OBJECTIVE: To evaluate the clinical effect and reproductive outcome of pelviscopic ovarian drilling in infertile patients with polycystic ovarian syndrome resistant to clomiphene citrate. METHODS: Twenty two patients involved in this study were taken pelviscopic ovarian drilling with needle electrocautery. Change of characteristic LH/FSH ratio before and after operative treatment, ovulation and pregnancy success were followed up. Paired t-test was applied for hormonal change (p<0.05). RESULTS: Thirteen of 14 patients (93%) treated only with pelviscopic ovarian drilling showed successful ovulation with or without clomiphene citrate and among these 10 patients (71%) were success in pregnancy and 9 patients delivered full term babies. When including patients who needed other assisted reproductive technique and specific medication of endometriosis 17 of 22 patients (77%) were successfully pregnant and 15 patients (68%) delivered healthy babies. The mean LH/FSH ratio 2.0+/-0.5 before treatment were decreased to 1.26+/-0.37 after treatment (p<0.05). Interestingly, among 22 patients, various degree endometriosis were found during pelviscopy and specific medication with GnRH analogue were followed. CONCLUSION: Pelviscopic ovarian drilling showed successful ovulation rate and effective reproductive outcome in clomiphene-resistant infertile patients with PCO. This surgical technique seems to be an alternative step for the management of clomiphene-resistant infertile patients with PCO and also for the diagnosis of possible high rate of endometriosis in these patents.
Clomiphene* ; Diagnosis ; Electrocoagulation ; Endometriosis ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Needles ; Ovulation ; Polycystic Ovary Syndrome* ; Pregnancy ; Reproductive Techniques, Assisted

Two types of urine dipstick assays, Multistix-SG and Comber-9-Test RL, were compared for compatibility, accuracy, specificity and predictive values of a positive and negative test in 501 patients' urine and artificially prepared specimen. We found that the results of semiquantitative tests of Multistix-SG and Comber-9-Test RL performed were statistically similar in patients' specimen. The urinary leukocyte esterase tests of Comber-9-Test RL assays compared with urine sediment microscopy in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative test 83.7%, 48.1%, 90.3%, 47.4% and 90.1%, respectively. The urinary nitrite tests of Comber-9-Test RL assays compared with urine culture tests, in regard to compatibility, sensitivity, specificity, and predictive values of a positive and negative test were 90.3%, 19.4%, 84.7%, 53.8% and 94.1, respectively. For the urinary protein, the sulfosalicylic acid method was the most sensitive test for any kinds of protein, and Multistix-SG appeared more sensitive than Comber-9-Test RL for the albuminuria. For the urinary bilirubin and glucose, two dipstick assays were similar in their diagnostic efficiency. Finally in the urinary occult blood tests, Comber-9-Test RL assays was more sensitive than Multistix-SG.
Albuminuria ; Bilirubin ; Glucose ; Leukocytes ; Methods ; Microscopy ; Occult Blood ; Sensitivity and Specificity ; Urinalysis

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Dermatitis* ; Tacrolimus ; Tetracycline*

OBJECTIVE: Evaluation of embryos using early cleavage to 2-cell stage has been proposed, but a critical time-point for selecting embryos is unclear. The aim of the present study is to provide a guideline including critical time-point in the selection of early cleaving embryo for the reduction of multiple pregnancies as well as the increase of pregnancy rate in human IVF. METHODS: This prospective study was performed in 116 cycles from 85 patients who underwent conventional IVF or ICSI at the infertility clinic of Good Moonhwa Hospital from January 2002 to December 2003. Early cleavage (EC) of embryos to 2-cell stage was assessed at 25 h and 27 h postinsemination/microinjection. Embryos that had early cleaved at each time point were designated as EC-1 and EC-2, respectively, while others were designated as non-early cleavage (NEC). RESULTS: At least one early cleavage embryo was observed in 54 (46.6%) for the EC-1 and 84 (72.4%) for the EC-2 of the 116 cycles assessed. Clinical pregnancy rates (PR) were significantly higher in the EC-1 group (66.7%) compared to the EC-2 group (53.6%) or the NEC group (31.2%) (p<0.05). Significant improvement of the pregnancy rate was found when at least two or more embryos were early cleaved at 25 h postinsemination or when the proportion of early cleavage embryo at 25 h postinsemination was higher than 20% (p<0.05). CONCLUSIONS: The critical time-point for the selection of early cleavage embryos with high implantation potential is more effective in 25 h postinsemination/microinjection compared to 27 h. The proportion as well as number of early cleavage embryos is also an important factor for the prediction of pregnancy outcome and the chance of multiple pregnancies. These results demonstrated that the evaluation of early cleavage embryos to 2-cell stage is an easy, simple, and objective method for the selection of good quality embryos suitable for embryo transfer.
Embryo Transfer ; Embryonic Structures* ; Female ; Humans* ; Infertility ; Pregnancy Outcome ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Prospective Studies ; Sperm Injections, Intracytoplasmic

