In recent years, marked increase in incidence of congenital syphilis has occured throughout the world due tochanges in social norms and development of penicillin-resistant strains. Early diagnosis plays an important rolein congenital syphilis as the clinical manifestations may simulalte many other conditions in the paediatric agegroup. The authors analized 52 cases of congenital syphilis admitted tot he department of paediatrics, ChosumUniversity Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 caseswere admitted from OPD, during the period of 8 years from Jan. 1975 to Dec. 1982. The reults obtained were asfollows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Amongthe 52 cases, a male predominance was observed with a male to female ratio of 2:1. 3. The serologic test (VDRL) ofthe 52 studied cases showed reactive in 49 cases (94%), and that of syphilitic mothers except 6 cases, rective inall studied cases. 4. The major manifstations of the 52 cases were bone tenderness (12%) and swelling of thejoints(7%) inskeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. Theradiological skeletal changes were detected in 45 of 52 cases(87%), and the commonest findings were detected in 45of 52 cases (87%), and the commonest findings were metaphsitis(83%) and periostitis(81%). The most characteristictype of metaphysitis were transverse trophic line(74%) and zone of rarefaction (65%). 6. The comonest bones to beaffected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order offreqeuncy were radius (80%), ulna(80%), tibia(77%), femur(69%) and hymerus(40%).
Early Diagnosis ; Female ; Humans ; Incidence ; Knee ; Male ; Mothers ; Radius ; Serologic Tests ; Skin ; Social Norms ; Syphilis, Congenital ; Wrist

A clinical and radiological obsevation was made on 62 cases of urinary tract injury in the Dept. of urology,Chosun Universtiy hospital during the period from January 1979 to December 1983. The results were as follows; 1.Age distribution of the lower urinary tract injury was the highest in the age 41 to 50(39.6%). The sex ratio, maleto female was 6.8:1. 2. The most common cause of the L.U.T.I. was traffic accident in 23 cases (37.1%) and othersare fall down in 15 cases (24.2%), blunt trauma in 13 cases (21.0%), saddle injury in 8 cases(12.9%). 3. Theradiological finding of the bladder injury shows intraperitoneal extravasation in 11 caess(64.7%), extraperitonealextravasation in 5 cases(29.4%), and deformity of bladder in 12 cases(70.6%). 4. The radiological finding of theurethral injury shows extravasation of contrast media in 44 cases(97.8%). venous intravasation in 11 cases(24.4%),penile urethra in 1 case(2.3%). 6. The L.U.T.I. was associated with pelvic bone fracture in 33 cases (53.2%) esp.pubic bone fracture in 24 cases(38.7%). 7. The complication of the L.U.T.I. was urethral stricture in 24cases(38.7%), fistula formation in 3 cases(4.8%), incontinence in 2 cases(3.2%).
Accidents, Traffic ; Congenital Abnormalities ; Extravasation of Diagnostic and Therapeutic Materials ; Female ; Fistula ; Fractures, Bone ; Humans ; Pelvic Bones ; Sex Ratio ; Urethra ; Urethral Stricture ; Urinary Bladder ; Urinary Tract

