Coronary artery milking is defined as a systolic compression of the coronary artery, usually resulting from myocardial bridging. Rarely, congenital heart disease, pulmonary hypertension and ventricular aneurysm can lead to coronary artery milking, and there has been a reported case of left anterior descending coronary artery milking after coronary stenting. Percutaneous coronary intervention (PCI) is an emerging strategy for treatment of stenosis in the left main stem. We report a case of symtomatic systolic milking at the left main stem treated by direct stenting during PCI in a patient with unstable angina pectoris.
Aneurysm ; Angina, Unstable ; Constriction, Pathologic ; Coronary Vessels ; Humans ; Hypertension ; Milk ; Myocardial Bridging ; Percutaneous Coronary Intervention ; Pulmonary Heart Disease ; Stents

No abstract available.
Occupational Diseases*

Knee pain is rarely an initial symptom of colon cancer, because most bone metastases develop in the late stage of cancer. Therefore, patients with colorectal cancer usually present with gastrointestinal symptoms. Recently, we experienced a 46-year-old female with rectal cancer that presented as knee pain due to tibial metastasis without other organ metastasis. She was evaluated for knee pain and diagnosed with a rectal cancer after biopsies of the tibial and rectal masses. We report the first such case in Korea with a review of the literature.
Biopsy ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Knee ; Korea ; Middle Aged ; Neoplasm Metastasis ; Rectal Neoplasms ; Tibia

OBJECTIVE: To evaluate the effect of uterine weight on short-term outcome of total laparoscopic hysterectomy (TLH) for benign gynecological conditions. METHODS: A retrospective medical records review of 265 cases of patients with TLH was performed. Patients included in this study underwent TLH as benign uterine disorders at Kangnam Sacred Heart Hostpital, Hallym University from January 2008 through June 2009. These patients were stratified into three groups; Group 1 patients with uterus weighing less than 180 g (n=60), Group2 patients with uterus weighing 180 g to 350 g (n=141), Group 3 patients with uterus weighing more than 350 g (n=64). The groups were compared as regard postoperative stay, operative time, estimated blood loss, hemoglobin change, conversion to open surgery, and postoperative complications. RESULTS: There was no significant difference in age, gravidity, body mass index, previous pelvic surgery and past medical history. The overall complication rates were not significantly different. But operative time prolonged as uterine weight increased. CONCLUSION: The TLH can be performed successfully in case of enlarged uterus. Therefore the enlarged uterus is not an absolute contraindication for TLH.
Body Mass Index ; Conversion to Open Surgery ; Gravidity ; Heart ; Hemoglobins ; Humans ; Hysterectomy ; Medical Records ; Operative Time ; Retrospective Studies ; Uterus

The pathogenetic mechanisms of minimal change disease and immunoglobulin A nephropathy remain uncertain, but recently various reports have reported the important role of the immunological aspect in the pathogenesis of glomerular injury. To assess the abnormalities of immunoregulatory system in these glomerular disease, the percentages of lymphocyte subpopulations in peripheral blood were studied in 24 cases of minimal change disease and 28 of immunoglobulin A nephropathy diagnosed by renal biopsy. The results were as follows: 1) CD4/CD8 ratio of the minimal change disease was significantly increased, compared with normal controls and immunoglobulin A nephropathy(P<0.05). 2) No significant difference in T helper cell and T suppressor cell was found between steroid response group and steroid non-response group in minimal change disease. 3) No significant difference in lymphocyte subpopulation was found between group with nephrotic range of proteinuria and group without nephrotic range of proteinuria in minimal change disease. 4) The discrepancies in lymphocyte subpopulations was not observed between group with infection and group without infection in immunoglobulin A nephropathy. 5) The pathologic grade (criteria of WHO) did not demonstrate a significant difference in lymphocyte subpopulation in immunoglobulin A nephropathy. In conclusion, these results suggest that the dysregulation of cell-mediated immunologic system is involved in the pathogenesis of minimal change disease and immunoglobulin A nephropathy, and some differences of immunoregulatory abnormalities between minimal change disease and immunoglobulin A nephropathy exist. But in this study the change in lymphocyte subpopulation does not anticipate the clinical course and prognosis of minimal change disease and immunoglobulin A nephropathy.
Biopsy ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Lymphocyte Subsets* ; Lymphocytes* ; Nephrosis, Lipoid* ; Prognosis ; Proteinuria ; T-Lymphocytes, Helper-Inducer

