A total of 369 patients with abnoirmal cervical eytology and suspicious lesions of the cervix were colposcoped end 356 patients of whom were, taken directed biopsy to assess the lesions preeisely and compare the aeeuracy of the eaeh methods. The results of cervical cytology were elso compared with the colpoacopic impression and colposcopically directed biopsies. 252 patients with abnr;irmal colyoaeopie findings were performl conization, simple hiysterectomy or radical hysterectomy depending on their current idisease statua. The rate of one grade less or more advanced correlation between the cervical cytology and directed biopsy was 72.4% and thiat of two grade less wns 80.3% and as for the correletion between the colposcopic imprwssions and the colposcopically directed biopsies, the rate of ciompatibility was 91.5%. Bases on the hetopathologic findings of the surgical apeeimen, the eompatibility rotcs of eervical cytology, colposcopic impressions and colposcopilIy divected hiopsies were 70.2%, 90.6% and 98.0% respectively. With these results, we can reach a conclusion that the colpnscopic impression itself is almost as accurate as the colposcopicolly directed biosy and the directed biopsy can take the place of conization so far as the diagnostic accuracy is concerned.
Biopsy* ; Cervix Uteri ; Conization ; Female ; Humans ; Hysterectomy

OBJECTIVE: To understand the regulatory mechanism of apoptosis by pro- and anti-apoptotic genes in the cyclic human endometrium. METHODS: Each case of endometrial status was classified by Noyes criteria, and grouped into early proliferative(n=13), late proliferative(n=14), early secretory(n=15), and late secretory phases(n=15). Expression of bcl-2, and bax were assessed by Northern blot and immunohistochemistry in relation to apoptotic index by TUNEL. Results: Apoptotic index showed increasing tendency as progressing to the late secretory phase, which phase showed significantly higher apoptotic index compared to the other phases(p<0.05). The intensity of bcl-2 8.5kb transcript by Northern blot was highest in the late proliferative phase significantly(p<0.05), decreasing to nadir in the late secretory phase. In contrast to bcl-2 expression, bax mRNA expression was highest in the late secretory phase significantly(p<0.05). Both the relative ratio of bcl-2 8.5kb transcript and bcl-2 5.5kb trascript to bax showed that the ratio was higher in the early, and late proliferative phase, but, reversed in the late secretory phase. Both the immunoreactivity of bcl-2 and bax proteins could be detected in the basal, functional, and stromal layers of endometrium. The immunoreactivity of bcl-2 protein was more prominent in the proliferative phase, however, bax protein was more prominent in the secretory phase. CONCLUSION: This study suggests that apoptosis could be regulated by the relative dominance of bcl-2 or bax expression in the human endometrium. Thus, bcl-2 and bax expressions might be one of the possible mechanism in the regulation of normal menstruation.
Apoptosis* ; bcl-2-Associated X Protein ; Blotting, Northern ; Endometrium* ; Female ; Humans* ; Immunohistochemistry ; In Situ Nick-End Labeling ; Menstruation ; RNA, Messenger

Inhibin is a glycoprotein usually produced by granulosa cell of ovary and is known as regulator of FSH secretion. Inhibin is consisted of two heterodimeric subunit of a, B . There are two distinct molecular forms of the B subunit that exist (BA and BB) and when combined with an a subunit, form inhibin A, and inhibin B, respectively. Ovarian reserve describes women's reproductive potential, which usually decreased according to chronological age. Because useful markers claimed for the prediction of ovarian response during controlled ovarian hyperstimulation for IVF-ET have not been always successful, new biomarker has been investigated. The purpose of this study was to observe the changes in serum and ovarian follicular inhibin A concentration during controlled ovarian hyperstimulation for IVF-ET program and to evaluate the clinical significance of inhibin A as a prognostic marker for assisted reproductive technology outcomes. From Jan 1996 to Dec 1996, 48 patients who underwent IVF-ET were included. In each patient, the Day 3 FSH, LH, E2q were measured in the first month of cycle before commencing GnRH agonist administration, In the stimulation period after pituitary down regulation, blood samples for inhibin A were collected at the day 3, day 7, day of hCG injection, day of oocytes aspiration, and day of embryo transfer. Ovarian follicular inhibin A was collected at the day of oocyte aspiration. Inhibin A concentration was measured using test kit for inhibin A (INHIBIN-EASIA (code 40.134.00), Belgium Medgenix). The changes in serum inhibin A, E2 concentration during IVF-ET program showed increasing pattern throughout controlled ovarian hyperstimulation periods. If the cut-off value of day 3 serum inhibin A determined to 0.28 U/ml, the sensitivity and specificity were 80.0%, 75.0% respectively in predicting the number of oocytes retrieved being more than five. If the cut-off value of peak serum E determined to 1316 pg/ml, the sensitivity and specificity were 89.0%, 100.0% respectively in predicting the number of oocytes retrieved being more than five. In conclusion, measurement of serum inhibin A concentration on the day of starting stimulation (day 3) could be used as a useful marker for predicting the ovarian response in IVF-ET program.
Belgium ; Down-Regulation ; Embryo Transfer ; Female ; Glycoproteins ; Gonadotropin-Releasing Hormone ; Granulosa Cells ; Humans ; Inhibins* ; Oocyte Retrieval ; Oocytes ; Ovary ; Reproductive Techniques, Assisted ; Sensitivity and Specificity ; Serum

