OBJETIVE: To analyze the antithrombin III deficiency in patients with recurrent spontaneous abortion. MATERIALS AND METHOD: The blood samples were tested by chromogenic assay to evaluate the activity of antithrombin III. RESULTS: There was only one case of antithrombin III deficiency. This patient experienced one neonatal death after delivery and one FDIU (fetal death in utero). And also this patient showed a lupus anticoagulant and the prolongation of PTT. CONCLUSIONS: Women with recurrent miscarriage who have no obvious identified cause should consider hematologic screening. Antithrombin III deficiency could be a cause of recurrent spontaneous abortion. But the incidence is very rare in Korean patients.
Abortion, Habitual ; Abortion, Spontaneous* ; Antithrombin III Deficiency* ; Antithrombin III* ; Female ; Humans ; Incidence ; Lupus Coagulation Inhibitor ; Mass Screening ; Pregnancy

Trachea is lined by a pseudostratified epithelium which usually expresses a complex mixture of stratified as well as simple epithelial-type cytokeratins. In the present work, the cytokeratin expressions was studied immunohistochemically in the tracheal epithelium and gland of human fetus at 14, 26 and 32 weeks of gestation. The primary antibodies used were CK7, 8, 10, 14, 18, AE8, 5D3, MNFl16 and AE3. In PAS-hematoxylin stain, the tracheal eithelium was composed of pseudostratified ciliated columnar type and consisted of surface, intermediate and basal layers regardless of gestational ages. The PAS positive cells, however, were decreased in number in proportion to gestational ages. The tracheal gland was not fully differentiated at 14 weeks of gestation, and had well differentiated secretory portions consisting mucous and serous cells at 26 and 32 weeks of gestation. The mucous cells and luminal border of the duct were positive for PAS stain. The tracheal eithelium showed different immunoreactivity between cartilageous and membranous portions. In general, CK7 and 5D3 were expressed in surface cells, AE8 in intermediate cells, and MNFl16 and AE3 in the cells of all layers. At 14 weeks of gestation, the tracheal epithelium immunoreacted for CK7, AE8, 5D3, MNFl16 and AE3. The premordium of tracheal gland was positive for 5D3, MNFl16 and AE3. The tracheal epithelium at 26 and 32 weeks of gestation showed same staining properties to those at 14 weeks of gestation. The duct cells at 26 weeks of gestation were immunoreactive for CK7, 8, 14, 18, AE8, 5D3, MNFl16 and AE3, and those at 32 weeks of gestation were immunoreactive for CK7, 14, 5D3, MNFl16 and AE3. The acinar cells at 26 and 32 weeks of gestation were positively stained for CK7, 8, 18, 5D3, MNFl16 and AE3. These results suggest that CK7 and 5D3 may serve as useful markers for mature cilated cells, AE8 (CKl3) for immature ciliated cells, and CKl4 for duct cells in tracheal epithelium and gland.
Acinar Cells ; Antibodies ; Epithelium* ; Fetus* ; Gestational Age ; Humans* ; Immunohistochemistry ; Keratins* ; Phenobarbital ; Pregnancy ; Trachea

No abstract available.
Humans

OBJECTIVE: To analyze the interrelationship between homocysteine and methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: Homocysteine and MTHFR mutation were tested by fluorescent polarizing immunoassay and PCR-RFLP method, respectively. RESULTS: In patients with homocysteine level less than 5 mmol/L, there was no case of normal group but there were four cases of heterozygosity and one case of homozygosity. In patients with homocysteine level 5~10 mmol/L, the number of normal, heterozygosity and homozygosity group were eleven, eighteen and eight, respectively. In patients with homocysteine level 10~15 mmol/L, the number of normal, heterozygosity and homozygosity group were four, one and one, respectively. In patients with homocysteine level more than 15 mmol/L, there was no case of normal and heterozygosity group but there were two cases of homozygosity. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. And there was a significant relationship between homocysteine and MTHFR mutation.
Abortion, Spontaneous* ; Female ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

