OBJECTIVES: To determine whether the body weight, body mass index (BMI), and basal serum level of LH, FSH, testosterone (T), dehydroepiandrosterone sulfate (DHEA-S) are related to the ovarian response to clomiphene citrate (CC) in patients with polycystic ovarian syndrome (PCOS). MATERIALS AND METHOD: From January 1996 to June 1997, total 57 patients with PCOS were enrolled in the present study. Women who had other infertility factors were excluded from our study. The ovulation induction using CC was used in all patients. The patients were grouped into 50 mg group, 100 mg group, and 150 mg group according to their daily CC dose. The patients were also grouped to ovulatory and non-ovulatory group. The body weight, BMI, arid basal serum level of LH, FSH, T, DHEA-S were measured in all patients on the 2nd or 3rd day of the menstrual cycle. Results were analysed with Student's t-test and Fisher's exact test. RESULTS: The body weight and BMI of the nonovulating group were significantly higher than those of the ovulating group in all groups (50, 100, 150 mg of CC). However, there were no significant differences of the level of LH and FSH between ovulating and nonovulating groups in all CC groups (50, 100, 150 mg). The level of T of nonovulating group was significantly higher in 50 and 100 mg of CC groups, but not in 150 mg group. The level of DHEA-S of the non-ovulating group is significantly higher in 50 mg group, but not in 100 and 150 mg groups. CONCLUSION: The body weight and BMI could be useful predictors of ovarian response to CC in patients with PCOS, and basal T and DHEA-S also might be useful in cases of low-dose CC treatment.
Body Mass Index ; Body Weight ; Clomiphene* ; Dehydroepiandrosterone Sulfate ; Female ; Humans ; Infertility ; Menstrual Cycle ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Testosterone

OBJECTIVE: To evaluate the effect of compensation or secondary gain on the pain behavior and psychometric characteristics. METHOD: We examined 88 patients who complained of chronic low back pain by the various pain questionnaires, electrodiagnostic study and magnetic resonance imaging (MRI). Total patients were classified into two groups (46 patients who wanted disability evaluation and 42 patients who did not). RESULTS: Mean score of visual analogue scale, total sum of McGill pain questionnaire and pain rating index on sensory, affective and miscellaneous dimensions were significantly higher in patients related to disability compensation than those in patients without compensation. Mean scores of pain disability index and symptom checklist-90-revision were significantly higher on various subclass in patients with compensation. Various pain scales were significantly correlated to each other in both group but the severity of electrodiagnostic study and MRI findings were not related with the degree of pain index score in both group. CONCLUSION: Compensation or secondary gain affect pain behavior and psychometric characteristics in chronic low back patients. So when we evaluate or treat the patients with chronic low back pain, we should consider above results.
Compensation and Redress ; Disability Evaluation* ; Humans ; Low Back Pain* ; Magnetic Resonance Imaging ; Pain Measurement ; Psychometrics* ; Surveys and Questionnaires ; Weights and Measures

OBJECTIVE: The aim of the present study was to understand biomechanical characteristics during the process of initiation of gait (IOG) from the standing position in hemiplegic patients. METHOD: We recorded the ratio of the vertical forces of both limbs to body weight and the movement of net center of pressure (COP) on two force platforms during the process of initiation of gait (IOG) from standing in 10 normal control and 10 hemiplegic patients and processed these data using ELITE DMA acquisition program. All data were collected with uninvolved limb and involved limb and compared each other by independent samples t-test. RESULTS: 1) In 10 hemiplegic patients, nine patients began taking a step with an uninvolved limb in the first, followed by an involved limb. 2) The period of IOG of the swing limb was 0.80 sec when patients walked with an uninvolved side and those of the stance limb was 1.60 sec with involved side. When the control group walked, the period of IOG of the swing limb was 0.70 sec and those of stance limb was 1.50 sec. The period of IOG of the swing limb in uninvolved side and those of the stance limb in involved side showed significant longer than control group. 3) The latency of IOG of swing and stance limb was significantly more prolonged than control groups. 4) Anteroposterior (AP) and mediolateral (ML) distance of net COP from release to unloading with uninvolved limb showed significant longer than control groups. 5) The velocity of net COP displacement from start to release with involved limb was significantly slower than control groups. CONCLUSION: This pattern of IOG could be used as one of the tools to evaluate postural control during gait training in the hemiplegic patients with gait disabilities, and it can be used as a basis for specific therapeutic intervention, and it allows evaluation of the effectiveness of treatment.
Body Weight ; Extremities ; Gait* ; Humans ; Stroke*

