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

The purpose of this study was to investigate the characteristics or the potassium channels existing in the rat urinary bladders. Smooth muscle strips of rat detrusor urinae were examined by isometric myography. Relaxation responses of detrusor muscle strips to the three potassium channel openers pinacidil, a cyanoguanidine derivative, BRL 38227, a benzopyran derivative and RP 52891, a tertrahydrothiopyran derivative were examined. The potassium channel openers reduced the basal tone, and the rank order of potency was RP 52891>pincidil>BRL 38227. Procaine, an inhibitor of the voltage-sensitive potassium channel tended to increase the basal tone, but it did not affect the relaxant effects of the calcium-activated potassium channel opener did not antagonize the relaxant effects, but it reduced the Emax of RP 52891 and BRL 38227. Glibenclamide, an inhibitor of the ATP-sensitive potassium channel, antagonized the relaxant effects of pinacidil, RP 52891 and BRL 38227 reducing the Emax of RP 52891 and BRl 38227. Galanin which inhibits secretion of insulin through opening the ATP-sensitive potassium channels in pancreatic β-cells rather increased the basal tone of the isolated detrusor strips. These results suggest that the urinary bladder of the rat has mainly the ATP-sensitive, glibenclamide sensitive potassium channel, which is a different type from that in the pancreatic β-islet cells.
Animals ; Cromakalim ; Galanin ; Glyburide ; Insulin ; KATP Channels ; Muscle, Smooth ; Myography ; Pinacidil ; Potassium Channels* ; Potassium Channels, Calcium-Activated ; Potassium* ; Procaine ; Rats* ; Relaxation ; Urinary Bladder

Primary small cell carcinoma of the salivary gland is a rare neoplasm that accounts for approximately 1.8% of all primary major salivary gland malignancies. Because of its rarity, it is difficult to diagnose small cell carcinoma of the parotid gland by fine needle aspiration cytology(FNAC). We experienced a case of primary small cell carcinoma of the parotid gland in a 72-year-old woman who presented with two palpable masses of the left infraauricular and ocular regions of two to three month's duration, respectively. Aspirate smears from the left infraauricular area were highly cellular on necrotic and lymphocytic background and showed individually dispersed cells or three-dimensional clusters of small cells. The tumor cells were round to oval with a very high nucleocytoplasmic ratio. Nuclei were about two times the size of lymphocytes and had uniformly dispersed but hyperchromatic to pyknotic chromatin. Nucleoli were occasionally visible but were generally inconspicuous. Numerous mitotic figures were detected. The clusters of these small tumor cells exhibited angular nuclear molding, irregular nuclear outlines, and occasionally rosette like arrangement. The tumor was confirmed by histology and immunohistochemistry.
Aged ; Animals ; Benzodiazepines* ; Biopsy, Fine-Needle ; Carcinoma, Small Cell ; Chromatin ; Female ; Fungi ; Humans ; Immobilization* ; Immunohistochemistry ; Lymphocytes ; Parotid Gland ; Rats* ; Receptors, GABA-A* ; Salivary Glands ; Thyroid Gland

Otocephaly is a rare malformations comprising hypoplasia or absence of the mandible (agnathia), ventromedial displacement and often fusion of external ears (synotia or otocephaly), and hypoplasia of the oral cavity (microstomia) and tongue (hypoglassia). This developmental complex represents a malformation of the first and second branchial arches and occurs sometimes with holoprosencephaly. We present the ultrasound detection of otocephaly and holoprosencephaly with cyclopia in a fetus of 27 gestational weeks 6 days. The use of three-dimensional (3-D) ultrasound made additional diagnostic ultrasound tomograms possible, and the volume reconstructions improved the imaging and the understanding of the condition.
Branchial Region ; Diagnosis* ; Ear, External ; Fetus ; Holoprosencephaly ; Mandible ; Mouth ; Tongue ; Ultrasonography

This study aimed to investigate the mechanism of action of baclofen on the detrusor muscle isolated from rat. Rats (Sprague-Dawley) were sacrificed by decapitation and exsanguination. Horizontal muscle strips of 2 mm x 15mm were prepared for isometric myography in isolated muscle chamber bubbled with 95% / 5%-OZ / CO2 at 371C, and the pH was maintained at 7.4 Detrusor strips. contracted responding to the.. electrical field stimulation (EFS) by 2 Hz, 2U msec, monophasic square wave of 60 VDC. The initial peak of EFS-Induced contraction was tended to be suppresed by a,p-methylene-adenosine 5'-triphosphate (mATP), a partial agonist of purinergic receptor, and baclofen, a GABAB receptor agonist (statistically nonsignificant). The late sustained contraction by EFS was suppressed significantly (p < 0.05) by additions of atropione, a cholinergic muscarinic receptor antagonist and baclofen. The adenosine 5'-triphosphate-induced contraction was completely abolished by mA TP but not by baclofen. In the presence of atropine, the subsequent addition of acetylcholine could not contract the muscle strips: but the addition of acetylcholine in the presence of baclofen evoked a contraction to a remarkable extent.
Acetylcholine ; Adenosine ; Animals ; Atropine ; Baclofen* ; Decapitation ; Exsanguination ; Hydrogen-Ion Concentration ; Myography ; Rats* ; Receptors, Muscarinic

Apocrine carcinoma is an uncommon, poorly characterized type of breast tumor. The histologic characteristics of apocrine epithelium in malignant breast lesion were first noted by Krompecher(1916), while the first detailed description of an apocrine carcinoma is credited to Ewing in 1928. The reported incidence of apocrine carcinoma is approximately 0.4% of breast cancers. Apocrine carcinoma has distinct histologic and ultrastructural features that distinguish it as a specialized form of infiltrating ductal carcinoma. The finding of a uniform pattern of apocrine differentiation with dense granularity typifying the majority of cells characterizes this variant. We experienced two cases of invasive apocrine carcinoma of the breast and report with a review of the related literature.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Epithelium ; Incidence

BACKGROUND: Nm23 gene was identified by the hybridization between two murine melanoma cell lines which had low or high metastatic potential and was located in chromosome 17q22. A number of tumor cohort studies have shown an inverse relationship between the levels of expression of nm23 protein and disease aggressiveness and tumor metastatic potential. METHODS: In order to determine the significance of overexpression of the antimetastatic gene nm23 protein in human-lymph node-negative breast cancer and to compare it with established clinicopathologic prognostic factors such as the tumor size, histologic grades, TNM stages, and hormonal receptor status, we analyzed the nm23 protein expressions by immunohistochemical staining in 53 lymph-node-negative breast-cancer tissue specimens. RESULTS: The nm23 protein expression was positive in 35 cases (66%). There was no relationship between nm23 protein overexpression and menopause status, tumor size, histologic grade, and hormonal receptor status, but tumor stage correlated with nm23 protein overexpression. Also, overexpression of the nm23 protein was significantly correlated with a longer disease-free survival rate. CONCLUSION: Expression of nm23 protein may be of value for predicting the long-term disease-free survival rate in lymph-node-negative breast-cancer patients.
Breast Neoplasms ; Breast* ; Cell Line ; Cohort Studies ; Disease-Free Survival ; Female ; Humans ; Lymph Nodes* ; Melanoma ; Menopause ; Staphylococcal Protein A*

OBJECTIVE: The purpose of this retrospective study was to evaluate the effect of neoadjuvant chemotherapy followed by radical surgery compared with conventional radical surgery in stage Ib1 cervical cancer as to operative complications, the rate of lymph node metastasis, recurrence and overall five-year survival rates. METHODS: The study materal (98 cases of stage Ib1 cervical cancer) was divided into two groups; The one group was neoadjuvant chemotherapy (Cisplatin + 5-FU) followed by radical surgery (n = 41) and the other was the conventional radical surgery (n = 57) group. Reviewing records of operative and pathological reports and clinical findings, the outcome was statistically analyzed and compared. RESULTS: As to the complication, bladder dysfuntion was more frequent in neoadjuvant chemotherapy group, statistically significant.(43.9% vs 22.8%, P=0.034). No significant difference was found in the incidence of lymphnode metastasis (17% vs 17.5%, P=0.779) and overall five year survial rates(85.3% vs 87.7%, P=0.735). CONCLUSION: No benefical effect of neoadjuvant chemotherapy could be found on stage Ib1 cervical cancer in this retrospective study. However, well controlled longterm prospective study will be need to get firm conclusion.
Drug Therapy* ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms*

OBJECTIVES: We aimed to compare the diagnostic performances of digital mammography (DM), digital breast tomosynthesis (DBT), ultrasound (US), magnetic resonance imaging (MRI), breast specific gamma imaging (BSGI) and/or positron emission tomography/computed tomography (PET/CT) for the detection of invasive lobular carcinoma (ILC). METHODS: Index ILCs and multifocal/multicentric (multiple) ILCs were analyzed using various imaging modalities. The final surgical pathology was regarded as the reference standard. The detection rate for index cancers and the diagnostic performance for multiple ILCs per breast were evaluated. RESULTS: Seventy-eight ILCs in 76 women were enrolled. Twenty-six breasts had multiple ILCs. DM (n=72), DBT (n=15), US (n=77), MRI (n=76), BSGI (n=50), and /or PET/CT (n=74) were performed. For index cancer, the detection rate was 100% for DBT, US, and MRI. For multiple ILCs, the sensitivity was 100% for DBT and MRI (P<0.001). The diagnostic accuracy for multiple ILCs were 73.3% for DBT and 73.0% for PET/CT (P=0.460). CONCLUSION: DBT was the most accurate imaging modality for both index and multiple ILCs. PET/CT was also valuable for multiple ILCs, whereas DM and BSGI showed relatively low diagnostic performances. DBT and PET/CT have promising roles in the diagnosis of multiple ILCs.
Breast ; Carcinoma, Lobular* ; Diagnosis ; Electrons ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Pathology, Surgical ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Ultrasonography

Purpose: The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. Materials and Methods: This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. Results: Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. Conclusion Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.