OBJECTIVE: To compare the clinical outcomes of intrauterine insemination (IUI) according to the catheter used. MATERIALS AND METHOD: From March 1998 to September 1998, total 95 infertile patients were included in this study. Patients were randomly allocated to TomCat group (n = 39) and Mackler group (n = 56) according to the catheter for insemination. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone agonist (GnRH-a) was used in all patients. Statistical analysis was performed using Student's t-test, Fisher's exact test, and x2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: The total dose and duration of exogeneous gonadotropin required were similar between the two groups. There were also no significant differences in serum estradiol (E2) level, endometrial thickness and texture on the day of hCG administration between the two groups. However, the percentage of uterine souding due to failure of initial approach was significantly higher in TomCat group compared to Mackler group (23.1% vs. 0%, p < 0.01). The percentage of bleeding after IUI in TomCat group seemed to be higher than that in Mackler group (15.4% vs. 3.6%, p = 0.06), although there was no statistically significant difference between the two groups. There was also no significant difference in the clinical pregnancy rate per patient between the two groups. CONCLUSION: These results suggested that using Mackler catheter might be effective for IUI, especially for the patients with cervical factor infertility.
Catheters* ; Estradiol ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Infertility ; Insemination* ; Pregnancy Rate

The pilomatricoma (calcifying epithelioma of Malherbe) is a rare, benign, asymptomatic tumor arising from the hair follicular matrix cells. It is usually a solitary lesion and it is most commonly found on the face and upper extremities. This tumor can occur in patients of any age, but about 60% of pilomatricomas are found in those patients less than twenty years old. The radiologic features of this neoplasm have rarely been described in the literature; in particular, the CT findings of pilomatricoma originating from the eyelid have not been published in Korea. We report here on a case of pilomatricoma that occurred in 69-year-old female; she had a hard subcutaneous mass on her right eyelid with overlying bluish skin.
Aged ; Carcinoma ; Eyelids* ; Female ; Hair ; Humans ; Korea ; Pilomatrixoma* ; Skin ; Upper Extremity

No abstract available.
Amphibians* ; HIV* ; Humans* ; Oocytes*

Congenital urachal abnormalities are more common in children, but urachal cyst is more frequently seen in adults. Infection within a cyst produces significant symptoms, which may explain the fact that three times as many infected cysts as uninfected urachal cysts are detected in adults. We report here on a case of infected urachal cyst with a fish bone and also the fistular formation between the ileum and urachus in a 63-year-old male with a history of urinary frequency and a tender mass at the lower abdominal quadrant.
Adult ; Child ; Fistula ; Humans ; Ileum ; Male ; Middle Aged ; Urachal Cyst* ; Urachus

Although many invasive studies in the biliary tract disase are replaced by noninvasive techniques such asultrasonography and CT, PTC does still play an important role indiagnosis of obstructive jaundice. Authors hadperformed 42 patients of PTC with Chiba needle at the department of radiology, Han Gang Sacred Heart Hospital for4 years from Jan. 1978 to April 1982. And we reviewed literatures. The results were as follows; 1. Forty twopatients of PTC were 22 males and 20 females. The success rate was 90.5%(38/42). The failed 4 cases of PTC werenonobstructive hepatobiliary diseases. 2. The PTC diagnosis of 38 cases were biliary stone (21 cases),cholangiocarcinoma(7 cases), pancreatic carcinoma (2 cases), hepatoma (2 cases), ascariasis(2 cases), andclonorchiasis(1 case), and the remainders were normal. 3. We made 2 cases of misdiagnosis on the basis of PTCfindings. They were one case of distal CBD stone with severe cholangitis diagnosed as ampullary carcioma andanother case of proximal CBD stone with cholangitis diagnosed as pancreas carcinoma. 4. We experienced 2 cases ofcomplication such as sepsis and severe hypotension, but they were recovered.
Biliary Tract ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangitis ; Diagnosis ; Diagnostic Errors ; Female ; Heart ; Humans ; Hypotension ; Jaundice, Obstructive ; Male ; Needles ; Pancreas ; Sepsis

