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

In an attempt to elucidate the pathological changes following common bile duct ligation, the present study was undertaken in male Sprague-Dawley rats. Morphologic studies of the livers were performed at 1, 2, 3, 5, 7, 9, 11, 13 and 15 weeks after common bile duct ligation. In an attempt to clarify the relationship between the process of bile duct formation and the nature of primitive cells observable around the primitive biliary structure, light microscopic, immunohistochemical and electron microscopic studies were performed. The results were noted as follows: 1) Light microscopically, proliferation of biliary cells began in the periphery of portal areas and expanded toward hepatic lobules. In severe cases of biliary structure proliferation, hepatocytic cords and classic hepatic lobules were inconspicuous. 2) Immunohistochemically, CK-19 expression was limited to biliary structures in protal areas and proliferated biliary epithelial cells. In the serial sections of paraffin block, proliferated intrahepatic biliary structures were associated with those of portal areas. Some oval cells in the ductular hepatocytes were stained for both CK-19 and MNF 116. 3) Ultrastructurally, the proliferated biliary epithelial cells divided into three patterns: absence of lumen, formation of incomplete lumen, and formation of complete lumen. Furthermore these patterns had spectral continuity of maturation in their structures. 4) In some biliary structures, individual biliary cells pushed the basement membrane toward neighboring tissue with accompanying destruction of basement membranes, patterns of budding. Sometimes these cells and hepatocytes comprised the same lumen. In summary, the results obtained by the present study indicate that proliferated biliary structures may be derived from the preexisting intralobular or portal biliary system.
Male ; Humans

The spotted grouped pigmented nevi is one of special forms of non-giant congenital melanocytic nevi. Histologically the nevus cells tend to proliferate around the skin appendages. We have experienced a case of spotted ground pigmented nevi in a 11 year old girl who had a pigmented plaque consisting of grouped brown black regularly distributed papules on the left inguinal region since birth. Histology revealed intradermal nevus. The skin appendages, especially the hair follicles and eccrine sweet ducts were enveloped by the neuvs cells. Electron microscopic study revealed that this nevus cells were mostly of type B cells. We would like to consider that the spotted grouped nevi are closely related pathogenically with the skin appendages.

To evaluate the appearance rate of typhoid granuloma, a clinical and histological study was made on bone marrow smears or biopsies of 60 patients with proven typhoid fever. The results were as follws: 1) Sixty cases consisted of 34 cases of bacteriologically proved group, 10 cases of serologically proved group, and 16 cases of clinically suspected group. The positive culture rate from bone marrow fluid was the highest (70.6%) among specimens although it was obtained 1.6 days in average after the administration of antibiotics. 2) Fourth-eight cases by bone marrow smear revealed the M:E ratio of 3.93:1 in average, mild myeloid hyperplasia and 50.5% of appearance rate of typhoid cells. 3) Fourth-nine cases of bone marrow biopsy revealed 8 cases of typhoid granuloma, all of which belonged to the bacteriologically proved group. All these have no pathognomonic morphologic features. 4) Fourty cases of bone marrow examination of patients with FUO except typhoid fever revealed no typhoid cells in smear and 3 cases of granulomatous lesion from two patients with miliary tuberculosis and one patient with Hodgkin's lymphoma.
Biopsy

No abstract available.
Colorectal Neoplasms* ; Humans ; Male*

We report a case of a 41-year-old female patient who suffered from the acute abdominal pain for several hours after eating raw sea-fishes. After the fibergastroscopy and the abdominal C-T scan, the clinicians found a gastric submucosal mass and performed the explolaparotomy to get an wedge of stomach. Sections revealed a larva surrounded by phlegmonous inflammation with intense eosinophilic infiltration in the widened gastic submucosa. The larva presented the characteristics of the Anisakis: two lateral chords with renette cell, thich smooth cuticle and well developed musculature.
Female ; Humans