Crohn's disease, a major form of inflammatory bowel disease (IBD), is a chronic inflammatory condition that is characterized by microvascular and macrovascular involvement. Some extraintestinal complications can occur due to chronic systemic inflammation in IBD. Among them, a pulmonary thromboembolism is a rare manifestation of IBD but is associated with a high morbidity and mortality. To our best of knowledge, there is only one case report of a pulmonary thromboembolism as a complication of Crohn's disease in Korea. We present another rare case of pulmonary thromboembolism as complication in a 25-year-old man with underlying Crohn's disease.
Adult ; Crohn Disease ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Korea ; Pulmonary Embolism

OBJECTIVE: To determine whether the presence of Y-chromosome microdeletion affects the outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) program. METHODS: Fourteen couples with microdeletion in azoospermic factor (AZF)c region who attempted IVF/ICSI or cryopreserved and thawed embryo transfer cycles were enrolled. All of the men showed severe oligoasthenoteratoazoospermia (OATS) or azoospermia. As a control, 12 couples with OATS or azoospermia and having normal Y-chromosome were included. Both groups were divided into two subgroups by sperm source used in ICSI such as those who underwent testicular sperm extraction (TESE) and those used ejaculate sperm. We retrospectively analyzed our database in respect to the IVF outcomes. The outcome measures were mean number of good quality embryos, fertilization rates, implantation rates, beta-hCG positive rates, early pregnancy loss and live birth rates. RESULTS: Mean number of good quality embryos, implantation rates, beta-hCG positive rates, early pregnancy loss rates and live birth rates were not significantly different between Y-chromosome microdeletion and control groups. But, fertilization rates in the Y-chromosome microdeletion group (61.1%) was significantly lower than that of control group (79.8%, p=0.003). Also, the subgroup underwent TESE and having AZFc microdeletion showed significantly lower fertilization rates (52.9%) than the subgroup underwent TESE and having normal Y-chromosome (79.5%, p=0.008). Otherwise, in the subgroups used ejaculate sperm, fertilization rates were showed tendency toward lower in couples having Y-chromosome microdeletion than couples with normal Y-chromosome. (65.5% versus 79.9%, p=0.082). But, there was no significance statistically. CONCLUSIONS: In IVF/ICSI cycles using TESE sperm, presence of Y-chromosome microdeletion may adversely affect to fertilization ability of injected sperm. But, in cases of ejaculate sperm available for ICSI, IVF outcome was not affected by presence of Y-chromosome AZFc microdeletion. However, more larger scaled prospective study was needed to support our results.
Avena ; Azoospermia ; Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Fertilization ; Fertilization in Vitro* ; Humans ; Live Birth ; Male ; Outcome Assessment (Health Care) ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Y Chromosome*

OBJECTIVE: Our purpose was to evaluate potential efficacy of selective estrogen receptor modulators (raloxifene and tamoxifen) to human uterine leiomyoma cells. METHODS: The samples were collected from ten hysterectomized specimen. we evaluated the estrogen-responsive growth of human uterine leiomyoma and normal myometrial cells. The potential efficacy of Selective Estrogen Receptor Modulators (SERMs: raloxifene and tamoxifen) to human uterine leiomyoma cells were conducted by MTS, cell count assay and Western-blot. RESULTS: Human uterine leiomyoma and normal myometrial cells that expressed estrogen receptor (ER) showed increases the cell number in the presence of estrogen compared with ER negative uterine leiomyoma cells. Raloxifene and tamoxifen inhibited estrogen-stimulated proliferation of ER-containing human uterine leiomyoma and normal myometrial cells. Raloxifene was more effective in inhibiting estrogen-induced increases of cell number compared with tamoxifen. CONCLUSION: The effect of SERMs on leiomyoma was inhibited the cell proliferation without apoptosis or cell cycle arrest. These data suggest that SERM should be examined as candidate of nonsurgical therapeutic agents for uterine leiomyoma.
Apoptosis ; Cell Count ; Cell Cycle Checkpoints ; Cell Proliferation ; Estrogens ; Humans* ; Leiomyoma* ; Raloxifene Hydrochloride ; Selective Estrogen Receptor Modulators* ; Tamoxifen

