INTRODUCTION There are three factors for successful implantation. These are embryo quality, uterine receptivity, and synchronization between embryonic and endometrial development. Despite remarkable progress in investigating embryos in human IVF, there has been slow progress in exploring the implantation process. It may be due to two reasons as follow. First, it is difficult to directly investigate the mechanism of implantation in the human, because of ethical considerations. Second, there is no sensitive and widely accepted marker for assessing endometrial development. Since the finding of a novel standard for dating endometrial biopsy by Noyes et. al.,. in 1950, there have been many attempts to identify suitable markers for uterine receptivity. Those include ultrasonographic changes (Ueno et.al., 1991; Grunfeld et al.,1991), three dimensional morphological changes of the endometrium such as pinopode formation (Market or alphaf., 1987; Mantel or alphaf., 1991; Nikas et al., 1995; Psychoyos & Nikas, 1994), integrin expression (Ilesanmi et al., 1993; Lessey et.al., 1992; Lessey, 1994), and measurement of endometrial proteins (Hell, 1986;Fay & Crudzinskas, 1991). Investigations in the rat (cartel et al., 1991)and human (cartel et al., 1987; Nikas et al., 1995; Psychoyos & Nikas, 1994) suggested the presence of pinopodes as a marker for the receptive phase.4 chronological barrier in uterine receptivity could be one of the major factors limiting IVF pregnancy rates. If we were able to manage the 'implantation window' we may be able to improve implantation and pregnancy rates in the human IVF program. In 1987, Martel et al., found early appearance of pinopodes in stimulated cycles for IVF compared to natural cycles in humans (Marcel et al., 1987). This effect was found in patients stimulated with clomephene citrate/hMG/hCG. The purpose of the present study was to evaluate the endometrial development in IVF patients stimulated with either by FSH/hMG/hCG or with GnRH agonist down regulation.
Animals ; Biopsy ; Down-Regulation ; Embryonic Structures ; Endometrium ; Female ; Gonadotropin-Releasing Hormone ; Humans* ; Oocyte Retrieval* ; Oocytes* ; Pregnancy Rate ; Rats

A clinical study of the Tibial Shaft fracture was made on 128 patients, who had been treated at the Department of Orthopedic Surgery, College of Medicine Kyung Hee Universlty from the October, 1971 to May, 1979. The results were as follows: 1. The rate of fracture union was accelerated under the age of 20 years but it was slow in aged group. 2. The poor prognosis of fracture union was shown in junction between middle and distal 1/3 than others. 3. The better prognosis of the fracture type was shown in oblique and spiral fracture than in the comminuted and segmental. 4. There was prolonged rate of union in case of associated fibula fracture. 5. The frequency of delayed and nonunion were more prevalent in open fracture. 6. Among the open comminuted tibial shaft fracture with skin and soft tissue loss, the good results was obtained by the Hoffmanns external skeletal fixation method.
Classification ; Clinical Study ; Fibula ; Fracture Fixation ; Fractures, Open ; Humans ; Methods ; Orthopedics ; Prognosis ; Skin

Omentum has the characteristic that it readily develops vascular anastomosis with adjacent tissues. It is suitable for eliminating a dead space regardless of the size, shape or site in the treatment of chronic osteomyelitis by use of technique of microvascular anastomoses. We report a case of chronic osteomyelitis treated by transplantation of autogenous omentum with microvascular anastomsis.
Omentum ; Osteomyelitis

The tuberculous infection of the skeletal system especially, tuberculous spondylitis is frequently encountered with orthopedic fields. Up to date, Various methods of the treatment are present but each method has problems. Recently, as a development of the microsurgical instrumentation and surgical technique, we had been tried to the two patients of tuberculous spondylitis by vascularized fibular bone graft and anterior fusion. The advantages were as follows; 1. Shortened the bony union times by this operative method. 2. Earlier returning to the social activities compared to the ordinary method. 3. The children involved tuberculous spondylitis with severe kyphosis, who can be corrected the severe kyphosis by this operative method. 4. We can be obtained the rigid graft bone fixation with adequate length of bone by this operative method.
Child ; Humans ; Kyphosis ; Methods ; Orthopedics ; Spondylitis ; Transplants

Malignant fibrous histiocytoma of the bone is relatively rare than that affecting the soft tissue. The authors have first experienced a case of malignant fibrous histiocytoma affecting the distal tibia of thirty-two years old woman in Korea. We obtained good results from free vascularized fibular graft after radical resection in stead of amputation. A case of malignant fibrous histiocytoma of the bone is reported with brief review of literature.
Amputation ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Tibia ; Transplants

