OBJECTIVE: This study was carried out to evaluate the effect of the isolation methods of inner cell mass from mouse blastocyst, types of feeder cells and treatment time of mitomycin C on the formation rate of ICM colony. METHODS: The inner cells were isolated by conventional immunosurgery, partial trophoblast dissection with syringe needles and whole blastocyst co-culture method. Commercially available STO and primary cultured mouse embryonic fibroblast (pMEF) feeder cells were used, and mitomycin C was treated for 1, 2 or 3 hours, respectively. The formation rate of ICM colony was observed after isolation of ICM and culture of ICM on the feeder cells for 7 days. RESULT: The ICM colony formation rate on STO were significantly higher in partial trophoblast dissection group (58%) than that in immunosurgery (12%) or whole blastocyst culture (16%) group (p<0.05). The formation rate on pMEF feeder layer was higher in partial trophoblast dissection (88%) and whole blastocyst culture (82%) group than that in immunosurgery (16%) group (p<0.05). When mitomycin C treated to pMEF for 2 hours, the formation rate of 88% was significantly higher than those of other conditions. CONCLUSIONS: Above results showed that the efficient isolation method of ICM from blastocyst was the partial trophoblast dissection and the appropriate treatment time of mitomycin C was 2 hours. However, the subculture of ICM colony and characterization of stem cells should be carried out to confirm the efficacy of the partial trophoblast dissection method.
Animals ; Blastocyst ; Coculture Techniques ; Feeder Cells* ; Fibroblasts ; Mice* ; Mitomycin* ; Needles ; Stem Cells ; Syringes ; Trophoblasts

Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.
Aspergillosis ; Autopsy ; Biopsy* ; Candidiasis ; Cytomegalovirus ; Diagnosis ; Early Diagnosis ; Humans ; Immunosuppression ; In Situ Hybridization ; Liver Transplantation ; Liver* ; Lymphoproliferative Disorders ; Mortality ; Primary Graft Dysfunction ; Prognosis ; Thrombosis ; Tissue Donors ; Transplants

Hallux valgus is a deformity characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. When planning an operative treatment, it is important to realize that the deformity is tridimensional and diverse. Operative techniques include medial eminence resection, distal soft tissue procedure, first metatarsal osteotomy (distal, diaphyseal, proximal, or multiple), proximal phalanx osteotomy, arthrodesis (first metatarsophalangeal or metatarsocuneiform joint), and so on. Among these techniques, osteotomy is the main procedure for correcting the hallux valgus. The objective of this article is to describe the characteristics and recent advancements made for corrective osteotomies in the hallux valgus. The pathophysiology of the hallux valgus is also described.
Arthrodesis ; Congenital Abnormalities ; Hallux Valgus* ; Hallux* ; Median Eminence ; Metatarsal Bones ; Osteotomy* ; Toes

Intussusception is a relatively common disease in children, but it is a rare clinical entity in adults. More than 80% of all patients with intussusception are less than two years of age, but adults account for only 5 to 10 percent of all intussusception cases. The significance of this disease in the aspect of statistics is mentioned as "rule of fives", which means 5% of all intussusceptions occur in adults, and it accounts for up to 5% of all cases of bowel obstruction in adults. In children, classic symptoms include episodic abdominal pain, "current-jelly" stool and a sausage-shaped abdominal mass on examination. However, in adults, it is likely to appear with non-specific gastrointestinal trouble without classic symptoms. Therefore, it is very important to use early diagnositic tool. In contrast to childhood intussusception, which is idiopathic in 90% of cases, adult intussusception has a definable lesion in more than 90% of cases 3). Tumors, both benign and malignant, are the most frequent cause of intussusecption in adults. We experienced seven cases of adult intussusception at Inha hospital from Jan. 1994 to Dec. 1997. The patients of adult intussusception are classified as three cases of ileoileal type and four ileocecal type. There were no specific signs or symptoms with patient experienced. It included abdominal pain, diarrhea and palpable mass. Their diagnosis was made in six patients using abdominal CT scan. It is difficult to define a diagnosis preoperatively, because the symptom of adult intussusception are variable and insignificant among individuals. We had been taken the final diagnostic tool with the abdominal CT scan in six of seven patients, which revealed "target lesions" in all cases. So, it is useful in the diagnosis of adult intussusception. Bowels were resected for the treatment of adult intussusception. The extent of the resection was contained the lesion and the defunctioned segments. The operations were performed as four segmental resections of small bowel and three ileocecal resections. The pathological findings were disclosed as three tumors, three lymphadenopathies and a adhesion of bowel. We concluded that the abdominal CT scanning is a usefull diagnostic tool in the diagnosis of adult intussusception.
Abdominal Pain ; Adult* ; Child ; Diagnosis ; Diarrhea ; Humans ; Intussusception* ; Tomography, X-Ray Computed*

