OBJECTIVE: We have attempted to identify prognostic factors regarding CC/hMG ovarian stimulation and IUI in infertility and to seek factors valuable in planning infertility treatment and predicting the success rate of IUI therapy in individual couples. METHODS: The variables selected for initial analysis were female age, duration of infertility, type and diagnosis of infertility, number of pre-ovulatory follicles (>or=16 mm, >or=18 mm follicles), thickness of the endometrium, number of the treatment cycles, result of semen analysis, ovarian stimulation protocol, number of IUI. A logistic regression method was used to identify significant variables that contribute to the success of CC/hMG/IUI treatment. RESULTS: Logistic regression analysis revealed four predictive variables as regards pregnancy: duration of infertility (p=0.011), infertility etiology (p=0.049), number of IUI (p=0.004), method of ovarian stimulation (p=0.042). A cause of infertility, especially ovarian dysfunction other than tubal factor, a shorter duration of infertility (<6 years) and CC/hMG minimal ovarian stimulation protocol with double IUI resulted in better treatment success in CC/hMG with IUI cycles. CONCLUSION: We concluded that careful patient selection criteria coupled with successful ovarian stimulation and increased sperm count in female reproductive tract is the model for CC/hMG/IUI sucess.
Diagnosis ; Endometrium ; Family Characteristics ; Female ; Humans ; Infertility ; Insemination* ; Logistic Models ; Ovulation Induction* ; Patient Selection ; Pregnancy ; Semen Analysis ; Sperm Count

No abstract available.
Biopsy, Fine-Needle* ; Thyroid Gland* ; Thyroid Nodule*

PURPOSE: Prostate cancer is rare in men younger than 50 years. Digital rectal examination (DRE) and measurement of prostate-specific antigen (PSA) concentrations are standard screening methods for detecting prostate cancer. We retrospectively investigated the risks and benefits of repeated transrectal ultrasonography-guided prostate needle biopsies in relation to the follow-up status of men younger than 50 years with a consistently high PSA concentration (>3.0 ng/mL). MATERIALS AND METHODS: During the period from January 2000 through February 2013, we reviewed patient's ages, dates of procedures, DRE results, frequencies of biopsies, results of the biopsies, periods of follow-up, PSA concentrations, and prostate volumes in Chonbuk National University Hospital records. We conducted telephone interviews in patients who did not undergo regular follow-up. RESULTS: The mean age of the patients was 44.7 years, and the mean PSA concentration was 8.59 ng/mL (range, 3.04-131 ng/mL) before biopsy. The PSA concentration was significantly different (p<0.001) between the patients with prostate cancer and those with benign prostatic hyperplasia (BPH). Nineteen patients underwent repeated prostate biopsy; however, in only one patient did the pathologic findings indicate a change from BPH to prostate cancer. We identified several complications after transrectal biopsy through an evaluation of follow-up data. CONCLUSIONS: All patients with benign prostatic disease based on their first biopsy were shown to have benign disease based on all repeated biopsies (15.83%), except for one patient; however, several complications were noted after biopsy. Therefore, the risks and benefits of repeated biopsy in young patients should be considered because of the low rate of change from benign to malignant disease despite continuously high PSA concentrations (>3.0 ng/mL).
Biopsy* ; Biopsy, Needle ; Digital Rectal Examination ; Follow-Up Studies* ; Hospital Records ; Humans ; Interviews as Topic ; Jeollabuk-do ; Male ; Mass Screening ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Diseases ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Retrospective Studies ; Risk Assessment* ; Young Adult

No abstract available.
Budesonide* ; Humans

To evaluate effect of coronary collateral circulation on left ventricular function in patients with acute myocardial infarction, global ejection fraction(EF), left ventricular end distolic pressure(LVEDP), peak creatine kinase(CK) level and regional wall motion were analysed and compared in 30 patients with acute myocardial infarction according to grade of coronary collateral circulation. Patients with total or near total(above 95% of diameter) occlsion of left anterior descending coronary artery without significant lesion in right coronary artery or left circumflex artery were selected and divided into 3 groups according to the degree of collateral circulation on coronary angiography, to be compared by the index of ejection fraction, peak creatine kinase level, left ventricular and diastolic pressure and regional wall motion. The result are as following : 1) There were no statistically significant differences in ejection fraction, peak creatine kinase level, left ventricualr and diastolic pressure among the groups. 2) Regional wall motion of infarct related area of G2+3 group(adequate collateral) were better than that of G0(no collateral) group(p<0.05). Therefore, adequate coronary collateral circulation in acute myocardial infarction is thought to have beneficial effect on left ventricular function especially in regional wall motion of infarct related area.
Arteries ; Blood Pressure ; Collateral Circulation* ; Coronary Angiography ; Coronary Vessels ; Creatine ; Creatine Kinase ; Humans ; Myocardial Infarction* ; Ventricular Function, Left*

