Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Cycle ; Cell Line ; CpG Islands ; Cyclins ; Discrimination (Psychology) ; DNA ; DNA Methylation ; Epigenomics ; G1 Phase ; Genes, p16 ; Genes, Regulator ; Head ; Humans ; Immunohistochemistry ; Incidence ; Intention ; Methylation ; Mouth ; Neck ; Oncogenes ; Paraffin ; Phosphotransferases ; Polymerase Chain Reaction ; Regulatory Sequences, Nucleic Acid ; Research Personnel ; S Phase ; Sodium

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.

Benign intestinal tumors are rare in infancy, however the authors describe an inflammatory myofibroblastic tumor (IMT) of the mesentery in a 3-month-old infant who was diagnosed incidentally. During operation, huge mass which was attached to proximal jejunum was resected, from which a histological diagnosis of IMT was made. A review of the literature for this rare condition was done to delineate the natural history of this tumor. Because of the risk of local recurrence and malignant transformation, IMT cases needed a long-term follow up.
Follow-Up Studies ; Humans ; Infant ; Jejunum ; Mesentery ; Myofibroblasts ; Natural History ; Recurrence

BACKGROUND: High-risk group neuroblastoma (HRNB) is one of the most incurable diseases in pediatric oncology field. This report explores the effectiveness, safety and feasibility of triple high dose chemotherapy followed by autologous stem cell transplantation (HDCT/ASCT) in contrast with single HDCT/ASCT for HRNB.METHODS: From Jan. 2001 to Dec. 2009, 25 patients newly diagnosed as HRNB have been analyzed. This study is a retrospective analysis with the medical records of these 25 HRNB patients.RESULTS: Eleven (44%) and the other fourteen (56%) patients were treated with single HDCT/ASCT and triple HDCT/ASCT, respectively. The 5-year event-free survival (EFS) of the whole group in HRNB is 37.2+/-10.0%. The 5-year EFS of single HDCT/ASCT and triple HDCT/ASCT were 27.3+/-13.4% and 46.8+/-13.8%, respectively (P=0.38). Between two groups, there were no statistically significant differences including clinical features, outcome, transplantation-related toxicities, and short-term/long-term complications.CONCLUSION: Triple HDCT/ASCT group showed similar transplantation-related toxicities and long-term complications when compared to single HDCT/ASCT group. We need more exploration to conclude the triple HDCT/ASCT as an optimal treatment for HRNB patients.
Disease-Free Survival ; Humans ; Medical Records ; Neuroblastoma ; Retrospective Studies ; Stem Cell Transplantation ; Stem Cells

Objective: Dual trigger is used to induce final oocyte maturation during the process of controlled ovarian hyperstimulation, yet yielding controversial results. Also, there are yet no data regarding the effect of the dosage of the dual trigger on clinical outcomes. Based on the Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) criteria, this study aimed to determine the clinical difference of a single bolus versus two boluses of gonadotropin-releasing hormone agonist (GnRHa) in POSEIDON group IV patients using dual trigger. Methods: We screened a total of 1,256 patients who underwent in vitro fertilization (IVF) cycles who met the POSEIDON group IV criteria. Six hundred and twenty-nine patients received one bolus of GnRHa, and 627 patients were given two boluses. All patients received the same dose of recombinant human chorionic gonadotropin during the dual trigger cycle. Results: Metaphase II oocyte retrieval rate, fertilization rate and clinical pregnancy rate did not differ between the two groups. However, a lower percentage of at least one top-quality embryo transfer (34.3% vs. 26.0%, P=0.001) in the two bolus-GnRHa group was noted. Conclusion A double bolus of GnRHa did not show superior clinical results compared to a single bolus of GnRHa in the dual trigger IVF cycle. Therefore, GnRHa doses for use should be decided based on individual clinical situations considering cost-effectiveness and patient compliance, but further investigation will be needed.

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.

