Exercise testing with Thallium imaging is widely used for the noninvasive evaluation of patients suspected of having coronary artery disease. However, many patients referred for stress testing connot exercise adequately for either physical or psychological reasons, and as a result may have nondiagnostic or suboptimal test results. Intravenous dipyridamole in conjunction with Thallium imaging is as effective alternative method without exercise. But, myocardial imaging using the standard scintillation camera technique(planner view) is hampered by superposition of proximal & distal cardial walls and by the segmental nature of myocardial ischemia. For this reason, Single Photon Emission Computed Tomography(SPECT) reslut in high specificity & sensitivity rates for the detection of coronar artery disease compared with conventional technique. So we performed dipyridamole Th-201 myocardial scintigraphy on 25 subjects who have suspicious angina or myocardial infarction instead of exercise Th-201 myocardial scintigraphy, and compared SPECT view with conventional plannar view. The results obtained are as follows : 1) T1-201 scintigraphic findings in 17 patients with suspicious angina were as follows ; redistribution defect was seen in 4 cases in plannar view and 13 cases in SPECT view. 2) T1-201 scintigraphic findings in 8 patients with myocardial infarction were as follows ; in planner view, perfusion defect was seen in all cases and 1 cases of them, redistribution defect was accompained, and in SPECT view, perfusion defect was seen in all cases and 6 cases of them, redistribution defect was accompained. 3) During dipyridamole infusion, the mean systolic & diatolic pressure decreased from 133+/-22.7/86+/-13.5 to 121+/-23.9/78+/-13.1mmHg and the heart rate increased from 68+/-12.4 to 84+/-12.4beats/min. 4) Adverse effects of dipyridamole were noted in 14(56%) of the subjects, but in 12 of these, the symptoms were mild in severity and subsided spontanously. To summarize, Dipyridamole-201 myocardial imaging is a useful and test for coronary artery disease, and the new tomographic technique, SPECT view, is more useful than the conventional plannar view.
Arteries ; Coronary Artery Disease ; Dipyridamole* ; Exercise Test ; Gamma Cameras ; Heart Rate ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Sensitivity and Specificity ; Thallium* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Glomerular Basement Membrane*

To get basic data for the development of health care toward the staff of a university, an evaluation study of the risk factors for the cardiovascular disease utilizing data from questionnaire and health examination performed in 1994 for 1233 staff of Chosun University and its affiliated Hospital. The results are as follows: 1. The mean values of systolic blood pressure was 122.0+/-14.7mmHg for the male and 111.8+/-12. lmmHg for the female. The mean values of diastolic blood pressure was 82. 5+/-12.0mmHg for the male and 73.7+/-10.0mmHg for the female. The mean values of serum total cholesterol was 185.6+/-33.4mg/dl for the male and 173.5+/-32.6mg/dl for the female. The mean values of body mass index(BMI) was 23. l+/-2.4kg/m2 for the male and 21.5+/-2.3kg/m2 for the female. The smoking rate of the male was 47. 6% and that of the female was 0.4%. 2. The systolic and diastolic blood pressure levels increased with age in both sexes. Under 55 years of age the mean blood pressures of the male were higher than that of the female, but the levels of both sexes at 55-64 year old group did not show any big difference. The mean values of serum total cholesterol and BMI also increased with age in both sexes. Under 45 years of age, the serum cholesterol and BMI levels of the male were higher than that of the female, but on the contrary, levels of the male were lower than that of the female at 55-64 year old groups. The mean cholestrol and BMI levels of both sexes at 45-54 year old group was similar. As the age increases, the rate of exsmoker increased and the rate of current smoker decreased among the male. 3. The additive cardiovascular risk scores were calculated considering the values of blood pressure, serum total cholesterol level and the smoking status. The distribution curve of risk scores for the male showed 39. 1% under 4 points and 60.9% above 4 points with the peak at 4 points. 61.7% of the female showed that the risk scores were under 4 points and the rest was more than 4 points with maximum 9 points. As a whole the risk scores of the female were lower than that of the male. 4. By the analysis of association between the risk score of cardiovascular disease and the subjective symptom under the stratification of age and sex, the prevalence of exertional dyspnea was significantly higher at 35-44 year male group and prevalence of dizziness was significantly higher at 45-64 year male group as the risk score of cardiovascular disease increased. Among 25 34 year and 45-64 year female group persons with lower risk score of cardiovascular disease showed higher prevalence of dizziness than persosns with higher risk score.
Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Delivery of Health Care ; Dizziness ; Dyspnea ; Female ; Humans ; Male ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Surveys and Questionnaires

