Neurenteric cysts are developmental cysts derived from embryonic endodermal layers. Fewer than 100 have been reported in which there were no associated bone or soft-tissue malformations and only six among those cases showed intramedullary location in the literatures. The authors report a 16-year-old young man with a thoracic intramedullary neurenteric cyst which presented with symptoms of axillary pain and paraparesis. The magnetic resonance imaging showed intramedullary mass extended from level of T3 to T7. There was no associated bone or soft-tissue anomaly. This cyst was partially excised and marupialized into subarachnoid space. The pathological findings were compatible with neurenteric cyst. Nine months later, the cyst recurred and at second operation, cyst wall was removed completely.
Adolescent ; Endoderm ; Humans ; Magnetic Resonance Imaging ; Neural Tube Defects* ; Paraparesis ; Recurrence ; Spine* ; Subarachnoid Space

The association of thymoma with pure red cell aplasia has been well documented, but amegakaryocytic thrombocytopenia is not a recognized paraneoplastic syndrome complicating thymoma. We report a case of thymoma-complicated pure red cell aplasia and amegakaryocytic thrombocytopenia in a 73-yr-old woman. Pure red cell aplasia was diagnosed seven months after the detection of thymoma. One year after the diagnosis of pure red cell aplasia and seven months after thymectomy, bone marrow aspiration and biopsy showed an absence of megakaryocytes, marked erythroid hypoplasia with normal myeloid series. A diagnosis of amegakaryocytic thrombocytopenia and pure red cell aplasia was made. Oral steroid maintenance therapy resulted in recovery of platelet count. She has still transfusion-dependant anemia but platelet and neutrophil counts had been maintained in normal range for more than five months, until the last follow-up. We think that autoreactive T cells may induce a clinical autoimmune response even after eradication of thymoma, and aplastic anemia as a late complication following thymectomy was described in previous cases. This patient also has to be under a close observation because of the possibility to evolve into aplastic anemia.
Aged ; Bone Marrow/pathology ; Female ; Humans ; Imidazoles/therapeutic use ; Megakaryocytes/pathology ; Pregnadienetriols/therapeutic use ; Red-Cell Aplasia, Pure/complications/*diagnosis ; Thrombocytopenia/*diagnosis/drug therapy/*etiology ; Thymectomy/*adverse effects ; Thymoma/*complications/diagnosis/surgery ; Thymus Neoplasms/*complications/diagnosis/surgery

OBJECTIVE: In our domestic market, Belotecan (Camptobel(R), chongkeundang, Korea) is newly introduced recently. Belotecan has many advantages of improved water solubility and fewer side effects like severe diarrhea or GI bleeding compare to other camptothecin derivatives. In this study, primary focus is aiming to evaluate the effectiveness of belotecan by providing the cytotoxicity and apoptotic pathway on cervical cancer cells. METHODS: Cervical cancer cell line, HeLa and Caski were used. Belotecan applied on both cell lines and checked whether it has anti tumor effect on cancer cell by using MTT assay. DNA fragmentation and western blot was performed to confirm cellular apoptosis pathway. Also cDNA microarray and RT-PCR were serially carried out in order to identify responsible genes for apoptosis. RESULT: Dose- and time- dependent inhibition of cell proliferation is noted on the Belotecan applied HeLa and CaSki cervical carcinoma cell line by MTT assay. DNA fragmentation assay showed the DNA ladder indicating apopoptosis. Also apoptotic pathway and genes that are related with Belotecan activities are identified. Apoptosis, cell cycle, and drug metabolism related gene, and DNA repair gene were found to be differently regulated by treatment of Belotecan in HeLa cells. Among the DNA repair gene, RT-PCR reconfirmed the increased expression of CIB1(Calcium and intergrin binding 1), APEX1 (APEX nuclease 1) and the decresed expression of EXO1 (Exonuclease 1), WDR33 (WD repeat domain 33), and GADD45A (Growth arrest and DNA-damage-inducible, alpha). CONCLUSION: The first domestically introduced 1st line anti- tumor agent, Belotecan shows its excellent inhibiting action on cervical cancer cell proliferation by apoptotic pathway in this study. Also genetic alterations in cDNA microarray leads to the new fact that Belotecan, as a topoisomerase I inhibitor, is not only involved with apoptotic, cell cycle-related pathway but also involved in DNA repair.
Apoptosis ; Blotting, Western ; Camptothecin ; Cell Cycle ; Cell Line* ; Cell Proliferation ; Diarrhea ; DNA ; DNA Fragmentation ; DNA Repair ; DNA Topoisomerases, Type I ; HeLa Cells ; Hemorrhage ; Humans ; Metabolism ; Oligonucleotide Array Sequence Analysis ; Solubility ; Uterine Cervical Neoplasms*