Ectopic pregnancy is a common medical problem that is difficult to diagnose and potentially may lead to significant mortality or morbidity. The incidence of ectopic pregnancy is definitely increasing due to the rise in pelvic inflammatory disease (PID), pelvic surgery, intrauterine device (IUD), and assisted reproductive technologies, such as in vitro fertilization and embryo transfer (IVF-ET). Combined ectopic gestations are much rare and their true incidence is unknown. Multiple ectopic gestations may occur in a variety of locations. The majority involve one or both fallopian tubes. We report a case of combined tubal and cervical pregnancies, and discuss their management.
Embryo Transfer ; Fallopian Tubes ; Female ; Fertilization in Vitro ; Incidence ; Intrauterine Devices ; Mortality ; Pelvic Inflammatory Disease ; Pregnancy* ; Pregnancy, Ectopic ; Reproductive Techniques, Assisted

OBJECTIVES: To examine the in vitro interactions of blastocyst attachment using type I collagen. MATERIALS AND METHODS: ICR mice were used and follicular growth was stimulated by pregnant mare serum gonadotropin and human chorionic gonadotropin. On day 4 of pregnancy, the uteri were removed and blastocysts were flushed. Mixtures of 1mL sterile water, 0.5mL DMEM, 2mL type collagen solution and 0.5mL 0.1M NaOH were prepared and transferred to an incubator where the collagen solution polymerized. Blastocysts were transferred to dishes previously coated with type I collagen. CMRL 1066 was used as the basic culture medium. It was supplemented with 1mM glutamine and 1mM sodium pyruvate plus 50 IU/ml penicillin and 50 mg/ml streptomycin. During the first 4 days the culture medium was supplemented with 20% fetal calf serum and thereafter with 20% heat inactivated human cord serum. All blastocysts were initially cultured for 2 days without media change. After 2 days, fresh medium was renewed daily. The stages of embryo growth were examined and recorded everyday under a dissecting microscope and classified according to the standard in vivo criteria set forth by Witschi. RESULTS: By 48h, nearly all blastocysts had attached to the surface of collagen pad. Following adhesion to the collagen pad, the blastocysts maintained their 3-dimensional integrity in contrast to control. The embryos in collagen pad were not flattening and kept polarity and spherical shape during culture. The polar trophoblast invaded the type I collagen downward unlike the horizontal growth in control. In the developmental stage of mouse blastocyst, there were significant differences between control and type I collagen group during day 4 and 5 culture. CONCLUSION: Blastocyst development was better in type I collagen group than control. Therefore, in vitro culture study using type I collagen could provide improved model for the establishment of blastocyst implantation study.
Animals ; Blastocyst ; Chorionic Gonadotropin ; Collagen ; Collagen Type I* ; Embryo Implantation ; Embryonic Structures* ; Female ; Glutamine ; Gonadotropins ; Hot Temperature ; Humans ; Incubators ; Mice* ; Mice, Inbred ICR ; Penicillins ; Polymers ; Pregnancy ; Pyruvic Acid ; Sodium ; Streptomycin ; Trophoblasts ; Uterus ; Water

