An epidemiological study was performed to know the recent infection status of Paragonimus westermani metacercariae (PwMc) in freshwater crayfish, Cambaroides similis, from 2 streams in Jeollanam-do, Republic of Korea. Crayfish were collected from creeks in Bogil-do (Island), Wando-gun, and in a creek near Daeheung Temple in Haenam-gun. The infection rate of crayfish with PwMc in Bogil-do was 89.8%, and the metacercarial burden was 37 PwMc per the infected crayfish. Crayfish in a creek near Daeheung Temple were larger and twice heavier than those in Bogil-do. Of them, 96.5% were infected with PwMc. An average of 140 metacercariae was found in the infected crayfish, almost quadruple to those of Bogil-do. There was a strong correlation between the number of PwMc and body weight of the crayfish. These results suggest that P. westermani metacercariae are still prevalent in crayfish of the 2 regions in Jeollanam-do, Korea.
Astacoidea* ; Body Weight ; Epidemiologic Studies ; Fresh Water* ; Incidence* ; Jeollanam-do* ; Korea* ; Metacercariae* ; Paragonimus westermani* ; Paragonimus* ; Republic of Korea ; Rivers

PURPOSE: The purpose of this pilot study was to evaluate the association between adenosine triphosphate-based chemotherapy response assays (ATP-CRAs) and subsets of tumor infiltrating lymphocytes (TILs) in gastric cancer. MATERIALS AND METHODS: In total, 15 gastric cancer tissue samples were obtained from gastrectomies performed between February 2007 and January 2011. Chemotherapy response assays were performed on tumor cells from these samples using 11 chemotherapeutic agents, including etoposide, doxorubicin, epirubicin, mitomycin, 5-fluorouracil (5-FU), oxaliplatin, irinotecan, docetaxel, paclitaxel, methotrexate, and cisplatin. TILs in the tissue samples were evaluated using antibodies specific for CD3, CD4, CD8, Foxp3, and Granzyme B. RESULTS: The highest cancer cell death rates were induced by etoposide (44.8%), 5-FU (43.1%), and mitomycin (39.9%). Samples from 10 patients who were treated with 5-FU were divided into 5-FU-sensitive and -insensitive groups according to median cell death rate. No difference was observed in survival between the two groups (P=0.216). Only two patients were treated with a chemotherapeutic agent determined by an ATP-CRA and there was no significant difference in overall survival compared with that of patients treated with their physician's choice of chemotherapeutic agent (P=0.105). However, a high number of CD3 TILs was a favorable prognostic factor (P=0.008). Pearson's correlation analyses showed no association between cancer cell death rates in response to chemotherapeutic agents and subsets of TILs. CONCLUSIONS: Cancer cell death rates in response to specific chemotherapeutic agents were not significantly associated with the distribution of TIL subsets.
Adenosine ; Adenosine Triphosphate ; Antibodies ; Cell Death ; Cisplatin ; Doxorubicin ; Drug Screening Assays, Antitumor ; Drug Therapy ; Epirubicin ; Etoposide ; Fluorouracil ; Gastrectomy ; Granzymes ; Humans ; Lymphocytes, Tumor-Infiltrating* ; Methotrexate ; Mitomycin ; Paclitaxel ; Pilot Projects* ; Stomach Neoplasms*

OBJECTIVE: To analyze the clinical characteristic of peripartum cardiomyopathy. METHODS: A retrospective review was undertaken on records of women who were diagnosed with peripartum cardiomyopathy at Yonsei University, Wonju College of Medicine, Wonju Christian Hospital between January 1994 and December 2004. We made criteria for its diagnosis, namely: (1) developement of heart failure in the last month of pregnancy or within 5 months after delivery, (2) absence of a determinable etiology for the cardiac failure, and (3) absence of demonstrable heart disease prior to the last month of pregnancy. (4) ejection fraction less than 45%. RESULTS: During the research period, 8 pregnant women were documented as peripartum cardiomyopathy. All of the women undertook echocardiography. Three women were complicated with pregnancy induced hypertension. One woman was in cardiogenic shock. CONCLUSION: Early diagnosis of the peripartum cardiomyopathy is extremely important. The echocardiography can provide helpful information on disease progression.
Cardiomyopathies* ; Diagnosis ; Disease Progression ; Early Diagnosis ; Echocardiography ; Female ; Gangwon-do ; Heart Diseases ; Heart Failure ; Humans ; Hypertension, Pregnancy-Induced ; Peripartum Period* ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Shock, Cardiogenic

