OBJECTIVE: The objective of this study is to nfluence of sequential embryo transfers in an invitro fertilization was examined. METHOD: After in vitro fertilization, a maximum of 6 fertilized oocytes was enrolled in this study. At day 3 after an oocytes retrieval, embryos with good quality were transferred (mean 4.9), remaining embryos (mean 2.0/cycle) were cryopreserved at blastocyst stage (Group 1). At day 5 after oocytes collection, second a embryos had reached the blastocyst stage (Group 2) using P1 supplemented with 10 SSS and 30% Follicular fluid. No statistical difference in the pregnancy rate could be seen between the group without a second embryo transfer (n=21; 28.6%) and the group with a second transfer (n=52; 28.8%). RESULTS: The incidence of multiple pregnancy rate per embryo transfer was not statistically different between both group and no high-rank multiple pregnancy (greater than triplete) were observed (o.9%, 15.4%, respectively, p=0.74, chi2). Out of 114 cycles (506 embryos) cultured embryos in group 2, 52 cycles (159 embryos, 29.8%) reached the blastocyst stage. CONCLUSION: The second transfer did not have a significant effect on the pregnancy rate. The most important factor for the pregnancy seems to be the quality of the embryos transferred on day 3 following oocyte retrieval. We recommend embryo transfer is performed only one, day 2~3 or D5.
Blastocyst ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Follicular Fluid ; Incidence ; Oocyte Retrieval ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple

Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

PURPOSE: We studied the diagnostic significance of bone scan in evaluation of bone metastasis by lung cancer, prevalence rate, and the causes of false positive bone scan and soft tissue accumulation of bone seeking agent. MATERIALS AND METHODS: The subject included 73 lung cancer patients with bone scan. We analyzed the frequency of bone metastasis, its distribution and configuration, and any relationship between bone pain and corresponding region on bone scan. The positive findings of bone scan were compared with simple X-ray film, CT, MRI and other diagnostic modalities. The false positive bone scan and the soft tissue accumulation of bone seeking agent were analized. RESULTS: The positive findings on bone scan were noted in 26 cases(36%) and they were coexistant with bone pain in 30%. The correspondance between bone scan and bone X-ray was 38%. False positive bone scans were seen in 12 cases(16%), which include fracture due to thoracotomy and trauma, degenerative bone diseases, and bifid rib. Accumulation of bone seeking agent in soft tissue were seen in 13 cases(18%), which included primary tumor, enlarged cervical lymph node, pleural effusion, ascites and pleural thickening. CONCLUSION: Bone scans should be carefully interpreted in detecting bone metastasis in primary malignancy, because of the 16% false positivity and 18% soft tissue accumulation rate. It is very important to note that the correlation between bone pain and positive findings of bone scans was only 38%.
Ascites ; Bone Diseases ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pleural Effusion ; Prevalence ; Ribs ; Thoracotomy ; X-Ray Film

No abstract available.

PURPOSE: We sought to identify the prevalence of sexual dysfunction and to evaluate the six domains of sexual function in female hemodialysis patients. MATERIALS AND METHODS: We undertook a cross-sectional study based on self-administered questionnaires and reviews of laboratory data that were collected from February to June 2007. A total of 49 women (mean age 52.3 years) from eight dialysis units were enrolled. Sexual function was assessed by the Korean version of the Female Sexual Function Index (FSFI). RESULTS: Forty-one patients (83.7%) reported sexual dysfunction during the prior 6 months. The mean score for sexual function in the sexual dysfunction group was 15.1, much lower than 29.6 for the normal sexual function group (t=10.2, p=0.000). In the six domains of sexual function for the dysfunction group, orgasm (range 0~6.0) was 2.4, desire (range 1.2~6.0) 1.9, and arousal (range 0~6.0) 1.9. The sexual dysfunction group was significantly older in age and lower in serum albumin level as compared with normal sexual function group. CONCLUSIONS: Sexual dysfunction in female patients on hemodialysis was highly prevalent. Interventions to promote orgasm, desire, and arousal in female patients on hemodialysis should be developed.
Arousal ; Cross-Sectional Studies ; Dialysis ; Female* ; Humans ; Orgasm ; Prevalence ; Surveys and Questionnaires ; Renal Dialysis* ; Serum Albumin

