Verrucous carcinoma arising from the larynx is a specific clinical entity which is unfamiliar to many otolaryngologists. As judged by reported cases, the mucous membranes of the head and neck are sites of predilection. This lesion makes up approximately 1 to 4% of all laryngeal carcinoma. The biologic behavior of verrucous carcinoma of the larynx is characterized by warty appearance, slow growth, local invasion, scarcity of metastases and benign histology. Most authors prefer surgical treatment for patients with verrucous carcinoma. Radiation therapy appears to hold a higher risk of recurrence, anaplastic transformation of tumor. Recently, the authors have experienced two cases of verucous carcinoma originated from the larynx in old male patients. The two patients were treated by surgical excision.
Carcinoma, Verrucous* ; Head ; Humans ; Larynx* ; Male ; Mucous Membrane ; Neck ; Neoplasm Metastasis ; Recurrence

Objective: The objective of the study was to compare the effects of long-term and short-term embryo culture to assess whether there is a correlation between culture duration and clinical outcomes. Methods: Embryos were divided into two study groups depending on whether their post-warming culture period was long-term (20–24 hours) or short-term (2–4 hours). Embryo morphology was analyzed with a time-lapse monitoring device to estimate the appropriate timing and parameters for evaluating embryos with high implantation potency in both groups. Propensity score matching was performed to adjust the confounding factors across groups. The grades of embryos and blastoceles, morphokinetic parameters, implantation rate, and ongoing pregnancy rate were compared. Results: No significant differences were observed in the implantation rate or ongoing pregnancy rate between the two groups (56.3% vs. 67.9%, p=0.182; 47.3% vs. 53.6%, p=0.513). After warming, there were more expanded and hatching/hatched blastocysts in the long-term culture group than in the short-term culture group, but there was no significant between-group difference in embryo grade. Regarding pregnancy outcomes, the completion of re-expansion was faster in women who became pregnant than in those who did not for both culture durations (long-term: 2.19±0.63 vs. 4.11±0.81 hours, p=0.003; short-term: 1.17±0.29 vs. 1.94±0.76 hours, p=0.018, respectively). Conclusion The outcomes of short-term culture and long-term culture were not significantly different in vitrified-warmed blastocyst transfer. Regardless of the post-warming culture time, the degree of blastocyst re-expansion 3–4 hours after warming is an important marker for embryo selection.

BACKGROUND: The most widely utilized indexes of sinus node dysfunction are the sinus node recovery time (SNRT) and the corrected sinus node recovery time (CSNRT), which generally require catheterization. Adenosine has negative chronotropic effect on the sinoatrial node. Non-invasive and reliable sinus node function test with intravenous adenosine was investigated. METHODS AND RESULT: The clinical value of rapid intravenous injection of adenosine for assessing sinus node dysfunction was examined in 14 patients with sick sinus syndrome (SSS) and 31 controls. After prophylactic insertion of a temporary pacemaker in the right ventricle, overdrive suppression test was conducted using the standard technique and CSNRT was measured to evaluate the sinus node function. Then, the CSNRT after administration of an intravenous bolus of adenosine (6 mg and 12 mg) was measured. Post-adenosine corrected sinus node recovery time (ADO: SNRT) was calculated by subtracting the basal sinus cycle length from the longest sinus cycle length. When ADO: SNRT over 550 msec was assumed as an indicator of sinus node dysfunction, intravenous injection of 6 mg of adenosine had a sensitivity of 85% and specificity of 100%, and 12 mg of adenosine had a sensitivity of 100% and specificity of 90% for detection of sick sinus syndrome. There were significant differences in ADO: SNRT between patient and control group (6 mg 1501+/-1081 msec vs 64+/-109 msec; 12 mg 4005+/-2055 msec vs 216+/-315 msec, respectively). CONCLUSION: he ADO: SNRT was a highly sensitive and specific index for diagnosing sick sinus syndrome, and should be considered as an alternative to invasive testing in patients with suspected sick sinus syndrome.
Adenosine* ; Catheterization ; Catheters ; Diagnosis* ; Heart Ventricles ; Humans ; Injections, Intravenous ; Sensitivity and Specificity ; Sick Sinus Syndrome* ; Sinoatrial Node