No abstract available.
Seizures* ; Sparganosis*

PURPOSE: To report a rare case of choroidal metastasis from renal cell carcinoma. CASE SUMMARY: A 61-year-old man visited our clinic with the chief complaint of decreased vision in the right eye. Three years earlier, he underwent right nephrectomy due to renal cell carcinoma. Best corrected visual acuity was 0.2 in the right eye and 1.0 in the left eye. Fundoscopic examination of the right eye revealed a yellowish, dome-shaped elevated choroidal mass with serous retinal detachment, measuring 5.0 x 4.0 disc diameter and located lateral to the macular area. Systemic evaluations showed multiple lung and brain metastases. A diagnosis of choroidal metastasis from renal cell carcinoma was made for the right eye, and the patient received local treatments with oral sorafenib therapy, composed of subtenon triamcinolone injection and intravitreal ranibizumab injection. Tumor progression continued, and visual acuity declined to hand motion. Enucleation was recommended, but the patient refused and is on a regular follow-up after transpupillary thermotherapy. CONCLUSIONS: Ocular manifestation may be the initial presenting sign of a recurrent tumor, and an extensive systemic evaluation for metastatic malignancy should be performed. The present example showed a rare case of choroidal metastasis from renal cell carcinoma.
Antibodies, Monoclonal, Humanized ; Brain ; Carcinoma, Renal Cell ; Choroid ; Eye ; Follow-Up Studies ; Hand ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Niacinamide ; Phenylurea Compounds ; Retinal Detachment ; Triamcinolone ; Vision, Ocular ; Visual Acuity ; Ranibizumab

The purpose of this study was to examine the effects of anti-sperm antibody (ASA) on the fertilization processes using conventional IVF and ICSI procedure in human and hamster oocytes. In human IVF, we have observed restricted fertilization with sperm testing positive for ASA. (23~90% IgA, 60-97 % IgG). However, if ICSI was perform in the next IVF cycle with the same patients, we could successfully fertilize the oocytes (37%; p<0.001), thus achieving pregnancy and delivery. When the sperm were cocultured in medium containing ASA, there were binding of ASA to sperm surface. In addition, the mean rate of the acrosomal reaction in an in vitro acrosome reaction test was lower for Ab-bound sperm (43.5%) than for Ab-free sperm group (51.3%, p<0.05). We used human sperm and hamster oocytes to confirm the negative effects of the ASA on fertilization. The sperm and/or oocytes have been expose to medium containing ASA before IVF and ICSI. In this experiment, the ASA was bound to the oocyte and sperm surface. The following results were obtain by using various combinations of ASA free or ASA bound sperm with ASA free or ASA bound oocytes for IVF. When ASA free sperm were inseminate with ASA free and ASA bound hamster oocytes, the fertilization rates are 89.6% and 74.3% respectively. However, when ASA bound human sperm were use the results were 62.5% and 55.6% respectively. These shows the fertilization rate was significantly decreased in both ASA bound and ASA free oocytes when using ASA bound sperm. No difference found when ASA are present on the oocyte surface. When the hamster oocytes was treated by ICSI with ASA free or ASA bound human spermatozoa, no significant difference was found. These results showed that ICSI is the most promising method for couples who fertilization was not possible by conventional IVF because of ASA.
Acrosome Reaction ; Animals ; Antibodies* ; Cricetinae ; Family Characteristics ; Fertilization ; Humans ; Immunoglobulin A ; Oocytes ; Pregnancy ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

More attention has been paid to bariatric surgery due to an increase in the obese population in Korea. Laparoscopic adjustable gastric banding (LAGB) is the most popular procedure for weight-loss but the complication rate may increase with time. Revision surgery is needed if there are complications or the weight is regained after LAGB, and a laparoscopic sleeve gastrectomy could be performed in the case of band failure. Successful band removal and sleeve gastrectomy wereperformed simultaneously without complications.
Bariatric Surgery ; Gastrectomy ; Korea ; Obesity, Morbid

PURPOSE: We retrospectively reviewed the medical records to estimate the feasibility and surgical outcome of laparoscopic herniorrhaphies in patients with previous lower abdominal surgery. METHODS: Between December 2000 and December 2008, a total of 1,101 cases of laparoscopic herniorrhaphies were performed in 974 patients, among them 47 cases (4.27%) of laparoscopic herniorrhaphy in 40 patients who had undergone previous lower abdominal surgery were enrolled to this study. RESULTS: Most patients (23 of 24) who had a history of appendectomy successfully underwent laparoscopic totally extraperitoneal (TEP) repair. Six patients who had history of a prostatectomy and 2 patients with a Pfannenstiel incision underwent an intraperitoneal only mesh (IPOM) repair after a failed TEP repair. Five patients had lower midline incisions due to panperitonitis, among them TEP repairs were performed in 3 patients and IPOM was performed after failed TEP repairs in 2 patients who had undergone surgery due to trauma-induced rupture of the bladder. CONCLUSION: Laparoscopic TEP hernia repair could be possible and reasonable in patients after an appendectomy; however, it is difficult in patients with previous pelvic surgeries. Additional studies are needed to determine whether or not laparoscopic TEP repair for inguinal hernias is feasible in patients who have undergone other general surgical procedures.
Appendectomy ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Laparoscopy ; Medical Records ; Prostatectomy ; Pyrazines ; Retrospective Studies ; Rupture ; Urinary Bladder