Krukenberg tumor is comparatively rate in metastatic ovarian tumor and is almost metastasized from gastrointestinal tract. We have experienced one case of tumor of unidentified primary focus and two coases of metastatic Krukenberg tmor from stomach and report this cases with a brief review of literatures.
Gastrointestinal Tract ; Krukenberg Tumor* ; Stomach

Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder characterized by innumerable bilateral renal cysts. It has an prevalence rate of one in 200~1,000 individuals and is a relatively common cause of renal failure. As renal function deteriorates, overall renal size usually diminish in patients with chronic renal failure. However, renal size of patients with ADPKD usually continues to increase, even after the initiation of dialysis therapy, because numerous cysts replace renal mass. Attempted methods to reduce the size of enlarged kidneys have included needle aspiration and sclerotherapy, cyst decompression surgery, laparoscopic and surgical nephrectomy. The outcome of these therapy frequently has been suboptimal, and there is a need to develop a more effective therapy. We report a case of renal arterial embolization using 99% ethanol and lipiodol mixture for ADPKD in a hemodialysis pathient, which has not been previously reported.
Decompression ; Dialysis ; Ethanol* ; Ethiodized Oil* ; Humans ; Kidney ; Kidney Failure, Chronic ; Laparoscopy ; Needles ; Nephrectomy ; Polycystic Kidney, Autosomal Dominant* ; Prevalence ; Renal Dialysis* ; Renal Insufficiency ; Sclerotherapy

Ospemifene—a third-generation selective estrogen receptor modulator approved by the Food and Drug Administration in 2013—is an oral medication for the treatment of dyspareunia. In postmenopausal women with vulvovaginal atrophy, ospemifene significantly improves the structure and pH levels of the vagina, reducing dyspareunia. It is available as a 60-mg tablet; hence, women who may have had prior difficulty with vaginal administration or on-demand use of nonprescription lubricants and moisturizers would likely prefer this form of treatment. Preclinical studies demonstrated that ospemifene has an estrogen agonist action on the bone, reducing the cell proliferation of ductal carcinoma in an in situ model. Studies evaluating the safety of treatment for up to 52 weeks have shown that ospemifene is a safe medication with minimal impact on the endometrium. Further studies with larger number of subjects are necessary to better conclude its effects and long-term safety.
Administration, Intravaginal ; Atrophy* ; Carcinoma, Ductal ; Cell Proliferation ; Dyspareunia ; Endometrium ; Estrogens ; Female ; Humans ; Hydrogen-Ion Concentration ; Lubricants ; Menopause ; Selective Estrogen Receptor Modulators ; Tamoxifen ; United States Food and Drug Administration ; Vagina ; Vulva

The interruption of hepatic blood flow has been adopted as a method of bleeding control in hepatectomy and liver transplantation. But this occlusion of hepatic inflow may result in significant hepatic injury by various kinds of oxygen radicals produced as a result of hepatic ischemia and following reperfusion. Arterial ketone body ratio(AKBR) is adequatc and convenient parameter by which both acute and prolonged changes of the hepatic function can be estimated. Pharmacological modulation of hepatic injury during warm ischemia and early reperfusion has shown some benefical effects. The authors conducted an experiment to evaluate the inhibitory effect of glutathione and prostaglandin E on hepatic injury due to acute hepatic ischemia and reperfusion. Thirty rabbits were divided into three groups, such as control(n=10), GSH(n=10) and PGE(n=10) groups. Acute hepatic ischemia was induced through the application of portal triad cross-clamping for 30 minutes, and thereafter hepatic reperfusion was induced with the removal of cross-clamping. A single bolus of 200 mg glutathione was injected 10 min before clamp in GSH group, and 200 ng/kg/min of PGE continuously from 10 min before clamp to 30 min after declamp in PGE group. AKBR and hepatic histological findings hefore clamp, 30 min after clamp, 5 min and 30 min after declamp, respectively were compared among 3 groups AKBR was markedly decreased during the clamping period in all groups (P<0.05). In control and PGE groups AKRR was significantly increased after reperfusion than before clamp (P<0.05), but was significantly lower than before clamp. Thirty minutes after reperfusion in GSH group AKBR returned to normal level and was significantly higher than in control group (P<0.05). On light tnicroscopic examination of liver biopsy, mild swollen hepatocytes in the centrilobular zone were seen at ischemia and reperfusion in control and GSH groups, but nearly normal hepatic architectures in PGE group. These results suggest that glutathione has some benefical effect on protection of hepatic dysfunction, and PGE1 on protection of hepatocellular injury during hepatic ischemia and reperfusion.
Alprostadil* ; Biopsy ; Constriction ; Glutathione* ; Hemorrhage ; Hepatectomy ; Hepatocytes ; Ischemia* ; Liver ; Liver Transplantation ; Prostaglandins E ; Rabbits* ; Reactive Oxygen Species ; Reperfusion Injury ; Reperfusion* ; Warm Ischemia