OBJECTIVE: To report the prevalence of lupus anticoagulants and anticardiolipin antibodies in patients with recurrent spontaneous abortion and infertility. MATERIAL AND METHOD: Lupus anticoagulants and anticardiolipin antibodies were analyzed by Diluted Russell's Viper Venom Test (DRVVT) and solid phase enzyme immunoassay, respectively. RESULTS: In 200 patients with infertility, there were 6 cases (3%) with positive lupus anticoagulants or anticardiolipin antibodies. Of these, 3 patients (1.5%) showed positive lupus anticoagulants and anticardiolipin antibodies, respectively. In 120 patients with recurrent spontaneous abortion, there were 13 cases (10.8%) of positive lupus anticoagulants or anticardiolipin antibodies. Of these, one patient (1%) showed lupus anticoagulants and 12 patients (10%) showed anticardiolipin antibodies. But in two groups, there was no cases with positive lupus anticoagulants and anticardiolipin antibodies. CONCLUSION: Lupus anticoagulants and anticardiolipin antibodies are definite cause of recurrent spontaneous abortion. There has been a speculation that they might be associated with infertility and repeated IVF failures. But it was found that the role of lupus anticoagulants and anticardiolipin antibodies in these cases are not clear.
Abortion, Spontaneous* ; Antibodies, Anticardiolipin* ; Anticoagulants* ; Female ; Humans ; Immunoenzyme Techniques ; Infertility* ; Pregnancy ; Prevalence ; Russell's Viper ; Venoms

OBJECTIVE: To evaluate factor XII deficiency in patients with recurrent spontaneous abortion and its relation to aPTT. MATERIAL AND METHOD: Factor XII was analyzed by clotting method. RESULTS: Of 70 patients with recurrent spontaneous abortion, there were 35 cases of factor XII deficiency. Among them, there were only 3 cases of prolonged aPTT. CONCLUSIONS: It is still unclear whether factor XII deficiency is related to recurrent spontaneous abortion. Molecular approaches should be used to understand further the causal relationship. But based on this result, in the workup of patients with recurrent spontaneous abortion, factor XII should be included. aPTT is not likely to represent the abnormality of factor XII.
Abortion, Spontaneous* ; Factor XII Deficiency* ; Factor XII* ; Female ; Humans ; Pregnancy

OBJECTIVE : To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in recurrent spontaneous abortion associated with hyperhomocysteinemia. MATERIAL AND METHOD: The blood Sample of habitual aborter with high fasting homocysteine level was tested by PCR-RFLP method. RESULTS: The patient was found to be a homozygosity for MTHFR gene mutation that was confirmed by the finding which is consistent with the mutation at the nucleotide 677 C to T, Corresponding to Ala to Val. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the MTHFR mutation should be examined in the workup of recurrent spontaneous abortion showing hyperhomocysteinemia.
Abortion, Spontaneous* ; Fasting ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

Inflammatory pseudotumor, originally described in the lung, is a relatively rare tumor-like lesion that occurs in various organs and tissues. It is usually well demarcated from the surrounding tissue, however it can be unfortunately resected as a malignant tumor. A few inflammtory pseudotumor in the kidney have been reported in English literature, but there have been no reports in Korea. We report a case with inflammatory pseudotumor of the kidney. A 48 year old woman had an intermittent flank pain on the right side. An ultrasonographic study suggested a renal cell carcinoma and a nephrectomy was done. Grossly, there were two separate masses with a well demarcated yellowish appearance, measuring 2.3 cm and 1.3 cm in diameter, respectively. Histologically, they were composed of smooth muscle actin positive spindle cells and a large number of foamy histiocytes, lymphocytes, and plasma cells in the fibrotic backgound.
Actins ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Granuloma, Plasma Cell* ; Histiocytes ; Humans ; Kidney* ; Korea ; Lung ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Nephrectomy ; Plasma Cells