Acute suppurative thyroiditis(AST) and thyroid abscess are uncommon in children. The remaining pyriform sinus tract with fistula is well known underlying abnormality of AST in pediatric patients. AST or thyroid abscess in children can be caused by infection through pyriform sinus fistulae which usually originate from the tip of the left pyriform sinus. The left-sided predominance of involvement and frequent recurrence are characteristic findings. We present a case history that include a left sided thyroid lesion of a 5-year-old girl and radiologic evidence of pyriform sinus fistula. The pus culture revealed the bacterial etiology as Staphylococcus epidermidis. Our discussion focused on the etiology and the management of AST and thyroid abscess in children.
Abscess ; Child ; Child, Preschool ; Female ; Fistula ; Humans ; Pyriform Sinus ; Recurrence ; Staphylococcus epidermidis ; Suppuration ; Thyroid Gland ; Thyroiditis, Suppurative*

To evaluate the significance of placental histology, a collaborative histological and cytogenetic study was performed on the products of 88 spontaneous abortions, and subsequently bcl-2 immunostaining was performed on 62 cases. The morphometric parameters included were DCIRCLE, FORMSHAPE, CPRATIO, and the expression of bcl-2 immunostainig was graded in four categories (I to IV). The results were as follows: 1) 40% (n=35) were chromosomally abnormal: trisomies predominated (57%, n=20) and was followed by triploidy (14%, n=5), double trisomy (6%, n=2), monosomy X (6%, n=2), inversion (9) (6%, n=2). 2) mean of DCIRCLE in chromosomally abnormal pregnancy was 40 micrometer larger than that in chromosomally normal pregnancy (p=0.012, one side t-test), while no difference was found in FORMSHAPE and CPRATIO between chromosomally abnormal and normal pregnancy. 3) bcl-2 expression was found in syncytiotrophoblast and cytotrophoblast. bcl-2 expression was weaker in chromosomally abnormal pregnancy with intensity I and II of 59% than chromosomally normal pregnancy with intensity I and II of 24%. 4) In comparison bcl-2 expression with DCIRCLE, in chromosomally normal abortion one (10%) in I & II and one (3%) in III & IV showed large DCIRCLE (above 360 micrometer), while 11 (85%) in I & II and 3 (33%) in III & IV in chromosomally abnormal pregnancy. It would mean that bcl-2 protein is necessary in preservation of pregnancy and placental morphology. Abnormal villous diameter and weak bcl-2 expression may be suggestive of chromosomal anomaly. Besides other histologic parameters, application of bcl-2 immunostaining and morphometric analysis probably give more sensitive and specific results in identifying chromosomally abnormal abortion.
Abortion, Spontaneous ; Cytogenetics ; Female ; Humans ; Placenta* ; Pregnancy* ; Triploidy ; Trisomy ; Trophoblasts ; Turner Syndrome

