OBJECTIVE: The objective of this study is to nfluence of sequential embryo transfers in an invitro fertilization was examined. METHOD: After in vitro fertilization, a maximum of 6 fertilized oocytes was enrolled in this study. At day 3 after an oocytes retrieval, embryos with good quality were transferred (mean 4.9), remaining embryos (mean 2.0/cycle) were cryopreserved at blastocyst stage (Group 1). At day 5 after oocytes collection, second a embryos had reached the blastocyst stage (Group 2) using P1 supplemented with 10 SSS and 30% Follicular fluid. No statistical difference in the pregnancy rate could be seen between the group without a second embryo transfer (n=21; 28.6%) and the group with a second transfer (n=52; 28.8%). RESULTS: The incidence of multiple pregnancy rate per embryo transfer was not statistically different between both group and no high-rank multiple pregnancy (greater than triplete) were observed (o.9%, 15.4%, respectively, p=0.74, chi2). Out of 114 cycles (506 embryos) cultured embryos in group 2, 52 cycles (159 embryos, 29.8%) reached the blastocyst stage. CONCLUSION: The second transfer did not have a significant effect on the pregnancy rate. The most important factor for the pregnancy seems to be the quality of the embryos transferred on day 3 following oocyte retrieval. We recommend embryo transfer is performed only one, day 2~3 or D5.
Blastocyst ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Follicular Fluid ; Incidence ; Oocyte Retrieval ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple

Hepatoblastoma (HB) is a rare embryonic malignant tumor of the liver. Most morphological studies on HB have limited to the histological characteristics and only 3 cases of HB have been described in the cytology literature. We present 2 cases of HB occurring in children aged 1 year and 3 years, respectively. The distinctive cytologic features of fine needle aspiration of HB were clusters of tumor cells showing acinar and trabecular pattern, smaller tumor cells with a high nuclear-cytopalsmic ratio and hyperchromatic nuclei having prominent nucleoli, and the presence of extramedullary hematopoiesis and osteoid material. These features were also found in the cell block and the biopsy specimen, and appeared very useful in the differentiation of HB from hepatocellular carcinoma.
Acute Kidney Injury* ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Hematopoiesis, Extramedullary ; Hepatoblastoma ; Humans ; Liver ; Nephrosis, Lipoid*

No abstract available.
Cryptococcosis*

BACKGROUND: Thyroid cancer is the most common tumor with a endocrine gland origin, and it has a gradually increasing incidence rate. An operative procedure is useful to obtain good results for this disease. Howevers, the selection of operation method remains controversial. Thus, we reviewed the variable prognostic factors which influence thyroid cancer recurrence in order to determine the treatment methods which reduce the recurrence rate. METHODS: We retrospectively reviewed the cases of 383 thyroid cancer patients who had received operations from January 1988 to December 1993. The review looked at age, sex, operation methods, lymph-node metastasis, histologic types, mass size and capsular invasions, and the correlations between these factors and recurrence were analyzed by using Chi-square and SAS trend tests. Complications which developed after various operation methods were also reviewed. RESULTS: Thyroid cancer recurred in 33 (8.6%) patients. Age, sex, lymph-node metastasis, histologic types and capsular invasions did not influence the cancer recurrence rate significantly. However, mass size and operation method were potential factors for recurrence. CONCLUSIONS: If thyroid cancer is diagnosed, a total thyroidectomy with lymph-node dissection is the best method for reducing the cancer recurrence rate. By careful management, complications can be prevented after a total thyroidectomy.
Endocrine Glands ; Humans ; Incidence ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

The classical Roentgenographic features of tuberculosis of the spine such as narrowing of the intervertebraldisc, collapse of the vertebral bodies, with or without the shadow of a cold abscess, present a specific pictureof the actural pathological process. However, the diagnosis of tuberculosis is not confirmed unless proven bybiopsy, or the finding of the tubercle bacillus. 120 cases of proven spinal tuberculosis, at Kwangju ChristianHospital during the period form Jan 1973 through Aug. 1980, were studied and analysed. The results were asfollows; 1. The ratio of male to female was 1:1.1. The age preference was under 30 years old. 2. The most frequentsite of involvement was the lumbar spine(44.1%) and next the thoracic(39.2%0. 3. The incidence of lytic type was50.8%, mixed type 36.7%, and sclerotic type 12.5%. 4. Associated pulmonary tuberculous lesions were observed in 94patients (78.3%). 5. The central type, with wedging or collapse of the vertebral body, was more common in theyounger age group and the intrevertebral articular type in older patients. 6. The incidences of typical radiologicfindings were : Collapse of vertebral body(90%), cold abscess (78.3%) and narrowing of intervertebral space(70%).7. Associated kyphosis was observed in 37 cases (30.8%). Among these 37 cases the range of angulation was between21 to 40 degrees in 40%.
Abscess ; Bacillus ; Diagnosis ; Female ; Gwangju ; Humans ; Incidence ; Kyphosis ; Male ; Spine ; Tuberculosis ; Tuberculosis, Spinal

