The LH and FSH responses to synthetic LH-RH and the prolactin response to synthetic T-RH were evaluated during different phases of the mentrual cycle in order to understand secretory capacity of the pituitary during the menstrual cycle. Eleven regularly menstruating women between 22 and 35 years of age with a usual cycle length of 27 to 31 days volunteered for this Study. Volunteers received an intra-venous injection of 100 microgram synthetic LH-RH and 200 microgram synthetic T-RH during the early and the late follicular phases and during the early and midluteal phases of the menstrual cycle. LH-RH induced a prompt increase in circulating LH, reaching the peak concentration at 30 minutes following LH-RH administration in all phases of the cycle studied. A change in responsiveness with greater and more sustained LH release from the early to the late follicular phases was observed. The response during the luteal phase was significantly greater than the responses in both the early and the late follicular phases. A concomitant but a much smaller FSH response was observed. T-RH elicited a prompt increase in circulating prolactin within 30 minutes and decreased gradually thereafter, reaching the baseline level by 2 hours after T-RH administration. Maximum concentration of prolactin was reached in 30 minutes following T-RH during all phases of the menstrual cycle. No variation in pituitary responsiveness to T-RH, however, was observed during different phases of the menstrual cycle. These data indicate that the sensitivity of the pituitary gonadotrophs to LH-RH varies during different phases of the menstrual cycle.
Adult ; Female ; Follicle Stimulating Hormone/secretion ; Gonadorelin/pharmacology* ; Human ; Luteinizing Hormone/secretion ; Menstruation* ; Pituitary Gland/drug effects* ; Protirelin/pharmacology*

BACKGROUND: This study was undertaken to reduce the side effects of epidural morphine through the addition of nalbuphine in 37 cesarean delivery. METHODS: Forty patients were divided into 2 groups; M(control) group: bolus administration of morphine 2 mg in 0.5% bupivacaine and continuous epidural 41 hour-infusion of morphine 7mg, N(experimental) group: bolus administration of morphine 2 mg in 0.5% bupivacaine combined with nalbuphine 10mg and continuous epidural 41 hour-infusion of morphine 7mg combined with nalbuphine 10mg via the Paragon infusor. RESULTS: During the postoperative 48 hours, their pain scores and side effects were recorded at 6, 12, 18, 24, 30, 36, 42 and 48 hours. The analgesic effects were good in two groups(mean VAS <3.0) and pain scores were statistically significant at 18 and 30 hour. The incidence of pruritus, nausea, vomiting and urinary retention was decreased in group N(p<0.05). CONCLUSIONS: We concluded that continuous epidural morphine combined with nalbuphine was one of recommendable methods to reduce side effects of morphine.
Bupivacaine ; Cesarean Section* ; Female ; Humans ; Incidence ; Infusion Pumps ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Urinary Retention ; Vomiting

BACKGROUND: Intrathecal (IT) neostigmine produces analgesia in animal and human. This study was designed to evaluate the efficacy and safety of IT neostigmine for post-cesarean section analgesia. METHODS: Forty-five women undergoing cesarean section under spinal anesthesia were randomly assigned into 3 groups to receive; normal saline 0.2 ml, or neostigmine 12.5 microgram, or neostigmine 25 microgram intrathecally with 0.5% hyperbaric bupivacaine 12 mg. Degrees of sensory and motor blocks, maternal hemodynamic changes, and side effects were recorded. Apgar scores and umbilical vein blood gas analysis (UVBGA) were checked for evaluation of fetal status. Postoperative analgesia was provided by intravenous patient-controlled analgesia (PCA) using fentanyl 500 microgram and ketorolac 150 mg in 100 ml. Pain scores with 10-cm visual analogue scale (VAS), time to first PCA use, cumulative PCA consumptions, and side effects were assessed at 1, 2, 4, 8, 12, 24, and 48 hr after IT injection. RESULTS: There were no significant differences among the three groups in characteristics of spinal anesthesia, maternal blood pressure and heart rate, Apgar scores, and UVBGA data. Compared to saline group, IT neostigmine significantly prolonged time to first PCA use and decreased 24 hr- and 48 hr-PCA consumptions (P<0.05). Pain scores in neostigmine groups were significantly lower than those in saline group for first 4 hr after which there were no differences among the three groups. There were significantly higher incidences of nausea and vomiting in neostigmine groups than in saline group. CONCLUSIONS: These data indicate that IT neostigmine can be an alternative postoperative analgesic without adverse fetal effects for cesarean section. However, high incidence of nausea and vomiting seem to limit its clinical usefulness. Further studies are necessary to enhance its analgesic effects and to decrease its adverse effects.
Analgesia* ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Animals ; Blood Gas Analysis ; Blood Pressure ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Ketorolac ; Nausea ; Neostigmine* ; Passive Cutaneous Anaphylaxis ; Pregnancy ; Umbilical Veins ; Vomiting

