Pregnancy rhinitis is a relatively common condition. It is characterized by the presence of nasal symptoms, especially nasal congestion, not present prior to pregnancy, but typically present during the last 6 or more weeks of pregnancy, without other signs of respiratory tract infection or any known allergic causes, and disappearing completely within 2 weeks after delivery. Nasal saline irrigation, intranasal steroid spray, and oral antihistamines are usually recommended as the first line of treatment for rhinitis. However, most pregnant women refuse medical treatment for pregnancy rhinitis because of the fear of teratogenicity. Severe pregnancy rhinitis increases the risk of snoring, which has been suggested as having adverse effects on the fetus. In cases where the patients are unable to control their symptoms, pregnancy rhinitis can negatively affect the quality of life (QOL) as well as the pregnancy outcome. Therefore, special caution is required for determining the appropriate diagnosis and treatment modalities for pregnancy rhinitis. Here, we report for the first time, the successful treatment of pregnancy rhinitis that was unresponsive to conservative management and medical therapy by using microdebrider-assisted inferior turbinoplasty at the final stages of pregnancy, along with a review of the relevant literature.
Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Fetus ; Histamine Antagonists ; Humans ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women ; Quality of Life ; Respiratory Tract Infections ; Rhinitis* ; Snoring

PURPOSE: To determine the relation between the initial plasma cytokine response and the neurological prognosis in term infants with severe fetal distress. METHODS: Infants with severe fetal distress at birth (n=23) were studied prospectively. Cytokine concentrations were measured from umbilical cord blood at 3 and 12 hours of life by enzyme-linked immunosorbent assays for interleukin (IL)-1beta, IL-6, and IL-18. The study groups were divided into good (n=14) or poor prognostic group (n=9) according to survival and presence of cerebral palsy (CP) later and correlations with afore mentioned cytokine levels were determined. RESULTS: Cord blood IL-1beta and IL-18 concentrations were similar in both groups. However, infants with poor prognosis had significantly higher median (range) IL-6 concentration than infants with good prognosis at 3 hours [323.6 (32.6-812.8) vs. 38.4 (6.3- 322.7) pg/mL] (P=0.001), and 12 hours of life [287.1 (16.4-769.1) vs. 66.2 (8.8-757.8) pg/mL] (P<0.05). Significant higher IL-6 levels greater than 200 pg/mL were observed at 3 hours (P=0.005) and at 12 hours of life (P=0.023) for poor prognosis group. CONCLUSION: There was a significant correlation between neurologic outcome and plasma IL-6 levels. Higher concentrations of IL-6 (>200 pg/mL) may be a useful indicator of poor neurological outcome in infants with severe fetal distress.
Cerebral Palsy ; Enzyme-Linked Immunosorbent Assay ; Fetal Blood ; Fetal Distress* ; Humans ; Infant ; Infant, Newborn* ; Interleukin-18 ; Interleukin-6 ; Interleukins ; Parturition ; Plasma ; Prognosis ; Prospective Studies

Four cases of primary transitional cell carcinoma (TCC) arising in the ovary (3 cases) and the parovarium (1 case) were collected for clinicopathologic analysis. The mean age was 46.2 years (range, 39-57 years). Two patients complained abdominal discomfort and vaginal discharge, respectively. Other 2 cases were incidentally found from routine check. Grossly, the tumors were solid and cystic (2 cases), solid (1 case) and surface papillary growth on capsule (1 case). Microscopically, the tumor showed almostly same to the histologic features of TCC of urinary bladder. Three cases were pure TCC, and one was mixed TCC and serous carcinoma. FIGO stage were 1 IIa, 2 IIc, and 1 IIIc. Treatment was surgery with adjuvant chemotherapy. Two patients are alive with no evidence of disease, and two have lung or brain metastasis.
Brain ; Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Ovary ; Urinary Bladder ; Vaginal Discharge

