No abstract available.
Compliance* ; Oxygen* ; Positive-Pressure Respiration* ; Respiratory Insufficiency* ; Ventilation*

No abstract available.
Compliance* ; Oxygen* ; Positive-Pressure Respiration* ; Respiratory Insufficiency* ; Ventilation*

This study was carried out to investigate the development rates of human embryos co-cultured with cumulus cells to each blastocyst stage. Human zygotes were co-cultured on cumulus cell monolayer in YS medium supplemented with 20% hFF. On day 2, if patient had four or more 'good' embryos(regular blastomeres without fragmentation), embryos were further cultured for 72hrs. Blastocysts on day 5 were classified into early blastocyst (ErB), early expanding blastocyst (EEB), middle expanding Blastocyst (MEB), and expanded blastocyst (EdB) on the basis of their morphological aspects of trophectoderm cells and blastocoele. Subsequently, maximum 3 of best blastocysts were transferred in 486 cycles. The results in this study were as follows: Patients who had four or more 'good' embryos on day 2 were 498 persons, but patients whose embryos could not be transferred due to failure in development to the blastocyst stage on day 5 were 12 persons (2.4%). The development rate of embryos to the blastocyst stage was 58.2% (2,885/4,957) on day 5, and the rates that developed to the ErB, EEB, MEB, and EdB stage were 15.0% (743/4,957), 14.9% (739/4,957), 14.4% (714/4,957), and 13.9% (689/4,957), respectively. Total 1366 blastocysts were transferred in 486 cycles (mean number=2.81). The implantation rate and the ongoing implantation rate obtained by observing the number of G-sac and FHB were 29.9% (409/1,366) and 22.5% (308/1,366), respectively. The clinical pregnancy rate was 51.2% (249/486), and the ongoing pregnancy rate was 39.1% (190/486). Among women showing ongoing pregnancy, women with singleton were 50% (95/190), women with twin were 37.9% (72/190), and women with triplet were 12.1% (23/190). Although triplet pregnancy rate in this study was high such as 12.1%, because many blastocysts with high viability were produced in our co-culture system using cumulus cells on day 5, we really believe that a multiple pregnancy except twin should not occur by selecting good embryos for maximum two blastocyst transfer. These results demonstrate that autologous cumulus cells may be used for the production of blastocysts with high developmental competence, and the use of autologous cumulus cells to be collected easily, and to be treated conveniently at OPU must be an effective means for obtaining high implantation and pregnancy rate.
Blastocyst* ; Blastomeres ; Coculture Techniques* ; Cumulus Cells* ; Embryo Transfer ; Embryonic Structures* ; Female ; Humans* ; Mental Competency ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Pregnancy, Triplet ; Triplets ; Zygote

OBJECTIVE: We previously described that Diva is highly expressed in matured metaphase II (MII) oocytes compared to immature germinal vesicle (GV) oocytes in mouse.1 We report here that the expression of Diva transcript as well as protein is oocyte-specific. To elucidate its physiological role in oocyte, the binding partner(s) of Diva has been identified by using immunoprecipitation (IP) followed by Mass Spectrometry. METHODS: NIH/3T3 cells were transiently transfected for 24 h with either empty vector for control or FLAG-tagged mouse Diva construct, and IP was performed with anti-FLAG antibody. The immuno-isolated complexes were resolved by SDS-PAGE on a 12% gel followed by Coomassie Blue staining. For in-gel digestion, 15 bands of interest were excised manually and digested with trypsin. All mass spectra were acquired at a positive reflector mode by a 4700 Proteomics Analyzer (Applied Biosystems, Framingham, MA). Proteins were identified by searching the NCBI nonredundant database using MASCOT Peptide Mass Fingerprint software (Matrixscience, London). RESULTS: Diva-associated complexes were formed in FLAG-tagged mouse Diva-overexpressed NIH/3T3 cells via IP using anti-FLAG-conjugated beads. Among the excised 15 bands, actin and actin-binding proteins such as tropomyosin, tropomodulin 3, and alpha-actinin were identified. Binding between Diva and actin or tropomyosin was confirmed by IP followed by Western blot analysis. Both bindings were also detected endogenously in mouse ovaries, indicating that Diva works with actin and tropomyosin. CONCLUSIONS: This is the first report that immuno-isolated Diva-associated complexes are related to actin filament of the cytoskeletal system. When we consider the association of Diva with actin and tropomyosin, oocyte-specific Diva may play a role in modulating the cytoskeletal system during oocyte maturation.
Actin Cytoskeleton ; Actinin ; Actins ; Animals ; Blotting, Western ; Dermatoglyphics ; Digestion ; Electrophoresis, Polyacrylamide Gel ; Female ; Immunoprecipitation ; Mass Spectrometry* ; Metaphase ; Mice ; Microfilament Proteins ; Oocytes ; Ovary ; Proteomics ; Tropomodulin ; Tropomyosin ; Trypsin

No abstract available.
Carcinoma, Renal Cell* ; Genes, Tumor Suppressor*

Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Antifungal Agents ; Aspergillosis* ; Aspergillus ; Biopsy ; Blindness* ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Cranial Nerves ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Headache* ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination ; Optic Nerve ; Orbit ; Sphenoid Sinus* ; Sphenoid Sinusitis

