OBJECTIVE: This study was aimed to obtain information on normal MIS serum levels according to menstrual cycles of adult normal cycling women . It was also designed to obtain information on the ontogeny of the production profile of MIS and the pattern of its localization in ovary from adult normal cycling women. METHODS: Between January 1998 and January 1999, normal MIS serum levels were measured according to menstrual cycles using 160 serum samples from adult normal cycling women by ELISA. The ontogeny of the production profile of MIS and the pattern of its localization were also studied by immunohistochemical staining using the rabbit polyclonal antibody against human recombinant MIS in 35 ovarian specimens from adult normal cycling women. RESULT: The MIS levels were gradually increased through the follicular phase, reaching at its maximum at the ovulatory phase(4.2+/-2.6 ng/ml), and sharply decreased at the beginning of the luteal phase being minimized at the premenstrual phase(0.5+/-0.2 ng/ml). In average, the MIS levels of the follicular phase(3.7+/-1.9 ng/ml) were significantly higher than those of the luteal phase(1.8+/-2.4 ng/ml)(P<0.05). The MIS levels of the preovulatory and ovulatory phase were significantly higher than those of the other cycle days(P<0.05). Even the early follicular phase(2.9+/-1.6 ng/ml) showed higher MIS levels than the advanced luteal phase(0.9+/-0.7 ng/ml) and the premenstrual phase(0.5+/-0.2 ng/ml)(P<0.05 and P<0.05, respectively). The first staining for MIS was detected in the cytoplasm of granulosa cells when the flattened granulosa cells changed to the cuboidal cells in primordial follicles. The granulosa cells of both single and multiple layered growing follicles showed strong specific staining for MIS. but the MIS staining was not found not in the mature follicle just before ovulation, atretic follicles, corpus luteum, and corpus albicans. MIS staining waned in the mature follicles just before ovulation. CONCLUSION: These experiments demonstrate that the MIS is produced by ovarian granulosa cells in normal reproductive females. The MIS may play an important role as a hormone of follicular development and oocyte maturation through interactions with female steroid hormones, gonadotropins, and growth factors during the adult reproductive cycle.
Adult ; Anti-Mullerian Hormone* ; Corpus Luteum ; Cytoplasm ; Enzyme-Linked Immunosorbent Assay ; Female ; Follicular Phase ; Gonadotropins ; Granulosa Cells ; Humans* ; Intercellular Signaling Peptides and Proteins ; Luteal Phase ; Menstrual Cycle* ; Oocytes ; Ovarian Follicle ; Ovary* ; Ovulation

OBJECTIVE: To elucidate the location of leptin and receptors of ovary specimens obtained from patients undergoing hysterectomy by immunohistochemical staining and to determine the effect of leptin on the steroidogenesis of cultured granulosa cells. METHOD: In the culturing process of the granulosa cells, FSH (1 IU/ml)and leptin (50 ng/ml), IGF-I (50 ng/ml) was administered to each study group (Group I: FSH; Group II: FSH, leptin; Group III: FSH, IGF-I, leptin), and the levels of estradiol, progesterone, androstenedione in the culture media was measured by radioimmunoassay. Statistical analysis was conducted by one-way ANOVA with Scheffe test. RESULTS: The results showed that leptin and leptin receptors were both found to be strongly stained in granulosa and theca cells, and also in some interstitial cells. Leptin receptors were also observed in cultured granulosa cells. While there was no statistically significant difference in the androstnedione concentrations between the groups, estradiol concentrations was significantly decreased in Group IV (2202.0+/-151.14 pg/ml) compared to Group III (2859.0+/-122.6 pg/ml), and progesterone concentrations were also significantly decreased in Group II(4696.3+/-190.6 ng/ml) and Group IV (4517+/-206.78 ng/ml) compared to Group III(5546.0+/-179.5 ng/ml). CONCLUSTION: The study result of this study suggest that leptin is directly involved in the regulation of ovarian functions, in particular steroidogenesis.
Androstenedione ; Culture Media ; Estradiol ; Female ; Granulosa Cells* ; Humans* ; Hysterectomy ; Insulin-Like Growth Factor I ; Leptin* ; Ovary ; Progesterone ; Radioimmunoassay ; Receptors, Leptin ; Theca Cells