BACKGROUND: Results of limb lengthening in patients with achondroplasia were previously reported in many studies. However, the reports of comparison among the three long bones (femur, tibia, and humerus) are rare, especially for the results of crossed lengthening (lengthening of one femur and contralateral tibia followed by that of the opposite side) for the lower limbs. The purpose of this study was to report the surgical results of a series of limb lengthening in achondroplastic or hypochondroplasia patients at our institution. METHODS: Fifteen patients (14 with achondroplasia and 1 with hypochondroplasia) underwent lower limb lengthening of the femur (n = 32) and tibia (n = 28), and 12 of them underwent crossed lengthening. Humeral lengthening was performed in 14 patients (n = 28). The mean age at the first operation was 11.7 years, and the mean follow-up duration was 66.7 months. The healing index, consolidation period index (duration of consolidation period/gained length), and other radiographic indices were analyzed. Limb length discrepancy and hip-knee-ankle alignment in lower limbs, and the occurrence of difficulties were assessed. RESULTS: The average gain in length for the femur, tibia, and humerus was 8.3 cm, 8.5 cm, and 7.4 cm, respectively. The mean healing index was 29.6 days/cm for the femur, 29.0 days/cm for the tibia, and 27.2 days/cm for the humerus. The mean consolidation period index was 14.7 days/cm for the humerus, which was significantly lower than that in the lower limb (17.3 days/cm for the femur and 17.8 days/cm for the tibia). Of the 12 who underwent crossed lengthening, five showed limb length discrepancy ≥ 1.0 cm. Among their 24 lower limbs, three showed valgus alignment ≥ 5° and one showed varus alignment ≥ 5°. Thirty-two pin site infections and three fractures were conservatively managed. Three femoral fractures, eight equinus deformities, and four cases with premature consolidation of the fibula were surgically treated. Obstacle and true complication related to humeral lengthening were not observed. CONCLUSIONS: Humeral lengthening was relatively effective and safe. Careful attention will be needed to avoid the occurrence of limb length discrepancy or malalignment in crossed lengthening.
Achondroplasia ; Equinus Deformity ; Extremities ; Femoral Fractures ; Femur ; Fibula ; Follow-Up Studies ; Humans ; Humerus ; Lower Extremity ; Osteogenesis, Distraction ; Tibia

Background: Different from adults, adolescents with genu varum or valgum can be treated with hemi-epiphysiodesis. We conducted a study to report our recent experience of treating idiopathic genu varum and valgum with clinical relevance to planning of hemi-epiphysiodesis. The aim of this study was to compare the varus and valgus groups focusing on the contribution of the distal femur and proximal tibia to the deformities. Methods: Among patients who visited the outpatient clinic during the recent 4 years, adolescents with genu varum (the varus group) or valgum (the valgus group) greater than 5° were included. The mechanical lateral distal femoral angle (mLDFA) and medial proximal tibial angle (MPTA) were measured. The contribution to deformity (%) in each of the distal femur and the proximal tibia was calculated. Results: One hundred twenty patients and their 120 legs (randomly selected in bilateral cases) were included. In the varus group (n = 51), the mean hip-knee-ankle alignment was varus 7.1° (range, 5.1°–12.1°). The contribution to deformity was 74.1% ± 27.6% at the proximal tibia (MPTA, 81.9° ± 2.0°) and 14.9% ± 25.1% at the distal femur (mLDFA, 88.1° ± 1.7°). In the valgus group (n = 69), the mean alignment was valgus 6.6° (range, 5.1°–11.9°). The contribution was 69.8% ± 30.8% at the distal femur (mLDFA, 82.4° ± 2.1°) and 33.1% ± 27.8% at the proximal tibia (MPTA = 89.2° ± 1.9°). In subgroup analyses, the MPTA was significantly lower in the varus ≥ 8.4° group than the varus < 8.4° group. The mLDFA was significantly lower and the frequency of MPTA > 91.5° was significantly higher in the valgus ≥ 7.7° group than the valgus < 7.7° group. Conclusions Genu varum was mainly associated with deformity of the proximal tibia, whereas genu valgum was related to deformities of the distal femur and proximal tibia. Considering the predominant deformity of the proximal tibia, performing hemiepiphysiodesis only at the proximal tibia is ideal in most adolescents with genu varum.

