The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.
Abortion, Habitual ; Abortion, Induced ; Autoantibodies ; Family Characteristics ; Female ; Histocompatibility ; Humans ; Immunotherapy* ; Infertility* ; Lymphocytes* ; Oocytes ; Pregnancy ; Research Personnel ; Spermatozoa

No abstract available.
Lower Extremity* ; Melanoma*

Immunohistochemical study was performed for CEA staining patterns and PCNA indices. And the relationship between immunohistochemical findings and well-known clinical prognostic factors on the purpose of the clinical usefulness was evaluated. In forty seven cases of surgically removed colorectal carcinomas, the results were as follows; CEA staining patterns were apical (17 cases) and cytoplasmic (30 cases) type. Carcinomas with cyto plasmic pattern for CEA revealed more advanced Dukes' stage and more undifferentiated type and higher incidence of lymph node metastasis and were correlated with increased serum CEA levels. But PCNA indices showed no correlation with the Dukes' stage, histologic grade and CEA staining patterns. The cytoplasmic pattern of CEA immunohistochemistry may be a useful marker suggesting more aggressive biologic behavior of the colorectal carcinomas.
Colorectal Neoplasms* ; Cytoplasm ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen*

The stress or fatigue fracture is well known in military medicine, but it is an unusual occurrence in civilian practice. The stress fracture of metatarsal bone is familiar to most, but in the tibia it is unusual. The clinical symptoms of pain, swelling and limping following strenuous activity were seen in the affected lower leg and proceeded radiological evidence of fracture. 17 cases of stress fracture of tibia were investigated in a military hospital between March 1973 and May, 1974. The results of this study are as follows, 1. The fractures mainly occurred in the upper one third of the tibia (13 cases among 17). 2. The cases with only callus formation were more frequent than the cases with fracture line on the tibia (11 cases among 17). 3. If pain occurs in the lower leg after strenuous activity, there should be attention with serial radiological checking.
Bony Callus ; Clinical Study ; Fractures, Stress ; Hospitals, Military ; Leg ; Metatarsal Bones ; Military Medicine ; Tibia

PURPOSE: The aim of the present study was to investigate the effect of single dose imipramine on nocturnal urine output in patients with nocturnal enuresis. METHODS:A total of 6 monosymptomatic enuretic patients of more than 5 years of age were enrolled in this study. We measured nocturnal urine output, urine osrnolality, creatinine clearance, osmolal clearance, excretion rate of solutes, fractional excretion of sodium and potassium, and plasma vasopressin with and without a single oral dose of imipramine(lmg/kg of body weight) at 8 p.m. RESULTS: The administration of imipramine was followed by a significant decrease in noctumal urine output(P=0.02). Urine osmolality was not significantly increased(P>0.05), but osmolal clearance was significantly decreased during imipramine medication(P=0.03). Urinary excretion rate of sodium and potassium showed a statistically insignificant trend toward lower values during imipramine administration in nocturnal enuretics. Fractional urinary excretion of sodium and potassium was significantly decreased during imipramine medication(P<0.05). There was no significant difference in plasma vasopressin level and creatinine clearance in nocturnal enuretics after imipramine. CONCLUSION: Imipramine has a vasopressin independent antidiuretic effect in patients with nocturnal enuresis. The antidiuretic effect of imipramine can be attributed prirnarily to increased a-adrenergic stimulation in the proximal tubules with secondary increased urea and water reabsorption more distally in the nephron. (J Korean Pediatr Soc 2000;43:792 - 797)
Antidiuretic Agents ; Creatinine ; Enuresis ; Humans ; Imipramine* ; Nephrons ; Nocturnal Enuresis* ; Osmolar Concentration ; Plasma ; Potassium ; Sodium ; Urea ; Vasopressins

We examined 646 neonates 1~3 days after birth at Seoul National University Hospital and Chungnam National University Hospital between April 1, 1986 and Dec. 31, 1986. To make neonates attentive, they were examined before feeding and if neonate was not attentive, we used side to side rocking or up and down movement to stimulate attentiveness. Their eye positions were tested with Hirschberg method and extraocular muscle function was tested with oculocephalic maneuver. Of these 646 neonates, 288(44.6%) had orthophoria, 337(52.2%) had exotropia, 6(0.9%) hadesotropia, 12(1.9%) had intermittent exotropia, 2(0.3%) had intermittent esotropia, and 1(0.2%) had exo-esotropia. None had infantile esotropia. Four months after birth, we reexamined 198 infants. Two of 88 infants who were orthophoric on previous examination had intermittent exotropia and 101 of 103 infants who were exotropic after birth had orthophoria. Two infants who were esotropic and 5 infants who were intermittently exotropic after birth had orthophoria. None had infantile esotropia.
Chungcheongnam-do ; Esotropia ; Exotropia ; Humans ; Infant ; Infant, Newborn* ; Parturition ; Seoul

