OBJECTIVE: To establish the evaluation system of the quality of oocytes on the basis of the incidence of cumulus cells apoptosis, to investigate the relationships between the incidence of cumulus cells and the outcomes of IVF-ET. METHOD: Thirth-four cycles undergoing controlled ovarian hypersimulation for IVF-ET with tubal infertility (23 cycles) or unexplained infertility (11 cycles) were included in this study. Cumulus cell masses surrounding mature oocyte and co-culture of embryos with autologous cumulus cells during IVF-ET process. The incidence of apoptosis in cumulus cells was assessed by apoptosis detection kit fluorescein. The effect of co-culture using cumulus cells and the incidence of cumulus cells apoptosis. RESULTS: The results were as follows: 1. The incidence of apoptosis in cumulus cells markedly increased in patients aged 40 or over, while the fertilization rate was greatly decreased in those age group. 2. Apoptosis in cumulus cells was found in both the fertilized oocytes and unfertilized oocytes, but the incidence of apoptosis was higher in unfertilized oocytes. 3. There is no clear correlation between apoptosis in cumulus cells and the number of oocytes retrieved. However, the incidence of apoptosis was increased when the number of oocytes retrieved was 5 and fewer in comparison with 6~10. 4. Embryo grade was significantly affected by the incidence of apoptosis in cumulus cells. 5. Pregnancy rate of IVF-ET per cycle was 29.4%, and the pregnant group had the higher fertilization rate and a significantly lower incidence of apoptosis in cumulus cells compared with the nonpregnant group. 6. When cumulus cells were used as helper cells in the co-culture of the embryo, in vitro activity of cumulus cells based on morphological change and proliferation did not influence the quality of embryo, but was closely associated with the implantation rate and pregnancy rate, which was enhanced when morphological changes and proliferation of cumulus cells was more active. 7. This difference in the outcome of IVF-ET according to in vitro activity of cumulus cells used for co-cultue was not associated with the incidence of apoptosis in cumulus cells, but rather had likely relations with the different secretion pattern of protein, which may be an embryotrophic factor by cumulus cells. CONCLUSION: These results suggest that the incidence of apoptosis in cumulus cells can be used in predicting oocyte qualities and the outcomes of IVF-ET. And the effect of co-culture largely depends on the in vitro activity of cumulus cells as well.
Apoptosis ; Coculture Techniques ; Cumulus Cells* ; Embryonic Structures ; Fertilization ; Fluorescein ; Humans ; Incidence ; Infertility ; Oocytes ; Pregnancy Rate ; T-Lymphocytes, Helper-Inducer

OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

The purpose of this study is to evaluate the correlation between the operative indications and the MRI findings in the herniated lumbar disc. We reviewed the lumbar spine MRI and medical records in the 158 patients of the herniated lumbar disc which were removed by open discectomy. We assessed the herniated lumbar disc in the MRI by the Steinmetz s classification and the operative findings with postoperative results at least 6 months. 170 levels of the operated lumbar discs in these patients consisted of protruded discs in 41 levels, extruded subligamentous discs in 91 levels, extruded transligamentous discs in 27 levels, sequestered discs in 11 levels. We recognized especially in the operated protruded discs that were combined with the lateral recess stenosis in most cases. Postoperatively, 139 patients (88%) had excellent and good results. We concluded that the clinical operative indications were correlated with the cases which were more severe than extruded subligamentous discs or protruded discs combined with lateral recess stenosis in MRI findings.
Classification ; Constriction, Pathologic ; Diskectomy* ; Humans ; Magnetic Resonance Imaging* ; Medical Records ; Spine

A total of the 16 cases of rheumatic vavular heart desease were examined in order to compare fibrillatriy F wave with left atrial size and biopsy findings from October 1986 to April 1987 at the Ewha Womans University Hospital. The results were as follows : 1) Of the 16 patients, there were 5 males and 11 females. The mean age of the patients was 41.9+/-12.7 years old. 2) Among the 16 patients PTF-V1 was lesser than -0.04nn-sec, the left atrial size measured by M-mode echocardiography was 57.1+/-8.9mm. Inverse correlation between PTF-V1 and the left atrial size measured by M-mode echocardiography was observed(P<0.01). 3) No significant correlation between PTF-V1 and left atrial was found(P>0.01). 4) There was a tendency that the size of the left atrium was, the more degeneration, necrosis and fibrosis of the left atrial wall appeared through pathological findings.
Atrial Fibrillation ; Biopsy* ; Echocardiography ; Female ; Fibrosis ; Heart ; Heart Atria ; Heart Valve Diseases* ; Humans ; Male ; Necrosis

It is well known that there is close relation of the left atrial pathology to atrial fibrillation(AF) in patients with mitral valvular disease. To evaluate such relation is existed or not in the right atrium, the right atrial wall biopsy was performed in 31 patients with mitral valvular disease during valve surgery. The specimens obtained were interpretated by the pathologist who had no information about the patients. The specimens were graded according to severity of morphological change. In Grade I, the atrial myocardium is degenerated and has moderate fibrosis in it. Grade II shows the atrial myocardial layer of the atrium and severe degenerated with pre and postoperative heart rhythm. Four patients had Grade I change and 3 patients among them had pre and postoperative AF. Eleven patients had Grade III changes and 9 among them had pre and postoperative AF. The results show there is strong tendency that the patients with pre and postopeative AF had Grade III change in the right atrium and the relation of the right atrial pathology to AF is same as that of the left atrium.
Atrial Fibrillation* ; Biopsy ; Fibrosis ; Heart ; Heart Atria ; Humans ; Myocardium ; Pathology*

