Dysphagia aortica is a rare form of mechanical dysphagia characterized by extrinsic compression of the esophagus by the aorta. A 69-year-old male reported experiencing swallowing difficulties for five months, along with nausea, abdominal discomfort, weight loss, and severe reflux. Considering his age and a medical history of hypertension and stenosis of the cerebral artery, poststroke dysphagia was initially suspected. However, brain magnetic resonance imaging revealed no evidence of acute or subacute stroke. Further evaluation was achieved via enhanced chest computed tomography to locate the focus of the systemic inflammation. A thoracic aortic aneurysm about 8.7×5.0 cm in size, with signs of impending rupture, was observed. This case reinforces that a high possibility for dysphagia aortica should be considered under conditions of unclear etiology of dysphagia but the presence of associated symptoms, such as progressive intolerance to solids and ultimately to liquids, weight loss, and nausea.

This clinical study was conducted to survey 300 cases of total laparoscopic hysterctomy (TLH) by the Department of Obstetrics and Gynecology of Boram Hospital in Ulsan, Korea from January, 2000 to June, 2001. TLH has been described in much of the recent literature. We analyzed 300 cases of TLH to evaluate the clinical data such as distribution of age, parity, clinical indication, previous operation history, type of surgery, operation time, weight of uterus, Hb change of post-operation first day and the complications of using this technique. The mean age of patients was 41.3. The mean parity of patients was 2.6. The clinical indications for TLH were myoma (72.3%), adenomyosis (11.3%), PID (5.3%), CIS (4%) and others (5.7%). The most previous operation was bilateral tubal ligation. Others were cesarean section, appendectomy. The most concomitant procedure with TLH was posterior colpoperineorrhaphy. Salpingo-oophorectomy and appendectomy were also carried out concomitantly. The mean operation time was 124 minutes. The mean weight of the uterus was 230 gm. The mean Hb change post-operation on the 1st day was 1.3g/dL. The complications of TLH were bleeding to need blood transfusion, ureteral injury and bladder injury. Thus this technique can be safely performed by skilled laparoscopists for properly selected patients but there is a need for prospective studies for comparision with various laparoscopic hysterctomies.
Adenomyosis ; Appendectomy ; Blood Transfusion ; Cesarean Section ; Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Korea ; Myoma ; Obstetrics ; Parity ; Pregnancy ; Sterilization, Tubal ; Ulsan ; Ureter ; Urinary Bladder ; Uterus

Uterine anomalies have been reported in 4% of women with infertility and in up to 15% of those with recurrent abortion. One of the major intrauterine disorder associated with infertility and recurrent abortions is intrauterine septum, The reproductive outcome of 41 patients of intrauterine septum (7 complete, 34 incomplete) with repeated abortions or infertility was assessed after the uterine septotomy. 5 of 7 patients with comlete uterine septum undergone uterine septotomy (3; hysteroscopic metroplasty, 2; abdominal metroplasty) had total 6 pregnancies and all of them had live biths. 28 patients with incomplete uterine septum got the hysteroscopic intrauterine septotomy and the viable pregnancy rate was 62% (3 ongoing pregnancies, 13 live biths of total 26 pregnancies). 6 patients with incomplete uterine septum had not the operation and 5 patients had 5 live births after total 6 pregnancies with 1 spontaneus abortion. Even though, the number of cases were small, the live birth rate in the group of septotomy of the patients of complete uterine septum (100%, 6/6) was higher than that in the group of not-done (50%, 1/2). The live birth rate in the group of not-done of the patients with incomplete uterine septum (83%, 5/6) was higher than that in the group of hysteroscopic uterine septotomy (62%, 16/26), but 5 of 6 had short uterine septal length (<1 cm), 1 had 1.5 cm septal length in the group of not-done. All the patients with successful pregnancy outcome had no other co-factors at the diagnostic laparoscopy, but the 5 primary infertility patients with no live birth even after treatment (all were with incomplete septum; 3 undergone hysteroscopic septotomy, 2 not-done with one abortion) had other co-factors such as endometriosis, peritoneal or tubal facor. In conclusion, hysteroscopic uterine septotomy would be useful for the patients with habitutal abortion or infertility and more advanced managemnet protocols should be applied to the patients having other co-factors if there was no pregnancy even after the uterine septotomy.
Abortion, Habitual* ; Endometriosis ; Female ; Humans ; Hysteroscopy* ; Infertility* ; Laparoscopy ; Live Birth ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate

This study was designed to analyze the prevalence rates of laboratory animal allergy (LAA) in laboratory workers who perform researches with animals, and detect the mouse urinary allergen (Mus m 1) level in animal facilities for the purpose of establishing program for prevention of exposure to allergen. Study subjects were 240 employees who were working for two animal research institutions in Korea. Then the questionnaire and skin prick tests (SPTs) using twenty allergens were conducted with them. Presence of Mus m 1 in each air borne sample collected from animal facility was determined by using enzyme-linked immunosorbent assay. Through 240 questionnaire sheets, we found that; (1) 17.0% of workers in the direct exposure group answered that they had allergic symptoms due to laboratory animals; and (2) 6.2% of them had asthmatic symptoms. Twenty one subjects (27.6%) among the subjects with common allergens positive result and five subjects (6.6%) among the subjects with negative result showed a positive response to LAA under the SPTs. The Mus m 1 concentration (1.339 ng/m3) in the sample collected during cage exchange in mouse breeding room was up to 2.8 times higher than its concentration (0.483 ng/m3) in the sample collected at the stationary state. We suggest that LAA management programs including control of exposure to laboratory animal allergens should be considered as a measure to reduce the incidence of LAA and relieve the laboratory worker's allergic sensitivity to laboratory animals.
Allergens ; Animal Experimentation ; Animals ; Animals, Laboratory ; Breeding ; Enzyme-Linked Immunosorbent Assay ; Hypersensitivity ; Incidence ; Korea ; Mice ; Prevalence ; Surveys and Questionnaires ; Skin

OBJECTIVE: Ovarian hyperstimulation syndrome (OHSS) is one of the well known complication of conttolled ovarian hyperstimulation. Though there have been numerous protocols for the prevention of OHSS, it has not been completely preventable until now. This study was performed to identify clinical predictors for early and late OHSS. METHODS: A retrospective analysis of all IVF cycles in 1993 up to June 1996 was performed. OHSS was diagnosed using the criteria of Rabau modified by Schenker. All cases of OHSS reported in this study presented with marked ovarian enlargement, ascites, oliguria, hemoconcentration and electrolyte disturbance. Ovarian stimulation was carried out using a combination of gonadotrophin releasing hormone-agonist, follicle-stimulation hormone and human menopausal gonadotrophin. 27 patients has moderate or severe OHSS presenting 3-7 days post-human chorionic gonadotrophin (hCG), and 21 patients had severe OHSS presenting 12-17 days post-hCG. RESULTS: No patient with early OHSS went onto develop late OHSS, and no patient with late OHSS had demonstrated early OHSS. Logistic regression showed that early OHSS was predicted by the number of oocytes retrieved and the estradiol concentration on the day hCG injection (P<0.05). Late OHSS was predicted by the transferred embryos, B-hCG on 14 day after hCG injection (P<0.05). CONCLUSION: Early OHSS was an acute effect of the hCG administered prior to egg retrieval in women with high estradiol and large number of retrieved oocytes. Our analysis of the risk factors for early OHSS indicates that cryopreservation of all embryos will not alter the risk of early OHSS even though it should prevent late OHSS. Late OHSS was induced by the rising serum concentration of hCG produced by the early pregnancy, the number of transferred embryos must be adjusted carefully, since it was associated with multiple gestation.
Ascites ; Chorion ; Cryopreservation ; Embryonic Structures ; Estradiol ; Female ; Humans ; Logistic Models ; Oliguria ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Ovum ; Pregnancy ; Retrospective Studies ; Risk Factors

PURPOSE: The medial meniscus is injured much more than the lateral meniscus. Because the medial meniscus is much larger in diameter, is thinner in its periphery and narrower in body than the lateral meniscus, and does not attach to either cruciate ligament. We evaluated correlations with sites of tear and history of trauma. METHODS AND MATERIALS: We reviewed retrospectively in 43 patients with meniscal tears on MRI(51 cases) and correlated them with history of trauma. RESULTS: The most common site of injury was the posterior horn of the medial meniscus(32/51), but high incidence of lateral meniscal tear compared with previous reports was seen. In the cases which had history of trauma, the posterior horn of medial meniscus was most commonly injured(26/34) and 5 meniscal tears were combined with meniscal tear in the other site. The tear in the anterior horn of the medial meniscus was seen only in a patient which had history of trauma and combined with meniscal tear in the other site. But in the meniscal tears without definite history of trauma, the incidence of meniscal tear was different from the meniscal tear with history of trauma. The incidence of lateral meniscal tear(11/17) was highter than medial meniscal tear and the posterior horn of lateral meniscus was commonly injured. CONCLUSION: We concluded that the medial meniscus was commonly injured, especially posterior horn, but in the cases which had no definite history of trauma, the lateral meniscus was commonly ipjured. An awareness of prevalent site of meniscal injuries may be helpful in the diagnostic interpretation of MR imaging of knee.
Animals ; Horns ; Humans ; Incidence ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Retrospective Studies