PURPOSE: This study was done using meta-analysis to examine 58 studies from studies published in the past eight years (2000 to 2007) that included variables related to adolescents' suicidal ideation. METHODS: The materials for this study were based on 32 variables which were selected from masters' thesis, doctoral dissertation and articles from Journals of the Korean Academy of Nursing. RESULTS: The classification consisted of 5 variables groups and 32 variables. In terms of effect size on risk, variables which were significant included psychological variables (0.668), socio-cultural variables (0.511), family environmental variables (0.405), school environmental variables (0.221), and personal characteristics variables (0.147). In terms of effect size on protection, variables which were significant included personal characteristics variables (-1.107), psychological variables (-0.526), family environmental variables (-0.264), and school environmental variables (-0.155). In terms of effect size on risk variables, psychological variables (0.668) were highest. In terms of effect size on protective variables, the variable of personal characteristic (-1.107) was the highest. CONCLUSION: While the results indicate possible risk and protective variables for suicidal ideation, but prediction is still difficult. Further study to compare adolescents with similar variables but no suicidal ideation and those with suicidal ideation is necessary.
Adolescent ; Family Relations ; Humans ; Risk Factors ; Socioeconomic Factors ; Stress, Psychological ; Suicide/*psychology

OBJECTIVE: A number of studies to improve in vitro culture conditions have been tried over past ten years by using co-culture system with helper somatic cells. However, the mechanism of coculture is poorly understood. This study was designed to understand the mechanism for the mode of actual action of co-culture system of ICR strain's 1-cell embryos with human oviduct epithelial cells by examining the effect of conditioned medium and contactless coculture using a cell culture insert on the embryo development and by measuring the level of superoxide anion from conditioned medium after co-culture. METHODS: ICR strain's zygote embryos were cultured in medium alone (control), coculture, conditioned medium, or contactless coculture system for 6 days. Conditioned media (CM) were prepared as following 5 groups. All CM were collected after culturing oviduct cells for 2 days. CM-1 was stored at -20degrees C until use, and CM-2 was prepared just before use as a culture medium. CM-3 was cocultured with embryos and retrieved just before use. CM-4 and CM-5 were derives from the microfilteration of CM-2 and CM-3, respectively, using Microcon-10 (10 kDa molecular weight cut-off). The percentage of the embryos developed to hatched blastocyst stage and the level of superoxide anion in supernatant from medium alone culture (control), coculture, and contactless coculture were measured. RESULTS: The rates of embryo development to the hatched blastocyst stage were significantly higher in coculture (43%) than in control (0%) (p<0.05). The CM-1 group had no embryo development since 2-cell embryonic stage, whereas the CM-2, CM-3, CM-4 and CM-5 groups had the improved development to 4 or 8 cell embryo stage, but the similar rate of development to hatched blastocyst compared to control. The effect of coculture on embryo develpment was disappeared in the contactless coculture group. The level of superoxide anion was significantly reduced in coculture group compared to control. CONCLUSION: It is concluded that the present coculture system overcomes the 2-cell block in vitro and improves the embryo development. This beneficial effect may be due to the direct cell-cell contact between embryo and helper cells or the removal of deleterious components from medium rather than the embryotrophic factors.
Animals ; Blastocyst ; Cell Culture Techniques ; Coculture Techniques* ; Culture Media, Conditioned ; Embryonic Development ; Embryonic Structures ; Epithelial Cells ; Female ; Humans ; Molecular Weight ; Oviducts ; Pregnancy ; Superoxides ; T-Lymphocytes, Helper-Inducer ; Zygote