We have experienced two cases of the Cri Du Chat Syndrome. The first case, 1 and 11/12 year old female, was admitted to evaluated profound mental retardation and failure to thrive. The other, 3 month old female, visit this dept for cat-like cry. They had the typical clinical characteristics of the Cri Du Chat Syndrome and showed showed the classical chromosome abnormality (46, XX 5p-), revealed by cytogenetic study.
Chromosome Aberrations ; Cri-du-Chat Syndrome ; Cytogenetics ; Failure to Thrive ; Female ; Humans ; Infant ; Intellectual Disability

OBJECTIVE: In this retrospective study, we analyzed the clinical and pathological characteristics of immature teratoma of the ovary. METHODS: Between 1990 and 2003, 26 patients with immature teratoma of the ovary treated in the Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea were identified, and reviewed retrospectively for patient profiles, International Federation of Gynecologists and Obstetricians (FIGO) disease stage, mode of therapy, and length of survival. RESULTS: The mean and median age at diagnosis was 27.0 and 25.5 years (range 11-58 years), respectively. Tumors were 73.1% (19/26) stage I, 3.8% (1/26) stage II, 19.2% (5/26) stage III, and 3.8% (1/26) stage IV. Eighteen patients (69.2%) had pathologic grade 2 or 3. Twenty of 26 patients underwent the conservative surgery including unilateral salpingo-oophorectomy, unilateral oophorectomy or cystectomy, and other patients were performed the total abdominal hysterectomy with bilateral salpingo-oophorectomy. All except five patients received adjuvant combination chemotherapy. Second look operation following combination chemotherapy was done in nine cases. Two patients who had grade III tumors died. Follow-up was available for all the patients, with a mean duration of 43.9 months. No recurrence was observed during this period. CONCLUSION: Immature teratoma of the ovary is a potentially curable disease in today's practice. Low stage and low grade tumors have an excellent prognosis and conservative surgery and preservation of fertility is warranted in those cases.
Cystectomy ; Diagnosis ; Drug Therapy, Combination ; Female ; Fertility ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Korea ; Obstetrics ; Ovariectomy ; Ovary* ; Prognosis ; Recurrence ; Retrospective Studies ; Teratoma*

Breast cancer patients who underwent mastectomy often experience stress, depression from body changes and loss of femininity. Choice of surgical method is important, because Korean women tend to be sensitive to the shape of the reconstructed breast, donor site scars and the changes in body contour. The latissimus dorsi musculocutaneous flap was one of the first methods of breast reconstruction. However, due to lack of volume, the latissimus dorsi flap has become a secondary choice for breast reconstruction. The authors evaluated the clinical cases who underwent breast reconstruction with the extended latissimus dorsi flaps at the authors' institution from March 2002 to February 2005. During the period, 87 cases of breast reconstruction with the extended latissimus dorsi flap were performed in 86 patients. All flaps survived completely. There occurred no partial necrosis and fat necrosis. The extended latissimus dorsi flap alone without implant could provide good to excellent autologous breast reconstruction for small to moderate sized breasts. Free TRAM flap is currently considered the "Gold standard" in autogenous breast reconstruction. But, the extended latissimus dorsi flap without implant could provide sufficient volume for breast reconstruction in selected cases and it is a reliable method for autologous breast reconstruction.
Breast Neoplasms ; Breast* ; Cicatrix ; Depression ; Fat Necrosis ; Female ; Femininity ; Humans ; Mammaplasty* ; Mastectomy ; Myocutaneous Flap ; Necrosis ; Superficial Back Muscles* ; Tissue Donors

