OBJECTIVE: To investigate whether fetal microchimeric cells were detected in ovarian tissues with pelvic endometriosis. METHODS: Ovarian tissues with endometriosis were obtained from five women who had at least one live-born son and who underwent enucleation of endometriotic cyst or oophorectomy after a diagnosis of endometriotic cyst. Control tissues were obtained from five women with endometriosis who had no pregnant history. Tissue sections were analyzed with fluorescence in situ hybridization for the presence of fetal cells, defined by X and Y chromosome. RESULTS: Fluorescence in situ hybridization using paraffin-embedded ovarian specimens was performed successfully. Male cells were found in ovarian tissues from all five patients. No male cells were found in ovarian tissues from all five controls. CONCLUSION: Fetal microchimeric cells, possibly from feto-maternal cell trafficking were detected in ovarian tissues with endometriosis were obtained from women who had prior male pregnancies. Further study is necessary to understand the role of persistent fetal microchimeric cells in the progression of endometriosis.
Chimerism* ; Diagnosis ; Endometriosis* ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Male ; Ovariectomy ; Pregnancy ; Y Chromosome

BACKGROUND: Video-assisted thoracic sympathicotomy is a definitive minimally invasive treatment for axillary hyperhidrosis. Different techniques exist for controlling axillary hyperhidrosis, but they are temporary and expensive. We compared the results after using two different levels of sympathicotomy for treating axillary hyperhidrosis: T3-T4 and T4. MATERIAL AND METHOD: Between June 2002 and May 2007, 30 patients with isolated axillary hyperhidrosis underwent either T3-T4 or T4 thoracoscopic sympathicotomy in the Department of Thoracic & Cardiovascular Surgery at Wonkwang University Hospital. The patients were divided into two groups. Group I (n=15) was composed of patients who underwent T3-T4 sympathicotomy (thermal ablation), and Group II (n=15) was composed of patients who underwent T4 sympathicotomy (thermal ablation). The procedures were bilateral and simultaneous, involving the use of two 2-mm trocars and a 0-degree 2-mm thoracoscope under general anesthesia with single endotracheal intubation. Outcome parameters included satisfaction rate of treatment, degree of compensatory sweating, and postoperative complications. Patients were interviewed by telephone regarding satisfaction and compensatory hyperhidrosis. RESULT: There were no differences in age between group I and group II. The mean follow-up for the T3-T4 group was 38.7+/-2.3 months, and the mean follow-up for the T4 group was 18.7+/-3.6 months. The immediate therapeutic success rate (within 2 weeks postoperative) was 100% in both groups, and there were no recurrences in either group during the long-term follow-up period. The satisfaction rate was higher (93.3%) in the T4 group than in the T3-T4 group (53.3%), and the incidence of compensatory hyperhidrosis was lower in the T4 group (6.7%) than in the T3-T4 group (46.7%). Postoperative complications included one mild pneumothorax and two instances of intercostal neuralgia. Digital infrared thermographic imaging (DITI) correlated well with postoperative satisfaction. CONCLUSION: Both techniques proved effective for controlling isolated axillary hyperhidrosis. The T4 group had a higher satisfaction rate and lower severity of compensatory hyperhidrosis. Hence, thermal ablation of the lower interganglionic fibers of the third thoracic sympathetic ganglion on the fourth rib is a more practical and minimally invasive treatment than is the T3-T4 surgical method, according to the degree of compensatory sweating in isolated axillary hyperhidrosis.
Anesthesia, General ; Follow-Up Studies ; Ganglia, Sympathetic ; Humans ; Hyperhidrosis ; Incidence ; Intubation, Intratracheal ; Neuralgia ; Pneumothorax ; Postoperative Complications ; Recurrence ; Ribs ; Surgical Instruments ; Sweat ; Sweating ; Telephone ; Thoracoscopes

