We recently experienced a case of an elderly patient with mediastinal abscess, which is a rare complication of esophageal perforation, in whom dyspnea, chest pain and odynophagia were main clinical symptoms after eating cooked fish. During evaluation, upper mediastinal widening, with air-fluid level, and eaophageal perforation plugged with pus were detected by chest X-ray films and endoscopic examinatien. After draining of pus(about 300 cc) through the perforation site by careful manipulation of endoscope, inner wall of abacess cavity communicating with esophagus could be observed through esophago-mediastinal fistula. For further management, drainage procedure of mediastinal abscess, esophageal diversion and feeding gastrostomy were done.
Abscess* ; Aged ; Chest Pain ; Drainage ; Dyspnea ; Eating ; Endoscopes ; Esophageal Perforation* ; Esophagus ; Fistula ; Gastrostomy ; Humans ; Suppuration ; Thorax ; X-Ray Film

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Temporal Bone*

The gastric adenoma, which is also called as borderline epithelial lesion, dysplasia, atypical epithelial lesion, is occasionally encoutered during gastroscopy, but the natural history of a gastric adenoma has not been clarified in view of the pre-melignant potential. In Korea, there has been few report for its gastroscopic feature, gastroscopic diagnostic accuracy, or loag-term clinical follow-up yet. (continue...)
Adenoma* ; Follow-Up Studies* ; Gastroscopy ; Korea ; Natural History

Malignant germ cell tumore occur in children and young women in reproductive age, of all the germ cell maligaanci orily pure dysgerminiomas had a high cure rate prior to 1970. This was due to the exquisite wdioseneitivity of these tumors. Multiple agent chemotherapy has dramatieally improved the pr nosis af patients with malignant ovarian germ cell tumors. The purpose of this study is to report the experience at Aaan Medical Center, department of Obstetrics and Gynecology, in 16 patients withmalignant ovarian germ cell tumors treated between July, l989 and June, l994. We analyzed the effect of age, histolagic subtype, FIGO stage, surgical pmcedurse and regimens of chemotherapy, on the prognosis of thwe tumors. The results obtained were as follows: 1. In histologic subtypes, dysgenninoma(38.0%), endodermal sinus tumor(25.0%), squamous cell carcinoma arising in mature cystic teratoma(19.0%), mixed cell tumor(6.0%), immature teratoma(6.0%), malignant ectodermal tumor in mature cystic teratoma(6.0%), were counted in order. 2. No site predilection was identifed. 3. Main initial symptoms were abdominal distension(31.0%), abdominal pain(31.0%), abdominal mass palpation(25.0%), amenorrhea(6.0%) in order. 4. Multiple tumor markers were considered to be useful in diagnosis and follow up of malignant germ cell tumors of ovary. 5. The mean age of malignant ovarian germ cell tumors was 29.5 years, and 11 cases(69.3%) of tumors under the age of 30.0 years. 6. The survival rate seemed to be decreased with advancing FIGO stage.
Carcinoma, Squamous Cell ; Child ; Diagnosis ; Drug Therapy ; Ectoderm ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Prognosis ; Survival Rate ; Biomarkers, Tumor

Embryos of most mammalian species grown in vitro would undergo developmental arrest at the approximate time of genomic activation. Stage-specific cell block and the resulting rapid loss of embryo viability in conventional culture media have limited the duration for which embryos may be cultured prior to transfer. As a result, embryos are usually transferred to the uterus at the 4-to 8-cell stage to avoid the loss of viability associated with long-term in vitro culture. Early transfer has led to asynchrony of the endometrium-trophectoderm interaction at the time of implantation and a resultant reduction in the rate of implantation. To overcome these problems, a variety of co-culture systems has been devised in which embryos can develop for a longer period prior to embryo transfer. Vero cells, derived from African green monkey kidney, share a common embryologic origin with cells from the genital tract. In addition, they are potentially safe to use, since they are highly controlled for viruses and other contaminants. Therefore, co-culture using Vero cells has been widely utilized to enhance embryo viability and development, although not without controversies. We thus designed a series of experiments to demonstrate whether Vero cells do indeed enhance mouse embryo development as well as to compare the efficacy of co-culturing mouse 1-cell embryos on Vero cell monolayer in both Ham's F-10 and human tubal fluid (HTF) culture media. 1-cell stage ICR mouse embryos were cultured either in the presence of Vero cells (Group A) or in conventional culture medium alone (Group B). In Ham's F-10 significantly more 3-to-8cell embryos developed in group A than group B (59.8 versus 10.0%; F<0.01). In contrast, there was no significant difference in embryonic development both group A and group B in HTF. However, significant differences were noted only in later embryonic stage (13 and 0%; p<0.05 of group A and B respectively, hatching or hatched). In Ham's F-10, we also could observe the beneficial effect of Vero cell on hatching process (70.7 and 42.1%; p<0.05 of group A and group B respectively).
Animals ; Cercopithecus aethiops ; Coculture Techniques* ; Culture Media ; Embryo Transfer ; Embryonic Development* ; Embryonic Structures* ; Female ; Humans ; Kidney ; Mice* ; Mice, Inbred ICR ; Pregnancy ; Uterus ; Vero Cells*