OBJECTIVE: To suggest the pregnancy outcome data according to the types of placenta previa in order to establish the optimal management of placenta previa. METHODS: A retrospective review of the clinical records of 179 women delivered with the diagnosis of placenta previa over 25 gestational weeks during the 6-year period from January 1, 1995 to December 31, 2000, at the Wonju Christian Hospital. We divided each groups into total, partial and marginal placenta previa in order to compare pregnancy outcomes. RESULTS: There were significant differences in the numbers of gravida, prior abortion, number of previous cesarean section between marginal and total placenta previa group. There were no significant differences in the gestational weeks at delivery, blood transfusion units, birth weight and placenta/birth weight ratio among each group. Statistically significant frequent hysterectomy in case of partial palcenta previa in comparison to marginal placenta previa was performed. Significant differences of the prior cesarean section (86.4% vs 3.8%) and placenta accreta (45.4% vs 37.5%) were noted between hysterectomy group and no hysterectomy group. CONCLUSION: Previous cesarean section history is strongly associated with cesarean hysterectomy. Women with placenta previa and history of previous cesarean section have more risk of placenta accreta. So, we should prepare sufficiently for cesarean hysterectomy in such cases.
Birth Weight ; Blood Transfusion ; Cesarean Section ; Diagnosis ; Female ; Gangwon-do ; Humans ; Hysterectomy ; Placenta Accreta ; Placenta Previa* ; Placenta* ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Retrospective Studies

Human uterus has been known as a immune privileged site for the product of conception. At the feto-maternal interface, Fas system is a underlying main mechanism of maternal immune acceptance. To date, the TRAIL (TNF-related apoptosis-inducing ligand) system is known to be another pivotal mechanism. OBJECTIVE: To clarify the protein expression of TRAIL ligand and receptors in the normal and pathologic (preeclampsia, hydatidiform mole) placenta, chorioamnion, decidua. METHODS: we investigated the expression of TRAIL system in the above-mentioned tissues by using Western Hybridization. RESULTS: All tissues expressed TRAIL ligand and only a DcR2 among TRAIL receptors (DR4, DR5, DcR1, DcR2). CONCLUSION: we demonstrated the expression of TRAIL ligand and DcR2 protein at the feto-maternal interface of the normal and pathologic pregnancies. Further study regarding the expression of other receptors and quantitative analysis between normal and pathologic pregnancies should be followed.
Apoptosis* ; Decidua ; Female ; Fertilization ; Gestational Trophoblastic Disease* ; Humans* ; Placenta ; Pregnancy ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; Uterus

OBJECTIVE: The authors have aimed to compare the efficacy of the computed tomography with other study methods, and to investigate if replacement by computed tomography is possible METHODS: From January 1998 to December 2002, 203 cervical cancer patients underwent pre-staging studies including computed tomography. The positive predictive values, negative predictive values, sensitivity, specificity of each method of study were compared. RESULTS: 1. Compared computed tomography with intravenous pyelonephrography. Each values of computed tomography for hydronephrosis or non visualization of kidney were sensitivity 91.7%, specificity 97.8%, positive predictive values 84.6%, negative predictive values 98.9%. 2. Compared computed tomography with cystoscopy. Each values of computed tomography for bladder invasion were sensitivity 90%, specificity 95.8%, positive predictive values 52.9%, negative predictive values 99.4%. 3. Compared computed tomography with sigmoidoscopy. Each values of computed tomography for rectal invasion were sensitivity 80%, specificity 94.4%, positive predictive values 26.6%, negative predictive values 99.4%. CONCLUSION: Rather than routine examination for staging of invasive cervical cancer in all patients, it is more ideal to first take a non invasive technique. then perform on intravenous pyelonephrography, cystoscopy and sigmoidoscopy only in patient showing positive findings of hydronephrosis or non visualization of kidney, bladder or rectal invasion on computed tomography.
Cervix Uteri* ; Cystoscopy ; Female ; Humans ; Hydronephrosis ; Kidney ; Sensitivity and Specificity ; Sigmoidoscopy ; Urinary Bladder ; Uterine Cervical Neoplasms