BACKGROUND: Ventricular septal defect (VSD) is rare but feared complication after acute myocardial infarction. The patient could survive by surgery only, but the surgical mortality is still high. We investigate the surgical result and predictors for early surgical mortality. MATERIAL AND METHOD: Between August 1993 and February 2006, 8 patients (male, 2; female, 6) with postinfarct VSD underwent surgical repair. Seven patients had one-vessel disease of left anterior descending artery, and 6 of them had wide extension of infarction to posterior septal wall as well as anterior septal wall of both ventricles. One patient had concomitant coronary bypass grafting to a coronary lesion unrelated to the infarction. Two patients had concomitant tricuspid annuloplasty and 1 patient mitral valvuloplasty. RESULT: Surgical mortality was 37.5% (3 patients). They all had only one-vessel disease of left anterior descending artery, which made extended posterior septal wall infarction as well as anterior septal wall infarction of both ventricles. In preoperative M-mode echocardiographic study of left ventricle, they had lower ejection fraction than survivors (34.9+/-4.2 vs. 54.8+/-12.3; p=0.036). CONCLUSION: Most of patients with postinfarction VSD had one-vessel disease of left anterior descending artery. Early surgical mortality occurred in the patients with poor ejection fraction of left ventricle and the wide anterior septal wall infarction extending to the posterior septum.
Arteries ; Echocardiography ; Female ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Infarction ; Mortality ; Myocardial Infarction ; Survivors ; Transplants

ABO discrepancy refers to an inconsistency between red cell and serum typings and has various causes, including hypogammaglobulinemia. IgM deficiency is a rare disorder that may accompany several conditions such as infection and autoimmune disorders. Here, we describe a case of IgM deficiency discovered during the evaluation of an ABO discrepancy in a 16-yr-old Korean boy. ABO blood grouping showed that while his cell type was O+, serum typing detected only anti-A (3+). Anti-B was not detectable at room temperature but was graded at 1+ at 4degrees C. ABO genotyping revealed an O/O genotype. His serum IgG, IgA, and IgM concentrations were 770 mg/dL (reference range: 800-1,700 mg/dL), 244 mg/dL (reference range: 100-490 mg/dL), and 13.5 mg/dL (reference range: 50-320 mg/dL), respectively. He was diagnosed with acute osteomyelitis on the basis of clinical presentation and imaging studies. The symptoms gradually improved within 3 weeks of treatment. However, the ABO discrepancy and IgM deficiency persisted even 6 months after recovery and lymphocyte subset analysis revealed CD19+ B cell deficiency. To the best of our knowledge, IgM deficiency detected by ABO discrepancy in a patient with acute osteomyelitis has not been reported before.
ABO Blood-Group System/genetics ; Acute Disease ; Adolescent ; B-Lymphocytes/cytology/immunology/metabolism ; Bone and Bones/radionuclide imaging ; Genotype ; Humans ; Immunoglobulin A/blood ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Immunologic Deficiency Syndromes/complications/*diagnosis ; Knee/radionuclide imaging ; Magnetic Resonance Imaging ; Male ; Osteomyelitis/complications/*diagnosis ; Radiopharmaceuticals/diagnostic use

ABO discrepancy refers to an inconsistency between red cell and serum typings and has various causes, including hypogammaglobulinemia. IgM deficiency is a rare disorder that may accompany several conditions such as infection and autoimmune disorders. Here, we describe a case of IgM deficiency discovered during the evaluation of an ABO discrepancy in a 16-yr-old Korean boy. ABO blood grouping showed that while his cell type was O+, serum typing detected only anti-A (3+). Anti-B was not detectable at room temperature but was graded at 1+ at 4degrees C. ABO genotyping revealed an O/O genotype. His serum IgG, IgA, and IgM concentrations were 770 mg/dL (reference range: 800-1,700 mg/dL), 244 mg/dL (reference range: 100-490 mg/dL), and 13.5 mg/dL (reference range: 50-320 mg/dL), respectively. He was diagnosed with acute osteomyelitis on the basis of clinical presentation and imaging studies. The symptoms gradually improved within 3 weeks of treatment. However, the ABO discrepancy and IgM deficiency persisted even 6 months after recovery and lymphocyte subset analysis revealed CD19+ B cell deficiency. To the best of our knowledge, IgM deficiency detected by ABO discrepancy in a patient with acute osteomyelitis has not been reported before.
ABO Blood-Group System/genetics ; Acute Disease ; Adolescent ; B-Lymphocytes/cytology/immunology/metabolism ; Bone and Bones/radionuclide imaging ; Genotype ; Humans ; Immunoglobulin A/blood ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Immunologic Deficiency Syndromes/complications/*diagnosis ; Knee/radionuclide imaging ; Magnetic Resonance Imaging ; Male ; Osteomyelitis/complications/*diagnosis ; Radiopharmaceuticals/diagnostic use

