It is the most important to select optimal culture conditions to promote safe embryo growth in the technique of human in vitro fertilization and embryo transfer. It has been shown that the addition of biologic fluids, such as blood serum, of various origins, improved fertilization and early cleavage rates in numerous species. The purpose- of this study is to attempt to measure developmental potential of mouse eggs fertilized and cleaved in Ham's F10 culture medium containing a chelating agent, EDTA and fetal cord serum. hi this study, we selected 40 female mice and 20 male mice, and investigated optimal serum concentration' for mouse embryo growth. Two cell stage mouse embryos were cultured in Ham's F-10 medium, Ham's F-10 medium with various concentrations of EDTA, or Ham's F-10 medium with EDTA and 10% human cord serum. Developmental ratios to morula in Ham's F-10 medium containing various concentrations of EDTA and/or 10% fetal cord serum were significantly higher than in unsupplemented Ham's F-10 medium (p<0.05). Developmental ratios to blastocyst in Ham's F-10 containing 10% fetal cord serum and 5011M or 100pM EDTA were significanldy higher than in unsupplemented Ham's F-10 medium (p<0.05). Developmental ratios to morula in Ham's F-10 containing 10% fetal cord serum and 100,uM EDTA were significanitly higher than in Ham's F-10 with 10% fetal cord serum used commonly in many human IVF centers(p<0.05). Developmental ratio to blastocyst in Ham's F-10 containing 10% fetal cord serum and 100pM EDTA was significanity higher than in Ham's F-10 with 200pM EDTA(p<0.05).
Animals ; Blastocyst ; Edetic Acid* ; Eggs ; Embryo Transfer ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Male ; Mice* ; Morula ; Ovum ; Serum

A 40-year-old man attended our hospital with presenting symptoms of an acutely swollen, tender testicle and bulging mass on the inguinal area. Considered it as urgent conditions no demonstrating blood flow to the involved testicle on Color Doppler ultrasonography, we underwent scrotal exploration right away. On operative finding the right testis was so enlarged and engorged secondarily to the irreversible ischemic damage, but torsion of spermatic cord was not found. Another inguinal approach revealed herniated mass protruding from internal inguinal ring and compressing the spermatic cord. For further evaluation abdominal ultrasonography and CT scan was done and huge mass occupying right lower quadrant of abdomen and pelvic cavity was noted. The resected tumor through surgical exploration was proved to be a retroperitoneal liposarcoma pathologically. Herein we report an uncommon case of testicular infarct, mimicking torsion of spermatic cord that is a urological emergency, caused by herniated retroperitoneal mass. So the present report suggest that, when adult men attend with symptoms of acutely swollen painful testicle, we pay a more careful attention to patient,s physical findings and recommend further diagnostic evaluation.
Abdomen ; Adult ; Emergencies ; Humans ; Inguinal Canal* ; Liposarcoma* ; Male ; Spermatic Cord ; Testis ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasonography, Doppler, Color

One hundred patients with hyperventilation syndrome presenting to emergency department(ED) were studied. Those were diagnosed on clinical basis by emergency medical physician. The male to female ratio was 15 : 85. In monthly distribution, the numbers of patients were increased during the two months, June and July. The 41% of patients visited the emergency center from 9:00 p.m. to 3:00 a.m.. The most common predisposing factors were the domestic problems, especially those between husband and wife(37%). Presenting complaints were dyspnea(34), paresthesia(30), muscle spasm(24), dizziness(6) and palpitation(6 patients). The initial examination of the patients in the ED were as follows, systolic blood pressure(134+/-7.15mmHg), heart rate(87.67+/-14.34/minute), respiratory rate(22.21+/-3.34/minute) and body temperature(36.61+/-0.31 degrees C, n=98). Arterial blood gas analysis showed alkalemia(pH 7.51+/-0.09) and hypocapnia(PCO2 26.67+/-8.30mmHg). After emergency cares, including carbone dioxide re-breathing and antianxietics, most of the symptoms were disappeared. The mean duration of stay in ED was 3.27+/-0.23 hours. The most important considerations in diagnosis of hyperventilation syndrome was the patients's history and the effective management was carbon dioxide rebreathing for a few minutes and antianxietics.
Blood Gas Analysis ; Carbon ; Carbon Dioxide ; Causality ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Heart ; Humans ; Hyperventilation* ; Male ; Spouses

