Cytotoxic Variant of Mycosis Fungoides with CD8+ CD56+ Phenotype: A Case Report and Review of Literature

No abstract available.

Fetal Heart Rate Regresses toward the Mean in the Third Trimester

The purpose of this study was to investigate the feasibility of different fetal heart rate (FHR) ranges in the nonstress test (NST) and to better understand the meaning of mild bradycardia and/or tachycardia without non-reassuring patterns. We employed the heredity to show that mild bradycardia (100-119 beats per minute, bpm) and mild tachycardia (161-180 bpm) regressed to the normal FHR range (120-160 bpm). We used linear regression to analyze FHR data from FHR tracings recorded 10 min before (NST, as the predictor) and 10 min after vibroacoustic stimulation testing (as the dependent variable). Acceleration for 15 bpm-15 seconds (Acc1515) and deceleration for 15 bpm-15 seconds (Dec1515) in the NST were also analyzed for each group. The slope of the best-fit line was the largest in the mild bradycardia group and the smallest in the normal range group. Dec1515 was most prominent in mild tachycardia and both the mild bradycardia and tachycardia groups regressed towards the mean FHR range. Therefore, we propose that both mild bradycardia and tachycardia of FHR in non-acute situations (range between 100 and 180 bpm) are not regarded a pathologic signal for clinical use.

Current Trends of the Incidence and Pathological Diagnosis of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) in Korea 2000-2009: Multicenter Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: As a result of various independently proposed nomenclatures and classifications, there is confusion in the diagnosis and prediction of biological behavior of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). A comprehensive nationwide study is needed in order to understand the biological characteristics of GEP-NETs in Korea. MATERIALS AND METHODS: We collected 4,951 pathology reports from 29 hospitals in Korea between 2000 and 2009. Kaplan-Meier survival analysis was used to determine the prognostic significance of clinicopathological parameters. RESULTS: Although the GEP-NET is a relatively rare tumor in Korea, its incidence has increased during the last decade, with the most significant increase found in the rectum. The 10-year survival rate for well-differentiated endocrine tumor was 92.89%, in contrast to 85.74% in well differentiated neuroendocrine carcinoma and 34.59% in poorly differentiated neuroendocrine carcinoma. Disease related death was most common in the biliary tract (62.2%) and very rare in the rectum (5.2%). In Kaplan-Meier survival analysis, tumor location, histological classification, extent, size, mitosis, Ki-67 labeling index, synaptophysin expression, lymphovascular invasion, perineural invasion, and lymph node metastasis showed prognostic significance (p<0.05), however, chromogranin expression did not (p=0.148). The 2000 and 2010 World Health Organization (WHO) classification proposals were useful for prediction of the prognosis of GEP-NET. CONCLUSION: The incidence of GEP-NET in Korea has shown a remarkable increase during the last decade, however, the distribution of tumors in the digestive system differs from that of western reports. Assessment of pathological parameters, including immunostaining, is crucial in understanding biological behavior of the tumor as well as predicting prognosis of patients with GEP-NET.

The preconception stress and mental health of couples

The ultimate goal of the 'baby plan' is a healthy pregnancy and successful child rearing. Focusing on baby planning, this article covers issues concerning a successful and healthy pregnancy with a psychiatric point of view-the stress and mental health before the pregnancy. According to recent findings, stress influences a women's infertility rate 10 to 15 percent, and a major psychological reason is found to be depression rather than anxiety disorder. The infertility of men is also influenced by stress, based on the research findings that the density and quality of sperm worsens after disasters. Excessive stress before and during pregnancy could result in pre-term labor, small for gestational age infants, or reduced infant weight. In order to prevent these preconception distresses, psychiatric care and treatment are needed. In this regard, Eastern traditional wisdom could be helpful in the view of psychotherapy, since it has been traditionally approved and welcomed for more than a thousand years. One of the insights is that a sound relationship between a husband and wife is a foundation of a good family, and this has already been determined from the moment when the two met for the first time. In conclusion, preconception stress could negatively influence fertility and could have a negative effect on a pregnancy. Thus stress should be alieviated for a healthy pregnancy and successful child rearing by psychotherapeutic intervention.

