No abstract available.
Ovarian Neoplasms*

PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a new surgical option using endoscopic advancement to the peritoneal cavity through the stomach, colon, vagina, or urinary bladder without an abdominal wall scar (incision). The aim of this study was to assess the feasibility of transgastric gastroscopic intra-abdominal exploration with gastric incision and closure before the NOTES would be done. METHODS: Under general anesthesia of a female dog, one-channel gastroscope was advanced to the stomach and the lumen was irrigated with anti-bacterial solution. The anterior wall of the antrum was incised by about 1 cm with a needle knife; then, the gastroscope was advanced into the peritoneal cavity. An exploration of the entire intra-abdominal cavity was performed. RESULTS: We were able to evaluate the stomach, the greater omentum, the diaphragm, the peritoneum, the urinary bladder, the bowel, the spleen, the liver, the gallbladder, the uterine horn, the uterine body, and the vagina, but could not evaluate the ovary, the kidney, and the pancreas. The observation of the abdominal cavity was followed by the gastric wall closure with a 135o endoclip. The dog was recovered after confirmation of secure closure of the incision site. CONCLUSIONS: Transgastric incision, closure, and abdominal exploration are feasible without an abdominal wall scar, and the NOTES can be one option for future abdominal operations in humans and needs to be further investigated.
Abdominal Cavity ; Abdominal Wall ; Anesthesia, General ; Animals ; Cicatrix ; Colon ; Diaphragm ; Dogs* ; Female* ; Gallbladder ; Gastroscopes ; Horns ; Humans ; Kidney ; Liver ; Natural Orifice Endoscopic Surgery ; Needles ; Omentum ; Ovary ; Pancreas ; Peritoneal Cavity ; Peritoneum ; Spleen ; Stomach ; Urinary Bladder ; Vagina

PURPOSE: Urinary tract infection (UTI) is a common bacterial infection in children and Escherichia coli is a predominant pathogen. The purpose of this study is to evaluate phylogenetic groups and virulence factors of E. coli causing UTI in children in Korea. METHODS: From October 2010 to April 2013, urinary E. coli strains were isolated from the 33 pediatric patients of UTI. Multiplex polymerase chain reactions were performed to evaluate the phylogenetic groups and 5 virulence factor genes (fimH, sfa, papA, hylA, and cnf1) of E. coli. Distribution of molecular characteristics of E. coli was analyzed by clinical diagnosis and accompanying vesicoureteral reflux (VUR). RESULTS: Most (84.8%) uropathogenic E. coli were belonged to phylogenetics group B2 and the others (15.2%) were belonged to group D. The virulence factors were distributed as: fimH (100%), sfa (100%), hylA (63.6%), cnfI (63.6%), and papA (36.4%). According to clinical diagnosis, phylogenetic distribution of E. coli strain was 92.3% of B2 and 7.7% of D in acute pyelonephritis and 57.1% of B2 and 42.9% of D in cystitis. Distribution of virulence factors was similar in both groups. In patients with acute pyelonephritis, phylogenetic distribution was similar in VUR and non-VUR group, but proportion of papA genes were lower in VUR group than that of non-VUR group (43.8% vs. 20.0%, P=0.399). CONCLUSIONS: This study provides current epidemiologic molecular data of E. coli causing pediatric UTI in Korea and will be a fundamental for understanding the pathogenesis of pediatric UTI.
Bacterial Infections ; Child* ; Cystitis ; Diagnosis ; Escherichia coli* ; Escherichia* ; Humans ; Korea ; Polymerase Chain Reaction ; Pyelonephritis ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux ; Virulence Factors* ; Virulence*

