A 49-year-old woman with anemia who developed headache and seizure after blood transfusion was diagnosed with posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging showed typical PRES findings including lesions in bilateral parieto-occipital subcortical white matter and overlying cortex. Only a few cases of PRES after transfusion have been reported and this case is unique in that there was a latent period between infusion and development of PRES. We postulate that rapid change of hemoglobin level may disrupt cerebral autoregulation and result in delayed PRES. We suggest that neurological symptoms after blood transfusion should be appropriately investigated.

OBJECTIVE: Cell therapy has been extensively studied as a gene complementation approach in muscular dystrophy including Duchenne muscular dystrophy (DMD), and adipose tissue has recently been identified as a uniquely abundant and adequately accessible source of pluripotent cells. In the present work, we investigated myogenic potentials of adipose-derived stem cells (ADSCs) depending on culture media and isolation with using surface markers. METHOD: Human ADSCs were obtained by liposuction and cultured in two different media; control and myogenic media. In addition we attempted to isolate ADSCs by utilizing surface markers: CD45 and CD133. The following observations were made to evaluate myogenic differentiation as the expression of myogenic regulatory factors (MyoD, Myf-5 and Myf-6) and desmin by RT-PCR and immunoflurescence study. RESULTS: Conversion of ADSCs to myogenic phenotype was observed by indirect immunoflurescence study of MyoD and Myf-5 in regardless of media type and isolation method. In addition mRNA of MyoD and Myf-5 were positive in both culture media, and there were no differences of MyoD and Myf-5 responses between CD45- and CD45-CD133-ADSCs. However, secondary myogenic regulatory factor (Myf-6) was not expressed constantly, and desmin were negative in all cultural condition. CONCLUSION: Our findings suggest that human ADSCs might have myogenic potentials. However, further studies are needed to express the secondary myogenic regulatory factors and proteins in myoblasts.
Adipose Tissue ; Complement System Proteins ; Culture Media ; Desmin ; Genes, vif ; Humans ; Lipectomy ; Muscular Dystrophies ; Muscular Dystrophy, Duchenne ; Myoblasts ; Myogenic Regulatory Factors ; Phenotype ; Proteins ; RNA, Messenger ; Stem Cells ; Tissue Therapy

Duplications of the gastrointestinal tract are rare congenital malformations that are usually present during the first decade of life. However, a smaller number of cases may remain occult until adulthood. Overall, the colon is the least common site of congenital gastrointestinal duplications. Colonic duplications can present with symptoms of diverticulitis and can be confused with acquired giant cysts or masses. We present a rare case of a duplication cyst of the colon in a female adult. Although the preoperative evaluations, including an abdominal CT scan and colonoscopy, were suggestive of a gastrointestinal tumor of the colon, the final diagnosis was a colonic duplication cyst based on the histopathologic examination of the resected specimen. Even if intestinal duplication cysts are uncommon, they should be considered in the differential diagnosis of intestinal masses.
Adult ; Colon ; Colonoscopy ; Diagnosis, Differential ; Digestive System Abnormalities ; Diverticulitis ; Female ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans

BACKGROUND/AIMS: Although endoscopic resection is widely used for the treatment of early colorectal cancer, the risk factors for lymph node metastasis are not clear. This study was designed to determine the risk factors for lymph node metastasis in patients with colorectal cancer who are treated by endoscopic resection. METHODS: The medical records of patients with histologically-proven early colorectal cancers who were treated by endoscopic resection between January 2002 and September 2008 were retrospectively reviewed. Information regarding the demographic data of patients and the clinicopathologic characteristics were recorded and analyzed. RESULTS: Twenty-nine patients who underwent subsequent surgical treatment after endoscopic resection for early colorectal cancer were enrolled in this study. Six patients (20.7%) had lymph node metastases on surgical pathologic examination. The predictive factors for lymph node metastasis were tumor morphology (non-polypoid flat tumors [p=0.019]), absence of background adenomas (p=0.033), and deep submucosal invasion > or = 2,000 um (p=0.012). Unexpectedly, the presence of vascular invasion was not associated with lymph node metastasis. CONCLUSIONS: The presence of vascular invasion might not be an absolute indication for additional surgical treatment of early colorectal cancer; however, deep submucosal invasion, accompanied by a gross tumor with a non-polypoid flat morphology, and the absence of background adenomas are potential risk factors for lymph node metastasis.
Adenoma ; Colorectal Neoplasms ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Medical Records ; Neoplasm Metastasis ; Retrospective Studies ; Risk Factors