Preconception infection and genetic counseling

Congenital malformations are a common cause of illness, handicapping conditions, and death. Errors of morphogenesis leading to congenital anomalies have many recognized causes, including specific single-gene mutations, chromosome imbalances, and the action of teratogenic agents. Most congenital anomalies, however, are of multifactorial origin, occurring by complex interactions between not yet well understood genetic and environmental factors. Two to six percent of the newborn babies worldwide, i.e., 3 to 9 million infants a year, suffer from major congenital anomalies and genetic diseases. However, a great deal of this misery could be avoided. In particular, preconception care is more important than prenatal care for prevention of congenital anomalies since as many as 30 percent of pregnant women begin traditional prenatal care in the second trimester (>13 weeks of gestation), which is after the period of maximal organogenesis. Women and their partners whose ethnic background, race, or personal or family history places them at increased risk of having a fetus with a genetic disease should receive appropriate counseling. Furthermore, certain laboratory tests of the infection status of couples may be helpful in assessing the risk for and preventing some complications during pregnancy. Preconception evaluation and appropriate counseling permits parents to make informed reproductive decisions and provides reassurance.

Importance of preconception care in low-fertility society of Korea

No abstract available.

The concepts and necessity of preconception care for men

Several international initiatives have taken place with themes such as "Men as Partners in reproductive health". Furthermore, many articles have recently been published concerning men's preconception care before pregnancy. However, little attention has been paid to this field in Korea. The concept of preconception health and health care for men is very important for pregnancy outcomes, and furthermore, for the health of their future families. Men's contribution to the pregnancy is clear for planned pregnancy and also offers an opportunity for disease prevention and health promotion in men themselves. This paper reviews the important concept of men's health for preparing for pregnancy, and summarizes key component of a comprehensive approach to optimizing the preconception health status of men as expecting fathers. In fact, many clinicians including most obstetricians-gynecologists in Korea are not trained to provide preconception health and care for men. In addition, no consensus has been developed on basic guidelines for preconception care including the pregnancy planning for men and women, laboratory tests before pregnancy, vaccination programs, and much more information on preparing for a successful pregnancy. To improve preconception care for men in Korea, many barriers must be overcome, such as lack of national services, financing, organization, and men's and women's understanding of the importance of preconception health for their pregnancy. Therefore, much more research is needed on men's preconception care in Korea.

Usefulness of the Attic Reconstruction Using the Tragal Cartilage and Perichondrium for Prevention of a Retraction Pocket

BACKGROUND AND OBJECTIVES: Bone defect of the attic wall is a critical cause of the postoperative retraction pocket after canal wall up mastoidectomy. So, proper treatment of the attic defect is important and attic reconstruction is an acceptable procedure but it is controversial when the attic is reconstructed or not. The aim of this study is to analyze the usefulness of the attic reconstruction using tragal cartilage and perichondrium for prevention of retraction pocket and propose the indication to perform the attic reconstruction. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 46 consecutive patients who underwent tympanomastoidectomy and attic reconstruction using tragal cartilage between January 2005 and January 2009. The follow-up period varied from 12 to 65 months, with the average period of 34 months. We analyzed postoperative status of the scutum and the tympanic membrane, and development of the residual or recurrent cholesteatomas and evaluate development of the retraction pocket according to the preoperative size of the bony defect of the scutum and status of the ossicular chain. RESULTS: Retraction pocket was developed in the 13% of the operations and most of the cases had large attic destruction more than 3 mm and destructed ossicular chain. CONCLUSIONS: Attic reconstruction using tragal cartilage is a simple method to repair the bony defect of the external ear canal and effective in preventing postoperative retraction pocket if the size of destructed scutum is less than 3 mm.

A Case of Spontaneous Temporomandibular Joint Herniation into the External Auditory Canal / 대한이비인후과학회지

Bony defects of the external auditory canal (EAC) may arise from a tumor, infection, inflammation, trauma, complications from ear surgery, or congenital disease. Congenital bony defects of the EAC are known as a patent Huschke's foramen. Here, we describe a 76-year-old male patient who presented an otalgia in his right ear. Physical examination revealed a dome shaped swelling of the anterior EAC wall, which repeated swelling and retraction as the patient's mouth closed and opened. Computed tomography revealed a bony defect of the anterior EAC wall. We believe that the patent Huschke's foramen allowed spontaneous herniation of the temporomandibular joint into the EAC.

