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

This study describes the characterization of 80 kDa protease showing gelationlytic property among three proteases in the excretory/secretory proteins (ESP) from Toxoplasma gondii. The protease activity was detected in the ESP but not in the somatic extract of RH tachyzoites. This protease was active only in the presence of calcium ion but not other divalent cationic ions such as Cu (2+), Zn (2+), Mg (2+), and Mn (2+), implying that Ca (2+) is critical factor for the activation of the protease. The 80 kDa protease was optimally active at pH 7.5. Its gelatinolytic activity was maximal at 37 degrees C, and significant level of enzyme activity of the protease remained after heat treatment at 56 degrees C for 30 min or 100 degrees C for 10 min. This thermostable enzyme was strongly inhibited by metal chelators, i.e., EDTA, EGTA, and 1, 10-phenanthroline. Thus, the 80 kDa protease in the ESP secreted by T. gondii was classified as a calcium dependent neutral metalloprotease.
Animals ; Calcium/metabolism ; Endopeptidases/*metabolism ; Hydrogen-Ion Concentration ; Molecular Weight ; Temperature ; Toxoplasma/*enzymology

The purposes of this study was to determine the effect of exercise in stroke patients and to define to strategy to promote their activity of daily living. decrease to their depression. The experiemental design was designed nonequivalent control group non-synchronized design. The study method had been done by investigating the experimental group and control group through the questionaire on 60 patients who had been in patient department in D University hospital and K University hospital in Busan from November 5th. 2000 to the end of February 28th. 2001. Exercise was conducted by the researcher and was carried out experimental group once per day for 20 minutes for daily fourteen days. ADL check List tool by Kang and Center of Epideilogic Studies-Depression (CES-D) were used for measurement in this study. The data was analyzed by means of freqency, percentage, mean+/-SD, t-test. chi-square test and ANOVA with SPSS/PC. The results were summarized as follow; 1. The experimental group which received exercise should be higher in activity of daily living than the control group was supported (t=2.70. P=.009) 2. The experimental group which received exercise should be lower in depression than the control group was not support(t = -1.120, P= .267) but experimental group post-pre depression score support(t = 7 .247, P= .000), 3. Factors influencing the activity of daily living measured are payer of medical expenses (F=3.98, P=.018) and complications(t=3.97. P= .056) 4. Factors influencing the depression measured are economic status(F=5.71. P= .009) and caregivers(F=3.09, P= .045). In conclusion, the exercise incresed the activity of daily living and effect on depression of stroke patiens. Based upon these results. it is recommended that the nurses who take care of stroke patients such as exercise.
Activities of Daily Living ; Busan ; Depression* ; Humans ; Stroke*

Changes of blood pressure, heart rate, ECG, respiration rate and pupil size by intracerebroventricular(ICV) infusion of hypertonic NaCl with 0.04 ml/min for 5 min(total 0.2ml) were observed in urethane-anesthetized rabbits. ICV infusion of 0.75M NaCl produced slight pressor effect (11mmHg) and did not affect other parameters. ICV infusion of 1.5M NaCl began to increase blood pressure from 2~3 min after the infusion and produced maximal increase(24mmHg) at 5~10 min. Then the pressor effect was recovered to the original level at 30~60 min. Change of heart rate by the infusion was not clear, but ST-segment of ECG was markedly depressed. Respiration rate increased about 1.5 times than the control in accordance with the pressor effect and the state was continued even after the recover of the pressor effect. Both pupils dilated markedly and light-reflex was lost. Changes of parameters by ICV infusion of 3.0M NaCl were similar to those by 1.5M NaCl and some rabbits caused severe arrhythmias and died. The purpose of present study is to investigate the mechansim(s) of the pressor effect induced by the ICV infusion of 1.5M NaCl. The pressor effect of 1.5M NaCl was attenuated by the continuous infusion of vasopressin antagonist(20microm/kg/min) but not affected by intravenous treatment with 2mg/kg phentolamine, 2mg/kg propranolol and 1mg/kg chlorisondamine. The pressor effect was not altered with ICV 0.12mg/kg phenoxybenzamine, 0.4mg diltiazem, 0.1mg/kg mecamylamine and 0.2mg/kg atropine. After ICV infusion of 25microg/kg/min of diazepam, however, the pressor effect was completely abolished and restored 3~4 hours after stopping diazepam infusion. The pressor effect was rather potentiated than inhibited in bilateral adrenalectomized or nephrectomized rabbits. Infusion of 2microg/kg/min of saralasin for 10 min in the bliateral adrenalectomized rabbit did not affect the pressor effect at all. These results suggest that hypertensive effect induced by ICV infusion of hypertonic NaCl is mediated by the increase of vasopressin secretion.
Arrhythmias, Cardiac ; Atropine ; Blood Pressure ; Chlorisondamine ; Diazepam ; Diltiazem ; Electrocardiography ; Heart Rate ; Infusions, Intraventricular* ; Mecamylamine ; Phenoxybenzamine ; Phentolamine ; Propranolol ; Pupil ; Rabbits* ; Respiratory Rate ; Saralasin ; Vasopressins

