No abstract available.
Porphyria, Acute Intermittent* ; Pregnancy*

OBJECTIVE: Vascular Endothelial Growth Factor (VEGF) is a potent stimulator of angiogenesis in solid tumors. Thrombospondin-1 (TSP-1) has inhibitory role in cancer cell proliferation and metastasis. To analyze the correlation with expression of VEGF and TSP-1 including microvessel density (MVD), the levels of VEGF/TSP-1 mRNA expression and microvessel count (MVC) were estimated in patients with invasive cervical carcinomas. METHODS: From 1996 to 1999, 37 carcinomas and 7 normal cervical tissues were collected, frozen and stored at -70 degrees C until used. The levels of VEGF and TSP-1 mRNAs were determined by quantitative RT-PCR. MVD was assessed by immunostaining for factor VIII-related antigen. The results are expressed as the largest number of microvessels present within a single x 40 field, and counted at x 100 field. RESULTS: Quantitative RT-PCR analysis demonstrated abnormally increased VEGF mRNA expression levels (>0.66) in 14 (37.8%) of 37 cervical carcinomas comparing to control groups (mean: 0.32+/-0.09) and abnormally low TSP-1 mRNA expression levels (<0.72) in 13 (35.1%) of 37 cervical carcinomas comparing to control groups (mean: 0.51+/-0.07). MVC was higher in tumors showing decreased expression of TSP-1 (but not statistically) (p<0.18) and overexpression of VEGF (p<0.05). When VEGF overexpression was accompanied with reduced TSP-1 expression, the microvessel density showed significantly increased pattern (p<0.05). CONCLUSION: Our study demonstrates that reduced expression of TSP-1 mRNAs and overexpression of VEGF mRNAs may be an important contributing factor in cervical carcinomas. Moreover, the inversed correlation of VEGF and TSP-1 mRNA expression can be an evidence of angiogenic role in cervical carcinomas.
Cell Proliferation ; Humans ; Microvessels* ; Neoplasm Metastasis ; RNA, Messenger* ; Thrombospondin 1 ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A* ; von Willebrand Factor

OBJECTIVE: The fragile histidine triad (FHIT) gene is located at chromosome 3p14.2 and encompasses the common fragile site, FRA3B, which may contribute to chromosome breakage and rearrangement of cancer cells. In this study, we examined whether transcriptional alterations of FHIT gene play a role in the development of human cervical carcinomas and the possibility that hypermethylation of CpG islands serves for FHIT inactivation. We then analyzed FHIT expression status with clinical parameters to determine whether it has any prognostic significance. METHODS: The study group included 50 squamous carcinomas, 4 adenocarcinomas, 4 adenosquamous carcinomas, 7 noncancerous tissue and the clinical stage is composed of 4 Ia, 37 Ib and 17 II. Tissue specimens were snap-frozen in liquid N2 and stored at -70degrees C until used. To examine for abnormal transcripts of the FHIT gene, quantitative RT-PCR, genomic DNA-PCR and nonisotopic RT-PCR-SSCP analysis were performed using the standard method. The methylation status was determined by methylation specific PCR. RESULTS: The FHIT gene was down-regulated in 15 of 58 (25.9%) cervical carcinomas. FHIT promoter hypermethylation was detected in 15 of 15 (100%) abnormally expression in cervical carcinomas. CONCLUSION: In this study, gene mutation is not a main mechanism for FHIT inactivation, but the aberrant promoter hypermethylation may be correlated with decreased expression of the FHIT gene. The significance of decreased expression of FHIT does not appear to be an independent prognostic factor in cervical cancers, although a still larger sample of patients will be required to asses this issue definitively.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Chromosome Breakage ; CpG Islands ; Equidae ; Histidine* ; Humans ; Methylation ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