One Case of Chronic Renal Failure and Another Case of Membraneous Glomerulonephritis Complicated by Acute A Viral Hepatitis / 대한신장학회지

Acute A viral hepatitis is a mild, self-limiting disease of liver and acute renal failure (ARF) is a rare complication. We report two cases of chronic renal failure (CRF) in nonfulminant acute A viral hepatitis and ARF. A 40-year-old man was admitted with ARF and acute A viral hepatitis, and underwent temporary hemodialysis therapy. The renal biopsy showed acute tubular necrosis with tubulointerstitial nephritis. At 13 months after discharge serum creatinine was 1.33 mg/dL and protein-creatinine ratio of spot urine was 0.47 (mg/mg Cr). The second case was a 28-year-old man and was managed conservatively. At discharge the serum creatinine was 3.14 mg/dL and the urinalysis showed hematuria, and protein-creatinine ratio 0.56 (mg/mg Cr). Thirty-nine months after discharge, the creatinine was 1.23 mg/dL, the urinalysis showed persistent nephritis findings and the protein-creatinine ratio 1.28. Kidney biopsy revealed the membranous glomerulopathy with mild tubulointerstitial nephritis, and all of findings suggested the systemic disease-associated secondary glomerulopathy. To our knowledge our case is the first one of chronic glomerulapathy that is confirmed by kidney biopsy.

Cytogenetic Study for Reciprocal and Robertsonian Translocation / 대한주산의학회잡지

PURPOSE:This study was aimed to evaluate the incidence of translocation and types of translocations (reciprocal or Robertsonian) in cases of cytogenetic analysis. Method:The incidence of translocation was calculated and types of translocation were classified in 390 individuals who perfomed cytogenetic analysis in Hanyang University Hospital from January, 2005 to February, 2009. RESULTS:The overall incidence of translocation was 3.1% (12/390). Among these translocations, 8 cases were having reciprocal translocations showing karyotypes of 47,XXY,t(11;22)(q23;q11.2), 46,XY,t(4;8)(q31.1;q11.2), 46,X,inv(Y)(p11.3q11.23),t(8;9)(q24.3;q34.1), 46,XY,t(14;16)(q32;q22), 46,XX,t(6;7)(q27;p11.2), 46,XX,t(1;4)(q25;q33), 46,XX,t(3;5)(q25;q22) and 46,XX,t(1;2)(p36.1;p25.1) in each. Last 4 cases of translocations were Robertsonian translocations showing karyotypes of 45,XY,der (13; 15)(q10;q10), 45,XY,der(13;14)(q10;q10), 45,XY,der(13;14)(q10;q10)and 45,XX,der (22;22)(q10;q10) in each. CONCLUSION:Although patients are phenotypically normal, they might be balanced translocation carriers. In high risk patients, translocations are more frequent than normal population. Classification of translocation is necessary for further genetic counseling according to the types.

A Case of Anterior Inferior Cerebellar Artery Infarction Initially Presented a Sudden Sensorineural Hearing Loss with a Normal Diffusion-weighted Brain MRI / 대한평형의학회지

A sudden hearing loss with vertigo may originate from vascular insufficiency and sometimes presents as a prodrome of anterior inferior cerebellar artery infarction. Here we describe the case of a 48-year-old male patient who presented with a sudden onset of hearing loss in his right ear and severe, whirling type dizziness without associated neurological signs or symptoms. The diffusion-weighted magnetic resonance imaging (MRI) was normal on initial presentation, but 4 weeks after the onset of symptoms, the patient developed ipsilateral facial paralysis and dysarthria. A follow-up MRI revealed acute infarction in the territory of the anterior inferior cerebellar artery, involving the right lateral pons, right middle cerebellar peduncle, and inferolateral cerebellum.

