No abstract available.
Gallbladder* ; Lithotripsy*

No abstract available.
Adenocarcinoma* ; Female ; Ovary*

OBJECTIVE: To analyze the efficacy of intracytoplasmic sperm injection (ICSI) for totally unfertilized oocytes by the conventional insemination during in vitro fertilization and embryo transfer (IVF-ET) METHODS: From March 1996 to April 1998, 15 couples who experienced total fertilization failure after conventional IVF without severe male factor infertility in semen analysis were evaluated. Fertilization were assessed by the presence of 2 pronucleus (PN) after 14-16 hours of conventional insemination. All unfertilized oocytes were reinseminated by ICSI and checked for signs of fertilization between 6-10 hours after ICSI. The embryos with fertilization and development were transferred to the uterine cavity and the outcome was analyzed. RESULTS: Total numbers of unfertilized oocytes were 120, and total numbers of oocytes injected on day 1 using ICSI were 102. Total numbers of oocytes with normal fertilization after ICSI were 74 and mean fertilization rate of 71.1 +/- 24.0% was obtained. The numbers of embryos transferred was 3.6 +/- 1.7. The biochemical pregnancy rate was 13.3% (2/15) and the clinical pregnancy rate was 6.7% (1/15) per cycle. CONCLUSION: ICSI to totally unfertilized oocytes by conventional insemination technique during IVF-ET on the next day of oocyte retrieval seems to be a relatively successful mean and afford a chance of pregnancy to the infertile couples whom the ET could not perfomed to because of total fertilization failure."
Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility ; Insemination ; Male ; Oocyte Retrieval ; Oocytes* ; Pregnancy ; Pregnancy Rate ; Semen Analysis ; Sperm Injections, Intracytoplasmic*

OBJECTIVE: To determine whether the somatostatin analogue, octreotide, given concunently with human menopausal gonadotropin (HMG) affects ovarian response, ovulation induction outcome, and serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) in infertile patients with polycystic ovarian syndrome (PCOS) resistant to clomiphene citrate (CC). METHODS: From August 1996 to June 1998, 42 infertile patients with PCOS urresponsive to CC were enrolled in the present study. Women who had other infertility factors were excluded from this study. Patients were randomly allocated either to combined HMG and octreotide treatment (treatment group) (n=21) or HMG alone (control group) (n=21). In the treatment group, 100 micrograms of octreotide were administered daily concomitantly with HMG from the 3rd day of menstrual cycle to the preceding day of human chorionic gonadotropin (HCG) injection. RESULTS: Patient's characteristics were comparable in both groups. One cycle in the control group was abandoned because of excessive follicular development. However, none of the cycles in the treatment group was abandoned. There were no differences in the number of HMG ampules required and the duration of HMG administration between the two groups. The number of follicles > 14mm diameter on the day of HCG injection was significantly less in the treatment group than that in the control group (p<0.01). The serum estradiol level on the day of HCG injection was also significantly lower in the treatment group, with 1391.0 +/- 695.5 pg/ml compared with 2217.5 +/- 811.6pg/ml in the control group (p<0.001). The incidence of severe ovarian hyperstimulation syndrome seemed to be lower in the treatment group, but the difference did not achieve significance (4.9% vs 23.8%). There were no differences in the clinical pregnancy rate, miscarriage rate and multiple pregnancy rate between the two groups. Although serum GH levels were comparable between the two groups, serum IGF-1 level on the day of HCG injection was significantly higher in the treatment gmup than that in the control group (p<0.001). CONCLUSION: This study suggests that the combined octreotide and HMG treatment could improve hormonal milieu and folliculogenesis compared to HMG alone, and therefore may be effective in ovulation induction for patients with PCOS resistant to CC.
Abortion, Spontaneous ; Chorionic Gonadotropin ; Clomiphene ; Estradiol ; Female ; Gonadotropins ; Growth Hormone ; Humans ; Incidence ; Infertility ; Insulin-Like Growth Factor I ; Menstrual Cycle ; Octreotide ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction* ; Ovulation* ; Polycystic Ovary Syndrome* ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Somatostatin*

