Twin-twin transfusion syndrome (TTTS) is a complex cardiovascular disease affecting monochorionic (MC) twin pregnancies, and has a high perinatal mortality rate. Its pathogenesis remains poorly understood, but TTTS involves unbalanced transfusion of blood from a donor to a recipient along one or more placental arteriovenous anastomosis in absence of adequate compensatory superficial counter-transfusion. Recent data demonstrated laser ablation to be better than amnioreduction, especially when the condition develops before 26 weeks of gestation.
Arteriovenous Anastomosis ; Cardiovascular Diseases ; Humans ; Laser Therapy ; Perinatal Mortality ; Pregnancy ; Pregnancy, Twin ; Tissue Donors

Acute osteomyelitis following a closed fracture is very rare. Only one case has been reported that trivial trauma (contusion) may be associated with the subsequent development of acute osteomyelitis in Korea. Authors report an acute osteomyelitis in the shaft of the femur after closed fracture in a child.
Child ; Femur ; Fractures, Closed ; Humans ; Korea ; Osteomyelitis

PURPOSE: This study evaluated the effectiveness of a selective nerve root block (SNRB) for a lumbar spinal stenosis (LSS) that indicated surgery. MATERIALS AND METHODS: Twenty-one LSS patients, who were indicated for surgery but could not be operated on due to a high anesthetic risk, were evaluated retrospectively an evaluated on average of 19.5 months (range, 12 to 60 months) following the SNRB from April 1998 to October 2002. There were 9 males and 12 females with a mean age of 66.4 years (range, 59 to 78 years). The medical records and radiologic studies were reviewed, and a telephone interview was carried out where needed. The anesthetic risk was evaluated by the American Society of Anesthesiologists (ASA) physical status classification. The Kirkaldy-Willis criteria (at 9 months after SNRB and last FU) and the recurrence of symptoms (at 2 weeks, 1 month, 3 months, 5 months, 9 months after the SNRB, and the last FU) were analyzed. RESULTS: Among the 21 patients, 8 patients were in the ASA class 3, 13 in class 4. The major physical conditions that indicated a high anesthetic risk was cardiac problems in 17 patients, renal problems in 2, and endocrine problem in 2. The interval between the onset of symptom and the SNRB ranged from one month to 30 years (average, 41.6 months). All but 3 patients had a recurrence of their symptoms at an average 1.9 months (range, 1 day to 9 months) after the SNRB. According to the Kirkardy-Wills criteria, 9 months after SNRB, the results were good in 1 patient, fair in 2, and poor in 18. At the last follow-up, all but 4 patients did not show a chang in their status according to the Kirkardy-Wills criteria, and 4 patients improved (poor to good in 2, poor to fair in 2) without treatment. CONCLUSION: The symptoms of LSS improved for a very short period (average, 1.9 month) by SNRB. These results suggest that SNRB suitable for the LSS patients who require need surgery.
Classification ; Female ; Follow-Up Studies ; Humans ; Interviews as Topic ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Spinal Nerves* ; Spinal Stenosis*

OBJECTIVES:Long standing observation, which may relate either to the causes or the effects of UC, reveals that there is a pronounced alteration of mucin such as quantitative and qualitative abnormalities of mucin glycoprotein. But recently in situ hybridization technique showed no specific difference in the expression of apomucin mRNA in UC. Therefore we investigated whether abnormality of mucin was originated from defect in glycosylation. And we also tried to find differences in the expression of Tn and sTn antigens between Korean and Jewish patients with UC. METHODS: We performed the immunohistochemical staining using the monoclonal antibody of mucin carbohydrate antigens Tn and sTn in 19 patients with UC. RESULTS: Tn and sTn antigens were not expressed throughout the crypt and surface epithelium in normal colon but both of mucin carbohydrates antigens were well expressed in mild UC, Tn antigen was seen in the surface epithelium with perinuclear pattern and sTn antigen was shown not only in surface but also in crypt epithelium. In severe UC, Tn antigen was well expressed, but sTn antigen was not expressed. Tn antigen seemed to be ex-pressed more frequently than sTn antigen with severity of inflammation. These results were similar in Korean and Jewish patients with UC. CONCLUSION: These results suggest that inflammatory bowel disease has some deterioration in the step of glycosylation in the cytoplasm and there was no racial difference in the expression of Tn and sTn antigen in Korean and Jewish patients with UC.
Carbohydrates ; Colitis, Ulcerative ; Colon ; Cytoplasm ; Epithelium ; Glycoproteins ; Glycosylation ; Humans ; In Situ Hybridization ; Inflammation ; Inflammatory Bowel Diseases ; Mucins* ; RNA, Messenger ; Ulcer*

Background: Tissue engineering can be used for bladder augmentation. However, conventional scaffolds result in fibrosis and graft shrinkage. This study applied an alternative polycaprolactone (PCL)-based scaffold (diameter = 5 mm) with a noble gradient structure and growth factors (GFs) (epidermal growth factor, vascular endothelial growth factor, and basic fibroblast growth factor) to enhance bladder tissue regeneration in a rat model. Methods: Partially excised urinary bladders of 5-week-old male Slc:SD rats were reconstructed with the scaffold (scaffold group) or the scaffold combined with GFs (GF group) and compared with sham-operated (control group) and untreated rats (partial cystectomy group). Evaluations of bladder volume, histology, immunohistochemistry (IHC), and molecular markers were performed at 4, 8, and 12 weeks after operation. Results: The bladder volumes of the scaffold and GF group recovered to the normal range, and those of the GF group showed more enhanced augmentation. Histological evaluations revealed that the GF group showed more organized urothelial lining, dense extracellular matrix, frequent angiogenesis, and enhanced smooth muscle bundle regeneration than the scaffold group. IHC for α-smooth muscle actin, pan-cytokeratin, α-bungarotoxin, and CD8 revealed that the GF group showed high formation of smooth muscle, blood vessel, urothelium, neuromuscular junction and low immunogenicity. Concordantly, real-time polymerase chain reaction experiments revealed that the GF group showed a higher expression of transcripts associated with smooth muscle and urothelial differentiation. In a 6-month in vivo safety analysis, the GF group showed normal histology. Conclusion This study showed that a PCL scaffold with a gradient structure incorporating GFs improved bladder regeneration functionally and histologically.