OBJECTIVE: It is known that mouse embryos before implantation develop in a low oxygen environment of 3- 8% concentration and with antioxidant materials such as vitamins, antioxidant enzymes, ferrous binding proteins, and albumin in follicular and tubal fluids. However, the 20% oxygen culture condition with chemically defined media might be produce an abundance of ROS, and leads to developmental delay or developmental block in vitro. In this study, we attempt to elucidate the relationship between intracellular H2O2 production and embryo development in different oxygen culture conditions of mouse embryos. METHODS: Prenuclear embryos from C57BL/CBA Fl hybrid and ICR mouse were cultured in incubators which provided 5% carbon dioxide, 20% oxygen and 5% carbon dioxide, 5% oxygen. Measurement of H2O2 level in a embryo was performed with DCHFDA(2, 7 -dichlorodihydroflourescein diacetate)and analyzed with Quanti-cell 700, and the number of blastomeres was counted with DAPI( 4, 6'-diamidino-2-phenylindole). RESULTS: Oxygen concentration of the culture medias was significantly higher in the 20% oxygen environment compared to that of 5% oxygen environment. Culture of mice embryos in high oxygen condition leads to high HO concentrations at 2 cell stage and developmental delay or ""2-cell block"" regardless of the strain. But in a 5% oxygen environment, which is similar to in-vivo conditions HO production was suppressed continuously through out culture and development of embryos was definitely improved. CONCLUSION: These results suggest that there is a difference in the production of ROS or protective mechanism according to the mouse strains and stage of development, and it is thought that in-vitro culture in 5% oxygen environment provides stable in vivo equilibrium but in a 20% oxygen environment there is production of ROS which overcome the protective mechanism which leads to cellular damage and embryo developmental delay.
Animals ; Blastomeres ; Carbon Dioxide ; Carrier Proteins ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Female ; Incubators ; Mice* ; Mice, Inbred ICR ; Oxygen* ; Pregnancy ; Vitamins

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

Twenty-seven consecutive patients who had post-traumatic stiffness of the elbow were treated by operative soft tissue release or by soft tissue release and distraction arthroplasty. The purpose of this study was to describe the method of operation and postoperative management and to evaluate the results in the patients who had operative treatment for the post-traumatic stiffness of the elbow. The type of operative procedure was determined by whether the factors limiting motion were extra-articular (extrinsic) or intra-articular (intrinsic) and by pre-operative radiographic evaluation. The soft tissue release was performed by staged adhesiolysis through lateral or combined lateral and medial approaches. And if the factors limiting motion included a severe intraarticular lesions, distraction arthroplasty using the Judet or Oganesian apparatus was added to soft tissue release. The mean pre-operative arc of active motion was 42 degrees. At follow-up examination, nineteen to sixty-six months postoperatively, the mean post-operative arc of active motion was 103 degrees. There were nine complications (33 percent) in twenty-seven patients. All of them was transient ulnar nerve paresthesia. And we analysed the final results with Mayo elbow performance index for the evaluation of clinical outcome. Twenty-five (93%) of twenty-seven patients had satisfactory result according to Mayo elbow performance index. We conclude arthrolysis with or without distraction arthroplasty is useful for the treatment of posttraumatic elbow stiffness. However, the accurate anatomical knowledge, operative skill, and careful postoperative rehabilitation program were needed in the operative treatment of post-traumatic elbow stiffness.
Arthroplasty ; Elbow* ; Follow-Up Studies ; Humans ; Paresthesia ; Rehabilitation ; Surgical Procedures, Operative ; Ulnar Nerve