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

OBJECTIVE: To assess the effect of recombinant human leukemia inhibitory factor on in vitro development of 1-cell ICR mouse embryo. MATERIALS AND METHOD: ICR mice were superovulated with PMSG/hCG and 1-cell stage mouse embryos were recruited. 1-cell mouse embryo were cocultured on human oviductal cells in a CO2 incubator (coculture group) and were cultured on 0.4% BSA+HTF media (control group). And anti-hLIF Ab was added the cocultured group in a different concentration (1pg, 10pg, 100pg, 1ng) and developmental rate was compaired to the control group, and rhLIF was added to the preincubated 0.4% BSA+HTF media in a different concentration (2000U, 1000U, 100U, 10U) and its developmental rate was compaired to group which was cultured on 0.4% BSA+HTF media only. RESULT: 1. The cleavage rate of 2-cell mouse embryo co-cultured with human tubal epithelial cell was significantly higher than that of cultured with media alone (HTF with 0.4% BSA) (p<0.05). 2. When LIF antibody was added to the medium with human tubal epitherlial cell, the mouse embryo could not cleave more than 2-cell in 1 ng of LIF antibody, and less than 1 ng, the cleavage rate was lower than cultured without LIF antibody group(p<0.05). 3. Two cell blocked ICR mouse embryos were developed into four cells under LIF(p<0.05), but no further development was observed. CONCLUSIONS: These results shows that LIF enhances the development of preimplantation embryo, and when rhLIF is applicated in vitro, it has positive effects on the development of early mouse embryo and can help overcoming the two-cell block.
Animals ; Blastocyst* ; Coculture Techniques* ; Embryonic Structures ; Epithelial Cells ; Humans ; Incubators ; Leukemia Inhibitory Factor* ; Leukemia* ; Mice ; Mice, Inbred ICR ; Oviducts

OBJECTIVE: To evaluate the effect of different kind of abdominal corsets on pulmonary function and energy consumption in the patients with cervical spinal cord injury. METHOD: Five subjects with quadriplegia due to cervical spinal cord injury were enrolled. A quantitative evaluation of vital capacity, tidal volume, and oxygen consumption was done using K4b2 (COSMED, Italy) under following six conditions; 1) supine position without abdominal corset, 2) sitting position without abdominal corset, 3) supine position with non-elastic abdominal corset, 4) sitting position with non-elastic abdominal corset, 5) supine position with elastic abdominal corset, 6) sitting position with elastic abdominal corset. Wilcoxon signed-rank test was applied for statistical assessment of group difference. RESULTS: Vital capacity and tidal volume in the condition with elastic abdominal corset were significantly increased than those of the condition without corset (p<0.05) or of the condition with non-elastic corset (p<0.01) in both sitting and supine position. Vital capacity and tidal volume in the condition with non-elastic abdominal corset were significantly decreased than those of the condition without corset (p<0.05) in both sitting and supine position. Oxygen consumption was least in the condition with elastic abdominal corset (p<0.05). CONCLUSION: These results demonstrated that the elastic abdominal corset is beneficial in improving the efficiency of breathing for the patients with cervical spinal cord injury. However, non-elastic abdominal corset is harmful to these patients.
Evaluation Studies as Topic ; Humans ; Oxygen Consumption* ; Oxygen* ; Quadriplegia ; Respiration ; Spinal Cord Injuries ; Supine Position ; Tidal Volume ; Vital Capacity