Lymphangiomas are made up of multiple lymphatic channels lined by benign-appearing endothelial cells. The lesions can occur anywhere in the body but most commonly affect head, neck and axilla. It rarely involves the gastrointestinal tract and particularly lymphangioma of the colon is very rare. Histologically, it is classified three types as simple or capillary, cavernous, and cystic. We experienced three cases of cavernous lymphangioma of the ascending colon. Case 1, 56-year-old male, had lymphangioma accompanied by ulcerating cancer of the cecum. Case 2, 51-year-old female, had lymphangioma of cecum. Case 3, 41-year-old male had lymphangioma at ileocecal valve. All cases could be diagnosed by colonoscopic snare polypectomy.
Adult ; Axilla ; Capillaries ; Cecal Neoplasms ; Cecum ; Colon* ; Colon, Ascending ; Endothelial Cells ; Female ; Gastrointestinal Tract ; Head ; Humans ; Ileocecal Valve ; Lymphangioma* ; Male ; Middle Aged ; Neck ; SNARE Proteins ; Ulcer

Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) o. testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.
Azoospermia* ; Biopsy ; Humans ; Male ; Oligospermia ; Pregnancy ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Spermatozoa ; Testis

Extra-adrenal paragangliomas are rare tumors of neural crest origin, usually arising from the carotid bodies, the glomus jugulare, or the retroperitoneum. And, though ten percents of cases are presented with malignancy, it`s prognosis is relatively good. In genitourinary area, there are a few reported cases of extra-adrenal paragangliomas of the urinary bladder and the spermatic cord. Herein, we report a case of paraganglioma arising in the scrotum, which is an extremely rare location.
Carotid Body ; Glomus Jugulare ; Neural Crest ; Paraganglioma ; Paraganglioma, Extra-Adrenal* ; Prognosis ; Scrotum* ; Spermatic Cord ; Urinary Bladder

PURPOSE: Intravenous immunoglobulin (IVIG) is effective for the treatment of idiopathic thrombocytopenic purpura (ITP) in children. Recently, several reports have been published that show its impact on the absolute neutrophil count. The present study was performed to confirm these findings. METHODS: Data on 26 ITP patients were analyzed. Patients with febrile illness or increased C-reactive protein levels at presentation, which would influence the neutrophil counts, were excluded to determine the sole impact of IVIG. In addition, patients who received steroid treatment were also excluded. RESULTS: Sixteen boys and ten girls were analyzed. For patients who received an IVIG dose of 0.4 g/kg/day (n=17), the absolute neutrophil count (ANC) measured next day was significantly decreased. For patients who received an IVIG dose of 1 g/kg/day (n=9), the ANC measured the next day was also significantly decreased. However, the decrease was more profound in the high-dose group compared to the low-dose group. Among six cases with profoundly decreased ANC greater than 1,000/ mm3, four patients (67%) received IVIG at a dose of 1 g/kg/day. All four cases with increased ANC were treated with IVIG dose of 0.4 g/kg/day, and three cases (75%) among them had a febrile reaction during IVIG administration. None of the cases with decreased ANC had a febrile reaction. No cases had infectious complications reported. CONCLUSION: IVIG treatment for ITP patients appears to suppress the ANC. This decrease of ANC was more pronounced when a higher dose of IVIG was used. Some cases with increased ANC counts after IVIG use were found only in low-dose IVIG group, and was associated with febrile reactions during IVIG use.
C-Reactive Protein ; Child* ; Female ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Neutrophils* ; Purpura, Thrombocytopenic, Idiopathic*

Objective: We studied the efficacy of the power spectral and nonspectral analysis and its diurnal variations for the early detection of the diabetic autonomic neuropathy. METHOD: The spectral and nonspectral analysis of 24hour-Holter monitoring were done for both diabetic neuropathy patients and controls. We also made a comparative analysis of the diurnal variations between the patient and control groups by means of hourly power spectral analysis. RESULT: 1) The power spectral density of the diabetic neuropathy patients was below than that of the normal controls (P<0.05) (Table 2, Fig. 1). 2) The nonspectral analysis of the diabetic neuropathy patients was below than that of the normal controls except for the mean RR intervals (P<0.05) (Table 3). 3) Every hour-power spectral analysis showed a diurnal variation of day time (06:00 to 16:00) decrease in high frequency area of the normal controls. On the contrary, there was a disappearance of the diurnal variation in patient group. CONCLUSION: The power spectral and nonspectral analyses after 24hour-Holter monitoring and its diurnal variation in the diabetic patients are considered as good means of the early detection of autonomic neuropathy, but further study of its diagnostic value will be needed.
Diabetic Neuropathies* ; Electrocardiography, Ambulatory* ; Humans