OBJETIVE: This study was performed to investigate the effect of metformin therapy on ovulation induction & pregnancy rate in clomiphene citrate-resistant PCOS women. METHOD: This study used a randomized, single-blinded, case-controlled methods. Total study group consisted of 21 women who showed clomiphene citrate-resistant parttern on previous ovulation induction cycles. Patients of metformin group received metformin 500 mg three times daily, for 7 weeks. Control group received none. Metformin group was consisted of 10 women and control group was consisted of 11 women. Then clomiphene was administrated at daily 50 mg for 5 days to both groups. Clomiphene dosage was increased to daily 150 mg until ovulation was occurred. Before and After metformin treatment, blood samples for measurement of insulin, glucose, steroids were obtained. RESULTS: In the metformin and control groups, 6 of 10 women (60%) and 2 of 11 women (18%) ovulated. And 4 of 10 women (40%) and 0 of 11 women (0%) conceived. Comparisons between the groups were significant. CONCLUSION: In PCOS women who are resistant to CC, metformin use increased the ovulation rate and pregnancy rate from CC treatment, significantly.
Case-Control Studies ; Clomiphene* ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Metformin* ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Pregnancy Rate ; Steroids

OBJECTIVE: This study was performed to compare the clinical outcomes of GnRH antagonist (Cetrorelix) single dose and multiple dose protocols for controlled ovarian hyperstimulation with GnRH agonist long protocol. MATERIALS AND METHOD: From September 2001 to March 2002, 48 patients (55 cycles) were performed controlled ovarian hyperstimulation for ART using by either GnRH antagonist and GnRH agonist. Single dose of 3 mg GnRH antagonist was administered in 15 patients (17 cycles, single dose group) at MCD #8 and multiple dose of 0.25 mg of GnRH antagonist was administered in 15 patients (18 cycles, multiple dose group) from MCD #7 to hCG injection day. GnRH agonist was administered in 18 patients (20 cycles, control group) by conventional GnRH agonist long protocol. We compared the implantation rate, number of embryos, and clinical pregnancy rate among three groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. RESULTS: There were no significant differences in ampules of used gonadotropins, number of mature oocytes, obtained embryos between single and multiple dose group, but compared with control group, ampules of used gonadotropins, number of mature oocytes, obtained embryos were decreased significantly in both groups. Clinical pregnancy rate and implantation rate were not different in three groups. There were no premature LH surge and ovarian hyperstimulation syndrome in three groups. Multiple pregnancy were occurred 1 case in multiple dose group and 2 case in control group. CONSLUSIONS: GnRH antagonist is a safe, effective, and alternative method in the controlled ovarian hyperstimulation compared with GnRH agonist. Clinical outcomes and efficacy of both single and multiple dose protocol are similar between two groups.
Embryonic Structures ; Female ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple

OBJECTIVE: This study was performed to compare the clinical outcomes of GnRH antagonist (Cetrorelix) single dose and multiple dose protocols for controlled ovarian hyperstimulation with GnRH agonist long protocol. MATERIALS AND METHOD: From September 2001 to March 2002, 48 patients (55 cycles) were performed controlled ovarian hyperstimulation for ART using by either GnRH antagonist and GnRH agonist. Single dose of 3 mg GnRH antagonist was administered in 15 patients (17 cycles, single dose group) at MCD #8 and multiple dose of 0.25 mg of GnRH antagonist was administered in 15 patients (18 cycles, multiple dose group) from MCD #7 to hCG injection day. GnRH agonist was administered in 18 patients (20 cycles, control group) by conventional GnRH agonist long protocol. We compared the implantation rate, number of embryos, and clinical pregnancy rate among three groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. RESULTS: There were no significant differences in ampules of used gonadotropins, number of mature oocytes, obtained embryos between single and multiple dose group, but compared with control group, ampules of used gonadotropins, number of mature oocytes, obtained embryos were decreased significantly in both groups. Clinical pregnancy rate and implantation rate were not different in three groups. There were no premature LH surge and ovarian hyperstimulation syndrome in three groups. Multiple pregnancy were occurred 1 case in multiple dose group and 2 case in control group. CONSLUSIONS: GnRH antagonist is a safe, effective, and alternative method in the controlled ovarian hyperstimulation compared with GnRH agonist. Clinical outcomes and efficacy of both single and multiple dose protocol are similar between two groups.
Embryonic Structures ; Female ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple

Neuroimaging of the brain is useful diagnostic evaluation of patients with hepatic encephalopathy msofar as it is able to exclude other causes of abno rmal mental status. Recently, changes of basal ganglia on MRI characteriwd by increased signal mtensity on Tl-weighted images were reported m patients with liver cirrhosis. Signal abnormality involves mainly the globus pallidus and seems to be specific for patients with chronic liver disease. Its pathogenesis and significance are obscure, and no pathological reports have been made. We experienced 3 cases of Chronic acquired hepatic failure whose MRI showed increased signal in-tensity in the basal ganglia on Tl-weighted imaging. Our findings su-ggest that basal ganglia signal abnormality could arise as a marker of brain impairment related to deposition of an unidentified paramagnetic substance or altered intracellular water relaxation.
Basal Ganglia ; Brain ; Globus Pallidus ; Hepatic Encephalopathy ; Humans ; Liver Cirrhosis ; Liver Diseases ; Liver Failure* ; Magnetic Resonance Imaging ; Neuroimaging ; Relaxation

