No abstract available.
Abdominal Pain* ; Vomiting*

OBJECTIVE: The purpose of this article is to assist in early diagnosis and treatment of ectopic pregnancy. METHODS: We analyzed clinical statistics of 401 patients, who visited Masan Samsung Hospital from January 1, 1998 to December 31, 2002, received treatment under diagnosis of ectopic pregnancy, and were comfirmed by histopathologic examination. RESULTS: During the index period, the occurrence rate of ectopic pregnancy was 1:16.5, with peak age of occurrence between 30 to 34 year-old (34.4%). Previous history of artificial abortion was noted in 76.1%, previous cesarean delivery in 17%, previous pelvic inflammatory disease in 15.7% and history of previous ectopic pregancy in 9.5%. Concerned to clinical manifestations, lower abdominal pain was reported in 93.3%, amenorrhea in 86.5%, and vaginal bleeding in 69.3%. Onset of clinical manifestation was 6-8 weeks from the last menstrual period in 39.7%, being the most common. As the implantation site, fallopian tube was affected in 95.3%, ovary in 3%, and cervix of the uterus in 1%. Total amount of intraperitoneal hemorrhage was less then 500 mL in 45.6%. As an operative treatment, salpingectomy of the affected side was conducted in 76.8%. Average lengths of hospital stay for laparoscopy versus laparotomy were 3.4 and 5.2 days, respectively. CONCLUSION: Ectopic pregnancy, as a common emergent disorders, requires continuous attention for women in reproductive age. With the aid of various diagnostic modalities, early diagnosis and treatment can reduce mortality and morbidity rates, and enhance future fetility.
Abdominal Pain ; Adult ; Amenorrhea ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Mortality ; Ovary ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic* ; Salpingectomy ; Uterine Hemorrhage ; Uterus

Physostigmine has been used to counteract somnolence or coma induced by different types of pharmacological agent, such as anticholinergics, opioids, ketamine, tricyclic antidepressants and inhalational anesthetics. In this study, we have assessed the effect of physostigmine on arousal and respiration after 50% N2O-50% O2-enflurane general anesthesia under controlled condition such as no premedication, no neuromuscular blockade, same operative procedure and duration. Fifty healthy gynecologic patients scheduled for dilatation & curettage and cervical cone biopsy were divided randomly into two groups such as control group and physostigmine group. In physostigmine group, 0.02 mg/kg of physostigmine was administered intravenously at the end of operation. We evaluated the recovery time of pain response, eye opening on verbal command and orientation after the end of operation. We also checked the end-tidal enflurane concentration with SARACAP spectrometry. Blood pressure, pulse rate, respiration rate and tidal volume were checked at the end of operation and at the time of each recovery parameters returned. The results were as follows; first, pain response time was 5.1+/-2.4 min in control group compared with 3.5+/-2.1 min in physostigmine group. Second, on simple order to patients, eye opening time was 8.5+/-2.3 min in control group compared with 6.5+/-2.1 min in physostigmine group. Third, recovery of orientation to time, place and person was 9.7+/-2.8 min in control group compared with 7.5+/-2.1 min in physostigmine group. Fourth, there was no significant difference in respiratory parameters between the two groups. But there was no significant difference in end-tidal enflurane concentration between the two groups inspite of rapid recovery time in physostigmine group. In conclusion, 0.02mg/kg of physostigmine has the effect of early arousal after enflurane anesthesia without specific problems.
Analgesics, Opioid ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Antidepressive Agents, Tricyclic ; Arousal* ; Biopsy ; Blood Pressure ; Cholinergic Antagonists ; Coma ; Dilatation and Curettage ; Enflurane* ; Female ; Heart Rate ; Humans ; Ketamine ; Neuromuscular Blockade ; Physostigmine* ; Premedication ; Reaction Time ; Respiration* ; Respiratory Rate ; Spectrum Analysis ; Surgical Procedures, Operative ; Tidal Volume

Urticaria pigmentosa is a form of urticaria characterized by abnormality of cutaneous mast cells. No prediction for either gender has been reported but it usually occurs in children. When it develops in an adult cutaneous manifestations often follows recalcitrant and persistent course. Though tendency of genetic inheritance with an autosomal dominant pattern has been suggested most of patients have no family history of mastocytosis. We report a case of adult-onset urticaria pigmentosa with references.
Adult ; Child ; Humans ; Mast Cells ; Mastocytosis ; Urticaria Pigmentosa* ; Urticaria* ; Wills

No abstract available.

Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Leukoplakia ; Mouth ; Neoplasm Recurrence, Local ; Neoplasms, Second Primary ; Prognosis ; Recurrence ; Tongue Neoplasms ; Tongue

