OBJECTIVE: To establish the evaluation system of the quality of oocytes on the basis of the incidence of cumulus cells apoptosis, to investigate the relationships between the incidence of cumulus cells and the outcomes of IVF-ET. METHOD: Thirth-four cycles undergoing controlled ovarian hypersimulation for IVF-ET with tubal infertility (23 cycles) or unexplained infertility (11 cycles) were included in this study. Cumulus cell masses surrounding mature oocyte and co-culture of embryos with autologous cumulus cells during IVF-ET process. The incidence of apoptosis in cumulus cells was assessed by apoptosis detection kit fluorescein. The effect of co-culture using cumulus cells and the incidence of cumulus cells apoptosis. RESULTS: The results were as follows: 1. The incidence of apoptosis in cumulus cells markedly increased in patients aged 40 or over, while the fertilization rate was greatly decreased in those age group. 2. Apoptosis in cumulus cells was found in both the fertilized oocytes and unfertilized oocytes, but the incidence of apoptosis was higher in unfertilized oocytes. 3. There is no clear correlation between apoptosis in cumulus cells and the number of oocytes retrieved. However, the incidence of apoptosis was increased when the number of oocytes retrieved was 5 and fewer in comparison with 6~10. 4. Embryo grade was significantly affected by the incidence of apoptosis in cumulus cells. 5. Pregnancy rate of IVF-ET per cycle was 29.4%, and the pregnant group had the higher fertilization rate and a significantly lower incidence of apoptosis in cumulus cells compared with the nonpregnant group. 6. When cumulus cells were used as helper cells in the co-culture of the embryo, in vitro activity of cumulus cells based on morphological change and proliferation did not influence the quality of embryo, but was closely associated with the implantation rate and pregnancy rate, which was enhanced when morphological changes and proliferation of cumulus cells was more active. 7. This difference in the outcome of IVF-ET according to in vitro activity of cumulus cells used for co-cultue was not associated with the incidence of apoptosis in cumulus cells, but rather had likely relations with the different secretion pattern of protein, which may be an embryotrophic factor by cumulus cells. CONCLUSION: These results suggest that the incidence of apoptosis in cumulus cells can be used in predicting oocyte qualities and the outcomes of IVF-ET. And the effect of co-culture largely depends on the in vitro activity of cumulus cells as well.
Apoptosis ; Coculture Techniques ; Cumulus Cells* ; Embryonic Structures ; Fertilization ; Fluorescein ; Humans ; Incidence ; Infertility ; Oocytes ; Pregnancy Rate ; T-Lymphocytes, Helper-Inducer

No abstract available.
Temporal Bone*

A case of intraneural ganglion, 5cm×2cm×1.5cm, which was located between the funiculi of the common peroneal nerve was excised completely under the operative microscope. There was no communication with adjacent bursa or joint.
Ganglion Cysts ; Joints ; Peroneal Nerve

We report the first case of an angiomyomatous hamartoma (AH) of the popliteal lymph nodes (LNs) occurring in association with diffuse pigmented villonodular synovitis (PVNS) of the knee. AH is a rare benign vascular disease with a predisposition for the LNs of the inguinal region. Twenty-five cases of AH have been reported to date; however, the precise pathogenesis is still undetermined. In the present case, an open synovectomy revealed two of three popliteal LNs in close proximity to the extra-articular component of diffuse PVNS. These LNs demonstrated irregularly distributed thick-walled blood vessels in the hilum. These vessels extended into the medulla and cortex and were associated with haphazardly arranged smooth muscle cells in the sclerotic stroma. These findings are compatible with an AH. Our observations raise the possibility that AH of the popliteal LNs may represent an abnormal proliferative reaction against the inflammatory process caused by PVNS of the knee.
Angiomyoma ; Blood Vessels ; Hamartoma ; Knee ; Lymph Nodes ; Myocytes, Smooth Muscle ; Synovitis, Pigmented Villonodular ; Vascular Diseases

Renal cell carcinoma (RCC) in autosomal dominant polycystic kidney (ADPKD) is rare. To date, 54 cases of RCC in ADPKD have been reported. Among these, only 2 cases have different histologic types of RCC. Here we describe a 45-year-old man who received radical nephrectomy for multifocal RCC with synchronous papillary and clear cell histology in ADPKD and chronic renal failure under regular hemodialysis. The case reported herein is another example of the rare pathological finding of RCC arising in a patient with ADPKD.
Carcinoma, Renal Cell ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Nephrectomy ; Polycystic Kidney, Autosomal Dominant ; Renal Dialysis

