OBJECTIVES: To investigate the effect of LH receptor in folliculogenesis, we confirm the expression level of LH receptor (LH-R) mRNA in human granulosa cells (GCs) and its expression levels were analyzed by comparison to embryo developmental rate and pregnancy rate. MATERIALS AND METHODS: GCs were obtained at the time of oocyte retrieval from the patients undergoing IVF-ET program. The patients were divided into two groups: Group I (n=20) is poor responder (retrieved oocyte(s)< or =3ea), Group II (n=80) is normal responder (retrieved oocytes>3ea). After the extraction of total RNA, semiquantitative RT-PCR was performed and the expression level of LH-R mRNA was normalized by beta-actin. Statistical analysis was performed by using Chi(2) test, Student's t-test and Pearson correlation. RESULTS: In Group II, the relative values of LH-R mRNA (0.680 vs. 0.463, p<0.005) and pregnancy rate (54.7% vs. 23.1%, p<0.05) were significantly higher than in Group I. Number of retrieved oocyte(s) was gradually increased when the expression of LH-R mRNA was increased (p<0.05). But the quality of retrieved oocyte and transferred embryo were not related with the expression of LH-R mRNA. When the pregnancy rate was compared with FSH only group and FSH combined with hMG group in the ovarian stimulation protocol, FSH combined with hMG group was significantly higher than FSH only group in Group I (37.5% vs. 0%), and the expression of LH-R mRNA was significantly higher in hMG combined group than FSH only group (p<0.05). CONCLUSION: Expression level of LH-R mRNA has important role in ovarian function related with the response to gonadotrophin in human folliculogenesis. Furthermore these data might provide the evidence that additional use of hMG is helpful to poor responders.
Actins ; Embryonic Development ; Embryonic Structures ; Female ; Granulosa Cells ; Humans ; Oocyte Retrieval ; Oocytes ; Ovulation Induction ; Pregnancy Rate ; Pregnancy* ; Receptors, LH* ; RNA ; RNA, Messenger

A 64-year-old woman with ischemic heart disease was admitted to our hospital because of both leg pain and difficulty to walk for 5 days. She had taken cerivastatin and gemfibrozil for atherosclerosis and ischemic heart disease. One year ago, she had been admitted to our hospital because of acute renal failure due to rhabdomyolysis of unknown origin and was improved after conservative therapy. Laboratory studies revealed serum creatinine 1.2 mg/dL, creatine kinase 23,700 IU/L, serum myoglobin >500 ng/mL, urine myoglobin >3,000 ng/mL. (99m)Tc-HDP whole body Bone scan showed multiple increased uptakes of the soft tissue, especially both calf. With supportive care, she was recovered and discharged with normal creatinine(0.8 mg/dL) and creatine kinase(260 IU/L).
Acute Kidney Injury ; Atherosclerosis ; Creatine ; Creatine Kinase ; Creatinine ; Female ; Gemfibrozil ; Humans ; Leg ; Middle Aged ; Myocardial Ischemia ; Myoglobin ; Rhabdomyolysis*

Pilomatricoma is a common, benign, cutaneous neoplasm, differentiating towards elements of the hair matrix and shaft. It typically presents as a deep-seated, solitary, firm nodule with overlying normal epidermis. However, pilomatricoma with bullous appearance is very rare. We report two cases of pilomatricoma with bullous appearance. The first case was an 11-year-old male who presented with 6 month history of a soft, erythematous, translucent polypoid mass on the left upper arm. The other case was a 20-year-old female who presented with 12 month history of a soft, slightly-brownish, peduncluated mass with indurated nodules on the left upper arm. In both cases, the histopathologic findings revealed multiple islands of shadow cells, with small foci of basophilic cells at the periphery of the deep dermis. There was dilation of lymphatic vessels in the overlying dermis, which explained the clinical bullous appearance.
Arm ; Basophils ; Child ; Dermis ; Epidermis ; Female ; Hair ; Humans ; Islands ; Lymphatic Vessels ; Male ; Pilomatrixoma* ; Young Adult

Pilomatricoma is a common, benign, cutaneous neoplasm, differentiating towards elements of the hair matrix and shaft. It typically presents as a deep-seated, solitary, firm nodule with overlying normal epidermis. However, pilomatricoma with bullous appearance is very rare. We report two cases of pilomatricoma with bullous appearance. The first case was an 11-year-old male who presented with 6 month history of a soft, erythematous, translucent polypoid mass on the left upper arm. The other case was a 20-year-old female who presented with 12 month history of a soft, slightly-brownish, peduncluated mass with indurated nodules on the left upper arm. In both cases, the histopathologic findings revealed multiple islands of shadow cells, with small foci of basophilic cells at the periphery of the deep dermis. There was dilation of lymphatic vessels in the overlying dermis, which explained the clinical bullous appearance.
Arm ; Basophils ; Child ; Dermis ; Epidermis ; Female ; Hair ; Humans ; Islands ; Lymphatic Vessels ; Male ; Pilomatrixoma* ; Young Adult