OBJECTIVE: To identify the clinical characteristics of the patients with hypoxic-hypotensive brain injury (HBI) and to compare the prognosis of HBI with patients with traumatic brain injury (TBI). METHOD: Six patients with HBI and sixteen patients with TBI, who had been comatose for more than 8 hours, were enrolled. The functional status was evaluated by the Functional Independence Measure (FIM) score. RESULTS: The causes of HBI were: two respiratory arrest, three cardiac arrest, and one hypotensive shock. Most patients had memory disturbance, confusion, spasticity, contracture of joints, and weakness after the HBI. Other problems included dysphagia, ataxia or tremor, dementia, and concomitant medical problems. Among these clinical features, confusion and spasticity were serious obstacles in rehabilitation. The HBI patients had lower initial and discharge total FIM score, total FIM gain, total FIM efficacy, cognitive FIM efficacy, and motor FIM efficacy than the TBI patients. The HBI patients had a poor outcome due to more widespread brain damage, medical complications, and delayed rehabilitation treatments as compared with TBI patients. CONCLUSION: We concluded that HBI patients had more diffuse and severe deficit than TBI patients.
Ataxia ; Brain Injuries ; Brain* ; Coma ; Contracture ; Deglutition Disorders ; Dementia ; Heart Arrest ; Humans ; Joints ; Memory ; Muscle Spasticity ; Prognosis* ; Rehabilitation ; Shock ; Tremor

Negative myoclonus (NM) is a shock-like jerky involuntary movement caused by a sudden, brief interruption of tonic muscle contraction. NM is observed in patients diagnosed with epilepsy, metabolic encephalopathy, and drug toxicity and in patients with brain lesions. A 55-year-old man presented with NM in both his arms and neck. He has taken medications containing tramadol at a dose of 80–140 mg/day for 5 days due to common cold. He had no history of seizures. Acute lesions were not observed during magnetic resonance imaging, and abnormal findings in his laboratory tests were not noted. His NM resolved completely after the discontinuation of tramadol and the oral administration of clonazepam. Our case report suggests that tramadol can cause NM in patients without seizure history or metabolic disorders, even within its therapeutic dose.

OBJECTIVE: To identify the neurobehavioral impairment in the traumatic brain injured (TBI) patients and to determine the relationship between the neurobehavioral impairment and functional recovery. METHOD: We analyzed and compared Functional Independence Measure (FIM) scores and neurobehavioral psychometry results in 16 patients with severe TBI. The neurobehavioral psychometry tests included Minimental Status Examination (MMSE), Galvestone Orientation and Amnesia Test (GOAT) as screening tools, Korean Wechsler Intelligence Scale (KWIS) for intelligence, Wechsler Memory Scale-Revised (WMS-R) test for memory function, Color Trail test (CTT) 1 and 2 for attention and concentration, Grooved Pegboard Test (GPT) and Finger Tapping Test (FTT) for motor function, Wisconsin Card Sorting Test (WCST) for executive function, and Symptom Checklist-90-Revision (SCL-90-R) for personality. RESULTS: At discharge, neurobehavioral psychometry of the TBI patients showed impairment of the attention and concentration as demonstrated by severe and moderate impairment in CTT 1 and CTT 2, repectively. Memory disturbance was also noted by the result of mental retardation in WMS-R. But GOAT and MMSE showed normal, KWIS was below average. Motor dysfunction was seen in GPT and FTT and mild executive dysfunction in WCST. Functional recuperation was influenced by attention and concentration, as the FIM score has significant correlation with CTT 1 and FTT. CONCLUSION: The TBI patients have the pervasive neurobehavioral impairment, especially severe dysfunction in the memory, attention and concentration. And functional recovery was significantly correlated with attention. The neurobehavioral psychometry will be useful in neurobehavioral evaluation in TBI patients. A further prospective study using Neurobehavioral psychometry would bring a more precise and valuable information.
Amnesia ; Brain Injuries ; Brain* ; Executive Function ; Fingers ; Goats ; Humans ; Intellectual Disability ; Intelligence ; Mass Screening ; Memory ; Wisconsin

OBJECTIVE: To assess the effects of partial weight bearing (PWB) harness with comparison of traditional exercise program by gait analysis in non-ambulatory acute stroke patients. METHOD: Nine patients participated with PWB harness on the treadmill, and nine patients with traditional exercise. In harness group, the gait training with 30% weight reduction was offered on treadmill, they were treated daily and gait training was done for 20 minutes. In no-harness group, traditional gait training was done by physical therapists. Variables were gait parameters assessed by VICON 370 Gait Analyzer, other function tested by Motricity Index and Functional Ambulatory Category. RESULTS: In linear parameter, the harness group had faster gait speed, longer stride length, and more decreased double support time compared to the no-harness group. In kinematic parameters, the maximal flexion of knee was significantly increased in harness group, but no significant differences was in hip and ankle motion. In kinetic parameters, hip flexion moment of normal side was increased in harness group at heel strike phase, knee flexion moment of normal side was decreased in harness group at heel strike phase. CONCLUSION: The gait training with partial weight bearing harness was more effective in acute stroke patients than traditional therapy, and was influenced in gait pattern, functional ability.
Ankle ; Gait* ; Heel ; Hip ; Humans ; Knee ; Physical Therapists ; Strikes, Employee ; Stroke* ; Weight Loss ; Weight-Bearing*