The effects of embryo number and incubation volume on the development of mouse embryos were evaluated. The growth rate of two-cell mouse embryos to attached blastocyst stage and the growth rate of blastocysts to early somite stage were assessed after culture in different incubation volumes and embryo densities. Embryos were collected from ICR female mice superovulated with pregnant mare serum gonadotropin and human chorionic gonadotropin and mated by ICR males. In experiment 1, groups of one, five, ten, twenty 2-cell embryos were cultured in 10-, 50-, 500-, 1000-microliter drops of BWW media under mineral oil at 37 degrees C in a humidified atmosphere of 5% CO2 and 95% air. As the incubation volume decreased, significantly (p<0.05) higher rates of embryos reached morular and blastocyst stage on day 3 and 4 culture, respectively In experiment 2, groups of one, five, ten, twenty blastocysts were cultured in 1- and 2-ml volumes of CMRL 1066 media under same condition as in experiment 1. However the reverse was the result. Decreasing the number of embryos incubated per volume from 1 to 20 significantly (p<0.05) increased the number of blastocysts reaching the late egg cylinde. (LEC) and early somite (ES) stage on day 6 and 8 culture, respectively, regardless of incubation volume. Blastocysts cultured in 2ml had higher (p<0.05) development rates to LEC and ES stage on day 6 and 8 culture, respectively, than embryos cultured in 1ml. Our results suggest that the effects of embryo number and incubation volume on the development of mouse embryos are stage specific and the shifting point was between hatching and EEC stage.
Animals ; Atmosphere ; Blastocyst ; Chorionic Gonadotropin ; Embryonic Structures* ; European Union ; Female ; Gonadotropins ; Humans ; Male ; Mice* ; Mineral Oil ; Ovum ; Somites

Splenic metastasis resulting from solid tumors is a rare event, and it is most often diagnosed at the time of autopsy. In those cases of widely disseminated cancer, splenic involvement may be fairly common, but solitary splenic metastasis in the absence of other metastases is exceedingly rare. The reported primary malignancies of patients with splenic metastases include lung, colorectal, endometrial, ovarian, thyroid, pancreatic, gastric cancers and most commonly, melanoma. The author report here on a case of 55- year-old male who was found to have a solitary splenic metastasis 12 months after undergoing a left upper lobectomy for stage Ib (pT2N0M0) adenocarcinoma of the lung and he was then treated by splenectomy.
Adenocarcinoma ; Autopsy ; Humans ; Lung Neoplasms ; Lung* ; Male ; Melanoma ; Neoplasm Metastasis* ; Splenectomy ; Splenic Neoplasms ; Stomach Neoplasms ; Thyroid Gland

No abstract available.
Seizures* ; Sick Sinus Syndrome* ; Syncope

A 21-year-old female with a history of bulimia nervosa came to the emergency room due to severe abdominal pain after excessive eating five hours previously. On arrival at the emergency room, extreme abdominal distension was detected and the patient's legs changed color. Computed tomography suggested severe gastric dilatation, so abdominal compartment syndrome was suspected and an emergent laparotomy was supposed to be conducted. Though anesthesia was induced without event, abrupt hemodynamic collapse developed just after the operation started. In spite of active resuscitation for 29 min, the patient did not recover and expired. As the incidence of eating disorders is increasing, anesthesiologists should keep in mind the possibility of abdominal compartment syndrome in patients with a recent history of binge eating, and prepare optimal anesthetic and resuscitation remedies against sudden deteriorations of a patient's condition.
Abdominal Pain ; Anesthesia ; Bulimia ; Bulimia Nervosa ; Eating ; Feeding and Eating Disorders* ; Emergency Service, Hospital ; Fatal Outcome* ; Female ; Gastric Dilatation* ; Hemodynamics ; Humans ; Incidence ; Intra-Abdominal Hypertension ; Laparotomy ; Leg ; Resuscitation ; Young Adult

Developmental foregut cysts, whether bronchogenic, esophageal, gastroenteric or pericardial, are frequently encountered in the mediastinum, and are also occasionally found in the upper abdomen, where they can mimic adrenal, pancreatic, renal or gastric masses. We present the computed tomographic (CT) and histologic findings of an intramuscular bronchogenic cyst of the gastric body, mimicking a retroperitoneal cystic mass. CT scanning demonstrated the presence of a relatively hyperattenuating cystic mass without enhancement. Histologic examination revealed a bronchogenic cyst secreting mucoid materials.
Abdomen ; Bronchogenic Cyst* ; Mediastinum ; Tomography, X-Ray Computed