PURPOSE: We aimed to describe the clinical features of late-onset circulatory collapse (LCC) in preterm infants. METHODS: The records of preterm infants with a gestational age of <33 weeks who were admitted to a single neonatal intensive care unit and survived more than 72 hrs between March 2006 and August 2012 were reviewed retrospectively. RESULTS: Of the total of 659 patients, 44 (6.7%) were diagnosed with LCC. Their mean gestational age was 26.0+/-1.9 weeks and their median birth weight 830 g. The median time of onset of LCC was 16.5 postnatal days. The patients exhibited oliguria that responded to hydrocortisone but not to hydration or catecholamines. Other clinical features of LCC were hypotension (73%), hyponatremia (52%), and hyperkalemia (34%). These abnormalities resolved in sequence: oliguria resolved first, after a median of 2.2 hrs, followed by hypotension after a median of 3.0 hrs, and the serum Na level became normal after 12.9 hrs. The incidence of LCC increased as the gestational age and/or birth weight decreased. A total of 26 patients (59%) developed LCC within 2 weeks after the initiation of levothyroxine therapy. CONCLUSION: LCC in preterm infants was a relatively reversible condition but could be associated with severe morbidity. We therefore recommend the implementation of careful measures for early detection and prompt management of LCC, particularly after stressful events.
Adrenal Insufficiency ; Birth Weight ; Catecholamines ; Gestational Age ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyponatremia ; Hypotension ; Incidence ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Life Change Events ; Oliguria ; Retrospective Studies ; Shock* ; Thyroxine

OBJECTIVE: To test whether the impact of thyroid-nodule size on the malignancy risk differs according to the ultrasonography (US) patterns of nodules. MATERIALS AND METHODS: This study is a post hoc analysis using data from the Thyroid Imaging Reporting and Data System (TIRADS) multicenter retrospective study which included 2000 consecutive thyroid nodules (≥ 1 cm) with final diagnoses. A total of 2000 consecutive thyroid nodules from 1802 patients (1387 women and 613 men; mean age, 51.2 ± 12.2 years) were enrolled in this study. The malignancy risk of the nodules was assessed according to the nodule size and US patterns (Korean-TIRADS). RESULTS: Overall, the malignancy risk did not increase as nodules enlarged. In high-suspicion nodules, the malignancy rate had no association with nodule size (p = 0.467), whereas in intermediate- or low-suspicion nodules there was a trend toward an increasing malignancy risk as the nodule size increased (p = 0.004 and 0.002, respectively). The malignancy rate of large nodules (≥ 3 cm) was higher than that of small nodules (< 3 cm) in intermediate-suspicion nodules (40.3% vs. 22.6%, respectively; p = 0.001) and low-suspicion nodules (11.3% vs. 7.0%, respectively; p = 0.035). There was a trend toward a decreasing risk and proportion of papillary carcinoma and an increasing risk and proportion of follicular carcinoma or other malignant tumors as nodule size increased (p < 0.001, respectively). CONCLUSION: The impact of nodule size on the malignancy risk differed according to the US pattern. A large nodule size (≥ 3 cm) showed a higher malignancy risk than smaller nodules in intermediate- and low-suspicion nodules.
Carcinoma, Papillary ; Diagnosis ; Female ; Humans ; Information Systems ; Male ; Retrospective Studies ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography*

Purpose: There has been a lack of study on the pains of Korean archers, who have been getting remarkable results in international competitions. In this study, we investigated the epidemiology of shoulder pain, which is known as the most commonly complained symptom of Korean archers. Methods: The participants were 58 elite archers in the city of Gwangju, South Korea. The method of the study was a retrospective cohort study by questionnaire and ultrasound and physical examination. Variables of individual characteristics, training patterns, the character of pain were analyzed in different age groups. Furthermore, groups were divided into those with shoulder pain and those without pain to analyze each group’s shoulder function. Results: The most common injury was shoulder injury (65.6%), and hand injury was the second-highest prevalent injury (29.3%). These two injuries were most prevalent in all age groups. Among 58 participants, 40 showed shoulder pain, but most were mild (n=30, 51.7%) and severe pain was observed in some participants (n=2, 3.5%). Mild pain was most common in each group and it showed the highest prevalence in college students (70.0%). Pain was most observed in the drawing arm, and it was triggered most when drawing the bow. In the shoulder function test category, Constant-Murley score and American Shoulder and Elbow Surgeons score were observed the lowest in the group with shoulder pain with statistical significance. Conclusion Shoulder injury had a high prevalence in Korean archers. Correspondingly, those with shoulder pain had lower shoulder function test scores.

