Technology for the long-term preservation of gamete and embryo has improved greatly over the past 20 years and currently is used for supporting various assisted reproductive technologies (ART). Recent progress in cryobiology and its related sciences have made it possible to preserve human embryos effectively, and several cryopreservation methods also have been developed. Successful freezing of supernumerary embryos has allowed patients undergoing ART the opportunity to achieve pregnancies from more than one embryo transfer without being subjected to controlled ovarian hyperstimulation and oocyte retrieval each time. It also allows a delay in embryo transfer where certain adverse conditions exist for fresh transfer, e.g. when the patient is at risk for ovarian hyperstimulation syndrome or when there is poor endometrial development during the retrieval cycle. Cryopreservation of all available embryos from retrieval is utilized when an oocyte recipient is not properly synchronized with oocyte donor's cycle. In this paper is to review the current status and perspectives of embryo cryopreservation in ART program. Also, briefly discuss the oocyte cryopreservation for the establishment of ovum bank.
Cryopreservation* ; Embryo Transfer ; Embryonic Structures* ; Female ; Freezing ; Humans* ; Oocyte Retrieval ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovum ; Pregnancy ; Reproductive Techniques, Assisted

BACKGROUND: A systematic literature review of interspinous dynamic stabilization, including DIAM, Wallis, Coflex, and X-STOP, was conducted to assess its safety and efficacy. METHODS: The search was done in Korean and English, by using eight domestic databases which included KoreaMed and international databases, such as Ovid Medline, Embase, and the Cochrane Library. A total of 306 articles were identified, but the animal studies, preclinical studies, and studies that reported the same results were excluded. As a result, a total of 286 articles were excluded and the remaining 20 were included in the final assessment. Two assessors independently extracted data from these articles using predetermined selection criteria. Qualities of the articles included were assessed using Scottish Intercollegiate Guidelines Network (SIGN). RESULTS: The complication rate of interspinous dynamic stabilization has been reported to be 0% to 32.3% in 3- to 41-month follow-up studies. The complication rate of combined interspinous dynamic stabilization and decompression treatment (32.3%) was greater than that of decompression alone (6.5%), but no complication that significantly affected treatment results was found. Interspinous dynamic stabilization produced slightly better clinical outcomes than conservative treatments for spinal stenosis. Good outcomes were also obtained in single-group studies. No significant difference in treatment outcomes was found, and the studies compared interspinous dynamic stabilization with decompression or fusion alone. CONCLUSIONS: No particular problem was found regarding the safety of the technique. Its clinical outcomes were similar to those of conventional techniques, and no additional clinical advantage could be attributed to interspinous dynamic stabilization. However, few studies have been conducted on the long-term efficacy of interspinous dynamic stabilization. Thus, the authors suggest further clinical studies be conducted to validate the theoretical advantages and clinical efficacy of this technique.
Decompression, Surgical ; Humans ; Postoperative Complications ; *Spinal Fusion/adverse effects/methods ; Spinal Stenosis/physiopathology/surgery

STUDY DESIGN: This is a retrospective study. OBJECTIVES: To analyze the clinical outcomes of simple discectomy in patients with recurrent lumbar disc herniation. SUMMARY OF LITERATURE REVIEW: There are two methods of studying the treatment of recurrent lumbar disc herniation. The first type of study considers fusion for the prevention of complications such as postoperative lumbar segmental instability and persistent back pain. The second type of study assumes that simple discectomy without fusion is sufficient in the surgical management of recurrent lumbar disc herniation. MATERIALS AND METHODS: Sixteen patients who underwent simple discectomy due to recurrent lumbar disc herniation were followed up over 3 years. The mean age was 52.8 years (38-68 years). The mean follow-up period was 75.4 months (36-144 months). VAS scores for back pain and radiating lower leg pain were each compared pre- and post-operatively. The Oswestry Disability Index (ODI) was used to analyze the clinical outcome. A modified MacNab's outcome was used to evaluate patient satisfaction. Subjective survey data in a Delphi checklist was reviewed to verify clinical lumbar instability. RESULTS: The mean back pain VAS score showed 87.5% improvement (p<0.001). The mean lower leg VAS score showed 89% improvement (p<0.001). The mean preoperative ODI score was 29.9, and the mean score checked at the last follow up was 3.5. It thus showed 88.3% improvement (p<0.001). Excellent or good satisfaction was reported by fourteen patients (87.5%), and clinical lumbar instability was identified in one patient (6.3%). CONCLUSIONS: Simple discectomy without fusion is one of treatment option for recurrent disc herniation without instability.
Back Pain ; Checklist ; Diskectomy* ; Follow-Up Studies ; Humans ; Leg ; Patient Satisfaction ; Recurrence ; Retrospective Studies

