BACKGROUND: Paraquat is widely used herbicide. But if it is ingested by accident or by suicidal attempt it causes severe toxicity. And in emergency room, it is a big problem that there is no effective treatment modality for paraquat intoxication. It is reported that the mechanism of toxicity is by oxygen fee radical. And Vitamin C is known as potent antioxidant. This study was designed to evaluate the antioxidant effect of Vitamin C to lipid peroxidaton in paraquat intoxication. METHODS: 24 rats were divided to 6 groups after paraquat injection(20mg/kg), and each groups 4 rats. In 2 control groups we only observed until 6 hours and 24 hours. And Vitamin C of 10 mg per kilogram body weight on the low dose group and 100 mg per kilogram body weight on the high dose group were infected simultaneously. And in 6 hours group, after 6 hours of paraquat and vitamin C injection biochemical levels of malondialdehyde, superoxide dismutase and catalase were measured in liver and lung. And in 24 hours group after 24 hours the same measures were done. The stasistical methods used were ANNOVA and Mann-Whitney test and P-value was 0.05. RESULTS: Malondialdehyde level of high dose Vitamin C group was significantly low compared to that of the control groups in liver tissues after 24 hours(p<0.05). And in lung tissues both low dose and high dose vitamin C groups show significantly low level of malondialdehyde level after 24 hours(p<0.05). On the superoxide dismutase activity, only high dose Vitamin C group shows significantly high level in 24hours both in liver and lung tissues. And the catalase activity is significantly elevated in high dome Vitamin C group after 24hours both in liver and lung tissues. (p<0.05) CONCLUSION: High dose Vitamin C suppresses lipid peroxidation, increases catalase activity and superoxide dismutase activity in paraquat intoxiation. It is thought to by antioxidant elect of vitamin C but it's effect is observed only in 24 hours after intoxication.
Animals ; Antioxidants* ; Ascorbic Acid* ; Body Weight ; Catalase ; Emergency Service, Hospital ; Fees and Charges ; Lipid Peroxidation ; Liver ; Lung ; Malondialdehyde ; Oxygen ; Paraquat* ; Poisoning* ; Rats ; Superoxide Dismutase ; Vitamins*

Ovarian metastases from a primary urinary tract carcinoma are extremely rare. This can be difficult to distinguish from transitional cell carcinomas (TCC) of ovarian origin because of histologic similarity. A 65-year-old woman who was diagnosed with renal pelvis TCC 4 months prior was referred for evaluation of a left ovarian mass. A 47-year-old woman who underwent radical cystectomy due to bladder TCC 1 year ago was referred because of a right ovarian mass. Both patients underwent a bilateral salpingo-oophorectomy. The tumor cells had morphology identical to those of the primary urinary tract tumors. Gynecologic oncologists should consider metastatic TCC of the ovary from urinary tract origin, as well as breast, and gastrointestinal tract origins.
Aged ; Breast ; Carcinoma, Transitional Cell ; Cystectomy ; Female ; Gastrointestinal Tract ; Humans ; Kidney Pelvis ; Middle Aged ; Neoplasm Metastasis ; Ovary ; Urinary Bladder ; Urinary Tract

Extramammary Paget's disease is a rare clinicopathologic entity. Because it is often associated with a subjacent or visceral malignancy and recurrence, extramammary Paget's disease is considered as malignant condition. We present one case of extramammary Paget's disease involving the penis and scrotum with clinical presentation and brief review of relevant literature.
Male ; Paget Disease, Extramammary* ; Penis* ; Recurrence ; Scrotum*

We report successful application of dual tracheobronchial stent to the diffuse tracheal stenosis. An one-month-old boy was transferred to the emergency room due to tachypnea and respiratory difficulty with CO2 retention. Preoperative computed tomography revealed pulmonary artery sling with diffuse tracheal stenosis. We found that the diameter of the both main bronchus was less than 3mm and the trachea was a complete ring. We divided the left pulmonary artery and implanted it to the main pulmonary artery under cardiopulmonary bypass. After that, tracheoplasty was performed with autologous pericardium. However, after the initial measures, CO2 retention and respiratory difficulty persisted due to the granulation tissue and dynamic obstruction of the airway ensued by the overlying pericardial flap. Therefore, we decided to apply a single tracheal stent. After the insertion of tracheal stent, residual stenosis of the both main bronchus opening continued to cause respiratory difficulty. Finally we applied dual tracheobronchial stent and resolved the airway obstruction.
Airway Obstruction ; Bronchi ; Cardiopulmonary Bypass ; Constriction, Pathologic* ; Emergency Service, Hospital ; Granulation Tissue ; Humans ; Male ; Pericardium ; Pulmonary Artery ; Stents* ; Tachypnea ; Trachea ; Tracheal Stenosis