PURPOSE: When pneumothorax occurs during a percutaneous needle biopsy, the radiologist usually stops the biopsy. We evaluated the usefulness of computed tomographic (CT) fluoroscopy-guided percutaneous needle biopsy in the presence of pneumothorax during biopsy. MATERIALS AND METHODS: We performed 288 CT fluoroscopy guided percutaneous needle biopsies to diagnose the pulmonary nodules. Twenty two of these patients had pneumothorax that occurred during the biopsy without obtaining an adequate specimen. After pneumothoax occurred, we performed immediate CT fluoroscopy guided percutaneous needle biopsies using an 18-gauge cutting needle. We evaluated the success rate of the biopsies and also whether or not the pneumothorax progressed. We classified these patients into two groups according to whether the pneumothorax progressed (Group 2) or not (Group 1) by measuring the longest distance between the parietal pleura and the visceral pleura both in the early and late pneumothorax. Additionally, we analyzed the relationship between the progression of pneumothorax after biopsy and 1) the depth of the pulmonary nodule; 2) the number of biopsies; 3) the presence or absence of emphysema at the biopsy site; and 4) the size of the pulmonary nodule. RESULTS: Biopsy was successful in 19 of 22 nodules (86.3%). Of the 19 nodules, 12 (63.2%) were malignant and 7 (36.8%) were benign. Twelve patients (54.5%) were classified as group 1 and 10 patients (45.4%) as group 2. The distance between the lung lesion and pleura showed a statistically significant difference between these two groups: < or = 1 cm in distance for group 1 (81.8%) and group 2 (18.2%), and > 1 cm in distance for group 1 (30%) and group 2 (70%), p < 0.03. Yet the number of biopsies, the presence or absence of emphysema at the biopsy site and the size of the pulmonary nodules were not related to the progression of pneumothorax (p > 0.05). CONCLUSION: When early pneumothorax occurs during a biopsy, CT fluoroscopy guided percutaneous needle biopsy is an effective and safe procedure. Aggravation of pneumothorax after biopsy is affected by the depth of the pulmonary nodule.
Biopsy* ; Biopsy, Needle* ; Emphysema ; Fluoroscopy ; Humans ; Lung ; Needles* ; Pleura ; Pneumothorax*

Cell therapy using stem cells has produced therapeutic benefits in animal models of COPD. Secretory mediators are proposed as one mechanism for stem cell effects because very few stem cells engraft after injection into recipient animals. Recently, nanovesicles that overcome the disadvantages of natural exosomes have been generated artificially from cells. We generated artificial nanovesicles from adipose-derived stem cells (ASCs) using sequential penetration through polycarbonate membranes. ASC-derived artificial nanovesicles displayed a 100 nm-sized spherical shape similar to ASC-derived natural exosomes and expressed both exosomal and stem cell markers. The proliferation rate of lung epithelial cells was increased in cells treated with ASC-derived artificial nanovesicles compared with cells treated with ASC-derived natural exosomes. The lower dose of ASC-derived artificial nanovesicles had similar regenerative capacity compared with a higher dose of ASCs and ASC-derived natural exosomes. In addition, FGF2 levels in the lungs of mice treated with ASC-derived artificial nanovesicles were increased. The uptake of ASC-derived artificial nanovesicles was inhibited by heparin, which is a competitive inhibitor of heparan sulfate proteoglycan that is associated with FGF2 signaling. Taken together, the data indicate that lower doses of ASC-derived artificial nanovesicles may have beneficial effects similar to higher doses of ASCs or ASC-derived natural exosomes in an animal model with emphysema, suggesting that artificial nanovesicles may have economic advantages that warrant future clinical studies.
Animals ; Cell- and Tissue-Based Therapy ; Emphysema* ; Epithelial Cells ; Exosomes ; Fibroblast Growth Factor 2 ; Heparan Sulfate Proteoglycans ; Heparin ; Lung ; Membranes ; Mice ; Models, Animal ; Pulmonary Disease, Chronic Obstructive ; Stem Cells