The development of a safe method of transfer of the greater toe for thumb reconstruction, using dorsalis pedis artery and the great saphenous vein, suggested the possibility of one stage microvascular transfer of the second toe for reconstruction of surgery. Based upon our part experience with microsurgical experiments, limb transplantation and toe-to-thumb transplantation since 1975, we accomplished the second toe-to-index transplantation done in Korea on October 24, 1979, and succeeded in one stage second toe-to-index transplantation in two cases. Following results were obtained. I. Free second toe-to index transplantation on making a index is the most excellent method of index reconstruction with results in minimum functional and cosmetic impairment. 2. Technically, skin incision, isolation of blood vessels and flexor tendon in preparation for transplantation of second toe is more difficult than that of greater toe. 3. The specialized microsurgical training with skillful technique is essential for success.
Arteries ; Blood Vessels ; Extremities ; Korea ; Methods ; Microsurgery ; Saphenous Vein ; Skin ; Tendons ; Thumb ; Toes

Profound reduction of anterograde coronary flow with concomitant ischemia is seen occasionally during percutaneous coronary intervention despite technically successful procedure. We found interesting coronary flow pattern in a patient with acute myocardial infarction, showing angiographic no reflow phenomenon after direct PTCA. The coronary blood flow pattern of the angiographic no-reflow phenomenon in this case was characterized by minimal systolic flow and sharp deceleration of diastolic flow. Coronary flow reserve calculated by the ratio of adenosine induced maximal hyperemic velocity and basal velocity was reduced. The Dopplertipped guide wire was useful for observation of phasic coronary flow pattern of angiographic no-reflow phenomenon.
Adenosine ; Deceleration ; Humans ; Ischemia ; Myocardial Infarction* ; No-Reflow Phenomenon ; Percutaneous Coronary Intervention

BACKGROUND: Previous studies indicated that there was important correlation between early patency of infarct-related artery, preservation of ventricular function, and improved survival after thrombolytic therapy for acute myocardial infarction. An increased infusion rate of rt-PA has been shown to result in faster thrombolysis and a high patency rate of occluded vessel in myocardial infarction. Therefore, we evaluated the effect of simplified triple bolus injection of rt-PA on early patency of infarct-related artery and evaluated safety and efficacy of triple bolus injection. METHOD: Patients with acute myocardial infarction presenting up to 6 hour from the onset of chest pain were recruited for the study. Aspring(100-200mg) was given immediately. Total dose for 1.5mg/kg of rt-PA(minimum 75mg, maximum 100mg) was administered as triple bolus intravenous injections. The half of total dose was injected initially, the quarter of total dose was injected at 10 minutes after 1st injection and the remainder was injected at 40 minutes after 1st injection. Five thousand units of heparin was given and 1,000-1,500unit/hr was given continuously. Coronary angiogram was performed at 60 minutes and 7-10 days after the first bolus injection. RESULTS: At 60 minutes, eleven of fourteen patients (78.6%) showed TMI grade-3 of patency in infarct-related coronary artery. There were two patients of hemorrhagic complications. One patient developed cerebellar hemorrhage at third day after rt-PA injection, and the other developed bleeding at femoral sheath site. There was no in-hospital mortality and reinfarction. CONCLUSION: In patients with acute myocardial infarction, the simplified triple bolus injection of rt-PA is associated with high early patency(TMI grade-3) in infarct-related coronary artery, with low risk of major bleeding comlications comparable to other studies.
Arteries ; Chest Pain ; Coronary Vessels ; Hemorrhage ; Heparin ; Hospital Mortality ; Humans ; Injections, Intravenous ; Myocardial Infarction* ; Thrombolytic Therapy ; Tissue Plasminogen Activator* ; Ventricular Function

