Prenatal Detection of a Congenital Pancreatic Cyst by Ultrasound

We present a case of a fetal pancreatic cyst, a rare disease in fetal life, detected prenatally at 30 weeks' gestation by ultrasound. Routine ultrasound examination at 30 weeks' gestation by primary obstetrician showed a cyst on the fetal abdomen. Initially, the suspected diagnosis was a mesenteric cyst. Subsequent ultrasound examination at weeks 32, 36 showed a fetal retroperitoneal cyst. A 3.6 kg female neonate was born to 23 yr old woman by spontaneous vaginal delivery at 38 weeks' gestation. The fetus underwent exploratory laparotomy. Histopathologic and immunohistochemical diagnosis revealed the cyst to be a pancreatic cyst. Surgical outcome was excellent. Thus, we report this case of a pancreatic cyst detected via prenatal ultrasonography.

Breast Carcinoma Following Silicone Injection

A 57-year-old woman developed an inflammatory carcinoma in her left breast next to the spot of a silicone injection that had been used for augmentation some 20 years previously. She underwent a modified radical mastectomy with an axillary lymph node dissection. There have been relatively few cases reported in the literature that have noted breast cancer associated with silicone injections. During physical examinations, such breasts are frequently firm, tender, painful, and inflamed. Far more important, in silicone-injected breasts, carcinomas become more difficult to detect by physical examination, mam mography, and other known methods. Although no causal relationship between silicone and breast carci nomas is implied, a heightened awareness of the possible coexistence of silicone mastopathy and a breast carcinoma is necessary.

Breast Carcinoma Following Silicone Injection

A 57-year-old woman developed an inflammatory carcinoma in her left breast next to the spot of a silicone injection that had been used for augmentation some 20 years previously. She underwent a modified radical mastectomy with an axillary lymph node dissection. There have been relatively few cases reported in the literature that have noted breast cancer associated with silicone injections. During physical examinations, such breasts are frequently firm, tender, painful, and inflamed. Far more important, in silicone-injected breasts, carcinomas become more difficult to detect by physical examination, mam mography, and other known methods. Although no causal relationship between silicone and breast carci nomas is implied, a heightened awareness of the possible coexistence of silicone mastopathy and a breast carcinoma is necessary.

Clinical Analysis of Fournier's Gangrene Caused by a Perianal Abscess

PURPOSE: Fournier's gangrene is a rapidly progressive fulminant infection of the perineum and abdominal wall along with the scrotum in men and the vulva in women. If the effective surgical treatment is delayed, the patients result in fatal. Modern surgical series report a mortality of 8-67%. Objective: The aims of this study were to examine the outcomes of 20 consecutive patients with Fournier's gangrene caused by a perianal abscess and to identify the factors leading to improved survival in these patients. METHODS: The medical records of all patients who had been treated at Chosun University Hospital between January 1991 and December 1999 for Fournier's gangrene caused by a perianal abscess were retrospectively reviewed. RESULTS: Twenty patients were identified (mean age 47 years, range 20-66). The sexual ratio was 2.3:1 (male:female). The etiologies included perianal fistula (35%), unknown (35%), hemorrhoidectomy (10%), rectal cancer perforation (10%), and injection therapy (10%). Associated conditions included diabetes mellitus (50%), liver cirrhosis (10%), pulmonary tuberculosis (5%), intestinal tuberculosis (5%), ulcerative colitis (5%), Crohn's disease (5%) and iron deficiency anemia (5%). Escherichia coli and bacteroid fragilis were most commonly identified. All 20 patients initially received multiple incisions and debridement. At the time of first surgery, a diverting colostomy was required in 35% of the cases and a ileostomy in 5%. Over the past 10 years, the survival rate of patients with Fournier's gangrene caused from perianal abscess has been high (100%). CONCLUSION: The keys to a successful outcome included early diagnosis, prompt surgical intervention with radical debridement, prompt fluid resuscitation, rapid initiation of broad-spectrum antibiotics, and hemodynamic support in an intensive care setting.

Induction of Metallothionein and Manganese-Containing Superoxide Dismutase by Paraquat in Peripheral White Blood Cells of Patients with Gastric Cancer

PURPOSE: It is known that deficiency of metallothionein (MT) and manganese-containing superoxide dismutase (Mn-SOD), scavengers of reactive oxygen species, results in aging and carcinogenesis by inducing DNA damage. Paraquat can produce reactive oxygen species and induce antioxidants in human. In this study, an attempt was made to verify the relation between gastric carcinogensis and the induction rates of these antioxidants. METHODS: Peripheral blood of 24 randomly selected patients with gastric cancer, who were treated at Chosun University Hospital between Febuuary 1999 and December 1999, was examined. 3 male and 3 female patients in each decade from 40 to 70 years were selected. Twenty-four (24) volunteers with no laboratory, chemical, radiologic and endoscopic abnormalities during the same period were used for the normal control group. White blood cells were isolated from peripheral blood and incubated in culture media, including paraquat, for 18 hours at 37oC. MT and Mn-SOD mRNA expressions were examined using the reverse transcription-polymerase chain reaction (RT-PCR) method. RESULTS: The induction rates of MT and Mn-SOD mRNA in the cancer group due to paraquat were lower than those in the control group. Also, the rates decreased in both groups with age. CONCLUSION: The inducibilities of MT and Mn-SOD mRNA by paraquat may play a role in the carcinogenesis of gastric cancer and in the aging process. Based on this result, patients with a high risk of gastric cancer should be screened actively for early detection.