Infectious mononucleosis is an EBV-induced infection, and this is a self-limiting clinical syndrome with such characteristics as fever, pharyngitis, headache, splenomegaly, hepatomegaly and multiple lymphadenopathy among children and young adults. On the other hand, EBV infection-induced gastrointestinal symptoms like anorexia, nausea, vomiting, dyspepsia, abdominal pain, gastric bleeding and diarrhea are non-specific signs and there is less of a chance of EBV infection being involved with gastrointestinal disease. Especially, the relation of gastric cancer and gastric lymphoma with EBV infection is well defined, but other EBV-related gastrointestinal diseases have rarely been reported. Therefore, we report here on a case of acute erosive EBV gastritis that was diagnosed as EBV-induced infectious mononucleosis, and this was confirmed by esophagogastroduodenoscopy with biopsy.
Abdominal Pain ; Anorexia ; Biopsy ; Child ; Diarrhea ; Dyspepsia ; Endoscopy, Digestive System ; Epstein-Barr Virus Infections ; Fever ; Gastritis* ; Gastrointestinal Diseases ; Hand ; Headache ; Hemorrhage ; Hepatomegaly ; Herpesvirus 4, Human* ; Humans ; Infectious Mononucleosis* ; Lymphatic Diseases ; Lymphoma ; Nausea ; Pharyngitis ; Splenomegaly ; Stomach Neoplasms ; Vomiting ; Young Adult

Infectious mononucleosis is an EBV-induced infection, and this is a self-limiting clinical syndrome with such characteristics as fever, pharyngitis, headache, splenomegaly, hepatomegaly and multiple lymphadenopathy among children and young adults. On the other hand, EBV infection-induced gastrointestinal symptoms like anorexia, nausea, vomiting, dyspepsia, abdominal pain, gastric bleeding and diarrhea are non-specific signs and there is less of a chance of EBV infection being involved with gastrointestinal disease. Especially, the relation of gastric cancer and gastric lymphoma with EBV infection is well defined, but other EBV-related gastrointestinal diseases have rarely been reported. Therefore, we report here on a case of acute erosive EBV gastritis that was diagnosed as EBV-induced infectious mononucleosis, and this was confirmed by esophagogastroduodenoscopy with biopsy.
Abdominal Pain ; Anorexia ; Biopsy ; Child ; Diarrhea ; Dyspepsia ; Endoscopy, Digestive System ; Epstein-Barr Virus Infections ; Fever ; Gastritis* ; Gastrointestinal Diseases ; Hand ; Headache ; Hemorrhage ; Hepatomegaly ; Herpesvirus 4, Human* ; Humans ; Infectious Mononucleosis* ; Lymphatic Diseases ; Lymphoma ; Nausea ; Pharyngitis ; Splenomegaly ; Stomach Neoplasms ; Vomiting ; Young Adult

Papillary carcinomas account for 85~90% of all thyroid cancers, with the tumor size considered an important prognostic factor. As the use of high-resolution ultrasonography and fine needle aspiration biopsy have increased, the diagnosis of papillary microcarcinomas of the thyroid gland; defined by the World Health Organization as being less than 1 cm in diameter, has increased. They are generally associated with an excellent prognosis, with distant metastasis being extremely rare. They usually remain clinically silent until their incidental histological diagnosis by autopsy or surgical material. The incidence discovered at autopsy varies between 3 and 36%. Cervical lymph node metastases from papillary microcarcinomas have often been discovered, which may be the first and sole manifestation of the disease, without clinical suspicion of a thyroid tumor. Herein, the case of a papillary thyroid microcarcinoma, diagnosed after a total thyroidectomy due to its first presentation as a contralateral cervical lymph node metastasis, without evidence of a clinical thyroid tumor, is described.
Autopsy ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Prognosis ; Thyroid Gland* ; Thyroidectomy ; Ultrasonography ; World Health Organization

