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

No abstract available.
Breast* ; Glucuronidase* ; Lipase* ; Milk, Human*

BACKGROUND: Cine MR imaging has been found to bo a non-invasive technique in evaluation cardiac anatomy and cardiovascular function in a variety of cardiac diseases. The capability of this technique for quantatively estimating the severity of regurgitation has not been tested in newborns. The purpose of this study is to compare the degees of tricuspid regurgitation by echorcardiography with those by cine MRI, and verify the utility of MRi in evaluating tricuspid regurgitation. METHODS: Fifty-one newborns with tricuspid regurgitation were evaluated on the same day by echocardiography and cine MRI. Area and regurgitant fraction of area were estimated at four chamber view by two techniques. RESULTS: The area of tricuspid regurgitation was similar by two techniques. The correlation for the area(r=0.66, p<0.025) and the regurgitant area fraction(r=0.647, p<0.025) of tricuspid regurgitation obained by cine MRI with echocardiographic data was good. CONCLUSION: Cine MR imaging can provide quantative data estimating for evaluation of tricuspid regurgitation in newborns.
Echocardiography ; Echocardiography, Doppler* ; Heart Diseases ; Humans ; Infant, Newborn* ; Magnetic Resonance Imaging ; Magnetic Resonance Imaging, Cine* ; Tricuspid Valve Insufficiency*

No abstract available.
Female ; Gonadotropin-Releasing Hormone* ; Humans ; Leiomyoma* ; Single Person*

A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
Actins ; Aneuploidy ; Coloring Agents ; Common Bile Duct ; Dendritic Cells, Follicular ; Herpesvirus 4, Human ; Immunohistochemistry ; Keratins ; Liver ; Lung ; Lymph Nodes ; Maxillary Sinus ; Membranes ; Muramidase ; Muscle, Smooth ; Myofibroblasts* ; Prognosis ; Recurrence ; S100 Proteins ; Thigh ; Urinary Bladder ; Vimentin

PURPOSE: The purpose of this study was to identify the effects of job stress, emotional labor, and positive psychological capital on the job satisfaction of physician assistants (PAs). METHODS: The sample consisted of 166 PAs working in general hospitals in B city, Y city, and C city. Data were analyzed through the SPSS/WIN 18.0 program using t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and multiple regression. RESULTS: The factors of job stress (β=−.488, p<.001), positive psychological capital (β=.188, p=.004), and total clinical career (β=−.147, p=.014) had the greatest influence on the level of job satisfaction experienced by the PAs. The total explanatory power was 49.9%. CONCLUSION: It was found that job stress, positive psychological capital, and total clinical career were influencing factors in the job satisfaction of PAs. Therefore, to improve their job satisfaction, it is necessary to develop strategies to manage the job stress experienced by PAs, and to strengthen and develop positive psychological capital.
Hospitals, General ; Humans ; Job Satisfaction ; Physician Assistants ; Stress, Psychological

PURPOSE: The purpose of this study was to identify the effects of job stress, emotional labor, and positive psychological capital on the job satisfaction of physician assistants (PAs). METHODS: The sample consisted of 166 PAs working in general hospitals in B city, Y city, and C city. Data were analyzed through the SPSS/WIN 18.0 program using t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and multiple regression. RESULTS: The factors of job stress (β=−.488, p<.001), positive psychological capital (β=.188, p=.004), and total clinical career (β=−.147, p=.014) had the greatest influence on the level of job satisfaction experienced by the PAs. The total explanatory power was 49.9%. CONCLUSION It was found that job stress, positive psychological capital, and total clinical career were influencing factors in the job satisfaction of PAs. Therefore, to improve their job satisfaction, it is necessary to develop strategies to manage the job stress experienced by PAs, and to strengthen and develop positive psychological capital.

OBJECTIVES: The purpose of this study was to determine whether or not the shed endometrial tissues in menstrual fluid (MF) have adhesive potentials, using human amniotic membrane (AM). METHODS: The MF from 20 patients with regular menstruation was collected with Wallace catheter by aspiration from the uterine cavity on the second or third day of the menstrual period. The AM was obtained from the placenta of term delivery without any complication. The MF was washed and diluted fivefold with Hams F-10 medium supplemented with 10% fetal bovine serum. The cell suspension was placed on either epithelial layer (EP) or extracellular matrix layer (ECM) of the AM. After 5 days of culture, the adhesion sites were observed under a stereomicroscope. For histological observation, each cultured AM was prepared for the serial paraffin section. RESULTS: The adhesion sites of endometrial tissues in MF were found both ECM (20/20) and EP (11/20) of the AM. The size of adhesion sites in each AM were highly variable from microscopic to macroscopic size. CONCLUSION: We found that the shed endometrial tissues in MF have adhesive potential to epithelial layer in addition to extracellular matrix layer of amniotic membrane. This adhesive potential may be related to pathogenesis of endometriosis. We suggest that this culture system can be useful as an in-vitro model for endometriosis.
Adhesives* ; Amnion* ; Catheters ; Endometriosis* ; Extracellular Matrix ; Female ; Humans ; Menstruation ; Paraffin ; Placenta

No abstract available.
Case-Control Studies* ; Health Promotion* ; Risk Factors*

No abstract available.
Aconitum* ; Arrhythmias, Cardiac* ; Cardiopulmonary Resuscitation*