Curcumin is naturally occurring polyphenolic compound found in turmeric and has many pharmacological activities. The present study was undertaken to evaluate anti-allergic inflammatory activity of curcumin, and to investigate its inhibitory mechanisms in immunoglobulin E (IgE)/Ag-induced mouse bone marrow-derived mast cells (BMMCs) and in a mouse model of IgE/Ag-mediated passive systemic anaphylaxis (PSA). Curcumin inhibited cyclooxygenase-2 (COX-2) dependent prostaglandin D2 (PGD2) and 5-lipoxygenase (5-LO) dependent leukotriene C4 (LTC4) generation dose-dependently in BMMCs. To probe the mechanism involved, we assessed the effects of curcumin on the phosphorylation of Syk and its downstream signal molecules. Curcumin inhibited intracellular Ca2+ influx via phospholipase Cgamma1 (PLCgamma1) activation and the phosphorylation of mitogen-activated protein kinases (MAPKs) and the nuclear factor-kappaB (NF-kappaB) pathway. Furthermore, the oral administration of curcumin significantly attenuated IgE/Ag-induced PSA, as determined by serum LTC4, PGD2, and histamine levels. Taken together, this study shows that curcumin offers a basis for drug development for the treatment of allergic inflammatory diseases.
Administration, Oral ; Anaphylaxis* ; Animals ; Arachidonate 5-Lipoxygenase ; Curcuma ; Curcumin* ; Cyclooxygenase 2 ; Histamine* ; Immunoglobulin E ; Immunoglobulins* ; Leukotriene C4 ; Mast Cells* ; Mice* ; Mitogen-Activated Protein Kinases ; Phospholipases ; Phosphorylation ; Prostaglandin D2

Curcumin is naturally occurring polyphenolic compound found in turmeric and has many pharmacological activities. The present study was undertaken to evaluate anti-allergic inflammatory activity of curcumin, and to investigate its inhibitory mechanisms in immunoglobulin E (IgE)/Ag-induced mouse bone marrow-derived mast cells (BMMCs) and in a mouse model of IgE/Ag-mediated passive systemic anaphylaxis (PSA). Curcumin inhibited cyclooxygenase-2 (COX-2) dependent prostaglandin D2 (PGD2) and 5-lipoxygenase (5-LO) dependent leukotriene C4 (LTC4) generation dose-dependently in BMMCs. To probe the mechanism involved, we assessed the effects of curcumin on the phosphorylation of Syk and its downstream signal molecules. Curcumin inhibited intracellular Ca2+ influx via phospholipase Cgamma1 (PLCgamma1) activation and the phosphorylation of mitogen-activated protein kinases (MAPKs) and the nuclear factor-kappaB (NF-kappaB) pathway. Furthermore, the oral administration of curcumin significantly attenuated IgE/Ag-induced PSA, as determined by serum LTC4, PGD2, and histamine levels. Taken together, this study shows that curcumin offers a basis for drug development for the treatment of allergic inflammatory diseases.
Administration, Oral ; Anaphylaxis* ; Animals ; Arachidonate 5-Lipoxygenase ; Curcuma ; Curcumin* ; Cyclooxygenase 2 ; Histamine* ; Immunoglobulin E ; Immunoglobulins* ; Leukotriene C4 ; Mast Cells* ; Mice* ; Mitogen-Activated Protein Kinases ; Phospholipases ; Phosphorylation ; Prostaglandin D2

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy

BACKGROUND: Hyperglycemia, a characteristic feature of diabetes, induces glucotoxicity in pancreatic beta-cells, resulting in further impairment of insulin secretion and worsening glycemic control. Thus, preservation of insulin secretory capacity is essential for the management of type 2 diabetes. In this study, we evaluated the ability of an Orthosiphon stamineus (OS) extract to prevent glucotoxicity in insulin-producing cells. METHODS: We measured insulin mRNA expression and glucose-stimulated insulin secretion (GSIS) in OS-treated INS-1 cells after exposure to a high glucose (HG; 30 mM) concentration. RESULTS: The hexane extract of OS elevated mRNA expression of insulin as well as pancreatic and duodenal homeobox-1 of INS-1 cells in a dose-dependent manner. The hexane OS extract also increased the levels of phosphorylated phosphatidylinositol 3-kinase (PI3K) in a concentration-dependent manner. Additionally, Akt phosphorylation was elevated by treatment with 100 and 200 micromol of the hexane OS extract. Three days of HG exposure suppressed insulin mRNA expression and GSIS; these expressions were restored by treatment with the hexane OS extract. HG elevated peroxide levels in the INS-1 cells. These levels were unaffected by OS treatment under both normal and hyperglycemic conditions. CONCLUSION: Our results suggested that the hexane extract of OS elevates insulin mRNA expression and prevents glucotoxicity induced by a 3-day treatment with HG. This was associated with the activation of PI-3K and Akt.
Glucose ; Hyperglycemia ; Insulin* ; Orthosiphon* ; Phosphatidylinositol 3-Kinase ; Phosphatidylinositol 3-Kinases ; Phosphorylation ; RNA, Messenger