Scrub typhus, an acute febrile infectious disease caused by R. tsutsugamushi, has been reported from various parts of the far east and pacific rim of Asia including Korea. It is well known that all human pathogenic rickettsia share an affinity to endothelial cells of the small blood vessels and evoke vascular inflammation variably associated with a rash, microthrombi, and hemorrhage. We infected the ICR mice by inoculating sublethal doses of R. tsutsugamushi R19 strain intraperitoneally and observed the pathologic changes by time sequence. The histopathologic features of experimentally induced scrub typhus in the mice were generally nonspecific interstitial inflammations characterized by interstitial pneumonitis, periportal inflammation, multifocal hepatic necrosis, interstitial nephritis, sinusoidal engorgement, and lymphohistiocytic cell infiltration in lymph nodes and spleen. Contrary to the general features of other rickettsial diseases, the pathologic process of scrub typhus experimentally induced by R. tsutsugamushi R19 strain mainly involved the interstitial connective tissue but not the blood vessels.
Animals ; Liver/pathology ; Lung/pathology ; Male ; Mice ; Mice, Inbred ICR ; Scrub Typhus/*pathology ; Spleen/pathology

BACKGROUND: A quantitative, rather than visual, assessment of the outcomes of facial surgery has recently become increasingly important, and this is best accomplished using anthropometry. However, most anthropometric methods have limited applicability in office settings. METHODS: We conducted preliminary studies on images of a 30-cm straight edge ruler with various camera-to-object distances (OD) and aperture sizes, and identified a convenient range of ODs and the most reliable aperture size of our camera for photogrammetry. Subsequently, we measured various lengths circumjacent to the center of the ruler in the images of different ODs with a graphics viewer program and calibrated the raw data using the central 20-mm length. We obtained a reliable circle in our camera's viewfinder from a chart of percentage differences between the calibrated data and coupled real ruler lengths. Following this, we replaced the concept of the central 20-mm length with a geometric sphere 20-mm in diameter, and applied it to clinical photogrammetry. RESULTS: The percentage differences were almost directly proportional to the real lengths. This value was below 0.48% in the central 160-mm of all images within an OD range of 50 to 125 cm. In clinical applications, the greatest difference compared to direct measurements was 0.97 mm. CONCLUSIONS: Using a graphics viewer program, we performed anthropometric measurements of images that included a sphere of known size, without printing the images; the difference between these and direct measurements was <1 mm. This method is simple enough for use in an office setting.
Anthropometry ; Methods ; Photogrammetry*

OBJECTIVES: To investigate the patterns of biochemical bone markers, such as urinary deoxypyridinoline (DPD), N-telopeptide of type I collagen (NTX), and serum osteocalcin (OC), bone-specific alkaline pbosphatase (BSAP) in postmenopansal women with hormone replacement therapy (HRT). Materials and METHOD: From July 1997 to January 1998, total 239 postmenopausal women were emolled in the present study, and 198 healthy premenopausal women with regular menstruation were served as control. The postmenopausal women were pouped into the HRT group and the non-HRT group. The women in the HRT poup have received estrogen with continuous or cyclic progestin therapy far more tban 6 months. The biochemical bone markers of all women were assayed. Results were analysed with Students t-test. RESULTS: The urinary DPD of the non-HRT group was sigaificantly higher than both the HRT poup and the premenopausal group(5.51 +/- 2.47 vs. 3.36 +/- 1.02 and 4.01 +/- 3.86 nM/mM, p < 0.05, repectively). The urinary NTX of the non-HRT group was also higher in comparison to the HRT group and the premenopausal group(48.71 +/- 11.54 vs. 33.70 +/- 17.43 and 33.70 +/- 17.43 nM BCE/mmol, p < 0.05, repectively). However, there were no significant differences in the concentrations of serum BSAP and OC among the three poups. CONCLUSION: The urinary DPD and NTX were more sensitive indicators of bone metabolism tban serum BSAP and OC in postmenopausal women undergoing HRT.
Collagen Type I ; Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Menstruation ; Metabolism ; Osteocalcin

OBJECTIVE: To determine if basal serom follicle stimulating harmone (FSH) level could be a prognostic factor of the clinical outcome in in vitro fertilization and embryo transfer (IVF-ET) with intracytoplasmic sperm injection (ICSI) in the couples with male factor infertility. Materials and METHOD: From December 1995 to March 1998, total 118 patients with male factor infertility were included in this study. Patients were allocated to the low basal FSH group (>8.5 mIU/ml) and the high basal FSH group (>8.5 mlU/ml). The basal levels of FSH were measured in the 3rd day of menstrual cycle preceding ovarian stimulation cycle in total IVF cycles by immunoradiometric assay (IRMA). Statistical analysis was performed using Student's t-test, Fishers exact test, and x2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: The total dose of exogeneous gonadotropin required in the patients of the high basal FSH group was significantly higher than that of the patients with the low basal FSH poup (p < 0.05). The numbers of retrieved oocytes, oocytes with grade I, II, fertilized oocytes, cleaved oocytes, embryos with grade I, II, and transferred embryos were significantly higher in the low basal FSH group (p < 0.05), The clinical pregnancy rate per cycle in the low basal FSH gmup (15.7%) seemed to be higher than that in the high basal FSH poup (3.4%) (p 0.08), however, there was no statistically significant difference between the two groups. CONCLUSION: These results suggested that the basal FSH levels could be predictive of pregnancy outcome and the results of ovarian stimulation in IVF-ET using ICSL.
Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Female ; Fertilization in Vitro ; Gonadotropins ; Humans ; Immunoradiometric Assay ; Infertility ; Male ; Menstrual Cycle ; Oocytes ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic*