No abstract available.
Pregnancy*

BACKGROUND/AIMS: Several randomized controlled studies have shown that responders who had treated with interferon alpha for chronic hepatitis B had better rate of sustained loss of HBeAg and HBV DNA than non-esponders. These studies also showed that non-esponders had higher rates of liver related complication and mortality. But there is very little data on how well sustained responders are and whether the responders eventually lose HBsAg in Korea. The aims of this study were to better define the long term remission of chronic hepatitis B induced by interferon alfa therapy and compare the clinical outcome among the interferon responders and non-esponders in Korea. METHODS: Sixty-ight patients with chronic hepatitis B who were treated with interferon alfa between 1987 and 1998 were followed up for serologic status (HBsAg, HBeAg, HBV DNA), biochemical tests and liver related complication or mortality. RESULTS: Among 68 patients with chronic hepatitis B who were treated with interferon alfa, 28 (41%) responded to treatment with loss of HBeAg within 1 year of starting treatment. Up to 129 months (mean 58 months) after therapy, responders had higher rate of cumulative clearance of HBeAg at five years than non-esponders (100% vs 35.1%, p<0.05). Responders had maintained the normal serum ALT than nonresponders at five years (94% vs 55.6%, p<0.05). Loss of HBsAg was not different between responders and non-esponders (5% vs 4%, NS). The rates of liver related complication and mortality did not differ between both groups. Delayed clearance of HBeAg occured in twelve out of forty non-esponders (30%). There were no differences in age, baseline ALT, histologic finding of liver biopsy, HBV DNA at the end of first year after study with IFN therapy between the non-esponders with and without delayed clearance of HBeAg. CONCLUSION: Remission in chronic hepatitis B induced by alfa interferon maintained in long duration. But clinical outcomes such as liver related complication, mortality and the elimination of HBV infection have no differences between responders and non-esponders. Further studies are needed for the role of interferon therapy in long-erm clinical outcome for chronic hepatitis B.
Biopsy ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons* ; Korea ; Liver ; Mortality

In order to determine the electrophysiologic properties of aberrant ventricular conduction we analyzed the electrophysiologic studies done for various reasons in SNUH(1983.3 -1987.8). All patients did not have underlying heart disease and were in sinus rhythm with normal PR intervals & no intraventricular conduction delay at the time of study. The patients of preexcitation syndrome were excluded. Only aberrant ventricular conduction induced by premature atrial stimulation at the high right atrium or(HRA) during sinus rhythm or HRA pacing was analyzed. 1) Aberrant ventricular conuction was induced by premature atrial extrastimulation in 34 subjects of 156 cases reviewed(21.8%). The patients were 16 to 70 years old(sixteen males and eighteen females). 2) The longest atrial coupling(A1S2) interval resulting in aberrant ventricular conduction approximated 45%(600-280) of the basic cycle length(450-1550 msec). 3) As a prerequisite for aberrant ventricular conduction, the functional refractory period(FRP) of the AV node should be less than the relative refractory period(RRP) of the His Purkinje System and the most important determinant of aberrant ventricular conduction by atrial extreastimulation was resultant H1H2 interval, which should be between RRP and effective refractory period(ERP) of HPS. 4) There was good linear correlation between the basic cycle length(BCL) and RRP of the HPS(RRP=0.247xBCL+247.048, r=0.885, p-value<0.001). 5) 155 different configurations of aberrant ventricular conduction were recorded during atrial extrastimulation till atrial ERP. The pattern frequencies were as follows : left anterior hemiblock, 6(3.9%) ; right bundle brach block, 92(59.4%) ; left bundle branch block, 28(18.0%) ; left anterior hemiblock combined with right bundle branch block, 14(9.0%) ; left posterior hemiblock combined with right bundle branch block, 9(5.8%) ; unclassified intraventricular conduction disturbances, 6(3.9%). 6) As the atrial coupling intervals were further shortened, aberrant conduction persisted up to the point of atrial ERP at 19/41 BCL's(46.3%). Other patterns of atrioventricular conduction were as follows : atrio-His block, 7(17.1%) ; His-ventricular block, 6(14.6%) ; normal conduction due to prolonged A2H2, 9(22.0%). But there was no statistical significance between the pattern of A-V conduction and the longest S2H2 & H2V2 intervals during VAB (p-value=0.235>0.050). In conclusion, atrial extrastimulation which is routinely done during clinical EPS is an effective method to induce aberrant ventricular conduction and to study the electrophysiologic characteristics of atrioventricular conduction. Further study with recording of bundle branch electrogram, after infusion of cardioactive drugs and pacing of HRA at fixed rate should be done to determine the electrophysiologic properties of VAB more completely.
Atrioventricular Node ; Bundle-Branch Block ; Heart Atria ; Heart Diseases ; Humans ; Male ; Pre-Excitation Syndromes

