This study was carried out to obtain the basic data for artificial culture of veiled lady mushroom (Dictyophora spp). The optimal conditions for the mycelial growth were 25degrees C and pH 5.0 for all isolates except the optimal temperature of 30degrees C for D. echinovolvata ASI 32002 and Phallus rugulosus . The optimal medium for Dictyophora spp. was PBA (potato bamboo sawdust extract agar) medium. The strain ASI 32002, D. echinovolvata , grew faster than. D. indusiata ASI 32003 and Phallus rugulosus ASI 25007 on the medium. Carbon sources such as glucose, maltose and inuline were favorable for stimulating a mycelial growth of the two strains of ASI 32002 and ASI 32003. Asparagine and glutamine appeared to be favorable to the strain ASI 32002 and ASI 32003, where as alanine, one of nitrogen source also favorable to the strain ASI 32002. The optimum C/N ratio of the two isolates of ASI 32002 and ASI 32003 was about 25 : 1 when 2% glucose as carbon source was mixed with the basal medium. While, in the case of 4% as carbon source, the optimum C/N ratio was about 30 : 1.
Agaricales* ; Alanine ; Asparagine ; Carbon ; Cultural Characteristics* ; Glucose ; Glutamine ; Hydrogen-Ion Concentration ; Inulin ; Maltose ; Nitrogen

PURPOSE: Multiple methods are used to diagnose acute appendicitis. However, with the current practice, the negative laparotomy rate for acute appendicitis is from 15% up to 30%. This study was designed to evaluate various pathologies of the appendix and other intraabdominal organs of patients preoperatively diagnosed with acute appendicitis and to analyze clinically the difference between acute appendicitis and other intraabdominal inflammatory diseases. METHODS: We reviewed the pathologic reports of 833 patients who underwent laparotomies for acute appendicitis from January 1997 to December 2001. We grouped these patients by pathology. Group I included patients with a negative appendectomy and no other intraabdominal pathology, group II included those with lesions within the appendix, and group III, those with intraabdominal lesions other than in the appendix. We also analyzed the age, sex distributions, the typical symptoms of appendicitis, the duration of symptoms, fever, and leukocytosis of 100 patients with typical appendicitis by random sampling to find the clinical differences that existed between pelvic inflammatory disease and cecal diverticular disease presented as appendicitis. RESULTS: The diagnostic accuracy for acute appendicitis was 79.7%, and the negative appendectomy and negative laparotomy rates were 17.4% and 15.5%, respectively. The percents of patients in group I, II, and III were 10.4%, 82.6%, and 7.0%, respectively. CONCLUSIONS: It is important to consider the possibility of various pathologies during diagnostic and operative procedures for an acute abdomen, especially one occurring in the right lower quadrant.
Abdomen, Acute ; Appendectomy ; Appendicitis* ; Appendix ; Diagnosis, Differential* ; Female ; Fever ; Humans ; Laparotomy ; Leukocytosis ; Pathology* ; Pelvic Inflammatory Disease ; Sex Distribution ; Surgical Procedures, Operative

An adenocarcinoma of the appendix is a rare tumor, and so far only 130 cases have been reported worldwide. We report one patient with peritoneal seeding of an adenocarcinoma. A 51-year-old man was admitted to our hospital with the impression of intestinal obstruction. He had undergone an appendectomy 5 years ago due to acute appendicitis. At that time, postoperative histopathological analysis had revealed an adenocarcinoid tumor in the appendix. The patient had been told to visit our hospital for follow-up but he hadn't visited. When he finally visited our hospital diagnostic laparoscopy revealed the peritoneal seeding of a recurrent adenocarcinoma. A palliative right hemicolectomy was done to relieve the bowel obstruction. After recovering from operation, the patient was treated with the 5-fluoruracil, leucovorin, and oxaloplatin (FOLFOX). The patient was discharged in improved general condition with a future plan for regular cyclic chemotherapy.
Adenocarcinoma ; Appendectomy ; Appendicitis ; Appendix* ; Carcinoid Tumor ; Drug Therapy ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Laparoscopy ; Leucovorin ; Middle Aged ; Neoplasm Metastasis*