Apoptosis, including the programmed cell death, is important event in normal cell turnover and maintenance of adult tissues. Apoptosis exerts a homeostatic function in relation to tissues dynamics, as the steady state of continuously renewing tissues achieved by a balance between cell replication and cell death. This study was undertaken to investigate the association between apoptosis and development of the cervical neoplasia. Archival cervical samples from normal epithelium (n 10), low-grade squamous intraepithelial lesions (LSIL, n = 10), high-grade squamous intraepithelial lesions (HSIL, n 10), microinvasive squamous cell carcinomas (n 10), and invasive squamous cell carcinomas (n = 10) were evaluated for apoptosis. We used in situ end-labeling of DNA strand breaks by terminal deoxynucleotidyltransferase incorporation of biotinylated deoxyuridine to 3-OH ends of DNA, identified by nickel-avidine-peroxidase. The apoptotic index (sum of apoptotic bodies divided by the total nuclei times 100) significantly decreased (P<0.05) as the degree of neoplasia increased: 3.1 + 0.9 % in normal epithelium, 5.5 +/- 1.4 % in LSIL, 1.6 +/- 0.4 % in HSIL, 1.9 +/- 0.5 % in microinvasive carcinomas, and 0.6 +/- 0.3 % in invasive carcinomas. Compared to normal epithelium, the total cell number per 200x field increased significantly (P<0,05): 379 +/- 47 in normal epithelium, 462 +/- 228 in LSIL, 670+/-293 in HSIL, 1035 +/- 254 in microinvasive carcinomas, and 1389 +/- 247 in invasive carcinomas. Consequently, these results suggest that progession of cervical carcinogenesis is associated with a decrease in apoptotic index and an increase in the number of the total cell.
Adult ; Apoptosis* ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Count ; Cell Death ; Deoxyuridine ; DNA ; DNA Nucleotidylexotransferase ; Epithelium ; Humans

PURPOSE: Calcium phosphate cement (CPC) is one of many useful materials for restoring tooth defects, periodontium and maxillofacial area. Chitosan is a biodegradable material that has been shown to promote the growth and differentiation of osteoblasts in culture. This study examined the interaction between odontoblasts and bio-calcium phosphate cement reinforced with chitosan. MATERIALS AND METHODS: 5x10(3) odontoblastic cells were seeded into each well. Various concentrations of bio-calcium phosphate cement reinforced with chitosan (10, 20, 50, 100, 200, 500 microg/ml, 1, 2, 4 mg/ml) were diluted and added to the wells. The well was incubated for 24 h, 48 h and 72 h. After incubation, the number of cells was assessed to determine the cell viability. A cytokinesis-block micronucleus assay and chromosomal aberration test were carried out to estimate the extent of chromosomal abnormalities. Microscopic photographs and RT-PCR were performed to examine the adhesion potential of bio-calcium phosphate cement reinforced with chitosan. RESULTS: Bio-CPC-reinforced chitosan did not show significant cytotoxicity. The number of damaged chromosomes in the cells treated with Bio-CPC-reinforced chitosan was similar to that in the control cells. There was no significant increase in the number of chromosomal aberrations in the Bio-CPC reinforced chitosan exposed cells. Microscopic photographs and RT-PCR confirmed the adhesive potential of bio-CPC reinforced chitosan to odontoblasts. CONCLUSION: Bio-CPC-reinforced chitosan did not affect the odontoblastic cell viability, and had no significant cytotoxic effect. Bio-CPC-reinforced chitosan showed adhesive potential to odontoblasts. These results are expected form the basis of future studies on the effectiveness of dental restorative materials in Bio-CPC reinforced with chitosan.
Adhesives ; Calcium ; Calcium Phosphates ; Cell Survival ; Chitosan ; Chromosome Aberrations ; Micronucleus Tests ; Odontoblasts ; Osteoblasts ; Periodontium ; Seeds ; Tooth

Aortic pseudoaneurysms are rare. When aortic pseudoaneurysms are detected, they demand timely surgical intervention because they trend to increase in size and cause complications. We experienced a rare case of a chronic traumatic pseudoaneurysm located at the distal descending aorta associated with chest pain during trans-urethral resection of the prostate under spinal anesthesia. Diagnostic testing led to appropriate management.
Anesthesia, Spinal ; Aneurysm, False* ; Aorta, Thoracic ; Chest Pain* ; Diagnostic Tests, Routine ; Prostate* ; Thorax*