OBJECTIVE: To investigate the usefulness of bioimpedance measurement for predicting the treatment outcome in breast cancer related lymphedema (BCRL) patients. METHOD: Unilateral BCRL patients who received complex decongestive therapy (CDT) for 2 weeks (5 days per week) were enrolled in this study. We measured the ratio of extracellular fluid (ECF) volume by using bioelectrical impedance spectroscopy (BIS), and single frequency bioimpedance analysis (SFBIA) at a 5 kHz frequency before treatment. Arm circumferences were measured at 10 cm above and below the elbow before and after treatment. We also investigated whether there is correlation between ECF ratio and SFBIA ratio with the change of arm circumference after CDT. RESULTS: A total of 73 patients were enrolled in this study. The higher ECF ratio was significantly correlated with higher reduction of arm circumference at both above and below the elbow after treatment, but the higher SFBIA ratio was correlated only with the higher reduction of arm circumference below the elbow. CONCLUSION: These results show that ECF volume measurements and SFBIA before treatment are useful tools for predicting the outcome of patients with lymphedema. We concluded that ECF volume measure can be used as a screening tool for predicting treatment outcome of BCRL patients.
Arm ; Breast ; Breast Neoplasms ; Elbow ; Electric Impedance ; Extracellular Fluid ; Humans ; Lymphedema ; Mass Screening ; Spectrum Analysis ; Treatment Outcome

PURPOSE: The aim of the present study was to assess the clinicopatholgical significance of Bcl-2 oncoprotein expression in childhood non-Hodgkin's lymphoma (NHL). METHODS: We have assessed 16 cases of childhood NHL during last 6 years from 1990 to 1995. Bcl-2 oncoprotein expression has been semiquantitatively analyzed in paraffin sections from 16 cases of childhood NHL with 39 control cases of adult NHL. The expression of Bcl-2 oncoprotein was correlated with histologic grade, immunophenotype, proliferative activity as measured by immunostain of Ki-67 antigen, clinical stage, and survival rate (event free survival rate, EFS). RESULTS: 1) Bcl-2 oncoprotein expression significantly decreased according to increase of histological grade (P<0.05). 2) High Bcl-2 oncoprotein expression was more frequent in B-cell NHL than T-cell NHL (P<0.05). 3) Proliferative activity as measured by immunostain of Ki-67 antigen was negatively correlated with Bcl-2 oncoprotein expression (P<0.05). 4) Bcl-2 oncoprotein expression was not correlated with clinical stage (P>0.05). 5) EFS of patients was significantly correlated with Bcl-2 oncoprotein expression, that is, reduced EFS was demonstrated in the patients with low Bcl-2 oncoprotein expression (P<0.05). CONCLUSIONS: Thus Bcl-2 oncoprotein, as demonstrated immunohistochemically in routinely paraffin embedded tissue, can be restrictively used in prediction of prognosis and grade of childhood NHL, in aggrement with the role of Bcl-2 oncoprotein in blocking of apoptosis and indirect contribution to increase of cellular proliferative activity of NHL.
Adult ; Apoptosis ; B-Lymphocytes ; Child ; Humans ; Ki-67 Antigen ; Lymphoma, Non-Hodgkin* ; Paraffin ; Prognosis ; Survival Rate ; T-Lymphocytes