Recurrent peritonitis is the major complication of continuous ambulatory peritoneal dialysis (CAPD) and a common reason for discontinuation of this form of therapy. Polymicrobial peritonitis by gram- negative organisms suggests intraabdominal pathology not directly associated with CAPD, necessitating early removal of catheter and/or abdominal exploration. The source of infection may still be gastrointestinal, especially in light of the polymicrobial gram-negative peritonitis and rarely be gastrointestinal malignancy. We recently experienced a case of 64-year-old woman with recurrent CAPD peritonitis by polymicrobial gram-negative organisms, originated from colon cancer. Colon cancer was confirmed by barium enema, abdominal CT and colonoscopic biopsy. She underwent right hemicolectomy and removal of catheter simultaneously. The biopsy revealed a moderately to poorly differentiated adenocarcinoma with abundant mucin production.
Adenocarcinoma ; Barium ; Biopsy ; Catheters ; Colon* ; Colonic Neoplasms* ; Enema ; Female ; Humans ; Middle Aged ; Mucins ; Pathology ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tomography, X-Ray Computed

PURPOSE: This study was performed to show the several clinical variables before and after the surgery that need to be considered for patient selection and whether there is an increased possibility of recurrence after surgery and whether this possibility can be reduced when adjuvant treatment is applied. METHODS: The outcome of SSM with immediate breast reconstruction, using follow-up data of cases performed at Asan Medical Center between September, 1996 and December, 2002, were retrospectively assessed and pathologically advanced breast cancer patients (stage III) were analyzed separately. RESULTS: 191 patients had undergone SSM with immediate reconstruction during the study period. The percentage of cases stage III was 15.2% (29 cases). Among these patients, 6 (20.7%) were suspected of being in the early stages of breast cancer prior to the surgery. The mean age of the advanced breast cancer patients was 37 years. Immediate breast reconstruction consisted of a pedicled TRAM flap (n=24), a insertion of tissue expander (n=4) or direct implant (n=1). Radiotherapy was performed in 16 patients (53.3%) and chemotherapy was conducted without delay in all case. With a median length of follow-up of 36.1 months for 22 patients, who under went the operation until December, 2001, local recurrence was 4.5% (1/22) with successful local treatment, and distant metastasis was 13.7% (3/22). There was no difference in the disease free survival compared to that of the non-reconstruction group (P=0.093). CONCLUSION: SSM with immediate reconstruction seems safe and effective for patients with advanced breast cancer. However an accurate preoperative assessment of the extent of the disease and discussion for the planning of treatment between surgeon and patient is required.
Breast Neoplasms* ; Breast* ; Chungcheongnam-do ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy* ; Neoplasm Metastasis ; Patient Selection ; Radiotherapy ; Recurrence ; Retrospective Studies ; Tissue Expansion Devices

BACKGROUND: Although bone marrow (BM) or mobilized peripheral blood (PB) is frequently used as the source of hematopoietic stem cells, hematopoietic stem cell transplantation (HSCT) using cord blood (CB) is gradually gaining popularity in many countries. However, BM or PB is still preferred over CB in Korea. Therefore, we tried to assess the awareness of CB transplantation (CBT) among domestic HSCT physicians and develop strategies for boosting its utilization by administering questionnaires to some of these physicians. METHODS: A direct questionnaire survey was conducted using the "Audience Response System" among 301 members who attended the annual meeting of the Korean Society of Blood and Marrow Transplantation. The data were analyzed for only 67 board certified physicians who were directly involved in HSCT activities. RESULTS: The poor outcomes resulting from insufficient experience in CBT was designated by the physicians as the main reason for the low domestic implementation of HSCT using CB. Other reasons identified in the survey were distrust in the quality and management of domestic CB and the high cost of obtaining CB. CONCLUSION: Increasing the use of donated CB would foremost require increasing the inventory of donated CB containing a sufficient cell number for CBT and securing structured quality control of the CB banks. In addition, it would be necessary to minimize CB supply costs and continue to provide academic data, including CBT guidelines, so that clinicians could perform CBT with more confidence.
Bone Marrow ; Cell Count ; Fetal Blood* ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Korea ; Quality Control ; Surveys and Questionnaires