Alagille syndrome is characterized by chronic cholestasis, posterior embryotoxon, skeletal abnormalities, cardiovascular abnormalities, and a typical face with prominent forehead and pointed chin. Its histological feature includes paucity of interlobular bile ducts. We experienced a 49-day-old female infant presenting with frequent upper respiratory tract infection and persistent jaundice. She had a typical face and chronic cholestasis. Echocardiograms revealed peripheral pulmonary stenosis. The histological examination of liver revealed paucity of interlobular bile ducts.
Alagille Syndrome* ; Cardiovascular Abnormalities ; Chin ; Cholestasis ; Female ; Forehead ; Humans ; Infant ; Jaundice ; Liver ; Pulmonary Valve Stenosis ; Respiratory Tract Infections

BACKGROUND/AIMS: The rate of laparoscopic appendectomy has been gradually increasing. The following studies were conducted to compare laparoscopic appendectomy (LA) with open appendectomy (OA). METHODS: We compared retrospectively 48 patients in the LA group with 135 patients in the OA group, all of whom were operated at Anam hospital, Korea University, from January 1996 to January 1997. Documentation included information such as age, sex, diagnostic method, postoperative diagnosis, misdiagnosis rate, operative time, conversion to open appendectomy, analgesics injection, hospital stay, and complicatians. RESULTS: 1) The mean age and male to female ratio were 28.5 years and 1: 2.4 in LA group, and 34.1 years and 1: 1.1 in OA group, respectively. 2) An abdominal sonogram was perfomed in 18.8% of the LA group and 28.9% in OA group (p < 0.05). 3) The operative time was 68.4 minutes in the LA group and 53.7 minutes in the OA group (p<0.05). 4) The number of analgesic injections was 1.23 in the LA group and 2.65 in the OA group (p<0.05). 5) The postoperative hospital stay was 3.38 days in the LA group and 3.84 days in the OA group (p > 0.05). 6) The complication rate was 10.9% in the LA group and 15,5% in the OA group (p >0.05), but the wound infection rate was 2.2% in the LA group and 8.5% in the OA group (p<0.05). CONCLUSIONS: LA is a safe and effective operation for acute appendicitis, and is particularly superior to OA in regard to diagnosis, postoperative pain, wound infection, and cosmetic benefits.
Analgesics ; Appendectomy* ; Appendicitis ; Diagnosis ; Diagnostic Errors ; Female ; Humans ; Korea ; Length of Stay ; Male ; Operative Time ; Pain, Postoperative ; Retrospective Studies ; Wound Infection

Adenoid basal carcinoma and adenoid cystic carcinoma of the uterine cervix are rare tumors that have often been regarded as a single entity. But adenoid basal and adenoid cystic carcinomas of the cervix differ from each other in their histology, treatment, and prognosis. We experienced 2 cases of these neoplasms, with 1 case in each category. Whereas adenoid basal carcinoma is a slow-growing, locally invasive lesion amenable to simply hysterectomy, adenoid cystic carcinoma is an aggressive tumor associated with regional lymph node involvement and late distant metastases. This study reviews the literature and formulates a program for the management of these rare lesions.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Cervix Uteri* ; Female ; Hysterectomy ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Sclerosing stromal tumor (SST) was first delineated as a distinct ovarian sex cord stromal tumor in 1973 by Chalvardjian and Scully. It is a benign neoplasm, distinguished from other ovarian stromal tumors by the production of collagen and a pseudolobular pattern, and it tends to occur in the second and third decades of life in diagnosed patients. We discovered two rare cases of SST in post-menopausal women which are the topic of this report. These case studies are accompanied by a brief review of the literature.
Collagen ; Female ; Humans ; Menopause ; Ovarian Neoplasms ; Ovary* ; Sex Cord-Gonadal Stromal Tumors