Beckwith-Wiedemann sydrome is a multisystemic pattern of congenital anomalies with overgrowth. This syndrome is first described independently by Beckwith in 1963 and by Wiedemann in 1964. There is wide spectrum of clinical manifestations, including prenatal or postnatal overgrowth, neonatal hypoglycemia, macroglossia, visceromegaly, omphalocele, hemihypertrophy and a predisposition for embryonal tumors, most frequently Wilms' tumor. We experienced a case of Beckwith-Wiedemann syndrome who developed left adrenal cortical neoplasm of indeterminate malignant potential.
Beckwith-Wiedemann Syndrome ; Hernia, Umbilical ; Hypoglycemia ; Macroglossia ; Wilms Tumor

No abstract available.
Denture, Overlay*

We studied 600 normal lower extremities of Korean students of elementary school in order to establish normal values for the rotational profile and to define any differences between ethnic groups. Rotational profile examined at this study included medial and lateral rotation of the hip and thighfoot angle. The mean value of medial rotation of the hip was 48 degrees with a range of 35 to 64 degrees in male subjects, and 50 degrees with a range of 35 to 60 degrees in female subjects. The mean value of lateral rotation of the hip was 57 degrees with a range of 43 to 75 degrees, and 53 degrees with a range of 40 to 72 degrees in female subjects. Unlike medial rotation, lateral rotation of the hip was greater in male than in female subjects by a mean difference of 4 degrees(T-test, p<0.05). The mean value of thigh-foot angle was 10 degrees with a range of -2 to 23 degrees in male subjects, and 12 degrees with a range of 0 to 21 degrees in female subjects. The total range of hip rotation was slightly greater in Korean than in Caucasians or in Chinese, but, to conclude this, more large study by the same methods will be needed in other areas of Korea.
Asian Continental Ancestry Group ; Ethnic Groups ; Female ; Hip ; Humans ; Korea ; Lower Extremity* ; Male ; Reference Values

BACKGROUND AND AIMS: When acute gastric anisakiasis is clinically suspected, endoscopic removal of larva is the only definite treatment method. However, there has been little known for endoscopic findings of gastric anisakiasis. METHODS: In 39 patients with gastric anisakiasis, the ingested species of marine products and clinical findings were investigated. The form of larvae, the mucosal changes of the insertion site, close and distant area were also analysed during endoscopic examination. RESULTS: Twelve patients (30.8%) ate raw Astroconger myriaster solely, and the most frequent mucosal insertion site of larvae was around the greater curvature of the body (59.5%). Endoscopic findings of erosion (33.3%), hemorrhagic erosion (33.3%) and redness of the mucosa (11.9%) were observed at the insertion site. The adjacent mucosal changes were edema and fold enlargement. All patients were treated medically. CONCLUSIONS: When acute gastric anisakiasis is suspected, the careful endoscopic examination of larva was necessary for confirmatory diagnosis and definite treatment of the disease.
Anisakiasis* ; Diagnosis ; Edema ; Humans ; Incheon* ; Larva ; Mucous Membrane

Since Pare's first report on Achilles tendon rupture in 1575, many authors have presented numerous operative and nonoperative methods for its treatment. Numerous controversies following its treatment have been concerned with the selection of its treatment method, which could minimizing the complications and enable early ambulation. We analysed 98 cases of Achilles tendon rupture in adults which were treated by direct repair, three-tissue bundle technique, or Plantaris/Peroneus augmentation repair for 3(1)/4 years from Oct. 1986 to Dec. 1989. We compared with types of cast after operation, periods for immobilization, and ankle motion of dorsiflexion at postoperative 6 weeks & long-term follow up. The results obtained from this study were as follows; l. After repair by three-tissue bundle technique, a short leg cast was applied, and then a weight bearing was started at postoperative 3 weeks. It can be demonstrated to shorten hospitalization and early ambulation when compared to other surgical techinques. 2. The patients who were repaired with the three-tissue bundle techinque averaged 12.5° dorsiflexion at the time of cast removal at postoperative 6 weeks, compared to 0°, 1° plantar flexion, and 4.4° plantar flexion with other techniques. The former group was significantly better than that of the latter group, and these differences were not present at long-term follow up. 3. On follow up period, discoverd complications were rerupture of Achilles tendon in 8 cases and mild wound infection in 3 cases, but the patients who were repaired by the three-tissne bundle technique showed no complications except mild wound infection in one case.
Achilles Tendon ; Adult ; Ankle ; Early Ambulation ; Follow-Up Studies ; Hospitalization ; Humans ; Immobilization ; Leg ; Methods ; Rupture ; Weight-Bearing ; Wound Infection

Local ablation therapy is considered as a conventional treatment option for patients with early stage hepatocellular carcinoma (HCC). Although radiofrequency (RF) ablation is widely used for HCC, the use of cryoablation has been increasing as newer and safer cryoablation systems have developed. The thermodynamic mechanism of freezing and thawing used in cryoablation is the Joule-Thomson effect. Cryoablation destroys tissue via direct tissue destruction and vascular-related injury. A few recent comparative studies have shown that percutaneous cryoablation for HCCs is comparable to percutaneous RF ablation in terms of long term therapeutic outcomes and complications. Cryoablation has several advantages over RF ablation such as well visualization of iceball, no causation of severe pain, and lack of severe damage to great vessels and gallbladder. It is important to know the advantages and disadvantages of cryoablation compared with RF ablation for improvement of therapeutic efficacy and safety.
Carcinoma, Hepatocellular/diagnostic imaging/*surgery ; Catheter Ablation ; *Cryosurgery ; Humans ; Liver Neoplasms/diagnostic imaging/*surgery ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Ultrasonography