No abstract available.
Sarcoma*

Problems of Adverse Drug Reaction (ADR) have been regarded as growing social concern in health. The purposes of this study were to analyze current domestic and foreign adverse drug reaction monitoring system and to develop a web-based reporting system and to test its performance. Two university hospitals, one clinic, and six pharmaceutical companies were participated in this pilot project. From March 1 to Oct. 30, 1998, a total of 310 cases were reported fromm the participating two hospitals. Of these, 240 cases were mild(77.42%), 61 cases were moderate(19.68%), and 9 cases were severe cases(2.9%). More ADR cases were report from the outpatients(83.22%) than inpatients. Oral intake was the most common route of administration(74.2%). A future ADR monitoring system was also presented in this paper.
Drug-Related Side Effects and Adverse Reactions ; Hospitals, University ; Humans ; Inpatients ; Pilot Projects

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*

The purpose of this study is to present the results of the clerkship evaluation by the students using questionnaire, to discuss the problems revealed in performing the evaluation, and to find out the ways to improve the evaluation. In 2000, the evaluation has been conducted by the Department of Radiology, Seoul National University College of Medicine. The questionnaires filled-up by 97 junior students who completed the clerkship schedule of 2 weeks were analyzed in this study. The questionnaire consisted of 28 structured items with 5-grade scale each, the contents of which included the amount and level of the overall clerkship course and those of 5 subtypes of the clerkship(self-learning, student conference, student seminar, on-site clerkship, and small group discussion with faculty). In small group discussion, enthusiasm of each faculty, delivery effect, and difficulty of the contents were also evaluated. As a result, the most items were assessed to be slightly better than average(3 or 4 point of 5 scale). It was found that the small group discussion was most favored, whereas the student seminar was least favored. Faculty activity was also scored to be better than average. There were no significant differences among all faculty activity. The limitation of this study is failure of assessing the validity and reliability of the student response. In order to improve the evaluation, we should consider following four subjects: First, all the items are carefully developed to enhance the validity and reliability of the evaluation. Second, students should be fully informed of the objects of the evaluation before it is carried out. Third, teaching support facilities for the faculty are needed. Finally, an organization which takes complete charge of the instruction evaluation must be established.
Appointments and Schedules ; Humans ; Reproducibility of Results ; Seoul ; Surveys and Questionnaires

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*

Ectopic pancreas is commonly located at stomach, duodenum and jejunum. It is a relatively rare entity and is usually of no clinical importance which especially is a very rare source of massive upper gastrointestinal bleeding. We have recently experienced a case of an ectopic pancreas in the second portion of the duodenum which was proven to be a source of massive gastrointestinal bleeding by duodenoscopy and was confirmed by surgical exploration.
Duodenoscopy ; Duodenum* ; Esophagus* ; Hemorrhage* ; Intestines* ; Jejunum ; Pancreas* ; Stomach*

No abstract available.
Stents

We evaluated abnormalities in medial portion of elbow in high-school weightlifter compared with the non weightlifter using a stress radiography and ultrsonography. The experimental group(G1) was 26 high school weightlifters with an average age of 17 years old (range, 16.18 years). The control group (G2) were comprised of 25 age matched general students. Both groups received physical examination, simple and valgus stress radiography and ultrasonography on both side of elbow. Physical examination showed 26.9% (14/52 elbows) tenderness and 19.2% (10/52 elbows) valgus laxity in G1, no tenderness and laxity in G2. There were no differences in medial joint gaps on simple radiography (G1, 3.3 mm, G2, 2.7 mm; p>0.05), but the valgus stress view showed 5.6+/-0.8 mm medial joint gap in G1 and 3.8+/-0.8 mm in G2 (p<0.001). Ultrasonography in G1, angular deformity was found in 67.3% (36/52) and G2 all in normal (p<0.01). The horizontal distance was an average 4.9+/-1.23 mm for the G1 and 3.1+/-0.78 mm for the G2 (p<0.001). Vertical distance of the proximal portion of the ulna was average 0.58+/-0.94 mm for the G1 and 1.59+/-0.49 mm for the G2 (p<0.001). In G1, angular deformity of male was 50% (15/30 elbows) and female was 95% (21/22 elbows) (p<0.001). Change of horizontal and vertical distance were larger in female (p<0.05). In conclusion, there were increased incidence of medial elbow joint laxity in high school weightlifter, especially in female, regardless of career. Sustained valgus laxity could be prone to ulnar collateral ligament injury and should be evaluated with ultrasonography-assisted dynamic study.
Collateral Ligaments ; Congenital Abnormalities ; Elbow Joint* ; Elbow* ; Female ; Humans ; Incidence ; Joints ; Male ; Physical Examination ; Radiography ; Ulna ; Ultrasonography