Pyogenic arthritis remain a difficult problem, despite the availability of a wide range of powerful modernantibiotics. Early and correct diagnosis is imperative to assure the prompt initiation of an effective therapeuticregimen and the prevent of late sequela. Careful clinical, laboratory and roentgenological analysis arefundamental to early and precise diagnosis. Therefore, plain roentgenogram shold not be overlooked. A radiologicaland clinical observation was made in 51 cases of pyogenic arthritis admittted to Chosun University Hospital duringthe period from January 1976 to Dec. 1983 and following results were obtained. 1. Among the 51 cases, 36 cases(70.6%) were male and 15 cases(29.4%) were females. The most prevalent age was 5 to 9 (27.6%). 2. Symptom durationless than 5 days was in 21 cases (41.2%) and more than 31 days was in 6 cases (11.7%). 3. The most common symptomon admission was pain around the involved joint and others are limitation of motion, swelling, tenderness, fever,local heating and erythema. 4. The underlying causes were composed of unknown in 21 cases(41.2%), trauma in 18cases(35.3%), infections focus in 8 cases (15.7%) and iatrogenic reasone 4 cases(7.8%) 5. The msot commonlyaffected joint was hip joint (45.1%). The other affected sites in order of frequency were knee, ankle, shoulder,S-I and elbow joint. In infants and children, hip and knee joint are commonly affected; In adults, knee joint ismost commonly affected. 6. In laboratory findings, the number of W.B.C and E.S.R were increased in 56.9%. Symptomduration more than 31 days in 5 cases were increased E.S,R only. Causative microorganism was isolated in 31 cases;the most common microorganism was Staphylococcus auterus in 22 cases. Others are B-hemolytic Streptococcus,Enterobacteriaceae species and Pseudomonas aeruginosa. 7. In 26 cases(50.9%) of the patients, roentgenographicfinding was negative. The most common radiological findig was soft tissue swelling and the others are include inorder of frequency: joint space widening, small erosions in articular cortex, subchondral osteoporosis. The comonradiological findings of symptom duration more than 31 days in 6 cases were lost of entire cortex, ankylosis andjoint space narrwoing.
Adult ; Ankle ; Ankylosis ; Arthritis ; Child ; Diagnosis ; Elbow Joint ; Erythema ; Female ; Heating ; Hip ; Hip Joint ; Hot Temperature ; Humans ; Infant ; Joints ; Knee ; Knee Joint ; Male ; Osteoporosis ; Pseudomonas aeruginosa ; Staphylococcus

Oocyte in vitro maturation (IVM) is an assisted reproductive technology in which oocytes are retrieved from the antral follicles of unstimulated or minimally stimulated ovaries. IVM of human oocytes has emerged as a promising procedure. This new technology has advantages over controlled ovarian stimulation such as reduction of costs, simplicity, and elimination of ovarian hyperstimulation syndrome. By elimination or reduction of gonadotropin stimulation, IVM offers eligible infertile couples a safe and convenient form of treatment, and IVM outcomes are currently comparable in safety and efficacy to those of conventional in vitro fertilization. IVM has been applied mainly in patients with polycystic ovary syndrome or ultrasound-only polycystic ovaries, but with time, the indications for IVM have expanded to other uncommon situations such as fertility preservation, as well as to normal responders. In this review, the current clinical experiences with IVM will be described.
Family Characteristics ; Female ; Fertility Preservation ; Fertilization in Vitro ; Gonadotropins ; Humans ; In Vitro Oocyte Maturation Techniques ; Infertility ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovary ; Ovulation Induction ; Polycystic Ovary Syndrome ; Reproductive Techniques, Assisted

OBJECTIVE: The aim of this study was to compare vitrification optimization of mouse embryos using electron microscopy (EM) grid, cryotop, and thin plastic strip (TPS) containers by evaluating developmental competence and apoptosis rates. METHODS: Mouse embryos were obtained from superovulated mice. Mouse cleavage-stage, expanded, hatching-stage, and hatched-stage embryos were cryopreserved in EM grid, cryotop, and TPS containers by vitrification in 15% ethylene glycol, 15% dimethylsulfoxide, 10 microg/mL Ficoll, and 0.65 M sucrose, and 20% serum substitute supplement (SSS) with basal medium, respectively. For the three groups in which the embryos were thawed in the EM grid, cryotop, and TPS containers, the thawing solution consisted of 0.25 M sucrose, 0.125 M sucrose, and 20% SSS with basal medium, respectively. Rates of survival, re-expansion, reaching the hatched stage, and apoptosis after thawing were compared among the three groups. RESULTS: Developmental competence after thawing of vitrified expanded and hatching-stage blastocysts using cryotop and TPS methods were significantly higher than survival using the EM grid (p<0.05). Also, apoptosis positive nuclei rates after thawing of vitrified expanded blastocysts using cryotop and TPS were significantly lower than when using the EM grid (p<0.05). CONCLUSION: The TPS vitrification method has the advantages of achieving a high developmental ability and effective preservation.
Animals ; Apoptosis ; Blastocyst ; Dimethyl Sulfoxide ; Embryonic Structures ; Ethylene Glycol ; Ethylenes ; Ficoll ; Mental Competency ; Mice ; Microscopy, Electron ; Plastics ; Sucrose ; Vitrification

