Aims: To study the validity of a scoring system in evaluating embryo quality and predicting pregnancy potential. The scoring system was formulated using morphologic parameters and cleavage rates. Embryos were scored between 0 and 10 according to morphologic criteria and cleavage rate. Materials and METHODS: The pregnancy results of 2,371 fresh embryos scored by this criteria and transferred between January 1991 and September 1992 in the Monash IVF Program, Melbourne, Australia were analysed for this study. RESULTS: Analysis of 2,371 fresh embryos scores from 926 consecutive transfers showed that intrauterine and multiple pregnancy rate increased significantly along with increased total score per transfer(p < 0.05). Pregnancy rate also increased from 10.7% to 21.6% as the number of embryos with a score of 7 or more(good embryo) increased from 0 to 3(p < 0.05). The well-known relationship between the number of embryos transferred and pregnancy rate was also found but this correlation could not seen when all of added embryos were scored less than 7. When all the embryos in a given transfer were scored less than 4(poor embryo), the pregnancy rate was near zero regardless of the number of embryos transferred. Conclusion: This study indicated that an embryo scoring system based on morphologic and cleavage rate criteria could be useful in selecting good quality embryos and predicting the pregnancy rate in an IVF/ET program.
Australia ; Embryonic Structures* ; Female ; Pregnancy Rate ; Pregnancy* ; Pregnancy, Multiple

Ovulation induction in hypothalamic amenorrhea using gonadotropin- releasing hormone(GnRH) pulse therapy is complicated by widely variant patient responses ranging from anovulation to multiple pregnancy. Route of administration(intravenous vs subcutaneous), pulse therapy, GnRH dose, infusion interval, or hormone preparation may contribute. We evaluated the bioactivity of 4 GnRH preparations(Relisorm,Serono; Lutrelef,Ferring; Factrel,Ayerst; GnRH,Sigma) in a rat anterior cell bioassay. Dispersed rat anterior pituitary cells were placed for 48 hrs at 5x105 cells/well, washed and incubated with GnRH. The GnRH was diluted according to the manufacturer's culture medium(10(-12) to 10(-5)M). GnRH stimulated immunoreactive luteinizing hormone(LH) production was assested in culture medium after 4 hrs by radioimmunoassay(RIA). A linear dose-response relationship was exhibited by all preparations from 10(-10) to 10(-7)M. Msximal LH production was 249+/-24 ng/ml/4hrs(mean+/-SEM) and was not different among the preparations tested(ANOVA, p>0.05). The minimal effective dose of GnRH was 10-10M for all preparations(basa1=27+/-4ng/ml/4hrs:mean+/-SEM). No significant differences were noted for MED, or dose-response slope(p<0.05, ANOVA and slope test for parallelism, respectively). In addition, bioactive LH and immuno and bioactive follicular stimulating hormone(FSH) dose responses were confirmed. We concluded that the principal variability of patient response seen with GnRH pulse therapy cannot be attributed to the bioactivity of these commercial GnRH preparations. But rather, most of the variability is due to the inherent individualism in patient response or other factors of the treatment protocol.
Amenorrhea ; Animals ; Anovulation ; Biological Assay ; Clinical Protocols ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Lutein ; Ovulation Induction ; Pregnancy ; Pregnancy, Multiple ; Rats

No abstract available.
Emergencies ; Korea

No abstract available.
Animals ; Rats* ; Wounds and Injuries*

OBJECTIVE: To compare the age of menarche, changing patterns of the menstrual characteristics in adolescent girls between 1988 and 1998. METHODS: A survey was undertaken for 1,500 highschool girls and compare with those of pervious study for 5,000 middle and highschool girls performed by same author in 1998 by means of questionnaire. RESULTS: During a decade, the mean menarcheal age decreased from 13.5+/-1.0 to 12.7+/-1.0 years(p=0.001). Gynecologic age, Body mass index were associated with age of menarche in both 1988 and 1998. The interval of menstruation was 30.6 3.5dyas in 1998 and shortened compared with 32.1+/-6.3 days in 1988(p=0.001). The duration of menstruation was lengthened in 1998 than in 1988(6.1+/-1.1 days vs 5.8+/-2.2 days, p=0.001). The incidence of irregular cycle(28.2% vs 58.2%, p=0.001), dysmenorrhea(73.9% vs 77.8%, p=0.001), and secondary amenorrhea(16.2% vs 27.2%, p= 0.001) decreased in 1998 compared with those of 1988. The incidence of agonies about menstruation was also decreased in 1998 than in 1988(26.2% vs 69.1%, p=0.001). The most common agony about menstruation in 1988 was irregular cycle(28.4%), but dysmenorrhea( 64.3%) in 1998. CONCLUSIONS: From the above results, the mean age of menarche was advanced since last decade but most of the adolescent girls still have suffered from dysmenorrhea.
Adolescent* ; Body Mass Index ; Dysmenorrhea ; Female ; Humans ; Incidence ; Menarche ; Menstruation ; Surveys and Questionnaire