Background: Ixekizumab is a humanized IgG4 monoclonal antibody that selectively binds to the IL-17A cytokine and inhibits its interaction with the IL-17 receptor. It has emerged as an effective treatment for moderate to severe psoriasis. However, to date, there are no real-world data for the use of ixekizumab in the treatment of psoriasis in Korean patients. Objective: To evaluate the effectiveness and safety of ixekizumab in the treatment of moderate to severe psoriasis in Korean patients. Methods: This was a retrospective single-center study. Thirty psoriasis patients who were treated with ixekizumab were analyzed. All patients’ medical records, Psoriasis Area and Severity Index (PASI) score, body surface area (BSA), Physicians’ Global Assessment (PGA), and adverse events were investigated. Results: A significant reduction in mean (±standard deviation) baseline PASI score (14.1±2.6) was detected at 4 weeks of ixekizumab therapy (3.8±2.7, p＜0.001), with a further improvement at weeks 12 and 24 (0.9±0.7 and 0.5±0.5, respectively) (p＜0.001). Our analysis showed that 100%, 87.5%, and 50% of patients achieved PASI 75, 90, and 100 responses, respectively, after 48 weeks of therapy. However, nine patients (30%) experienced a mild adverse event such as injection site reaction, urticaria, upper respiratory tract infection, and stomatitis. No serious adverse events were observed. Conclusion This study provides evidence for the use of ixekizumab in real-world clinical practice and confirm that it is effective and safe in treating Korean patients with moderate to severe psoriasis.

Cryptococcus spp. other than Cryptococcus neoformans or Cryptococcus gattii were previously considered saprophytes and thought to be non-pathogenic to humans. However, opportunistic infections associated with non-neoformans and non-gattii species, such as Cryptococcus laurentii and Cryptococcus albidus, have increased over the past four decades. We experienced a case of cryptococcosis caused by non-neoformans and non-gattii spp. in a 47-year-old female with refractory acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation. The patient underwent salvage chemotherapy with fluconazole prophylaxis and subsequently developed neutropenic fever with multiple erythematous umbilicated papules. A skin biopsy revealed fungal hyphae and repetitive blood cultures showed yeast microorganisms that were identified later as C. laurentii by Vitek-II®. Skin lesions and fever began to improve with conventional amphotericin B therapy. The treatment regimen was continued for 21 days until the disseminated cryptococcosis was completely controlled.
Amphotericin B ; Biopsy ; Cryptococcosis ; Cryptococcus gattii ; Cryptococcus neoformans ; Cryptococcus* ; Drug Therapy ; Female ; Fever ; Fluconazole ; Hematopoietic Stem Cell Transplantation ; Humans ; Hyphae ; Leukemia, Myeloid, Acute* ; Middle Aged ; Opportunistic Infections ; Skin Manifestations* ; Skin* ; Yeasts

PURPOSE: To describe CT and MR findings of Primary nasal NK/T-cell lymphoma and to evaluate the usefulness ofCt and MR imaging for initial diagnosis and during follow-up. MATERIALS AND METHODS: Thirteen patients withbiopsy-proven primary nasal NK/T-cell lymphoma (M:8, F:5;age 30-78, mean:47.3 years) were included in this study.CT scans were obtained in seven patients and MR images in ten, and both CT and MR images in four. Duringfollow-up, CT images were obtained in four patients, MR images in eight, and both types of image in two. Signalintensity or attenuation, location, and shape of the tumor were assessed on CT and MR images, which were alsocompared in terms of evaluation of the extent of the tumor and the assessment of residual tumor during follow-up. RESULTS: Enhanced CT scans showed slightly lower(6/7) or iso-attenuation (1/7) or the tumor than of the wall ofthe nasal cavity. In all cases, the tumor was of slightly lower signal intensity on T2WI and gadolinium-enhancedT1WI than nasal cavity mucosa. Infiltrative wall thickening of the nasal cavity (13/13) and a polypoid mass (5/13)were demonstrated on CT and MR images. The tumor margin was partially indistinct (6/7) or distinct (1/7) oninitial CT, but distinctily identified on initial MR images in all cases. During follow-up, MR was superior to CTfor the assessment of residual tumor in two patients. CONCLUSION: Infiltrative wall thickening of the nasalcavity may be a characteristic feature of primary nasal NK/T-cell lymphoma, and MR images were superior to CT forthe assessment of tumor extent and for the diagnosis of residual tumor during follow-up.
Diagnosis* ; Follow-Up Studies* ; Humans ; Lymphoma* ; Magnetic Resonance Imaging* ; Mucous Membrane ; Nasal Cavity ; Neoplasm, Residual ; Tomography, X-Ray Computed

Despite the modern advance in effective chemotherapy, gastrointestinal tuberculosis is considered to be relatively frequent in developing countries. The ileocecal region is the most common site of intestinal tuberculosis and duodenal involvement is rare. The isolated duodenal tuberculosis are reported 9 cases in Korea. The symptoms and signs of gastrointestinal tuberculosis are nonspecific and vague. In the absence of pulmonary tuberculosis, the diagnosis may be difficult. Pain and vomiting are common symptoms of duodenal tuberculosis. Patients may present with upper gastrointestinal bleeding. Therefore, tuberculosis should be considered in the differential diagnosis of gastrointestinal bleeding. We herein report a case of duodenal tuberculosis presenting as hematemesis and necessitating hospitalization. After anti-tuberculosis therapy, we have confirmed the healing of the lesion by the follow-up endoscopy, and review the current literature.
Developing Countries ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Endoscopy ; Follow-Up Studies ; Hematemesis* ; Hemorrhage ; Hospitalization ; Humans ; Korea ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Pulmonary ; Vomiting