OBJECTIVE: The present study was performed to investigate whether apoptosis occur in human embryos by annexin staining and detect the expression of Fas, Fas-ligand (FasL), Bax, and Bcl-2 in human fragmented embryos derived from IVF-ET by immunofluorescence and Western blot analysis. MATERIALS AND METHODS: Using annexin staining, immunofluorescence and Western blot analysis on normal and fragmented embryos, we were able to detect apoptotsis and apoptotic gene products in fragmented embryos. RESULTS: Phosphatidylserine (PS) translocation, the marker for apoptosis, were detected frequently in fragmented embryos. Bcl-2 and Bax protein were detected in both fragmented and non-fragmented embryos. When fragmented embryos compared to normal embryos, immunofluorescent intensity of Bcl-2 tended to be lower in fragmented embryos. Bax gene expression increased in the fragmented embryos compared to the normal embryos. This result supports a model in which the molar ratio of Bcl-2 to Bax determines whether apoptosis induced or inhibited in human embryo. Fas was highly expressed in human preimplantation embryos but not FasL. It suggests that embryo may undergo apoptosis by binding with FasL produced by follicular or immune cells. CONCLUSION: The over expression of Bax and Fas will trigger apoptosis to lead embryo fragmentation and change embryo to be nonviable.
Apoptosis* ; bcl-2-Associated X Protein ; Blastocyst ; Blotting, Western ; Embryonic Structures* ; Fluorescent Antibody Technique ; Gene Expression ; Humans* ; Molar

BACKGROUND: Non-small cell lung carcinoma is a common tumor with a poor prognosis. Of all malignancies, it is the main cause of death for male and female patients in the Western world. Resection remains the most effective treatment when feasible. Accurate description and classification of the extent of cancer growth are important in planning treatment, estimating prognosis, evaluating end results of therapy, and exchanging information on human cancer research. Until effective systemic therapy is available for non-small cell lung cancer, development of new treatment strategies depends on knowledge of the end results achieved for carefully staged groups of patients in the lung cancer populations. For these reasons, we investigated the sruvival rate in radically resected non-small cell lung cancer patients by newly revised staging system adopted by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer. METHODS: Clinical, surgical-pathologic and follow-up informations on 84 consecutive, previously untreated, patients who received their primary treatment for non-small cell lung cancer were investigated. Staging definitions for the T(primary tumor), N(reginal lymph node), and M(distant metastasis) components were according to the International Staging System for Lung Cancer. Death from any causes was the primary target of the evaluation. RESULTS: The median survival rates were as follows; stage I;79.1 months, stage II;47.3 months, stage III a;22.7 months, stage III b;16.1 months, and stage IV;15.2 months versus newly revised stage I a;58.5 months, stage I b;76.0 months, stage II a; not available, stage II b;43.0 months, stage III a;22.5 months, stage III b;16.1 months, and stage IV;15.2 months. The survival rates were not significantly different between old and newly revised staging system. Cumulative percent survival at 36months after treatment was 100% in stage I a, 80% in stage I b, not available in stage II a,26% in stage II b, and 21% in stage III a respectively. CONCLUSIONS: Although these data were not significantly different statistically, the newly revised lung cancer staging system might be more promising for the accurate evaluation of the prognosis in the non-small cell lung cancer patients.
Carcinoma, Non-Small-Cell Lung* ; Cause of Death ; Classification ; Female ; Follow-Up Studies ; Humans ; Joints ; Lung Neoplasms* ; Lung* ; Male ; Prognosis ; Survival Rate ; Western World

PURPOSE: Hip fractures in hemodialysis patients are accompanied by high rates of complications and morbidities. Previous studies have mainly reported on nonunion and avascular necrosis of femoral neck fractures in this patient group. In this study the complication and clinical results of hemodialysis patients with intertrochanteric fractures treated with proximal femoral intramedullary nailing have been investigated through comparison with patients with normal kidney function. MATERIALS AND METHODS: Forty-seven patients were included; the hemodialysis group (n=17) and the control group with normal kidney function (n=30). The medical history and clinical findings including preoperative and postoperative blood examinations, radiological examinations and ambulatory status (measured using the Koval score). The rate of complications and morbidities were also investigated and compared. RESULTS: Preoperative hemoglobin/hematocrit was lower but a significant increase in partial thromboplastin time was observed in the hemodialysis group. The amount of bleeding/transfusions were higher and operative time was longer in the hemodialysis group. Upon radiologic examination, there was no significant difference in rate of unstable fracture and nonunion between the two groups. However the postoperative Koval score was significantly worse and the odds ratio of inability to walk after surgery was 13.5 times higher in the hemodialysis group. CONCLUSION: There was no significant difference in radiological results, but the risk of inability to walk after surgery was 13.5 times higher in the hemodialysis group. Hemodialysis patients have more morbidities and are hemodynamically unstable therefore require special attention. Accurate reduction and firm fixation is required and attentive postoperative rehabilitation is needed.
Femoral Neck Fractures ; Femur ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Kidney ; Necrosis ; Odds Ratio ; Operative Time ; Partial Thromboplastin Time ; Rehabilitation ; Renal Dialysis*

