Systemic arteriovenous (AV) fistulas are a rare but well-recognized cause of hyperkinetic circulation that, if undetected, may lead to congestive heart failure. We experienced a very rare case of acquired arteriovenous fistula. A 61-year-old female patient presented with congestive heart failure symptoms after percutaneous pinning for right sternoclavicular joint dislocation. We surgically obliterated the fistula between aorta and innominate vein and performed tricuspid annuloplasty for severe tricupid insufficiency simultaneously. She was discharged with complete relief of her symptoms and has been well during 2 years and 6 months follow up.
Aorta ; Arteriovenous Fistula* ; Brachiocephalic Veins ; Dislocations ; Female ; Fistula ; Follow-Up Studies ; Heart Failure ; Humans ; Joints* ; Middle Aged ; Sternoclavicular Joint ; Tricuspid Valve

No abstract available.

OBJECTIVE: These experiments were conducted to investigate the optimal expose length of propidium iodide (PI) and bisbenzimide on differential staining of mouse blastocysts. MATERIALS AND METHODS: A total 964 blastocysts (early~hatched) was exposed to PI (n=831) (group I: Animals ; Bisbenzimidazole* ; Blastocyst* ; Mice* ; Propidium*

Malignant mixed m llerian tumors are uncommon neoplasms of the female genital track that histologically consist of malignant epithelial and stromal components. Malignant mixed m llerian tumors generally occur in elderly woman and are associated with a poor prognosis. We experienced a case of malignant mixed m llerian tumor recieved pelvic irradiation for the uterine cervical cancer 11 years prior to the diagnosis of the tumor and report with a brief review of the literature.
Aged ; Diagnosis ; Female ; Humans ; Prognosis ; Uterine Cervical Neoplasms*

The variable clinical responses seen with rnost cancer immunotherapy suggests that there is a large interindividual variation in immunoiogic response to tumors. One of the key functional parameter.s of an immune response is the loca1 production of cytokines. These multifunctional cytokines have been implicated in growth stimulation and cytotoxicity of ovarian tumor celle. To determine the presence and quantities of cytokines in ovarian cancer tissue, the cons-titutive expression of cytokine mRNA in biopsies from epithelial ovarian carcinomas was determined by using a PCR-assisted mRNA amplification asssy(RT-PCR). Using a set of cytokine-specific primers for 14 different cytokines, distinctive patterns of cytokine gene expression between normal and malignant ovarian tissues could be found. Several cytokines were detected even in the norma1 ovarian tissue including IL-1A, IL-8, TGF-A, TGF-B, GM-CSF, and IL,-2R. In case of the ovarian cancer, the signals were more intense than normal and we could detect the expression of some other cytokines, such as IL-1B, IL- 4, IL-6, IL-l0, TNF, and INF-T, which could not be detected in normal tissue. The presence of eytokines in ovarian cancer tissue could be impartant in the growth and development of cancer, more specifically, in relation to host immune responsiveness.
Biopsy ; Cytokines ; Gene Expression* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Growth and Development ; Immunotherapy ; Interleukin-6 ; Interleukin-8 ; Ovarian Neoplasms* ; RNA, Messenger

OBJECTIVE: Mammalian embryos undergo changes of energy environment for transfer from oviduct to uterus. An experimental design was used to examine the effects of glucose on the development in vitro of mouse embryos. METHODS: Two cell embryos were recovered from ICR female mice (3-4 weeks) at 46-50 hrs after 5 IU hCG injection (mated just after hCG injection) and cultured in 50 micro gram MEM droplets supplemented with nothing (control; n=46), 0.5 mM glucose (Group A; n=46) or 3.15 mM glucose (Group B; n=46) under mineral oil. All experimental media were supplemented with 20% human follicular fluid. Results were observed: (i) the number of zona-intact blastocysts (ZiB); (ii) the number of zona-escaped blastocysts (ZeB; hatching~hatched); (iii) the mean cell numbers; and (iv) the proportion of inncer cell mass (% ICM) in the blastocysts. RESULTS: Total blastocyst formation rates were (NS) in glucose groups (group A: 52.2; B: 47.8%) than control group (60.9%). ZiB rates the highest (p<0.05) in control (47.8%) than those in group A (21.7%) and B (28.3%). ZeB rates the highest (NS) in group A (30.4%) than those in control (13.0%) and group B (19.6%). Blastocysts, cultured in group B (50.5), had the highest (NS) mean cell numbers compared with the others (control: 39.2; group A: 45.6). The % ICM in blastocysts cultured in group A (20.6%) was the highest (NS) than those of other tested groups (control: 15.2%; group B: 13.9%). CONCLUSION: This study shows that a low dose of glucose added to culture medium increases the developmental capacity of 2 cell embryos in mice.
Animals ; Blastocyst* ; Cell Count* ; Embryo, Mammalian ; Embryonic Structures* ; Female ; Follicular Fluid ; Glucose* ; Humans ; Mice* ; Mineral Oil ; Oviducts ; Research Design ; Uterus