Background: Different from adults, adolescents with genu varum or valgum can be treated with hemi-epiphysiodesis. We conducted a study to report our recent experience of treating idiopathic genu varum and valgum with clinical relevance to planning of hemi-epiphysiodesis. The aim of this study was to compare the varus and valgus groups focusing on the contribution of the distal femur and proximal tibia to the deformities. Methods: Among patients who visited the outpatient clinic during the recent 4 years, adolescents with genu varum (the varus group) or valgum (the valgus group) greater than 5° were included. The mechanical lateral distal femoral angle (mLDFA) and medial proximal tibial angle (MPTA) were measured. The contribution to deformity (%) in each of the distal femur and the proximal tibia was calculated. Results: One hundred twenty patients and their 120 legs (randomly selected in bilateral cases) were included. In the varus group (n = 51), the mean hip-knee-ankle alignment was varus 7.1° (range, 5.1°–12.1°). The contribution to deformity was 74.1% ± 27.6% at the proximal tibia (MPTA, 81.9° ± 2.0°) and 14.9% ± 25.1% at the distal femur (mLDFA, 88.1° ± 1.7°). In the valgus group (n = 69), the mean alignment was valgus 6.6° (range, 5.1°–11.9°). The contribution was 69.8% ± 30.8% at the distal femur (mLDFA, 82.4° ± 2.1°) and 33.1% ± 27.8% at the proximal tibia (MPTA = 89.2° ± 1.9°). In subgroup analyses, the MPTA was significantly lower in the varus ≥ 8.4° group than the varus < 8.4° group. The mLDFA was significantly lower and the frequency of MPTA > 91.5° was significantly higher in the valgus ≥ 7.7° group than the valgus < 7.7° group. Conclusions Genu varum was mainly associated with deformity of the proximal tibia, whereas genu valgum was related to deformities of the distal femur and proximal tibia. Considering the predominant deformity of the proximal tibia, performing hemiepiphysiodesis only at the proximal tibia is ideal in most adolescents with genu varum.

Background: Different from adults, adolescents with genu varum or valgum can be treated with hemi-epiphysiodesis. We conducted a study to report our recent experience of treating idiopathic genu varum and valgum with clinical relevance to planning of hemi-epiphysiodesis. The aim of this study was to compare the varus and valgus groups focusing on the contribution of the distal femur and proximal tibia to the deformities. Methods: Among patients who visited the outpatient clinic during the recent 4 years, adolescents with genu varum (the varus group) or valgum (the valgus group) greater than 5° were included. The mechanical lateral distal femoral angle (mLDFA) and medial proximal tibial angle (MPTA) were measured. The contribution to deformity (%) in each of the distal femur and the proximal tibia was calculated. Results: One hundred twenty patients and their 120 legs (randomly selected in bilateral cases) were included. In the varus group (n = 51), the mean hip-knee-ankle alignment was varus 7.1° (range, 5.1°–12.1°). The contribution to deformity was 74.1% ± 27.6% at the proximal tibia (MPTA, 81.9° ± 2.0°) and 14.9% ± 25.1% at the distal femur (mLDFA, 88.1° ± 1.7°). In the valgus group (n = 69), the mean alignment was valgus 6.6° (range, 5.1°–11.9°). The contribution was 69.8% ± 30.8% at the distal femur (mLDFA, 82.4° ± 2.1°) and 33.1% ± 27.8% at the proximal tibia (MPTA = 89.2° ± 1.9°). In subgroup analyses, the MPTA was significantly lower in the varus ≥ 8.4° group than the varus < 8.4° group. The mLDFA was significantly lower and the frequency of MPTA > 91.5° was significantly higher in the valgus ≥ 7.7° group than the valgus < 7.7° group. Conclusions Genu varum was mainly associated with deformity of the proximal tibia, whereas genu valgum was related to deformities of the distal femur and proximal tibia. Considering the predominant deformity of the proximal tibia, performing hemiepiphysiodesis only at the proximal tibia is ideal in most adolescents with genu varum.