Magnetic resonance imaging(MRI)has proved to be a valuable method for evaluation of the head and neck. Unfortunately, metallic devices associated with certain dental fillings and applicances often cause variable artifacts that can obscure normal or pathologic conditions on MR and computed tomography. In this work, we assessed the MR appearance of dental prosthetic materials in vitro and in vivo including precious alloys. Nonprecions alloys, resin, amalgam and titanium alloy, For in vivo studies, these materials were placed in healthy volunteer's mouths and then images were assesed. Analyis of the appearance of shape and extent of artifact,and observed influence of these artifacts on the image interpretation at 0.2 Tesla permanent type MR scanner were valuated. Material used as temporary or permanent filling of crowns such as amalgam. precious alloy and, microfilled resin did not cause artifact on the image. The size of the artifact produced by the nonprecious alloys was influenced by the ferromagnetism of the object and the volume prosthesis, and was related to the scanning sequence. Nonprecious alloys produced minimal local signal distortions, where precious alloys, and dental resin had no effect on the MR image in vivo. These results were mainly from a low field strength MR scanner used in this study.
Alloys ; Artifacts* ; Crowns ; Dental Materials* ; Equidae ; Head ; In Vitro Techniques ; Magnetic Resonance Imaging* ; Magnets ; Methods ; Mouth ; Neck ; Prostheses and Implants ; Resins, Synthetic ; Silicone Elastomers ; Titanium

OBJECTIVE: It is known that normal follicular growth and pregnancy are possible using Follicular stimulating hormon(FSH) alone during controlled ovarian hyperstimulation(COH) for IVF-ET. The purpose of this study was to compare and analize the results of COH for IVF-ET between a group using only FSH-HP and a group using FSH/hMG METHOD: 111 cycle of the total 280 COH for IVF-ET cycles belonged to the FSH-HP group, and the FSH/hMG group accounted for remaining 169 cycles. The amount of gonadotropin administered, the duration of hormonal therapy, the number of embryos transfered, the endometrial thickness, and the pregnancy rate were compared between the two groups and statistically analized using the t-test. p values less than 0.05 deemed statistically significant. RESULT: There were no statistical differences on the amount of gonadotropin administered, the duration of hormone therapy, number of oocytes retrieved, nor the endometrial thickness between the two groups. However,the serum E2 level was significantly lower, and the number of embryos of high quality(GradeIandII) significantly higher in the FSH-HP group. In pregnancy rate, FSH-HP group shows higher than FSH/hMG group(38.8% VS 34.2%). but the difference was not large enough to be considered statistically significant. CONCLUSION: The results of this study show that compared to using FSH/hMG, treatment with FSH-HP alone allowed the retrieval of more embryos of high quality, and although not statistically significant, achieved a higher pregnancy rate, thus indicating that it can be used as an effective method for COH.
Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro* ; Gonadotropins ; Oocytes ; Pregnancy ; Pregnancy Rate

BACKGROUND: There are many reports about the correlation between cardiovascular disorders and estrogen deficiency in postmenopausal women. The purpose of current study is to know that postmenopausal estrogen therapy may affect the lipid metabolism and endogenous fibrinolytic system and exercise tolerance. METHOD: We investigated the relation of estrogen treatment (srogen 0.625 mg/day) to serum lipid levels, angiotensin converting enzyme activity, plasminogen activator inhibitor-1 and parameters of treadmill test in 22 postmenopausal women of normal coronary artery with abnormal exercise test complained with chest pain accompanied by postmenopausal symptoms. RESULTS: Estrogen treatment significantly elevated the serum HDL-cholesterol level (42.8 to 50.1 mg/dl, p<0.05) and reduced the PAI-1 level (16.2 to 10.4 ng/dl, p<0.01) without considerable side effects. During the exercise test, the positivity appearance time and total exercise duration is significantly increased after estrogen treatment. CONCLUSION: The postmenopausal use of estrogen favorably changed the lipid level, fibrinolytic system and might improve the microcirculation which may protect against the ischemic heart disease risk without significant side effects.
Chest Pain ; Coronary Vessels ; Estrogens* ; Exercise Test ; Exercise Tolerance ; Female ; Humans ; Lipid Metabolism ; Microcirculation ; Myocardial Ischemia ; Peptidyl-Dipeptidase A ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Postmenopause