Adenoid cystic carcinoma (ACC) is a rare type of breast carcinoma and this tumor makes up less than 0.1% of all mammary carcinomas; ACC is known to show a relatively favorable prognosis. Among a variety of microscopic growth patterns of mammary ACC, a solid variant is the rarest and this can cause diagnostic difficulties. We present here a case of a solid variant of mammary ACC that occurred in the right breast of a 40-year-old woman who was initially diagnosed with invasive ductal carcinoma. We discuss the histological and clinical characteristics of this case.
Adenoids* ; Adult ; Breast ; Breast Neoplasms ; Carcinoma, Adenoid Cystic* ; Carcinoma, Ductal ; Female ; Humans ; Prognosis

Until 1972, many carcinoid tumors of the thymus were not recognized as distinct lesions and were mistakenly labeled as variants of thymomas. Thymic carcinoid tumors are unusual neoplasms that show different morphological, functional, and behavioral characteristics than those of thymomas. We report a case of a 65-year-old woman with thymic carcinoid tumor. The cinicopathological findings are discussed with a review of the literature.
Aged ; Carcinoid Tumor* ; Female ; Humans ; Thymoma ; Thymus Gland

Thymoma is the most common tumor in the compartment of anterior mediastinum. The malignant thymoma is classified into invasive thymoma( category I ) and thymic carcinoma( category II ). Recently, well-differentiated thymic carcinoma is a proposed category 1.5 used to describe a subset of thymic epithelial tumors, allowing for the existence of intermediate form based on the clinical features and the histological characteristics. Thymic cyst is a congenital or a acquired disorder. Congenital thymic cyst may develop due to failure of the thymopharyngeal duct to obliterate and acquired thymic cyst develops from inflammation( multilocular thymic cyst ), or neoplasm( cystic thymoma ). Cystic degeneration in thymoma is a relatively frequent but focal event. In rare cases, the process proceeds to the extent that most or all of the lesion becomes cystic. Until now, well-differentiated thymic carcinoma with extensive cystic degeneration has not been reported in our country. We experienced a case of 14 year-old female patient showing extensive cystic degeneration in well-differentiated thymic carcinoma. and so we report it with review of the articles related.
Adolescent ; Female ; Humans ; Mediastinal Cyst ; Mediastinum ; Thymoma*

Food-dependent exercise-induced anaphylaxis has been recognized a variant of exercise-induced anaphylaxis charaterised by symptoms occuring on exertion after certain meal. We experienced a patient who developed an anaphylaxis induced by wheat flour made food followed by exercise only in cold temperature. A 22-year-old male patient was presented urticaria, angioedema, dyspnea, and loss of consciousness induced by exercise after ingestion of wheat flour made food only in winter. Skin prick test was negative for wheat or bread but positive for mushroom. By contrast, RAST was positive for wheat and negative for mushroom. In order to confirm the diagnosis exercise challenge test was done. The attack developed after ingestion of wheat flour made food and 10 min of outdoor jogging in temperature about 10 degrees C, but not by indoor treadmill test in temperature about 20 degrees C or ingestion of mushroom. This is the first case of food-dependent exercise-induced anaphylaxis developed only in cold temperature in Korea.
Agaricales ; Anaphylaxis* ; Angioedema ; Bread ; Cold Temperature ; Diagnosis ; Dyspnea ; Eating ; Exercise Test ; Flour ; Humans ; Jogging ; Korea ; Male ; Meals ; Skin ; Triticum ; Unconsciousness ; Urticaria ; Young Adult