OBJECTIVE: This study aimed to determine the safety and clinical effect of artificial shrinkage (AS) in terms of assisted hatching of fresh blastocysts. Also, we evaluated the correlation between patient age and the effect of AS on clinical outcome. METHODS: Two AS methods, using a 29-gauge needle and laser pulse, were compared. Seventy-three blastocysts were shrunk using a 29-gauge needle and the same number of other blastocysts were shrunk by a laser pulse. We evaluated the shrunken blastocysts hourly and considered them viable if they re-expanded >70%. Blastocyst transfer cycles (n=134) were divided into two groups: a control group consisted of the cycles whose intact embryos were transferred (n=100), while the AS group consisted of the cycles whose embryos were replaced following AS (n=34). The implantation and pregnancy rates of the control group and AS group were compared (p<0.05). RESULTS: The re-expansion rates of the 29-gauge needle and laser pulse AS groups were similar (56 [76.7%] vs. 62 [84.9%], respectively). All of the remaining shrunken blastocysts were re-expanded within 2 hours. There was no degeneration of shrunken blastocysts. The total and clinical pregnancy rate of the AS group (23 [67.6%]; 20 [58.8%], respectively) was significantly higher than that of the control group (47 [47.0%]; 39 [39.0%], respectively). In the older patient group, there was no difference in the clinical outcomes between the AS and control groups. CONCLUSION: These results suggest that AS of blastocoele cavity, followed by the transfer, would be a useful approach to improve the clinical outcome in cycles in which fresh blastocyst stage embryos are transferred.
Blastocyst ; Embryo Transfer ; Embryonic Structures ; Fertilization in Vitro ; Humans ; Needles ; Pregnancy Rate

OBJECTIVE: To study the clinical outcomes of single frozen-thawed blastocyst transfer cycles according to the hatching status of frozen-thawed blastocysts. METHODS: Frozen-thawed blastocysts were divided into three groups according to their hatching status as follows: less-than-expanded blastocyst (≤EdB), hatching blastocyst (HgB), and hatched blastocyst (HdB). The female age and infertility factors of each group were evaluated. The quality of the single frozen-thawed blastocyst was also graded as grade A, tightly packed inner cell mass (ICM) and many cells organized in the trophectoderm epithelium (TE); grade B, several and loose ICM and TE; and grade C, very few ICM and a few cells in the TE. The clinical pregnancy and implantation rate were compared between each group. The data were analyzed by either t-test or chi-square analysis. RESULTS: There were no statistically significant differences in average female ages, infertility factors, or the distribution of blastocyst grades A, B, and C in each group. There was no significant difference in the clinical pregnancy and implantation rate of each group according to their blastocyst grade. However, there was a significant difference in the clinical pregnancy and implantation rate between each group. In the HdB group, the clinical pregnancy and implantation rate were similar regardless of the blastocyst quality. CONCLUSION: There was an effect on the clinical outcomes depending on whether the blastocyst hatched during single frozen-thawed blastocyst transfer. When performing single frozen-thawed blastocyst transfer, the hatching status of the frozen-thawed blastocyst may be a more important parameter for clinical outcomes than the quality of the frozen-thawed blastocyst.
Blastocyst* ; Embryo Transfer* ; Epithelium ; Female ; Humans ; Infertility ; Pregnancy ; Retrospective Studies* ; Single Embryo Transfer ; Vitrification