It was reported that the etiologies of recurrent spontaneous abortion are immunologic factors, endocrinologic problems, anatomical abnormalities, genetic abnormalities, infection, and unexplained factors. Among those etiologic factors, genetic abnormalities occur in about 5% of the couples who experience recurrent spontaneous abortions, and most common parental chromosomal abnormality contributing to recurrent abortion is balanced translocation. The advent of in vitro fertilization (IVF), the development of skills associated with the handling of human embryo, and an explosion of knowledge in molecular biology have opened the possibility of early diagnosis of genetic disease in preimplantation embryos. Therefore preimplantation genetic diagnosis (PGD) is indicated for couples, infertile or not, at risk of transmitting a genetic disease. A case of successful pregnancy and term delivery by PGD using fluorescence in situ hybridization (FISH) technique in patient with recurrent spontaneous abortion due to balanced translocation is presented with brief review of literatures.
Abortion, Habitual ; Abortion, Spontaneous* ; Blastocyst ; Chromosome Aberrations ; Early Diagnosis ; Embryonic Structures ; Explosions ; Family Characteristics ; Female ; Fertilization in Vitro ; Fluorescence ; Humans ; Immunologic Factors ; In Situ Hybridization ; Molecular Biology ; Parents ; Pregnancy* ; Preimplantation Diagnosis* ; Prostaglandins D

PURPOSE: In general, the depth of tumor invasion correlates with lymph node metastasis in gastric cancer, but some cases show a discrepancy between the tumor depth and nodal status. Therefore, this study was designed to investigate the factors affecting tumor growth patterns including the depth of invasion and lymph node metastasis. METHODS: The clinico-pathological characteristics of 1048 gastric cancer, from 1993 to 1999, were investigated. These cancer cases were divided into three groups: the early gastric cancer with lymph node metastasis (EP), the serosa infiltrated advanced cancer with no lymph node metastasis (SN), and the serosa infiltrated advanced gastric cancer with lymph node metastasis (SP) groups. The expression status of the proteins related with tumor growth, including matrix metalloproteinase-2 and 9 (MMP-2 and MMP-9), VEGF, nm23 and p53, were compared using immunohistochemical stain, p53 gene mutation, Microsatellite instability (MSI) and Loss of heterozygosity (LOH). RESULTS: There were 35 (3.4%) of the total cases in the EP group, and 10.1% in Early gatric cancer cases. The female ratio in the EP group was higher than in the SN group but this was not statistically significant. The most common gross types in the EP and SN groups were IIc and Borrmann type III, respectively, and the mean tumor size was largest in the SN group. The cell differentiation of the SN group was better than that in the EP group (68.6 vs. 41.2%). The levels of MMP-2 and -9 were higher in the SN and SP groups than those in the EP group. However, the levels of VEGF and nm23 between the groups were no different. The EP group had the highest degree of p53 mutation. There was no difference in the MSI and LOH expression status between the groups. CONCLUSION: There were some different growth patterns in the gastric cancers between the lymph node metastasis dominant (EP) and depth of infiltration dominant (SN) groups. MMP-2 and -9, tumor differentiation and mutated p53 gene exon may correlated with the tumor growth pattern. Further study is suggested to find the difference between the EP and SN groups, which could provide information on which factors determine nodal metastasis or the depth of a infiltration dominant growth pattern.
Cell Differentiation ; Exons ; Female ; Genes, p53 ; Humans ; Loss of Heterozygosity ; Lymph Nodes ; Matrix Metalloproteinase 2 ; Microsatellite Instability ; Neoplasm Metastasis ; Serous Membrane ; Stomach Neoplasms* ; Vascular Endothelial Growth Factor A

