To evaluate the possible functional role of serum during the process of parturition, 15 serum samples were collected and analyzed for the nickel concentrations in each 3 groups(Group 1 for the period during parturition, Group 2 for the period from delivery of fetus to delivery of placenta, and Group 3 for the period after delivery of placenta) of normal, uncomplicated full term vaginal delivery and one control group composed of healthy unmarried women in 3rd decades of age. Data revealed that average serum nickel concentration of Group 2(26.6 microgram/l) and Group 1(22.2 microgram/l) were significantly higher than that of Control group(13.7 microgram/l), but Group 3's(13.8 microgram/l) was almost same as Control group's. There were significant negative correlation between age and serum nickel concentration in group 2, and a tendency of higher nickel concentration in women who have no previous experiences of pregnancy than who have previous experiences of pregnancy, although it was not significant. These result could be indicative of close causal relationship between serum nickel concentration and the entire process of parturition.
Female ; Fetus ; Humans ; Nickel* ; Parturition ; Placenta ; Pregnancy ; Single Person

The incidence of cervical pregnancy and the number of combined intrauterine pregnancy and ectopic pregnancy seems to be increasing. So the possibility of heterotopic pregnancy should always be considered by every gynecologist, especially those who treat infertility problem. We experience a case of a heterotopic pregnancy coexisting of an intrauterine pregnancy and a cervical pregnancy after in-vitro fertilization and embryo transfer, and was successfully managed by transcervical evacuation and resulted in a normal intrauterine pregnancy. Here we present the case with review of literatures.
Embryo Transfer ; Female ; Fertilization ; Fertilization in Vitro* ; Incidence ; Infertility ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Heterotopic*

PURPOSE: To elucidate the mechanism of neoangiogenesis in human retinal pigment epithelium under oxidative stress. METHODS: Paraquat was added to cultured human retinal pigment epithelium (HRPE) for 72 hours to induce oxidative stress milieu. Expression and production of angiogenic factors, including vascular endothelial growth factor (VEGF) and pigment epithelial derived factor (PEDF), was checked by RT-PCR and Western blot, respectively. The induction of neoangiogenesis was monitored by both tube formation in ECV 304 cell and migration assay of human fetal dermal microvascular endothelial cells. RESULTS: Competitive RT-PCR showed that PEDF gene in paraquat-treated HRPE was expressed at a significantly lower level than in non-treated HRPE. However, Western blot showed a significant increase of VEGF production (p<0.05) and a decrease of PEDF production (p<0.05). Moreover, angiogenesis was dose-dependently increased when the various concentrations of paraquat were added to HRPE. CONCLUSIONS: Taken together, oxidative stress by addition of paraquat caused HRPE to produce more VEGF and less PEDF, thereby leading to neoangiogenesis, and suggesting that the neovascularization in age-related macular degeneration (AMD) is caused by destroying the balance of angiogenic factors in HRPE such as VEGF and PEDF; that is, in oxidative stressed HRPE, more VEGF is released and less PEDF, as compared to normal HRPE.
Angiogenesis Inducing Agents ; Blotting, Western ; Endothelial Cells ; Humans* ; Macular Degeneration ; Oxidative Stress* ; Paraquat ; Retinal Pigment Epithelium ; Vascular Endothelial Growth Factor A

PURPOSE: This study was conducted to examine the effects of a multicultural course on nursing students' multicultural acceptability and competency. METHODS: The research design for this study was a non-equivalent control group, non-synchronized pre- and post-test. The experimental group (n=28) took 13 weeks of the multicultural course, while the control group (n=28) received only regular classes over the same period. Pre- and post-tests were done to identify the effects of the program. The data were collected using self-administered questionnaires and analyzed using the PASW 18.0 program. RESULTS: All indices of multicultural acceptability and competency in the experimental group were significantly higher than that of control group after the program, except for two: universality (a measure of multicultural acceptability) and multicultural awareness (a measure of multicultural competency). CONCLUSION: These results suggest that the multicultural course was effective in elevating the level of multicultural acceptability and competency among nursing students.
Cultural Competency ; Humans ; Nursing* ; Research Design ; Students, Nursing*