Herpes zoster is acute viral infection characterized by the appearance of vesicles that occur on the skin and mucous membrane along the pathway of an involved sensory nerve. The incidence is increased in those who have history of trauma, malignant tumor, radiation therapy and the immuno-suppressive drug users. Although herpes zoster is usually as benign viral infection, complications may occur especially when cranial nerves are involved. So careful treatment is necessary when cranial nerves are involved. We have treated two cases. One is involved trigeminal nerve mandibular branch, another maxillary branch. We have used conservative therapy, pain control, acyclovir on this area and obtained good result. After 17 and 8 months respectively, no complications occur in our two cases. So we present two cases with review of literature.
Acyclovir ; Cranial Nerves ; Drug Users ; Herpes Zoster* ; Humans ; Incidence ; Mucous Membrane ; Skin ; Trigeminal Nerve

PURPOSE: The traditional approach with surgery and/or radiotherapy(RT) for advanced head and neck cancer provides anticipated cure rates of 10-65% depending on stages and sites. Recently, combined modality with chemotherapy have been extensively investigated in attempts to improve survival and local control. We retrospectively analysed our experience of 31 patients with advanced head and neck cancer METHODS AND MATERIALS: From November 1983 to October 1994, 31 patients with Stage II and IV squamous cell head and neck cancer were treated with RT. Sixteen patients were treated with RT alone. and 15 patients were treated with combined RT plus chemotherapy. All patients were treated with 4-MV LINAC and radiation dose ranged from 5000 cGy to 7760 cGy(median 7010 cGy). In combined group. 7 patients were treated with cis-platin plus 5-FU, 2 patients were treated with methotrexate plus leucovorin plus 5-FU plus cisplatin or carboplatin, and 6 patients were treated with cisplatin as a radiosensitizer. RESULTS: Median follow up period was 16 months (range 4-134 months). The major responses (CR+PR) were noted in 10 patient (66.6%) of the RT alone group and 14 patient (93.3%) of the chemoradiation group. There was no statistical difference in CR rate between the two groups. The overall survival rates at 5 years were 23.4% in the radiation alone group. 23.5% in the chemoradiation group. Disease-free survival rates at 3 year were 44.5% in the radiation alone group. 40% in the chemoradiation group. There was no statistical differences in overall survival rates and disease free survival rates between the two groups.Local recurrences occurred in 71.5% of the radiation alone group. 72.7% of the chemoradiation group and distant metastasis occurred in 14.4% of radiation alone group. 9.1% of the chemoradiation group. The frequencies of complications were comparable in both groups except hematologic toxicity. CONCLUSION: Total response rates in the combined chemotherapy and radiotherapy was relatively higher than radiotherapy alone. But our result failed to show any survival benefit of the combined chemotherapy and radiotherapy. The accrual of large number of patients and long term follow-up may be necessary to confirm the present result of combined chemotherapy and radiotherapy.
Carboplatin ; Carcinoma, Squamous Cell* ; Chemoradiotherapy* ; Cisplatin ; Disease-Free Survival ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Head and Neck Neoplasms ; Head* ; Humans ; Leucovorin ; Methotrexate ; Neck* ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Survival Rate

BACKGROUND: Early detection and treatment of chronic kidney disease (CKD) are important for inhibition of kidney disease progression and prevention of cardiovascular complications. Treatment of Anemia that is frequently accompanied with CKD, are important for prevention of cardiovascular complications. The lastest K/DOQI-CKD guideline targets early detection and treatment of kidney disease, and the study for these are necessary in Korea. In Korea, until mowadays, the study for prevalence, severity of anemia and influencing factors on anemia in CKD , were rare. Thus in our center, we classified patient for severity of CKD as K/DOQI-CKD guideline and studied prevalence, severity of anemia and influencing factors on anemia. METHODS: According to K/DOQI-CKD guideline, patients were staged by GFR calculated by Adbbreviated MDRD Study Equation. Anemia was defined by Hb less than 10.0 g/dL below which hemodynamic change develops. We examined the frequency of anemia and independent factors that influences on anemia in study patients. RESULTS: Mean creatinine levels for stage 1 to 5 were 0.87 +/- 0.15 (0.7-1.1) mg/dL; 1.04 +/- 0.18 (0.8-1.4) mg/dL; 1.69 +/- 0.36 (1.1-2.7) mg/dL; 2.90 +/- 0.66 (1.9- 4.7) mg/dL; 5.01 +/- 1.28 (3.3-8.8) mg/dL. Mean Hb levels and percentage of anemic patients in each stages were 12.95 +/- 1.46 (10.5-15.4) g/dL, 0%; 13.31 +/- 2.20 (7.8-17.7) g/dL, 10.3%; 11.32 +/- 2.07 (7.4-16.6) g/ dL, 25.5%; 10.10 +/- 1.71 (6.7-14.0) g/dL, 54.8%; 9.21 +/- 1.53 (6.2-12.2) g/dL, 76.9%. The frequency of anemia were high in Diabeltes Mellitus (DM) compared to Non-Diabeltes (Non-DM) at stage 3, 4, 5 [36.7 vs 12.0% (p=0.06); 70.6 vs 35.7% (p=0.000); 100 vs 64.7 % (p=0.06)]. Multivariate logistic regression analysis revealed that DM as etiology (OR 2.53, p=0.033 compared with Non-DM), Albumin level (OR of 5.38, p= 0.001 for 3.0-1.4 compared with 4.0-5.3 g/dL) were independent factor determing anemia state in addition to K/DOQI guideline stage. GFR, sex, DM, Albumin level were independent factors associated with hemoglobin levels (R2=0.571, p<0.001). CONCLUSION: Anemia in CKD was developed relatively early and frequently at stage 3 (Cr, 1.69 +/- 0.36 mg/dL, 25.5%) and more aggravated as decreasing renal function (stage 4. 5; 54.8%, 76.9%). DM as underlying disease, hypoalbuminemia were, independently influenced Anemia development.
Anemia* ; Creatinine ; Dialysis* ; Hemodynamics ; Humans ; Hypoalbuminemia ; Kidney Diseases ; Korea ; Logistic Models ; Prevalence ; Renal Insufficiency, Chronic*

