Aortic transection or interruption is a rare condition which developed after an acute deceleration injury. Its occurrence depends on the location and direction of the force applied and is usually from motor vehicle accident or falling down. The exact incidence of aortic transection in trauma is not known but, when develops, only about 10-15% of the victims can furtive and be transported to the hospital. Even in the survivors, majority of them will be fatal within a few days if a prompt diagnosis and surgical treatments are not made. Aggressive diagnostic work-up is recommended for the patients with high suspicious index, which would salvage the victims with this fatal condition. We report the experience of two cases of aortic transection or interruption following motor vehicle accidents.
Deceleration ; Diagnosis ; Early Diagnosis* ; Humans ; Incidence ; Motor Vehicles ; Survivors ; Thorax* ; Wounds and Injuries*

OBJECTIVE: The purpose of this study was to review the incidence, types, chemotherapy regimens, operation methods, pregnancy rate and propiosis of the ov#arian malignancy under the age of twenty years old. METHODS: Retrospective reviews of the medical recordings for 22 patients with ovarian malignancy under the age of twenty years old in the Department of Obstetrics and Gynecology, Hanyang University from 1986 to 1997 were done. RESULTS: Gerin cell tumor accounts for the majority of cases (77%), whereas 5 patients(23%) belong to the common epithelial poup which were all mucinous type. Our experiences with 22 cases are as followings: 5 mucinous cystadenocarcinoma, 8 immature teratoma, 4 endodermal sinus tumor, 3 dysgernma and 2 mixed germ cell tumor. The incidence of this group was 8.2% (22/266) in all ovarian malignancy. Fourteen of them are stage I, each one is, stage II and IV, and six patients are stage III. The average age was 14.9 years old in germ cell tumor and 18.4 yems old in mucinous cystadenoearcinoma. Malignant ovarian cancer under the age of twenty can be treated with conservative surgery, followed by adjuvant chemotherapy. Commonly used chemotherapeutic regimens were VAC(Vincristine, Actinomycin-D; Cyclophosphamide), VBP(Vinblastine, Bleomycin, Cisplatin) and BEP(Bleomycin, Etoposide, Cisplatin). Second look operations were done in 11 patienth and histologic positive findings were detected in 4 of them. The length of follow-up ranged ftom 3 months to 137 months and median value was 44 rnonths. CONCLUSIONS: It is concluded that for young women who wish to preserve child-bearing capacity, regardless of the stage of the tumor, fertility preserving surgery with complete surgical staging, if necessary followed by combination chemotherapy is an appropriate treatment.
Bleomycin ; Chemotherapy, Adjuvant ; Cystadenocarcinoma, Mucinous ; Drug Therapy ; Drug Therapy, Combination ; Endodermal Sinus Tumor ; Etoposide ; Female ; Fertility ; Follow-Up Studies ; Gynecology ; Humans ; Incidence ; Medical Records ; Mucins ; Neoplasms, Germ Cell and Embryonal ; Obstetrics ; Ovarian Neoplasms ; Pregnancy Rate ; Retrospective Studies ; Teratoma

STATEMENT OF PROBLEM: In its preceding work, change in surface characteristics were investigated in consideration that both microtopograpy and macroscopic configuration of implants surface are two of the most important factors, in that they can construct agreeable environment by raising surface energy, to affect osseointegration and biocompatibility explained by cell proliferation. PURPOSE: This study focused on examining cytocompatibility of dental implants materials Ti-Ag alloys, of which mechanical and electrochemical superiority to cp-Ti or Ti6Al4V were verified, in comparison with that of cp-Ti, and Ti6Al4V. MATERIALS AND METHODS: In this regard, MTT tests for L-929, the fibroblast connective tissues and cell proliferation tests for osteoprogenitor cells, MC3T3-E1 were performed on cp-Ti, Ti6Al4V, and Ti-Ag alloys following thermal oxidation according to appropriate heat treatment temperature(untreated, 400, 600, 800degrees C) and heat treatment duration(untreated, 0.5, 1, 4 hr). RESULTS: The MTT tests on fibroblasts L-929 resulted in cell viability of over 90% in all experimental group entities, where, especially, the 100% of the viability for Ti-Ag alloys specimens accounted for the slightest adverse effect of ions release from those alloys on the cell. In MC3T3-E1 proliferation tests, the population of cells in the experimental group was roughly increased as experimentation proceeded, after two to four days. Proliferation showed highest viability for most of specimens, including Ti2.0Ag, treated at 600degrees C. CONCLUSION: In conclusion, it is the heat treatment temperature, not the duration that has considerable effects on thermal oxidation of specimens. Ti-Ag alloys treated at 600degrees C proved to have the best surface morphology as well as cytocompatibility when compared with Ti or Ti6Al4V for short-term biocompatibility tests.
Alloys* ; Cell Proliferation ; Cell Survival ; Connective Tissue ; Dental Implants ; Fibroblasts ; Hot Temperature ; Ions ; Osseointegration

OBJECTIVE: Notochordal cells in the intervertebral disc interact with nucleus pulposus (NP) cells and support the maintenance of disc homeostasis by regulation of matrix production. However, the influence of notochordal cells has not been evaluated in the annulus fibrosus (AF), which is the primary pain generator in the disc. We hypothesized that the notochordal cell has the capacity to modulate inflammatory mediators secreted by AF cells secondary to stimulation. METHODS: Notochordal and AF cells were isolated from adult New Zealand white rabbits. AF pellets were cultured with notochordal cell clusters or in notochordal cell-conditioned media (NCCM) for 24 or 48 hours with proinflammatory cytokines at varying concentrations. Gene expression in AF pellets were assayed for nitric oxide synthase (iNOS), cyclo-oxygenase (COX)-2, and interleukin (IL)-6 by real time reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: AF pellet in NCCM significantly decreased the iNOS and COX-2 messenger ribonucleic acid (mRNA) levels compared to AF pellets alone and AF pellets with notochordal cells (p < 0.05). AF pellet resulted in dose-dependent iNOS and COX-2 expression in response to IL-1beta, stimulation, demonstrating that 1 ng/ml for 24 hours yielded a maximal response. AF pellet in NCCM significantly decreased the expression of iNOS and COX-2 in response to 1ng/ml IL-1beta, stimulation at 24 hours (p < 0.05). There was no difference in IL-6 expression compared to AF pellets alone or AF pellets with notochordal cell clusters. CONCLUSION: We conclude that soluble factors from notochordal cells mitigate the gene expression of inflammatory mediators in stimulated AF, as expected after annular injury, suggesting that notochordal cells could serve as a novel therapeutic approach in symptomatic disc development.
Adult ; Cytokines ; Gene Expression ; Homeostasis ; Humans ; Interleukin-6 ; Interleukins ; Intervertebral Disc ; Nitric Oxide Synthase ; Notochord ; Prostaglandin-Endoperoxide Synthases ; Rabbits ; Reverse Transcriptase Polymerase Chain Reaction ; RNA

Endovascular treatment of the aortic aneurysm with a stent graft is rapidly evolving. We describe here a case of hybrid TEVAR (thoracic endovascular aortic repair) in which the stent grafts were placed in the aortic arch after debranching of the arch vessels. The patient had undergone ascending aorta replacement for acute type I aortic dissection 2.5 years earlier. The aneurysmal change of the distal dissection progressed with time. A provisional bypass surgery from the ascending aorta to the innominate artery and left carotid artery was performed and then stent grafts were inserted via an antegrade route that covered the whole aortic arch and proximal descending thoracic aorta.
Aneurysm ; Aneurysm, Dissecting ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Brachiocephalic Trunk ; Carotid Arteries ; Chimera ; Humans ; Stents ; Transplants

Diffuse alveolar hemorrhage (DAH) is a relatively uncommon disorder that most often occurs in patients with systemic autoimmune or idiopathic disease. DAH may result from coagulation disorders, inhaled toxins, or infection. The principal histopathologic features of pulmonary capillaritis include capillary wall necrosis with infiltration by neutrophils, interstitial erythrocytes, and/or hemosiderin, and interalveolar septal capillary occlusion by fibrin thrombi. New inert materials such as polymerized silicones, artecoll is used as injectable aesthetic microimplants. They are still able to stimulate a clinically evident granulomatous reaction. The rate of allergic reaction is very low. We report the case of diffuse alveolar hemorrhage following administration of artecoll.
Capillaries ; Collagen ; Erythrocytes ; Fibrin ; Hemorrhage* ; Hemosiderin ; Humans ; Hypersensitivity ; Necrosis ; Neutrophils ; Polymers ; Silicones

BACKGROUND: Tissues for transplantation can save lives or restore essential functions. According to national policies and regulations, access to suitable transplantation, as well as the level of safety, quality, efficacy of donation, and transplantation of tissues, differ significantly between countries. We reviewed a few guidelines on tissue banking from the aspect of screening tests. In addition, four-year experience with screening panels for donated bones and donors at a tertiary hospital is introduced. METHODS: Seven national and international guidelines for screening tests for donors and donated tissues were reviewed. At our institution, screening tests for donation involve two steps. At retrieval, the first screening panel, including ABO/Rh typing, unexpected antibody screening, VDRL, HBsAg, anti-HBs, anti-HBc IgM, anti-HCV, anti-HIV, and microbiological cultures was performed. The second screening panel, including the same tests, except culture studies, was performed after 90 days. From 2008 to 2011, a total of 245 retrievals of bone tissue were performed and the screening panel results were analyzed. RESULTS: Mandatory screening serologic tests for living donors can differ according to local law or regulation and/or screening for endemic diseases. At our institution, among 245 donated bones for a period of four years, 61 bone tissues were discarded due to noncompliance for the second screening (n=32), contamination or no culture study results (n=9), abnormal serologic test results (n=8), and so on. CONCLUSION: Donor screening policies for tissue banking are various according to national laws or endemic disease status. Second screening tests with consideration of the window period should be adopted.
Adoption ; Bone and Bones ; Donor Selection ; Endemic Diseases ; Hepatitis B Surface Antigens ; Humans ; Immunoglobulin M ; Jurisprudence ; Living Donors ; Mandatory Testing ; Mass Screening ; Serologic Tests ; Social Control, Formal ; Tertiary Care Centers ; Tissue Banks ; Tissue Donors ; Transplants

Mullerian inhibiting substance (MIS) is a glycoprotein hormone produced by fetal Sertoli cells that causes regression of the Mullerian ducts in males during sexual differentiation. Cell lines derived from human ovarian epithelium and rodent Leydig cell tumors, which respond to MIS in growth inhibition assays and express the MIS type II receptors (MISR II). But the pathophysiological role of MIS in human ovarian neoplasia development has not yet been fully established. In order to understand its role in pathogenesis of ovarian neoplasia, the expression and localization of the MIS and MISR II were studied in 5 normal ovaries, 11 benign tumors, 9 borderline ovarian malignancies, 40 ovarian malignancies in paraffin embedded tissue and tissue microarrays by using immunohistochemical stain. The results were as follows; 1. The first staining for MIS and MISR II were detected in granulosa cells in primary follicles of normal ovary. Among the growing follicles, larger developing follicles stained more intensely than smaller follicles. 2. In benign ovarian tumors, 8 (72.73%) in MIS and 5 (45.45%) in MISR II out of 11 cases were stained. The intensity scores of staining were 1.18 in MIS and 0.64 in MISR II. 3. In borderline malignancies, 6 (66.67%) in MIS and 7 (77.78%) in MISR II out of 9 cases were stained. The intensity scores of staining were 0.89 in MIS and 1.22 in MISR II. 4. In ovarian malignancies, the expression of MIS and MISR II were 50% (9/18) and 50% (9/18) in epithelial, 92.30% (12/13) and 76.72% (10/13) in germ cell, and 88.9% (8/9) and 100% (9/9) in sex-cord stromal tumors. The intensity scores of MIS and MISR II expression were 0.72 and 0.72 in epithelial, 1.45 and 1.62 in germ cell, and 1.78 and 1.67 in sex-cord stromal tumors. 5. There was significant high expression of MIS and MISR II in non-epithelial (90.91%, 86.36%) than epithelial ovarian cancers (50%, 50%). The scores of expression intensity was also higher in non-elithelial cancers (MIS: 1.67 +/- 0.16 vs 0.72 +/- 0.20, p=0.003, MISR II: 1.64 +/- 0.20 vs 0.72 +/- 0.21, p=0.022). In conlusion, the expression of MIS and MISR II were not different according to the differentiation, but tissue type specific. The frequency of MIS and MISR II expression was higher in non-epithelial cancers, especially in sex-cord stromal tumors. The results of this experiment could be utilized as scientific basis of researches, furthermore clinical applications in diagnosis and treatment of non-epithelial ovarian malignancies.
Anti-Mullerian Hormone* ; Cell Line ; Diagnosis ; Epithelium ; Female ; Germ Cells ; Glycoproteins ; Granulosa Cells ; Humans ; Leydig Cell Tumor ; Male ; Mullerian Ducts ; Ovarian Neoplasms ; Ovary ; Paraffin ; Rodentia ; Sertoli Cells ; Sex Differentiation

BACKGROUND: For pretransfusion testing, ABO and D antigen tests along with unexpected antibody screening tests are performed. When unexpected antibodies are identified, selection for specific antigen-negative blood units is needed in order to ensure safety of transfusion. METHODS: A questionnaire survey was conducted from August 23 to September 10, 2012 in 36 medical institutes in order to evaluate the current status of management for specific antigen-negative blood units in Korea. The questionnaire consisted of a method for detection of unexpected antibodies, the number of antibodies identified in the last year, and the antigen tests performed for specific antigen-negative blood units. For the institutes where blood donations are obtained, we asked about the enrollment of donors for specific antigen-negative or rare blood types. RESULTS: Among the 36 institutes, antigen testing for specific antigen-negative blood units was performed in 20 institutes. Of the remaining 15 institutes, except for one institute which answered as not applicable, eight institutes requested blood units at blood centers and another seven institutes replaced antigen tests with crossmatching tests. Among the 21 institutes where blood donations are obtained, two institutes had enrolled donors for specific antigen-negative or rare blood types. CONCLUSION: For selection of specific antigen-negative blood units for recipients who have identified antibodies, standardization of antibody detection tests and antigen tests is needed. In addition, the accurate antigen frequency in the Korean population should be investigated and donors for specific antigen-negative or rare blood types should be enrolled and managed systematically. Following these efforts, practical measures for obtaining specific antigennegative blood units could be suggested for medical institutes in Korea.
Academies and Institutes ; Antibodies ; Blood Donors ; Humans ; Korea* ; Mass Screening ; Methods ; Tissue Donors ; Surveys and Questionnaires

BACKGROUND: CD36 deficiency was first identified in a patient who showed refractoriness to HLA-matched platelet transfusion. CD36 deficiency can be divided into two subgroups. The type I phenotype is characterized by platelets and monocytes exhibiting CD36 deficiency. The type II phenotype lacks surface expression of CD36 in platelets only. In this study, the frequency of type I and type II CD36 deficiency in Koreans was evaluated. METHODS: A total of 220 samples were randomly selected from subjects who requested CBC testing from August 2013 to February 2014. The expression levels of CD36 on platelets and monocytes were analyzed by flow cytometry using FITC-conjugated CD36 antibodies. Correlation between the median fluorescence intensity of CD36 and the number of platelets or monocytes was evaluated using Pearson's correlation coefficient. RESULTS: Type I phenotype, lacking CD36 on platelets and monocytes, was present in 0.9% and type II, lacking CD36 on platelets, was present in 3.2%. The median fluorescence intensity of CD36 did not show correlation with the count of platelets or monocytes. CONCLUSION: Type I subjects may produce alloantibodies against CD36 following transfusion or pregnancy, leading to refractoriness to HLA-matched platelet transfusion, post-transfusion purpura, or neonatal immune thrombocytopenia. Studies to determine exact frequency of CD36 deficiency in Koreans, including a larger population, should be conducted, and more case reports on patients immunized against CD36 are also needed in order to elucidate the clinical importance and relevance of CD36 deficiency testing and the transfusion of CD36-deficient platelets.
Antibodies ; Blood Platelets ; Flow Cytometry ; Fluorescence ; Humans ; Isoantibodies ; Monocytes* ; Phenotype ; Platelet Transfusion ; Pregnancy ; Purpura ; Thrombocytopenia