PURPOSE: This study was conducted to survey children's health status and need of customized visiting health care services in one province. METHODS: The participants in this study were 237 caregivers of infants and preschoolers. Data were collected at the participant's home or public health center. RESULTS: Many of the children did not receive developmental screening tests or dental examinations. In the beneficiary group, the prenatal checkup rate and children's vaccination rate were lower, and caregivers had more health problems than the other groups. On the assessment of home safety, unsafe conditions were more frequently found in the beneficiary group. The caregivers in the beneficiary group showed lower child rearing confidence than the other groups, and wanted customized visiting health care services most in the areas of developmental screening, regular health check-up and counseling, nutritional supplementation, and oral health care. CONCLUSION: These results indicate that it is necessary for children and parents in poverty to be provided with professional home visiting interventions for the promotion of child health and prevention of developmental problems and diseases. These findings can be used for developing future customized visiting health care service programs for infants and children in this community area.
Caregivers ; Child Rearing ; Child Health ; Child* ; Counseling ; Delivery of Health Care* ; House Calls ; Humans ; Infant ; Mass Screening ; Oral Health ; Parents ; Poverty ; Public Health ; Social Class* ; Vaccination

This study was performed to investigate the anthropometric data, serum profiles, and nutrient intakes of high school students who are living in Seoul. Anthropometric data showed that mean height and weight were 174.1 cm and 66.6 kg in 99 male and 161.4 cm and 54.0 kg in 116 female students. Mean BMI for male and female students were 21.9 and 22.3 kg/m2, and subjects with BMI > 25 kg/m2 were 14 and 7%, respectively. Total cholesterol, HDL- and LDL-cholesterol of subjects were 149.6 +/- 3.1, 46.4 +/- 1.3, 86.4 +/- 2.3 mg/dl for males and 169.2 +/- 3.1, 50.7 +/- 1.0, 100.9 +/- 2.7 mg/dl for females, respectively. Hemoglobin (Hb) and total iron binding capacity (TIBC) were 12.8 +/- 0.1 g/dl, 437.3 +/- 7.2 microgram/dl in male and 11.9 +/- 0.1 g/dl, 439.4 +/- 5.7 microgram/dl in female, respectively. Based on Hb classification, 45.6% of male and 45.0% of female students fell into anemic condition. Intakes of energy, Ca, Fe, Zn, riboflavin, and folate were below the Korean RDA. In particular Ca (male and female, respectively, 64.6 and 643% RDA) and Fe (male and female, respectively, 78.6 and 64.3%RDA) intakes were extremely low. Serum triglyceride was positively significantly correlated with weight (r = 0.22), BMI (r = 0.279), waist circumference (WC, r = 0.235), triceps skin-fold thickness (TSF, r = 0.197) and obesity index (OI, r = 0.279). Hb concentration was positively correlated with height (r + 0.387), weight (r = 0.349), BMI (r = 0.191) and waist/hip ratio (WHR, r = 0.380). As for the correlation between serum profiles and nutrient intakes, the Hb concentration was positively correlated with energy (r = 0.163), protein (r = 0.149), Na (r = 0.153), vitamin A (r = 0.165), thiamin (r = 0.201) and niacin (r = 0.192, p < 0.01). These result suggest that the prevalence of Ca and Fe deficiency of student is high and dietary guideline for prevent anemia in this age needs to contain the adequate intake of energy and its related vitamins.
Anemia ; Cholesterol ; Classification ; Female ; Folic Acid ; Humans ; Iron ; Male ; Niacin ; Nutrition Policy ; Obesity ; Prevalence ; Riboflavin ; Seoul* ; Triglycerides ; Vitamin A ; Vitamins ; Waist Circumference