PURPOSE: The present study is to investigate the clinical utility of tumor marker cutoff ratio (TMR) and develop a TMR combination scoring system based on preoperative tumor marker (TM) levels to prognosis prediction in gastric cancer. METHODS: We include 1,142 patients for whom two or more TMs were measured and who underwent radical gastrectomy between 1990 and 2003. RESULTS: Five-year risk of recurrence (5 YRR) for carcinoembryonic antigen (CEA) TMRs were 18.3%, 29.8%, 61.4% for TMR < 1.0, 1.0 < or = TMR < 2.0, TMR > or = 2.0 respectively. 5 YRR for carbohydrate antigen 19-9 (CA 19-9) TMR were 19.7%, 35.6%, 58.4% for TMR < 1.0, 1.0 < or = TMR < 3.0, TMR > or = 3.0, respectively. 5 YRR for carbohydrate antigen 72-4 (CA 72-4) TMR were 15.2% and 33.6% for TMR < 1.0 and TMR > or = 1.0, respectively. We defined high TMR (TMR > or = 2.0 for CEA, TMR > or = 3.0 for CA19-9), low TMR (1.0 < or = TMR < 2 for CEA, 1.0 < or = TMR < 3.0 for CA 19-9 and 1.0 < or = TMR for CA72-4) and negative TMR (TMR < 1.0 for all TMs). A TMR combination scoring system was devised with negative scored as zero points, low as 1 and high as 2 for each TMR. TMR scores were divided into four categories (score 0, 1, 2, 3 and above) based on the calculated TMR score and 5 YRR were found to be 12.8%, 23.9%, 45.5%, and 68.3%, respectively (P < 0.05). Multivariate analysis showed that our scoring system was a significant independent prognostic factor. CONCLUSION: Preoperative TMRs such as CEA, CA 19-9, and CA 72-4 show a correlation with prognosis and the TMR combination scoring system could be a useful tool for the prediction of prognosis in gastric cancer.
Biomarkers, Tumor ; Carcinoembryonic Antigen* ; Cinnarizine ; Gastrectomy ; Humans ; Multivariate Analysis ; Prognosis ; Recurrence ; Stomach Neoplasms*

PURPOSE: The purpose of this study was to evaluate early outcomes of ALTA (aluminum potassium sulfate and tannic acid, Ziohn(R)) injection compared with those of a submucosal hemorrhoidectomy for the treatment of internal hemorrhoids. METHODS: From September 2008 to April 2009, a total of 50 patients who had internal hemorrhoids (Golliger grade II to IV) were treated by using either ALTA injection (n=25) or a submucosal hemorrhoidectomy (n=25). Outcomes with respect to pain scores, analgesics use, and satisfaction levels of the patients, and complications were compared. RESULTS: The mean number of hemorrhoidal piles was 3.52 in the ALTA injection group and 3.56 in the operation group. The average amount of ALTA injection was 27.34 cc. Pain scores measured at one day and 7 days after the treatment, and the number of analgesics used in the injection group were significantly lower than those in the operation group (P<0.001). However, there was no significant difference in the satisfaction level between two groups. One case of treatment failure was found in the ALTA injection group. There was no difference in complications between the injection group (n=4) and the operation group (n=5) (P=0.725). CONCLUSION: When compared with a submucosal hemorrhoidectomy, ALTA injection showed less post-treatment pain and less analgesics use. Overall complication rates were not different between the two groups. We found the early outcomes of ALTA injection for the treatment of internal hemorrhoids to be comparable to those of surgery. Thus, large-scale and long-term follow-up studies are needed to clarify the proper indications for ALTA injection.
Analgesics ; Follow-Up Studies ; Hemorrhoidectomy ; Hemorrhoids ; Humans ; Potassium ; Sclerotherapy ; Sulfates ; Tannins ; Treatment Failure

F-18 FDG-PET/CT could be used to evaluate the surveillance of recurrent stomach cancer, but some cases reported as false-positives. The authors found an activated charcoal granuloma from intraperitoneal chemotherapy by using a curative resection and mitomycin C for stomach cancer. A mass behind the right colon that showed on CT 6 months after an operation in a 46-year-old male patient had no progression in size, but 36 months after the operation, an increase was seen on F-18 FDG-PET/CT, and a metastatic tumor was suspected. The tumor was resected by an explorative laparotomy and was diagnosed as being an activated charcoal granuloma based on the histologic finding. Based on this case, we should be reminded of the possibility of a false-positive on analysis of F-18 FDG-PET/CT caused by an activated charcoal granuloma in a patient who has intraperitoneal chemotherapy.
Charcoal* ; Colon ; Drug Therapy* ; Granuloma* ; Humans ; Laparotomy ; Male ; Middle Aged ; Mitomycin ; Stomach Neoplasms

