The truffle and ectomycorrhizal roots formed by Tuber sp. were collected from the rhizosphere of Quercus aliena in Korea. The morphological characteristics of the ascoma, and molecular phylogenetic analysis using sequences from the internal transcribed spacer (ITS) and large subunit (LSU) of ribosomal DNA, translation elongation factor 1-alpha (TEF), and RNA polymerase second largest subunit (RPB2) regions confirmed the distinct morphology of the truffle. This truffle belongs to a monophyletic clade among the other Tuber species in the phylogeny. This study describes the truffle, Tuber koreanum, as a new species reported from Korea.

PURPOSE: Circumferential pulmonary (PV) vein isolation (CPVI) is the most important treatment strategy for atrial fibrillation (AF). While understanding left atrial wall thickness around PVs (PVWT) prior to catheter ablation is important, its clinical implications are not known. This study aimed to evaluate PVWT characteristics according to underlying disease and to identify associations between PVWT and reconnections of PV potentials (PVPs) in redo ablation. MATERIALS AND METHODS: In 28 patients who underwent redo-AF ablation, PVWT and reconnected PVPs were evaluated at 12 sites (1–12 o'clock) around each PV. Clinical characteristics including stroke and CHA₂DS₂-VASc scores were analyzed according to the PVWT. RESULTS: The PVWT was thicker in males than females (p<0.001) and in those with diabetes (p=0.045) or heart failure (p=0.002) than in those without. Patients with strokes or high CHA₂DS₂-VASc scores (≥3) had significantly thinner PVWTs than those without strokes or low CHA₂DS₂-VASc scores (p<0.001). In redo-ablation, reconnected PVPs were detected in 60 (53.6%) of 112 PVs, and the PVs were thicker (p<0.001) and had more reconnected PVs (p=0.009) than right PVs. A PVWT of >0.6 mm predicted PV reconnections with a sensitivity of 76.7% and specificity of 52.2% with an area under the curve of 0.695. CONCLUSION: Thick PVWs were associated with diabetes and heart failure, and also showed significant inverse correlations with stroke and the CHA₂DS₂-VASc score. Thick PVWs were associated with reconnected PVPs after the CPVI, which were related to AF recurrence.
Atrial Fibrillation* ; Catheter Ablation ; Female ; Heart Failure ; Humans ; Male ; Pulmonary Veins* ; Recurrence ; Sensitivity and Specificity ; Stroke* ; Veins

PURPOSE: Intra-abdominal adhesion related to prior abdominal surgery is the most common cause of small bowel obstruction (SBO). However, there are subsets of patients with SBO without a history of previous operation. We studied the characteristics of these patients. METHODS: The medical records of 311 patients underwent operations at Seoul National University Hospital between Jan. 1994 and Oct. 2005 were reviewed. A retrospective analysis of the incidence, etiology, diagnostic method, preoperative hospital stay, operative findings and methods, complication rates, postoperative hospital stay, re-admission rate, and reoperation rate of SBO was performed, and the results were compared with those of patients with a history of previous operation. RESULTS: Among the 311 patients (54.4 +/- 14.7 yr, M:F=1.5:1), 48 patients (15.3%) had no history of operation. The etiologies of SBO without a history of operation were malignancy (23.0%), bezoar (14.5%), adhesion (10.4%), Crohn's disease (10.4%), tuberculosis (8.3%), and appendicitis (8.3%). SBO without prior abdominal surgery showed a longer preoperative hospital stay, which was not statistically significant. The accuracies of CT and small bowel series among patients without a history of operation were 68.4% and 54.5%, respectively. SBO without prior abdominal surgery showed a lower complication rate (8.3% vs. 26.6%, P=0.006) and shorter postoperative hospital stays (12.7 +/- 6.9 days vs. 16.1 +/- 10.4 days, P=0.032). CONCLUSIONS: Among the patients who underwent an operation for SBO, 15.3% had no history of previous operation. The most common cause of SBO without a history of operation was malignancy. SBO without a history of operation showed a lower complication rate and a shorter postoperative hospital stay compared with SBO with a history of operation.
Appendicitis ; Bezoars ; Crohn Disease ; Humans ; Incidence ; Length of Stay ; Medical Records ; Reoperation ; Retrospective Studies ; Seoul ; Tuberculosis