OBJECTIVE: The frequency of CYP2C8 gene polymorphisms in Korean patients with epithelial ovarian cancer was identified and their association with toxicity and effect of the anticancer drug according to haplotypes was analyzed. METHODS: DNA was extracted from 57 epithelial ovarian cancer patients between January 2004 and March 2005. Genetic variations that are three common SNPs (CYP2C8*1D; -411T>C, CYP2C8*1C; -370T>G and CYP2C8*1B; -271C>A) by direct sequence analysis from 57 Korean women with epithelial ovarian cancer were observed. 33 patients who received debulking surgery, were diagnosed over FIGO state III, serous ovarian cancer were enrolled and received paclitaxel based chemotherapy. Among 33 patients 21 chemo-sensitive patients and 12 resistant patients were analyzed. Using these SNPs, We constructed haplotypes and haplotype pairs. CYP2C8 genotypes according to the clinical characteristics were analyzed and evaluated. RESULTS: Genetic analysis revealed the common SNPs' allele frequencies of -411T>C, -370T>G, and -271C>A were 0.3, 0.44, and 0.1. Two common SNPs allele frequency was similar to the data in Korean population substantially, but CYP2C8*1C frequency was more frequent in epithelial ovarian cancer patients and especially in FIGO stage III. Disease free interval in CYP2C8*1C homologous group was longer than others. CONCLUSION: CYP2C8*1C SNPs were detected more frequently in epithelial ovarian cancer patients and especially in FIGO stage III patients. CYP2C8*1C homologous patients had more longer disease free interval than others.
Cytochrome P-450 Enzyme System ; DNA ; Drug Therapy ; Female ; Gene Frequency ; Genetic Variation ; Genotype ; Haplotypes ; Humans ; Ovarian Neoplasms* ; Paclitaxel ; Polymorphism, Single Nucleotide ; Sequence Analysis

Anterograde jejunojejunal intussusception after total gastrectomy is a very rare postoperative complication. We report a 54-year-old man with a history of total gastrectomy, uncut Roux-en-Y gastric bypass, and Braun's jejunojejunal anastomosis. An upper gastrointestinal endoscopy revealed a bulky, reddish mass in the efferent loop with congestion, edema, and mucosal bleeding. An emergency computed tomography showed a target-like multilayered wall thickening in the afferent loop and a lamellar structure arranged in a concentric circle. Surgical exploration revealed an anterograde intussusception of the afferent proximal jejunum adjacent to the jejunojejunostomy site. This is a very uncommon occurrence because most intussusceptions after total gastrectomy are of the retrograde type. Moreover, anterograde jejunojejunal intussusception tends to occur in the early postoperative period. We report a case of late postoperative anterograde jejunojejunal intussusception after total gastrectomy with Braun's jejunojejunal anastomosis in a 54-year-old Korean man and review the related literature.
Edema ; Emergencies ; Endoscopy, Gastrointestinal ; Estrogens, Conjugated (USP) ; Gastrectomy* ; Gastric Bypass ; Hemorrhage ; Humans ; Intussusception* ; Jejunum ; Middle Aged ; Postoperative Complications ; Postoperative Period

OBJECTIVE: To compare the morphological, phenotypical, and functional characteristics of dendritic cells (DCs) generated from two precursor cell sources (CD 14+ monocyte and CD34+ hematopoietic stem cell) of human umbilical cord blood (UCB) under identical ex vivo generation conditions and to determine the best cellular source for DCs-based anticancer immunotherapy. METHODS: CD14+ monocytes and CD34+ hematopoietic stem cells were isolated from human UCB and induced to differentiate into DCs under identical culture conditions using granulocyte macrophage colony stimulating factor (800 U/mL) and IL-4 (500 U/mL). Then maturation of DCs was induced with IFN-gamma (1000 U/mL) and LPS (1 microgram/mL). Morphology was compared with confocal microscopy and phenotypical analysis was done with FACS. The level of IL-12p70 production was determined with ELISA kit and T cell proliferation capacity was assessed with mixed lymphocyte reaction (MLR). RESULTS: Eight-day-old mature DCs from CD14+ monocytes or CD34+ hematopoietic stem cells had identical morphology. Flow cytometric analysis revealed that CD14+ monocyte-derived DCs (M-DCs) and CD34+ hematopoietic stem cell-derived DCs (CD34-DCs) showed similar enhanced expression of CD80, CD83, and CD86 (P>0.05). The level of IL-12p70 production was significantly higher in mature DCs (8-day-old) than immature DCs (6-day-old) of either source (P<0.05), but it was significantly highly elevated in CD34-DCs (P<0.05). DCs of both precursors showed potent stimulation capacity in MLR, with CD34-DCs having a maximum effect at 1:2 ratio and M-DCs at 1:20 ratio, although CD34-DCs had significantly greater proliferative effects at all ratios (P<0.05). CONCLUSION: These findings suggest that CD34-DCs may be a more attractive source for DC-based immunotherapy. But because of morphologic, phenotypical, and functional similarities between the two cellular sources, both are good sources for generating DCs and one is not superior to the other. Thus cellular availability could be an important factor in determining DC-generation protocol to be used if all other issues are equal. Further comparative testing for these two precursors is in need.
Cell Proliferation ; Dendritic Cells* ; Enzyme-Linked Immunosorbent Assay ; Fetal Blood* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Hematopoietic Stem Cells* ; Humans* ; Immunotherapy ; Interleukin-4 ; Lymphocyte Culture Test, Mixed ; Microscopy, Confocal ; Monocytes* ; Umbilical Cord*

Avulsion fracture of the calcaneal tuberosity is an uncommon injury. Usually it occurs from indirect trauma, and can be seen in old patients with osteoporosis or in patients with diabetic neuropathy. Follow-up studies showed fracture healing in most cases, but skeletal deformity may develop in some cases. Therefore we should do plain X-ray evaluations in diabetic patients with foot and ankle pain, even though there have been no definite trauma history. Four cases of calcaneus avulsion fracture were treated operatively in diabetic patients, and reported.
Ankle ; Calcaneus* ; Congenital Abnormalities ; Diabetic Neuropathies ; Follow-Up Studies ; Foot ; Fracture Healing ; Humans ; Osteoporosis