No abstract available.
Brain ; Brain Abscess ; Craniocerebral Trauma ; Head

STUDY DESIGN: Retrospective radiographic study. PURPOSE: To evaluate the efficacy of the proximal lumbar curve flexibility compared with the traditional whole lumbar curve flexibility in patients with main thoracic adolescent idiopathic scoliosis (MT-AIS). OVERVIEW OF LITERATURE: Traditionally the flexibility of the whole lumbar curve was measured, and the flexibility of the proximal lumbar curve was not analyzed in any study. METHODS: Twenty-eight MT-AIS patients treated by anterior selective thoracic fusion (STF) were evaluated after mean follow-up of 50.1 months (range, 25 to 116 months). The male : female ratio was in 5 : 23. The man age at surgery was 14 years and 8 months (range, 11.4 to 18.4 years). The lumbar curve was divided into the proximal and distal curves by the lumbar apex. RESULTS: The mean final correction rates (CR)/(flexibilities) of the MT, lumbar, proximal lumbar, and distal lumbar curves were 65.2%/(50.5%), 61.9%/(92.8%), 65.3%/(90.9%), and 36.4%/(134%), respectively. With the final lumbar CR, the lumbar flexibility (r = 0.267, p > 0.05) and the proximal lumbar flexibility (r = 0.327, p > 0.05) was similarly correlated. The mean lumbar CR was similar to the proximal lumbar CR (61.9% vs. 65.3%, p = 0.305). And the correlation between the flexibility and the CR was significant only in the proximal lumbar curve (r = 0.457, p < 0.05), but not in the lumbar curve (r = 0.267, p > 0.05) or the distal lumbar curve (r = 0.175, p > 0.05). CONCLUSIONS: The proximal lumbar curve flexibility may be an alternative method of measuring the lumbar flexibility in MT-AIS patients treated by STF.
Adolescent ; Female ; Follow-Up Studies ; Humans ; Male ; Pliability ; Retrospective Studies ; Scoliosis

BACKGROUND: Isocitrate dehydrogenase (IDH) catalyzes the oxidative decarboxylation of isocitrate to yield alpha-ketoglutarate (alpha-KG) with production of reduced nicotinamide adenine dinucleotide (NADH). Dysfunctional IDH leads to reduced production of alpha-KG and NADH and increased production of 2-hydroxyglutarate, an oncometabolite. This results in increased oxidative damage and stabilization of hypoxia-inducible factor alpha, causing cells to be prone to tumorigenesis. METHODS: This study investigated IDH mutations in 61 Ewing sarcoma family tumors (ESFTs), using a pentose nucleic acid clamping method and direct sequencing. RESULTS: We identified four cases of ESFTs harboring IDH mutations. The number of IDH1 and IDH2 mutations was equal and the subtype of IDH mutations was variable. Clinicopathologic analysis according to IDH mutation status did not reveal significant results. CONCLUSIONS: This study is the first to report IDH mutations in ESFTs. The results indicate that ESFTs can harbor IDH mutations in previously known hot-spot regions, although their incidence is rare. Further validation with a larger case-based study would establish more reliable and significant data on prevalence rate and the biological significance of IDH mutations in ESFTs.
Carcinogenesis ; Constriction ; Decarboxylation ; Humans ; Incidence ; Isocitrate Dehydrogenase ; NAD ; Prevalence ; Sarcoma, Ewing*

STUDY DESIGN: A retrospective radiographic study. PURPOSE: To evaluate the axial plane lumbar responses after anterior selective thoracic fusion (STF) in patients with main thoracic adolescent idiopathic scoliosis (MT-AIS). OVERVIEW OF LITERATURE: Anterior scoliosis surgery induces more MT derotation through disc preparation than posterior surgery. METHODS: Twenty-eight MT-AIS patients treated with STF were evaluated after a minimum follow-up (FU) of 2 years. The MT and lumbar coronal angles, as well as the MT and lumbar rotational angles at the most rotated vertebrae were measured. RESULTS: At the last FU, the MT coronal correction and derotation rates were 65% and 41%, respectively. The lumbar coronal correction rate was 61% but there was minimal lumbar derotation (2%). Nine cases were decompensated (coronal balance >10 mm). After surgery, the compensated and decompensated groups showed similar MT coronal and axial correction rates. During the FU, the MT and lumbar apecies rotated in the same direction (r=0.443). In addition, significant MT derotation occurred in the decompensated group with increasing lumbar rotational correction loss. At the last FU, while the MT coronal correction was similar between the two groups, there was more MT derotation in the decompensated group. Furthermore, the MT rotational change was strongly associated with the coronal C7 plumb line position (r=0.728). CONCLUSIONS: After anterior STF in patients with MT-AIS, the final MT derotation is strongly associated with the coronal C7 plumb line position. During the FU, the excessive MT derotation in the decompensated group was attributed to excessive lumbar rotational correction loss.
Adolescent ; Follow-Up Studies ; Humans ; Retrospective Studies ; Scoliosis ; Spine

BACKGROUND AND OBJECTIVES: The Epstein-Barr virus (EBV) is a human herpes virus which causes certain type of lymphoma and some epithelial neoplasm such as undifferentiated nasopharyngeal carcinoma. However, the role of EBV as a causative factor in other head and neck tumor especially, in laryngeal squamous cell carcinoma is not fully elucidated. The aim of this study was to analyze the relationship between the prescence of EBV in laryngeal squamous cell carcinoma and clinicopathologic characteristics. MATERIALS AND METHODS: 65 cases of laryngeal squamous cell carcinoma were retrieved from formalin-fixed, paraffin-embedded blocks and analyzed for EBV by immunohistochemical staining. Results : The EBV was detected in 26(40%) of the 65 patients with laryngeal squamous cell carcinoma and 2(10%) of the 20 control ases. In 26 cases of EBV-positive patients, 13(46.4%) cases were supraglottic cancer and 13(35.1%) cases were glottic cancer. CONCLUSION: These results suggest that EBV may possibly play an etiologic role in the pathogenesis of laryngeal squamous cell carcinoma.
Carcinoma, Squamous Cell* ; Head ; Herpesvirus 4, Human* ; Humans ; Lymphoma ; Neck ; Neoplasms, Glandular and Epithelial