OBJECTIVE: This study was performed to evaluate and compare the embryonic developmental capacity and pregnancy rates in conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) with ejaculated sperm or testicular sperm cycles. MATERIALS AND METHODS: Fertilization was examined in the following morning after IVF (group I), ICSI (group II) or TESE-ICSI cycles (group III). Fertilized oocytes were co-cultured with Vero cells until embryo transfer (ET). On day 2 and 5~7, grades of embryos (<4- or > or =4-cell) and blastocysts (BG1, 2, 3 or early) were evaluated. Clinical pregnancy rate was determined by detecting G-sac with transvaginal ultrasonogram. We analyzed the results bychi2 and Student's t-test and considered statistically significant when P value was less than 0.05. RESULTS: Fertilization rate was significantly higher (p<0.05) in group I (79.0+/-21.2%) than in group II and III (56.8+/-21.6% and 36.7+/-25.3%). Cleavage and blastulation rate of group I (95.8+/-13.8% and 59.5+/-25.3%) were significantly higher (p<0.05) than those of group III (83.4+/-18.6% and 40.4+/- 36.5%). Clinical pregnancy rate was significantly higher (p<0.05) in group I and II (40.7% and 41.7%) than that in group III (12.5%). No differences were found in the rates of multiple pregnancy and abortion among three groups. Embryonic implantation rate was higher in group I (15.1+/-20.2%, p<0.05) and II (14.7+/-20.6%, NS) than that in group III (5.1+/-15.6%). However, embryonic implantation rate was increased in ET with blastocyst(s) among three groups. CONCLUSIONS: Fertilized oocytes obtained from TESE-ICSI were harder to be successfully cultured to blastocyst stage for 5~7 days than that from IVF cycles. However, all blastocyst(s) ET increased the embryonic implantation rate equally in IVF, ICSI and TESE-ICSI cycles.
Blastocyst ; Embryo Transfer ; Embryonic Development* ; Embryonic Structures ; Female ; Fertilization ; Fertilization in Vitro ; Oocytes* ; Pregnancy ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Sperm Injections, Intracytoplasmic* ; Spermatozoa ; Ultrasonography ; Vero Cells

BACKGROUND: Treatment outcome with only chemotherapy for multi-drug resistant tuberculosis is usually considered not to be satisfactory. However, the combined therapy of chemotherapy with surgical treatment has been producing higher sputum AFB negative conversion and longer survival rates, and this treatment strategy is expected to be a set-up for the patients with multi-drug resistant tuberculosis. MATERIAL AND METHOD: A retrospective review was performed with the medical records and laboratory findings in 49 patients with multi-drug resistant tuberculosis of 130 patients who underwent pulmonary resection for pulmonary tuberculosis between January 1995 and December 1999 at National Masan Tuberculosis Hospital. RESULT: A mean number of the resistant drugs was 4.5 with a mean age of 35 years. Cavitary lesions on plain chest x-ray were shown in 43 patients of 49(87.8%). Thirty one had positive sputum cultures preoperatively(63.3%). Operative techniques were as follows; 12 pneumonectomies, 28 lobectomies, 7 lobectomies with segmentectomies or wedge resections, one wedge resection and a cavernoplasty. Sputum AFB negative conversion rate was 93.5 % with continuous postoperative chemotherapy. There was no death after operation. Air leakage over a week, postoperative bleeding and wound disruption were developed as postoperative complications. CONCLUSION: We experienced the higher effectiveness of postoperative chemotherapy with pulmonary resection on multi-drug resistant tuberculosis. Although there are several different ideas about operative indications, postoperative drug regimens and length of postoperative medications, pulmonary resection should be considered actively as a effective combination measure with chemotherapy to give a treatment for multi-drug resistant pulmonary tuberculosis.
Drug Therapy ; Hemorrhage ; Hospitals, Chronic Disease ; Humans ; Mastectomy, Segmental ; Medical Records ; Pneumonectomy ; Postoperative Complications ; Retrospective Studies ; Sputum ; Survival Rate ; Thorax ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant* ; Tuberculosis, Pulmonary ; Wounds and Injuries

Endometriosis is a relatively common disease, affecting 5-10% of women of reproductive age. But, endometriosis affecting the urinary tract is very rare entity. Involvement of urinary tract by endometriosis occurs in about 1% of women with pelvic endometriosis. Ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms at clinical presentation and difficult preoperative diagnosis. The involvement of the ureter is rarely intrinsic by implantation of endometrial tissue in the wall of the ureter, but rather due to external compression by adjacent endometriosis and its attendant inflammation and fibrosis. We have experienced a case of right severe hydroureteronephrosis due to ureteral stricture from endometriosis. Laparoscopic nephrectomy was done due to renal atrophy. At the same time, laparoscopic total hysterectomy with right salpingo-oophorectomy was performed because of the uterine adenomyosis and right ovarian endometrioma. So, we report that with a brief review of literatures.
Adenomyosis ; Atrophy ; Constriction, Pathologic* ; Diagnosis ; Endometriosis* ; Female ; Fibrosis ; Humans ; Hydronephrosis* ; Hysterectomy ; Inflammation ; Nephrectomy ; Ureter* ; Urinary Tract

Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.
Adult ; Deglutition Disorders ; Drug Therapy ; Esophageal Stenosis* ; Esophagectomy ; Esophagitis ; Esophagitis, Peptic ; Fibrosis ; Humans ; Induction Chemotherapy* ; Leukemia ; Leukemia, Myeloid, Acute

Angiomyofibroblastoma is a recently described mesenchymal tumor characterized by unique morphologic features, a propensity to arise in the vulva, and a non-aggressive beni-gn biologic behavior. It is typically well circumscribed and superficially located tumor and its cellularity is variable with hypercellular and hypocellular areas composed of bland-looking, pump stromal cells showing the immunophenotype of vimentin-/desmin - positive, and muscle specific actin(MSA)-/alpha-smooth muscle actin(ASMA) - negative. Spindle or plasm-acytoid cells are the characteristic cell types of most tumors. It is similar to an aggressive pelvic angiomyxoma in histology. Because of histologic similarity and differences in the clinical course and treatment, distinction from aggressive angiomyxoma was needed. It rep-resents new type in the expanding spectrum of tumors of which myofibroblasts constitute an integral component. We experienced a case of angiomyofibroblastoma of the vulva occuring in a 42 years old woman. The lesion was relatively well encapsulated mass(3 X 1.5 X 0.9 cm in dimension), showing intimate admixture of hypercellular and hypocellular area. The tumor contained prominent, somewhat ectatic vessels surrounded by smooth muscle cells, some of which blend or fan out from the muscular walls of the vessels. The margin was relatively free from tumor cells. At immunohistochemical stain, vimentin and desmin was diffuse and weak positive, smooth muscle actin was very a few and weak positive in tumor cells.
Actins ; Adult ; Desmin ; Female ; Humans ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Myofibroblasts ; Myxoma ; Stromal Cells ; Vimentin ; Vulva*

Castleman's disease is a relatively rate disorder of lymphoid tissue and poorly understood etiology. The disease may occur anywhere along the lymphatic chain, but is most commonly found as a solitary mass in the mediastinum. The hyaline vascular type represents 91% of Castlemen's disease, and these are most often discovered in the asymptomatic patient on routine chest film. Patients with the plasma cell type often exhibit systemic symptoms, including fever, night sweats, anemia, and hypergammaglobulinemia. Surgical excision effects cure, although resection of the hyaline vascular type may be associated with significant hemprrage owing to extreme vascularity. We recently experienced a case of hyaline vascular type Castleman's disease which was treated by surgical resection through the anterior mini-thoracotomy, and report with its review.
Anemia ; Fever ; Giant Lymph Node Hyperplasia ; Humans ; Hyalin ; Hypergammaglobulinemia ; Lymphoid Tissue ; Mediastinal Neoplasms ; Mediastinum* ; Plasma Cells ; Sweat ; Thorax

OBJECTIVES: The purpose of the current study was to evaluate the usefulness of the following four comorbidity indices in gastric cancer patients who underwent surgery: Charlson Comorbidity Index (CCI), Cumulative Illness rating scale (CIRS), Index of Co-existent Disease (ICED), and Kaplan-Feinstein Scale (KFS). METHODS: The study subjects were 614 adults who underwent surgery for gastric cancer at K hospital between 2005 and 2007. We examined the test-retest and inter-rater reliability of 4 comorbidity indices for 50 patients. Reliability was evaluated with Spearman rho coefficients for CCI and CIRS, while Kappa values were used for the ICED and KFS indices. Logistic regression was used to determine how these comorbidity indices affected unplanned readmission and death. Multiple regression was used for determining if the comorbidity indices affected length of stay and hospital costs. RESULTS: The test-retest reliability of CCI and CIRS was substantial (Spearman rho=0.746 and 0.775, respectively), while for ICED and KFS was moderate (Kappa=0.476 and 0.504, respectively). The inter-rater reliability of the CCI, CIRS, and ICED was moderate (Spearman rho=0.580 and 0.668, and Kappa=0.433, respectively), but for KFS was fair (Kappa=0.383). According to the results from logistic regression, unplanned readmissions and deaths were not significantly different between the comorbidity index scores. But, according to the results from multiple linear regression, the CIRS group showed a significantly increased length of hospital stay (p<0.01). Additionally, CCI showed a significant association with increased hospital costs (p<0.01). CONCLUSIONS: This study suggests that the CCI index may be useful in the estimation of comorbidities associated with hospital costs, while the CIRS index may be useful where estimatation of comorbiditie associated with the length of hospital stay are concerned.
Adult ; Aged ; Comorbidity/trends ; Data Interpretation, Statistical ; Gastrectomy ; Humans ; Length of Stay ; Logistic Models ; Male ; Middle Aged ; Neoplasm Staging ; Statistics, Nonparametric ; Stomach/pathology ; Stomach Neoplasms/*epidemiology/mortality/pathology/surgery

PURPOSE: Colorectal cancer (CRC) is generally considered a disease of old age. Most CRCs are diagnosed at age 50 and over. CRC rarely occurs in teenagers, and the clinical features and prognosis of CRC are not clear in this population. The aim of this study was to uncover the clinicopathologic characteristics of teenage sporadic CRC.METHODS: Of the 21,042 patients who underwent operation for primary CRC at Asan Medical Center between July 1989 and December 2014, 19 cases (0.09%) without a familial history of CRC before 20 years of age at diagnosis were enrolled in this study. The clinicopathologic features of the teenage sporadic CRC patients were retrospectively reviewed.RESULTS: Of the 19 patients, 16 patients (84.2%) were male. The most common primary site was the left colon (descending colon & sigmoid colon) in nine patients. With respect to histologic type, adenocarcinoma represented 57.8% of cases, mucinous adenocarcinoma, 31.5%, and signet ring cell carcinoma, 10.5%. Six (31.5%) patients showed peritoneal seeding at presentation. In survival analysis, the 5-year overall survival rate of the patients who underwent curative surgery was 71.3%.CONCLUSION: Teenage sporadic CRC is a very rare disease and the proportion of patients with a poor histologic subtype is high, but early detection and radical treatment can lead to favorable survival rates.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Adolescent ; Carcinoma, Signet Ring Cell ; Chungcheongnam-do ; Colon ; Colon, Sigmoid ; Colorectal Neoplasms ; Diagnosis ; Humans ; Male ; Prognosis ; Rare Diseases ; Retrospective Studies ; Survival Rate

No abstract available.
Blastocyst ; Coculture Techniques ; Fertilization ; Oocytes* ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval* ; Spermatozoa*

BACKGROUND: During the 2009 influenza pandemic in Korea, school-age children were mostly attacked by the novel influenza A virus (H1N1). Nevertheless, there is limited information on the cumulative incidence of the 2009 influenza pandemic among school populations. The aim of this study was to estimate the incidence of 2009 H1N1 influenza and influenza-like illness (ILI), and characterize the epidemiology among school-based populations in Korea. MATERIALS AND METHODS: This study analyzed the data collected by the daily school influenza reporting system for laboratory-confirmed influenza (H1N1 2009 pdm) and ILI in elementary, middle and high schools in Korea during the period, July 1 to December 20, 2009. RESULTS: Between July 1 and December 20, 2009, a total of 525,668 cases of H1N1 2009 pdm were reported from the schools analyzed. The cumulative incidence of H1N1 2009 pdm was highest in elementary school children between 8 and 13 years of age (11,058 per 100,000 population), followed by middle school students between 14 and 16 years of age (10,080 per 100,000), and high school students between 17 and 19 years of age (8,886 per 100,000). With the alignment of the epidemic curves by the three levels of school education, the age group-specific differences in the timing of the infection became apparent. The infections peaked 1 week earlier in both middle and high school students (November 3, 2009) than in elementary school children (November 10, 2009). The infections occurred an average of 7.3 [95% confidence interval(CI): 7.2-7.4] and 3.4 (95% CI: 3.3-3.5) days earlier in the middle and high school students, respectively, than elementary school children (P<0.001). The overall trend of the epidemic waves from the school reporting system data was similar to that of the national surveillance date from the Korea Centers for Disease Control and Prevention. CONCLUSIONS: This study suggests that during the 2009 pandemic, one student in every 10 was infected with H1N1 2009 pdm, which is double that estimated from the national surveillance data. In addition, middle and high school students were important drivers of H1N1 2009 pdm transmission in 2009. During the 2009 influenza pandemic, the daily school reporting system provided valuable information for estimating the incidence as well as the epidemiological characteristics in school-based populations.
Centers for Disease Control and Prevention (U.S.) ; Child ; Humans ; Incidence ; Influenza A virus ; Influenza, Human ; Korea ; Pandemics