PURPOSE: We have evaluated changes of body composition for patients that underwent a radical gastrectomy for stomach cancer by the use of available bioelectrical impedance analysis during the first year following surgery. We plan to utilize these findings in nutritional and physiological studies. MATERIALS AND METHODS: We evaluated clinical changes in body composition in patients using the bioelectrical impedance method (Inbody 4.0, Biospace, Korea), between November 2003 to November 2004. A total of 98 patients agreed to enroll in this study among all of the patients that underwent a radical gastrectomy. RESULTS: The average weight decreased by 6.7%, and 9.4%, within the first and 6 months after surgery, respectively (P<0.01). The fat free mass (FFM) dropped by 4.9% within the first month and there were no more changes after this period (P<0.01). The fat mass (FM) and visceral fat area (VFA) decreased 24.3% and 14.1% within the first 6 months (P<0.01), respectively. The reduction effects for female patients were greater than for male patients for weight, FFM and VFA (P<0.05). The edema index was higher in patients with stage III-IV disease than in patients with stage I-II disease (P<0.05). There were significant differences for Billroth I and BillrothI II patients as compared to patients that underwent an esophagojejunostomy for a reduction of the FM, as measured in the in the 12th month after surgery (27.6%, 22.1%, and 41.2%, respectively; P<0.05). CONCLUSION: Since nutritional supplementation and an improvement in body weight loss after a radical gastrectomy is significantly related with quality of life, nutritional and physiological studies should be greatly considered. In this study, bioelectrical impedance analysis was very useful in analyzing the diminution of body composition and we hope this study on the nutritional and physiological aspects related to a radical gastrectomy will be useful for later studies.
Adenocarcinoma* ; Body Composition* ; Body Weight ; Edema ; Electric Impedance* ; Female ; Gastrectomy* ; Gastroenterostomy ; Hope ; Humans ; Intra-Abdominal Fat ; Male ; Quality of Life ; Stomach Neoplasms

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

PURPOSE: To evaluate the efficacy of the sutureless amniotic membrane (AM) patch for the treatment of ocular surface disorders. METHODS: A sutureless AM patch using a silicone ring was utilized to treat neurotrophic ulcer, persistent epithelial defect (PED), Shield ulcer, chemical injury and Stevens-Johnson syndrome. Primary outcome was the time to complete corneal and conjunctival epithelialization. Secondary outcome was the number of repeated insertions and complications of the inserted ring. RESULTS: Neurotrophic ulcer was observed in 4 eyes, PED in 2 eyes, Shield ulcer in 1 eye, chemical injury in 4 eyes and Stevens-Johnson syndrome in 4 eyes. The mean (SD) time to complete epithelialization was 13 (7.2) days (6-20 days) in neurotrophic ulcer, 17.5 (7.7) days (12-23) in PED, 5 days in Shield ulcer, 10.6 (6.6) days (3-15) in chemical injury and 13.5 (0.7) days (13-14) in Stevens-Johnson syndrome. There were no protrusion or mechanical trauma of the inserted ring. In 1 case of neurotrophic ulcer and 1 refractory case of chemical injury, repeated insertion was performed due to incomplete healing after dissolution of the AM. In 2 eyes with Stevens-Johnson syndrome, repeated insertion was necessary with heavy accumulation of inflammatory debris on the AM. No symblepharon or fornix contracture was found in chemical injury or Stevens-Johnson syndrome patients. CONCLUSIONS: The sutureless AM patch using a silicone ring was shown to be effective and safe for the treatment of ocular surface disorders. The patch can help surgeons avoid suture-related trauma to the ocular surface during the acute inflammatory period.
Amnion ; Contracture ; Eye ; Silicones ; Stevens-Johnson Syndrome ; Ulcer

BACKGROUND: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. METHODS: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. RESULTS: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. CONCLUSIONS: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.
Bone Screws ; Elbow ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Humeral Fractures ; Shoulder ; Shoulder Joint