BACKGROUND: This prospective phase II trial was performed to determine the efficacy and toxicity of mitomycin C, vinorelbine and cisplatin combination chemotherapy for patients with previously untreated stage IIIB or IV non-small cell lung cancer (NSCLC). METHODS: Between January 1999 and April 2001, 30 patients with chemotherapy- naive stage IIIB or IV NSCLC were entered into this study. Mitomycin C at a dose of 7 mg/m2, vinorelbine at a dose of 25 mg/m2 and cisplatin at a dose of 75 mg/m2 on day 1 and vinorelbine at a dose of 25 mg/m2 on day 8 were administered. This regimen was repeated every 4 weeks. RESULTS: 29 patients out of 30 patients were assessable. Among the assessable patients, 15 (51.7%) patients had a partial response. The median duration of response and survival was 22 weeks and 39 weeks, respectively. Grade 3 or 4 leukopenia and thrombocytopenia were observed in 28.3% and 4.7% of all the cycles, respectively. Nausea and vomiting of grade 3 occurred only in 2.4% of all the cycles. CONCLUSION: The regimen of mitomycin C, vinorelbine and cisplatin for non-small cell lung cancer is active against advanced NSCLC with tolerable toxicities.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Non-Small-Cell Lung/*drug therapy/pathology ; Cisplatin/*administration & dosage ; Dose-Response Relationship, Drug ; Female ; Human ; Lung Neoplasms/*drug therapy/pathology ; Male ; Middle Aged ; Mitomycin/*administration & dosage ; Treatment Outcome ; Vinblastine/*administration & dosage/*analogs & derivatives

PURPOSE: To compare the clinical results of spontaneous rupture of extensor pollicis longus tendon treated by palmaris longus tendon graft (group I) versus extensor indicis proprius tendon transfer (group II). MATERIALS AND METHODS: Out of twenty-five patients who suffer from spontaneous extensor pollicis longus tendon rupture, twelve patients were treated by palmaris longus tendon graft and thirteen patients were treated by extensor indicis proprius tendon transfer. Postoperatively thumbs were immobilized with thumb spica splint for three weeks. Active and passive movement was allowed subsequently for six weeks. The functions of the thumbs were assessed by the Geldmacher criteria and statistically compared. RESULTS: The overall outcome was excellent in 5(20%) of patients and good in 17(68%) of patients and satisfactory in 3(12%) of patients. The mean scores using the Geldmacher criteria were 18.50 for palmaris longus tendon graft and 19.69 for extensor indicis proprius tendon transfer. No significant difference was noted between two groups. CONCLUSION: Both methods establish equally good clinical results in patient with chronic extensor pollicis longus tendon rupture. Extensor indicis proprius tendon transfer seems more available methods.
Humans ; Rupture ; Rupture, Spontaneous ; Splints ; Tendon Injuries ; Tendon Transfer ; Tendons ; Thumb ; Transplants

BACKGROUND: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. METHODS: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age,sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. RESULTS: 1) Group 1 patients had lower glucose level{63.3+/-30.8(mg/dl)} than that of the group 2{98.5+/-34.2(mg/dl), p<0.05}, and higher LDH level{776.3+/-266.0(IU/L)} than the group 2 patients{376.3 +/-123.1(IU/L), p<0.05), and also longer duration of symptom before treatment{2.0+/-1.7(month)} than the group 2{ 1.1 +/-1.2(month), p<0.05)}, respectively. 2) In group 1, FVC changed from preoperative 2.55+/-0.80(L) to postoperative 2.99+/-0.78(L)(p<0.05), and FEV1 changed from preoperative 2.19 +/- 0.70(L/sec) to postoperative 2.50+/-0.69(L/sec) (p<0.05). 3) There was no difference in pleural fluid protein level(5.05+/-1.01(gm/dL) and 5.15+/-0.77 (gm/dl), p>0.05) and WBC differential count between group 1 and group 2. CONCLUSION: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.
Biochemistry ; Cell Count ; Drug Therapy ; Dyspnea ; Glucose ; Humans ; Pleural Effusion* ; Pleurisy ; Prospective Studies ; Tuberculosis, Pleural*