OBJECTIVE Present study was aimed to verify the effect of granulocyte macrophage-colony stimulating factor (GM-CSF) in the preimplantation development of mouse embryos and the involvement of the mitogen activated protein kiase (MAPK) in the GM-CSF signaling. METHODS: Two-cell embryos were cultured for 96 h in the presence or absence of GM-CSF (0, 0.4, 2, 10 ng/ml) and PD98059, a MEK inhibitor (10 muM). Morphological development, cell number per blastocyst, and apoptotic nuclei, were eamined. MAPK activity of embryonic immunoprecipitate by MAPK (ERK1/2) antibody was measured by in vitro phosphorylation of myelin basic protein. RESULTS: At post hCG 122 h the embryonic development among the experimental groups was significantly different (p=0.018). The rate of blastocyst development and cell number per embryo were the highest in 2 ng/ml GM-CSF treatment group. The percent of apoptotic cells of the GM-CSF-treated embryos was the lowest among the group. in blastocysts, GM-CSF treatment transiently increased MAPK activity. PD098059 attenuated the effect of GM-CSF on the morphological development, increase in cell number per blastocyst, down regulation of apoptosis, and upregulation of MAPK activity, suggesting that activation of MAPK cascade possibly mediated the embryotropic effect of GM-CSF. CONCLUSION: This result suggested that GM-CSF potentiated the development of preimplantation mouse embryos by activation of MAPK.
Animals ; Apoptosis ; Blastocyst ; Cell Count ; Down-Regulation ; Embryonic Development ; Embryonic Structures* ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes* ; Mice* ; Myelin Basic Protein ; Phosphorylation ; Pregnancy ; Up-Regulation

Diagnostic angiographic evaluations were done in 33 patients with gastrointestinal bleeding for recent 5 yearsat Department of Radilogy, Seoul National University hospital. On 11 patients of them, therapeutic interventionalprocedures were made and the results were analysed. 1. In a total of 33 cases, there were 18 cases of upper GIbleeding and 15 cases of lower GI bleeding. The most frequent causes were peptic ulcer in the former andintestinal typhoid fever in the latter. 2. Bleeding sites were localized angiographically in 28 cases, so thedetection rate was 85%. Four of the five angiographically negative cases were lower GI bleeding cases. 3. The mostfrequent bleeding site was left gastric artery(7/33). The next was ileocecal branch of superior mesentericartery(6/33). 4. Among the 11 interventional procedures, Gelfoam embolization was done in 7 cases and Vasopressininfusion was tried in 4 cases. They were successful in 4 and 3 cases, suggesting 57% and 47% success ratesrespectively.
Diagnosis ; Gelatin Sponge, Absorbable ; Hemorrhage ; Humans ; Peptic Ulcer ; Seoul ; Typhoid Fever

Muscle herniation is a relatively common disorder in the extremities, particularly in the lower extremity where the tibialis anteior muscle is the most commonly affected. Usually muscle herniation is asymptomatic or mild but a few patients complain of cramping or severe pain. We report a case of a bilateral hernia of the tibialis anterior muscle that was confirmed by dynamic ultrasonography.
Diagnosis* ; Extremities ; Hernia ; Humans ; Lower Extremity ; Muscle Cramp ; Ultrasonography*

PURPOSE: The recommended treatments for iliac arterial occlusive disease are an endovascular procedure in TASC type A patients, but surgery in TASC type D patients. However, in TASC type B and C patients, more evidence is required to make any firm recommendations about the best treatments. This study aimed to evaluate the best treatments for patients classified using the TASC morphological stratification. METHOD: A retrospective review of the patients who had undergone stent insertion into iliac arterial occlusive lesions, between 1995 and 2004, at the Chonnam National University Hospital, was performed. All patients were also classified using the TASC morphologic stratification. The TASC type was determined from the initial peripheral angiography findings. Also, the stenosis-free patency was used as an objective end point to evaluate the hemodynamic outcome of stent insertion. RESULT: A total of 86 patients were included in the study. The number of patients classified as TASC types A, B, C and D were 1 25, 17, and 43, respectively. Stent insertion was successfully performed in all patients. The mean follow up period was 26 months. The 1-year stenosis-free patency rates were 94.4, 74.0, and 19.1% in TASC type B, C, and D, respectively. The 5-year patency rates were 50.4, 18.5, and 6.0% in TASC type B, C, and D, respectively. CONCLUSION: The TASC morphological stratification was a useful prognostic factor in relation to the short and long-term iliac stent patency. For TASC types B and C, more evidence and experience of endovascular therapy are needed to confirm the best treatment. For TASC type D, surgical treatment is strongly recommended.
Angiography ; Arterial Occlusive Diseases ; Consensus* ; Endovascular Procedures ; Follow-Up Studies ; Hemodynamics ; Humans ; Jeollanam-do ; Retrospective Studies ; Stents*