BACKGROUND: Appendicitis is one of the most common causes of abdominal emergency with a life time risk of 6-8%. Children are unable to give an accurate history, and since acute nonspecific abdominal pain is more common than appendicitis at this age, diagnosis and management of appendicitis are often delayed. This results in more frequent complications and difficult management. In order to evaluate whether pediatric appendicitis should be thought as more urgent and serious because of the delay in its diagnosis, we compared the clinical characteristics and outcomes of appendicitis in children with those of adults. METHODS: We retrospectively reviewed 106 adults and 43 children who were pathologically verified with appendicitis after an appendectomy. RESULTS: There was no difference in the duration of symptoms. Advanced appendicitis was more frequent in children (60.5% vs. 53.7%). In children, the symptom durations of advanced appendicitis were similar to those that of early appendicitis, but were significantly longer in adults. Children showed no increase in cumulative rate of advanced appendicitis in relation with prolonged symptom duration whereas adults showed a steady increase after 72 hours of onset. The complication rate was higher in advanced cases in both, but children had a lower complication rate than adults. The postoperative hospital stay was significantly longer in advanced cases in both, but children had a relatively shorter hospital stay. CONCLUSIONS: Pediatric appendicitis was more prone to early perforation with a relatively higher perforation rate. However, children had a lower morbidity rate and a shorter admission stay. Therefore, appendicitis in children is not necessarily more serious and urgent than in adults.
Abdominal Pain ; Adult* ; Appendectomy ; Appendicitis* ; Child* ; Diagnosis ; Emergencies ; Humans ; Length of Stay ; Retrospective Studies

BACKGROUND: It is well known that coronary arterial thrombosis plays an important role in the pathogenesis of acute coronary syndrome and this has focused interest on the role of the fibrinolytic system, especially tissue plasminogen activator(t-PA) and plasminogen activator inhibitor-1(PAI-1), which are major determinants of fibrinolytic system. But there are considerable variations in the reported association between these two components and acute coronary syndrome. METHODS: To evaluate association between t-PA, PAI-1 and myocardial infarction, plasma level of t-PA and PAI-1 in resting state and after venous occlusion were measured and analysed in patients with previous myocardial infarction at least 6 months after the acute phase, who showed less than 70% luminal narrowing angiographically and control group. The relationship between t-PA, PAI-1 antigen and activity and relation to age, serum triglyceride, cholesterol, and peak creatine kinase(CK) enzyme were also analyzed. RESULTS: 1) In resting state, there was a significant difference of plasma level of both t-PA and PAI-1 antigen, activity between patient and control group(10.72+/-3.28 vs 8.16+/-4.03ng/ml, 0.53+/-0.34 vs 0.02+/-0.07U/ml, 26.24+/-8.30 vs 20.82+/-8.82ng/ml, 14.62+/-5.97 vs 6.99+/-6.44U/ml)(p<0.05), and resting plasma level of PAI-1 activity showed a good correlation with peak creatine kinase(CK) enzyme(r=0.76, p<0.01). 2) After venous occlusion, plasma level of t-PA antigen was significantly increased(8.16+/-4.03 vs 9.87+/-3.86ng/ml)(p<0.05) whereas t-PA activity and PAI-1 antigen were not significantly changed in control group. In patient group, t-PA antigen, t-PA activity and PAI-1 antigen were significantly inceased after venous occlusion(10.72+/-3.28 vs 14.66+/-5.41ng/ml, 0.53+/-0.34 vs 1.41+/-1.69U/ml, 26.24+/-8.30 vs 29.87+/-8.78ng/ml)(p<0.05). PAI-1 activity was significantly decreased after venous occlusion in both groups(6.99+/-6.44 vs 6.06+/-5.99U/ml, 14.62+/-5.97 vs 12.67+/-6.46U/ml)(p<0.05). CONCLUSION: Both fibrinolytic and anti-fibrinolytic systems are augmented in resting and after fibrinolysis stimulation test in patient group. These findings suggested a impairment of fibrinolytic system in patient group and a possibility that both elevated plasma levels of t-PA and PAI-1 may be markers of coronary artery disease.
Acute Coronary Syndrome ; Cholesterol ; Coronary Artery Disease ; Creatine ; Fibrinolysis ; Humans ; Myocardial Infarction* ; Phenobarbital ; Plasma* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Thrombosis ; Tissue Plasminogen Activator* ; Triglycerides