With increased participation in sporting activity, overuse tendon injuries are a major problem in sports medicine. Tendinopathy is generic descriptive term for the clinical conditions in and around tendons arising from overuse. Tendinopathy is debilitating condition that results in significant deficits in performance and prolonged time away from activity. Histological studies show either absent or minimal inflammation. There are three main theories to explain the development of tendinosis, including the mechanical theory, vascular theory, and neural theory. Risk factors are divided into intrinsic factors and extrinsic factors. The management of tendinopathy revolves around modulating tendon pain, as pain is the presenting and limiting factor for activity. Despite an abundance of therapeutic options, the scientific evidence base for managing tendinopathies is limited. The aim of this review is to report the options for most widely used conservative management of tendinopathy.
Athletic Injuries* ; Inflammation ; Intrinsic Factor ; Risk Factors ; Sports Medicine ; Sports* ; Tendinopathy* ; Tendon Injuries ; Tendons

The implatnation of malignant cells along the needle tract is an extremely rare complication after a percutaneous fine-needle aspiration biopsy(FNAB). However, it is very serious and may result in a change in the prognosis of lung cancer, especially in the curable early stage(T1-2,N0,M0). Recently, we experienced two cases of such complications. A 43 years old female underwent a fine needle aspiration biopsy and a right middle lobectomy with adjuvant chemotherapy due to an adenocarcinoma(T2N0M0). Two years later, a new tumor developed at the site of the needle aspiration biopsy. It had the same pathological findings as the previous lung cancer. Therefore, it was concluded to be an implantation metastasis, and she was treated successfully by a right pneumonectomy and a resection of the chest wall mall with adjuvant radiotherapy. In another case, a 62 years old man was diagnosed with squamous cell lung cancer by a fine needle aspiration biopsy and underwent a right upper lobectomy(T2N0M0) with adjuvant chemotherapy. eight months later, a protruding chest wall mass developed at the aspiration site. It showed the same pathological findings as the previous lung cancer. Consequently, a total excision of the mass with adjuvant radiotherapy was done. Two years after the second operation, although the right lung was intace a metachronous squamous cell lung cancer was found at the left lower lobe. The two patients were still alive 15 and 37 months after thenresection of the chest wall mass, respectively.
Biopsy ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung Neoplasms* ; Lung* ; Needles ; Neoplasm Metastasis* ; Pneumonectomy ; Prognosis ; Radiotherapy, Adjuvant ; Thoracic Wall* ; Thorax*

PURPOSE: The purpose of this study was to compare the morphologic change of the posterior cruciate ligament (PCL) on magnetic resonance imaging (MRI) in chronic anterior cruciate ligament (ACL) tear before and after reconstruction. MATERIALS AND METHODS: On the MRI image after ACL reconstruction, a base line (BL) was drawn between the femoral and tibial insertion sites of the PCL. Point A was established as the vertically farthest point from BL. Line 1 and 2 were drawn respectively between point A and the insertions of PCL. The angles between BL and Line1 and 2 were defined as angle a and angle b. Correlations between the preoperative anterior knee instability assessed with the KT 1000 arthrometer and the parameters were evaluated. RESULTS: The average angle a was 52.3degrees+/-7.1degrees preoperatively and 30.1degrees+/-3.4degrees postoperatively, and the average angle b was 28.95degrees+/-4.62degrees preoperatively and 22degrees+/-2.9degrees postoperatively (p<0.05). The preoperative manual maximal side-to-side difference was 7.2+/-2.3 mm, which had no significant correlation with angle b. CONCLUSIONS: The preoperative buckling of PCL in the case of chronic ACL injury disappeared after ACL reconstruction. The degree of PCL buckling had no correlation with the degree of preoperative anterior instability.
Anterior Cruciate Ligament ; Knee ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Posterior Cruciate Ligament ; Rupture

PURPOSE: Little is known about the isometry of anatomic single-bundle anterior cruciate ligament (ACL) tunnel positions in vivo although it is closely related to graft tension throughout the range of motion. The purpose of this study was to evaluate intraoperative graft isometry in anatomic single-bundle ACL reconstruction in vivo. MATERIALS AND METHODS: Graft length changes were assessed before bio-screw fixation in the tibial tunnel by pulling the graft with tensions of 20 lbs and 30 lbs in full extension at flexion angles of 30°, 60°, 90°, and 120°. RESULTS: At the flexion angle of 30°, 20 lbs and 30 lbs of tension showed −0.4 mm and −0.6 mm length changes, respectively. The greater the flexion angle of the knee, the shorter the graft length in the joint. At the flexion angles of 90° and 120°, there was significant difference in the graft length change between 20 lbs and 30 lbs of tension. CONCLUSIONS: Anatomic single-bundle ACL reconstruction was non-isometric. The graft length was the longest in full extension. The tension of graft became loose in flexion. At the flexion angles of 90° and 120°, there was significant difference in the graft length change between 20 lbs and 30 lbs of tension.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Joints ; Knee ; Range of Motion, Articular ; Transplants