This is a clinical study of 129 cases of colorectal cancer who were treated in the department of surgery, Inchon Christian Hospital from January 1989 to December 1996. The results were as follows; 1) The peak age incidence was 7th decade and the ratio between male and female was 1.87 : 1 2) The most frequent site of the tumor was the rectum(59.7%). 3) In the right and left colon cancer the most frequent symptom was abdominal pain and in the rectal cancer the most frequent symptom was bloody stool. 4) The duration of symptoms prior to admission was within 3months(58%). 5) The diagnostic methods were digital examination, sigmoidoscopy colonofiberscopy, barium enema and abdominal CT scanning. 6) The most frequently performed operation was Abdominoperineal resection(27%). 7) The staging of tumors was performed according to modified Dukes' classification and Dukes C was most frequent(55.1%). 8) The most common histopathologic type was adenocarcinoma(98%). 9) The most common macroscopic finding was ulcerative pattern. 10) The most common distant metastatic site was pelvic organ(12%). 11) The most common post-operative complication was wound infection(10.1%). 12) The 5year survival rate was analyzed by Kaplan-Meier's method : the overall 5year survival rate was 60.7%.
Abdominal Pain ; Barium ; Classification ; Colonic Neoplasms ; Colorectal Neoplasms* ; Enema ; Female ; Humans ; Incheon ; Incidence ; Male ; Rectal Neoplasms ; Sigmoidoscopy ; Survival Rate ; Tomography, X-Ray Computed ; Ulcer ; Wounds and Injuries

No abstract available.
Teratoma*

OBJECTIVE: This study was performed to compare the clinical response to controlled ovarian hyperstimulation (COH) of in vitro fertilization and embryo transfer (IVF-ET) according to the size of baseline ovarian cyst. METHOD: From February 1992 to March 1999, a retrospective analysis was done of 272 cases who underwent COH using mid-luteal phase long protocol of gonadotropin-releasing hormone agonist (GnRH-a) for IVF-ET. These cases were divided into four group; group 1 (n=63) had cysts with mean diameters between 20.2 and 29.0 mm on their baseline ultrasound on cycle day 3, group 2 (n=57, 30.0~49.0mm), group 3 (n=68, >50.0mm) and control group (n=84). Cases were excluded according to the following criteria; pure male factor infertility, the presence of only one ovary, high CA-125 level and previous endometriosis. RESULTS: There were no statistically significant differences between cases with baseline ovarian cyst <50.0 mm in diameter and control group in any of the parameters. However, cases with baseline ovarian cyst>50.0 mm in mean diameter needed more amount of human menopausal gonadotropin (hMG), showed significantly lower estradiol (E2) level, the number of follicle >15.0 mm on the day of human chorionic gonadotropin (hCG) administration, the number of oocytes retrieved, the number of mature oocytes, and pregnancy rate compared with control group. CONCLUSION: This study suggests that cases with baseline overian cyst <50.0 mm in diameter do not adversely impact on IVF-ET outcome. However, cases with baseline ovarian cyst >50.0 mm in diameter had adverse effects on various parameters. Therefore, to improve the outcome of IVF-ET in these cases, ovarian cyst aspiration prior to initiating COH may be required.
Chorionic Gonadotropin ; Embryo Transfer* ; Embryonic Structures* ; Endometriosis ; Estradiol ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Male ; Oocytes ; Ovarian Cysts* ; Ovary ; Pregnancy Rate ; Retrospective Studies ; Ultrasonography

The recent development of microsurgical tissue transfer has enabled any defect in any area to be reconstructed with free flaps. However, the need for a more functional and thinner flap has been raised due to bullkiness of the flap and donorsite morbidity. For better functional and aesthetic results, various perforator flaps excluding muscles or adjacent subcutaneous tissue have been recently reported. We report 44 cases of perforating artery pedicled flaps from April 1995 to August 1998, including 21 cases of anterolateral thigh flap, 12 cases of gluteal artery perforator flap, 4 cases of posterior interosseous flap, and 7 cases of paraumbilical perforator flap for various soft tissue defects. Even though marginal necrosis of flap occurred in 9 cases, complete healing without significant problem was possible. The advantages of perforator flaps are as follows: 1. It is possible to obtain a relatively thin fasciocutaneous flap, but still with sufficient volume 2. Donor site morbidity was reduced without damage of main artery. 3. In spite of diverse vascular pattern of the perforator, the location of perforating arteries can be Detected with relative ease and mapped preoperatively with an ultrasound Doppler. The need of meticulous and tedious dissection could be a sole disadvantage of these flaps. This report describes the clinical experience with a perforator-based flap, anticpating applications of many other types of perforator flap in the future.
Arteries* ; Free Tissue Flaps ; Humans ; Muscles ; Necrosis ; Perforator Flap ; Subcutaneous Tissue ; Surgical Flaps* ; Thigh ; Tissue Donors ; Ultrasonography