BACKGROUND: The goal of this study is to evaluate the differences of the rate and the ratio of heart rate changes, which is well known to reflect the vagal reactivation, after peak exercise between ischemic heart disease and normal during treadmill exercise test. Additionally R-wave amplitude changes are evaluated to have the discriminal power between ischemic heart disease and normal. METHODS: We have studied 253 human (196 control, 57 patients) who took the symptom-limited exercise test using Marquette case 8000 model. The 57 patients who showed the positive result by exercise test have confirmed by coronary angiography. The rate of heart rate changes was defined as the absolute difference of the heart rate subtracted by the just-previous stage heart rate. The ratio of heart rate changes was defined as the percentile of the rate of heart rate changes comparing to the just-previous stage heart rate. The changes of R-wave amplitude at lead V5 and aVF were obtained by the subtraction of R-wave amplitude at the peak exercise stage from that at the standing rest stage respectively. Additively heart rate recovery was defined as the rate of heart rate change which was obtained at 1 minute later after peak exercise. RESULTS: In patients and control, the resting heart rate were 70 +/- 13 bpm and 69 +/- 11 bpm (p>0.05), and the peak heart rate were 136 +/- 22 bpm and 155 +/- 18 bpm respectively (p<0.001). The rate of heart rate changes in patients group were significantly lower than that in control at 1 minute, 3 minute, and 5 minute respectively (p<0.001, p=0.008, p=0.002). The ratio of heart rate changes in patients group were also significantly lower than that in control at 1 minute, 3 minute, and 5 minute respectively (p=0.017, p=0.027, p=0.002). With comparing both groups, the incidences of ventricular ectopy were not different during exercise and recovery stages, and the difference in the changes of R-wave amplitude at lead V5 and aVF were not observed respectively. CONCLUSION: The rate and ratio of heart rate changes are significantly lower in iscemic heart disease than in normal, and these are resulted from the depression of vagal reactivation. These findings are supplemental to make a diagnosis and a arrhythmic risk stratification of ischemic heart disease.
Coronary Angiography ; Depression ; Diagnosis ; Exercise Test ; Heart Diseases ; Heart Rate* ; Heart* ; Humans ; Incidence ; Myocardial Ischemia*

Microinvasive carcinoma of the uterine cervix(FIGO stage IA) has been reported as highly curable disease even with conservative surgery such as conization and simple hysterectomy. Nevertheless, the surgical management for microinvasive carcinomas has been proposed varying from conservative surgery to radical hysterectomy with pelvic nodes dissection according to different diagnostic criterias for microinvasive carcinoma. We reviewed 512 patients who had been diagnosed as microinvasive carcinoma of the uterine cervix at the Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center from Jan. 1988 to Dec. 1995. Among them, 376 patients were included in this study satisfying guided criterias such as proper management and follow up more than at least one year, and they were analyzed retrospectively based on the clinicopathologic characteristics, pattern of surgical management and postoperative status. (continue)
Cervix Uteri* ; Conization ; Delivery of Health Care ; Diagnosis* ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies

Atrial flutter is one of the rare diseases in neonatal period, and characterized by a regular sawtooth p waves. We experienced a case of neonatal atrial flutter who was delivered from mother with fetal tachyarrhythmia, and the neonate had multiple tuber lesions in brain and heart. Atrial flutter was successfully controlled with digoxin therapy without further relapse. Thus, we report a case neonatal atrial flutter accompanied to tuberous sclerosis with brief review of literature.
Atrial Flutter* ; Brain ; Digoxin ; Heart ; Humans ; Infant, Newborn ; Mothers ; Rare Diseases ; Recurrence ; Tachycardia ; Tuberous Sclerosis*

Partial long arm deletion in chromosome 2 is a rare disease in world-wide. The disease is characterized by multiple anomalies of craniofacial, extremities, cardiovascular system, hypotonia and mental retardation. We report a premature infant with long arm deletion of chromosome 2 who was diagnosed by clinical features and chromosomal analysis [46, XX, del(2)(q36-ter)]. She had multiple anomalies including microcephaly, frontal bossing, micropthalmia, low set ear, short webbed neck, horseshoe kidney, ventriculomegaly and cardiac anomalies of patent ductus arteriosus, atrial septal defect, ventricular septal defect, and pulmonary hypertension. A brief review of literature is included.
Arm* ; Cardiovascular System ; Chromosomes, Human, Pair 2* ; Ductus Arteriosus, Patent ; Ear ; Extremities ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Hypertension, Pulmonary ; Infant, Newborn ; Infant, Premature ; Intellectual Disability ; Kidney ; Microcephaly ; Muscle Hypotonia ; Neck ; Rare Diseases