Wernicke's encephalopathy is an acute neurolopsychiatric syndrome caused by thiamine deficiency, and classically presents with the triad of opthalmopathy, ataxia and altered mentality. Both prolonged total parenteral nutrition and reduced oral intake can induce Wernicke's encephalopathy during hematopoietic stem cell transplantation (HSCT). Although early treatment is important for recovery from Wernicke's encephalopathy, the vague symptoms and characteristics hinder early diagnosis. Furthermore, Wernicke's encephalopathy is not infrequent and can develop at any age during HSCT. Herein, we present two young patients developing Wernicke's encephalopathy during HSCT.
Ataxia ; Early Diagnosis ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Parenteral Nutrition, Total ; Thiamine ; Thiamine Deficiency ; Wernicke Encephalopathy*

Synovial sarcoma is a rare malignancy in the thoracic cavity, especially in the mediastinum. In this paper, a case of primary mediastinal synovial sarcoma is reported. A 34-year-old woman was hospitalized with dyspnea. Her chest X-ray and computed tomography (CT) showed a 16x13x11 cm mass in her anterior mediastinal space. Surgical resection was performed but was incomplete. The pathological and immunohistochemical analysis confirmed the diagnosis of monophasic spindle cell synovial sarcoma. The patient underwent adjuvant radiotherapy for two months, but local recurrence and metastasis occurred in her pleural cavity. She eventually underwent chemotherapy for one year and died 18 months after her operation.
Dyspnea ; Female ; Humans ; Mediastinum ; Neoplasm Metastasis ; Pleural Cavity ; Radiotherapy, Adjuvant ; Recurrence ; Sarcoma ; Sarcoma, Synovial ; Thoracic Cavity ; Thorax

Matched sibling bone marrow transplantation (BMT) in severe aplastic anemia (SAA) has been known as the treatment of choice in children and young adults. To overcome graft failure, second stem cell transplantation showed good results in previous studies. Here we report two cases of aplastic anemia patients with late graft failure and resulted in successful complete recovery after selective CD34+ cell boost infusion. The patients previously underwent allogeneic BMT from HLA-matched sibling donors and the engraftment was achieved although their CBC started to decrease respectively 3 months and 11 months after transplantation. Both patients received selective CD34+ cell infusion without additional conditioning therapy. Their CBC showed significant improvement and they are doing well without transfusion or complications. From this study we suggest that selected CD34+ cell boost treatment can be a promising curative treatment for late graft failure after matched sibling BMT in SAA patients.
Anemia, Aplastic ; Behavior Therapy ; Bone Marrow Transplantation ; Child ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Siblings ; Stem Cell Transplantation ; Tissue Donors ; Transplants ; Young Adult

BACKGROUND: Diagnostic value of Bone marrow (BM) biopsies for fever of unknown origin (FUO) remain controversial and BM biopsies are difficult to perform in young patients. Our study aimed to elucidate the diagnostic yield of BM biopsies in FUO patients of all age, particularly for diagnosing hematological malignant diseases.METHODS: The medical records of 150 patients, hospitalized between January 1, 2008 and June 30, 2013, who underwent BM biopsies were evaluated to determine the cause of FUO. FUO was defined as fever (38.3degrees C, 101) either on several occasions during the 3 hospital days without a clear cause, after 1 week of invasive investigation, or after 3 outpatient visits. BM-specific diagnoses included those determined by BM biopsies (i.e., leukemia, lymphoma, myeloproliferative disease, myelodysplastic syndrome, aplastic anemia, and hemophagocytic lymphohistiocytosis).RESULTS: The final diagnoses of 24 patients (16%) were determined by BM biopsies; the majority included hematologic diseases and malignant neoplasms. Low hemoglobin levels, thrombocytopenia, bicytopenia, increased Lactate dehydrogenase (LDH) and ferritin levels, and ultrasonographic/computed tomographic abnormalities were significant risk factors (P<0.05). The young patient group (<18 years old) was safer from the tendency of BM biopsy diagnosis compared to adult patient group (>40 years old).CONCLUSION: Some laboratory abnormalities were related to the BM biopsy diagnostic yield. Furthermore, pediatric age was an important factor for deciding to do not perform excessive BM biopsies in FUO cases.
Adult ; Anemia, Aplastic ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Ferritins ; Fever of Unknown Origin ; Fever ; Hematologic Diseases ; Hematologic Neoplasms ; Humans ; L-Lactate Dehydrogenase ; Leukemia ; Lymphoma ; Medical Records ; Myelodysplastic Syndromes ; Outpatients ; Risk Factors ; Thrombocytopenia