No abstract available.
Blister ; Humans ; Necrosis ; Rhabdomyolysis

OBJECTIVE: The involvement of IGF system in hyperandrogenism and abnormal follicular development is controversial. This study is to assess whether IGF system contribute to it in the women with polycystic ovary(PCO). METHODS: Baseline serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (ADD), prolactin, thyroid stimulating hormone (TSH), free insulin-like growth factor(IGF)-I, free IGF-II, insulin-like growth factor binding protein(IGFBP)-1, and IGFBP-3 were measured in twelve healthy regularly cycling volunteers and forty-two women with PCO then, the changes of baseline serum levels were evaluated after laparoscopic ovarian electrocauterization in nine PCO patients. In addition, the expression pattern of IGF-I and IGF-II was examined in the ovary of control and PCO group. RESULTS: Baseline levels of LH, ADD, free IGF-II, and IGFBP-3 were significantly higher in PCO group. However, there were no significant differences in the levels of free IGF-I and IGFBP-1, although free IGF-I showed decreasing tendency in PCO group. And there was a significant positive correlation between the LH and free IGF-II level in the PCO(P=0.011, r2=0.3899), but not in the control. After ovarian electrocauterization, LH, T, and ADD levels decreased, and free IGF-I and IGFBP-3 level increased. While free IGF-II and IGFBP-1 level showed no significant changes. In the ovary, expression of both IGFs showed similar pattern in normal and PCO ovaries. CONCLUSIONS: The elevated IGFBP-3 level may alter the bioavailability of IGF(s) in the PCO. The change in IGF-I level and resumption of ovulation after electrocauterization, suggest a possible role of IGF system in the impairment of follicular development in the PCO.
Androstenedione ; Biological Availability ; Carrier Proteins* ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hyperandrogenism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Luteinizing Hormone ; Ovary* ; Ovulation ; Prolactin ; Somatomedins* ; Testosterone ; Thyrotropin ; Volunteers

Human assisted reproductive technology programs have been being developed marvelously during this decade. However, implantation rates following embryo replacement remain low, regardless of increased fertilization rates by ICSI. One proposed possibility limiting the successful implantation is an impaired hatching caused by suboptimal culture conditions. As to improve the hatching potential of blastocysts, assisted hatching by an artificial alteration of zona pellucida(ZP) have been done in many laboratories using the various methods. We tried to investigate whether the supplementation of proteases into culture media has any effect on development, zona structure, and/or hatching of mouse embryos. Supplementation of either pronase E(PE) or proteinase K(PK) in culture media did not affect development up to blastocyst but significantly increased hatching rate. And we observed the alteration of ultrastructure and casein binding properties of ZP in mouse embryos. Also we investigated the effects of protease on development of human embryos and pregnancy rates in human ART program. From July 1994 to December 1996, 792 cycles(for study I) and 1095 cycles(for study II) undergoing the IVF-ET program in MizMedi Hospital were randomly selected for BAH. The concentrations of proteases used in this study were 1microgram/ml PE, 0.1microgram/ml PK and 1microgram/mlPE+0.1microgram/ml PK in HTF with 0.5% human serum albumin(HSA), and in vitro fertilized embryos were cultured for 24 hours. We analyzed the efficiency and stability of biochemical assisted hatching(BAH) according to the clinical profiles of patients and fertilization methods. After cultured in HTF with proteases for 24 hours of human embryos, the thinning in zona pellucida of embryos was observed but its development was not disturbed. Also, clinical pregnancy rates were higher in the PE, PK and PE+PK groups than the control group without proteases(36.0%(32/89), 35.3%(36/102), 35.1%(39/111) vs. 25.5%(125/490), p<0.05). The live birth rate in the PE, PK and PE+PK groups were increased than control, and the abortion rate were not different. They were showed a effect and safety of proteases treatment in human embryos. We selected PE as BAH for study II because of slightly better embryonic morphology and pregnancy rate. In patients over 35 years old, clinical pregnancy rates of the BAH group was higher than that of the control group(31.4%(58/185) vs. 22.2%(51/230); p<0.05). And in the cases with few oocytes retrieval, or less than 3 cycles of IVF-ET, clinical pregnancy rates of the BAH group was significantly higher than that of the control group(36.8%(86/234) vs. 27.2%(93/342), p<0.05; 36.8%(148/402) vs. 29.9%(168/562), p<0.05). In BAH groups, the clinical pregnancy rate was similar between conventional IVF and ICSI group. From above results, it is suggested that improved hatching by protease treatment is due to physiological alteration of ZP structure, giving rise to the similar hatching process to that in vivo. We suggest that BAH using protease is a simple, safe and economic technique compared to the other known assisted hatching techniques in human ART program.
Abortion, Induced ; Adult ; Animals ; Blastocyst ; Caseins ; Culture Media ; Embryonic Structures* ; Female ; Fertilization ; Herpes Zoster ; Humans* ; Live Birth ; Mice ; Oocytes ; Peptide Hydrolases ; Pregnancy Rate ; Pronase ; Reproductive Techniques, Assisted ; Sperm Injections, Intracytoplasmic ; Zona Pellucida