OBJECTIVE: To compare the pregnancy outcomes of transvaginal multifetal pregnancy reduction (MFPR) according to the gestational period when the procedure was performed METHODS: From January l995 to February 1998, total 27 patients with multiple pregnancy were included in this study. The patients were grouped to early MFPR group (<8 weeks, n=16) and delayed MFPR group (>8 weeks, n=ll) according to the gestational age that MFPRs were performed. All MFPRs were performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The complete pregnancy loss rate before 24 weeks of gestation, spontaneous loss of embryo, procedure-related complication, gestational age at delivery, and pregnancy complication were compared between the two groups. Statistical analysis of data was performed using Students t-test and Fishers exact test as appropriate. Statistical significance was defined as p<0.05. RESULTS: There was no significant difference in the complete pregnancy loss rate between the early MFPR group (6.3%) and the delayed MFPR group (27.3%). The incidence of partial spontaneous loss of embryo in the two groups were not differed significantly (6.3% vs. 18.2%). The procedure-related complication of the delayed MFPR group (36.4%) seemed to be higher than that of the early MFPR group (6.3%), however there was no statistical difference (p=0, 07). Especially, all 3 patients in whom the MFPR was performed after 10 weeks suffered from the procedure-related complication. The mean gestational age at delivery of the two groups were not differed significantly (36.3+2.8 weeks vs. 37.0+1.3 weeks). There was also no significant difference in the mean birth weights of the two groups (2378.8+563.7 gm vs. 2427.1+436.2 gm). CONCLUSION: Although there was no statistically significant difference, the early transvaginal MFPR might be a safe and useful method without significant adverse complications compared to the delayed MFPR.
Birth Weight ; Embryonic Structures ; Female ; Gestational Age ; Humans ; Incidence ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Pregnancy Reduction, Multifetal* ; Pregnancy, Multiple

It is well known that the clinical test for responsibility of accurate fertilization capacity in male partners is very important to diagnose and treat the infertility. However, it has been reported that the traditional semen analysis cannot accurately predict fertilization and pregnancy potential. The present study was performed to evaluate the acrosomal reaction to ionophore challenge (ARIC) test as a prognostic indicator for fertilization of sperm and oocyte in an in vitro fertilization and embryo transfer (IVF-ET) program. From March 1996 to Februry 1997, 30 couples undergoing IVF program were allocated to this study group. All female partners in the study group were 35 years old or less and their serum level of basal follicle stimulating hormone (FSH) and estradiol (E2) were normal. All the male partners have normal parameters of semen analysis. The ARIC tests were performed on the day of ovum pick up and in vitro insemination in all the male partners. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone (GnRH) agonist was used in all couples for IVF-ET. The acrosomal reaction with 10microliter of 10% DMSO was induced spontaneously in 10.1+/-9.8%, and acrosomal reaction with calcium ionophore A 23187 was induced in 27.4+/-18.1%, and the ARIC value was 17.4+/-16.2%. There were no significant correlation between the ARIC value and the fertilization rate (r2=0.044, p=0.268). There were also no significant correlation between the ARIC value and the percentage of the grade I, II embryos (r2=0.046, p=0.261). On the basis of above results, it was suggested that ARIC test might not be a useful prognostic indicator for fertilization in IVF-ET in male partners with normal parameters of conventional semen analysis. We guessed that IVF-ET could be performed to the patients primarily without universal appilcation of ARIC test to all male partenrs, and if fertilization failure occurs, the microassisted fertilization (MAF) such as intracytoplsmic sperm injection (ICSI) might be used as an alternative mode of treatment with acceptable success rate.
Acrosome Reaction* ; Acrosome* ; Adult ; Calcimycin ; Calcium ; Dimethyl Sulfoxide ; Embryo Transfer ; Embryonic Structures ; Estradiol ; Family Characteristics ; Female ; Fertilization ; Fertilization in Vitro* ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Humans ; Infertility ; Insemination ; Male ; Oocytes ; Ovum ; Pregnancy ; Semen Analysis ; Spermatozoa