BACKGROUND: In this randomized, double-blinded study, we evaluated the efficacy of ramosetron and ondansetron for preventing postoperative nausea and vomiting (PONV) after middle ear surgery. METHODS: Seventy patients of either sex, ASA 1-2, scheduled middle ear surgery (mastoidectomy and tympanoplasty) under general anesthesia with sevoflurane and remifentanil were included. Patients were randomly divided into two groups and received IV ramosetron 0.3 mg (group R) or ondansetron 4 mg (group O) before the end of operation (n = 35 each). The incidence and severity of PONV, pain score (VAS), rescue antiemetic, rescue analgesic and side effects were assessed following 6 hr, 24 hr and 48 hr after surgery. RESULTS: The incidence of PONV showed no significant difference between groups at each time points after surgery. There were no difference in the severity of nausea, pain score, rescue antiemetic, analgesic drug usage and side effects between groups. CONCLUSIONS: Prophylactic therapy with ramosetron is as effective and safe as conventional prophylactic therapy with ondansetron for preventing PONV in patients undergoing general anesthesia for middle ear surgery.
Anesthesia, General ; Benzimidazoles ; Ear, Middle ; Humans ; Incidence ; Methyl Ethers ; Nausea ; Ondansetron ; Piperidines ; Postoperative Nausea and Vomiting ; Vomiting

No abstract available.
Adult* ; Cholesterol* ; Gyeongsangbuk-do* ; Humans ; Jeollanam-do* ; Triglycerides*

BACKGROUND: After an esophageal resection for an esophageal disease, the stomach becomes the most common organ for a substitute. The stomach has the advantages of being simple with fewer complications when used properly. The complications of an esophageal reconstruction using the stomach as the substitute are assessed and discussed. MATERIAL AND METHOD: Between 1990 and 1998, 44 patients who underwent esophagogastric anastomosis were treated in the department of Thoracic and Cardiovascular Surgery of Yongdong Severance Hospital, Seoul, Korea. RESULT: The rate of postoperative complications and mortality in these 44 patients were 70.5% and 13.6%, respectively. The major complications in our series involved the stricture of anastomosis(13.6%), pneumonia(11.4%), and wound infection(9.1%). The most frequent causes of postoperative deaths were pulmonary complications and sepsis(6.8%). CONCLUSION: Anastomotic leakage is no longer a major complication of an esophagogastrostomy. Most postoperative stricture can be overcome with frequent esophageal dilations. Postoperative pulmonary infection, nutrition, and physiotherapy are very important in reducing the rate of pulmonary morbidity and mortality.
Anastomotic Leak ; Constriction, Pathologic ; Esophageal Diseases ; Humans ; Korea ; Mortality* ; Postoperative Complications ; Seoul ; Stomach ; Wounds and Injuries

BACKGROUND: Pectus excavatum is the most common deformity of anterior chest wall. Since the first surgical correction performed by Meyer et al. in 1911, various operative techniques have been developed. These methods, however, needed a large skin incision on the anterior chest wall and wide excision of costal cartilages. Nuss et al. has introduced a less invasive method of inserting a molded stainless steel bar through the small incisions on the lateral chest wall in young patients. MATERIAL AND METHOD: This retrospective analysis was performed on 14 cases of pectus excavatum corrected between Nov. 1999 and July 2000. The correction under 15 of age was done using one bar. Above 16 of age, we used two bars. RESULT: There were 11 male and 3 female patients with ranging 2 years to 52 years. The pectus index was 5.3+/-1.84 and asymmetric index was 1.06+/-0.03. They were transferred to general ward at the next day of operation. Mean hospital stays were 4.2 days. The postoperative complications were pneumonthorax in one, hemothorax in one and delayed pleural effusion in one and all complications were among adults. CONCLUSION: We have corrected the pectus excavatum successfully using Nuss' method. In adults, the deformed walls were corrected with two bars but complications were higher than younger patients because of fully developed muscles and bones.
Adult ; Cartilage ; Congenital Abnormalities ; Female ; Fungi ; Funnel Chest* ; Hemothorax ; Humans ; Length of Stay ; Male ; Muscles ; Patients' Rooms ; Pleural Effusion ; Postoperative Complications ; Retrospective Studies ; Skin ; Stainless Steel ; Thoracic Wall