Defect in Post-mortem Examination System Reviewed by the Realities of Death Certificate Issuing / 대한법의학회지

Death certificate is one of the most important medical documents for public health surveillance and it serves a tool for national health statistics. The authors analyzed 125 cases of death certificate for suspicious death from 276 medico-legal autopsy cases. When compared to autopsy results, almost all death certificates were inaccurate and inadequate for estimation of cause of death and manner of death. To decide a man's cause of death or manner of death is not easy job, even though for forensic pathologist after completing dissection and toxicological analysis. The authors think that inadequate death certificate is originated from insufficient medical education system and imperfect postmortem examination system. It may cause covering up the serious crime. The authors assert to reform the issuing system of death certificate, especially separation of death certification by attending physician and certification for death on arrival cases. The summary of present study is as follows ; 1. 52 cases (41.6%) did not follow the new form of death certificate ruled by law. 2. 66 cases (52.8%) were undetermined on the manner of death in death certificate, 3. Matching rate of cause of death and manner of death between death certificate and autopsy result was 56.8% (71 cases) and 36.8% (46 cases), respectively. 4. There were many critical or trivial faults in writing of death certificate, for example omission of direct cause of death or manner of death determination or serial number, etc.

Two Consecutive Deaths from Choking Asphyxia / 대한법의학회지

Choking is a type of asphyxia caused by obstruction within the air passages. Two old men died consecutively in a rural community party while enjoying raw beef and drinks. The time interval between the two deaths was about 3 hours. A lump of raw beef obstructing the laryngeal inlet was found in both cases accompanying conjunctival petechiae, heart blood liquidity and congested internal solid organs. The first victim had moderate to severe degrees of coronary atherosclerosis and fatty liver with the blood alcohol level 0.251% and the second one showed liver cirrhosis and the same coronary lesion with the blood alcohol level 0.175%. It is interesting but uncommon to see the circumstance that accidental choking asphyxias with raw beef occur within a few hours in the same place.

Expression of immunoreactive leptin and its receptor in epithelial ovarian cancer / 대한산부인과학회지

OBJECTIVE: Leptin, a secreted protein of the Ob gene by white adipose tissue, plays an important role in the regulation of food intake and energy consumption in the brain and acts as a potential growth stimulator in normal and neoplastic breast cancer cells. However, a potential role of leptin as an endocrine regulator is unknown in ovarian cancer. In the present study, we investigated the expression of leptin and its receptors in various histologic types of ovarian cancer and immortalized ovarian cancer cell lines to find out potential effect of leptin on the cell growth and activation of ovarian cancer cell line. METHODS: The ovarian cancer tissues, serous (n=18), mucinous (n=15), clear cell (n=12) and endometrioid type (n=14), were used for immuno-histochemical staining for leptin (Ob) and leptin-receptors (Ob -R). Ovrian cancer cell lines (non-mucinous: SNU-8, OVCAR-3, and SKOV-3) and mucinous: MUC) were used for RT-PCR, Western blot analysis, and [H3] thymidine incorporation assay for the cell growth and activation of mitogen-activated protein kinase. RESULTS: Both long (Ob-Rb) and short (Ob-Rt) isoforms of leptin receptors are expressed in non-mucinous type of ovarian cancer tissues (serous, clear cell carcinoma and endometrioid cell carcinoma) and in non-mucinous ovarian cancer cell lines (SNU-8, OVCAR-3 and SKOV-3 cells). However, leptin and its receptors are not found in mucinous cancer cells and mucinous cancer cell line (MUC). In immunohistochemical staining, the immunreactive leptin is expressed on the nuclei of the stratified cuboidal-to-columnar epithelial cells whereas its receptor was sparsely expressed on the innermost epithelial cell clusters and cytoplasm in non-mucinous tumor. However, there are no immunoreactive leptin and its receptor expressions in the mucinous tumor. In addition, treatment with leptin resulted in the growth stimulation of ovarian cancer cell line, an activation of ERK 1/2 and inhibition of constitutive phosphorylation of p38 Mitogen-activated protein kinase (MAPK). CONCLUSION: Taken together, our data demonstrates preliminary that the expression of leptin and its receptor is different according to the cell types of the ovarian cancer. Also it canbe thought that leptin immunolocalized on the nuclei in non-mucinous type but not in mucinous possibly acts as a nuclear transcription factor. Further studies are necessary to validate whether leptin may be a potential regulator for ovarian cancer.

