OBJECTIVE: Evaluation of embryos using early cleavage to 2-cell stage has been proposed, but a critical time-point for selecting embryos is unclear. The aim of the present study is to provide a guideline including critical time-point in the selection of early cleaving embryo for the reduction of multiple pregnancies as well as the increase of pregnancy rate in human IVF. METHODS: This prospective study was performed in 116 cycles from 85 patients who underwent conventional IVF or ICSI at the infertility clinic of Good Moonhwa Hospital from January 2002 to December 2003. Early cleavage (EC) of embryos to 2-cell stage was assessed at 25 h and 27 h postinsemination/microinjection. Embryos that had early cleaved at each time point were designated as EC-1 and EC-2, respectively, while others were designated as non-early cleavage (NEC). RESULTS: At least one early cleavage embryo was observed in 54 (46.6%) for the EC-1 and 84 (72.4%) for the EC-2 of the 116 cycles assessed. Clinical pregnancy rates (PR) were significantly higher in the EC-1 group (66.7%) compared to the EC-2 group (53.6%) or the NEC group (31.2%) (p<0.05). Significant improvement of the pregnancy rate was found when at least two or more embryos were early cleaved at 25 h postinsemination or when the proportion of early cleavage embryo at 25 h postinsemination was higher than 20% (p<0.05). CONCLUSIONS: The critical time-point for the selection of early cleavage embryos with high implantation potential is more effective in 25 h postinsemination/microinjection compared to 27 h. The proportion as well as number of early cleavage embryos is also an important factor for the prediction of pregnancy outcome and the chance of multiple pregnancies. These results demonstrated that the evaluation of early cleavage embryos to 2-cell stage is an easy, simple, and objective method for the selection of good quality embryos suitable for embryo transfer.
Embryo Transfer ; Embryonic Structures* ; Female ; Humans* ; Infertility ; Pregnancy Outcome ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Prospective Studies ; Sperm Injections, Intracytoplasmic

OBJECTIVE: The purpose of this investigation is to determine the frequency of chromosomal or genetic causes of recurrent spontaneous abortion. METHODS : A cytogenetic study was made in of 921 couples for 13 years from January 1984 to December 1997 in which the woman was ascertained to have had two or more spontaneous abortions at our Cytogenetic Laboratory, Institute of Reproductive Medicine and Population, Seoul National University. RESULTS : The overall incidence of chromosome anomaly was 80 out of 921 (8.7%). There were 34 cases (3.69%) of reciprocal balanced translocation and 13 cases (1.41%) of Robertsonian translocation. Also 17 cases (1.85%) of inversion and 5 cases (0.54%) of X chromosome mosiacism was observed. In the case of reciprocal balanced translocation, chromosome 8,6,7,13 were preferentially involved over others. And in the case of Robertsonian translocation, chromosome 13 was preferentially involved. CONCLUSION: Our study demonstrates that cytogenetic analysis is indicated in couples with 2 or more spontaneous abortion and about half of these disorders are reciprocal balanced or Robertsonian translocations.
Abortion, Spontaneous* ; Chromosomes, Human, Pair 13 ; Cytogenetic Analysis ; Cytogenetics* ; Family Characteristics ; Female ; Humans ; Incidence ; Pregnancy ; Reproductive Medicine ; Seoul ; X Chromosome

OBJECTIVE: To evaluate the effect of short coasting, by withdrawing both gonadotropins and GnRH agonist (GnRHa), on the prevention in severe ovarian hyperstimulation syndrome (OHSS) without compromising pregnancy outcome. METHOD: Thirty-seven women who had been coasted during COH for IVF were coasted when > or =20 follicles > 15 mm with serum E2 level of 4,000 pg/ml were detected. Coasting was initiated for one or two days depending on the status of follicle on ultrasound and serum E2 level. Both gonadotropin and GnRHa were withheld for coasting. Retrospective study was carried and changes of serum E2 levels, number of oocytes retrieved, fertilization rate, pregnancy rate were compared and analyzed. RESULTS: The mean serum E2 level fell from 6,993 pg/ml on the onset of coasting to 3,396 pg/ml on the day of hCG administration. The mean number of oocytes retrieved and fertilization rate were 15.7 and 70.0%, respectively. Fifteen patients were pregnant (40.6%) and implantation rate was 15.2%. Twenty-six (70.3%) patients were coasted for one day and 11 (29.7%) were coasted for two days. The mean decrease rate of serum E2 level was 43% in one day coasting group and 15% (1st day) and 81% (2nd day) in two day coasting group. The pregnancy outcome was similar between the two groups. After coasting, no severe or moderate OHSS occurred in any patients and mild OHSS occurred in 3 (8.1%) patients. CONCLUSIONS: Coasting for one or two days can be used successfully in the prevention of OHSS without compromising IVF cycle outcome.
Female ; Fertilization ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Ultrasonography

No abstract available.
Breech Presentation* ; Female ; Fetus* ; Pregnancy

BACKGROUND AND OBJECTIVES: Many expeerimental evidences have beensupported that the vestibulocerebellum involved in recovery of vestibular compensation. The purpose of this study was to investigate effect of unilateral ablation of uvula and nodular lobes on early stage of vestibular compensation. MATERIALS AND METHODS: Adult Sprague-Dawley rats weighing 250~300 g were used and divided into control (CON) group receiving sham operation, unilateral labyrinthectomy (ULX) group, ULX plus left uvulonodulectomy (ULX+Lt-UNLX) group, and ULX plus right uvulonodulectomy (ULX+Rt-UNLX) group. UNLX was performed 1 hour following ULX. Spontaneous nystagmus (SN) and roll head tilt (RHT) were recorded for 3 days following ULX. Temporal change of c-Fos protein expression in the medial vestibular nuclei (MVN) was measured for 2 days following ULX. RESULTS: There were observed SN with contralateral direction to injured labyrinth and RHT toward ipsilateral side with flexion of ipsilateral limb and extenstion of contralateral one just after ULX. There was significant increase in SN frequency of ULX+Rt-UNLX group compared with that of ULX group. In addition, ULX+Rt-UNLX group resulted in severe postural asymmetry. ULX elicited prominent expression of c-Fos protein in contralateral MVN 2 hours but in ipsilateral one 6, 24 hours after ULX, respectively. In contrast, number of c-Fos positive neurons was higher in contralateral MVN. 24 hours after ULX higher expression of c-Fos protein in contralteral MVN was still remained in ULX+Rt-UNLX group but that in ipsilateral MVN was observed in ULX+Lt-UNLX group. CONCLUSION: These results suggest that UNLX have a different effect on the early stage of vestibular compensatory process and the uvulonodulus serves the restoration of balance between intervestibular nuclear activities after ULX by inhibition of vestibular nuclear complex through nhibitory Purkinje system.
Adult ; Animals ; Compensation and Redress* ; Ear, Inner ; Extremities ; Head ; Humans ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Uvula ; Vestibular Nuclei

No abstract available.
Abscess* ; Citrobacter koseri

We report a case of rhinocerebral mucormycosis in a 63-year-old female with a 1-year history of poorly controlled diabetes mellitus. She had black necrotic ulcers on the hard palate, bloody nasal discharge, swelling of the left side of her face, left blepharoptosis, proptosis, and conjunctival injection. Histopathological examination of the palatal lesion showed large, nonseptate, right-angled branching fungal hyphae in the dermis, and Rhizopus species was isolated on Sabouraud's agar media. The patient was treated with a combination of amphotericin B and surgical debridements but died of asphyxia one month after admission. This is a relatively uncommon, opportunistic infection occurring in a diabetic woman, and only several cases are reported in the Korean literature up to date.
Agar ; Amphotericin B ; Asphyxia ; Blepharoptosis ; Debridement ; Dermis ; Diabetes Mellitus ; Exophthalmos ; Female ; Humans ; Hyphae ; Middle Aged ; Mucormycosis* ; Opportunistic Infections ; Palate, Hard ; Rhizopus ; Ulcer

A 65-year-old male received captoPnl therapy (25mg three times a day, for the treatment of congestive heart failure. Seven months after starting the captopril therapy he developed flaccid vesiculobullae and erythematous patches with oozing, crusted surfaces on his trunk and the proximal portion of his extremities. The mucous membranes were not involved. The mucous membranes were not involved.) The histopathologic findings showed subcorneal bulla containing a few acantholytic cells and direct immunofluorescent studies revealed intercellular deposition of IgG and C3 throughout entire epidermis, consistent with pemphigus foliaceus. After captopril therapy was discontinued, the skin lesions gradually improved within 1 month. Pemphigus foliaceus; is a rare complication of captopril therapy and this is, to our knowledge, the first case report in Korea.
Aged ; Captopril ; Epidermis ; Extremities ; Heart Failure ; Humans ; Immunoglobulin G ; Korea ; Male ; Mucous Membrane ; Pemphigus* ; Skin

No abstract available.
Female* ; Humans ; Pregnancy*

No Abstract Available.
Hyperpigmentation*