Multifetal pregnancy reduction(MFPR) appears to be an efficacious method for impro-ving the perinatal outcome of high order multifetal pregnancies(three or more fetuses). But it is controversial that larger initial fetal number before MFPR affects pregnancy outcomes adversely. The purpose of this study is to determine the affects of the initial fetal numbers on pregnancy outcomes and to compare the obstetrical outcomes according to the initial fe-tal numbers. Eighty four patients who conceived triplet or more by assisted reproductive technology(ART) in our infertility clinics and underwent MFPR to twins between January 1993 and December 1995. Sixteen patients were lost follow-up. Among the remaining 68 patients, four pateints were excluded from this study because of the pregnancy loss before 20 weeks gestation. The patients(n=64) were divided into three groups by the initial fetal number before reduction. 33 patients with triplet gestations(group 1), 18 patients with qua-druplets gestations(group 2), and 13 patients with quintuplet or more gestations(group 3) were retrospectively enrolled. Gestational age at delivery and birthweights were compared according to the initial fetal numbers. The mean maternal age was similar in each three groups. The results were as follows : 1) Although there was a trend of decreasing gestati-onal weeks at delivery and decreased birthweight in each groups(mean+/-SEM : 36.9+/-0.3, 34.7+/-1.3, 32.7+/-1.9 and 2,600+/-58, 2,161+/-215, 1,855+/-249 respectively), there were no stati-stical difference between group 1 and group 2, but there were significantly lower in group 3, compared with group1(p < 0.05). 2) The incidence of birth before 36 weeks gestation in each group 1, group 2, and group 3 were 12.1%, 38.9%, and 53.8% respectively(p < 0.05). 3) The incidence of low birthweight( < 2,500gm) in each group 1, group 2, and group 3 were 30.3%, 55.6%, and 69.2% respectively(p < 0.05). In conclusion, although MFPR reduced the high order multifetal pregnancy into twin pregnancy, the duration of gestation and the birth weight of newborn were still had a tendency of shortening and low respectively in high order multifetal pregnancy. Therefore strict control of the number of dominant follicles during superovulation and the number of transfered embryo in in vitro fertilization(IVF) is required for improving the pregnancy outcomes in ART.
Birth Weight ; Embryonic Structures ; Female ; Fertilization in Vitro ; Follow-Up Studies ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infertility ; Maternal Age ; Parturition ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Twin ; Quintuplets ; Reproductive Techniques, Assisted ; Retrospective Studies ; Superovulation ; Triplets