Female phenotype of a 46,XY male may originates from male pseudohermaphroditism due to 17alpha-hydroxylase deficiency. Lack of cortisol increases adrenocorticotropic hormone (ACTH) and mineralocorticoid production, leading to low renin hypertention and hypokalemia. A 41-year-old phenotypic female presented primary amenorrhea and hypertension. In the hormonal profile, the levels of serum estradiol, testosterone, rennin, and cortisol were decreased and ACTH and deoxycorticosterone were increased. Laparoscopic bilateral gonadectomy was performed, and corticosteroid, antihypertensive drugs, and estrogen were administered. We report this case with a brief review of the literatures.
46, XY Disorders of Sex Development* ; Adrenal Hyperplasia, Congenital ; Adrenocorticotropic Hormone ; Adult ; Amenorrhea ; Antihypertensive Agents ; Chymosin ; Desoxycorticosterone ; Estradiol ; Estrogens ; Female ; Humans ; Hydrocortisone ; Hypertension ; Hypokalemia ; Male* ; Phenotype ; Renin ; Testosterone

OBJECTIVE: We tested the usefulness of swim-down technique using human follicular fluid (hFF) in sperm preparation. METHODS: Semen samples were obtained from twelve male partners showing asthenozoospermia (sperm motility < 50%) at the time of routine andrologic evaluation in Seoul National University Bundang Hospital. After dividing into two aliquots, each samples were processed either by swim-down using 100% hFF or density gradient using SpermGrad. Sperm quality was assessed by computer-assisted semen analyzer (CASA). RESULTS: Motility, Rapid motility, VCL (curvilinear velocity), ALH (amplitude of lateral head displacement), and hyperactivated sperms were significantly increased, and LIN (mean linearity) was decreased significantly after sperm preparation in both groups. Motility was significantly higher after swim-down using 100% hFF when compared with density gradient using SpermGrad (81.2+/-4.7 vs. 67.6+/-2.3, p=0.02). The other parameters assessed by CASA were not different between the two methods. CONCLUSION: Swim-down method with 100% hFF may be a useful method in preparation of sperm from asthenozoospermia.
Asthenozoospermia* ; Female ; Follicular Fluid* ; Head ; Humans* ; Male ; Semen ; Seoul ; Spermatozoa*

OBJECTIVE: To investigate the effects of female age on in vitro maturation and fertilization of immature oocytes from controlled ovarian hyperstimulation (COH) in human IVF-ET program. METHOD: A total of 96 immature oocytes (GV & metaphase I) obtained from 40 cycles of IVF-ET (29 patients). The mean age of female patients was 31.8+/-3.1 years. Ovulation was triggered by urinary or recombinant hCG. Immature oocytes were cultured with YS medium containing 30% of patients' human follicular fluids, LH (1 IU/mL), FSH (1 IU/mL) and EGF (10 ng/mL), and then matured oocytes were fertilized by ICSI. In vitro maturation and fertilization of immature oocytes were analyzed according to age of female (< 34 or > or = 34 years). RESULTS: The maturation rate was similar between two groups (68% vs 64%). The fertilization rate of in?vitro-matured oocytes was higher in patients < 34 years old, but there was no statistical significance (64% vs 50%, p=0.347). The fertilization rate of in-vitro-matured oocytes was significantly lower compared with those of in-vivo-matured oocytes in both age groups (64% vs 79%, p=0.035, 50% vs 86%, p=0.007). CONCLUSION: In older female group, fertilization rate of in-vitro-matured oocytes seems to be decreased. Further investigations should be warranted to increase fertilization potential of in-vitro-matured oocytes.
Adult ; Epidermal Growth Factor ; Female ; Fertilization* ; Follicular Fluid ; Humans* ; Metaphase ; Oocytes* ; Ovulation ; Sperm Injections, Intracytoplasmic