Changes of bone turnover with aging are responsible for bone loss and play a major role in osteoporosis. Among the early postmenopausal women, as are known by previous study, there are about 35% ""fast bone losers and bone turnover is more uncoupled in osteoporotic group than in normal control. So, early detection of such fast losers"" and women who have high turnover rate is important to prevent postmenopausal osteoporosis and spontaneous fracture. Dual-energy X-Ray absorptiometry (DEXA), however, cannot reflect current bone loss because changes in bone mineral density (BMD) are only seen after 1 or more years of bone densities declining. In this study, we have measured a battery of new sensitive and specific markers of bone turnover which reflect current bone loss. To investigate the changing pattern of those markers, 674 healthy women including 451 postmenopausal women were classified, according to their menopausal period (less than 5 years, 5-10 years, more than 10 years). Bone formation was assessed by serum osteocalcin (OC), bone-specific alkaline phosphatase (BSAP) and bone resorption by the urinary excretion of deoxypyridinoline (DPD), cross-linked N-telopeptide of type I collagen (NTX). All Biochemical markers, except OC, significantly increased after menopause (p < 0.05). NTX and BSAP remained elevated after 10 years of menopause. These data indicated that the overall rates of both bone formation and bone tesorption increased after menopause and remained high in elderly women.
Absorptiometry, Photon ; Aged ; Aging ; Alkaline Phosphatase ; Biomarkers ; Bone Density ; Bone Resorption ; Collagen Type I ; Female ; Fractures, Spontaneous ; Humans ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal

BACKGROUND: Left ventricular function and left ventricular hypertrophy often show weak correlation with the degree of blood pressure in hypertensive patients. So we assessed correlation of hemodynamic load to left ventricular hypertrophy and left ventricular performance, and whether left ventricular wall stress is the major factor on the regulation of left ventricular function. METHODS: Relationships between echocardiographic hemodynamic parameters and indices of left ventricular hypertrophy and left ventricular function were evaluated in 40 patients with essential hypertension who have not been previously treated. RESULTS: Left ventricular mass index correlated weakly with blood pressure, cardiac index, and stroke volume. End-diastolic left ventricular relative wall thickness, as an index that assess the severity of concentric hypertrophy showed significantly negative correlation with cardiac index (r=-0.49, p<0.001),stroke index(r=-0.46, p<0.001) and a positive correlation with total peripheral resistance (r=0.55, p<0.001). Furthermore, patient with cardiac indices tend to have higher end-diastolic wall thickness at any given level of blood pressure. Fractional shortening suggesting left ventricular systolic function was not related with blood pressure. stroke volume, cardiac index, left ventricular mass index, and peak systolic wall stress. In contrast there were significant negative correlations between fractional shortening with mean wall stress index (r=-0.42, p<0.005) and with end-systolic wall stress (r=-0.72, p<0.001). CONCLUSIONS: These results suggest that anatomic and hemodynamic changes may be pathophysiologically interdependent and left ventricular function was regulated by the level of left ventricular wall stresses reflecting afterload (blood pressure).
Blood Pressure ; Echocardiography ; Hemodynamics* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Stroke Volume ; Vascular Resistance ; Ventricular Function, Left