Reactive arthritis occurs after a preceding infection such as urogenital or gastroenteral tract infection. Trichomoniasis, due to Trichomonas vasinalis infection, is one of the most common causes of vaginitis. Reactive arthritis associated with trichomoniasis is uncommon and there has been no report in Korea. We present a 28 year-old woman who had oligoarthritis after Trichomonas vaginalis infection. The arthritis subsided with treatment of the Trichomoniasis with metronidazole and non-steroidal anti-inflammatory drug.
Adult ; Arthritis ; Arthritis, Reactive* ; Female ; Humans ; Korea ; Metronidazole ; Trichomonas Infections ; Trichomonas vaginalis* ; Trichomonas* ; Vaginitis

The purpose of this study was to investigate variations in the communicating branch between the musculocutaneous and the median nerves and to discuss their clinical significance. Seventy two arms from 36 Korean adults were used. Twenty four cases (33.4%) among 72 arms had communications between the musculocutaneous and the median nerves. In 19.5%, a communicating branch ran from the musculocutaneous to the median nerves and in 4.2% of these a communicating branch formed a loop. A branch running from the median to the musculocutaneous nerves was observed in 6.9%. There were more than two communicating branches between two nerves in 5.6%. The average angle between the musculocutaneous nerve proximal and distal to the coracobrachialis was 159+/-9degrees at adduction of the arm. The musculocutaneous nerve did not pierce the coracobrachialis muscle in 2.8%. One case (1.4%) showed partial fusion of the trunks of the musculocutaneous and median nerves. The musculocutaneous nerve ran next to the median nerve after the coracobrachialis muscle and coursed laterally in 5.6% with or without a communicating branch. In these cases, the angle of the musculocutaneous nerve was more acute. The musculocutaneous nerve entrapment is discussed with this angle.
Adult ; Arm ; Humans ; Median Nerve* ; Musculocutaneous Nerve ; Running

PURPOSE: Bone marrow contains many kinds of primitive cells and endothelial progenitor cells that secrete several growth factors. We hypothesized that angiogenesis could be induced by autogenous whole bone marrow stem cell implantation in an animal ischemic limb. METHOD: A chronic ischemic hind limb model was created by encircling the femoral artery with an ameroid constrictor (2 mm inner diameter) in a dog model. About 20 ml of autogenous whole bone marrow stem cells were aspirated from the femur and then injected into ischemic limb muscles. Contralateral limbs injected with 20 ml of normal saline as controls. To assess angiogenic effects, an angiogram and a histologic evaluation were performed at 8 weeks after bone marrow stem cell implantation. RESULT: Imaging analysis of angiograms showed that newly developed capillaries were significantly more plentiful in treated limbs. Mean capillary density in the treated limb group was significantly greater than that in the control group (151+/-11.7 vs 81.5+/-7.2 cap/mm2, respectively, P<0.05), and the proportion of larger diameter (Fig. 6) newly developed capillaries was significantly higher in treated limbs than in control limbs. CONCLUSION: These findings indicated that autogenous whole bone marrow stem cell implantation increases the efficiency of angiogenesis.
Animals* ; Bone Marrow* ; Capillaries ; Dogs ; Extremities ; Femoral Artery ; Femur ; Intercellular Signaling Peptides and Proteins ; Models, Animal* ; Muscles ; Stem Cells*

From July, 1989 to June, 1998 forty-two patients with malignant germ cell tumors of the ovary treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center, were identified. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow-up of those patients were reviewed retrospectively. The patients with malignant germ cell tumor constituted 11.1% of all ovarian malignancies and 5.6% of all ovarian germ cell tumors ecountered during this period. The most common histologic subtype was dysgerminoma (26.2%) followed by endodermal sinus tumor (23.8%) and immature teratoma (19.0%). The age of the patients ranged from 8 to 64 years (mean+/-S.D.; 26.0+/-12.9) and the mean parity was 0.8 (+/-1.6). The most frequent initial symptoms were adbominal pain (33.3%) or abdominal distension (31.0%). Most had stage I(25 cases, 59.9%) or II(6 cases, 14.3%) diseases. Elevated level of serum alpha-FP was observed in all cases of endodermal sinus tumor and embryonal cell carcinoma, CA 125 was elevated in 63.9% of all malignant germ cell tumors. Thirty-one patients (73.8%) were treated by surgery and chemotherapy and 10 patients (23.8%) by surgery only. The major chemotherapeutic regimens were BEP (bleomycin +etoposide +cisplatin) and VAC (vincristine +actinomycin-D +cytoxan). The mean follow-up duration was 24.6 (+/-23.5) months and 2-year survival rate was 88.6% (+/-0.6).
Chungcheongnam-do ; Drug Therapy ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Parity ; Retrospective Studies ; Survival Rate ; Teratoma ; Ulsan