The anesthetic management of a patient with pheochromoctoma in pregnancy is presented. Preoperative phenoxybenzamine therapy and careful intraoperative monitoring preduced successful cesarean section and tumor reseetion in this patient. Problems that occurred during mamagement of this patient are hypoxemia(R/0 pulmonary edema) and cardiovascular flucctuation according to the operative procedure. Hypoxemia oceurred possibly due to large amount of crystalloid infusion in a short time and was solved with applying positive end expiratory pressure and using diuretics. Blood pressure was controlled effectively with sodium nitroprusside or phenylephrine infusion according to the operative procedure. Preoperative pregnancy induced liver disease in this patient was recovered after delivery.
Anesthesia, General ; Anoxia ; Blood Pressure ; Cesarean Section ; Diuretics ; Female ; Humans ; Liver Diseases ; Monitoring, Intraoperative ; Nitroprusside ; Phenoxybenzamine ; Phenylephrine ; Pheochromocytoma* ; Positive-Pressure Respiration ; Pregnancy* ; Surgical Procedures, Operative

PURPOSE: To evalvate the usefulness of single-voxel localized proton MR spectroscopy(MRS) in monitoring changes in cerebral metabolites in cases of acute cerebral infarction. MATERIALS AND METHODS: In 15 cats with common carotid artery occlusion and 21 patients with acute cerebral infarction T2-weighted (T2WI), diffusion-weighted (DWI), and MR spectroscopic images were obtained at various times after stroke onset. RESULTS: In the cat model, Lac and alpha-Glx levels increased as early as 30minutes after vascular occlusion and continued to increase for a further 2 hours. The remaini ng metabolites, NAA, Cho, mI, and alpha, alpha-Glx, showed no significant change. During clinical study, increases in Lac and alpha,alpha-Glx, and decreases in NAA were detected three hours after stroke onset. These metabolites continued to change until 72 hours had elapsed. The remaining metabolites, Cho, mI, and alpha-Glx tended to be constant. CONCLUSION: MRS is capable of measuring and monitoring the metabolites involved in acute cerebral infarction. MRS may play an important role in the investigation of pathophysiology as well as in the early diagnosis of acute cerebral infarction.
Animals ; Carotid Artery, Common ; Cats ; Cerebral Infarction* ; Early Diagnosis ; Humans ; Magnetic Resonance Spectroscopy* ; Protons* ; Stroke

Dendritic cells (DC) are highly efficient antigen-presenting cells that initiate the primary immune response. Several laboratories have developed culture systems for human DC from peripheral blood monocytes. Most of these studies have used fetal calf serum (FCS) containing culture conditions that are inappropriate for human application. GM-CSF and IL-4 were used to make immature DC. The monocyte-conditioned medium (MCM) was used to induce the final maturation of DC. Using the previously described methods, the quality of MCM has unpredictable variations. Therefore using a defined cocktail of growth factors for the generation of mature DC would be advantageous for experimental as well as clinical purposes. In this study, it is suggested that combinations of both GM-CSF/IL-4 or GM-CSF/IL-13 could be used as the first-step culture to produce immature DC, and that cytokine cocktail (GM-CSF, IL-4, IL-1beta, TNF-alpha, IL-6, PGE2) was as efficient as MCM for the second step-culture to produce fully maturated DC. Here, we have generated an easily reproducible culture system for DC that allows for the generation of large amounts of immature and mature DC, and we also now have established the method in a FCS-free system that is suitable for clinical use.
Cell Division/drug effects ; Culture Media/pharmacology ; Cytokines/pharmacology ; Cytological Techniques* ; Dendritic Cells/cytology* ; Human ; Monocytes/cytology*