OBJECTIVE: To investigate the effects of botulinum toxin on the mechanical hyperalgesia, electrophysiology and motor functions in the persistent muscle pain rat model. METHOD: A secondary mechanical hyperalgesia in the bilateral hindpaws of Sprague-Dawley rats was produced by the repeated injections of acidic saline into gastrocnemius. Botulinum toxin A (BTX-A(4): 4 U/kg, BTX-A(7): 7 U/kg) was administrated into same muscle 24 hours after a second injection of saline. The mechanical hyperalgesia was measured with withdrawal threshold to von Frey filament. The grade of muscle paralysis was evaluated with electrophysiology and the locomotor performance using inclined plane board. RESULTS: The mechanical hyperalgesia was significantly decreased from 5 days to 2 weeks in BTX-A(7) group in the injected side. The dose-dependent decreased amplitude of compound muscle action potential and reduced prevalence of endplate noise from the first day of botulinum toxin injection lasted for 4 weeks in both gastrocnemius. The maximum angle maintained at initial position on the inclined plane board did not change. CONCLUSION: Local muscular injection of botulinum toxin A reduced ipsilateral hyperalgesia dose-dependently in persistent muscle pain rat model without motor deficit. The antinociceptive mechanism of botulinum toxin might act at a local or peripheral rather than a systemic or central effect due to ineffectiveness of contralateral hyperalgesia. Clinically, botulinum toxin A might be useful for the treatment of local and referred pain of muscle origins.
Action Potentials ; Animals ; Botulinum Toxins ; Electrophysiology ; Hyperalgesia ; Muscles ; Noise ; Pain, Referred ; Paralysis ; Prevalence ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: The present study was undertaken to determine the value of developmental assessment, multimodality evoked potentials, brain magnetic resonance image (MRI) and electroencephalography (EEG) and to identify correlations between each evaluation. METHOD: Developmental assessments such as Bayley scales of infant development and Vineland social maturity scale, brain MRI, EEG and evoked potentials findings were evaluated in 45 children with spastic cerebral palsy to assess the developmental level and abnormalities of the anatomical structure of the brain and to elucidate the relationship between the test methods. RESULTS: 1) Mean mental developmental index (MDI) and psychomotor developmental index (PDI) were 69.6 and 68.6, respectively and mean Vineland social maturity quotient (SQ) was 76.1 and there was a significant correlation between the MDI, PDI, and SQ in cerebral palsied children. 2) Abnormal findings of brain MRI and EEG were found in 73.3% and 44.4% of the cases, respectively. 3) There was significant correlation between findings of brain MRI, auditory evoked potentials, visual evoked potentials, median somatosensory evoked potentials and social quotient. CONCLUSION: Developmental assessment, multimodality evoked potentials, EEG, and brain MRI would be a useful method to evaluate the maturity of brain and estimate the level of development.
Brain* ; Cerebral Palsy* ; Child Development ; Child* ; Electroencephalography* ; Evoked Potentials* ; Evoked Potentials, Auditory ; Evoked Potentials, Somatosensory ; Evoked Potentials, Visual ; Humans ; Magnetic Resonance Imaging* ; Weights and Measures

BACKGROUND/AIMS: Anti-C-reactive protein (CRP) antibody has been introduced as a potential biologic marker in Systemic lupus erythematosus (SLE). The aim of study is to evaluate the level of anti-CRP antibody in patients with SLE. METHODS: This study investigated the relationship between levels of anti-CRP antibodies and disease activity markers, such as complement, anti-double-stranded DNA antibody, and SLE disease activity index in 34 patients with SLE. RESULTS: The serum anti-CRP antibody levels of the patients with SLE were significantly higher than those of the healthy controls (11.3 ± 5.6 µg/mL vs. 9.1 ± 2.8 µg/mL). The percentages of the positive anti-CRP antibody were 52.9% in SLE and 27.8% in controls. Disease duration of SLE showed significant correlation with the anti-CRP antibody (r = 0.234, p = 0.026). However no significant relationship was observed between the levels of anti-CRP antibodies and disease activity markers. CONCLUSIONS: These data show that the anti-CRP antibody levels of the patients with SLE were significantly higher than those of healthy controls. We observed that the presence of the anti-CRP anti-CRP antibody was not associated with disease activity of SLE.
Antibodies ; Biomarkers ; Complement System Proteins ; DNA ; Humans ; Lupus Erythematosus, Systemic*