In order to study the implantation mechanism various methods for culture of endometrial cells in vitro have been attempted. However, a disadvantage is that primary cultures of stromal and epithelial cells do not have the ability to differentiate, and therefore cannot be reproduced in the same manner as in vivo endometrium. The object of this study is to establish a three dimensional culture of endometrial cells which are both morphologically and functionally identical to in vivo endometrium. Endometrial tissues obtained after hysterectomies were cut into thin slices and treated with collagenase and trypsin-EDTA. The stromal cells and the epithelial cells were separated by centrifugation and cultured for 24 hours in DMEM media containing 10% FCS, 100 nM progesterone, and 1 nM estradiol. The cultured stromal cells were mixed with collagen gel and solidified, after which it was covered with matrigel. Epithelial cells were inoculated on the top and then cultured for 3 days. The three dimensionally cultured endometrial cells were stained for integrin alphal, alpha4, beta3, and cyclooxygenase-1, -2 by immunohistochemistry, which all showed strong expression. The cultured epithelial cells showed the formation of microvilli, tight junctions and pinopodes by electron microscopy. Studies are currently under way utilizing this three dimensional culture model to ascertain the interaction between the embryo and human endometrial cells at the time of implantation, and it is thought that further studied into a new culture environment which would allow longer periods of culture will be necessary.
Antigens, CD11a ; Centrifugation ; Collagen ; Collagenases ; Cyclooxygenase 1 ; Embryonic Structures ; Endometrium ; Epithelial Cells ; Estradiol ; Female ; Humans* ; Hysterectomy ; Immunohistochemistry ; Microscopy, Electron ; Microvilli ; Progesterone ; Stromal Cells ; Tight Junctions

BACKGROUND: In survivors of acute myocardial infarction(ANI), reduced heart rate variability(HRV) has been demonstrated to be an independent predictor of sudden cardiac death and mortality. The heart rate variability can be examined and analyzed non-invasively and quantitated with 24-hour ambulatory ECG monitoring. In general, the patency of infarct-related artery appears to be one of the most important prognostic factor after AMI. Therefor, the correlation between infarct artery patency and HRV was examined in survivors of AMI. METHODS: The 24-Hour ambulatory electrocardiogram was performed in 23 patients with AMI and 20 normal controls, and analyzed for frequency & time domain HRV. HRV was recorded dwithin 7 days after AMI, and coronary angiogram was performed at 7th day after AMI. The AMI patients were divided into two groups, depending upon patency of infarct-related artery and correlated to clinical manifestations. Thirteen patients had patent vessel(Group 1) and ten patients had non-patent vessel(Group 2). Parameters of frequency domain HRV include LF, HF & LF/HF ratio and time domain HRV include SDNN, SDANN, SD, rMSSD and pNN50. RESULTS: All parameters of HRV was depressed in patients of AMI than in normal control(p<0.05). The mean left ventricular ejection fraction(LVEF) was 54.1+/-10.6% in group 1 and 42.6+/-12.2% in group 2(p<0.05). The mean values of LF, SDNN, SDANN, and SD in group 1 and group 2 were 5.09+/-0.83msec2/Hz & 4.09+/-0.53msec2/Hz, 84.5+/-24.2msec & 59.0+/-11.8msec, 73.2+/-22.8msec & 50.5+/-12.6msec, and 37.8+/-13.1msec & 27.2+/-4.4msec(p<0.05), respectively. There was no difference between two groups in HF,rMSSD and pNN50. The location of infarction and thrombolytic therapy itself did not influence of HRV. The mean values of HF, SDANN, rMSSD and pNN50 in patients with LVEF<40% were reduced significantly than in patients with LVEF> or =40%. There was a significant correlation between LVEF and LF, between LVEF and HF and between LVEF and LF/HF ratio(r:0.55, p<0.05;r:0.67, p<0.05;r:-0.56, p<0.05). CONCLUSION: HRV was depressed due to reduced vagal activity in patients with AMI. The values of LF, SDNN, SDANN, and SD in group of patent infarct-related artery were reduced significantly than in non-patent group.
Arteries* ; Death, Sudden, Cardiac ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Infarction ; Mortality ; Myocardial Infarction* ; Survivors ; Thrombolytic Therapy

