No abstract available.
Nasal Surgical Procedures*

OBJECTIVE: To compare the clinical outcomes of patients with vitrified-thawed embryos transferred using either the 0.25 mL straw method and the pull and cut straw (PNC) method. To evaluate the clinical outcomes of patients with transferred embryos that underwent assisted hatching at the cleaved embryo (day 3) or the blastocyst (day 5) stage. METHODS: The study population consisted of women who underwent vitrified-warmed embryo transfer between May 2000 and December 2011 and assisted hatching was performed after warming of embryos. Cycles of thawing between assisted hatching treated and non treated groups were compared for survival and pregnancy rates. RESULTS: The PNC vitrification method improved survival and pregnancy rates in partial lysed embryos. While assisted hatching did not affect the developmental and clinical pregnancy rates of the vitrified-warmed blastocyst group, it did increase the pregnancy rate of poor quality vitrified-warmed cleaved embryos. CONCLUSION: These results suggest that PNC may increase the number of clinical pregnancies via the vitrification of both cleaved embryos and blastocysts. In addition, selective assisted hatching treatment of embryos that show a poor prognosis after warming may increase the rate of clinical pregnancy.
Blastocyst ; Embryo Transfer ; Embryonic Structures ; Female ; Humans ; Pregnancy ; Pregnancy Rate ; Prognosis ; Vitrification

G and P tying of group A porcine rotaviruses (P(o)RV) from field fecal samples were performed using reversetranscriptase polymerization chain reaction (RT-PCR) and restriction fragment length polymorphism (RFLP) analysis. After amplifying full length VP7 and partial length VP4 genes, restriction endonucleases were used to digest and analyze the cutting pattern of the gene products. After analysis of digests with restriction endonucleases, seven and six RFLP types were observed for VP7 and VP4, respectively. The G typing analysis of 50 fecal samples revealed that 68% (34/50) were G4, which included G4-like (22/50); 22% (11/50) were G5; 6% (3/50) were G4 and G5 mixed types. The P typing analysis of the same fecal samples revealed that 36% (18/50) were P2B, 52% (26/50) were P9, 1 sample (2%) was a mixture of P2B and P9. Combinations of G and P types, the G4P2B and G4P9 types including G4-like accounted for 26% (13/50) and 32% (16/50), respectively. The G5P2B and G5P9 type also represented 4% (2/50) and 18% (9/50) of the samples. No G3 and G11 or other new P types were identified from the samples tested. Information on the G and P types and G/P combinations in the field fecal samples is useful for developing more effective PoRV vaccines and understanding the epidemiology of PoRV infections in the field.
DNA Restriction Enzymes ; Epidemiology ; Polymerization ; Polymers ; Polymorphism, Restriction Fragment Length* ; Rotavirus* ; Vaccines

Current guidelines recommend sorafenib as the first-line molecular target agent for advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis and unresectable HCC. Sorafenib was reported to show survival benefit for patients with advanced HCC. However, complete response is extremely rare in patients treated with sorafenib. Here, we report a 52-year-old man with advanced HCC and pulmonary metastasis who showed complete response by sequential transarterial chemoembolization and continuous sorafenib. Complete response was sustained for 53-month until now.
Carcinoma, Hepatocellular* ; Humans ; Middle Aged ; Neoplasm Metastasis*

PURPOSE: To investigate the incidence, clinical manifestations, and risk factors of ocular graft-versus-host disease (GVHD) as well as the survival of the patients after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: The medical records of 99 patients who visited our clinic and were screened for ocular GVHD after allogeneic HSCT were reviewed retrospectively. Subjects were divided into 2 groups depending on the occurrence of ocular GVHD on slit-lamp biomicroscopy. We compared clinical manifestations and survival between the 2 groups and analyzed the risk factors associated with the development of ocular GVHD. RESULTS: Ocular GVHD was diagnosed in 38 patients (38.38%) at a mean of 315 days after HSCT. Out of the 38 patients who developed ocular GVHD, 22 patients (57.89%) were diagnosed with dry eye only and 16 patients (42.11%) were diagnosed with conjunctival disease. The presence of extraocular GVHD (hazard ratio (HR) 35.76, p < 0.001), the number of extraocular GVHD (HR 3.07, p < 0.001), skin GVHD (HR 2.31, p = 0.029), oral GVHD (HR 8.16, p < 0.001), and gastrointestinal tract GVHD (HR 5.00, p = 0.002) were independent risk factors of ocular GVHD. Comparisons of the survival demonstrated decreased survival of patients with conjunctival disease compared to patients without ocular GVHD and patients with dry eye only, but there was no statistically significant differences (log rank test, p = 0.208). CONCLUSIONS: Ocular GVHD is common after allogeneic HSCT. The majority of ocular GVHD occurs in the chronic stage and is associated with decreased survival. Therefore, more intensive and long-term follow-up with ophthalmic and systemic monitoring is necessary, especially in patients who have extraocular GVHD, for early recognition and proper treatment of ocular GVHD.
Conjunctival Diseases ; Follow-Up Studies ; Gastrointestinal Tract ; Graft vs Host Disease* ; Hematopoietic Stem Cell Transplantation* ; Humans ; Incidence ; Medical Records ; Retrospective Studies ; Risk Factors* ; Skin