OBJECTIVES: To investigate the effect of granulocyte colony stimulating factor (G-CSF) and granulocyte macrophage colony stimulating factor (GM-CSF) on expression of matrix metalloproteinase-2, 9 (MMP-2, 9) mRNA in mouse embryos. Materials and METHOD: From October 1997 to December 1998, morula stage mouse embryos were cultured for 48 hours with G-CSF and GM-CSF at concentrations of 0.1 pg/ml, 1 pg/ml, 10 pg/ml, 100 pg/ml, 1 ng/ml and 10 ng/ml, respectively. Embryos not treated with G-CSF or GM-CSF were served as control. Reverse transcription-polymerase chain reaction (RT-PCR) has been used to examine the expression of MMP-2, 9 mRNA in developed blastocysts. Following reverse transcription, strategically designed nested primers, optimized for specificity, were used for amplification from the cDNA equivalent of a single embryo. The products were then verified by restriction enzyme digestion and sequence analysis. Results were analyzed with Kolmogorov-Smirnov test and analysis of variance (ANOVA). The statistical significance was defined as p< 0.05. RESULTS: The relative quantities (relative volume x intensity) of MMP-2 mRNA expressed in embryos of all G-CSF treatment groups were significantly increased than in the control, especially in 10, 100 pg/ml and 1 ng/ml treatment groups. The relative quantities of MMP-2 mRNA in all GM-CSF treatment groups were also significantly increased than in the control, especially in 100 pg/ml treatment group. The relative quantities of MMP-9 mRNA of all GM-CSF treatment groups except 10 ng/ml group were significantly increased than in the control, especially 10, 100 pg/ml and 1 ng/ml treatment group. However, the relative quantity of MMP-9 mRNA was significantly increased in only 10 ng/ml G-CSF treatment group than in the control and other treatment groups. CONCLUSION: This study suggests that G-CSF and GM-CSF may increase the m-RNA expression of MMP-2 or 9 in mouse blastocysts with the concentration-specific manner.
Animals ; Blastocyst ; Colony-Stimulating Factors* ; Digestion ; DNA, Complementary ; Embryonic Structures* ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Granulocytes* ; Matrix Metalloproteinase 2* ; Mice* ; Morula ; Reverse Transcription ; RNA, Messenger ; Sensitivity and Specificity ; Sequence Analysis

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 evaluate whether the basal serum luteinizing hormone (LH) levels in the presence of normal serum follicle stimulating hormone (FSH) are useful as a prognostic indicator of ovarian response to controlled ovarian hyperstimulation (COH). METHODS: From January 1997 to January 1999, 91 infertile women with tubal factor who had undergone in vitro fertilization and embryo transfer (IVF-ET) were enrolled in the present study. COH was performed using long protocol of gonadotropin-releasing hormone (GnRH) agonist. All patients included in this study had blood samples drawn on cycle day 2 or 3 prior to COH for measurement of basal FSH and LH. Women who had other infertility factors or high basal FSH levels (> or = 8.5 mIU/ml) were excluded from this study. The results of COH and IVF-ET were compared between two groups according to the level of basal LH (low LH group [< 3mIU/ml] vs. control group [> or = 3mIU/ml]). RESULTS: Patient's characteristics were comparable in both groups except basal LH level. The number of ampules and duration of exogenous gonadotropins required were significantly higher in the low LH group than those in the control group (p<0.001; p<0.005, respectively). The number of follicles > or = 14mm diameter on the day of human chorionic gonadotropin (hCG) injection was significantly less in the low LH group than that in the control group (p<0.001). The serum estradiol level on the day of hCG injection was also significantly lower in the low LH group, with 1115.5 +/- 380.9 pg/ml compared with 1340.6 +/- 403.0 pg/ml in the control group (p<0.005). There were significantly lower numbers in oocytes retrieved, oocytes fertilized and embryos frozen in the low LH group than those in the control group (< 0.001; < 0.001; <0.005, respectively). However, there was no difference in the fertilization rate between the two groups. The clinical pregnancy rate per cycle seemed to be lower in the low LH group, but the difference did not achieve significance (26.2% vs 39.7%). There were no differences in the miscarriage rate and multiple pregnancy rate between the two groups. CONCLUSION: This study demonstrates that the low basal LH levels ( < 3 mIU/ml) could be predictive of low ovarian response to COH and poor IVF results.
Abortion, Spontaneous ; Chorionic Gonadotropin ; Embryo Transfer ; Embryonic Structures ; Estradiol ; Female ; Fertilization ; Fertilization in Vitro ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Infertility ; Lutein* ; Luteinizing Hormone* ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple