No abstract available.
Mitral Valve*

PUPOSE: Anastomosis site stricture is a common complication after a total gastrectomy. End-to-end anastomosis (EEA) stapler devices are preferred to a hand-sewn esophagojejunostomy these days. However, stapling devices have been reported not to reduce the incidence of esophagojejunostomy site stricture considerably. MATERIALS AND METHODS: From Sep. 1998 to Dec. 2000, at Korea Gastic Cancer Center, Seoul Paik Hospital, Inje University, we experienced 228 total gastrectomies in which EEA stapling devices had been used. We investigated the correlation of the stricture with the size of the EEA stapling device, the type of esophagojejunal reconstruction, reflux esophagitis, and duration of stricture development. RESULTS: Among the 228 cases, as far as the patient's age was concerned, the 7th decade was the most common 64 cases, followed by the 5th decades. The Male-to-female ratio was 2.3 : 1. A loop esophagojejunostomy was used in 223 cases, and the Roux-en-Y method was used in 5 cases. The 32 patients with anastomosis site stricture were patients with loop esophagojejunal anastomosis. Anastomosis site stricture occurred in 14% (32/228) of the total gastrectomy cases, in15.9% (11/69) of the total gastrectomies involving stapler devices with a 25-mm diameter, and in 13.2% (21/159) of the total gastrectomies involving staper devices with a 28-mm diameter. There was no correlation between the incidence of stricture and EEA- stapling device size (P>0.05). Reflux esophagitis occurred in 56 of the 228 cases, with 7 of those 56 cases (12.5%) and 25 of the remaining 172 cases (14.5%) having strictures. There was no considerable difference in the stricture incidence rate according to the presence of reflux esophagitis (P>0.05). The onset of stricture development, occurred within 6 months in 16 cases, including 4 cases of reflux esophagitis, between 7 and 18 months in 14 cases, including 3 cases of reflux eshophagitis, and after 19 months in 2 cases. CONCLUSION: An esophagojejunostomy site stricture after a total gastrectomy was not correlated with the esophagojejunal reconstruction type, the size of the stapling device, or the presence of reflux esophagitis. General anastomosis technical factors (e.g., adequate blood supply, tension-free manner, adequate hemostasis) may be more important to prevent anastomosis site stricture after an esophagojejunostomy during a total gastrectomy.
Constriction, Pathologic* ; Esophagitis, Peptic ; Gastrectomy* ; Humans ; Incidence ; Korea ; Seoul

No abstract available.
Heterografts*

Background and Objectives: In recent years, brain organoid technologies have been the most innovative advance inneural differentiation research. In line with this, we optimized a method to establish cerebral organoids from feeder-free cultured human pluripotent stem cells. In this study, we focused on the consistent and robust production of cerebral organoids comprising neural progenitor cells and neurons. We propose an optimal protocol for cerebral organoid generation that is applicable to both human embryonic stem cells and human induced pluripotent stem cells. Methods: and Results: We investigated formation of neuroepithelium, neural tube, and neural folding by observing the morphology of embryoid bodies at each stage during the cerebral organoid differentiation process. Furthermore, we characterized the cerebral organoids via immunocytochemical staining of sectioned organoid samples, which were prepared using a Cryostat and Vibratome. Finally, we established a routine method to generate early cerebral organoids comprising a cortical layer and a neural progenitor zone. Conclusions We developed an optimized methodology for the generation of cerebral organoids using hESCs and hiPSCs. Using this protocol, consistent and efficient cerebral organoids could be obtained from hiPSCs as well as hESCs. Further, the morphology of brain organoids could be analyzed through 2D monitoring via immunostaining and tissue sectioning, or through 3D monitoring by whole tissue staining after clarification.