OBJECTIVE: The aim of this study was to investigate the relationship between follicular blood flow and the follicular fluid vascular endothelial growth factor (VEGF), and nitric oxide (NO) concentrations, and to determine which factor might be a better predictor of the outcome of IVF-ET. METHODS: In our prospective study, forty-seven cycles who underwent in vitro fertilization with tubal factor (25 cycles) and male factor (22 cycles) at the infertility clinic of Pusan National University Hospital from Feb. 2002 to June 2002 were assessed. Follicular blood flow was estimated on the day of hCG administration. Each follicular fluid was collected at the oocyte retrieval and follicular fluid VEGF and NO concentrations were assessed. According to the age of patients, the cause of infertility, and pregnancy rate, follicular blood flow and follicular fluid VEGF and NO concentrations were measured. RESULTS: Of 47 cycles, 18 cycles were pregnant (38.3%). Follicular blood flow was significant higher in the pregnant group compared to the nonpregnant group (p<.05), but there was no statistical significantly difference in the age and infertility cause. Follicular fluid concentrations of VEGF and NO were not statistically different in age, infertility cause, and pregnancy outcome. As follicle size increases, the follicular blood flow and follicular fluid VEGF concentrations increased significantly, but follicular fluid NO concentrations decreased. There was no correlation between VEGF and NO concentrations in follicular fluid by linear regression analysis. CONCLUSION: Our present study showed that follicular blood flow was positively associated with outcome of pregnancy as well as size of follicles, follicular fluid VEGF, but NO had no correlation with patient's age and pregnancy outcome. These results suggest that follicular blood flow might be a more effective prognostic marker of the pregnancy outcome of in vitro fertilization rather than follicular fluid VEGF and NO concentrations.
Busan ; Female ; Fertilization in Vitro ; Follicular Fluid* ; Humans ; Infertility ; Linear Models ; Male ; Nitric Oxide* ; Oocyte Retrieval ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Prospective Studies ; Vascular Endothelial Growth Factor A*

BACKGROUND: Female sex was known to be a risk factor for mortality after coronary bypass grafting (CABG), and women showed higher in-hospital mortality than men. MATERIAL AND METHOD: Between 1992 and 1996, 147 consecutive patients (98 men and 49 women) undergoing CABG were included in the study. Most patients had undergone CABG with left internal thoracic artery and saphenous vein under cardiopulmonary bypass. We examined the influence of gender on survival after CABG and looked for risk factors for survival. RESULT: There was no in-hospital mortality in women, but 3 death (3.0%) in men. During the mean follow-up period of 138.5+/-23.0 months, mortality was lower in women than in men (20.4% vs 44.9%, p=0.004), and the most common cause of death in women was chronic renal failure (40%). Survival in women at 1, 5, 10, and 14 years was 100%, 98.0+/-2.0%, 81.2+/-5.6%, and 78.4+/-6.1%, respectively, which was better than in men (p=0.004). Although preoperative left ventricular ejection fraction was higher in women than in men, this did not affect early and long-term survival difference between two sexes (p=0.15). Risk factor for long-term survival in women was diabetes (p=0.033) and in men number of diseased coronary artery (p=0.006). CONCLUSION: Long-term survival after CABG was better in women than men. Risk factor for long-term survival in women was morbid disease rather than cardiac disease.
Cardiopulmonary Bypass ; Cause of Death ; Coronary Artery Bypass* ; Coronary Vessels* ; Female ; Follow-Up Studies ; Heart Diseases ; Hospital Mortality ; Humans ; Kidney Failure, Chronic ; Male ; Mammary Arteries ; Mortality ; Risk Assessment ; Risk Factors ; Saphenous Vein ; Stroke Volume ; Survival Analysis ; Transplants

A pseudoaneurysm occurs as a late complication of an arterial wall injury after a surgical procedure or injuries such as a fracture, stab injury and penetrating trauma. Acute compartment syndrome as an elevation of the pressure in a closed compartment results in vascular compromise and a dysfunction. However, its occurrence in the thigh is quite rare. We report a case of a patient treated with an excision of a pseusoaneurysm and an artificial vessel graft who had compartment syndrome of the thigh caused by a pseudoaneurysm of the femoral artery that had developed after a blunt injury.
Aneurysm, False* ; Compartment Syndromes* ; Femoral Artery* ; Humans ; Thigh* ; Transplants ; Wounds, Nonpenetrating