No abstract available.
Amenorrhea* ; Anovulation* ; Female

PURPOSE: The purpose of this study was to investigate the diametral tensile strength of polymer-based temporary crown and fixed partial denture (FPD) materials, and the change of the diametral tensile strength with time. MATERIAL AND METHODS: One monomethacrylate-based temporary crown and FPD material (Trim) and three dimethacrylate-based ones (Protemp 3 Garant, Temphase, Luxtemp) were investigated. 20 specimens (the empty set 4 mm x 6 mm) were fabricated and randomly divided into two groups (Group I: Immediately, Group II: 1 hour) according to the measurement time after completion of mixing. Universal Testing Machine was used to load the specimens at a cross-head speed of 0.5 mm/min. The data were analyzed using one-way ANOVA, the multiple comparison Scheffe test and independent sample t test (alpha = 0.05). RESULTS: Trim showed severe permanent deformation without an obvious fracture during loading at both times. There were statistically significant differences among the dimethacrylate-based materials. The dimethacrylate-based materials presented an increase in strength from 5 minutes to 1 hour and were as follows: Protemp 3 Garant (23.16 - 37.6 MPa), Temphase (22.27 - 28.08 MPa), Luxatemp (14.46 - 20.59 MPa). Protemp 3 Garant showed the highest value. CONCLUSION: The dimethacrylate-based temporary materials tested were stronger in diametral tensile strength than the monomethacrylate-based one. The diametral tensile strength of the materials investigated increased with time.
Acrylic Resins ; Bisphenol A-Glycidyl Methacrylate ; Collodion ; Composite Resins ; Crowns ; Denture, Partial, Fixed ; Methacrylates ; Polymethacrylic Acids ; Tensile Strength

OBJECTIVE: The use of oral hypoglycemic drugs in pregnant women has been limited and therefore there is scanty information on their safety. Concern about possible adverse effects of these drugs on the fetus led us to collect the cases of unintentional fetal exposure to oral antidiabetic agent during embryogenesis for comparision with an appropriately matched control group from the same clinic population. METHODS: Eight type 2 diabetic pregnant women with accidental exposure to oral antidiabetic agent during early pregnancy and 20 type 2 diabetic pregnant women matched for age, weight, and glycemic control but not exposed to oral antidiabetic agent were studied retrospectively. RESULTS: Three neonates (38%) in the exposed group had congenital malformations and still birth, compared with 5 (25%) in the control group (Odds ratio 1.8 (0.2-13.8), P>0.05). In the control group, the mean of HbA1c of 5 mothers of neonates with anomalies and stillbirth were higher than that of 15 mothers of neonates without anomaly (8.8% vs 6.2%, p=0.1) and the anomalies were major congenital malformation including three congenital heart diseases (1 ventricular septal defect, 2 patent ductus arteriosus) and one renal agenesis. In the exposed group, the mean of HbA1c of 3 mothers of neonates with anomalies and stillbirth were higher than that of 5 mothers of neonates without anomaly (9.0% vs 6.3%, p=0.4) and the anomlies were urachal sinus and facial palsy which was not commonly described in diabetic embryopathy. CONCLUSION: Although this study, due to the limited number of pregnancies examined, does not exclude an association between treatment with oral antidiabetic agent at the time of embryogenesis and congenital malformations in the offspring, the risk of our results is lower than that of others. The final answer will demand a much larger number of pregnancies studied prospectively.
Embryonic Development* ; Facial Paralysis ; Female ; Fetal Diseases ; Fetus* ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Hypoglycemic Agents* ; Infant, Newborn ; Mothers ; Parturition ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Stillbirth