BACKGROUND: Recent randomized studies have shown a reduction of restenosis rate after denovo coronary stenting as compared to classical PTCA. The purpose of this study was to evaluate a new medication protocol using antiplatelet therapy(ticlodipine, aspirin) and heparin in conjunction with routine high pressure ballooning after stenting. METHODS AND RESULTS: Seventy two patients(47 males and 25 females, mean age : 58+/-11 years) underwent Palmaz-Schatz coronary stenting in 76 coronary lesions. Their clinical characeristice were ; 38 cases(63%) of unstable angina, 14 cases(19%) of stable angina and 20 cases(28%) of acute myocardial infarction(MI, Q : 16 cases, non-Q : 4 cases). In 15 out of 20 acute MI cases, stents were implanted in the infarct-related arteries. Primary elective stenting was indicated for 40 lesions(53%) ; 34 for de novo and 6 for restenosis after PTCA. Stents were implanted in 27 lesions(35%) with suboptimal result after PTCA and 9 lesions(12%) as a bailout procedure ; 8 threatened closures and 1 acute closure. All patients were treated with heparin for 48 hours and antiplatelet agents(aspirin 100-200mg/day and ticlopidine 200-500mg/day) after the procedure. All stents were greater than 3.0mm in size. Postdilatation was obtained with a max balloon diameter of 3.5+/-0.6mm(balloon-to-vessel ratio of 1.12+/-0.20) at a max inflation pressure of 14.4+/-2.8 atm. Percent diameter stenosis decreased from 70.4+/-15.5% to -1.2+/-4.8%(p<0.0001), and minimal luminal diameter increased from 0.94+/-0.57mm to 3.15+/-0.51mm(p<0.0001) after stenting. During mean follow-up duration of 5.1+/-3.0 months there were 3 cases(4.2%) of myocardial infarction, 2(2.7%) of repeat angioplasty, 1(1.4%) of CABG and 1(1.4%) of death. CONCLUSION: Palmaz-Schatz coronary stenting with poststenting routine high pressure ballooning appears to be safe and feasibile without anticoagulation and without use of intravascular ultrasound in selected patients.
Angina, Stable ; Angina, Unstable ; Angioplasty ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Female ; Follow-Up Studies ; Heparin ; Humans ; Inflation, Economic ; Male ; Myocardial Infarction ; Phenobarbital ; Stents* ; Ticlopidine ; Ultrasonography

BACKGROUND: The characterization of normal coronary blood flow dynamics should provide crucial guidelines for the accurate functional assessment of diseased coronary artery. However, the regional characteristics of coronary blood flow dynamics in normal human coronary artery have not been fully evaluated. METHODS: We performed proximal and distal segment velocity measurement of angiographically normal left anterior descending(LAD) and right coronary artery(RCA) in 25 patients(14 males, 12 females, age 50+/-10 yesre) with atypical chest pain. Spectral flow velocity parameters including average peak velocity(APV), average diastolic peak velocity(ADPV), average systolic peak velocity(ASPV), and diastolic-to-systolic velocity ratio(DSVR) were measured using 0.014 inch 15MHz Doppler wire at baseline and intracoronary adenosine-induced maximal hyperemic state. Coronary flow reserve(CFR) was calculated from the ratio of hyperemia to baseline APV. RESULTS: Comparison between LAD with RCA. LAD showed significantly higher APV than RCA at baseline(proximal ; 18+/-6cm/s vs 14+/-4cm/s, p<.005, and distal ; 17+/-6 cm/s vs 12+/-4cm/s, p<.005. LAD showed significantly higher ADPV and lower ASPV than RCA, therefore significantly higher DSVR than RCA> CFR was significantly lower in LAD than in RCA(proximal ; 301+/-0.9 vs 3.8+/-1.0 , p<3001, and distal ; 3.1+/-0.7 vs 3.6+/-0.8, p<.05). Comparison between proximal with distal segment. There was significant reduction in APV and ASPV from proximal to distal segment in RCA, but not in LAD. There was significant increase in DSVR from proximal to distal segment in RCA, but not in LAD. There was no difference in CFR between proximal and distal segment in both coronary arteries. CONCLUSION: We measured coronary blood flow velocities in angiographically normal coronary artery to characterized normal coronary blood flow dynamics and provide the reference values for the assessment of coronary artery disease. Significant regional differences of coronary blood flow velocities should be considered when we assess the diseased coronary artery.
Blood Flow Velocity ; Chest Pain ; Coronary Artery Disease ; Coronary Vessels* ; Female ; Humans ; Hyperemia ; Male ; Reference Values

STUDY DESIGN: This is a retrospective study analyzing the results of chip PLIF with pedicle screw instrumentation for various spinal lesions. OBJECTIVES: To analyze the clinical and radiologic results of chip PLIF and to compare the amount of blood loss and transfusion and operation time with the ordinary PLIF. SUMMARY OF LITERATURE REVIEW: The ordinary PLIF has 86-95% of radiologic union rate and 80% of clinical satisfactory rate. The problems of ordinary PLIF were donor site morbidity, limited bone resources, prolonged operation time and excessive blood loss. MATERIALS AND METHODS: Forty patients were treated by chip PLIF utilizing cubical chip bone obtained from spinous process, facets and lamina from October 1995 to October 1997. Twenty-four patients, followed up over 12 months, were included in this study. Radiologic union, disc space collapse and change of kyphotic angle were assessed by simple X-ray and clinical results by improvement of back pain, radicular pain and change of neurological deficits. Twenty-nine patients treated by ordinary PLIF were compared concerning the operation time, amount of blood loss and transfusion. RESULTS: The mean age was 51.5 years(27-68 years) and mean follow-up was 20.7 months(12-30 months). Complete radiologic union rate was 47.6%, which was lower than ordinary PLlf. Satisfactory clinical result rate was 79%, which was similar with other fusion methods. Operation time, amount of blood loss and transfusion were less than the ordinary PLIF. There were three complications that were one dural tear ailed two pedicle screw breakages. CONCLUSION: There was no relationship between radiologic union rate and clinical satisfactory result after chip PLIF. Although operation time is relatively short and blood loss is less, it's not a good method to obtain nice bony union in spinal lesions.
Back Pain ; Follow-Up Studies ; Humans ; Retrospective Studies ; Tissue Donors

The effective inactivation of microorganisms in drinking water by Ultraviolet (UV) irradiation is regarded as a new low-cost water treatment method shoeing high removal rate of relatively stable infectious virus particles including poliovirus. In the present study, we examined virus inactivation by UV in various water environments. Samples were collected from finished water and surface water, and tested for turbidity. UV dose of 18, 22, 30, 36 and 40 milli-Joule (mJ)/cm2 were used by combination of 2 mW/cm2 UV intensity and time of 9, 11, 15, 18 and 20 second. Depths of water were fixed at 0.37 cm and 8 cm, and virus titers were shown by plaque forming unit (PFU). Poliovirus was inactivated to 99.0% by 18 mJ/cm2 of UV dose in the condition of 0.08 Nephelometry Turbidity Unit (NTU) and 8 cm depth of water. Poliovirus at 30 mJ/cm2 of UV dose under the same condition was inactivated to 99.7%. Furthermore, Poliovirus at 56.60 NTU and 8 cm depth of water was inactivated to 92.0% and 98.5% by 18 mJ/cm2 and 30 mJ/cm2 of UV dose, respectively. The degrees of virus inactivation were dependent upon the UV dose, the turbidit, y and the depth of water. In conclusion, introduction of UV disinfections can be considered in drinking water purification systems in case reasonable engineering support is possible.
Drinking Water ; Nephelometry and Turbidimetry ; Poliovirus ; Shoes ; Virion ; Virus Inactivation ; Water Purification ; Water*

The effective inactivation of microorganisms in drinking water by Ultraviolet (UV) irradiation is regarded as a new low-cost water treatment method shoeing high removal rate of relatively stable infectious virus particles including poliovirus. In the present study, we examined virus inactivation by UV in various water environments. Samples were collected from finished water and surface water, and tested for turbidity. UV dose of 18, 22, 30, 36 and 40 milli-Joule (mJ)/cm2 were used by combination of 2 mW/cm2 UV intensity and time of 9, 11, 15, 18 and 20 second. Depths of water were fixed at 0.37 cm and 8 cm, and virus titers were shown by plaque forming unit (PFU). Poliovirus was inactivated to 99.0% by 18 mJ/cm2 of UV dose in the condition of 0.08 Nephelometry Turbidity Unit (NTU) and 8 cm depth of water. Poliovirus at 30 mJ/cm2 of UV dose under the same condition was inactivated to 99.7%. Furthermore, Poliovirus at 56.60 NTU and 8 cm depth of water was inactivated to 92.0% and 98.5% by 18 mJ/cm2 and 30 mJ/cm2 of UV dose, respectively. The degrees of virus inactivation were dependent upon the UV dose, the turbidit, y and the depth of water. In conclusion, introduction of UV disinfections can be considered in drinking water purification systems in case reasonable engineering support is possible.
Drinking Water ; Nephelometry and Turbidimetry ; Poliovirus ; Shoes ; Virion ; Virus Inactivation ; Water Purification ; Water*