Brunn nests are the most common proliferative lesions of the bladder uroepithelium, but exuberant proliferation can mimic bladder tumor on radiologic imaging and cystoscopy. We describe a case of pathologically proven Brunn nests in a 34-year-old man, misdiagnosed as bladder tumor on preoperative imaging studies.
Adult ; Cystoscopy ; Humans ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Human-derived materials are a crucial element of research in the life sciences. The Korea Biobank Network (KBN) portal is a shared open platform that provides the nationʼs most extensive disease resources, possessed by Human Bioresource Unit Banks of the KBN, to the public, including those in the fields of industry, academia, and research.This platform was developed to increase the efficient use of national disease resources. In the KBN portal, the current status of disease resources collected in Korea can be checked online. Human bioresources and clinical information are provided to consumers through systematic search and efficient distribution programs. Additionally, by simultaneously operating the KBN Distribution Support Center, we are working to support the rapid and convenient distribution of human resources in response to the needs of consumers. To effectively utilize the open human bioresource sharing platform, it is necessary to introduce an integrated clinical information management system. Currently, the KBN is in the process of establishing standard terminology for data and applying a common data model for the integrated management of various clinical information held by the KBN. We provide communications through the KBN portal, which is interconnected with the distribution support center, regional biobanks, and consumers. In conclusion, the KBN portal will provide open innovation by creating a business or service model by delivering shared open data and internalizing external innovative capabilities.

OBJECTIVE: To compare the efficacy of GnRH antagonist multi dose protocol in controlled ovarian hyperstimulation (COH) for IVF-ET or ICSI with GnRH agonist long protocol. METHODS: From January 2003 to December 2004, total of 583 cycles which underwent IVF-ET or ICSI using r-FSH were enrolled in this study. 447 cycles of the study group were performed in controlled ovarian hyperstimulation by using GnRH antagonist multi dose protocol and 136 cycles of the control group were performed by using GnRH long protocol. We compared patients characteristics, controlled ovarian hyperstimulation outcomes and IVF-ET outcomes between two groups. RESULTS: Patients characteristics and baseline hormone levels were not different between the two groups. The duration of stimulation was significantly shorter in study group comparing with control group (12.8+/-1.5 days vs 13.7+/-1.7 days, p<0.05). There were no differences between the two groups in the number of follicles, endometrial thickness and serum E2 level on hCG day. The pregnancy rate seemed to be lower in the study group (32.4% vs 35.4%), but the difference was not statistically significant. There were also no differences in number of oocytes retrieved, matured oocytes, fertilized oocytes and transferred embryos between two groups. CONCLUSION: GnRH antagonist multi dose protocol in COH might be a simple and effective method compared with GnRH agonist long protocol.
Embryonic Structures ; Gonadotropin-Releasing Hormone* ; Humans ; Oocytes ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic

Esophageal duplication (ED) is rarely diagnosed in adults and is usually asymptomatic. Especially, ED that is connected to the esophagus through a tubular communication and combined with bronchoesophageal fistula (BEF) is extremely rare and has never been reported in the English literature. This condition is very difficult to diagnose. Although some combinations of several modalities, such as upper gastrointestinal endoscopy, esophagography, computed tomography, magnetic resonance imaging, and endoscopic ultrasonography, can be used for the diagnosis, the results might be inconclusive. Here, we report on a patient with communicating tubular ED that was incidentally diagnosed on the basis of endoscopy and esophagography during the postoperational evaluation of BEF.
Adult ; Bronchial Fistula ; Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal ; Endosonography ; Esophageal Fistula ; Esophagus ; Fistula* ; Humans ; Magnetic Resonance Imaging

Catamenial hemoptysis is a rare condition, characterized by recurrent hemoptysis associated with the presence of intrapulmonary or endobronchial endometrial tissue. Therapeutic strategies proposed for intrapulmonary endometriosis with catamenial hemoptysis consist of medical treatments and surgery. Bronchial artery embolization is a well-established modality in the management of massive or recurrent hemoptysis, but has seldom been used for the treatment of catamenial hemoptysis. We report a case of catamenial hemoptysis associated with pulmonary parenchymal endometriosis, which was successfully treated by a bronchial artery embolization.
Bronchial Arteries* ; Embolization, Therapeutic ; Endometriosis ; Female ; Hemoptysis*