No abstract available.
Fibrin Tissue Adhesive* ; Fibrin*

The objective of this retrospective study was to evaluate whether the transvaginal ultrasonographic analysis of endometrial pattern and thickness could predict the stage of menstrual cycle. Endometrial pattern and thickness were observed in those patients receiving infertility work up from April, 1 f94 to July, 1998 at Seoul National University Hospital. The study group was 185 patients with normal regular menstrual cycles. Among them, 44 patients received endometrial biopsy, and the date of endometrium was compared with the observed endometrial pattern and thickness. The observed endometrial pattern was presence or absence of central cavity echogenicity, triple line sign, endometrial hypoechogenicity, ring sign, endometrial hyperechogenicity and posterior acoustic sonic enhancement. The results were as follows; Central cavity echogenicity was seen throughout menstrual cycle. Triple line sign was observed in 81.1% of patients during early secretory phase. However, in mid to late secretory phase, triple line sign was appeared in only 6.8%. The percentage of positive endometrial hypoechogenicity was highest in early secretory phase. In contrast to hypoechogenicity, positive endometrial hyperechogenicty was highest in mid to late secretory phase. Ring sign was observed in 73.5% of the patients during early secretory phase with peak incidence. Posterior acoustic enhancement was seen in 72.7% of the patients during late secretory phase The sensitivity and specificity of being a secretory phase if the patients showed hyperechogenic endometrium, were 84.2%, 83.3% respectively. The sensitivity and specificity of being a secretory phase if the patients showed posterior acoustic enhancement were 93.8%, 58.3% respectively. Endometrial thickness was not correlated with endometrial dating. In conclusion, transvaginal ultrasonographical delineation of the endometrial pattern might to useful tool in predicting endometrial status during normal menstrual cycle. But, endometrial thickness could not predict the endometrial dating.
Acoustics ; Biopsy ; Endometrium ; Female ; Humans ; Incidence ; Infertility ; Menstrual Cycle* ; Retrospective Studies ; Sensitivity and Specificity ; Seoul

Despite orthodontic treatment(tooth moving) is dynamic act, many orthodontists have used mainly static evaluation method for evaluating effectiveness of the orthodontic appliances. They want to find which is better appliance, especially in the treatment results and treatment period, when they chose one appliance from sugessted appliances for obtaining same treatment goal. The author and colleagues invented and manufactured new machine for getting information about the relative effectiveness from many suggested orthodontic appliances and we named it Calorific machine. We used this Calorific machine to find the relative differences about tooth moving mechanism and tooth moving time between the Burstone's PLA(single force mechanism) and Molar-up's PLA(couple mechanism) for correcting the posterior cross bite. We measured the distance of tooth moving on the occlusal X-ray film and recorded the moving time of the anchored(control elct o-thermal tooth) and lingually tipped lower second molars(experimental electro-thermal tooth) and then processed paired t-est by SAS program The results were as follows. 1. Molar-up's PLA showed more extrusive and horizontal movement than Burstone's PLA at the lingually tipped molar(p=0.0000). 2. There is no finding of tooth movement by Molar-up's PLA at the uprighted molar(p=o.3475) but Burstone's PLA showed a little change(02 mm) at the same molar(p=O.0001). 3. Burstone's PLA took 17.8 minutes for tooth moving but Molar-up's PLA took only 3.8 minutes(p=0.0001)
Malocclusion ; Orthodontic Appliances ; Tooth Movement ; Tooth* ; X-Ray Film