OBJECTIVE: To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation. METHODS: Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retrospectively. Continuous end-tidal CO₂ (ETCO₂) and pulse oxyhemoglobin saturation (SpO₂) monitoring were performed. Extubation success was defined as a state not requiring invasive mechanical ventilation via endotracheal tube or tracheotomy during a period of at least 5 days. RESULTS: A total of 18 patients with ventilatory failure who initially experienced extubation failure were finally placed under part-time NIV after extubation. No patient had any serious or long-term adverse effect from NIV, and all patients left the hospital alive. CONCLUSION: NIV may promote successful weaning in neuromuscular patients with experience of reintubation.
Humans ; Neuromuscular Diseases* ; Noninvasive Ventilation* ; Oxyhemoglobins ; Rehabilitation ; Respiration, Artificial ; Retrospective Studies ; Tracheotomy ; Weaning*

No abstract available.
Sarcoma, Kaposi*

The corpus callosum consists of white fibers connecting the cerebral hemispheres. Agenesis of the corpus callosum is an uncommon congenital anomaly which is easily diagnosed in the postnatal period by ultrasound and computed tomographic scan or MRI, but its prenatal sonographic diagnosis is difficult because of fetal head positioning and limiting trans-axial scans. We experienced a case of agenesis of the corpus callusum with chromosomal anomaly. The prenatal sonographic findings are ventricular abnormalities that demonstrated dilatation of lateral ventricles and disproportionate enlargement of the occipital horns, which were suggestive findings for the corpus callosal agenesis. We could confim the diagnosis of the corpus callosal agenesis with chromosome anomaly by postnatal MRI and chromosome analysis.
Agenesis of Corpus Callosum* ; Animals ; Cerebrum ; Corpus Callosum ; Diagnosis ; Dilatation ; Head ; Horns ; Lateral Ventricles ; Magnetic Resonance Imaging ; Ultrasonography

BACKGROUND: Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stage III non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it huts at most only a modest effect on survival. Recently, cisplatin(cia-diamminedichloroplatinum ) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and METHOD: Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given 10 times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 timed in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. RESULTS: There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p<0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p<0.05). In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. CONCLUSION: There was. no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Compliance ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Radiation Pneumonitis ; Radiotherapy*

BACKGROUND AND OBJECTIVES: The diagnosis of thyroid nodular diseases is critical in clinical management. Fine needle aspiration cytology and ultrasound-guided core needle biopsy are widely considered as diagnostic techniques in assessment of thyroid nodular diseases. Because of the histological similarity of follicular patterned thyroid lesions, the differential diagnosis between some thyroid lesions is often difficult to determine, even with permanent sections. For this reason, we assessed diagnostic usefulness of immunohistochemical staining for the three potential markers of malignant thyroid nodule, Galectin-3, MUC1 and EGFR (Epidermal growth factor receptor) in the tissue obtained by surgery. SUBJECTS AND METHOD: The immunohistochemical expression of galectin-3, MUC1 and EGFR was evaluated in 76 thyroid lesions obtained by surgery to assess their potential as markers in differential diagnosis of thyroid nodule. The following were studied: 20 cases of papillary carcinoma, 16 cases of follicular carcinoma, 20 cases of follicular adenoma and 20 cases of adenomatous goiter. RESULTS: The expression of Galectin-3 was stronger in malignant thyroid nodules, especially in papillary carcinoma, than in benign thyroid nodules. However, there were no significant differences in the expression rates of MUC1 and EGFR between malignant thyroid nodules and benign thyroid nodules. The expression of MUC1 and EGFR was weaker in follicular neoplasm than in other thyroid nodules. CONCLUSION: Galectin-3 was a reliable marker for papillary carcinoma. The expression of MUC1 and EGFR was increased in the papillary carcinoma and goiter, so if we could selectively identify cytoplasm MUC1, we could distinguish papillary carcinoma from the goiter.
Adenoma ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Carcinoma, Papillary ; Cytoplasm ; Diagnosis, Differential ; Epidermal Growth Factor ; Galectin 3 ; Goiter ; Receptor, Epidermal Growth Factor ; Thyroid Gland ; Thyroid Nodule