Autologous cartilage grafts have become an integral part of aesthetic and reconstructive plastic surgery. However, little objective information is available about the actual quantitative resorption of cartilage in human. This study sought to objectively quantify and compare the resorption of costal cartilage in human. To compare the resorption characteristics of rib cartilage autografts, we harvested rib cartilage grafts from 37 microtia patients. All autografts were implanted subcutaneously on chest and then removed after 6 to 17 months. Graft mass and volume were compared before and after implantion. Rib cartilage grafts with perichondrium averaged 10.8+/-7.4% resorption by volume, On the other hand rib cartilage grafts without perichondrium 25.5+/-6.8%. There was no evidence of necrosis or inflammatory changes. The rib cartilage is the preferred source of autogenous cartilage for auricular reconstruction. Short-term resorption of rib cartilage without perichondrium appears to be higher than with perichondrium. The low resorption of cartilage with perichondrium may be due to in part to cartilage forming capacity of the perichondrium. It remains to be seen whether these differences in resorption persist in the long term.
Autografts ; Cartilage* ; Hand ; Humans* ; Necrosis ; Ribs ; Surgery, Plastic ; Thorax ; Transplantation, Autologous ; Transplants*

The technique of in situ hybridization using synthetic oligonucleotides labelled by non-radioactive method was developed to localize vasoactive intestinal polypeptide, arginine-vasopressin and oxytocin mRNAs in the rat brain. Also double in situ hybridization technique where combination of non-radioactive and radioactive probes were applied was developed to localize 2 neuropeptide mRNAs in single tissue section. The results were as follows; In non-radioactive in situ hybridization methods using digoxigenin-labelled oligonucleotide probe, alkaline-phosphates method using NBT and BCIP as substrates gave the best result that specific hybridization signals were observed. In radioactive in situ hybridization methods using 35S-labelled oligonucleotide probe, specific hybridization signals were observed in both nuclear track emulsion and X-ray film autoradiography. In double in situ hybridization methods using combination of 35S-labelled and digoxigenin-labelled oligonucleotide probes, specific hybridization signals were observed in the group where K5 emulsion was applied as nuclear track emulsion. The technique of in situ hybridization using digoxigenin-labelled oligonucleotide applied in this study will be useful as alternative for radioactive in situ hybridization technique. Moreover, combination of non-radioactive and radioactive labelled probes in double in situ hybridization technique will be a useful tool for the simultaneous localization of various mRNAs in single section for the study of various neurotransmitters, neuropeptides, receptors and signal transduction molecules.
Aging ; Animals ; Autoradiography ; Brain* ; Corpus Callosum ; Digoxigenin ; In Situ Hybridization* ; Magnetic Resonance Imaging ; Mesencephalon ; Neuropeptides ; Neurotransmitter Agents ; Oligonucleotide Probes ; Oligonucleotides ; Oxytocin* ; Pons ; Rats* ; RNA, Messenger* ; Signal Transduction ; Vasoactive Intestinal Peptide* ; Vasopressins* ; X-Ray Film

Purpose: De novo malignancy is common after liver transplantation (LT); however, there are limited reports on the clinical outcomes of gastric cancer surgery after LT. Our study aimed to investigate the feasibility and safety of gastric cancer surgery after LT. Methods: Seventeen patients underwent gastric cancer surgery after LT at a single institution between January 2013 and June 2021. We retrospectively collected data on surgical complications, survival, and recurrence status of these cases. Results: Fifteen patients (88.2%) underwent curative gastrectomy, with 10 open distal (66.7%) and 5 laparoscopic distal (33.3%) gastrectomies. Surgical and severe complication rates were 3 of 15 (20.0%) and 1 of 15 (6.7%), respectively. There were no significant differences between laparoscopic (33.3%) and open surgery (66.7%) in terms of operation time and complication rate. No surgery-related mortalities occurred. Immunosuppressants could be maintained without difficulty, and no suspicious acute rejection was identified during the perioperative period. There was 1 recurrence after curative surgery (recurrence rate, 6.7%), and the 5-year cancer-specific survival rate after curative surgery was 93.3%. Conclusion Laparoscopic gastrectomy can be safely done even after LT in terms of postoperative complications and graft safety.