OBJECTIVE: To investigate the influence of laparoscopic surgery on the pregnancy rate of infertile women with endometriosis. MATERIALS & METHODS: Retrospective analysis was performed in 33 infertile patients with endometriosis and infertility who had operative laparoscopy at Seoul National University Hospital from January 1991 to February 1998. We investigated the pregnancy rate during the 12 months following conservative laparoscopic surgery. RESULTS: The overall rate of spontaneous intrauterine pregnancy rate (IUP) during the 12 months was 48.5% (16/33). Most of spontaneous pregnancy occurred during the 3 months after surgery (12/16). There was no correlation between spontaneous pregnancy rate and the revised American Fertility Society (rAFS) classification or laparoscopic findings. The rate of IUP was 50% (7/14) for patients with stage I or II endometriosis and 47.4% (9/19) for the patients presenting stage III or IV endometriosis. CONCLUSION: Conservative laparoscopic surgery may be an effective treatment for infertile patients with endometriosis and most of spontaneous pregnancy occurred during the 3 months after surgery .
Classification ; Endometriosis* ; Female ; Fertility ; Humans ; Infertility ; Laparoscopy* ; Pregnancy Rate* ; Pregnancy* ; Retrospective Studies ; Seoul

Intra-abdominal desmoplastic small round cell tumor (DSRCT) is a highly malignant tumor of uncertain histogenesis. Here we report a case of DSRCT involving the stomach, initially misdiagnosed as gastric cancer. A 12-year-old boy presented with upper abdominal pain developed 1 month prior. On gastroscopy, a 7-cm mass was noted involving the esophago-gastric junction to the fundus, and positron emission tomography showed multiple hot uptakes suggesting distant metastasis. Gastroscopic biopsy showed poorly differentiated malignant cells. We diagnosed as stage IV gastric cancer and treated with 6 cycles of chemotherapy. Laparotomy revealed a huge gastric mass along with peritoneal disseminations. Palliative proximal gastrectomy was performed. Pathological examination revealed transmural involvement of DSRCT, and t(11;22)(p12;q12) was demonstrated on fluorescence in situ hybridization test. The chemotherapeutic regimen was changed and the patient underwent 8 additional cycles of post-operative chemotherapy. The patient is now alive and the residual tumor shows no significant changes after chemotherapy.
Abdominal Pain ; Biopsy ; Child ; Desmoplastic Small Round Cell Tumor ; Fluorescence ; Gastrectomy ; Gastroscopy ; Humans ; In Situ Hybridization ; Laparotomy ; Neoplasm Metastasis ; Neoplasm, Residual ; Positron-Emission Tomography ; Stomach ; Stomach Neoplasms

No abstract available.
Animals ; Female ; In Situ Hybridization ; Mice* ; Ovary*

OBJECTIVE: This study was performed to assess whether uterine intraendometrial or intramyometrial arterial blood flow impedance in Doppler sonography is related to the outcomes of IVF-ET cycles. METHODS: A total of 24 patients undergoing IVF-ET was recruited for the study. All patients received controlled ovarian hyperstimulation(COH) with GnRH agonist and gonadotropins. Doppler sonographic examinations were performed by using Combison 530(Medison) with 5.5 MHz transvaginal probe. Pulsatility index(PI) was evaluated for uterine, radial, and spiral arteries on the days of hCG administration, oocyte retrieval, and embryo transfer(ET). Serum E2 level was assayed on the hCG day. RESULTS: The overall pregnancy rate after IVF-ET was 29.2%(7/24). There was no significant difference in PI of uterine artery between pregnant and nonpregnant groups, No pregnancy occurred in 4(16.7%) patients without intraendometrial or subendometrial blood flow. Compared with nonpregnant group, PI of radial artery on the hCG day and PI of spiral artery on the hCG and oocyte retrieval days were significantly lower in pregnant group. There were no significant correlations between Serum E level on the hCG day and Pl of any three arteries. CONCLUSION: This study suggests that the Doppler sonographic parameter, PI, of intraendometrial and intramyometrial arteries are more useful than that of uterine artery not only in predicting the success of IVF-ET, but also in assessing the endometrial receptivity.
Arteries* ; Electric Impedance ; Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro* ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Oocyte Retrieval ; Pregnancy Rate ; Pregnancy* ; Radial Artery ; Serum ; Ultrasonography ; Ultrasonography, Doppler* ; Uterine Artery