A 24-year-old pregnant woman started to have severe hyperemesis gravidarum at 6 weeks' gestation. Six weeks later, dizziness, ataxia, visual disturbance, diplopia and confusion were developed. On admission, she presented ophthalmoplegia, nystagmus, deaeased tendon reflex, intention tremor, ataxia, confusion and memory disturbance. She was diagnosed to Wernicke-Korsakoff syndrome and 100mg of thiamine was administered intravenously daily till 28 weeks gestation and then intramuscularly. Her ocular symptns, together with neurological signs, were gradually improved. Memory disturbance slightly improved but remained at the time of delivery. The case will be presented in more details with a brief revie of literatures.
Ataxia ; Diplopia ; Dizziness ; Female ; Humans ; Hyperemesis Gravidarum* ; Korsakoff Syndrome* ; Memory ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Reflex, Stretch ; Thiamine ; Tremor ; Young Adult

PURPOSE: The importance of the deformities in alar - columellar complex has been underestimated in Asian ethnic groups for the last few decades. Fortunately, with increasing familiarity of the open rhinoplasty techniques, the anatomic details of the nasal tip have been pointed up. Definitely, having an interest and demand for improving the sub-normal relationship between the alar rim and columella are indebted for such growing of knowledge about nasal tip anatomy. However, it is true that any single procedure is not settled as versatile and fully confident modality to correct the retracted notching of the alar rim. With this article, I would like to propose another useful option for treating retracted ala. METHODS: The authors have tried to correct alar rim retraction by means of: (1) Triangular onlay septal cartilage graft on the lower lateral cartilage with the medial end fixed to the anterior surface of the lateral crus(Alar extension graft), (2) Inserting lateral end of the alar extension graft to the vestibular skin pocket in the form of a finger-in-groove, (3) using the vestibular skin in the form of an advancement flap, and (4) using the soft shield graft to prevent possible visible step-off of the alar margin. RESULTS: The authors applied an alar extension graft to 16 patients in order to correct a retracted ala for the last 27 months (August 2003-October 2005). The distance from alar rim to long axis of nostril was improved to be within 2mm in all cases, and also the shape of the alar rim changed to a round form. Nostril asymmetry (6%) was observed in one case, temporary palpable step-off (18%) in three cases, temporary visible step-off (6%) in one case, and temporary paresthesia of the tip (25%) in four cases, respectively. CONCLUSION: The alar extension graft is simple and efficacious. It does not need donor sites other than the operative field, and its results are predictable. In particular, since it may give structural intensity to a weak lower lateral cartilage, it may be preferentially used for the correction of a retracted ala that arises from hypoplastic lower lateral cartilage. Moreover intensified lower lateral cartilage also improves the esthetic shape of lobule.
Asian Continental Ancestry Group ; Axis, Cervical Vertebra ; Cartilage ; Congenital Abnormalities ; Ethnic Groups ; Humans ; Inlays ; Paresthesia ; Recognition (Psychology) ; Rhinoplasty ; Skin ; Succinates ; Tissue Donors ; Transplants