OBJECTIVE: The purpose of this study was to investigate whether high dose progesterone intramuscular injections before oocyte retrieval and thereafter increase the implantation and pregnancy rates through improvement of uterine receptivity in patients undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS: The retrospective randomized analysis was performed in whom undergoing conventional IVF- ET at Chonnam National University Hospital Infertility Clinic from August, 1996 to July, 2001. The study group consisted of 57 patients having intramuscular progesterone injections for 4-5 days from the day of hCG injection to the day of embryo transfer and 60 patients without progesterone supplement (control group). We compared between two groups with respect to age distribution, cause of infertility, blood levels of hormone, number of aspirated ovum, number of fertilized egg, number of cleaved embryo, number of transfered embryo, embryo transplantation, cumulative embryo score, chemical and clinical pregnancy rates. RESULTS: The oocytes retrievals were done at 87 cycles in study group and 82 cycles in control group. There were no significant differences in the average age and distribution of causes of infertility. Tubal factor was the dominant cause of infertility in both groups. There were no significant differences in the number of aspirated eggs, number of fertilized eggs, cleavage rates and number of multinuclear fertilized eggs. The embryo transfer were performed 76 out of 87 cycles in study group, and 64 out of 82 cycles in control group. The average number of transferred embryos to the uterine cavity was not different, in the study and control group (2.72+/-1.64 and 2.39+/-2.03 respectively). The chemical pregnancy rate did not differ significantly (7.89% in study group, and 6.25% in control group). The clinical pregnancy rate was higher in the control group (18.75%) than in the study group (12.84%), but the result was not statistically significant. However, the number of fertilized eggs and cumulative embryo score were significantly higher in study group. CONCLUSION: High dose of progesterone supplementation before and after oocyte retrieval in IVF-ET cycles did not improve pregnancy outcome, instead showed lower pregnancy rate than no supplement group, thus we cannot consider progesterone supplementation improve endometrial receptivity and increase implantation and pregnancy rate. But, since we could improve the fertilization rate and embryo development rate through increase of the number of fertilized eggs and cumulative embryo score, further evaluation is needed in this field and we have to make vigorous efforts to increase implantation rate in IVF-ET cycles.
Age Distribution ; Eggs ; Embryo Transfer* ; Embryonic Development ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Humans ; Infertility ; Injections, Intramuscular ; Jeollanam-do ; Oocyte Retrieval ; Oocytes ; Ovum ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Progesterone* ; Retrospective Studies ; Zygote

Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Furthermore, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treatment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison's disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.
Addison Disease ; Adrenal Insufficiency ; Glucocorticoids ; Humans ; Hyponatremia ; Middle Aged ; Ofloxacin ; Rifampin ; Tuberculosis, Pulmonary

OBJECTIVE: To compare the clinical outcomes of day 2 embryo tranfer with those of day 3 embryo transfer after In Vitro Fertilization (IVF). METHODS: Medical records of 192 patients (217 cases) undergoing IVF-ET at Chonnam National University Hospital from February 1995 to July 2001 were reviewed. The number of cases of the day 2 transfer (D-2) group and the day 3 transfer (D-3) group was 152 and 65, respectively. Clinical characteristics, mean number of fertilized oocytes, frequency of embyo qualities, mean number of embyo transferred, cumulative embryo score (CES) per transfer, pregnancy rate per cycle, clinical pregnancy rate per cycle and implantation rate per transferred embyo were compared between the two groups. RESULTS: In embyo quality, grade I in D-2 group (69.5%) was much more than in D-3 group (52.3%) in number, and grade III and IV in D-3 group (9.7% and 6.2%) was much more than in D-2 group (1.0% and 0.2%). CES was significantly higher in D-3 group than in D-2 group (62.4+/-40.0 versus 49.1+/-34.2). However, there were no statistically significant differences between the two groups in number of fertilized oocytes, number of embryo transferred, pregnancy rate, implantation rate and pregnancy outcome. There were also no significant differences between the two groups in implantation and pregnancy rates according to age, under 35 vs over 35 and the presence or absence of previous IVF-ET failure. CONCLUSION: There were no difference in the pregnancy rate and implantation rate between the two groups. The CES which indicates the quality of embryo was higer in D-3 group than in D-2 group. Since this study did not show the direct effect of better quality of D-3 embryo on implantation rate and pregnancy rate, further investigation should be needed. In addition, further studies about improving culture media for embryonic development and selecting better quality embryos for delayed embryo transfer should be continued.
Culture Media ; Embryo Transfer* ; Embryonic Development ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Humans ; Jeollanam-do ; Medical Records ; Oocytes ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate