Ectopic pregnancy refers to gestation in which the fertilized ovum implants on any other tissure than tbe mucus membrane lining the uterine cavity. Cornual (intertitial) pegnancy is a relatively uncommon but potentially catastrophic form of ectopic pregnancy, defined as implantation in the intramural portion of a fallopian tube. A hydatidiform mole usually occupies the uterine cavity but it's occurrence in the uterine tube is extremely rare. Only a few cases of primary hydatidifm mole of the tube have been reported. We experienced a case of ectopic hydatidiform mole in the uterine cornua and so present it with brief review of literatures.
Fallopian Tubes ; Female ; Hydatidiform Mole* ; Membranes ; Mucus ; Pregnancy ; Pregnancy, Ectopic ; Zygote

The purpose of this study was to investigate the effects of smoking on adult periodontitis after non-surgical periodontal therapy. The study population consisted of 40 patients with moderate to advanced periodontitis. Smokers(n=20) were defined as individuals smoking at least twenty cigarettes per day at the time of the initial examination. The non-smoking group(n=20) consisted of individuals who were not smoking at the initial examination. The average age was 42.4 years for the smoking and non-smoking group. Examination regarding plaque index, gingival index, pocket depth and contrast phase microscope were performed. Evaluation were made at the first, the second and the fourth weeks after periodontal non-surgical therapy. The results were as follows: 1. Clinical indices including plaque index, gingival index, and pocket depth were decreased in both smoking and non-smoking group at the first, the second, and the fourth weeks. Especially, clinical indices of non-smokers were more significantly decreased than those of smokers. 2. Non-motile rods were increased and motile rods were reduced at the fourth week. spirochetes were reduced significantly in the non-smoking group at the fourth week. These results suggest that smoking play a minor role in adult periodontitis after non-surgical periodontal therapy.
Adult* ; Chronic Periodontitis* ; Humans ; Periodontal Index ; Periodontitis ; Smoke* ; Smoking* ; Spirochaetales ; Tobacco Products

OBJECTIVE: To analyze the efficacy of intracytoplasmic sperm injection (ICSI) for totally unfertilized oocytes by the conventional insemination during in vitro fertilization and embryo transfer (IVF-ET) METHODS: From March 1996 to April 1998, 15 couples who experienced total fertilization failure after conventional IVF without severe male factor infertility in semen analysis were evaluated. Fertilization were assessed by the presence of 2 pronucleus (PN) after 14-16 hours of conventional insemination. All unfertilized oocytes were reinseminated by ICSI and checked for signs of fertilization between 6-10 hours after ICSI. The embryos with fertilization and development were transferred to the uterine cavity and the outcome was analyzed. RESULTS: Total numbers of unfertilized oocytes were 120, and total numbers of oocytes injected on day 1 using ICSI were 102. Total numbers of oocytes with normal fertilization after ICSI were 74 and mean fertilization rate of 71.1 +/- 24.0% was obtained. The numbers of embryos transferred was 3.6 +/- 1.7. The biochemical pregnancy rate was 13.3% (2/15) and the clinical pregnancy rate was 6.7% (1/15) per cycle. CONCLUSION: ICSI to totally unfertilized oocytes by conventional insemination technique during IVF-ET on the next day of oocyte retrieval seems to be a relatively successful mean and afford a chance of pregnancy to the infertile couples whom the ET could not perfomed to because of total fertilization failure."
Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility ; Insemination ; Male ; Oocyte Retrieval ; Oocytes* ; Pregnancy ; Pregnancy Rate ; Semen Analysis ; Sperm Injections, Intracytoplasmic*

OBJECTIVE: To determine whether the somatostatin analogue, octreotide, given concunently with human menopausal gonadotropin (HMG) affects ovarian response, ovulation induction outcome, and serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) in infertile patients with polycystic ovarian syndrome (PCOS) resistant to clomiphene citrate (CC). METHODS: From August 1996 to June 1998, 42 infertile patients with PCOS urresponsive to CC were enrolled in the present study. Women who had other infertility factors were excluded from this study. Patients were randomly allocated either to combined HMG and octreotide treatment (treatment group) (n=21) or HMG alone (control group) (n=21). In the treatment group, 100 micrograms of octreotide were administered daily concomitantly with HMG from the 3rd day of menstrual cycle to the preceding day of human chorionic gonadotropin (HCG) injection. RESULTS: Patient's characteristics were comparable in both groups. One cycle in the control group was abandoned because of excessive follicular development. However, none of the cycles in the treatment group was abandoned. There were no differences in the number of HMG ampules required and the duration of HMG administration between the two groups. The number of follicles > 14mm diameter on the day of HCG injection was significantly less in the treatment group than that in the control group (p<0.01). The serum estradiol level on the day of HCG injection was also significantly lower in the treatment group, with 1391.0 +/- 695.5 pg/ml compared with 2217.5 +/- 811.6pg/ml in the control group (p<0.001). The incidence of severe ovarian hyperstimulation syndrome seemed to be lower in the treatment group, but the difference did not achieve significance (4.9% vs 23.8%). There were no differences in the clinical pregnancy rate, miscarriage rate and multiple pregnancy rate between the two groups. Although serum GH levels were comparable between the two groups, serum IGF-1 level on the day of HCG injection was significantly higher in the treatment gmup than that in the control group (p<0.001). CONCLUSION: This study suggests that the combined octreotide and HMG treatment could improve hormonal milieu and folliculogenesis compared to HMG alone, and therefore may be effective in ovulation induction for patients with PCOS resistant to CC.
Abortion, Spontaneous ; Chorionic Gonadotropin ; Clomiphene ; Estradiol ; Female ; Gonadotropins ; Growth Hormone ; Humans ; Incidence ; Infertility ; Insulin-Like Growth Factor I ; Menstrual Cycle ; Octreotide ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction* ; Ovulation* ; Polycystic Ovary Syndrome* ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Somatostatin*

Transition metal ions including Se2+, Cd2+, Hg2+ or Mn2+ have been thought to disturb the bone metabolism directly. However, the mechanism for the bone lesion is unknown. In this study, we demonstrated that MC3T3E1 osteoblasts, exposed to various transition metal ions; selenium, cadmium, mercury or manganese, generated massive amounts of reactive oxygen species (ROS). The released ROS were completely quenched by free radical scavengers-N-acetyl cysteine (NAC), reduced glutathione (GSH), or superoxide dismutase (SOD). First, we have observed that selenium (10 micrometer), cadmium (100 micrometer), mercury (100 micrometer) or manganese (1 mM) treatment induced apoptotic phenomena like DNA fragmentation, chromatin condensation and caspase-3-like cysteine protease activation in MC3T3E1 osteoblasts. Concomitant treatment of antioxidant; N-acetyl-L-cysteine (NAC), reduced-form glutathione (GSH), or superoxide dismutase (SOD), prevented apoptosis induced by each of the transition metal ions. Catalase or dimethylsulfoxide (DMSO) has less potent inhibitory effect on the apoptosis, compared with NAC, GSH or SOD. In line with the results, nitroblue tetrazolium (NBT) stain shows that each of the transition metals is a potent source of free radicals in MC3T3E1 osteoblast. Our data show that oxidative damage is associated with the induction of apoptosis in MC3T3E1 osteoblasts following Se2+, Cd2+, Hg2+ or Mn2+ treatment.
Acetylcysteine ; Apoptosis* ; Cadmium ; Catalase ; Chromatin ; Cysteine ; Cysteine Proteases ; Dimethyl Sulfoxide ; DNA Fragmentation ; Free Radicals ; Glutathione ; Ions ; Manganese ; Metabolism ; Metals ; Nitroblue Tetrazolium ; Osteoblasts* ; Reactive Oxygen Species ; Selenium ; Superoxide Dismutase

Bone is a complex tissue in which resorption and formation continue throughout life. The bone tissue contains various types of cells, of which the bone forming osteoblasts and bone resorbing osteoclasts are mainly responsible for bone remodeling. Periodontal disease represents example of abnormal bone remodeling. Osteoclasts are multinucleated cells present only in bone. It is believed that osteoclast progenitors are hematopoietic origin, and they are recruited from hematopoietic tissues such as bone marrow and circulating blood to bone. Cells present in the osteoclast microenvironment include marrow stromal cells, osteoblasts, macrophages, T-lymphocytes, and marrow cells. These cells produce cytokines that can affect osteoclast formation. In vitro model systems using bone marrow cultures have demonstrated that IL-1 beta, IL-3, TNF-alpha, bFGF can stimulate the formation of osteoclasts. In contrast, IL-4 inhibits osteoclast formation. Knowledge of cytokines and bFGF that affect osteoclast formation and their capacity to modulate the bone-resorbing process should provide critical insights into normal calcium homeostasis and disorders of bone turnover such as periodontal disease, osteoporosis and Paget's disease.
Bone and Bones ; Bone Marrow* ; Bone Remodeling ; Calcium ; Cytokines* ; Fibroblast Growth Factor 2 ; Homeostasis ; Interleukin-1beta ; Interleukin-3 ; Interleukin-4 ; Macrophages ; Osteoblasts ; Osteoclasts* ; Osteoporosis ; Periodontal Diseases ; Stromal Cells ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

Congenital diaphragmatic hernia (CDH) is caused by a failure of fusion of the muscular diaphragm and results in herniation of abdominal viscera into the thorax, It occurs in appoximately 1 in 2,200 to 5,000 live births, and most cases are probably multifactorial, but they can be also associated with chromosomal abenation. Due to the improvement of sonography, it can be diagnosed more accurately. However, the mortality associated with CDH is extremely high. It is well known that the incidence of congenital anomaly in infants after in vitro fertilization and embryo transfer (IVF-ET) is not increased copared with that of general population, and CDH that occurred following IVF-ET has not been reported. A case of CDH that occurred following IVF-ET is presented with brief review of literatures.
Diaphragm ; Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro* ; Hernia, Diaphragmatic* ; Humans ; Incidence ; Infant ; Live Birth ; Mortality ; Thorax ; Viscera

With the advent of intracytoplasmic sperm injection (ICSI), the fertiliution and pregnancy have been reported even in complete asthenozoospermia. However, the results of ICSI in men with totally immotile sperm was still disappointing. The reasons for the total lack of sperm movement are not yet determined. The immotility of ejaculated spermatozoa is probably caused by sperm degeneration during epididymal transport, therefore higher viable spermatozoa can be obtained by testicular sperm recovery in some cases with low viability and total lack of movement of ejaculated spermatozoa. Recourse to testicular spermatozoa for ICSI is thus an alternative treatment possibility in this kind of pathology. This clinical study was performed to investigate the efficacy of ICSI employing testicular and ejaculated spermatozoa. From December 1995 to March 1998, 35 couples with totally immotile spermatozoa were included in the study. In 14 patients, the ejaculated spermatozoa were used whereas in 21 patients the spermatozoa were recovered from the testis. There were no significant differences in the fertilization and cleavage rates between the testicular sperm group with 62.6%, 52.7% and the ejaculated sperm group with 56.1%, 74.3%. Two pregnancies were achieved, one in the testicular spnm poup and the other in the ejaculated group. A healthy child was delivered at term in the ejaculated sperm group, but a clinical abortion occurred in a pregnancy in the testicular sperm group. In conclusion, it was suggested that ICSI using ejaculated sperm might be a primary treatment in cases with totally immotile spermatozoa and, if failed, testicular sperm could be used as an alternative mode of heatment.
Asthenozoospermia ; Child ; Family Characteristics ; Fertilization ; Humans ; Male ; Pathology ; Pregnancy ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic* ; Spermatozoa* ; Testis