BACKGROUND: The most consistent chromosomal abnormality in ependymomas, is loss of 22q (17-75%) and gain of 1q (0-50%). However, significance of this abnormality is uncertain. METHODS: Genomic imbalances in 27 Korean ependymomas, including 21 low grade ependymomas, 4 anaplastic and 2 myxopapillary ependymomas, were analyzed by degenerate oligonucleotide primed-PCR-comparative genomic hybridization. RESULTS: Common gains were found in 17 (63%), 20q (59%), 9q34 (41%), 15q24-qter (33%), 11q13 (30%), 12q23 (26%), 7q23-qter (26%), 16q23-qter (30%), 19 (26%), and 1q32-qter (22%). DNA amplification was identified in 12 tumors (44%). Chromosomal loss was a less common occurrence in our study, but was found in 13q (26%), 6q (19%), and 3 (11%). CONCLUSION: The recurrent gains or losses of the chromosomal regions which were identified in this study provide candidate regions that may be involved in the development and progression of ependymomas.
Chromosome Aberrations ; Comparative Genomic Hybridization ; DNA ; Ependymoma* ; Nucleic Acid Hybridization* ; Polymerase Chain Reaction

Pyrolysis of tissue in a hypoxic environment can produce carbon monoxide. Peritoneal cavity is hypoxic during laparoscopic cholecystectomy by insufflation with 100% carbon dioxide, then, carbon monoxide is produced by electrocautery of tissue. To determine whether carbon monoxide was being absorbed in dangerous amounts to patients and operating room workers, blood was analyzed for carboxyhemoglobin in patients and their operators. Twenty-one patients undergoing this procedure, sampling the insufflation gas before, after use of electrocautery analyzed for carbon monoxide. Carbon monoxide was present in the peritoneal cavity, 5 min after use of electrocautery at a median concentration of 430 ppm(range 20~1000 ppm), and at the end of surgery at a median concentration of 174 ppm(range 10~720 ppm). This is well in excess of the 35 ppm upper limit for a 1-hr exposure set by the Environmental Protection Agency in U.S.A.. The patients carboxyhemoglobin concentrations(mean +/- SD) at the beginning, at the end and 3 hrs after surgery were 0.51+/-0.30%, 0.41%+/-0.28%, and 0.45%+/-0.74%, respectively. The operator's carboxyhemoglobin concentrations before and at the end of surgery were 1.12%+/-1.09% and 1.03%+/-1.03%, respectively. Although there was no evidence of significant absorption of carbon monoxide in these patients and operators, care should be taken to scavenge the gases produced by electrocautery of tissues to avoid operating room contamination during laparoscopic cholecystectomy.
Absorption ; Carbon Dioxide ; Carbon Monoxide* ; Carbon* ; Carboxyhemoglobin* ; Cholecystectomy, Laparoscopic* ; Electrocoagulation* ; Gases ; Humans ; Insufflation ; Operating Rooms ; Peritoneal Cavity ; United States Environmental Protection Agency