PURPOSE: We aimed to assess retrospectively the benefit of the use of ultrasonography (US) in comparison with the use of only CT imaging for the detection of the transition zone and adhesions to determine a diagnosis of adhesive small-bowel obstruction (SBO). MATERIALS AND METHODS: Thirty-five patients underwent an additional US examination after CT imaging to determine a diagnosis of SBO. All of the patients were surgically confirmed as having adhesive SBO. The CT images were interpreted for the location of the transition zone, the location and shape of adhesions and for other SBO findings. All of the additional US scans were performed with reference to the CT findings. The standard of reference for the diagnosis was the surgical findings. The diagnostic accuracy and mean confidence score of the transition zone location and the detection rate of adhesions were evaluated for both CT imaging alone and for CT imaging with additional US. RESULTS: The diagnostic accuracy to locate the transition zone was significantly increased with the use of additional US with CT imaging (94.6%, 33/35) as compared to 65.7% (23/35) with the use of only CT imaging (p = 0.01). The mean confidence score was significantly increased (by 0.95) with the use of an additional US examination (p < 0.01). The detection rate for adhesions was 20% (7/35) with the use of only CT imaging and the detection rate was 68.6% (24/35) with the use of an additional US examination. CONCLUSION: The use of a US examination in addition to CT imaging can increase the accuracy and confidence to locate the transition zone and can increase the rate to detect adhesions in patients with adhesive SBO. An additional US examination may be especially helpful when the CT findings are equivocal.
Adhesives ; Humans ; Retrospective Studies

Purpose: To evaluate the long-term outcomes of inverted internal limiting membrane (ILM) flap and ILM insertion in idiopathic macular hole (MH) and to compare the outcomes between the two techniques. Methods: We retrospectively reviewed the medical records of 17 eyes that underwent an inverted ILM flap procedure (flap group, n = 9) or ILM insertion procedure (insertion group, n = 8) for idiopathic MH. Within each group, best-corrected visual acuity (BCVA) before surgery was compared with that at the final follow-up. The BCVA at the final follow-up was compared between the two groups. In addition, the incidence of restoration of the external limiting membrane (ELM) and ellipsoid zone was evaluated. Results: The mean follow-up period was 25.1 ± 13.7 months after surgery. All MHs were closed after the surgery. In all 17 eyes, the logarithm of minimal angle of resolution BCVA had improved significantly from a mean value of 0.88 ± 0.23 before surgery to 0.42 ± 0.23 at the final follow-up (p < 0.001). The BCVA was significantly improved in both the flap group (from 0.92 ± 0.25 to 0.37 ± 0.29, p = 0.007) and the insertion group (from 0.83 ± 0.19 to 0.48 ± 0.15, p = 0.018). There was no significant difference in BCVA at the final follow-up between the two groups (p = 0.075). The incidence of restoration of the ELM and ellipsoid zone was significantly higher in the flap group (seven eyes, 77.8%) than in the insertion group (one eye, 12.5%). Conclusions Both inverted ILM flap and ILM insertion are effective in MH treatment. The restoration of retinal outer layers was better in the flap group. Further studies with a larger study population are needed to evaluate the long-term visual outcomes of the two methods.