The effect of amiodarone on reperfusion arrhthmias after release of left anterior descending coronary artery(LAD) occlusion was studied in 22 anesthetized cats. All cats underwent 20 minutes LAD occlusion followed by reperfusion and amiodarone(20mg/Kg) or normal saline was given on cats which had reperfusion arrhythmias through the left ventricular catheter to observe the antiarrhythmic effect of amiodarone. And also the incidence and type of arrhymias during occlusion and reperfusion were analyzed. During the 20 minute LAD occlusion, 10 of 22 cats(45%) had no arrhythmias, and 12 cats(55%) had nonsustatined ventricular tachycardia. After release of occlusion, 5 of 22 cats(23%) had no arrthmias, and 17 cats(77%) developed sustained ventricular arrhythmias(ventricular tachycardia (n=5), ventricular fibrillation(n=12)). The 17 cats which had reperfusion arrhythmias were randomly divided and given normal saline(control(n=8)) or amiodarone(amiodarone group(n=9)). There was no difference on 2 groups. The reperfusion arrhythmias disappeared in 6 out of 9 cats(66.7%) vs none of 8 controls(P<0.01). We conclude that amiodarone seems to be the effective antiarrhythmic drug on reperfusion arrhythmias after release of LAD occlusion in anesthetized cats, and might be useful for the treatment of reperfusion arrhythmias in human.
Amiodarone* ; Animals ; Arrhythmias, Cardiac* ; Catheters ; Cats ; Humans ; Incidence ; Reperfusion* ; Tachycardia ; Tachycardia, Ventricular

No abstract available.
Evoked Potentials, Motor*

Unstable femoral intertrochanteric fractures are characterized by comminution of the posteromedial cortex, resulting in a fragment of variable size containing the lesser trochanter. Need for fixation of the fracture fragment of lesser trochanter remained controversial. We assessed the superior and medial migration of the fracture fragment of lesser trochanter, bone union, change of hip flexor power, limitation of motion and clinical results in a 29 unstable femoral intertrochanteric fractures which had been internally fixed with gamma interlocking nail (14 cases), compression hip screw (10 cases) and anatomical bent plate (5 cases). The fracture fragment of lesser trochanter was fixed with long trans-fixation screw in the cases of the anatomical bent plate. Superior migration of the fracture fragment of lesser trochanter is statistically different between Gamma interlocking nail and the other operations (P<0.05). Medial migration, bone union, change of hip flexor power, LOM and clinical results are not statistically different in the each operations (P>0.05). Although the stability could be provided by trans-fixation of the fracture fragment of lesser trochanter because the fragment acts as a buttress, clinical results was not influenced whether the fixation of the fracture fragment of lesser trochanter was done or not. We conclude that additional trans-fixation screw doesn t need if major fracture site was firmly fixed through any operation.
Femur* ; Hip ; Hip Fractures*

PURPOSE: In order to evaluate microstructural changes after shock wave exposure, gross, light microscopic and transmission electron microscopic findings were analyzed with rabbit gallgladders. MATERIALS AND METHODS: A preliminary study(2 rabbits) was performed to determine the dosage intensity of shock waves needed to inflict damage, using a EDAP LT 01 piezoelectric extracorporeal shock wave Iothotriptor. The gallbladders of three different groups of rabbits were given shock waves of various intensity. A storage value of 100, 50, 25 at rate of 20/sec under 80% power were given to group I (4 rabbits), group II( 4 rabbits), and group III(3 tabits), respectively. The rabbits were sacrified 6--12 hours later. RESULTS: The observed pathologic changes in the transmission electron microscopy were vaculization of cytoplasm and swelling of epithelial cells with dilatation and structural alteration of intracellular organelles, especially endoplasmic reticulum. Cell membrane rupture and necrosis were observed at the markedly affected area. The structural changes of intracellular organelles were minimally found at a storage value of 25. However, above pathologeic changes with dilatation and structural alterations of endoplasmic reticulums were more profund at value of 100. CONCLUSION: Early histologic changes induced by shock waves are dose dependent and the findings of cellular damage caused by ESWL might be explained as above.
Cell Membrane ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum ; Epithelial Cells ; Gallbladder* ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rabbits ; Rupture ; Shock*

Vertebroplasty is now extensively used worldwide for thoracic and lumbar osteoporotic compression fractures. Although percutaneous vertebroplasty is considered a minimally invasive procedure, it may result in several complications. In this report, we present two patients where pyogenic spondylitis developed after vertebroplasty surgery was required. The serious nature of these infections, surgical management and complication avoidance are discussed.
Fractures, Compression ; Humans ; Spondylitis* ; Vertebroplasty*