OBJECTIVE: Postoperative acute renal failure (PO-ARF) is an important cause of mortality among surgical patients. Although there have been many reports on PO-ARF after cardiac surgery and liver transplantation, less is known about the risk of PO-ARF after gynecologic operations. We aimed to investigate the risk of PO-ARF on gynecologic malignancy operations. METHODS: 1,155 patients' medical charts were reviewed who underwent therapeutic surgery for gynecologic malignancies from January 1, 2005 to December 31, 2007, at the Asan Medical Center, Seoul, Korea. RESULTS: Of these, 10 patients, comprising 0.89% of those who underwent radical hysterectomies and 0.86% of those who underwent debulking operations, were diagnosed with PO-ARF. Their mean age was 61.9+/-10.1 years. Five patients had preoperative risk factors. Mean operating time was 360.8+/-96.2 minutes. Five patients experienced intra-operative hypotension and all patients were given blood transfusions during surgery. Eight patients underwent hemodialysis, with two continuing on dialysis to date. Only two patients fully recovered. CONCLUSION: Patients undergoing surgery for gynecologic malignancies may be at high risk for PO-ARF, because of old age, long operation times, and profuse bleeding. It is necessary to monitor these patients for postoperative renal function and urine output. If a postoperative oliguric state is detected, aggressive volume expansion should be started immediately, followed by hemodialysis.
Acute Kidney Injury ; Blood Transfusion ; Dialysis ; Hemorrhage ; Humans ; Hypotension ; Hysterectomy ; Korea ; Liver Transplantation ; Organothiophosphorus Compounds ; Renal Dialysis ; Risk Factors ; Thoracic Surgery

When forensic anthropologists tried to reconstruct the biological profile, they would rely on the statistical data of documented human osteological/anatomical specimens. However, the metric data of Korean ancestry which is suitable for determining sex has not been established because documented human skeletal specimens are lack in Korean. The aim of this study is to discuss the possibility of determination of sex by metric data of atlas in Koreans. We measured 43 (male 25 and female 18) atlas from the department of anatomy, College of Medicine, Soonchunhyang University and the department of anatomy, Yonsei University College of Medicine. We measured 21 measurements of atlas using digimatic caliper and performed statistic analysis using SPSS to establish the discriminant functions. Among 21 measurements of atlas, the measurement values of the width of atlas exhibited the strongest relation with sexes. The accuracy of arbitrary discriminant functions derived from 6 measurements exhibited 93.9% and that of stepwise discriminant functions derived from 3 measurements exhibited 97.0%. In conclusion, this study could indicate that metric data of atlas is helpful to determine the sex in Koreans, but a further investigation should be followed.
Female ; Humans

BACKGROUND AND OBJECTIVES: Since 1987, coronary stents have changed the pattern of practice of interventional cardiology, by reducing the complications and improving the clinical outcomes. However, coronary stent restenosis still remains a significant clinical problem in the field of interventional cardiology. The aim of this trial was to compare the clinical efficacy of a rotational atherectomy (ROTA), with that of a plain old balloon angioplasty (POBA), in patients with coronary stent restenosis. SUBJECTS AND METHODS: One hundred and three patients (men 80, 58.4+/-10.3 years of age), diagnosed with coronary stent restenosis, at Chonnam National University Hospital, between January 1999 and December 2000, were analyzed. The clinical end-points were the occurrence of major adverse cardiac events (MACE): death, myocardial infarction and target lesion revascularization (TLR) during the one-year clinical follow-up. RESULTS: The baseline clinical and angiographic characteristics were similar between the two groups. Before the percutaneous coronary intervention (PCI), the diameter of stenosis of the POBA and ROTA groups were 81.9+/-14.0 and 82.9+/-10.0%, respectively, which decreased to 25.5+/-15 and 22.7+/-12% after treatment. At the one-year clinical follow-up, the TLR rates were 7.0 and 6.3% in the POBA and ROTA groups, respectively. The MACE results were not different between the two groups (7.0 and 9.4% in the POBA and ROTA groups, respectively). CONCLUSION: There was no significant long-term clinical benefit of a rotational atherectomy prior to a POBA, compared with a POBA alone, for the treatment of coronary stent restenosis.
Angioplasty ; Angioplasty, Balloon* ; Atherectomy, Coronary* ; Cardiology ; Constriction, Pathologic ; Follow-Up Studies* ; Humans ; Jeollanam-do ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stents*