PURPOSE: We investigate the impact of tumor multifocality on the biochemical recurrence rate after radical prostatectomy. MATERIALS AND METHODS: Data was collected from 525 patients who underwent radical prostatectomy for clinically localized prostate cancer from 2003 to 2007. We evaluated the potential associations of multifocality with various clinical and pathologic factors. The ability to predict extra-capsular extension(ECE) was tested by logistic regression models, whereas biochemical recurrence(BCR) was assessed via Kaplan-Meier analyses and Cox-hazard regression models. The BCR was defined as a level of serum prostate-specific antigen(PSA) of 0.2ng/ml or greater on consecutive evaluations. RESULTS: Multifocality was observed to be significantly associated with the presence of a high grade Gleason pattern(p=0.014), the pT stage(p< 0.001), ECE(p=0.005) and a positive surgical margin(PSM)(p=0.019). Moreover, it was the independent predictor of ECE on multivariate logistic regression analyses(p=0.039). However, although multifocality had a significant influence on biochemical recurrence on the Kaplan-Meier analyses (log rank test, p=0.019), only the PSA level and the Gleason score were significant predictors of BCR on the multivariated Cox-hazard analyses. CONCLUSIONS: Although multifocality was associated with adverse pathologic features, it had no significant effect on biochemical recurrence on the multivariated cox-hazard analyses.
Humans ; Logistic Models ; Neoplasm Grading ; Prostatectomy ; Prostatic Neoplasms ; Recurrence

BACKGROUND: Many autopsy studies have shown that the extent of extracranial carotid and coronary artherosclerosis is correlated and B-mode ultrasonographic intima-media thickness(IMT) and histologic IMT have been good correlation. In recent years. as it has been reported that IMT of carotid artery had something to do with risk factors of atherosclerosis and occurrence of coronary artery disease, in this study, we tried to investigate if the grade of atherosclerosis in B-mode ultrasonography of carotid artery could predict coronary artery disease and have something to do with the severity of coronary artery disease. METHODS: We classified the patients who were examined coronary angiography into control group without significant(>50%) stenosis(11 patients) and coronary artery disease(CAD) group(45 patients) according to the existence of significant stenosis, and we subdivided CAD group into single vessel disease(SVD) group(25 patients) and multivessel disease(MVD) group(20 patients). Practicing B-mode ultrasonography of common carotid artery(CCA), carotid artery bifurcation(BIF) and internal carotid artery(ICA), we measured IMT and IMT/L(lumen diameter) of each segment. Adding all values of each segment, we got mean aggregated IMT and mean aggregated IMT/L. RESULTS: 1) As IMT of left BIF in both six segments, control group was 0.55+/-0.16mm, SVD group was 0.71+/-0.36mm and MVD group was 1.02+/-0.61mm. So compared with control group and SVD, MVD group were significantly thick. As IMT/L, control group was 0.07+/-0.02, SVD group 0.08+/-0.05 and MVD group was 0.13+/-0.08. So compared with control group and SVD, MVD group was ignificantly high. 2)IMT of BIF in three segments, control group was 0.59+/-0.16mm, CAD group was 0.82+/-0.47mm and MVD group was 0.90+/-0.54mm. So compared with control group and CAD, MVD group were significantly thick. Also as IMT/L of BIF, compared with control group(0.07+/-0.02) and CAD(0.10+/-0.06), MVD(0.11+/-0.07) group was high.= 3) As mean aggregated IMT, control group was 0.57+/-0.34mm, CAD group was 0.69+/-0.45mm, SVD group was 0.63+/-0.12mm and MVD group was 0.74+/-0.21mm. So CAD group was thicker than control group and MVD group was thicker than SVD group. As mean aggregated IMT/L, control group was 0.07+/-0.03, CAD group was 0.10+/-0.05, SVD group was 0.09+/-0.01 and MVD group was 0.11+/-0.03. So CAD group was higher than control group and MVD group was higher than SVD group. CONCLUSION: These data support use of the mean aggregated B-mode ultrasonographic IMT and IMT/L in carotid bifurcation for correlation with the status of coronary atherosclerosis.
Atherosclerosis ; Autopsy ; Carotid Arteries* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Risk Factors ; Ultrasonography