Analysis of 12 Autopsy Cases related with Insurance Money / 대한법의학회지

Life insurance has been developed in means of providing economic compensation for unexpected accidental losses. As the insurance industry of Korea grows along with improvement of economic state, the life insurance crime has now appeared as an increasing social issue. The studies on the life insurance crime in Korea have been barely done with the viewpoint of forensic medicine and science. An understanding of insurance crime cases may be fundamental to develop the system to uncover or prevent it. The authors examined the definition of life insurance crime and twelve cases of insurance money related death investigated by postmortem examination through autopsy file of WDO, NISI in Korea. This article analyzes twelve autopsy cases related with insurance money, even though some cases have no proven investigative evidence or court ruling. A feature found in the cases is that it has the tendency of occurring among family members. Other characteristic is that automobiles are exploited with elaborately planned crime plots. To achieve an efficient prevention method for cutting down these insurance crimes, active government's engagement, assiduous operation of investigation authorities, insurance company's co-effort, and good information exchange system should be worked cooperatively.

A case of one fetal demise of twin pregnancy by umbilical artery stricture / 대한주산의학회잡지

A death of one fetus in twin pregnancy is a rare obstetric complication. And the stenosis of umbilical cord artery is a very rare complication of cord abnormalities. The umbilical cord showed a false knot due to accentuation of a vascular spiral with a dilated vein and two arteries with incomplete patency of the lumen. This is the first report of single demise of twin pregnancy due to umbilical artery stenosis and umbilical vein varix.

Computerized analysis of fetal heart rate in normal term pregnant women categorized by birth weight and fetal sex / 대한주산의학회잡지

PURPOSE: The objective of this study is to compare the difference of each fetal heart rate (FHR) variables between each categorized group according to birth weight and fetal sex using computerized analysis system of fetal heart rate. METHODS: Non stress test (NST) of four hundred normal pregnant women were grouped based on birth weight to 4 groups, <2,500 g, 2,500~<3000 g, 3,000~<3,500 g and above 3,500 g. Fifty male and 50 female babies entered to each group. So, 100 normal pregnant women entered for the study in each group. For collection and analysis of data and values of each variables, our own FHR interpretation sofware, HYFM-II (Windows version 1.0) was used. RESULT: From the comparison between each group classified by each criteria, there were no specific significant differences in baseline FHR, FHR variability (amplitude & mean minute range), signal loss rate, number of fetal movements, the number of FHR acceleration & the number of FHR deceleration those were obtained by our computerized FHR analysis system. CONCLUSION: We confirm that there were no specific differences in each FHR varibles according to birth weight and fetal sex at least in term normal pregnancy.

A De Novo Centric Fission of Chromosome 11 in a Patient with Recurrent Miscarriages

We report on a de novo centric fission of chromosome 11 in a healthy female referred for chromosome analysis due to recurrent miscarriages. Both fission products were mitotically stable. This centric fission of chromosome 11 appears to have no clinical significance for this patient other than recurrent miscarriages.

The Morris Water Maze Performance in Androgenized Female Rats: Sexual Dimorphisms in Spatial Memory and Effects of Testosterone / 신경정신의학

OBJECTIVES: It is widely accepted that gonadal steroids are involved in organization and activation of sexual dimorphism in the brain areas related with spatial learning. This study aimed to test the following hypothesis: 1) spatial memory is affected by sex, 2) this difference is related with brain differentiation by exposure to testosterone in the neonatal period, and/or 3) the sexual difference of spatial memory is the result of the interaction between organization of sexual dimorphism in the brain and the circulating testosterone after growing up. METHODS: Testosterone enanthate 100 microgram ('androgenized') or vehicle ('control') was randomly administered to 28 female and 25 male rat pups within 24 hour of birth. The escape latencies (EL) in Morris water maze were measured in 15 and 16 week of age with vehicle ('baseline') and with 10 micromol/kg of testosterone ('with testosterone'), respectively. Each session consisted of 10 trials, and means of the last 5 trials were analyzed. RESULTS: The baseline EL of the males were significantly shorter than females regardless of neonatal exposure to testosterone. With testosterone, EL of the androgenized females were significantly shorter than control females and comparable to those of males. CONCLUSION: Neonatal exposure to testosterone in female rats may develop a tesosterone-dependent male-like spatial learning system.