PURPOSE: Paranasal sinusitis, easily overlooked owing to it's benign symptomatology, should be considered when the upper respiratory tract infction persists longer than seven days. Without early recognition and appropriate management, the disease will take a chronic course and the incidence of complications will be increased. The significance of paranasal sinusitis among Korean children has not appropriately been appreciated; therefore, a clinical study was under-taken to help understand clinical characteristics of paranasal sinusitis in Korean children. METHODS: One hundred sixty five(34.3%), out of 481 patients with no underlying disease seen at the outpatient division of the department of pediatrics, Hanyang university hospital from April 1992 to August 1993, were diagnosed of maxillary sinusitis and included in the study to investigate age and sex distributions, clinical manifestations, radiographic findings, and response to antibiotics therapy. Five patients followed up for less thant two weeks and 45 patients lost in follow up within 3 weeks were excluded in the evaluation of therapeutic response, which were done on the basis of clinical and radiographical analysis. RESULTS: 1) Maxillary sinusitis occurred frequently in young children; among 165 patients, 129 patients(78.3%) were wunder 5 years of age, with 83 patients(50.4%) younger than 3 years of age. The male to female ratio was 1.4:1. 2) One hundred twently three patients(74.5%) had acute sinusitis, 39 patients(23.7%) subacute sinusitis, and 3 patients(1.8%) chronic sinusitis. The most common clinical symptom was cough in 124 patients(75.2%), followed by nasal discharge in 103 patients(62.4%), nasal obstruction in 76 patients(46.1%), and fever in 49 patients(29.7%). The physical finding most commonly observed was postnasal drip in 35 patients(21.2%), followed by otitis media in 21 patients(12.7%), and throat injection in 19 patients(11.5%); however, physical examination was not contributory in 77 patients(46.7%). 3) Radiographic findings on Water's view illustrated opacification in 98 patients(59.4%), mucoperiosteal thickening in 82 patients(49.7%), and air-fluid level in 4 patients(2.4%). Bi-lateral radiographic involvement was 4 times more common than unilateral one. 4) The patients with maxillary sinusitis were trated with amoxicillin(AMX), trimethoprim-sulfamethoxazole(TMP-SMZ)+/-erythromycin(EM), amoxicillin-clavulanate(AMX-CLV) or cefaclor(CCL) in sequence depending on the therapeutic response to each antibiotics. The therapeutic outcome with each antibiotics was 16.3%(15/92) with AMX, 56.7%(51/90) with TMP-SMZ, 70.6%(24/34) with AMX-CLV or CCL. Among 115 patients who have been followed up longer than 3 weeks , 90 patients(78.3%) improved clinically and/or radiographically. Among 90 patients with improvement, 32 patients(35.5%) showed clinical and/or radiographical responses in less than 3 weeks of treatment with effective antibiotics, however 19 patients(21.2%) needed to be treated for longer than 7 weeks. CONCLUSIONS: The data indicated that paranasal sinusitis is a common disease among Korean children, especially in very young ones. Once antibiotic therapy had begun, the follow-up were not infrequently interrupted. The therapeutic response to antibiotics, recommended currently for therapy of paranasal sinusitis, were not good.
Anti-Bacterial Agents ; Child* ; Cough ; Female ; Fever ; Follow-Up Studies ; Humans ; Incidence ; Male ; Maxillary Sinus* ; Maxillary Sinusitis* ; Nasal Obstruction ; Otitis Media ; Outpatients ; Pediatrics ; Pharynx ; Physical Examination ; Respiratory System ; Sex Distribution ; Sinusitis

Hailey-Hailey disease is a rare hereditary dermatosis that begins in the 2nd or 3rd decade of life. The skin lesion is characterized by a localized, recurrent eruption of small vesicles on an erythematous base. It courses remissions and exacerbations. It seldom begins in early childhood, and main treatment modalities are conservative ones. We report a case of Hailey-Hailey disease that began on a 7-month old infant and improved by surgical treatment. In according to review of the previous reports, it is probably the earliest onset age and it is may be the first case which was treated with surgery in Korea.
Age of Onset ; Humans ; Infant ; Korea ; Pemphigus, Benign Familial* ; Skin ; Skin Diseases