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

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

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

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

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

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*

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

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

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*