OBJETIVE: To assess the effects of progesterone and acetyl-L-carnitine used after treated with IsolateR gradient before semen cryopreservation-thawing on sperm parameters and membrane integrity. MATERIALS AND METHODS: From April 2001 to July 2001, ten normal male partner of couples who were visited in vitro fertilization (IVF) clinics. the semens were treated with IsolateR gradient before cryopreservation, spermatozoa was incubated with progesterone (1, 5 and 10 micrometer), acetyl-L-carnitine (2.5, 5 and 10 micrometer), or both (progesterone, 1 micrometer; and acetyl-L-carnitine, 5 micrometer) for 30 min. RESULTS: There were no differences in sperm parameters and vital stain among isolate only treated group, progesterone (1, 5 and 10 micrometer), acetyl-L-carnitine (2.5, 5 and 10 micrometer) and both (progesterone, 1 micrometer; and acetyl-L-carnitine, 5 micrometer). But, in high concentration of acetyl-L-carnitine (10 micrometer) treated group, sperm parameters and vital stain were decreased. The statistical method was used ANOVA (Kruskal-Wallis test) and p value was <0.01. CONCLUSIONS: Neither progesterone nor acetyl-L-carnitine show to be protective effect on the cryodamage assessed by sperm parameters and vital stain (eosin-Y stain) in normal sperm. High concentration of acetyl-L-carnitine (10 micrometer), however, was harmful effect on cryoprevention.
Acetylcarnitine* ; Cryopreservation ; Family Characteristics ; Fertilization in Vitro ; Humans ; Male ; Membranes* ; Progesterone ; Semen ; Spermatozoa*

BACKGROUND/AIMS: The aim of this study was to assess the diagnostic use of endoscopic ultrasonograpy (EUS) in detecting the cause of common bile duct (CBD) dilatation in patients in whom abdominal ultrasonography or abdominal CT scan could not identify the cause of dilatation. METHODS: Thirty-seven patients (23 men, 14 women, mean age 62.2 years) with uncertain causes of CBD dilatation on abdominal sonogram and CT scan between October 1999 and November 2003 were enrolled. All patients were evaluated by EUS and endoscopic retrograde cholangiopancreatography (ERCP). Final diagnosis were determined by ERCP, surgical exploration and clinical follow-up. RESULTS: The following diagnosis were made by EUS: choledocholithiasis in 11 patients, CBD dilatation only in 12, benign stricture of distal CBD in 8, periampullary tumor in 6. The definitive diagnosis of choledocholithiasis (n=11), benign stricture of distal CBD (n=10), ampullary tumor (n= 5) were determined by ERCP with or without sphincterotomy and surgical exploration. EUS provided the accurate explanation for CBD dilatation in 32 of the 37 patients (86%). CONCLUSIONS: When the diagnosis of biliary obstruction remains obscure on abdominal sonography or CT scan, EUS may be useful.
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct* ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Endosonography* ; Female ; Follow-Up Studies ; Humans ; Male ; Tomography, X-Ray Computed ; Ultrasonography

The pleural and lesser omental effusion were commonly seen on acute or chronic recurrent pancreatitis complication. But pericardial effusion is rare complication of recurrent pancreatitis and may result to tamponade. We report a case with literature on alcoholic acute recurrent pancreatitis complicated by development of pericardial and pleural effusion, which resolved after catheter drainage.
Alcoholics ; Catheters ; Drainage ; Humans ; Pancreatitis* ; Pericardial Effusion* ; Pleural Effusion

We report the findings of a patient with an asymptomatic Arc of Buhler (AOB) aneurysm, which was successfully treated by transcatheter coil embolization. An abdominal CT and angiography revealed an intact pancreaticoduodenal artery arcade (PDAA) and an anomalous communication between the SMA and celiac axis, termed an AOB. An aneurysm was observed at the origin of the AOB and treated with a transcatheter embolization using coils. A follow-up CT imaging confirmed the total occlusion of the aneurysm with a patent PDAA. The successful results of this treatment suggest that the endovascular therapy of an AOB aneurysm with a celiac axis occlusion and an intact PDAA is feasible and safe.
Adult ; Aneurysm/radiography/*therapy ; Angiography ; Celiac Artery/*abnormalities ; *Embolization, Therapeutic ; Humans ; Male ; Mesenteric Artery, Superior/*abnormalities ; Tomography, X-Ray Computed

Primary choriocarcinoma of fallopian tube is a extremely rare. At the time of initial presentation, symptoms are usually similar to those of traditional tubal pregnancies. The diagnosis is usually made on histological examination of a surgically resected specimen. Chemotherapy is required in most patients following initial operation including unilateral adnexectomy or salpingectomy. Primary choriocarcinoma of fallopian tube appears to have the same favorable prognosis as does uterine choriocarcinoma. We experienced one case of primary choriocarcinoma of fallopian tube, and report this with brief review of the literatures.
Choriocarcinoma* ; Diagnosis ; Drug Therapy ; Fallopian Tubes* ; Female ; Humans ; Pregnancy ; Pregnancy, Tubal ; Prognosis ; Salpingectomy

BACKGROUND/AIMS: Conventional colonoscopy is limited in some patients with several causes, such as fixed angulation, extensive loop or adhesion. Therefore, small-caliber scopes are considered alternatives to unsuccessful conventional colonoscopy. The aim of this study is to evaluate the usefulness of gastroscope in patients with unsuccessful colonoscopy. METHODS: From May 2008 to April 2009, a total of 2,548 colonoscopies were performed in Wonkwang University Hospital. The gastroscope was used subsequently when conventional colonoscopy failed. RESULTS: There were 27 cases (1.06%) of unsuccessful colonoscopy. The causes of failure were assessed as fixed angulation of the sigmoid colon (59.2%, 16/27), excessive looping (14.8%, 4/27), stricture (14.8%, 4/27), sigmoid diverticulosis (7.4%, 2/27), and adhesion of transverse colon (3.7%, 1/27). The average time of intubation to cecum with the gastroscope was 7 minutes and 28 seconds (range, 2 to 20 minutes). With the gastroscope, 77.8% (21/27) were intubated to the cecum. The pain score of gastroscope was reduced, as compared with that of conventional colonoscopy (4.95 vs. 5.94, P<0.001). CONCLUSIONS: Gastroscope would be a useful alternative tool in patients with unsuccessful colonoscopy.
Cecum ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Constriction, Pathologic ; Diverticulum ; Gastroscopes ; Humans ; Intubation

Carcinoid tumors of the duodenum are infrequent, represent 2.0-3.0% of all gastrointestinal carcinoid tumors in western countries and 14.8% of those in Japan. Small carcinoid tumors of the duodenum are often asymptomatic, discovered endoscopically, Duodenal carcinoid tumors have been treated by surgical resection or endoscopic resection with strip biopsy or polypectomy. We experience a case of carcinoid tumor of duodenum in 49 years woman. Endoscopic examination, 0.7 cm sized polypoid mass with central depression was noted on duodenal bulb area. We present a case of a small duodenal carcinoid treated with strip biopsy technique.
Biopsy* ; Carcinoid Tumor* ; Depression ; Duodenum ; Female ; Humans ; Japan

BACKGROUND/AIMS: Gastro-esophageal reflux disease (GERD) is a chronic condition, with 50-80% of patients experiencing recurrence within one year following completion of initial treatment. The present study aimed to estimate recurrence rate and treatment response in GERD patients treated with proton pump inhibitor. METHODS: A total of 207 symptomatic GERD patients, which were confirmed by endoscopy from July 2008 till January 2009, were enrolled. They were divided into non-erosive reflux disease (NERD) group and erosive reflux disease (ERD) group by endoscopic findings. Patients were treated with lansoprazole 15 mg (NERD group) or 30 mg (ERD group) once daily for 8 weeks. The presence of symptoms was assessed in each patient at baseline and post-treatment using a questionnaire. Subsequent symptomatic recurrence on the cessation of therapy in each improved patients was checked by telephone survey or outpatient interview. RESULTS: Ninety-four patients and 113 patients were first diagnosed with NERD and ERD, respectively. The mean post-treatment follow-up period was 24.4+/-8.5 weeks. Recurrence rate was 40.0% (NERD, 43.8%; ERD, 37.1% (p=0.224)). Recurrence time was 10.1+/-5.8 weeks (NERD 9.6 weeks; ERD, 10.6 weeks (p=0.444)). Regarding the symptom improvement after 8 week therapy with lansoprazole, 89.4% (NERD, 85.1%; ERD, 92.9% (p=0.056)) of total patients were symptomatically improved. CONCLUSIONS: Forty percentage of GERD patients recurred within 6 months following the completion of 8 week therapy with lansoprazole. Recurrence rate, recurrence time, and rate of symptom improvement were not significantly different between NERD group treated with half dose and ERD group treated with full dose lansoprazole.
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; Adult ; Aged ; Anti-Ulcer Agents/therapeutic use ; Female ; Follow-Up Studies ; Gastroesophageal Reflux/*drug therapy ; Gastroscopy ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Proton Pump Inhibitors/therapeutic use ; Questionnaires ; Recurrence

BACKGROUND/AIMS: The most appropriate treatment for acute gastric variceal bleeding (GVB) is currently endoscopic gastric variceal obturation (GVO) using Histoacryl(R). However, the secondary prophylactic efficacy of beta-blocker (BB) after GVO for the first acute episode of GVB has not yet been established. The secondary prophylactic efficacy of BB after GVO for the first acute episode of GVB was evaluated in this study. METHODS: Ninety-three patients at Soonchunhyang University Hospital with acute GVB who received GVO using Histoacryl(R) were enrolled between June 2001 and March 2010. Among these, 42 patients underwent GVO alone (GVO group) and 51 patients underwent GVO with adjuvant BB therapy (GVO+BB group). This study was intended for patients in whom a desired heart rate was reached. The rates of rebleeding-free survival and overall survival were calculated for the two study groups using Kaplan-Meyer analysis and Cox's proportional-hazards model. RESULTS: The follow-up period after the initial eradication of gastric varices was 18.14+/-25.22 months (mean+/-SD). During the follow-up period, rebleeding occurred in 10 (23.8%) and 21 (41.2%) GVO and GVO+BB patients, respectively, and 39 patients died [23 (54.8%) in the GVO group and 16 (31.4%) in the GVO+BB group]. The mean rebleeding-free survival time did not differ significantly between the GVO and GVO+BB groups (65.40 and 37.40 months, respectively; P=0.774), whereas the mean overall survival time did differ (52.54 and 72.65 months, respectively; P=0.036). CONCLUSIONS: Adjuvant BB therapy after GVO using Histoacryl(R) for the first acute episode of GVB could decrease the mortality rate relative to GVO alone. However, adjuvant BB therapy afforded no benefit for the secondary prevention of rebleeding in GV.
Adrenergic beta-Antagonists/*therapeutic use ; Adult ; Aged ; Enbucrilate/therapeutic use ; Endoscopy, Digestive System ; Esophageal and Gastric Varices/*drug therapy ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage/mortality/*therapy ; Heart Rate ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Proportional Hazards Models ; Propranolol/therapeutic use ; Risk Factors ; Severity of Illness Index

OBJECTIVE: GnRH antagonist has been recently developed and has provided a new treatment option for controlled ovarian hyperstimulation (COH). However, the use of GnRH antagonist (GnRH-ant) has been hesitated in women with polycystic ovary syndrome (PCOS) due to their high levels of tonic luteinizing hormone (LH). This study was performed to evaluate the efficacy of 2 kinds of GnRH-ant multidose protocols (MDPs) in infertile women with PCOS undergoing IVF-ET, compared with standard GnRH agonist (GnRH-a) luteal long protocol (LP). METHODS: Sixty-five patients with PCOS, aged 24-38 years were recruited for this prospective study and they were randomized to undergo GnRH-ant MDP during early and late follicular phase (GnRH-ant MDPEL) (group 1), GnRH-ant MDP during late follicular phase (GnRH-ant MDPL) (group 2), or GnRH-a luteal LP (group 3). All of the subjects were pretreated with low dose monophasic oral contraceptives (OCs) and they were administered recombinant FSH for ovarian stimulation. RESULTS: There were no differences in serum concentrations of progesterone and endometrial thickness on the day of hCG injection among three groups but serum concentrations of estrogen are higher in group 3 (GnRH-a luteal LP) than other groups. Total dose and duration of rFSH used for COH were significantly higher in group 3 than those in group 1 or 2. Number of retrieved oocytes, grade I/II embryos, fertilized oocytes were significantly higher in group 3 than those in group 2 but there were no differences in any parameters including IVF results between group 1 and 3. No difference in ongoing pregnancy rate was found among 3 groups. CONCLUSION: The use of the GnRH-ant, especially during early and late stimulation period (GnRH-ant MDPEL) is as effective as GnRH-a LP and might be considered more advantageous because of the short-term and small dose application, and therefore GnRH-ant MDPEL could be cheaper alternative in COH for PCOS women undergoing IVF-ET.
Contraceptives, Oral ; Embryonic Structures ; Estrogens ; Female ; Follicular Phase ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Oocytes ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Pregnancy Rate ; Progesterone ; Prospective Studies