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

Gitelman syndrome is an autosomal recessive renal tubular disorder characterized by hypokalemic metabolic alkalosis, and it is distinguished from Batter syndrome by hypomagnesemia and hypocalciuria. This disorder is caused by mutation in SLC12A3 gene which encodes thiazide-sensitive Na(+)-Cl(-)cotransporter (NCCT) which is expressed in the apical membrane of cells, lining distal convoluted tubule. A 8-year old boy who presented with Rolandic epilepsy, and horseshoe kidney accidentally showed clinical features of metabolic alkalosis, hypokalemia, hypocalciuria without hypomagnesemia. So we identified a heterozygote mutation and an abnormal splicing in the SLC12A3 gene, encoding NCCT. The mutation was detected in the exon 15 and 22 of SLC12A3 gene.
Alkalosis ; Epilepsy, Rolandic ; Exons ; Gitelman Syndrome ; Heterozygote ; Hypokalemia ; Kidney ; Magnesium ; Membranes

For evaluating the reproductive performances of GTD patients, we found 115 cases of GTD patients, 77 HM and 38 GTT, who became pregnant after the completion of treatments and follow-up period. The results of this study suggest subsequent pregnancies after the completion of treatments may promise normal reproductive outcomes regardless of the chemotherapy.
Drug Therapy ; Follow-Up Studies ; Gestational Trophoblastic Disease* ; Humans ; Pregnancy

Sexual dysfunction is a common side effect in patients treated with antipsychotics but significant differences exist across different compounds. We report hypersexuality symptoms in two female patients with schizophrenia who were receiving treatment with aripiprazole. The patients experienced more frequent sexual desire and greater sexual preoccupation after taking aripiprazole. We discuss the potential neuro-chemical mechanisms for this and argue that aripiprazole's unique pharmacological profile, partial agonism with high affinity at dopamine D2-receptor, may have contributed to the development of these symptoms.
Antipsychotic Agents ; Dopamine ; Felodipine ; Female ; Humans ; Piperazines ; Quinolones ; Schizophrenia ; Aripiprazole

Retina, a part of CNS, has served valuable and accessible tissue for elucidating the cellular properties of neurons and glia due to its similarity to brain. Unlike mammalian counterpart, avian retina is devoid of vessels and astrocytes. However little is known about glial reaction to neuronal injuries in this species. Therefore, this study was performed to investigate the microglial responses in the quail retina following neuronal injuries. The retinae from normal and optic nerve transected adult quails were studied immunohistochemically with anti-QH1, a marker known to be specific for microglia. In the normal retina, QH1-labeled microglial cells displayed typical feature of ramified (resting) form and were localized mainly in the inner plexiform layer. After optic nerve transection (ONT) morphology of microglial cells changed from the ramified to the amoeboid form. This feature of microglial cells maintained throughout the post operational periods until 28 days after ONT. Particularly, at 14 and 21 days after ONT amoeboid microglia displayed cell bodies with stout and bushy processes, suggesting active phagocytosis. The distribution pattern of microglia also changed in accord to ganglion cell degeneration: they gradually moved to layers of ganglion cells and optic nerve fibers where ganglion cell bodies and axons were under degeneration. This change of microglial distribution was most prominent at 14 days of ONT. The result of this study is generally consistent with that reported in mammalian counterpart and this similarity between the avascular avian retina and the vascularized mammalian counterpart suggests that processes of microglial activation, such as migration and phagocytosis, can occur in the vessel-free CNS tissue.
Adult ; Astrocytes ; Axons ; Brain ; Ganglion Cysts ; Humans ; Microglia* ; Neuroglia ; Neurons ; Optic Nerve Injuries* ; Optic Nerve* ; Phagocytosis ; Quail ; Retina ; Retinaldehyde*

Ovary is one of the organs in which angiogenesis occurs during ovarian cycle. Angiogenesis is associated with angiogenic factor like acidic fibroblast growth factor, basic fibroblast growth factor and transformation growth factor. Therefore, we performed this study to identify the distribution and mRNA expression of angiogenin, new potential angiogenic factor, in ovary of Korean native cattle by immunohistochemistry and in situ hybridization. Angiogenin immunoreactivity and mRNA expression were observed in endothelial cells, fibroblast and vascular smooth muscle cells. However, we could not observed angiogenin immunoreactivity and mRNA expression in primordial ovarian follicle. In follicular epithelial cells of primary ovarian follicle, weak angiogenin immunoreactivity and mRNA expression were observed. Follicular epithelial cells, theca interna and externa in secondary ovarian follicles, showed angiogenin immunoreactivity, while follicular epithelial cells did the weak mRNA expression. Angiogenin immunoreactivity and mRNA expression were observed in follicular epithlial cells, theca interna and oocyte in tertiary ovarian follicle. The corpus luteum showed strong immunoreactivity and mRNA expression but atretic follicle weak. However, these angiogenin immunoreactivity and mRNA expression became to be weaker during regression. These results suggest that angiogenin may play a role as not only an angiogenic factor but a growth factor in ovary.
Angiogenesis Inducing Agents ; Animals ; Cattle ; Corpus Luteum ; Endothelial Cells ; Epithelial Cells ; Female ; Fibroblast Growth Factor 1 ; Fibroblast Growth Factor 2 ; Fibroblasts ; Immunohistochemistry ; In Situ Hybridization ; Menstrual Cycle ; Muscle, Smooth, Vascular ; Oocytes ; Ovarian Follicle ; Ovary* ; RNA, Messenger* ; Theca Cells