OBJECTIVE: To evaluate pattern of associated structural anomalies, abnormal karyotypes and perinatal outcomes of fetuses with prenatally diagnosed single umbilical artery and to evaluate the relation of absent side of a single umbilical artery in association with anomalies and abnormal karyotypes. MATERIALS AND METHODS: 30 fetuses with a single umbilical artery were detected by prenatal ultrasound examnination between March 1998 and June 2001 at Eul-Ji University Hospital. All medical records were reviewed for maternal demographics, associated anomalies, karyotypic analysis, pregnancy complications, and neonatal outcome. RESULTS: Of the 30 fetuses, 11 (36.7%) were terminated because of severe anomalies and 2 (6.7%) experienced neonatal death. 17 fetuses (56.7%) had an associated structural anomaly. The structural anomalies found in association with single umbilical artery were cardiovascularac system (9 cases, 30.0%), urogenital system (6 cases, 20.0%), central nervous system (5 case, 16.7%) and ectopia cordis (1 case, 5.9%) and 7 cases (20%) among these had multiple malformations. Karyotype analysis was availabe in 25 cases and 5 (20%) of these were chromosomally abnormal. All of the karyotypically abnormal fetuses had a structural defect diagnosed on prenatal ultrasound examination in addition to the single umbilical artery. Of 13 fetuses without any associated structural or chromosomal anomalies, 3 (23.1%) demonstrated growth restriction. Of the 26 cases identified the absent side of a single umbilical artery, the right umbilical artery was absent in 13 (50%) and the left in 13 (50%) fetuses. The frequency with associated structural and chromosomal anomalies was equal on right (53.8%; 15.4%) and left (69.2%; 15.4%) sides. CONCLUSION: Scanning the umbilical cord should be one of the essential parts of 2 nd trimester ultrasonographic examination. When single umbilical artery is detected, a detailed ultrasonographic examnination including fetal echocardiography and fetal karyotyping should be recommended for search of associated structural and chromosomal abnormalities. In cases where single umbilical artery is an isolated finding on prenatal ultrasound, careful attention to fetal growth is necessary.
Abnormal Karyotype ; Central Nervous System ; Chromosome Aberrations ; Demography ; Echocardiography ; Ectopia Cordis ; Fetal Development ; Fetus* ; Karyotype ; Karyotyping ; Medical Records ; Pregnancy Complications ; Single Umbilical Artery* ; Ultrasonography ; Umbilical Arteries ; Umbilical Cord ; Urogenital System

OBJECTIVE: To evaluate pattern of associated structural anomalies, abnormal karyotypes and perinatal outcomes of fetuses with prenatally diagnosed single umbilical artery and to evaluate the relation of absent side of a single umbilical artery in association with anomalies and abnormal karyotypes. MATERIALS AND METHODS: 30 fetuses with a single umbilical artery were detected by prenatal ultrasound examnination between March 1998 and June 2001 at Eul-Ji University Hospital. All medical records were reviewed for maternal demographics, associated anomalies, karyotypic analysis, pregnancy complications, and neonatal outcome. RESULTS: Of the 30 fetuses, 11 (36.7%) were terminated because of severe anomalies and 2 (6.7%) experienced neonatal death. 17 fetuses (56.7%) had an associated structural anomaly. The structural anomalies found in association with single umbilical artery were cardiovascularac system (9 cases, 30.0%), urogenital system (6 cases, 20.0%), central nervous system (5 case, 16.7%) and ectopia cordis (1 case, 5.9%) and 7 cases (20%) among these had multiple malformations. Karyotype analysis was availabe in 25 cases and 5 (20%) of these were chromosomally abnormal. All of the karyotypically abnormal fetuses had a structural defect diagnosed on prenatal ultrasound examination in addition to the single umbilical artery. Of 13 fetuses without any associated structural or chromosomal anomalies, 3 (23.1%) demonstrated growth restriction. Of the 26 cases identified the absent side of a single umbilical artery, the right umbilical artery was absent in 13 (50%) and the left in 13 (50%) fetuses. The frequency with associated structural and chromosomal anomalies was equal on right (53.8%; 15.4%) and left (69.2%; 15.4%) sides. CONCLUSION: Scanning the umbilical cord should be one of the essential parts of 2 nd trimester ultrasonographic examination. When single umbilical artery is detected, a detailed ultrasonographic examnination including fetal echocardiography and fetal karyotyping should be recommended for search of associated structural and chromosomal abnormalities. In cases where single umbilical artery is an isolated finding on prenatal ultrasound, careful attention to fetal growth is necessary.
Abnormal Karyotype ; Central Nervous System ; Chromosome Aberrations ; Demography ; Echocardiography ; Ectopia Cordis ; Fetal Development ; Fetus* ; Karyotype ; Karyotyping ; Medical Records ; Pregnancy Complications ; Single Umbilical Artery* ; Ultrasonography ; Umbilical Arteries ; Umbilical Cord ; Urogenital System