Sarcopenia has been defined as the considerable loss of skeletal muscle mass and strength that results in frailty in the elderly. Because muscle tissue plays diverse important roles in human, sarcopenia presents many negative health-related consequences including impaired energy homeostasis, falls and cardiovascular disease, and subsequently higher mortality. It is becoming evident that sarcopenia has a negative impact on the healthy life of the elderly. The European Working Group on Sarcopenia, the International Working Group on Sarcopenia and the Asian Working Group on Sarcopenia have released position statement regarding sarcopenia, and more recently the Foundation for the National Institutes of Health Sarcopenia Project has provided a new guideline for assessment of sarcopenia. At this time, there have been several data delineating the status of sarcopenia in Korea. This review focuses on largescale cohorts that assessed sarcopenia and highlights the controversies surrounding the clinical definition and prevalence of sarcopenia in Korea.
Aged ; Asian Continental Ancestry Group ; Cardiovascular Diseases ; Cohort Studies ; Homeostasis ; Humans ; Korea ; Mortality ; Muscle, Skeletal ; National Institutes of Health (U.S.) ; Prevalence* ; Sarcopenia*

The occurrence of an abdominal wall hematoma caused by abdominal paracentesis in patients with liver cirrhosis is rare. This paper presents a case of an abdominal wall hematoma caused by abdominal paracentesis in a 67-year-old woman with liver cirrhosis with a review of the relevant literature. Two days prior, the patient underwent abdominal paracentesis for symptom relief for refractory ascites at a local clinic. Upon admission, a physical examination revealed purpuric patches with swelling and mild tenderness in the left lower quadrant of the abdominal wall. Abdominal computed tomography revealed advanced liver cirrhosis with splenomegaly, tortuous dilatation of the para-umbilical vein, a large volume of ascites, and a large acute hematoma at the left lower quadrant of the abdominal wall. An external iliac artery angiogram showed the extravasation of contrast media from the left deep circumflex iliac artery. Embolization of the target arterial branches using N-butyl-2-cyanoacrylate was then performed, and the bleeding was stopped. The final diagnosis was an abdominal wall hematoma from the left deep circumflex iliac artery after abdominal paracentesis in a patient with liver cirrhosis.

PURPOSE: The present study aimed to examine the clinical implications of CD4, CD8, and FOXP3 expression on the prognosis of human epidermal growth factor receptor 2 (HER2)-positive breast cancer using a web-based database, and to compare the immunohistochemical expression of T-lymphocyte markers using primary and metastatic HER2-positive tumor tissues before and after HER2-targeted therapy. METHODS: Using the cBioPortal for Cancer Genomics and Kaplan-Meier plotter, the mRNA expression, association between T-lymphocyte markers, and survival in HER2-positive cancers were investigated according to various cutoff levels. Immunohistochemistry analysis was performed using paired primary and metastatic tissues of 29 HER2-positive tumors treated with systemic chemotherapy and HER2-directed therapy. RESULTS: HER2 mRNA was mutually exclusive of T-lymphocyte markers, and a significant correlation between T-cell markers was observed in the cBioPortal for Cancer Genomics. According to analysis of the Kaplan-Meier plotter, the impact of T-lymphocyte marker expression on survival was statistically insignificant in clinical HER2-positive tumors, irrespective of the cutoff levels. However, in the intrinsic HER2-positive subtype, the individual analyses of T-cell markers except for FOXP3 and combined analysis showed significantly favorable survival irrespective of cutoff points. Although the small clinical sample size made it difficult to show the statistical relevance of immunohistochemistry findings, good responses to neoadjuvant treatments might be associated with positive expression of combined T-lymphocyte markers, and approximately half of the samples showed discordance of combined markers between baseline and resistant tumors. CONCLUSION: T-lymphocyte markers could be favorable prognostic factors in HER2-positive breast cancers; however, a consensus on patient section criteria, detection methods, and cutoff value could not be reached. The resistance to HER2-directed therapy might involve different and personalized mechanisms, and further research is required to understand the association between immune function and HER2 expression and to overcome the resistance mechanisms to HER2-targeted therapies.
Biomarkers ; Breast ; Breast Neoplasms ; Consensus ; Drug Resistance ; Drug Therapy ; Epidermal Growth Factor* ; Genomics ; Humans* ; Immunohistochemistry ; Neoadjuvant Therapy ; Prognosis ; Receptor, Epidermal Growth Factor* ; RNA, Messenger ; Sample Size ; T-Lymphocytes*