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

OBJECTIVE: To evaluate the maternal and fetal outcomes after transvaginal selective fetal reduction(SFR) in multifetal pregnancy. MATERIALS AND METHODS: Transvaginal SFR using fetal intracardiac puncture with KCl injection and aspiration of amniotic fluid was performed in 58 multifetal pregnancies achieved after assisted reproductive technology(ART). After transvaginal SFR, 55 twin and 3 singleton pregnancies were evaluated and analyzed retrospectively with the medical records of mothers and babies. RESULTS: Of 58 cases, abortion within 4 weeks after SFR occurred in 1 case(1.7%). Miscarriage of all fetuses occurred in 8 cases(13.8%) from 4 weeks after SFR until 24 weeks of gestation. Perinatal death occurred in 8 newborns from 5 mothers due to extreme prematurity in 7 cases and anencephaly in 1 case. Take-home baby rate, that is, discharge with at least 1 healthy baby, was 77.6%(45/58). CONCLUSION: Transvaginal SFR is an acceptable and effective management option in the cases of excessive multifetal pregnancy after infertility treatment. The ultimate successful outcomes of reduced multifetal pregnancy may be enhanced by more extensive experience with SFR.
Abortion, Spontaneous ; Amniotic Fluid ; Anencephaly ; Female ; Fetus ; Humans ; Infant, Newborn ; Infertility ; Medical Records ; Mothers ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Punctures ; Retrospective Studies

PURPOSE: Among many pathophysiologic mechanisms of hypoxic-ischemic brain injury, reactive oxygen species (ROS) cause or contribute to brain damage relates to their ability to attack the fatty acid moiety of plasma and subcellular membranes. Because ROS are generated by hypoxia-ischemia especially during reperfusion period of recovery, repetitive hypoxia-reoxygenation in newborn brain may result in more severe damage than a similar single insult. It is to determine whether repetitive hypoxia-reoxygenation may produce more ROS than a similar single insult in newborn rat brain. METHODS: We compared the production of lipid peroxidation in 3 days old rat brain following normoxia, repetitive hypoxia-reoxygenation and an equal duration of sustained hypoxia-reoxygenation by measuring 8-isoprostane-F2alpha. 8-isoprostane-F2alpha is free radical catalyzed metabolites of arachidonic acid, which is produced independent of cyclooxygenase. RESULTS: Compared to a single duration hypoxia-reoxygenation, repetitive hypoxia- reoxygenation produce more ROS (8-isoprostane-F2alpha) in newborn rat brain (P < 0.005). CONCLUSION: It can be speculated that repetitive hypoxia is more detrimental than equal duration of single insult in new born rat brain. Relations between increased ROS production and brain injury following repetitive hypoxia-reoxygenation should be evaluated.
Animals ; Anoxia* ; Arachidonic Acid ; Brain Injuries ; Brain* ; Humans ; Infant, Newborn* ; Lipid Peroxidation* ; Membranes ; Plasma ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Reactive Oxygen Species ; Reperfusion