OBJECTIVE: This study was performed to assess the prognostic value of serum hCG, progesterone, and inhibin A levels measured at 11 days post-ET for predicting pregnancy outcome in women participating in IVF. METHODS: Between May 2005 and April 2008, sera were obtained from 70 infertile women who underwent IVF-ET at 11 days post-ET and stored. HCG, progesterone, and inhibin A levels were measured by commercial enzyme-linked immunosorbent assay kits. The predictive accuracy of hCG, progesterone, and inhibin A levels for establishment of intrauterine pregnancy and ongoing pregnancy was calculated by receiver-operating characteristic curve analysis. RESULTS: For the prediction of intrauterine and ongoing pregnancy, serum hCG was better than progesterone and inhibin A. The predictive performance of progesterone and inhibin A was similar. The serum progesterone and inhibin A levels were significantly correlated each other (r=0.915, p=0.010). CONCLUSION: A single measurement of the serum hCG level is sufficient to predict pregnancy outcome in IVF-ET patients.
Biomarkers ; Chorionic Gonadotropin ; Embryo Transfer ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertilization in Vitro ; Humans ; Inhibins ; Pregnancy ; Pregnancy Outcome ; Progesterone

BACKGROUND: Hyperkalemia, one of life threatening medical emergencies, has had its prognosis and treatment determined clinically based on the findings of EKG. To date, there hasn't been enough data on the effect of very early EKG features of hyperkalemia on the long-term outcome of treatment. Therefore, we have conducted this study to suggest possible treatment guideline for hyperkalemia by analyzing the correlations between initial parameters, treatment methods and treatment outcomes. METHODS: We reviewed retrospectively the medical records of 58 patients with hyperkalemia who visited the Hanyang University Kuri Hospital from May 1995 to April 2000. We examed underlying diseases, electrolytes, regular hemodialysis, hemodialysis trials, clinical and ECG findings(at initial and recovery state). RESULTS: High systolic pressure seems to be significantly correlated with high recovery rate. Subjects with unique EKG finding of hyperkalemia were more likely to have higher serum potassium level and death rate than those without unique EKG finding. However, this group has shown improved recovery rate after undergoing hemodialysis. Serum potassium level of hyperkalemia phase does not correlate with final outcomes and EKG findings. Over 80 percent of the hyperkalemic subjects are accompanied with renal failure, and there was significant improvement in the survival rate in renal failure subjects whom had undergone hemodialysis. CONCLUSION: In hyperkalemia, the EKG has the importance in diagnosis, severity classification and treatment choice. However, prognosis of the hyperkalemia does not rely solely on the EKG itself but rather on the appropriate individualized treatment including hemodynamic stabilization and hemodialysis. Therefore, prompt and adequate treatment based on early speculation upon possible etiologic candidates, EKG, and general condition may lead to recovery from the hyperkalemia, including critical conditions such as conduction disorder and severe arrhythmia.
Arrhythmias, Cardiac ; Blood Pressure ; Classification ; Diagnosis ; Electrocardiography* ; Electrolytes ; Emergencies ; Hemodynamics ; Humans ; Hyperkalemia* ; Medical Records ; Mortality ; Potassium ; Prognosis* ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Survival Rate

BACKGROUND: Hyperkalemia, one of life threatening medical emergencies, has had its prognosis and treatment determined clinically based on the findings of EKG. To date, there hasn't been enough data on the effect of very early EKG features of hyperkalemia on the long-term outcome of treatment. Therefore, we have conducted this study to suggest possible treatment guideline for hyperkalemia by analyzing the correlations between initial parameters, treatment methods and treatment outcomes. METHODS: We reviewed retrospectively the medical records of 58 patients with hyperkalemia who visited the Hanyang University Kuri Hospital from May 1995 to April 2000. We examed underlying diseases, electrolytes, regular hemodialysis, hemodialysis trials, clinical and ECG findings(at initial and recovery state). RESULTS: High systolic pressure seems to be significantly correlated with high recovery rate. Subjects with unique EKG finding of hyperkalemia were more likely to have higher serum potassium level and death rate than those without unique EKG finding. However, this group has shown improved recovery rate after undergoing hemodialysis. Serum potassium level of hyperkalemia phase does not correlate with final outcomes and EKG findings. Over 80 percent of the hyperkalemic subjects are accompanied with renal failure, and there was significant improvement in the survival rate in renal failure subjects whom had undergone hemodialysis. CONCLUSION: In hyperkalemia, the EKG has the importance in diagnosis, severity classification and treatment choice. However, prognosis of the hyperkalemia does not rely solely on the EKG itself but rather on the appropriate individualized treatment including hemodynamic stabilization and hemodialysis. Therefore, prompt and adequate treatment based on early speculation upon possible etiologic candidates, EKG, and general condition may lead to recovery from the hyperkalemia, including critical conditions such as conduction disorder and severe arrhythmia.
Arrhythmias, Cardiac ; Blood Pressure ; Classification ; Diagnosis ; Electrocardiography* ; Electrolytes ; Emergencies ; Hemodynamics ; Humans ; Hyperkalemia* ; Medical Records ; Mortality ; Potassium ; Prognosis* ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Survival Rate