION: This study suggests that the risk of obesity is increased in moderate flushing drinkers compared to non-drinkers and in heavy non-flushing drinkers.
Alcohol Drinking ; Body Mass Index ; Flushing ; Humans ; Male ; Obesity ; Obesity, Abdominal ; Waist Circumference

Pulmonary arterial hypertension is a critical manifestation of systemic sclerosis (SSc) and is a main cause of death. Several treatment modalities for SSc have been identified, with effects that improve quality of life and mortality rates. However, whether these drugs can also normalize pulmonary arterial pressure, remains unclear. Here, we report the case of a woman with diffuse SSc with pulmonary arterial hypertension, who had a functional status equivalent to the New York Heart Association class III. The patient was treated with inhaled iloprost. After six years of inhaled iloprost therapy, echocardiography showed that pulmonary arterial pressure normalized, accompanied by improvement in functional capacity. Inhaled iloprost might not only normalize pulmonary arterial pressure, but also improve the functional status of patients with SSc with pulmonary arterial hypertension.
Arterial Pressure ; Cause of Death ; Echocardiography ; Female ; Heart ; Humans ; Hypertension* ; Hypertension, Pulmonary ; Iloprost* ; Mortality ; Quality of Life ; Scleroderma, Systemic*

Recent studies have suggested a close association between prenatal maternal distress and allergic diseases in the offspring. We selected relevant birth-cohort or national registry studies using a keyword search of the PubMed database and summarized current evidence on the impact of prenatal maternal distress on the development of offspring's allergic diseases. Moreover, we postulated possible pathways linking prenatal distress and allergic diseases based on relevant human and animal studies. Both dysregulated hypothalamic-pituitary-adrenal axis and increased oxidative stress may cause structural (altered brain/lung development) and functional (skewed immune development) changes, which may predispose the fetus to developing allergic diseases during childhood. Although many facts are yet to be discovered, changes in the placental response and epigenetic modification are presumed to mediate the whole process from maternal distress to allergic diseases. Maternal prenatal distress can also interact with other physical or environmental factors, including familial or physical factors, indoor and outdoor pollutants, and early childhood psychological distress. The gut-microbiome-brain axis and the role of the microbiome as an immune modulator should be considered when investigating the stress-allergy relationship and exploring potential intervention modalities. Further research is needed, and particular attention should be given to defining the most vulnerable subjects and critical time periods. To this end, studies exploring relevant biomarkers are warranted, which can enable us to explore adequate intervention strategies.
Animals ; Asthma ; Biomarkers ; Epigenomics ; Fetus ; Humans ; Microbiota ; Oxidative Stress ; Placenta

Recent studies have provided some clues with regard to the relationship existing between uncoupling protein 1 (UCP1) and blood pressure in animal experiments. In an attempt to determine the genetic polymorphisms that are associated with blood pressure in humans, we have analyzed genetic polymorphisms in UCP1 gene. In this study, we assessed the association between UCP1 genotypes and systolic blood pressure (SBP) and diastolic blood pressure (DBP), in a population comprised of 832 Korean female subjects, using a general linear model, which was adjusted for age and body mass index (BMI). Among 4 genetic polymorphisms and the haplotypes constructed from them, haplotype3 of UCP1, UCP1-ht3[GAGA], evidenced significant associations with SBP (p=0.005) and DBP (p=0.013). However, this haplotype was not significantly associated with obesity phenotypes, including BMI or fat mass (p>0.05), thereby suggesting that its association with blood pressure was independent of obesity phenotypes.
Adult ; Alleles ; Blood Pressure ; Body Mass Index ; Female ; Genotype ; Haplotypes ; Humans ; Ion Channels/*genetics ; Korea ; Mitochondrial Proteins/*genetics ; Models, Genetic ; Obesity/genetics ; Phenotype ; *Polymorphism, Genetic

Acute gastric anisakiasis is occurred when men intake a raw or inadequate cooked anisakis infected fish. The clinical symptoms are severe cramping abdominal pain, nausea, vomiting, and epigastric fulling sensation. It is well known that the whale is final host and man is opportunistic host. Recently, we experienced three cases of acute gastric anisakiasis. We think that acute gastric anisakiasis is probably rather undetected than rare disease. So through immediate gastrofiberscopy of patients with severe cramping epigstric pain occuring after ingestion of raw fish,we can find more cases of the anisakis larvae. In is adequate to abstract of larvae by biopsy forceps through gastrofiberscopy.
Abdominal Pain ; Anisakiasis ; Anisakis* ; Biopsy ; Eating ; Humans ; Larva ; Male ; Muscle Cramp ; Nausea ; Rare Diseases ; Sensation ; Surgical Instruments ; Vomiting ; Whales

We report a case of reticulum cell sarcoma in the right cervical lymph node of a 42-year-old male. It was a slowly growing, non-tender movable mass of 8 months duration. Microscopically, the lymph node was effaced by proliferating spindle cells arranged in broad sheets, bands, or fascicular patterns in paracortical area sparing of B-cell region. The tumor component was divided by fibrous band. The individual cells had oval to round or elongated nuclei, with inconspicuous nucleoli and moderate amounts of cytoplasms with indistinct cell borders. Pleomorphic large cells with binucleated, or multinucleated bizarre nuclei with prominent nucleoli, were partly admixed. In immunohistochemical stain, the tumor cell was strong positive for S-100 protein, HLA-DR, Mac387 and weakly positive for Leukocyte common antigen and equivocal for Vimentin. But it was negative for CD21, Ki-1, Desmin, Epithelial membrane antigen and Cytokeratin. These immunohistochemical findings suggested that the neoplastic cell was originated from the interdigitating reticulum cell of lymph node. The patient was treated by radiation therapy, and alive well at 37 months of follow-up.