It is well known that the clinical test for responsibility of accurate fertilization capacity in male partners is very important to diagnose and treat the infertility. However, it has been reported that the traditional semen analysis cannot accurately predict fertilization and pregnancy potential. The present study was performed to evaluate the acrosomal reaction to ionophore challenge (ARIC) test as a prognostic indicator for fertilization of sperm and oocyte in an in vitro fertilization and embryo transfer (IVF-ET) program. From March 1996 to Februry 1997, 30 couples undergoing IVF program were allocated to this study group. All female partners in the study group were 35 years old or less and their serum level of basal follicle stimulating hormone (FSH) and estradiol (E2) were normal. All the male partners have normal parameters of semen analysis. The ARIC tests were performed on the day of ovum pick up and in vitro insemination in all the male partners. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone (GnRH) agonist was used in all couples for IVF-ET. The acrosomal reaction with 10microliter of 10% DMSO was induced spontaneously in 10.1+/-9.8%, and acrosomal reaction with calcium ionophore A 23187 was induced in 27.4+/-18.1%, and the ARIC value was 17.4+/-16.2%. There were no significant correlation between the ARIC value and the fertilization rate (r2=0.044, p=0.268). There were also no significant correlation between the ARIC value and the percentage of the grade I, II embryos (r2=0.046, p=0.261). On the basis of above results, it was suggested that ARIC test might not be a useful prognostic indicator for fertilization in IVF-ET in male partners with normal parameters of conventional semen analysis. We guessed that IVF-ET could be performed to the patients primarily without universal appilcation of ARIC test to all male partenrs, and if fertilization failure occurs, the microassisted fertilization (MAF) such as intracytoplsmic sperm injection (ICSI) might be used as an alternative mode of treatment with acceptable success rate.
Acrosome Reaction* ; Acrosome* ; Adult ; Calcimycin ; Calcium ; Dimethyl Sulfoxide ; Embryo Transfer ; Embryonic Structures ; Estradiol ; Family Characteristics ; Female ; Fertilization ; Fertilization in Vitro* ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Humans ; Infertility ; Insemination ; Male ; Oocytes ; Ovum ; Pregnancy ; Semen Analysis ; Spermatozoa

OBJECTIVE: To compare the pregnancy outcomes of transvaginal multifetal pregnancy reduction (MFPR) according to the gestational period when the procedure was performed METHODS: From January l995 to February 1998, total 27 patients with multiple pregnancy were included in this study. The patients were grouped to early MFPR group (<8 weeks, n=16) and delayed MFPR group (>8 weeks, n=ll) according to the gestational age that MFPRs were performed. All MFPRs were performed by transvaginal sonography-guided fetal aspiration or mechanical trauma. The complete pregnancy loss rate before 24 weeks of gestation, spontaneous loss of embryo, procedure-related complication, gestational age at delivery, and pregnancy complication were compared between the two groups. Statistical analysis of data was performed using Students t-test and Fishers exact test as appropriate. Statistical significance was defined as p<0.05. RESULTS: There was no significant difference in the complete pregnancy loss rate between the early MFPR group (6.3%) and the delayed MFPR group (27.3%). The incidence of partial spontaneous loss of embryo in the two groups were not differed significantly (6.3% vs. 18.2%). The procedure-related complication of the delayed MFPR group (36.4%) seemed to be higher than that of the early MFPR group (6.3%), however there was no statistical difference (p=0, 07). Especially, all 3 patients in whom the MFPR was performed after 10 weeks suffered from the procedure-related complication. The mean gestational age at delivery of the two groups were not differed significantly (36.3+2.8 weeks vs. 37.0+1.3 weeks). There was also no significant difference in the mean birth weights of the two groups (2378.8+563.7 gm vs. 2427.1+436.2 gm). CONCLUSION: Although there was no statistically significant difference, the early transvaginal MFPR might be a safe and useful method without significant adverse complications compared to the delayed MFPR.
Birth Weight ; Embryonic Structures ; Female ; Gestational Age ; Humans ; Incidence ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Pregnancy Reduction, Multifetal* ; Pregnancy, Multiple