PURPOSE: The purpose of this study was to compare the mitigative effect of alendronate and risedronate on osteolysis in the mouse calvarian model by using titanium (Ti) and polymethylmethacrylate (PMMA) particles. MATERIALS AND METHODS: Experimental mice (male C57/BL6) are divided into three groups; control, Ti particle-treated and PMMA particle-treated group. Each Ti and PMMA particle-treated group was divided into three subgroups which received no bisphosphonates, which received alendronate, and which received risedronate. We measured number of osteoclast, area of osteolysis, bone and soft tissue thickness, ratio of bone and total tissue on mid-sagittal suture area (MSSA) and compared between two groups. RESULTS: Both alendronate and risedronate had significant inhibitory effect on Ti or PMMA particle-induced osteolysis in mouse calvarian model (p<0.05). Furthermore, bisphosphonates prevented formation of particleinduced osteolysis as RANK/Fc. Risedronate had better capability for preserving bone thickness in PMMA treated mice and also showed decreased soft tissue thickness in Ti treated mice than alendronate (p<0.05). CONCLUSION: Both alendronate and risedronate may be an effective agents on mitigation of Ti and PMMA particle-induced osteolysis. However, risedronate showed better structual bone preserving capacity than alendronate in particle-treated mouse calvariae.
Alendronate ; Animals ; Diphosphonates ; Etidronic Acid ; Mice ; Osteoclasts ; Osteolysis ; Polymethyl Methacrylate ; Sutures ; Titanium ; Risedronate Sodium

Acute bilateral reexpansion pulmonary edema after pleurocentesis is a rare complication. In one case, bilateral reexpansion pulmonary edema after unilateral pleurocentensis in sarcoma was reported. Verious hypotheses regarding the mechanism of reexpansion pulmonary edema include increased capillary permeability due to hypoxic injury, decreased surfactant production, altered pulmonary perfusion and mechanical stretching of the membranes. Ragozzino et al suggested that the mechanism leading to unilateral reexpansion pulmonary edema involves the opposite lung when there is significant contralateral lung compression. Here we report a case of bilateral reexpansion pulmonary edema and acute respiratory distress syndrome after a unilateral pleurocentesis of a large pleural effusion with contralateral lung compression and increased interstitial lung marking underlying chronic liver disease.
Capillary Permeability ; Liver Diseases ; Lung ; Membranes ; Perfusion ; Pleural Effusion ; Pulmonary Edema* ; Respiratory Distress Syndrome, Adult ; Sarcoma

PURPOSE: To evaluate the antiadhesive effects and safety of an oxidized regenerated cellulose (Interceed) after thyroidectomy. METHODS: Seventy-six thyroidectomized patients were prospectively randomized into two groups with regard to the use of Interceed. We evaluated each group for their adhesive symptoms using four subjective and four objective items at the 2nd week, 3rd and 6th month after thyroidectomy. All patients were examined for vocal cord motility by indirect laryngoscope at each period. RESULTS: Total adhesion scores at each postoperative follow-up period decreased with time, but were not significantly different in each group. The median score for swallowing discomfort for liquid was significantly lower in the Interceed group than in the control group 2 weeks after surgery. In addition, the severity of skin adhesion to the trachea was reduced in the Interceed group compared with the control group 6 months after surgery. During the study, there were no adverse effects or significant differences in postoperative complications between the groups. CONCLUSION: Interceed appeared to be safe and effective in improving neck discomfort at early postoperative periods and preventing skin adhesion to the trachea 6 months after thyroidectomy.
Adhesives ; Cellulose ; Cellulose, Oxidized ; Deglutition ; Follow-Up Studies ; Humans ; Laryngoscopes ; Neck ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Skin ; Thyroidectomy ; Trachea ; Vocal Cords

PURPOSE: To compare the radiographic evaluations between two radiographic views (AP and lateral views) and four radiographic views (AP, lateral and both oblique views) in ankle fractures. MATERIALS AND METHODS: From January 2000 to June 2002, 60 cases of ankle fractures were treated with open reduction and internal fixation and its followed up periods were at least 2 years. All cases were classified into three groups according to the method of preoperative radiographic evaluation. Two radiographic views (AP and lateral views) were taken in group A and four radiographic views (AP, lateral and both oblique views) were taken in group B. 12 Cases were evaluated with three dimensional computed tomography (3D CT). Four radiographic views and 3D CT were taken in group C. All cases were classified according to the Danis-Weber and Lauge-Hansen classification. Displacement of fracture fragment of medial, lateral, posterior malleolus and size of fracture fragment of posterior malleous were measured using picture archiving communication system (PACS). RESULTS: Although kappa value between two or four radiographic views were good or excellent in Danis-Weber classification and Lauge-Hansen classification of ankle fractures, the displacements of medial and lateral malleoli were statistically different. Four radiographic views evalulated the degree of displacement of medial and lateral fragments more accurately compared to two radiographic views. CONCLUSION: Four radiographic views will be more useful than two radiographic views to decide the method of treatment and operation considering the displacement of fracture fragment.
Ankle Fractures* ; Ankle* ; Classification

