The purpose of this study is compare IVF cycle outcome in poor responders between clomiphene citrate (CC) stimulated and controlled ovarian hyperstimulation (COH) protocol. A total of 94 patients responding poorly in previous IVF cycles (estradiol<600 pg/ml or less than 3 oocytes retrieved) subsequently underwent either COH (COH group: 122 cycles, 68 patients) or CC-stimulated cycles (CC group: 43 cycles, 26 patients). CC was administered for five consecutive days starting on cycle day 3 at a dose of 100 mg daily. Serial transvaginal ultrasound examination was done from cycle day 8. Urine was collected 3~4 times before hCG injection for the detection of LH surge. The hCG was administered when serum estradiol reached greater than 150 Pg/ml and mean follicle diameter>16 mm. In COH group, ovarian stimulation was done using short protocol (GnRH-a/FSH/HMG/hCG). No difference in age or number of transferred embryos was found between CC group and COH group. COH group had significantly (p<0.05) higher mean peak level of E2 (810+/-112 vs 412+/-55 pg/ml) and greater number of retrieved oocytes (3.0+/-0.2 vs 2.0+/-0.2) than CC group. CC group had significantly embryos (1.8+/-0.2) compared with (2.1+/-0.2) in COH group. However, CC group had higher pregnancy rate than COH group per retrieval [26.9% (7/26) vs 6.2% (6/97)], or per transfer [31.8% (7/22) vs 7% (6/86)]. Although cycle cancellation rate in CC group (48.8%) was higher than that of COH group (21.3%), the pregnancy rate per cycle in CC group was still higher (16.3%) than COH group (4.9%). In addition, implantation rate in CC group was 17.5% (7/40), which was significantly p<0.01) higher than 3.9% (7/180) in COH group. These data suggest that oocyte and embryo quality are lower in COH cycles of poor responders than CC cycles. We suggest that clomiphene citrate stimulated IVF cycle may be more efficient than COH IVF cycle in poor responders in terms of lower costs and higher pregnancy performance.
Clomiphene* ; Embryonic Structures ; Estradiol ; Fertilization* ; Humans ; Oocytes ; Ovulation Induction ; Pregnancy ; Pregnancy Rate ; Ultrasonography

The purpose of this study was to provide fundamental data by figuring out fatigue differences in patients on hemodialysis and peritoneal dialysis. The subjects for this study were 49 patients on hemodialysis and 54 patients on peritioneal dialysis at C university medical center in Seoul Results were as follows: 1. The average fatigue score in peritoneal dialysis patients tended to be higher in patients on peritoneal dialysis(42.22) than in patients on hemodialysis(39.41). Peritoneal dialysis patients showed higher score than hemodialysis patients in some general characteristics in groups with male, ones in 20's, 40's, 50's, married, college degree, having religion, having occupation, and not take regular nap. 2. The percents of this subjects with feel fatigue at the time of survey was higher in peritoneal dialysis patients(68.5%) than in hemodialysis patients(57.1%). The percentages of the subjects who feel fatigue in peritioneal dialysis patients was higher than hemodialysis patients, and the high tendencies in peritoneal dialysis patients in were obsemed in groups with male, ones in 30's, to have college degree, periods so of 1-2years in peritoneal dialysis, region, men without occupation, regular exercises, regular nap etc.
Academic Medical Centers ; Dialysis* ; Exercise ; Fatigue* ; Humans ; Male ; Occupations ; Peritoneal Dialysis ; Renal Dialysis ; Seoul

No abstract available.
Embryonic Structures* ; Humans*

OBJECTIVES: This study is to compare psychopathology and their perceived parental rearing pattern of the children of mothers with major depression, bipolar disorder and those of normal control group. The correlation was also assessed between behavior problem and perceived parenting style. METHODS: The subjects were 30 children (age range 12-18) of mothers who met the DSM-IV criteria of major depressive disorder or bipolar I disorder and 30 children of normal mother group. All completed self-report questionnaires containing Child, adolescent Behavior Problem Checklist (K-CBCL), Youth Self Report (YSR) and Parental Bonding Instrument (PBI). RESULTS: 1) The mean score of the subscales of somatic complaints, anxious/depressed, internalizing problems in K-CBCL was significantly higher in the control subjects compared with that of the children of mothers with affective disorders (p<0.05). 2) In YSR, there was a tendency of increased behavior problems among the children of mothers with major depression compared with the control subjects. Compared with children of mothers with bipolar disorder, children of mothers with major depression had significantly more behavior problems (p<0.05). 3) Mothers with affective disorders tended to display less caring and fathers and mothers with affective disorders tended to display more overprotective parenting style than the control subjects. 4) There was positive correlation between paternal overprotection and behavior problems in the children of mothers with affective disorders. CONCLUSION: In summary, the author identified that the children of mothers with affective disorders have more behavior problems in social adjustment than normal control subjects. Parental rearing style is thought to have more negative influence on the children of mothers with affective disorders than normal control. It is surmised that less caring and more overprotective rearing style could influence behavior problems of their children.
Adolescent ; Adolescent Behavior ; Bipolar Disorder ; Checklist ; Child ; Depression ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Fathers ; Humans ; Mood Disorders* ; Mothers* ; Parenting ; Parents ; Psychopathology ; Surveys and Questionnaires ; Self Report ; Social Adjustment