BACKGROUND: We evaluated the effects of neurofeedback as an augmentation treatment on depressive symptoms and functional recovery in patients with treatment-resistant depression (TRD). METHODS: We included 24 adult patients with TRD and 12 healthy adults. 24 TRD patients were assigned to the neurofeedback augmentation group (n = 12) and the medication-only (treatment as usual [TAU]) group (n = 12). The neurofeedback augmentation group underwent combined therapy comprising medication and 12–24 sessions of neurofeedback training for 12 weeks. To assess the serum levels of brain-derived neurotrophic factor (BDNF) in both groups, pre- and post-treatment blood samples were obtained. Patients were evaluated using the Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI), Clinical Global Impression-Severity (CGI-S), 5-level version of European Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D-5L), and Sheehan Disability Scale (SDS) at baseline, and at the 1-, 4-, and 12-week. RESULTS: From baseline to week 12, neurofeedback training reduced mean scores on HAM-D, BDI-II, CGI-S, and SDS, and increased mean EQ-5D-5L tariff score. In the neurofeedback augmentation group, the response and remission rates were 58.3% and 50.0%, respectively, at week 12. Changes in HAM-D, EQ-5D-5L tariff score, and SDS were significantly larger in the neurofeedback group than in the medication-only (TAU) group. No significant difference in BDNF level was found pre- vs. post-treatment in any of the groups. CONCLUSION: Despite the small sample size, these results suggest that neurofeedback treatment may be effective as an augmentation treatment, not only for depressive symptoms, but also for functional recovery, in patients with TRD. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0004183 ClinicalTrials.gov Identifier: NCT04078438
Adult ; Brain-Derived Neurotrophic Factor ; Classification ; Depression ; Depressive Disorder, Major ; Humans ; Information Services ; Neurofeedback ; Pilot Projects ; Quality of Life ; Sample Size

The Angio-Seal is a widely used arterial closure device that helps achieve faster hemostasis and provide early ambulation to patients. However, it can cause various complications in clinical practice. We present the uncommon complication of popliteal artery occlusion following Angio-Seal deployment, and describe an effective interventional approach to its treatment. Because fluoroscopy-guided Fogarty embolectomy has the advantages of complete removal of the embolus without fragmentation, and clear visualization of the exact location of the embolus during the procedure, it is a suitable method for treating this complication.
Embolectomy/*instrumentation ; Embolism/radiography/*surgery ; Equipment Design ; Fluoroscopy/*methods ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; *Popliteal Artery ; Surgery, Computer-Assisted/*methods

OBJECT: Human chorionic gonadotropin (hCG) is used to induce final follicular maturation in women undergoing controlled ovarian hyperstimulation (COH). Urinary preparations are associated with a number of disadvantages including an uncontrolled source, batch-to-batch variability and lack of purity. We performed this study to compare the efficacy of recombinant hCG and urinary hCG for induction of final follicular maturation in women undergoing IVF-ET. METHODS: Prospective trial was performed on a total of 84 IVF cycles carried out in 84 infertile women with tubal and peritoneal factor. Patients were randomized 1:1 to 250 microgram of recombinant hCG subcutaneous injection or 10,000 IU of urinary hCG intramuscular injection after completing recombinant human follicle stimulating hormone (FSH) stimulation. Oocyte pickup was scheduled 36 hours after hCG administration and embryos were transferred 3 days after oocyte pickup. We measured the efficacy points including the number of retrieved and fertilized oocytes, quality of oocytes and embryos, and clinical pregnancy rate. RESULTS: Serum progesterone and hCG level on post-hCG day 5 were significantly higher in the recombinant hCG group (p<0.01, p<0.05). There were no significant differences in outcome including the number of retrieved oocytes, quality of oocytes and embryos, clinical pregnancy rate between the two preparations. The incidence of injection-site reactions such as pain, itching, and bruising were significantly lower in the recombinant hCG group (p<0.01, p<0.01 and p<0.05). CONCLUSIONS: For triggering ovulation, recombinant hCG seems to have significant advantages compared with urinary hCG in terms of luteal progesterone and local tolerance.
Chorionic Gonadotropin* ; Embryonic Structures ; Female ; Follicle Stimulating Hormone, Human ; Humans* ; Incidence ; Injections, Intramuscular ; Injections, Subcutaneous ; Oocytes ; Ovulation ; Pregnancy Rate ; Progesterone ; Prospective Studies ; Pruritus

Paracentesis is a diagnostic, therapeutic procedure performed in patients with ascites. It is generally thought to be a safe procedure and transfusion of platelet concentrate or fresh frozen plasma is not recommended before the procedure, because the incidence of clinically significant bleeding is very low. We report a case of lateral abdominal wall hematoma due to the injury of the deep circumflex iliac artery after paracentesis in patient with alcoholic liver cirrhosis who was treated with transcatheter arterial embolization.
Abdominal Wall/*blood supply ; Embolization, Therapeutic ; Hematoma/etiology/*therapy ; Humans ; Iliac Artery/injuries ; Liver Cirrhosis, Alcoholic/diagnosis ; Male ; Middle Aged ; Paracentesis/adverse effects