This study was performed to determine the effect of hydrosalpinx on the outcome with in vitro fertilization and embryo transfer(IVF-ET). Hydrosalpingeal fluid may leak into theuterine cavity during or after ovarian hyperstimulation and can cause deletorious effect onembryo or implantation. Herein, we reported the effect of hydrosalpinx on the cycle outcomeof IVF in controlled ovarian hyperstimulation cycles and cryopreserved-thawed embryotransfer cycles.In controlled ovarian hyperstimulation cycles, comparisons were made between 59 IVFcycles of 54 patients having tubal disease without hydrosalpinx(control group) and 36 IVFcycles of 35 patients carrying hydrosalpinx(hydrosalpinx group). Both clinical pregnancyand implantation rates were significantly lower in hydrosalpinx group(25.4 versus 8.3%,and 11.6 versus 2.0% respectively). Four ectopic pregnancies were noted in hydrosalpinxgroup compared to one in the control group.In cryopreserved-thawed embryo transfer cycles, comparisons were made between 27IVF cycles of 25 patients having tubal disease without hydrosalpinx(control group) and 13IVF cycles of 13 patients carrying hydrosalpinx(hydrosalpinx group). There was a tendencyof decreased pregnancy and implantation rates in hydrosalpinx group compared to the control(37.0 versus 15.4%, and 9.9% versus 4.0% respectively). One ectopic pregnancy was notedin the hydrosalpinx group compared to none in the control group.These data indicate that the presence of hydrosalpinx may negatively affect IVF outcome.We suggest that patients presenting with hydrosalpinx should consider surgical correctionto optimize their outcome with IVF procedure.
Cryopreservation ; Embryo Transfer ; Embryonic Structures ; Female ; Fertilization in Vitro ; Humans ; Pregnancy ; Pregnancy, Ectopic

Uterine anomalies have been reported in 4% of women with infertility and in up to 15% of those with recurrent abortion. One of the major intrauterine disorder associated with infertility and recurrent abortions is intrauterine septum, The reproductive outcome of 41 patients of intrauterine septum (7 complete, 34 incomplete) with repeated abortions or infertility was assessed after the uterine septotomy. 5 of 7 patients with comlete uterine septum undergone uterine septotomy (3; hysteroscopic metroplasty, 2; abdominal metroplasty) had total 6 pregnancies and all of them had live biths. 28 patients with incomplete uterine septum got the hysteroscopic intrauterine septotomy and the viable pregnancy rate was 62% (3 ongoing pregnancies, 13 live biths of total 26 pregnancies). 6 patients with incomplete uterine septum had not the operation and 5 patients had 5 live births after total 6 pregnancies with 1 spontaneus abortion. Even though, the number of cases were small, the live birth rate in the group of septotomy of the patients of complete uterine septum (100%, 6/6) was higher than that in the group of not-done (50%, 1/2). The live birth rate in the group of not-done of the patients with incomplete uterine septum (83%, 5/6) was higher than that in the group of hysteroscopic uterine septotomy (62%, 16/26), but 5 of 6 had short uterine septal length (<1 cm), 1 had 1.5 cm septal length in the group of not-done. All the patients with successful pregnancy outcome had no other co-factors at the diagnostic laparoscopy, but the 5 primary infertility patients with no live birth even after treatment (all were with incomplete septum; 3 undergone hysteroscopic septotomy, 2 not-done with one abortion) had other co-factors such as endometriosis, peritoneal or tubal facor. In conclusion, hysteroscopic uterine septotomy would be useful for the patients with habitutal abortion or infertility and more advanced managemnet protocols should be applied to the patients having other co-factors if there was no pregnancy even after the uterine septotomy.
Abortion, Habitual* ; Endometriosis ; Female ; Humans ; Hysteroscopy* ; Infertility* ; Laparoscopy ; Live Birth ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate

This study is the retrospective evaluation of ninety-six patients with biopsy-proven carcinoma of nasopharynx treated with radiotherapy at Yonsei University, College of Medicine, radiation Oncology from January 1971 to December 1985. Patient's age ranged from 15 to 71 years with a median age of 49 years. Fifty-two point five percent of local control and 47.5% of actuarial 5 year survival were achieved with radical radiotherapy. Five year survival rate for Stage I & II, III and IV were 75.0%, 74.6% and 41.4%, respectively. Distant metastasis rate was related with N stage (N1 12.5%, N1 0%, N2 23.5%, N3 32.1%) and histologic type (lymphoepithelioma 41.7%, squamous cell carcinoma 6.5%) but not with T stage. Thirty-one of sixty-seven patient covered adequate radiation field received induction chemotherapy. However induction chemotherapy dose not appear to improve over all survival.
Carcinoma, Squamous Cell ; Humans ; Induction Chemotherapy ; Nasopharynx ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate

OBJECTIVE: Ovarian hyperstimulation syndrome (OHSS) is one of the well known complication of conttolled ovarian hyperstimulation. Though there have been numerous protocols for the prevention of OHSS, it has not been completely preventable until now. This study was performed to identify clinical predictors for early and late OHSS. METHODS: A retrospective analysis of all IVF cycles in 1993 up to June 1996 was performed. OHSS was diagnosed using the criteria of Rabau modified by Schenker. All cases of OHSS reported in this study presented with marked ovarian enlargement, ascites, oliguria, hemoconcentration and electrolyte disturbance. Ovarian stimulation was carried out using a combination of gonadotrophin releasing hormone-agonist, follicle-stimulation hormone and human menopausal gonadotrophin. 27 patients has moderate or severe OHSS presenting 3-7 days post-human chorionic gonadotrophin (hCG), and 21 patients had severe OHSS presenting 12-17 days post-hCG. RESULTS: No patient with early OHSS went onto develop late OHSS, and no patient with late OHSS had demonstrated early OHSS. Logistic regression showed that early OHSS was predicted by the number of oocytes retrieved and the estradiol concentration on the day hCG injection (P<0.05). Late OHSS was predicted by the transferred embryos, B-hCG on 14 day after hCG injection (P<0.05). CONCLUSION: Early OHSS was an acute effect of the hCG administered prior to egg retrieval in women with high estradiol and large number of retrieved oocytes. Our analysis of the risk factors for early OHSS indicates that cryopreservation of all embryos will not alter the risk of early OHSS even though it should prevent late OHSS. Late OHSS was induced by the rising serum concentration of hCG produced by the early pregnancy, the number of transferred embryos must be adjusted carefully, since it was associated with multiple gestation.
Ascites ; Chorion ; Cryopreservation ; Embryonic Structures ; Estradiol ; Female ; Humans ; Logistic Models ; Oliguria ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Ovum ; Pregnancy ; Retrospective Studies ; Risk Factors

Autophagy is a self-degradation system of cellular components through an autophagosomal-lysosomal pathway. Over the last 15 yr, yeast genetic screens led to the identification of a number of genes involved in the autophagic pathway. Most of these autophagy genes are present in higher eukaryotes and regulate autophagy process for cell survival and homeostasis. Significant progress has recently been made to better understand the molecular mechanisms of the autophagy machinery. Especially, autophagy process, including the regulation of autophagy induction through mTOR and the nucleation and elongation in autophagosome formation through class III phosphatidylinositol 3-kinase complex and ubiquitin-like conjugation systems, became evident. While many unanswered questions remain to be answered, here, we summarize the recent process of autophagy with emphasis on molecules and their protein complexes along with advanced molecular mechanisms that regulate the autophagy machinery.
Autophagy/genetics/*physiology ; Carrier Proteins/genetics/metabolism ; Class III Phosphatidylinositol 3-Kinases/genetics/metabolism ; Humans ; Intracellular Signaling Peptides and Proteins/genetics/metabolism ; Membrane Proteins/genetics/metabolism ; Microtubule-Associated Proteins/genetics/metabolism ; Models, Biological ; Protein-Serine-Threonine Kinases/genetics/metabolism ; Small Ubiquitin-Related Modifier Proteins/genetics/metabolism

Numerous studies have established a link between autophagy and aging; however, the relationship has not been clearly defined. Aging is a very complex process caused by the accumulation of various factors due to the gradual failure of cellular maintenance. Recent studies have shown that autophagy reduces the stress responses induced by starvation, reactive oxygen species, and the accumulation of intracellular proteins and organelles through cytoprotection, clearance of damaged mitochondria, and lysosomal degradation. Here, we summarize our current understanding of the relationship between autophagy and the aging process.
Aging* ; Autophagy* ; Caloric Restriction ; Cytoprotection ; Mitochondria ; Organelles ; Proteins ; Reactive Oxygen Species ; Starvation