The spinal injuries were reported by relatively low incidence than other fracture and dislocation in the body. However, the rate of spine injury tend to increase year by year as the rate of traffic accident and industrial accident have been increased. Authors have experienced 403 cases of various type of injuries from Jan, 1966 to Aug. 1971. They were analysed as follows. 1. Out of 330 patient, males were 212 cases (64.2%) and female 118 (37.8%) Among them 74% of cases were between 20 to 40 years of age. About 51.9% of cases of the spinal injury were caused by traffic road accident. 2. The most most common fracture site in the spinal segments were between 12th thoracic spine and 2nd lumbar spine (69.0%) and most common types of spine injury was simple wedge fracture (70.7%) which is induced by flexion violence. 3. The stable injuries of the spine (69.4% 229 cases) were treated by functional methods such as bed rest, early ambulation. Injured spine were not immobilized in cast. They gave a more functional results than rigidly immobilized group. 4. 27 cases (8.2%) were complicated by paraplegia and mostly (59.3%) were caused by rotational fracture-dislocation. The common site of lesion were between D12-L2 (67.4%) 5. Among the 185 cases who were followed over 6 months, sponetaneous spinal fusion within 6 months after injury occured in 166 cases (89.7%) 76.8% of them were fused within 4 months. 6. Among the 27 paralysed cases, 3 were died within 2 weeks of admission, and 3 cases had complete recovery without residua.
Accidents, Occupational ; Accidents, Traffic ; Bed Rest ; Dislocations ; Early Ambulation ; Female ; Humans ; Incidence ; Male ; Paraplegia ; Spinal Fusion ; Spinal Injuries ; Spine ; Violence

No abstract available.
Arteriovenous Fistula* ; Biopsy*

Blue Rubber Bleb Nevus syndrome, or Bean's syndrome is a very rare disease characterized by an association of 1) hemangioma cutis in which the nevi feel like rubber blebs; 2) hemangiomas of the digestive organs; 3) iron-deficiency anemia due to hemorrhage from the digestive tract. Sometimes, the bleeding is so severe and massive that the patient needs blood transfusions and/or emergency operations. We present a 29-year-old man with Blue Rubber Bleb Nevus syndrome. This patient was admitted to out hospital due to recently aggrevated dizziness and intermittent rectal bleeding. Multiple bluish tumors were noted on the palm, sole and glans penis. Laboratory examination revealed severe iron-deficiency anemia. Barium studies revealed multiple polypoid masses in the stomach, small bowel and colorectum. On esophagogastroduodenoscopy and colonoscopy, three or four dozens of hemangiomas with variable size and shape were noted in the stomach, duodenum at or around the ampulla of Vater and colorectum. This patient was of particular interest because rectal bleeding occurred from rectal lesion which protruded out of anus and caused bleeding during defecation, and which showed as a 2.0 cm Yamada type III polypoid lesion. Endoscopic ultrasonography confirmed us that this lesion was confined to the mucosa and submucosa without extension into muscle layer. Endoscopic polypectomy of this lesion was performed because which considered as the main focus of current rectal bleeding. He was discharged without any complication and 4 months later, he was well without rectal bleeding and his hemoglobin level increased upto 13.5 g/dl. To our knowledge, this is the first case of Blue Rubber Bleb Nevus syndrome in Korea.
Adult ; Ampulla of Vater ; Anal Canal ; Anemia, Iron-Deficiency ; Barium ; Blister* ; Blood Transfusion ; Colonoscopy ; Defecation ; Dizziness ; Duodenum ; Emergencies ; Endoscopy, Digestive System ; Endosonography ; Gastrointestinal Tract ; Hemangioma ; Hemorrhage ; Humans ; Korea ; Male ; Mucous Membrane ; Nevus* ; Penis ; Rare Diseases ; Rubber* ; Stomach

Takayasu's arteritis is a chronic, granulomatous, large-vessel arteriopathy of unknown cause. A 45-year-old women developed multiple subcutaneous nodules preceded by fever, chills, weakness and weight loss. There were several developed pyoderma gangrenosum-like ulcerations which resulted from the breakdown of subcutaneous nodules on both forearms. A skin biopsy specimen from a forearm nodule revealed characteristics of polyarteritis nodosa including necrosis of the muscular arteries of the deep dermis and subcutaneous tissues destruction of the elastic lamella, thrombus formation, and an acute and chronic inflammatory cell infiltrates. Seven years later, the diagnosis of Takayasu's arteritis was suggested by the absence of the left radial pulse and confirmed by angiography.
Angiography ; Arteries ; Biopsy ; Chills ; Dermis ; Diagnosis ; Female ; Fever ; Forearm ; Humans ; Middle Aged ; Necrosis ; Polyarteritis Nodosa* ; Pyoderma ; Pyoderma Gangrenosum ; Skin ; Subcutaneous Tissue ; Takayasu Arteritis* ; Thrombosis ; Ulcer ; Weight Loss