BACKGROUND: There has been a general feeling among surgeons that recurrence or metastasis following a curative gastric resection is a hopeless surgical proposition. This study was conducted to evaluate the clinical features and significance of relaparotomy following a gastrectomy for gastric cancer. METHODS: Fifty-six cases of relaparotomies following resection for 53 gastric cancer patients, which were performed over a nine-year period, were investigated retrospectively. On preoperative diagnosis, there were 17 cases of remnant and anastomotic recurrence, 15 cases of intestinal obstruction, 7 cases of cholecystitis, 7 cases of rectosigmoid obstruction, 5 cases of E-loop obstruction and 5 cases of other diseases. RESULTS: Of all the laparotomies eleven cases (19%) were non-recurrence, benign diseases and forty-six (81%) were recurrence. In the 17 cases of remnant and anastomotic recurrence, re-resection was possible in 13 (76%) and major postoperative complications developed in 4 cases with 2 cases of death within one month. Also 6 of 7 re-resected cases which was stage I at first operation were still alive well. In 15 cases of mechanical obstruction, 5 cases were non-recurrence and 10 cases involved recurrence, of which 6 had a bypass or enterostomy and 4 an exploration only. All cholecystitis cases had a cholecystectomy; metastasis was found in 2 cases. Rectal obstruction and E-loop obstruction all involved recurrence and a palliative resection was possible in only one case of each type of obstruction. CONCLUSIONS: In a relaparotomy of remnant and anastomotic recurrence, most of the survival-improving re-resection cases were in stage I at the first operation. In late-onset cholecystitis tumor recurrence should be suspected and a relaparotomy of the malignant obstruction, with bypass and ostomy procedure, can be justified for symptomatic relief.
Cholecystectomy ; Cholecystitis ; Diagnosis ; Enterostomy ; Gastrectomy ; Humans ; Intestinal Obstruction ; Laparotomy ; Neoplasm Metastasis ; Ostomy ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*

BACKGROUND: The p16 protein is a cyclin-dependent kinase inhibitor (CDKI) that inhibits cell cycle progression from phase G1 to phase S in the cell cycle. Many p16 gene mutations have been noted in many cancer-cell lines and in some primary cancers. These mutated genes caused abnormal or aberrant expression of the p16 protein, which might have contributed to the malignant progression of the cells by deranging the cell cycle. This study was to examine the abnormal or aberrant expression of the p16 protein in breast cancer tissue by using p16 protein specific immunohistochemical staining. METHODS: p16-protein-specific immunohistochemical staining was performed on 31 breast-cancer tissue samples. Twenty-four cases among the 31 tissue staining slides simultaneously showed a normal breast-tissue portion on the same staining slide. Microscopic photographs of both the breast-cancer and the normal- tissue portion were taken at the same magnification to compare the statistically analyzed fraction of red or brown colored p16 stained nuclei. RESULTS: In the breast cancer tissue, 7 (22.6%) showed totally negative, with less than 5% of the nuclei staining. The completely negative cases were not related to the stage of the disease (p=0.096) or to the histopathologic grade (p=0.20). The staining ratios of the breast-cancer tissue and the normal tissue were 26.2 ( +/- 18.7)% and 72.4 ( +/- 18.8)%, respectively. In the breast-cancer tissue, the ratio of expression of the p16 protein was significantly lower than in the normal tissue (p=0.001). CONCLUSIONS: In the carcinogenesis of some breast cancers, low expression of the p16 protein may play an important role in the unlimited proliferation of tumor cell due to a loss of the cell-cycle-regulating role of the p16 protein.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Cycle ; Cyclin-Dependent Kinase Inhibitor p16* ; Genes, p16 ; Humans* ; Phosphotransferases