This retrospective analysis describes the clinical characteristics, treatment, and long-term outcome of 30 patients with axis fracture admitted to our institution between January 1991 and December 1995. The incidence of axis fracture was 27.2% in the 110 cervical spine fractures. Among these, odontoid process fracture was the most common type, 19 cases(63%) followed by 8 hangmans fractures(27%), 3 miscellaneous fractures(10%). Hangman's fractures, odontoid type III fractures and miscellaneous fractures were treated with external immobilization devices. Remaining 11 odontoid type II fractures, and six patients with dens dislocation of 6 mm or greater were initially treated by early surgical stabilization. Individuals with dens dislocated less than 6 mm were treated by external immobilization only. Among the nonoperative group of acute axis fractures, there was no fusion failure. In the early operated group, all patients were stable clinically or radiologically. But three patients with posterior wiring and bone graft complained of their neck motion limitation.
Axis, Cervical Vertebra* ; Dislocations ; Humans ; Immobilization ; Incidence ; Neck ; Odontoid Process ; Retrospective Studies ; Spine ; Transplants

BACKGROUND: Laryngoscopy and endotracheal intubation are potent stimuli that increase heart rate and blood pressure. Especially, hypertensive patients are more prone to have significant increase in heart rate and blood pressure and cardiac complications such as arrythmia, myocardial ischemia and infarction can lead to fatal situation. This study was designed to evaluate the effectiveness of different dosage of propofol on cardiovascular responses to tracheal intubation in hypertensive patients. METHODS: Sixty hypertensive patients, ASA PS 1 or 2, scheduled for elective surgery were selected randomly. They were divided into three groups(Group 1: propofol 2.0 mg/kg, Group 2: propofol 2.5 mg/kg, Group 3: propofol 3.0 mg/kg, n=20 in each group). Induction of Anesthesia was started with propofol 2.0 mg/kg(Group 1), 2.5 mg/kg(Group 2), 3.0 mg/kg(Group 3) and succinylcholine(1 mg/kg). After tracheal intubation, pancuronium bromide 0.08 mg/kg was injected, 50 % nitrous oxide in oxygen and 2 % enflurane were inhaled. Using noninvasive automatic blood pressure monitor(CRITIKON DINAMAP TM 1846SX, USA), blood pressure(systolic, diastolic, and mean arterial pressure) and heart rate were measured at 4 points; 1) as the control value, on arrival to operating room, 2) 1 minute after tracheal intubation, 3) 3 minutes after intubation, 4) 5 minutes after intubation. RESULTS:In group 3, systolic, diastolic pressure and mean arterial pressure at 1 minutes, 3 minutes, 5 minutes after intubation were less increased than group 1, 2 and blood pressure response was more effectively blunted than heart rate response CONCLUSIONS: we suggested that 3.0 mg/kg of propofol for the induction of anesthesia could blunt hemodynamic changes caused by laryngoscopy and endotracheal intubation in hypertensive patients, but we had to give attention to the side effect until postoperative period.
Anesthesia ; Anesthetics ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Enflurane ; Heart Rate ; Hemodynamics ; Humans ; Infarction ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Myocardial Ischemia ; Nitrous Oxide ; Operating Rooms ; Oxygen ; Pancuronium ; Postoperative Period ; Propofol*

Papillary endothelial hyperplasia(PEH), usually originates in extracranial soft tissue, is considered a reactive proliferation of endothlium and an unusual form of thrombus organization. However the occurance of PEH in the cranial cavity is very rare. The authors report a case of a PEH involving intracranial sella, parasella, cavernous sius, ethmoid and sphenoid sinus in an 11-year-old boy. The patient was presented with sudden right visual disturbance. Magnetic resonance image showed a well-enhanced mass in the right cavernous sinus extending into the ethmoid and sphenoid sinus. The cerebral angiography demonstrated a vigorous tumor staining supplied by both internal and external carotid arteries. The right fronto-temporal craniotomy and subtotal resection of the tumor were performed. The mass was comprised in a highly vascular red-black nodular tissue associated with a mixture of fresh and organizing thrombi. The histopathological examination revealed papillary structures lined by endothelium within vascular space with organized thrombus. While the patient was waiting for second operation in order to remove remaining small tumor in the ethmoid and sphenoid sinues, the lesion exhibited rapid regrowth and the size became to the preoperative size at three months after operation. At reoperation, gross total removal was accomplished by a combination of trans-cranial and trans-sphenoidal approaches. Postoperative radiotherapy was given.
Carotid Artery, External ; Cavernous Sinus* ; Cerebral Angiography ; Child ; Craniotomy ; Endothelium ; Humans ; Hyperplasia* ; Male ; Radiotherapy ; Reoperation ; Sphenoid Sinus* ; Thrombosis