PURPOSE: Chondroid syringoma, previously known as 'mixed tumor of the skin', is a rare benign tumor. It usually presents an asymptomatic solitary firm intradermal or subcutaneous slowly growing nodule. It occurs frequently in the head and neck region of middle-aged men. We would like to report an uncommon chondroid syringoma about the clinical and histologic presentation. about the clinical and histologic presentation. METHODS: We experienced two cases of chondroid syringoma on the nose and the upper lip, each other. Both masses were totally excised with clear margin. RESULTS: On histologic examination, the masses showed a biphasic pattern-an epithelial component exhibiting apocrine/eccrine differentiation and a stromal component exhibiting myxoid/collagenous change-consistent with the diagnosis of chondroid syringoma. There have been no evidence of recurrence and malignant transformation during postoperative follow-up. CONCLUSION: There is no one distinctive clinical feature that is specific for chondroid syringoma. However, it should be included in the differential diagnosis of a solid nodule in head and neck region with long standing duration, such as epidermal inclusion cyst, pilomatrixoma, dermoid cyst, sebaceous cyst, neurofibroma, and basal cell carcinoma.
Adenoma, Pleomorphic* ; Carcinoma, Basal Cell ; Dermoid Cyst ; Diagnosis ; Diagnosis, Differential ; Epidermal Cyst ; Follow-Up Studies ; Head ; Humans ; Lip* ; Male ; Neck ; Neurofibroma ; Nose ; Pilomatrixoma ; Recurrence

PURPOSE: For facial reconstruction, skin color match is crucial to achieve great aesthetic result. Forehead flap and full thickness skin graft have been used for many years to reconstruct facial defect. Their results are aesthetically valuable with remarkable resemblance and harmony of the skin color between donor and recipient sites. The purpose of this study is to evaluate and compare the aesthetic outcome of the two methods as the analysis of skin color match. METHODS: From January 1995 to December 2005, ten forehead flaps and ten full thickness skin grafts were performed. The reconstructed areas of forehead flaps were five noses and five eyelids. Recipient sites of full thickness skin grafts were seven eyelids, two noses and one forehead. In order to obtain the objective validity, the skin color of flap(or graft) and the recipient sites were measured by chromameter. The skin colors were quantified according to a three-dimensional coordinate system used in chromameter, L*(brightness), a*(redness), and b*(yellowness). RESULTS: There was no significant color difference between forehead flap site and adjacent skin in all color values. On the other hand, the L* and b* values of graft sites were significantly lower than those of the adjacent skins. The a* values of graft sites were higher than those of the adjacent skins. CONCLUSION: This study reveals that skin color match of forehead flap is greater than that of full thickness skin graft. As forehead flap has adequate volume and great color match, it can be useful to reconstruct deep facial defect such as nasal defect. On the other hand, full thickness skin graft can be used for superficial defect like partial eyelid defect.
Eyelids ; Forehead ; Hand ; Humans ; Nose ; Skin ; Tissue Donors ; Transplants

A bleeding peptic ulcer is the most common cause of upper gastrointestinal bleeding as well as for hospitalization and death. Many endoscopic methods of treating bleeding peptic ulcers are currently being studied and developed. Among them, the endoscopic pure ethanol injection therapy is favored because of its high efficacy, low cost, and rapid administration. Pure ethanol is an excellent agent to stop bleeding and manifests itslef by inducing tissue dehydration, fixation and vessel compression, which in turn causes arterial coagulation and tissue necrosis. However, an excessive injection volume may bring about extensive mucosal necrosis; hence, caution should be taken when deciding upon the injection volume and depth. We report a case of extensive necrosis of the gastric mucosa following endoscopic ethanol injection therapy of a bleeding peptic ulcer along with a review of the relevant literature.
Dehydration ; Ethanol ; Gastric Mucosa ; Glycosaminoglycans ; Hemorrhage ; Hospitalization ; Necrosis ; Peptic Ulcer

PURPOSE: In colorectal cancer, the role of detecting free malignant cells from peritoneal lavage is currently unclear. In this study, we investigated the positive rate of free malignant cells in peritoneal lavage fluid and their predictive value for prognosis and peritoneal recurrence after a curative resection. METHODS: From October 2009 to December 2011, in a prospective manner, we performed cytologic examinations of peritoneal lavage fluid obtained just after the abdominal incision from 145 patients who underwent curative surgery for colorectal cancer. We used proportional hazard regression models to analyze the predictive role of positive cytology for peritoneal recurrence and survival. RESULTS: Among total 145 patients, six patients (4.1%) showed positive cytology. During the median follow-up of 32 months (range, 8-49 months), 27 patients (18.6%) developed recurrence. Among them, 5 patients (3.4%) showed peritoneal carcinomatosis. In the multivariate analysis, positive cytology was an independent predictive factor for peritoneal recurrence (hazard ratio [HR], 136.5; 95% confidence interval [CI], 12.2-1,531.9; P < 0.0001) and an independent poor prognostic factor for overall survival (HR, 11.4; 95% CI, 1.8-72.0; P = 0.009) and for disease-free survival (HR, 11.1; 95% CI, 3.4-35.8; P < 0.0001). CONCLUSION: Positive cytology of peritoneal fluid was significantly associated with peritoneal recurrence and worse survival in patients undergoing curative surgery for colorectal cancer. Peritoneal cytology might be a useful tool for selecting patients who need intraperitoneal or systemic chemotherapy.
Ascitic Fluid ; Carcinoma ; Colorectal Neoplasms* ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Peritoneal Lavage* ; Prognosis* ; Prospective Studies ; Recurrence*