Distal thumb injuries are a common and difficult problem for hand surgeons. Coverage of soft tissue on the fingers may be difficult due to the size of the defect or the limitation of local flap mobilization. However, the variable anatomy of the dorsal hand vascular system sometimes prevents successful flap harvest. The purpose of this study was to clarify the vascular anatomy of the dorsal side of the thumb and the first web for the flaps. Twenty six hands (13 right and 13 left hands) from Korean embalmed cadavers were dissected. A catheter was inserted into the radial artery in the forearm, and the red colored latex (Latex 671, Dupont Industry, France) was injected until the dorsum of the hand was colored. The arrangement of the first dorsal metacarpal artery (FDMA) and its branches were vary and classified into three categories according to their branching patterns; Both dorso-ulnar thumb branch (DUTB) and dorso-radial index branch (DRIB) arose from the FDMA (10 cases, 38.5%). Each DUTB and DRIB arose separately from the radial artery (5 cases, 19.2%). The DUTB and the DRIB originated from the princeps pollicis artery and the radial artery, respectively (11 cases, 42.3%). The typical course of the FDMA and its branches ran overlying the first dorsal interosseous muscle in 17 cases of the 26 specimens (65.4%). However, in nine cases (34.6%) the DRIB ran on the first dorsal interosseous muscle and the DUTB had a deep course within the substance of the first dorsal interosseous muscle. The FDMA flap represents a good option to cover defects for the thumb. These anatomical findings in the present study could provide useful knowledge of flaps for dorsal aspect of the thumb and the first web.
Arteries ; Cadaver ; Catheters ; Fingers ; Forearm ; Hand ; Latex ; Muscles ; Radial Artery ; Thumb

OBJECTIVE: This study was conducted to compare the effects of static culture, dynamic culture, and the combination of dynamic culture with specialized surfaces involving co-culture on human embryonic development. Embryos cultured using conventional static culture (SC) techniques served as a control group. We compared dynamic culture using micro-vibration culture (MVC) and micro-vibration with co-culture (MCoC), in which autologous cumulus cells were used as a specialized surface. METHODS: We conducted a chart review of patients who were treated between January 2011 and November 2014 in order to compare embryonic development rates and pregnancy rates among the groups. Zygotes were cultured in micro-droplets, and embryos were subsequently selected for transfer. Some surplus embryos were cryopreserved, and the others were cultured for blastocyst development. A micro-vibrator was set at the frequency of 42 Hz for duration of 5 seconds per 60 minutes to facilitate embryo development. RESULTS: No significant differences among the groups were present in patient's characteristics. However, the clinical pregnancy rates were significantly higher in the MVC group and the MCoC group than in the SC group. No significant differences were found in the blastocyst development rate between the SC group and the MVC group, but the blastocyst development rate in the MCoC group was significantly higher than in the SC and MVC groups. CONCLUSION: The clinical pregnancy rate was significantly increased by the application of micro-vibration to the embryonic cultures of poor responders. The blastocyst development rate was significantly increased by the application of MCoC to surplus embryos.
Blastocyst ; Coculture Techniques* ; Cumulus Cells ; Embryo Culture Techniques ; Embryonic Development ; Embryonic Structures ; Female ; Humans ; Pregnancy ; Pregnancy Rate ; Zygote

Septic arthritis is the infection of a joint by an infectious agent, leading to arthritis. It is therefore important to identify and treat the correct bacteria in septic arthritis. However, accurate identification of bacteria by conventional methods is difficult because of the distinct biochemical characteristics of individual bacteria. This case report aims at assessing septic arthritis caused by Streptococcus dysgalactiae subsp. equisimilis(SDSE) using nucleotide sequences and discusses the associated treatment. Here, Streptococcus agalactiae was determined to be the causative bacteria for septic arthritis in a 77 year-old woman using the conventional method of hemolysis pattern interpretation and morphology. However, nucleotide sequence analysis of 16S ribosomal RNA revealed that SDSE was the causative strain. 16S rRNA gene sequencing can correctly identify bacteria strains that are difficult to be identified by traditional method, and this correct identification can provide patients with the opportunity for adequate treatment using the proper antibiotics.
Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious ; Bacteria ; Base Sequence ; Female ; Genes, rRNA* ; Hemolysis ; Humans ; Joints ; Knee* ; Methods ; RNA, Ribosomal, 16S ; Streptococcus agalactiae ; Streptococcus*