This study aimed to discover potential biomarkers for dioxynivalenol (DON) intoxication. B6C3F1 male mice were rally exposed to 0.83, 2.5 and 7.5 mg/kg body weight (bw) DON for 8 days and the differential protein expressions in their blood plasma were determined by SELDI - Time-of-Flight/Mass Spectrometry (TOF/MS) and the immunoglobulins (Igs) G, A, M and E in the serum were investigated. 11.7 kDa protein was significantly highly expressed according to DON administration and this protein was purified by employing a methyl ceramic HyperD F column with using optimization buffer for adsorption and desorption. The purified protein was identified as a haptoglobin precursor by peptide mapping with using LC/Q-TOF/MS and MALDI-TOF/MS and this was confirmed by western blotting and ELISA. IgG and IgM in serum were decreased in a dose-dependent manner and IgA was decreased at 7.5 mg/kg bw DON administration, but the IgE level was not changed. To compare the expressions of haptoglobin and the Igs patterns between aflatoxin B1 (AFB1), zearalenone (ZEA) and DON intoxications, rats were orally administered with AFB1 1.0, ZEA 240 and DON 7.5 mg/kg bw for 8 days. Haptoglobin was increased only at DON 7.5 mg/kg bw, while it was slightly decreased at ZEA 240 mg/kg bw and it was not detected at all at AFB1 1.0 mg/kg bw. IgG and IgA were decreased by DON, but IgG, IgA, IgM and IgE were all increased by AFB1. No changes were observed by ZEA administration. These results show that plasma haptoglobin could be a diagnostic biomarker for DON intoxication when this is combined with examining the serum Igs.
Aflatoxin B1/toxicity ; Animals ; Blood Proteins/drug effects/*metabolism ; Enzyme-Linked Immunosorbent Assay ; Haptoglobins/drug effects/*metabolism ; Immunoglobulins/*blood/drug effects ; Male ; Mass Spectrometry ; Mice ; Mice, Inbred Strains ; Rats ; Rats, Wistar ; Trichothecenes/*toxicity ; Zearalenone/toxicity

BACKGROUND AND OBJECTIVES: Various methods to induce tracheal stenosis in an animal model have been introduced. However, most methods use non-physiologic mechanical or chemical injury to tracheal mucosa or cartilage. In this study, we sought to develop an animal model of tracheal stenosis using a segmented endotracheal tube. MATERIALS AND METHOD: Nine New Zealand White Rabbits were included in this feasibility study. A segmented 1.5 cm LEVIN-Tube (16 French) was inserted into tracheal lumen via tracheotomy site and fixed with a nylon tape circumferentially tied around the trachea. The tube was removed transorally one week later and the tracheal lumen was observed with bronchoscopy every week. Rabbits were sacrificed two weeks after the tube removal and the trachea was evaluated with histologic image. Three rabbits underwent tracheotomy and closure only to evaluate possible impact of tracheotomy procedure to tracheal stenosis (sham surgery). RESULTS: None of the 6 rabbits showed significant complications or death during the study. No significant change of tracheal lumen was identified in 3 sham models. The mean grade of stenosis was 57.2±9.9% (range, 43-70%). Histologic image showed thickening and fibrosis of lamina propria with relatively intact tracheal cartilage framework. CONCLUSION: We developed an animal model of tracheal stenosis using a segmented endotracheal tube fixed with a nylon tape. Since this model has similar pathophysiology to prolonged endotracheal intubation, it may be used in various studies related to tracheal stenosis.
Animals* ; Bronchoscopy ; Cartilage ; Constriction, Pathologic ; Feasibility Studies ; Fibrosis ; Intubation, Intratracheal ; Methods ; Models, Animal* ; Mucous Membrane ; Nylons ; Rabbits ; Trachea ; Tracheal Stenosis* ; Tracheotomy