Beta-lapachone (beta-Lap; 3,4-dihydro-2, 2-dimethyl-2H-naphthol[1, 2-b]pyran-5,6-dione) is a novel anti-cancer drug under phase I/II clinical trials. beta-Lap has been demonstrated to cause apoptotic and necrotic death in a variety of human cancer cells in vitro and in vivo. The mechanisms underlying the beta-Lap toxicity against cancer cells has been controversial. The most recent view is that beta-Lap, which is a quinone compound, undergoes two-electron reduction to hydroquinone form utilizing NAD(P)H or NADH as electron source. This two-electron reduction of beta-Lap is mediated by NAD(P)H:quinone oxidoreductase (NQO1), which is known to mediate the reduction of many quinone compounds. The hydroquinone forms of beta-Lap then spontaneously oxidizes back to the original oxidized beta-Lap, creating futile cycling between the oxidized and reduced forms of beta-Lap. It is proposed that the futile recycling between oxidized and reduced forms of beta-Lap leads to two distinct cell death pathways. First one is that the two-electron reduced beta-Lap is converted first to one-electron reduced beta-Lap, i.e., semiquinone beta-Lap (SQ).- causing production of reactive oxygen species (ROS), which then causes apoptotic cell death. The second mechanism is that severe depletion of NAD(P)H and NADH as a result of futile cycling between the quinone and hydroquinone forms of beta-Lap causes severe disturbance in cellular metabolism leading to apoptosis and necrosis. The relative importance of the aforementioned two mechanisms, i.e., generation of ROS or depletion of NAD(P)H/NADH, may vary depending on cell type and environment. Importantly, the NQO1 level in cancer cells has been found to be higher than that in normal cells indicating that beta-Lap may be preferentially toxic to cancer cells relative to non-cancer cells. The cellular level of NQO1 has been found to be significantly increased by divergent physical and chemical stresses including ionizing radiation. Recent reports clearly demonstrated that beta-Lap and ionizing radiation kill cancer cells in a synergistic manner. Indications are that irradiation of cancer cells causes long-lasting elevation of NQO1, thereby sensitizing the cells to beta-Lap. In addition, beta-Lap has been shown to inhibit the repair of sublethal radiation damage. Treating experimental tumors growing in the legs of mice with irradiation and intraperitoneal injection of beta-Lap suppressed the growth of the tumors in a manner more than additive. Collectively, beta-Lap is a potentially useful anti-cancer drug, particularly in combination with radiotherapy.
Animals ; Apoptosis ; Benzoquinones ; Cell Death ; Electrons ; Humans ; Hydroquinones ; Injections, Intraperitoneal ; Leg ; Mice ; NAD ; Naphthoquinones ; Necrosis ; Radiation Tolerance ; Radiation, Ionizing ; Reactive Oxygen Species ; Recycling ; Substrate Cycling

To study left ventricular diastolic filling in patient with hypertension in different form of left ventricular hypertrophy(LVH), 105 patients with hypertension and 30 normal persons underwent M-mode echocardiography and pulsed Doppler measurement of the left ventricular inflow. From the M-mode echocardiographic measurement of left ventricular dimension, hypertensive patients were subdivided into three grouops : group I(n=27) ; no LVH, group II(n=36) ; concentric LVH, grooup III(n=42) asymmetric septal hypertrophy. From the digitized trace of the pulsed Doppler at the mitral valve level, Doppler diastolic time intervals, peak velocities at rapid filling (E velocity) and atrial contraction(A velocity) and the triangle area under the A velocity(A area) and triagle area under the E velocity(E area) were measured. The peak A velocity(normal subjects ; 0.51+/-0.08m/sec, group I ; 0.73+/-0.14m/sec, group II ; 0.78+/-0.15m/sec, group III ; 0.8+/-0.23 m/sec) and the A area(noral subjects ; 4.71+/-1.64, group I; 6.24+/-1.78, group II ; 7.75+/-2.93, group III ; 8.05+/-3.11) and the peak A/E velocity ratio and the A/E area ratio were significantly different from the normal controls(P<0.01). The peak E velocity(normal subjects ; 0.76+/-0.13, group I ; 0.7+/-0.12, group II ; 0.63+/-0.12, group III ; 0.59+/-0.15m/sec) and E area (normal subjects ; 9.61+/-2.8, group I ; 8.11+/-2.13, group II ; 7.82+/-2.73, group III ; 7.34+/-3.07) were significantly different between hypertensive groups with LVH and normal controls. Doppler time intervals, total area were not different between groups. This study shows that abnormal pattern of left ventricular diastolic filling occur in patients with hypertension and the peak A velocity and the peak A/E velocity ratio and the peak A/E area ratio are the earliest findings that can detectable by Doppler echocardiography.
Cardiomyopathy, Hypertrophic ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension* ; Mitral Valve