Spontaneous umbilical cord hematoma is a rare cause of fetal distress and intrauterine fetal death. The perinatal mortality rate approaches 50%. Various causes of the cord hematoma have been suggested as congenital abnormalities, short cord, trauma, cord around neck, torsion, syphilis, or postmature pregnancy. We have experienced one case of the fetal distress from umbilical cord hematoma, which is presented with a brief review of the literatures.
Congenital Abnormalities ; Fetal Death ; Fetal Distress* ; Hematoma* ; Neck ; Perinatal Mortality ; Pregnancy ; Syphilis ; Umbilical Cord*

Intramural pregnancy is one of the rarest forms of ectopic pregnancy. The pathologic diagnosis of the intramural ectopic pregnancy requires that the myometrium surrounds the products of conception separated from the endometrial cavity or fallopian tubes. Because the early diagnosis is very difficult, most cases are found after the onset of complications such as a uterine rupture or hemoperitoneum. The previous histories of curettage, cesarean section, myomectomy, salpingectomy and manual removal of the placenta are known as possible etiology of the intramural pregnancy. We have recently experienced a case of intramural pregnancy after 10 times of curettages and are reporting with a brief review of the literatures.
Animals ; Cesarean Section ; Curettage ; Diagnosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertilization ; Hemoperitoneum ; Mice ; Myometrium ; Placenta ; Pregnancy* ; Pregnancy, Ectopic ; Salpingectomy ; Uterine Rupture

Sex identification may be described in terms of some characteristics. Any individual with testicular formation and contraindiction of any of the anatomical criteria of sex may be considered as a male pseudohermaphrodite. Most of them have genitalia that are more feminine than masculine, are best raised as females. We report a 26-year-old male pseudohermaphrodite who was phenotypically female with amenorrhea, little breast development and little sexual hair. For treatment, multidisciplinary team approach including pubic hair transplantation is needed to enhance self-image and confidence in intersexuality.
46, XY Disorders of Sex Development* ; Adult ; Amenorrhea ; Breast ; Disorders of Sex Development ; Female ; Genitalia ; Hair* ; Humans ; Male*

BACKGROUND AND AIMS: Long term results of an endoscopic sphincterotomy (EST) have still been poorly estimated. The aim of this study was to assess late complications of EST. METHODS: The rate of late complications were retrospectively evaluated in with 91 patients (mean age, 59.1 years; range, 28~86 years; M:F, 44:47), who underwent EST for choledocholithiasis. RESULTS: Forty six patients (50.5%) had their gallbladder in situ, and 45 patients (49.5%) underwent cholecystectomy. Early complications (<30 days) such as hemorrhage, pancreatitis, and perforation occurred in 7 patients (7.7%). During a mean period of 53.4 months (range, 24~134 months), 26 patients (28.0%) developed late complications, including a recurrence of CBD stones in 20 patients (22.0%) (8-gallbladder in situ, 12-cholecystectomized). An univariate analysis of risk factors for stone recurrence revealed dilated ducts, stone sizes, and stone numbers which were not related with stone recurrence. The history of choledocholithotomy with cholecystectomy was significantly related to stone recurrence. CONCLUSIONS: After EST for bile duct stones, late complications occurred in a significant proportion of patients and it was determined that a history of choledocholithotomy with cholecystectomy was significantly correlated with stone recurrence.
Bile Ducts ; Cholecystectomy ; Choledocholithiasis ; Gallbladder ; Hemorrhage ; Humans ; Pancreatitis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Sphincterotomy, Endoscopic