Cyclins are proteins that activate different cyclin-dependent kinases(CDKs) and promote the cell cycles. Their correlations with several human cancers have been identified. Cyclin E, as one of G1 cylins, produces DNA replication through the progression of cell cycle G1 --> S phase. In contrast, cyclin-dependent kinase inhibitors(CDKI) bound with cyclin E-cdk2 complex control the cell cycle and inhibit the cell proliferation. P21(WAF1) proteins, which are CDKIs, are transcripted by a p53 gene and participate in the cell cycle inhibition. Variant p53 proteins produced by a mutated p53 gene lose the ability to control of the cell cycle resulting in cell proliferation. This study is aimed to reveal the expressions of cyclin E, p21(WAF1) protein, p53 variant protein in colorectal adenomas and carcinomas, and also reveal their correlations in the process of carcinogenesis. Twenty-one colorectal adenomas or adenomatous polyps, and thirty colorectal carcinoma tissues were obtained by operative resections or endoscopic polypectomies. Immuno histochemical stains of the above-mentioned three proteins and a statistical analysis of their correlations were made. The results were as follows: 1. P21 proteins were expressed in the upper-one third layer of all normal colonic mucosa, but cyclin E and variant p53 protein were not identified. 2. Cyclin E was expressed in 23.8% of adenomas and 76.7% of carcinomas. Variant p53 protein was expressed in 71.4% of adenomas and 83.3% in carcinomas. The degree of positivity of variant p53 expression was correlated with cancer staging. P21 protein was expressed in all adenomas, similar to normal mucosa, but was not expressed in 43.3% of carcinomas. 3. Expression of cyclin E was increased as to the positivity of variant p53 proteins but the correlations of p21 proteins and cyclin E, and p21 proteins and variant p53 proteins were not identified. Cancer staging was not correlated with the expressions of the three proteins. In conclusion, it can be thought that the overexpression of cyclin E and variant p53 proteins, and the loss of p21 proteins are related with the colorectal carcinogenesis. We can also identify the relationship of cyclin E and variant p53 proteins.
Adenoma* ; Adenomatous Polyps ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Colon ; Colorectal Neoplasms ; Coloring Agents ; Cyclin E* ; Cyclins* ; DNA Replication ; Genes, p53 ; Humans ; Mucous Membrane ; Neoplasm Staging ; Phosphotransferases ; S Phase

Duplication of the ureter occurs in 0.6 to 0.8% of adults and it is sometimes encountered in kidney transplantation. We experienced a case of duplicated uretor in kidney transplantaion, so we reports about it with a brief review of literature.
Adult ; Humans ; Kidney Transplantation* ; Kidney* ; Ureter*

BACKGROUND: Kidney transplantation (KT) is the optimal treatment for end stage renal disease. However, the relative shortage of organs for transplantation (from human leukocyte antigen- or ABO incompatible [ABOi] living donors) has led to ABOi KT as an accepted method to expand the pool of living kidney donors. To date, reports of the outcomes of ABOi KT are limited; therefore this study aims to evaluate the outcomes of ABOi KT in recipients. METHODS: We identified 45 patients who underwent live-donor ABOi KT between February 2007 and November 2011 at Maryknoll Medical Center. All of them were treated according to the scheduled protocol of plasmapheresis with low dose intravenous immunoglobulin, and low dose rituximab- or tacrolimus-based triple immunosuppressant regimens. Clinical parameters and the incidence of rejections in these patients were analyzed. RESULTS: We had three cases (6.6%) of biopsy-proven acute antibody-mediated rejections and one case (2.2%) of acute cellular rejection, all of which were successfully treated. The median follow-up duration was 20 months (range, 2~59). Antibody depletion was scheduled according to baseline anti-ABO antibody titer (tube method: median immunoglobulin G titer/immunoglobulin M titer 64 [range, 8~4,096]/16 [range, 2~256], respectively). Although there was no patient death, one patient lost his graft due to nonadherence to immunosuppressants. CONCLUSIONS: Our analysis of ABOi KT has shown excellent and promising outcomes. These practices may therefore represent an acceptable option for expanding the pool of living kidney donors.
Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulins ; Immunosuppression ; Incidence ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Leukocytes ; Plasmapheresis ; Rejection (Psychology) ; Tissue Donors ; Transplants

Tracheo-innominate artery fistula (TIAF) is rare, yet the most fatal complication after tracheostomy. In the absence of immediate diagnosis and surgical management, the mortality rate is very high, because the complication can lead to sudden massive tracheal hemorrhage. Tracheal obstruction and hypovolemic shock are the major life threatening conditions. The 46-year-old woman received tracheostomy tube insertion after stroke. Three months later, there was occurrence of active bleeding at the site of tracheostomy in the patient, who participated in comprehensive rehabilitation program. Immediately, the patient received an endotracheal tube insertion into the tracheostomy site and thus massive bleeding was controlled. The patient was transferred to the intensive care unit, where her breathing was maintained by mechanical ventilation. Based on computed tomography and laryngoscopy, no remarkable findings about TIAF were detected. Nevertheless, transfemoral angiography findings revealed that innominate artery made small luminal outpouching to trachea at the carotid artery and at the subclavian artery bifurcation level, based on which a diagnosis of TIAF was made. She had an operation for TIAF, tracheoplasty with bypass graft. Subsequently, she was discharged after 15 weeks. In the present report, we describe a case of TIAF, which can occur in the patients with tracheostomy tube during rehabilitation.
Angiography ; Arteries ; Brachiocephalic Trunk ; Carotid Arteries ; Female ; Fistula ; Hemorrhage ; Humans ; Intensive Care Units ; Laryngoscopy ; Phenobarbital ; Respiration ; Respiration, Artificial ; Shock ; Stroke ; Subclavian Artery ; Trachea ; Tracheostomy ; Transplants

PURPOSE: A fistula in ano is a granulating track between the anorectum and the perianal region or perineum. A typical fistula may consist of the track, the primary (internal) opening and secondary (external) opening. Its hallmark is frequent discharge through external opening. Sometimes this track become occluded and a sinus remains. Therefore abscence of an external opening should not be taken as evidence that there is no fistula, and then this study is aimed to make clear perianal sinus as another form of fistula in ano. METHODS: This study is a clinical analysis of 17 patients with perianal sinus, who were treated at the Department of General Surgery of Pundang-CHA hospital from June, 1995 to December, 1998. As comparative group, 91 patients of typical fistula in ano were also taken in same period. RESULTS: The ratio of male to female was 4.6:1 in sinus group, 4.1:1 in fistula group. The prevalent ages were in the third decade in both group. The main symptoms of sinus group were a palpable mass (94.1%), pain & discomfort (35.3%) but that of fistula group were purulent discharge (87.9%) and pain (28.6%). The most frequent duration of illness was 6 months~1 year (52.9%) in sinus group, within 6 months (40.7%) in fistula group. The distributions of sinus size were 7 cases (41.2%) in <1 cm, 8 cases (47.0%) in 1~2 cm and 2 cases (11.8%) in >2 cm. The most common type was intersphincteric in both group. The operative procedures included excision with fistulectomy in 4 cases (23.5%), lay open of sinus with fistulotomy in 11 cases (64.7%), seton procedure in 2 cases (11.8%). The mean hospital stay was 5.0 day in sinus group, 4.9 day in fistula group. CONCLUSIONS: There was no distinct difference in the clinical features or characteristics between the both groups, therefore perianal sinuscould be taken as fistula in ano and treated similar procedures.
Female ; Fistula* ; Humans ; Length of Stay ; Male ; Perineum ; Surgical Procedures, Operative

Colorectal cancer is one of the malignant tumours of which molecular genetic alterations have been much unveiled among the human cancers. In the multi-stepwise process to the carcinogenesis, it has been recently revealed that the neoplastic growth is originated either from the activiation of oncogene through its mutation, rearragement and amplification, or from the inactivation of the tumour suppression gene through its mutation and deletion. DCC(Deleted in colon cancer) protein is the product of DCC gene, the representative of tumor suppressor genes. The alteration of DCC protein may be related with the aggressiveness of carcinoma and metastasis. As a result, the prognosis of the cancer may be also thought to be affected. Now the prognosis of colorectal cancer mainly depends on pathologic staging, but there are some variations of survival and recurrence among the patients in same stage. Then this study is aimed to reveal the significance of alteration of DCC protein as an independent factor related to prognosis. Twenty three cancer tissues were obtained from the rejected specimens of colorectal carcinomas. We exacted the DCC gene products in the cancer tissues by the methods of immunohistochemical stains and Western blots. We also analyzed the relationships between the alteration of DCC proteins and the status of regional lymph node metastasis or the serum levels of CEA's(carcinoembryonic antigen). As results, we found the abscence or very scanty stains of DCC protein by Western lot in 14 cancer tissues of available 19 cases, but there were all negative responses in immunohistochemical stains. In contrast with above results, there were all positively stains of DCC proteins in corresponding 23 normal colorectal tissues by both the methods. There was no significantly statistical relation between the alteration of DCC proteins and the status of regional lymph node metastasis or the serum level of CEA. In conclusion, we can confirm that the DCC proteins are abscent or very scanty in colorectal cancer tissues and that may be related with the process of carcinogenesis. But the role of DCC protein loss as an independent prognostic factor was not found in this study.
Blotting, Western ; Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Coloring Agents ; Genes, DCC ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Molecular Biology ; Neoplasm Metastasis ; Oncogenes ; Prognosis ; Recurrence ; Staphylococcal Protein A

PURPOSE: 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. METHOD: Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). RESULTS: 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. CONCLUSION: On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.
Biopsy ; Breast Diseases ; Breast Neoplasms* ; Breast* ; Cohort Studies* ; Female ; Humans ; Live Birth ; Mammography ; Menarche ; Risk Assessment ; Risk Factors ; Ultrasonography