PURPOSE: Bone involvement is known to develop in 40-70Yo of pediatric acute leukemia. We aimed to analyze the clinical course and result of therapy in pediatric acute leukemia with bone involvement. METHODS: Twenty-seven patients diagnosed as pediatric acute leukemia at Dong San Medical Center from Jan. 1996 to Aug. 1998 were evaluated. According to bone X-ray and whole body bone scan, the patients were divided into two groups. RESULTS: Twenty-seven patients were enrolled in this study with 14 patients(52Yo) showing definite bone involvement on simple X-ray or bone scan. Mean age of patients with bone involvement was 5.5 years. Regarding the type of leukemia, 9 patients(64%) were acute lymphocytic leukemia. Ten patients(71%) out of 14 with bone involvement complained of bone pain at the involved bony site. Site of involvement was most frequent in the lower extremity. On simple X-ray, osteolytic lesion was found in 7 patients(50%), diffuse osteopenia in 2 patients(14%) and pathologic fracture in 2 patients(14%). In bone scan, radioactivity was increased in whole cases of patients with bone involvement. Thirteen patients(93%) were completely remitted by chemo-therapy, but, one AML patient died due to induction failure. CONCLUSION: Bone involvement occured in 52% of pediatric acute leukemia. Bone involvement was more frequent in male patients in the lower extremity, and osteolytic lesion was the most frequent finding on simple X-ray. There was no relevence between bone involvement and prognosis. Further study will be needed to evaluate long-term survival and prognosis. (J Korean Pediatr Soc 2000;43:806-813)
Bone Diseases, Metabolic ; Fractures, Spontaneous ; Humans ; Leukemia* ; Lower Extremity ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Radioactivity

Ground-glass opacity is a frequent but nonspecific finding seen on high-resolution CT scans of lung parenchyma. Histologically, this appearance is observed when thickening of the alveolar wall and septal interstitium is minimal or the alveolar lumen is partially filled with fluid, macrophage, neutrophils, or amorphous material. It has been shown that ground-glass opacity may be caused not only by an active inflammatory process but also by fibrotic processes. When a focal area of ground-glass opacity persists or increases in size, the possibility of neoplasm-bronchioloalveolar carcinoma or adenoma, or lymphoma, for example- should be considered. Diffuse nonsegmental ground-glass opacity in both lung fields was incidentally found on follow up abdominal CT in a stomach cancer patient and signet-ring cell-type metastatic lung cancer was confirmed by transbronchial lung biopsy. We report a case of diffuse ground-glass opacity seen in metastatic lung cancer from adenocarcinoma of the stomach.
Adenocarcinoma* ; Adenoma ; Biopsy ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lung* ; Lymphoma ; Macrophages ; Neoplasm Metastasis* ; Neutrophils ; Stomach Neoplasms ; Stomach* ; Tomography, X-Ray Computed

Regional left ventricular wall motion was evaluated by two-dimensional echocardiographic technique with floating-axis (internal frame of reference) system in three groups of subject; normal subject (n=12), patients with acute anterior myocardial infraction(n=16), and patients with acute inferior myocardial infraction(n=10). Significant hypokinetic wall motion were detected in apical portion (Mean Percent Shortening; 0.27-5.84% in anterior infraction group and 9.64-13.17% in controls) and apicoanterior portion (MPS; 2.86% in anterior infraction group and 14.13% in controls) in patients with acute anterior myocardial infraction (P<0.01), and inferior portion (MPS; 3.56-6.93% in inferior infraction group and 18.26-19.8% in controls) and apical portion (MPS; 4.04% in inferior infraction group and 9.64% in controls) in patients with acute inferior myocardial infraction (P<0.01) in apical long-axis views. We conclude that echocardiographic wall motion analysis by floating axis system is an accurate non-invasive method for detecting abnormal wall motion in patients with acute anterior and in ferior myocardial infraction.
Axis, Cervical Vertebra ; Echocardiography* ; Humans ; Myocardial Infarction*