The recent introduction of chemotherapy in the treatment of gynecological malignancies has gained wide acceptance along with prstoperative and prostperative adjuvant therapy and with preradiation and concurrent chemoradiation therapy. But, the side effects of chemotherapy including bleeding and infection due to, bone marrow suppression have reaulted in delayed treatment and a reduction in the chemotherspeutic agent used. Recent efforts overcome this bone marrow suppression have led to development of the various human colony-stimulating factor indluding recombinant granulocyte colony-stimulating factor. The author investigated the clinical benefita and toxicity of G-CSF used during chemotherapy of various gynecological malignancies at the Departent of Obstetrics & Gynecology at Hanyang University between August, 1991 and July, 1992. The results were as follows ; 1. An increase in the number of neutrophils following a single injection of G-CSF was noted in 19 out of 21 cases(600~1,000/mm3 before injection, 4,500~12,000/mm3 after injection). The remaining 2 cases showed an increase after 3~5 continuous injections. 2. To assess the increase in neutrophils according to the dosage of G-CSF given, 100 and 300microgram/m* of G-CSF were injected in each trial of chemotherapy in a single case of ovarian cancer. The results were a 1.5 time increase when injected when injected with 300microgram/m*. 3. After injecting into a patient with recurrent endometrial cancer who was managed with 15gm of ifosfamide, 50gm of cis-platinum, 50gm of adriamycin and 3gm of mesna following surgery, no evidence of neutropenia could be found after 4days of prophylactic G-CSF injections. 4. Patients with cervix cancer with metastasis to the lung were first treated with GM-CSF in one trial and G-CSF in the nest. Patients treated with Gm-CSF for a period of 7 days showed leukocytosis(3,600/mm3) but the number was reduced to 1,400/mm3 after 7 days. On the other hand, patients treated with G-CSF showed an increase of 5,700/mm3 within one day and this figure did not decrease until 20 days later. 5. The toxic effects of G-CSF included on case of severe back pain was easily managed by administration acetaminophen. Others were headache, chills, general weakness and redness of the oral mucosa and injection area. Most of these symptoms disappeared within 2 days. The G-CSF is effective in neutropenia during chemotherapy thereby decreasing the incidence of treatment delay or dose reduction. It also increases the amount of chemotherapeutic agent administered and its toxicity is more tolerable making a rigid systemic chemotherapeutic regime possible.
Acetaminophen ; Back Pain ; Bone Marrow ; Chills ; Cisplatin ; Colony-Stimulating Factors ; Doxorubicin ; Drug Therapy* ; Endometrial Neoplasms ; Female ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Gynecology ; Hand ; Headache ; Hemorrhage ; Humans ; Ifosfamide ; Incidence ; Leukopenia* ; Lung ; Mesna ; Mouth Mucosa ; Neoplasm Metastasis ; Neutropenia ; Neutrophils ; Obstetrics ; Ovarian Neoplasms ; Uterine Cervical Neoplasms

A rare case of spinal meningeal mesenchymal chondrosarcoma in 3 10/12 year old boy is reported. The tumor was located in lumbosacral region. Osteoplastic laminotomy was performed for total removal of tumor. The postoperative result was good and related literatures were reviewed.
Chondrosarcoma, Mesenchymal* ; Humans ; Laminectomy ; Lumbosacral Region ; Male

No abstract available.
Adenocarcinoma* ; Cell Line*

From January 1984 to June 1991, we studied testicular relapsed patients among 105 cases of acute lymphocytic leukemia in children who were admitted to the Department of Pediatrics and Yonsei Cancer Center, Yonsei University Severance Hospital. The results were as follows: 1) 15 out of 105 (14.4%) cases of acute lymphocytic leukemia were diagnosed as testicular relapse. According to the prevalence by the age groups, there were no patient under 2 years old, 14 out of 73 (19.4%) in 2~9 years old and 1 out of 26 (3.8%) over 10 years old groups. 2) At initial diagnosis of acute lymphocytic leukemia there were significant correlation between testicular relapse and initial lymphadenopathy (p=0.09), but not with WBC count, hemoglobin level, platelet count, hepatomegaly and splenomegaly. 3) Mean duration to testicular relapse from initial diagnosis of acute lymphocytic leukemia was 3.1+/-1.7 years. 4) Among 15 patients, 7 cases combined with bone marrow or central nervous system relapse. Their survival rate was lower than isolated testicular relapse groups. 5) The 5 years survival rate of testicular relapsed patients was 67% after the combinations of chemotherapy, radiotherapy and orchiectomy.
Bone Marrow ; Central Nervous System ; Child ; Child, Preschool ; Diagnosis ; Drug Therapy ; Hepatomegaly ; Humans ; Lymphatic Diseases ; Orchiectomy ; Pediatrics ; Platelet Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prevalence ; Radiotherapy ; Recurrence* ; Splenomegaly ; Survival Rate

Myotonic dystrophy is an autosomal-dominantly inherited neuromuscular disorder characterized by slowly progressive muscular dystrophy, muscle weakness and myotonia. The clinical features may vary from just cataracts to involvement of multiple organ systems such as various muscles, heart, lung and intestine. During pregnancy and delivery, serious maternal and obstetrical complications may occur. The myotonia is often aggravated during pregnancy and it leads to obstetrical complications such as fetal loss, preterm premature delivery, hydrops, in-utero fetal death, difficulties in fetal expulsion, postpartum hemorrhage and/or anesthetic accidents. The affected neonate may display severe hypotonia, facial displegia and respiratory distress. This report presents a woman with myotonic dystrophy complicated with congestive heart failure and preterm delivery during pregnancy.
Cataract ; Edema ; Estrogens, Conjugated (USP)* ; Female ; Fetal Death ; Heart Failure* ; Humans ; Infant, Newborn ; Intestines ; Lung ; Muscle Hypotonia ; Muscle Weakness ; Muscular Dystrophies ; Myocardium ; Myotonia ; Myotonic Dystrophy* ; Obstetric Labor, Premature* ; Postpartum Hemorrhage ; Pregnancy*