PURPOSE: Computed tomography (CT) scan is an effective modality for detecting fatal traumatic brain injury. However, radiation exposure from CT can increase the risk of cancer, and children are more vulnerable to radiation than adults. We aimed to investigate the effect of introducing the Pediatric Emergency Care Applied Research Network (PECARN) rule to the emergency department (ED).METHODS: Medical records of children younger than 2 years with minor head injury who visited ED from January 2013 to June 2015 were reviewed. We started the education of radiation hazard and the PECARN rule in January 2014. The children were divided into pre- and post- education groups. The baseline characteristics, CT rate, and clinical outcomes were analyzed. The safety and efficacy of CT were defined as patients who received head CT scan per those experiencing clinically important traumatic brain injury (ciTBI) and patients without CT scan per those without ciTBI, respectively.RESULTS: Of 911 patients, 360 (39.5%) visited during the post-education period. Median age was 16.0 months (interquartile range, 11.0–20.0 months), and boys accounted for 58.5%. CT rate was reduced from 40.5% to 12.8% (P < 0.001). There was no difference in ciTBI rates between the two groups (1.3% vs. 1.7%, P = 0.622). The safety was 100% in both periods and the efficacy increased from 52.9% to 88.7%.CONCLUSION: We have seen a significant decrease in CT rate through the education of the PECARN rule. After its introduction, CT use was reduced, and the efficacy was improved without decrease in the safety.
Adult ; Brain Injuries ; Brain ; Child ; Craniocerebral Trauma ; Education ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Head ; Humans ; Medical Records ; Pediatrics ; Radiation Exposure ; Tomography, X-Ray Computed

Purpose: p21 protein is an inhibitor of cyclin-dependent kinases, which may be able to arrest the cell cycle at the G1 phase by inhibiting DNA replication through the interaction with proliferating cell nuclear antigen. From experimental studies, p21 has been considered a tumor suppressor gene. Herein, the effects of p21 on the development, stage, grade, recurrence, progression and patient's survival in human bladder cancers were evaluated. Materials and Methods: The mRNA expression levels of p21 were examined in 149 tumor specimens obtained from patients with primary bladder cancer and in 18 normal bladder mucosae using real-time polymerase chain reaction (PCR). Results: p21 was significantly expressed in human bladder tumor tissues at high levels (7.11+/-0.69pg/ml), but was not expressed in the normal bladder mucosae. Compared with invasive bladder cancer (5.03+/-0.95), the p21 expression levels were significantly enhanced in superficial bladder cancer (7.96+/-0.88pg/ml) (p=0.0250); whereas, the grade was not related to the expression of p21. The levels of p21 expression were enhanced in non-recurred (9.33+/-1.38) and non-progressed (8.13+/-0.86) compared with recurred (6.03+/-0.75) and progressed (3.67+/-0.52) patients (each p<0.05). The level of p21 expression was significantly correlated with the disease free survival in patients the bladder cancers. Conclusions: The enhanced expression of p21 is strongly associated with the development of bladder cancer. Moreover, increased expressions of p21 are also positively associated with the low rate of recurrence and progression of bladder cancer. Conversely, an enhanced expression of p21 provides a survival benefit for patients with bladder cancer. These results suggest that p21 might be useful as a marker in assessing tumor diagnosis, recurrence, progression and the survival in human bladder cancer patients.
Cell Cycle ; Cyclin-Dependent Kinase Inhibitor p21 ; Cyclin-Dependent Kinases ; Diagnosis ; Disease-Free Survival ; DNA Replication ; G1 Phase ; Genes, Tumor Suppressor ; Humans ; Mucous Membrane ; Polymerase Chain Reaction ; Proliferating Cell Nuclear Antigen ; Real-Time Polymerase Chain Reaction ; Recurrence ; RNA, Messenger ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The Surgery Treatment Modality Committee of the Korean Gynecologic Oncology Group has determined to develop a surgical manual to facilitate clinical trials and to improve communication between investigators by standardizing and precisely describing operating procedures. The literature on anatomic terminology, identification of surgical components, and surgical techniques were reviewed and discussed in depth to develop a surgical manual for gynecologic oncology. The surgical procedures provided here represent the minimum requirements for participating in a clinical trial. These procedures should be described in the operation record form, and the pathologic findings obtained from the procedures should be recorded in the pathologic report form. Here, we describe surgical procedure for ovarian, fallopian tubal, and peritoneal cancers.
Female ; Gynecologic Surgical Procedures ; Humans ; Manuals as Topic ; Ovarian Neoplasms ; Research Personnel

PURPOSE: It has been postulated that soybean isoflavones act as inhibitory factors in several cancers. Recently, various in vitro and in vivo experimental studies have demonstrated that these isoflavones inhibit prostate cancer. Therefore, we investigated whether soybean isoflavones influenced the development of prostate cancer by comparing the levels of circulating isoflavones between prostate cancer patients and controls. MATERIALS AND METHODS: The serum levels of genistein, daidzein and equol were determined using reverse-phase, high-performance liquid chromatography-multiple reaction ion monitoring mass spectrometry(HPLC-MS) and compared in 122 experimental subjects(61 prostate cancer patients and 61 cancer-free controls) from 6 hospitals. RESULTS: The serum concentrations of genistein, daidzein and equol in the patients were 130.7+/-181.4ng/ml, 53.6+/-69.3ng/ml and 11.37+/-43.4ng/ml, with control values of 95.6+/-95.2ng/ml, 55.2+/-121.8ng/ml and 23.2+/-34.5ng/ml, respectively. There was no statistical difference between the 2 groups. Daidzein non-metabolizers who were unable to degrade daidzein into equol were compared between the patients and the controls, and were found to be significantly more common in the patient group (p=0.001, OR=3.44, 95% CI=1.6243-7.2855). However, the equol/daidzein ratio was significantly lower in the patients than in the controls(p=0.0072). No association between age, stage, Gleason score or isoflavone concentrations was found. CONCLUSIONS: These results suggest that the capability to produce equol (i.e., the mechanism for the metabolism of daidzein into equol) is closely involved in the lower incidence of prostate cancer, and that a diet based on soybean isoflavones would be useful in preventing prostate cancer.
Diet ; Equol ; Genistein ; Humans ; Incidence ; Isoflavones ; Metabolism ; Neoplasm Grading ; Prostate* ; Prostatic Neoplasms* ; Soybeans*

Spinal muscular atrophy (SMA) is an autosomal recessive disorder, caused by homozygous absence of the survival motor neuron gene (SMN1) in approximately 94% of patients. Since most carriers have only one SMN1 gene copy, several SMN1 quantitative analyses have been used for the SMA carrier detection. We developed a reliable quantitative real-time PCR with SYBR Green I dye and studied 13 patients with SMA and their 24 parents, as well as 326 healthy normal individuals. The copy number of the SMN1 gene was determined by the comparative threshold cycle (Ct) method and albumin was used as a reference gene. The homozygous SMN1 deletion ratio of patients was 0.00 and the hemizygous SMN1 deletion ratio of parents ranged from 0.39 to 0.59. The delta delta Ct ratios of 7 persons among 326 normal individuals were within the carrier range, 0.41-0.57. According to these data, we estimated the carrier and disease prevalence of SMA at 1/47 and 1/8,496 in Korean population, respectively. These data indicated that there would be no much difference in disease prevalence of SMA compared with western countries. Since the prevalence of SMA is higher than other autosomal recessive disorders, the carrier detection method using real-time PCR could be a useful tool for genetic counseling.
Adult ; Aged ; Aged, 80 and over ; DNA Mutational Analysis/*methods ; Female ; Genetic Predisposition to Disease/epidemiology ; Genetic Screening/*methods ; Heterozygote ; Heterozygote Detection/methods ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Muscular Atrophy, Spinal/*epidemiology/genetics/*metabolism ; Nerve Tissue Proteins/*genetics ; Polymorphism, Genetic ; *Quantitative Trait, Heritable ; Reverse Transcriptase Polymerase Chain Reaction/*methods ; Risk Assessment/*methods ; Risk Factors

OBJECTIVE: This study is to determine serum carbohydrate antigen (CA) 19-9 levels in ovarian mature cystic teratoma (MCT) as a possible differential diagnostic tool. METHODS: The study group was composed of 201 patients who underwent removal of ovarian MCT and pathologically confirmed at Yonsei University Medical Center from January 2001 to July 2005. All of them were tested for serum CA19-9 levels before operation. Their data was compared with routine gynecologic evaluation group who showed normal serum CA19-9 level. Statistical analysis was carried out with t-test and Pearson correlation by SPSS version 12.0. RESULTS: Serum CA19-9 level was significantly elevated in the patients with ovarian MCT (p=0.011). Serum CA19-9 level and size of MCT showed positive correlation (p=0.009). Moreover, postoperative serum CA19-9 level showed significant decrease, compared to preoperative level (p=0.007). CONCLUSION: Serum CA19-9 can be used as an effective method for differential diagnosis of ovarian MCT, and it is proper to be used as a postoperative follow-up test.
Academic Medical Centers ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Teratoma*