Objective: The aim of this study was to determine whether co-administration of a gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (hCG) for final oocyte maturation improved mature oocyte cryopreservation outcomes in young women with decreased ovarian reserve (DOR) compared with hCG alone. Methods: Between January 2016 and August 2019, controlled ovarian stimulation (COS) cycles in women (aged ≤35 years, anti-Müllerian hormone [AMH] <1.2 ng/mL) who underwent elective oocyte cryopreservation for fertility preservation were retrospectively analyzed. Results: A total of 76 COS cycles were triggered with a GnRH agonist and hCG (the dual group) or hCG alone (the hCG group). The mean age and serum AMH levels were comparable between the two groups. The duration of stimulation, total dose of follicle-stimulating hormone used, and total number of oocytes retrieved were similar. However, the number of mature oocytes retrieved and the oocyte maturation rate were significantly higher in the dual group than in the hCG group (p=0.010, p<0.001). After controlling for confounders, the dual-trigger method remained a significant factor related to the number of mature oocytes retrieved (p=0.016). Conclusion We showed improved mature oocyte collection and maturation rate with the dual triggering of oocyte maturation in young women with DOR. A dual trigger appears to be more beneficial than hCG alone in terms of mature oocyte cryopreservation for young women with DOR.

OBJECTIVE: Vitrification requires a high concentration of cyroprotectant (CPA) and an elevated cooling speed to avoid ice crystal formation. We have evaluated the effect of different combinations of cooling rate and CPA on embryonic integrity (developmental competence) in order to increase the efficiency of vitrification without impairing embryo viability. We hypothesized that the combination of CPA or the increase of cooling rates can reduce the concentration of toxic CPA for vitrification. As consequently, we performed experiments to evaluate the effect of various composition of CPA or slush nitrogen (SN2) on the mouse embryonic development following vitrification using low CPA concentration. METHODS: Vitrification of mouse embryos was performed with EM grid using liquid nitrogen (LN2) or SN2 and different composition of CPAs, ethylene glycol (EG) and dimethylsulfoxide (DMSO). After vitrification-warming process, their survival and blastocyst formation rates were examined. For analyzing long-term effect, these blastocysts were transferred into the uterus of foster mothers. RESULTS: Survival and blastocyst formation rates of vitrified embryos were higher in EG+DMSO group than those in EG only. Furthermore, the group using SN2 with a lower CPA concentration showed a higher survival of embryos and developmental rates than group using LN2. CONCLUSION: The combination of EG and DMSO as CPAs may enhance the survival of mouse embryos and further embryonic development after vitrification. SN2 can generate high survival and developmental rate of vitrified/warmed mouse embryos when a lower concentration of CPA was applied. Therefore, these systems may contribute in the improvement of cryopreservation for fertility preservation.
Animals ; Blastocyst ; Cryopreservation ; Dimethyl Sulfoxide ; Embryonic Development ; Embryonic Structures ; Ethylene Glycol ; Ethylenes ; Female ; Fertility Preservation ; Ice ; Mental Competency ; Mice ; Nitrogen ; Pregnancy ; Uterus ; Vitrification

The relationship between the adrenal cortex and medulla has been studied since the 1960s. Rarely, a patient with an adrenal cortical adenoma presents with the findings of pheochromocytoma. However, there has been no report of a case with the clinical features of pheochromocytoma showing the pathological features of an adrenal cortical adenoma with medullary hyperplasia on histological examination. We report a 59-year-old-man who was shown to have an adrenal cortical adenoma, with medullary hyperplasia, during a diagnostic work up for pheochromocytoma.
Adrenal Cortex ; Adrenocortical Adenoma ; Humans ; Hyperplasia ; Pheochromocytoma

Hepatic peribiliary cysts are characterized by multiple tiny cysts of peribiliary glands located in the hilum of the large portal tracts. A 54-year-old man was diagnosed as multiple peribiliary cysts by a magnetic resonance cholangiopancreatogram. A course of observation was taken, since surgery due to misdiagnosis of peribiliary cysts as a malignancy is a possibility. The present case highlights the need for precise diagnosis and observation of peribiliary cysts.
Diagnostic Errors ; Humans ; Magnetic Resonance Spectroscopy ; Middle Aged