The congenital nasal piriform aperture stenosis (CNPAS) is a rare cause of neonatal airway obstruction and could be easily mistaken as the choanal stenosis or atresia. The piriform aperture is a term used to refer to the anterior nasal openings. The nasal airway obstruction in the neonate can result in respiratory difficulties and may be going to life threatening consequences. Computed tomography demonstrates in detail the underlying anatomic abnormalities which allows differentiation of the CNPAS from other upper airway abnormalities. We reported a case of CNPAS, a 1-month-old male infant presented with respiratory difficulties. Shortly after birth, he had mild respiratory difficulties and there was difficulty passing a nasal catheter intranasally. But he was improved through only conservative management and discharged at the age of 5 days. At the age of 1 month, CT scan revealed bilateral CNPAS.
Airway Obstruction ; Catheters ; Constriction, Pathologic* ; Humans ; Infant ; Infant, Newborn ; Male ; Nasal Obstruction ; Parturition ; Tomography, X-Ray Computed

A 48-year-old woman with cystic fibrosis and a previous left pneumonectomy had surgery planned for single lung transplantation under general anesthesia. Due to progressive dyspnea and recurrent respiratory infection, she could not maintain her normal daily life without lung transplantation. The anesthetic management and surgical procedure was expected to be difficult because of the left mediastinal shift and an asymmetric thorax after the left pneumonectomy, but the single lung transplantation was successfully done under cardiopulmonary bypass.
Anesthesia, General ; Cardiopulmonary Bypass ; Cystic Fibrosis ; Dyspnea ; Female ; Humans ; Lung ; Lung Transplantation ; Middle Aged ; Pneumonectomy ; Thorax

OBJECTIVE: Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. METHODS: This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 kgf.cm) and the low torque group (distraction force< or =6 kgf.cm) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. RESULTS: The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days (y=0.99x-1.1, r2=0.82; y=0.77x-0.63, r2=0.73, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively (3.1+/-1.3, 2.6+/-1.0 compared with 6.0+/-0.6, 4.9+/-0.8, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. CONCLUSION: Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 kgf.cm.
Arm ; Diskectomy ; Humans ; Intervertebral Disc ; Neck ; Neck Pain ; Pain, Postoperative ; Spinal Fusion ; Torque ; Zygapophyseal Joint

PURPOSE: Laparoscopic adrenalectomy has become the standard of care for a variety of benign adrenal pathologies. A total of 111 consecutive adrenalectomies were performed using a lateral transperitoneal or posterior retroperitoneal approach, each with its own inherent benefits and shortcomings. The authors compared the effectiveness and safety of posterior retroperitoneal adrenalectomy (PRA) with that of lateral transperitoneal adrenalectomy (LTA). METHODS: Medical records of 111 patients diagnosed with adrenal tumor who underwent laparoscopic adrenalectomy from January 2000 through April 2012 at Chungnam National Hospital were reviewed retrospectively. Study variables included operative time, length of hospital stay, number of days of pain control, diet beginning and advance, and complications. RESULTS: PRA was shorter in most variables, including operative time, hospital stay, first diet beginning, and full diet advance time compared with that of LTA. In pheochromocytoma less than or equal to 7 cm in size, operation time for LTA was longer than that of PRA. One PRA-specific complication was pseudo-hernia of the ipsilateral abdominal wall, which was resolved spontaneously within 1~2 months. CONCLUSION: Laparoscopic adrenalectomy is a safe and effective approach to benign adrenal pathology, and PRA should be considered in patients with tumors less than or equal to 7 cm.
Abdominal Wall ; Adrenalectomy* ; Chungcheongnam-do ; Diet ; Humans ; Length of Stay ; Medical Records ; Operative Time ; Pathology ; Pheochromocytoma ; Retrospective Studies ; Standard of Care

To evaluate the effectiveness of the human umbilical cord blood (HUCB) transplantation for the treatment of intrinsic sphincter deficiency (ISD), we analyzed the short term effects of HUCB mononuclear cell transplantation in rats with induced-ISD. ISD was induced in rats by electro-cauterization of periurethral soft tissue with HUCB mononuclear cell injection after 1 week. The sphincter function measured by mean leak point pressure was significantly improved in the experimental group compared to the control group at 4 weeks. (91.75+/-18.99 mmHg vs. 65.02+/-22.09 mmHg, P=0.001). Histologically, the sphincter muscle was restored without damage while in the control group it appeared markedly disrupted with atrophic muscle layers and collagen deposit. We identified injected HUCB cells in the tissue sections by Di-I signal and Prussian blue staining. HUCB mononuclear cell injection significantly improved urethral sphincter function, suggesting its potential efficacy in the treatment of ISD.
Animals ; Cells, Cultured ; Cord Blood Stem Cell Transplantation/*methods ; Humans ; Leukocytes, Mononuclear/*transplantation ; Rats ; Rats, Sprague-Dawley ; Treatment Outcome ; Urinary Incontinence, Stress/diagnosis/*physiopathology/*surgery ; Urologic Surgical Procedures/*methods