Limy bile is characterized by excessive precipitation of calcium carbonate, and generally preceded by gallbladder obstruction. Three case reports have been found in the domestic literatures. It is rare that limy bile syndrome associates cholangitis or calcified gallbladder. We report the case of a patient with limy bile, located in the gallbladder, common bile duct, and intrahepatic duct, with association of calcified gallbladder. This case showed characteristic radiologic and endoscopic findings. The patient was treated by endoscopic sphincterotomy and laparoscopic cholecystectomy.
Bile* ; Calcium Carbonate ; Cholangitis* ; Cholecystectomy, Laparoscopic ; Common Bile Duct ; Gallbladder* ; Humans ; Sphincterotomy, Endoscopic

STUDY DESIGN: Retrospective study. OBJECTIVES: The goal of this study was to evaluate the risk factors of osteoporotic vertebral fractures (OVFs) in patients with Cushing syndrome. SUMMARY OF LITERATURE REVIEW: In most reports, vertebral fractures in Cushing syndrome have been found to be related to osteoporosis. However, few studies have analyzed the clinical risk factors for OVFs. MATERIALS AND METHODS: Thirty-two patients with Cushing syndrome who visited the orthopaedic department complaining of back pain were included in this study. Standing lateral X-rays were performed to evaluate the presence of vertebral fractures, and bone mineral density (BMD) was measured. RESULTS: Of the 32 patients with Cushing syndrome with back pain, 8 (25%) were diagnosed with OVFs using morphometric criteria. The average weight and body mass index of the vertebral fracture group (VF group) were significantly higher than the values observed in the non-vertebral fracture group (non-VF group) (p=0.004, p=0.018). Lumbar BMD was significantly lower in the VF group (p=0.006). A risk factor for OVFs in Cushing syndrome was osteoporosis (odds ratio=18.56, 95% confidence interval=1.72-200.21, p=0.016) regardless of gender, obesity, menopause, or urine free cortisol levels. CONCLUSIONS: OVFs in Cushing syndrome have been associated with overweight, and overweight is an indicator of compliance in the treatment of Cushing syndrome. Therefore, weight reduction and the prevention of osteoporosis should be emphasized in patients with Cushing syndrome to prevent OVFs.
Back Pain ; Body Mass Index ; Bone Density ; Compliance ; Cushing Syndrome* ; Female ; Humans ; Hydrocortisone ; Menopause ; Obesity ; Osteoporosis ; Overweight ; Retrospective Studies ; Risk Factors* ; Weight Loss

PURPOSE: It is unknown whether cilostazol pretreatment reduces postprocedural myonecrosis (PPMN). Cilostazol pretreatment reduces PPMN after percutaneous coronary intervention (PCI). MATERIALS AND METHODS: A total of 120 patients with stable angina scheduled for elective PCI were randomly assigned to a 7-day pretreatment with Cilostazol (200 mg/day) or to a control group. Creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) levels were measured at baseline and at 6 and 24 hours after PCI. The primary end-point was the occurrence of PPMN, defined as any CK-MB elevation above the upper normal limit (UNL). Aspirin and clopidogrel were co-administered for 7 days before PCI, and resistance to these agents was then assayed using the VerifyNow System. RESULTS: There was no difference in baseline characteristics between the final analyzable cilostazol (n=54) and the control group (n=56). Despite a significantly greater % inhibition of clopidogrel in the cilostazol group (39+/-23% versus 25+/-22%, p=0.003), the incidence of PPMN was similar between the cilostazol group (24%) and the control group (25%, p=1.000). The rate of CK-MB elevation at > or =3 times UNL was also similar between the two groups (6% versus 5%, p=0.583). The incidence of cTnI increase over the UNL or to 3 times the UNL was not different between the two groups. There was no significant difference in terms of the rate of adverse events during follow-up, although the cilostazol group showed a tendency to have a slightly higher incidence of entry site hematoma. CONCLUSION: This trial demonstrated that adjunctive cilostazol pretreatment might not significantly reduce PPMN after elective PCI in patients with stable angina.
Aged ; Angina, Stable/drug therapy/enzymology/therapy ; Angioplasty, Balloon, Coronary/*adverse effects ; Creatine Kinase, MB Form/blood ; Female ; Heart Injuries/etiology/prevention & control ; Humans ; Male ; Middle Aged ; Myocardium/pathology ; Necrosis ; Phosphodiesterase 3 Inhibitors/*administration & dosage ; Prospective Studies ; Tetrazoles/*administration & dosage