Evaluation method for vinyl chloride exposed workers

BACKGROUND: This study was conducted to evaluate vinly chloride exposure in vinyl chloride and poly vinyl chloride manufacturing factories. The object of this study was compare two different type of air sampling method that of, NIOSH and OSHA recommended and Investigate quantitative correlation between level of vinyl chloride exposure and urinary thiodiglycolic acid excretion. METHODS: Air sampling was conducted by two method and sampling mediums were located at workers breathing zone in the same location. Sampling mediums were changed in 60 minute interval and sampling pumps were recalibrated at the same time. Urine was collected before and end of shift were stored frozen and determined by GC/FID analysis. RESULTS: In NIOSH method, time weighted average was 3.562 +/- 2.898 ppm and OSHA method time weighted average was 4.051 +/- 3.700 ppm. Concentration of urinary TdGA in before shift was 0.527 +/- 0.828 g/g creatinine and end of shift was 4.190 +/- 7.665 mg/g creatinine. Difference of urinary TdGA between end of shift to before shift was 3.662 +/- 7.865 mg/g creatinine. In NIOSH method, correlation coefficient between 8hour-time weighted average (8hrs-TWA) and urinary concentration of TdGA was r=0.666. and last period vinyl chloride level (6th-TWA) and urinary TdGA concentration was r=0.972. In OSHA method, correlation coefficient between last period vinyl chloride level (6th-TWA) and urinary concentration of TdGA was r=0.976 and this was highest value. CONCLUSION: There was no statistically significant difference in NIOSH method and. OSHA method. A correlation were found between level of vinyl chloride exposure and urinary thiodiglycolic acid excretion. Also, vinyl chloride exposure had significantly effected on the urinary thiodiglycolic acid excretion.

Simultaneous analysis of urinary 2-thiothiazolidine-4-carboxylic acid and thiocarbamide as a biological exposure index for carbon disulfide exposure

The objectives of this study were to develop optimal analytic methods for detecting urinary 2-thiothiazolidine-4-carboxylic acid (TTCA) and thiocarbamide simultaneously and to evaluate the usefulness of these metabolites to a biological exposure index (BEI) for carbon disulfide (CS2) exposure. For this experiment, synthesized TTCA and thiocarbamide were used. The synthesized TTCA was identified by infrared spectrophotometer, nuclear magnetic resonance spectrometer and thin layer chromatography. The recovery rates of both metabolites were calculated to find the optimum analytical method. The amounts of urinary TTCA and thiocarbamide were measured by using an ultraviolet detector connected to high performance liquid chromatography (HPLC) after the administration of CS2 (350, 700 mg/kg) into Sprague-Dawley rats intraperitoneally. The maximum absorbance wave lengths for TTCA and thiocarbamide were 272 and 236 nm, respectively. Ethyl acetate extraction with NaCl as a salting-out reagent was used as a simultaneous extraction method for these metabolites. HPLC conditions for these metabolites included using a NH2 column, 50 mM KH2PO4: acetonitrile (85:15) and pH 3. Excreted amounts of urinary TTCA and thiocarbamide were increased significantly following CS2 administration. TTCA, which was already adopted as a BEI for CS2 by the American Conference of Governmental Industrial Hygienists (ACGIH), seems to be a more useful BEI for CS2 exposure than thiocarbamide. However further studies are needed to increase analytical efficiency before thiocarbamide can be adopted as a BEI and to apply this analytic method for simultaneous analysis of these metabolites in workers exposed to CS2.

The Effect of the Cyclosporine in the Renal Ischemic and Reperfusion Injury / 대한이식학회지

During renal ischemia, ATP is degraded to hypoxanthine and xanthine oxidase is accumulated. When reperfusion develops, large amount of oxygen is supplied and superoxide radicals are generated. Free radical species were generated by a series of oxygen mediated reaction resulted in lipid peroxidation in the cellular membrane, which causes renal injury. Cyclosporin (CsA) is a potent immunosuppresant. however, one of the main adverse effects of CsA is nephrotoxicity. The mechanism of nephrotoxicity is still not fully understood. Only we proposed it as being responsible for the derangement of renal function, enhanced free radical species, vasoconstriction, ATP depletion, several vasoactive mediators. Based on the previously studied data with experimental animals, we studied a relationship between ischemia and reperfusion renal injury and cyclosporine with experimental rats. Four groups of Sprague-Dawley rats were studied: 1) a control group, only 60 minnites clamping and on day 3 is sacrified, 2) second control group, 60 minnites clamping and on day 5 is sacrified, 3) in the third and fourth group, after 60 minnites clamping, cyclosporine, 20 mg/kg/day was administrated intraperitoneally and were sacrified on day 3 and day 5, respectively. Antioxidant enzymes (SOD, Catalase), TBA-RS, GGT were measured by a specific biochemical method, and results were analyzed according to Wilcoxon rank sum test. p-value <0.05 was considered statistically significant. In cyclosporin administrated rats, GGT was elevated significantly on day 3 and day 5 (p=0.0367, p=0.0216), but SOD, Catalase, TBA-RS were not identified a significant change. In conclusion, on renal ischemia and reperfusion,cyclosporin induced renal injury is not related to free radical species, which suggests that other unknown mechanisms influence renal injury.