Depth of prostate volume from the skin can vary due to intra-fractional and inter-fractional movements, which may result in dose reduction to the target volume. Therefore we evaluated the feasibility of automated depth determination-based adaptive proton therapy to minimize the effect of inter-fractional movements of the prostate. Based on the center of mass method, using three fiducial gold markers in the prostate target volume, we determined the differences between the planning and treatment stages in prostate target location. Thirty-eight images from 10 patients were used to assess the automated depth determination method, which was also compared with manually determined depth values. The mean differences in prostate target location for the left to right (LR) and superior to inferior (SI) directions were 0.9 mm and 2.3 mm, respectively, while the maximum discrepancies in location in individual patients were 3.3 mm and 7.2 mm, respectively. In the bilateral beam configuration, the difference in the LR direction represents the target depth changes from 0.7 mm to 3.3 mm in this study. We found that 42.1%, 26.3% and 2.6% of thirty-eight inspections showed greater than 1 mm, 2 mm and 3 mm depth differences, respectively, between the planning and treatment stages. Adaptive planning based on automated depth determination may be a solution for inter-fractional movements of the prostate in proton therapy since small depth changes of the target can significantly reduce target dose during proton treatment of prostate cancer patients.
Humans ; Prostate ; Prostatic Neoplasms ; Proton Therapy ; Protons ; Skin

Depth of prostate volume from the skin can vary due to intra-fractional and inter-fractional movements, which may result in dose reduction to the target volume. Therefore we evaluated the feasibility of automated depth determination-based adaptive proton therapy to minimize the effect of inter-fractional movements of the prostate. Based on the center of mass method, using three fiducial gold markers in the prostate target volume, we determined the differences between the planning and treatment stages in prostate target location. Thirty-eight images from 10 patients were used to assess the automated depth determination method, which was also compared with manually determined depth values. The mean differences in prostate target location for the left to right (LR) and superior to inferior (SI) directions were 0.9 mm and 2.3 mm, respectively, while the maximum discrepancies in location in individual patients were 3.3 mm and 7.2 mm, respectively. In the bilateral beam configuration, the difference in the LR direction represents the target depth changes from 0.7 mm to 3.3 mm in this study. We found that 42.1%, 26.3% and 2.6% of thirty-eight inspections showed greater than 1 mm, 2 mm and 3 mm depth differences, respectively, between the planning and treatment stages. Adaptive planning based on automated depth determination may be a solution for inter-fractional movements of the prostate in proton therapy since small depth changes of the target can significantly reduce target dose during proton treatment of prostate cancer patients.
Humans ; Prostate ; Prostatic Neoplasms ; Proton Therapy ; Protons ; Skin

Extramedullary plasmacytoma (EMP) is a plasma cell tumor located outside of the bone marrow. It most often occurs in the upper respiratory tract (85%), as well as the head and neck, and very rarely occurs in the retroperitoneum. Here we report the case of a 57-year-old woman with retroperitoneal EMP.
Bone Marrow ; Female ; Head ; Humans ; Middle Aged ; Multiple Myeloma ; Neck ; Plasmacytoma* ; Respiratory System ; Retroperitoneal Fibrosis ; Retroperitoneal Space

Primary extrapulmonary small cell carcinoma(SCC) is appearing with increased frequency in the literature. These tumors have been described in the esophagus, stomach, pancreas, larynx, hypopharynx, salivary gland, nasal cavity & paranasal sinus, thymus, small & large bowel, uterine cervix, endometrium, breast, prostate, urinary bladder and skin. Small cell carcinoma of the stomach is extremely rare and a total 9 cases have been reported in the English literature. Like SCC in the lung, SCC in the alimentary tract has a aggresive behavior and prognosis of the patient is poor. We are reported a case of advanced gastric cancer diagnosed as small cell type by endoscopic biopsy. Grossly, the lesion of small cell carcinoma of the stomach, located in the upper body and gastric angle, is ulcerated with irregular margin and dirty surface covered with blodd clots and exudates.
Biopsy ; Breast ; Carcinoma, Small Cell* ; Cervix Uteri ; Endometrium ; Endoscopy ; Esophagus ; Exudates and Transudates ; Female ; Humans ; Hypopharynx ; Larynx ; Lung ; Nasal Cavity ; Pancreas ; Prognosis ; Prostate ; Salivary Glands ; Skin ; Stomach Neoplasms ; Stomach* ; Thymus Gland ; Ulcer ; Urinary Bladder