OBJECTIVES: Percutaneous renal biopsy may be carried out in several ways. Recently, the use of a spring-loaded biopsy gun has become popularized. There have been much controversies on the tissue adequacy and the incidence of complications when compared to the manual biopsy. The present study was performed to compare tissue adequacy and the incidence of complications between manual biopsy and automated biopsy. METHODS: We have studied 108 patients in whom the method of renal biopsy was assigned to one of the two methods[14G Tru-cut needle manual bx (group I) and 18G automated gun biopsy(group II)] according to their national resident's identification number in a randomized and prospective manner. RESULTS: There were 50 patients in group I and 58 patients in group II. There was no difference in gender, age, hemoglobin, prothrombin time, partial thromboplastin time, diastolic and systolic blood pressure pre-biopsy in group I and II. Indications for biopsies were proteinuria accompained by hematuria (37%), proteinuria(34.3%), acute renal failure (9.3%), SLE (8.3%), chronic renal failure (5.6%), hematuria only (5.6%). In Group I the number of passes was 2.4+/-0.8, the glomeruli obtained were 25.3+/-13.2 and the number of glomeruli per pass were 11.6+/-6.5, and in Group II 3.4+/-1.1, 19.4+/-10.8, and 6.8+/-4.0, respectively. These showed a significant difference (p<0.05). In all cases pathological diagnosis were possible. The histology showed IgA nephropathy in 27.8%, MCNS in 14.8%, lupus nephritis in 11.1, MGN in 11.1%, MPGN in 7.4%, and others. The incidence and area of perinephric hematoma demonstrated on ultrasound 24 hours post-biopsy was increased in group I (24%, 937.7+/-640.0mm2 compared to 10.3%, 372.4+/-327.4mm2 in group II) although no statistically significant difference existed. There was no significant difference in gender, age, prothrombin time, partial thromboplastin time, systolic and diastolic blood pressure between the group with and without hematomas. Hematocrit levels before and after biopsy showed a significant difference (34.5+/-8.2, 33.5+/-8.1, p<0.05) in group I, but no significant difference was observed in group II (34.7+/-6.4, 34.8+/-6.4). CONCLUSION: Both techniques rendered adequate tissue sampling, but the extent of bleeding seems to be more severe with manual 14G Tru-cut needle biopsy.
Acute Kidney Injury ; Biopsy* ; Biopsy, Needle ; Blood Pressure ; Diagnosis ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Hematocrit ; Hematoma ; Hematuria ; Hemorrhage ; Humans ; Incidence ; Kidney Failure, Chronic ; Lupus Nephritis ; Needles ; Partial Thromboplastin Time ; Prospective Studies* ; Proteinuria ; Prothrombin Time ; Ultrasonography

Autoimmune pancreatitis is now considered to be a systemic fibroinflammatory disease that can involve multiple organs. As it is associated with IgG4-positive plasma cells by an autoimmune mechanism, extrapancreatic organs as well as the pancreas could be affected with a lymphoplasmacytic infiltrate. The proximal bile duct, the salivary gland, the retroperitoneum and the kidney are well known to be involved with, but less is known about the involvement of hollow viscus which is pathologically associated with autoimmune pancreatitis. We report here on a case of gastric involvement in a 53-year-old man with autoimmune pancreatitis.
Bile Ducts ; Humans ; Immunoglobulin G ; Kidney ; Middle Aged ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic ; Plasma Cells ; Salivary Glands