OBJECTIVE: The purpose of this study was evaluate the clinicopathologic prognostic factors of granulosa cell tumors (GCTs) of the ovary. METHODS: We reviewed the medical records retrospectively of 15 patients of GCT who confirmed GCT pathologically after surgery from June, 1994 to December, 2006. Initial symptom, age, size of tumors, FIGO stage, treamtment modality and mitotic index were investigated from medical records. RESULTS: The median age of the patients were 47 (range 22-78). Distribution of patients by FIGO stage were stage I 80% (12/15), stage III 20% (3/15). Complete surgical staging was performed in 5 patients. Other patients were performed total abdominal hysterectomy with bilateral or unilateral salpingo-ophorectomy, bilateral or unilateral salpingo-ophorectomy 5 patients were given adjuvant chemotherapy. Recurrence were founded in 3 patients. Two patients were FIGO sage III and one was stage I with large tumor size. The mitotic index was 13, 11 and one patients was not described about that. Eight year survial rate of all patients was 62.5%. CONCLUSION: There was recurrence in high FIGO stage. Mitotic index was related with FIGO stage. Mitotic index and tumor size are the probable prognostic factors and need to study the relationship with recurrence in stage I.
Chemotherapy, Adjuvant ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Hysterectomy ; Medical Records ; Mitotic Index ; Ovary* ; Recurrence ; Retrospective Studies

OBJECTIVE: the enzymes cyclooxygenase(COX)-1 and -2 are necessary for the synthesis of prostaglandins. COX-2 is usually absent in normal cells and is upregulated and expressed as a product of the "immediate early" gene during inflammatory processes. In previous studies, the expression of COX-2 has been shown to be induced by prointlammatory cytockines, and suggestions have been made that overexpression of COX-2 supresses apoptosis and is directly related to tumor growth. We the authors have attempted to determine a relationship between the tumor invasion and metastasis of uterine cervical cancer and COX and apoptosis by comparing the protein expression of apoptosis and COX-I and COX-2 in tumor tissues confirmed with cytokeratin, and therefe determine the clinicopathologic risk factors. MATERIALS AND METHODS: The subjects were 18 patients who were FIGO stage IB uterine cervical cancer patients who underwent surgery at the Ajou University Medical Center. The 18 cases were comprised of 12 cases of squamous cell carcinoma, 3 cases each of adenocarcinoma and adenosquamous carcinoma. There were 9 cases with lymph node or prarametrial involvement and 13 cases with lymphvascular space involvement. All tissues obtained from the cases were subject to immunohistochemical staining for COX-1, -2 and TUNEL method for apoptosis detection, and the following results were obtained. RESULTS: Tumor tissues confirmed by cytokeratin wae separated into tumor surface, tumor stroma, and invasion site portions, and in which increased apoptosis was observed in the tumor surface and tumor stmma, but not in the invasion sites. COX-2 expression was observed in all tumor tissues, which was especially strong in the tumor invasion site. Therefore, it is suggested that COX-2 expression may supress cell apoptosis at the site of tumor invasion. When COX-2 expression was investigated when the cases were divided into groups with regard to the presence or absence of lymph node or parametrial involvement, there was statistically significant (Mann-Whitney U test) COX-2 expression seen microscopically in the tumor stroma (p-value=0.028) and tumor invasion site (p-value=0.040) compared to the tumor surface (p-value=0.499). In other words, in surgically treated stage IB cervical cancer patients, COX-2 was significantly expressed when lymph node or parametrial involvement was present. CONCLUSIONS: These results suggest that the expression of COX-2 in stage IB cervical cancer patients may downregulate apoptosic processes and thus enhances tumor invasion and metastasis.
Academic Medical Centers ; Adenocarcinoma ; Apoptosis ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Humans ; In Situ Nick-End Labeling ; Keratins ; Lymph Nodes* ; Neoplasm Metastasis* ; Prostaglandin-Endoperoxide Synthases* ; Prostaglandins ; Risk Factors ; Uterine Cervical Neoplasms*

Primary pulmonary hypertension is a rare and progressive disease with poor prognosis. Despite much previous studies, there is neither clear explanation in the etiology and the pathogenesis nor confirmative treatment modalities. Its main cause of death is due to the right ventricular failure but the left ventricular function is relatively well preserved. The chest pain mimickig the angina pectoris is common and it is mostly due to the right ventricular ischemia or distension of pulmonary artery, but left ventricular ischemia or infarction is very rarely seen. We experienced a case of primary pulmonary hyperetension with left ventricular hypertrophy that complicated to acute myocardial infarction in 14-year-old male.
Adolescent* ; Angina Pectoris ; Cause of Death ; Chest Pain ; Humans ; Hypertension, Pulmonary* ; Hypertrophy, Left Ventricular* ; Infarction ; Ischemia ; Male* ; Myocardial Infarction* ; Prognosis ; Pulmonary Artery ; Ventricular Function, Left