Traumatic anterior dislocation of the hip is rare. Bilateral traumatic anterior dislocation is an even rarer injury; indeed, only 5 cases have been reported in the English literature. We describe a case of a bilateral traumatic anterior dislocation of the hip and a concomitant unstable lumbar burst fracture following a mechanism of injury distinctly different from other reports.
*Accidents, Occupational ; Acetabulum/injuries ; Buttocks/*injuries ; Fractures, Bone/complications/etiology/radiography ; Hip Dislocation/etiology/*radiography ; Humans ; Lumbar Vertebrae/*injuries ; Lumbosacral Region/*injuries ; Male ; Middle Aged ; Spinal Fractures/etiology/*radiography

BACKGROUND: This study was desined to determine the efficacy and clincial usefulness of alfentanil and a combined use of alfentanil and esmolol for blunting hemodynamic responses after tracheal intubation in hypertensive patients who needed a rapid sequence induction. METHODS: Group 1 received alfentanil 15microgram/kg and group 2 received alfentanil 15microgram/kg and esmolol 1 mg/kg intravenously. Thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg were used for the induction of anesthesia. Changes in blood pressure and herat rate were measured during intubation and induction of anesthesia with enflurane-N2O-O2 and vecuronium. Rate pressure products (RPP) was calculated and the frequencies of hypertension, hypotension, tachycardia, bradycardia were measured. RESULTS: In group 1, systolic blood pressure increased significantly at 1, 2 minute and decreased significantly at 4, 5, 10, 15 minute compared to base, and diastolic blood pressure increased significantly at 1 minute and decreased significantly at 4, 5, 10 minute. Heart rate increased significantly at 1, 2 minute. In group 2, systolic blood pressure decrease significantly at 3, 4, 5 minute after tracheal intubation compared to base, and diastolic blood pressure increased at 1 minute and decreased at 4, 5, 10, 15 minute. HR did not change significantly (P < 0.05). CONCLUSION: In treated hypertensive patients, the use of a combination of alfentanil 15/kg and esmolol 1 mg/kg is a useful method to attenuate hemodynamic responses after endotracheal intubation and especially for rapid sequence induction.
Alfentanil* ; Anesthesia ; Blood Pressure ; Bradycardia ; Heart Rate ; Hemodynamics* ; Humans ; Hypertension ; Hypotension ; Intubation ; Intubation, Intratracheal* ; Succinylcholine ; Tachycardia ; Thiopental ; Vecuronium Bromide

PURPOSE: Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients. MATERIALS AND METHODS: Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected. RESULTS: Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis. CONCLUSION: Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.
Anthracyclines ; Cardiotoxicity ; Dexrazoxane ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Multivariate Analysis ; Neoplasms, Second Primary ; Risk Factors* ; Stem Cell Transplantation

Purpose: Renal tumors account for approximately 7% of all childhood cancers. These include Wilms tumor (WT), clear cell sarcoma of the kidney (CCSK), malignant rhabdoid tumor of the kidney (MRTK), renal cell carcinoma (RCC), congenital mesoblastic nephroma (CMN) and other rare tumors. We investigated the epidemiology of pediatric renal tumors in Korea. Materials and Methods: From January 2001 to December 2015, data of pediatric patients (0–18 years) newly-diagnosed with renal tumors at 26 hospitals were retrospectively analyzed. Results: Among 439 patients (male, 240), the most common tumor was WT (n=342, 77.9%), followed by RCC (n=36, 8.2%), CCSK (n=24, 5.5%), MRTK (n=16, 3.6%), CMN (n=12, 2.7%), and others (n=9, 2.1%). Median age at diagnosis was 27.1 months (range 0-225.5) and median follow-up duration was 88.5 months (range 0-211.6). Overall, 32 patients died, of whom 17, 11, 1, and 3 died of relapse, progressive disease, second malignant neoplasm, and treatment-related mortality. Five-year overall survival and event free survival were 97.2% and 84.8% in WT, 90.6% and 82.1% in RCC, 81.1% and 63.6% in CCSK, 60.3% and 56.2% in MRTK, and 100% and 91.7% in CMN, respectively (p < 0.001). Conclusion The pediatric renal tumor types in Korea are similar to those previously reported in other countries. WT accounted for a large proportion and survival was excellent. Non-Wilms renal tumors included a variety of tumors and showed inferior outcome, especially MRTK. Further efforts are necessary to optimize the treatment and analyze the genetic characteristics of pediatric renal tumors in Korea.