The role of glycine as an inhibitory neurotransmitter is well established, and glycinergic neurons appear to play an important role in the mammalian retinae[Ikeda & Sheardown, 1983 ; Bolz et al., 1985]. Though it has been reported that certain conventional and displaced amacrine cells and a few of bipolar cells are consistently labeled with anti-glycine antiserum in the mammalian retinae so far[W ssle et al., 1986 ; Pourcho & Goebel, 1987 ; Davanger et al., 1991 ; Yoo & Chung, 1992], little has been studied on the synaptic circuitry of glycinergic neurons to clarify mechanism of its action in the visual processing of the mammalian retinae. This study was conducted to localize glycinergic neurons and to define their synaptic circuitry in the rat retina by immunocytochemical method using anti -glycine antiserum. The results were as follows : 1. Glycinergic neurons of the rat retina were conventional and displaced amacrine cells, interstitial cells and bipolar cells. 2. Glycinergic amacrine cells could be subdivided into two types, that is, A II amacrine cells and other amacrine cells, according to their ultrastructures. Glycinergic A II amacrine and other amacrine cell processes comprised postsynaptic dyad at the ribbon synapse of rod bipolar axon terminals in the sublamina b of the inner plexiform layer of the retina. Glycinprgic A II amacrine cell processes made gap junctions with axon terminals of unlabeled invaginating cone bipolar cells in the sublamina b, and made chemical synapses onto axon terminals of unlabeled flat cone bipolar cells and onto dendrites of ganglion cells in the sublamina a of the inner plexiform layer. In the sublamina b of the inner plexiform layer, g1ycinergic amacrine cell processes were postsynaptic to axon terminals of unlabeled invaginating cone bipolar cells, and made chemical output synapses onto axon terminals of unlabeled invaginating cone bipolar and rod bipolar cells and onto the dendrites of ganglion cells. Such cases that pre- and post-synaptic processes of glycinergic amacrine cell processes were non- glycinergic amacrine cell processes were frequently observed throughout the inner plexiform layer. In some cases, glycinergic amacrine cell processes receiving synaptic inputs from other glycinergic amacrine cell process made synaptic outputs onto the non-glycinergic or glycinergic amacrine cell processes. 3. Glycinergic bipolar cells could be subdivided into invaginating and flat cone bipolar cells. Postsynaptic dyads of cone bipolar cells at the ribbon synapses were non-glycinergic amacrine and amacrine cell processes, glycinergic amacrine and amacrine cell processes, glycinergic amacrine and non-glycinergic amacrine cell processes, and dendrite and dendrite of ganglion cells. These results demonstrate that [1] glycinergic A II amacrine cell receiving synaptic input from rod bipolar cells inhibit flat cone bipolar cells and OFF ganglion cells via chemical synapse, and excite ON cone bipolar cells via electrical synapse ; thereby visual information in the darkness can be transmitted to ON ganglion cells via ON cone bipolar cells, and [2] glycine released from glycinergic neurons inhibits directly ON and OFF ganglion cells or indirectly ON and OFF ganglion cells via non-glycinergic amacrine or bipolar cells.
Amacrine Cells ; Animals ; Darkness ; Dendrites ; Electrical Synapses ; Ganglion Cysts ; Gap Junctions ; Glycine ; Neurons* ; Neurotransmitter Agents ; Presynaptic Terminals ; Rats* ; Retina* ; Synapses

BACKGROUND: Carcinoma of the uterine cervix is a theoretically preventable disease because its precursor lesions can be detected by cervical Papanicolau smears and appropriately treated, Although cervical cytology screening programmes have resulted in the redution of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. The focus of criticism has been the false-negative Pap smear, and the false-negative Pap smear is the major quality issue currently facing the physicians. To reduce the false-negative rate of Pap smear, it is essential to improve the accuracy of Pap smear. But false-negative rate of Pap smear has been reported variously. OBJECTIVE: This study was undertaken to evaluate accuracy of Pap smear by study false-negative and false-positive rate of Pap smear and to determine whether false-negative and false-positive rate had any correlations with clinical factors. STUDY DESIGN: The study population was comprised of 346 women, who were undertaken gynecologic operation at the Department of Obstetrics & Gynecology at Hanyang University hospital between March, 1997 and April, 1998. All patients were taken Pap smear before operation. In 93 women of these, preoperative diagnosis were cervical intraepithelial neoplasia and carcinoma in situ of uterine cervix, and in 253 women of these, preoperative diagnosis were benign disease as uterine myoma or adenomyosis, etc. All of their surgical specimen were examined. Pap smear, pathology, medical charts of all patients were reviewed retrospectively, and false-negative rate and false-positive rate were calculated. Clinical factors that associated with false-negative and false-positive rate were evaluated. Fishers exact test and Pearson chi-square test were used of statistical analysis, RESULTS: False-negative rate of Pap smear was 7.2%, false-positive rate was 4.6%, corresponding rate with histology was 88.2%. Sensitivity and specificity of PAP smear were 87.0% and 97.0% respctively. According to gross finding of uterine cervix, erosion was 46.6% in cervical intraepithelial neoplasia, 67.8% in carcinoma in situ, 66.6% in microinvasive carcinoma of uterine cervix and 55.3% of 103 erosion findings was cervical intraepithelial neoplasia, carcinoma in situ or microinvasive carcinoma. 23.1% of cervical lesion were normal gross finding. Menopause was associated with false-negative rate and previous vaginal infection history, previous cervical minor operation, delivery mode, contraception method, pelvic inflammatory disease history, vaginal bleeding at Pap smear and gross finding of cerbix were not associated. There were no clinical factors that were associated with false-positive rate. CONCLUSION: Compared with other reports, false-negative rate(7.2%) and false-positive rate(4.6%) of Pap smear was lower and corresponding rate(88.2%) was higher in Hanyand university hospital. Because of higher false-negative rate in menopausal women, it need more careful to take and interpretate Pap smear in these group.
Adenomyosis ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Contraception ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Leiomyoma ; Mass Screening ; Menopause ; Mortality ; Obstetrics ; Pathology ; Pelvic Inflammatory Disease ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Hemorrhage