No abstract available.
Arthritis, Juvenile* ; Fractures, Compression* ; Humans

A 50 year-old woman was scheduled for clipping of giant middle cerebral artery (MCA) aneurysm. Preoperative four-vessel angiography and computed tomography scan revealed a giant aneurysm (3.5x3.3x3.5 cm) at bifurcation of right MCA. Induced hypotension and brain protection using sodium nitroprusside (SNP) and thiopental loading were planned to prevent cerebral damage during the operation. Before induction, esmolol, lidocaine and vecuronium were administered. Mask ventilation with isoflurane in N2O and O2 was performed over 5 minutes and then tracheal intubation was done. Anesthesia was maintained by isoflurane+N2O+O2 with pancuronium. Electrocardiography, pulse oxymetry, capnography, central venous pressure, evoked potential and invasive arterial blood pressure were monitored. She was hyperventilated intraoperatively with a PaCO2 around 30 mmHg. Perioperative hypotension was achieved with infusion of SNP (0.3~1.0 microg/kg/min). During the actual aneurysm surgery, mean arterial pressure was lowered to approximately 50 mmHg. Adjuvant drugs such as methylprednisolone, mannitol and furosemide to reduce intracranial pressure were also administered. This technique established good brain conditions during clipping of the aneurysm. A thiopental loading (4 mg/kg) was supplied while the aneurysm was approached. Satisfactory and well-controlled hypotension was obtained after thiopental and SNP. Postoperatively, the patient was transferred to the intensive care unit.
Anesthesia ; Aneurysm ; Angiography ; Arterial Pressure ; Brain ; Capnography ; Central Venous Pressure ; Electrocardiography ; Evoked Potentials ; Female ; Furosemide ; Humans ; Hypotension ; Intensive Care Units ; Intracranial Aneurysm* ; Intracranial Pressure ; Intubation ; Isoflurane ; Lidocaine ; Mannitol ; Masks ; Methylprednisolone ; Middle Cerebral Artery ; Nitroprusside ; Pancuronium ; Thiopental ; Vecuronium Bromide ; Ventilation

Detailed mechanism of uterine cervical cancer progression still remains unclear. Altered programmed cell death (apoptosis) and cellular proliferation are associated with the development of neoplasia. The authors investigated the expressions of bcl-2, which inhibit apoptosis, and caspase-3, which is involved in the induction of apoptosis and has been considered to be correlated with apoptosis, and proliferating activity according to the degree of malignancy in the squamous neoplasia of the uterine cervix. Correlation between bcl-2 and caspase-3 expression and proliferating activity was done. The materials were low grade squamous intraepithelial lesions (LSIL, n=15), high-grade squamous intraepithelial lesions (HSIL, n=15), microinvasive squamous cell carcinoma (n=15), and squamous cell carcinoma (n=15). Immunohistochemical stainings for bcl-2, caspase-3, and MIB-1 were done. bcl-2 and MIB-1 expressions were progressively increased in accordance with the increasing degree of malignancy, but caspase-3 immunoreactivity was higher in LSIL than invasive cancers. There was an inverse relationship between bcl-2 and caspase-3 expression, but the difference did not reach statistical significance. No significant correlation between MIB-1, bcl-2, and caspase-3 expressions was observed. These results suggest that an inhibition of apoptosis and the augmentation of proliferating activity of tumor cells might be separately involved in the development of the cervical squamous neoplasia.
Apoptosis ; Carcinoma, Squamous Cell ; Caspase 3* ; Cell Death ; Cell Proliferation ; Cervix Uteri* ; Female ; Uterine Cervical Neoplasms

No Abstract Available.
HIV-1* ; Transcription Factors*

We describe cytologic findings of two cases of pilomatrixoma which had been cytologically misdiagnosed as suspicious malignant and malignant lesions in 35 year-old and 22 year-old females who presented a palpable neck mass. The cytologic smears showed many basaloid cells with a high nuclear-cytoplasmic ratio, nuclear hyperchromatism and prominent nucleoli, keratinized squamous cells with pyknotic nuclei, foreign body giant cells, and chronic inflammatory cells in necrotic background. Retrospective view of this aspiration smear revealed that these findings were characteristic features of pilomatrixoma, and the evenly distributed chromatin pattern as well as the lack of nuclear pleomorphism were considered to be the differential points from malignant neoplasm. Pilomatrixoma is a benign neoplasm which should be included in differential diagnosis if the fine needle aspiration cytologic smear of a neck mass or subcutaneous mass of any site showed these features.
Female ; Humans ; Diagnosis, Differential

PURPOSE: The purpose of the study was to research how elder abuse affected the abuse results (self-esteem, depression, somatization) through coping strategies. METHOD: A convenient sample consisted of 499 subjects from 65 to 85 years old. Data was collected using structured questionnaires from July to August, 2002. The SPSS WIN 10.0 version was used for data analysis. RESULTS: The pathway of elder abuse affecting elder's self-esteem was researched by passive coping, emotional abuse, financial abuse, and physical abuse as the variables that directly affected self-esteem. The pathway of elder abuse affecting elder's depression was researched by passive coping, aggressive coping, verbal abuse, and neglect as the variable that directly affected depression. The pathway of elder abuse affecting somatization was researched by neglect, emotional abuse, and aggressive coping as the variables that directly affected somatization. CONCLUSION: We should develop a systematized intervention program so that elders can learn positive coping in their abuse circumstance.
*Adaptation, Psychological ; Aged ; Aged, 80 and over ; Depression/etiology ; Elder Abuse/*psychology ; Female ; Humans ; Male ; Self Concept ; Somatoform Disorders/etiology