OBJECTIVE: It is generally accepted that ectopic pregnancy (EP) may adversely affected on the female fertility. However, it is not fully understood how it influences on the future fertility after treatment of an EP, so we intended to evaluate its effects, METHODS: This study was undertaken on 473 patients with clinically and pathologically proven diagnosis of ectopic pregnancies at the Department of Obstetrics and Gynecology, Anam Hospital, Kroea University Medical College hom Jan. 1, 1989 to Aug. 31, 1996. RESULTS: The incidence of ectopic pregnancy was 1 in 19.6 deliveries (5.1%). The overall spontaneous conception rate after treatment of ectopic pregnancy was 67.4%, and among them, the rate of intrauterine pregnancy (IUP) and repeat ectopic pregnancy (rEP) was 56.3% and 11.1% respectively. The occurrance rate of infertiity after treatment of EP was 32.6%. The mean time to IUP after treatment of EP was 16.5 months, and 79.0% of all IUP were conceived within 2 years after treatment. The mean time to repeat ectopic pregnancy was 15.9 months. With increasing maternal age, IUP rate was decreased and rEP rate was increased but they were statistically not signiTicant. Repeat EP rate was also increased in multiparous women but it was also statistically not significant. Overall PR (IUP and rEP) was decreased in women who have organic lesions (adhesions, endometriosis, PID etc.) in pelvic cavity(p=0.003). Patients who were treated with conservative surgery achieved a lower conception rate without statistical significance and it may be due to low cases. CONCLUSION: Future fertility rate was not significantly altered by EP itself, but rather affected by patient's age, organic lesions and previous history of pelvic surgery. Recently, the advent of assisted reproductive technology and its associated techniques improved the female fertility in women with such a problem.
Birth Rate ; Diagnosis ; Endometriosis ; Female ; Fertility* ; Fertilization ; Gynecology ; Humans ; Incidence ; Maternal Age ; Obstetrics ; Pregnancy ; Pregnancy, Ectopic* ; Reproductive Techniques, Assisted

OBJECTIVE: The prevalence of multifetal pregnancies has increased up to 30% as a result of the introduction of ovulation inducing agents for assisted reproductive teclmology(ART). An exttemely poor pognosis could be expected for viable pregnancies in multifetal gestation. So, to decrease the consequence of multiple pregnancies and prevent complications, especially premature baby irreversibly damaged, selective fetal reduction to the smaller number of fetuses should be considered in an early gestational period. METHODS: From May 1994 to Apr 1998, transvaginal selective fetal reduction in 13 pati including 9 triplet, 3 quadruplet and 1 quintuplet. Of the 13 patients, 4 were obtained by controlled ovarian hyperstimulation with intrauterine insemination (COH with IUI), 6 were by IVF-ET, 2 wae by controlled ovarian hyperstimulation with natural contact and 1 was by natural conception. Selective fetal reduction using intracardiac KC1 injection and aspiration of amniotic fluid carried out in 8-11 weeks of gestation. RESULTS: After procedures, 8 patients were remained as twin pregnancies, 5 patients as singleton pregnancies and 1 of the remaining twin embryos vanished after procedure. There have been 7 sets of twin delivery including 1 stillbirth and 3 singleton delivery. 1 cases are ongoing state. All of the singleton delivery were completed after 37 weeks of gestation. Of the twin delivery, 2 cases were delivered after 37 weeks of gestation, 2 cases in 35-37 weeks, and 3 cases before 35 weeks of gestation. Unfortunately, 1 stillbirth occurred in 20 weeks of gestation and 2 cases of singleton were aborted. As 3 losses(2 singleton, 1 twin) occurred, the delayed fetal loss rate in this selective fetal reduction was 25.0%(3/12). There was no fetal anomaly related to the procedure. CONCLUSION: Selective fetal reduction in multifetal pregnancies is a rather safe procedure and it may improve the outcome of multiple pregnancies.
Amniotic Fluid ; Embryonic Structures ; Female ; Fertilization ; Fetus ; Humans ; Insemination ; Ovulation ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Multiple ; Pregnancy, Twin ; Prevalence ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted* ; Stillbirth ; Triplets

OBJECTIVE: Quantitative analysis of both apoptosis and proliferation should provide important insight into tumor biology. The aim of this study is to clarify the significance of apoptosis in the progression of uterine cervical neoplasia, including cervical intraepithelial neoplasia, and microinvasive and invasive squamous cell carcinoma categories. in relation to cell proliferation. METHODS:: Forty five cases of cervical intraepithelial neopasia. 10 of microinvasive carcinoma, and 10 of invasive squamous cell carcinoma were examined using formalin fixed and paraffin embedded samples. The TdT mediated dUTP-biotin nick end labelling(TUNEL) method for apoptotic cells, and Ki-67 and Topo-II immunojhistochemistry for proliferating activity were performed. RESULTS: Apoptotic and proliferative indices, calculated by counting positive nuclei among 1,000 nuclei of cancer cells, should significant positive correlation with histological malignancy grading in CIN and tumor cell invasion into stroma, and showed also significant positive correlation between them. CONCLUSION: These findings suggest that apoptosis in cervical neoplasia may be closely related to tumor cell differentiation and progression.
Apoptosis* ; Biology ; Carcinoma, Squamous Cell ; Cell Differentiation ; Cell Proliferation ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Female ; Formaldehyde ; Paraffin

No abstract available.
Mandibular Fractures

PURPOSE: In adriamycin(ADR)-induced cardiomyopathy, several different mechanisms are suggested. However, little information is available regarding the role of apoptosis. In the present study, we examined the induction of apoptosis on ADR treatment and anti-apoptotic effects of probucol, a lipid-lowering drug, and we also studied the changes of bcl-2 expression in order to see the molecular mechanisms underlying the effect of probucol. METHODS: Cardiac myocytes were isolated from 3-day-old rats, and cultured in low(1 pM) or high doses(10pM) of ADR for 24 hours. Probucol(50 pM) was added 30 minutes before ADR administration. Apoptosis was determined by TUNEL staining, and bcl-2 expression was estimated by immunocytochemistry. RESULTS: The number of TUNEL-positive cells significantly increased in both groups treated with ADR. However, anti-apoptotic effect of probucol was evident only in low dose. In addition, the expression of bcl-2 was significantly increased only in the low-dose ADR treatment group and its expression was inhibited by pretreatment of probucol. CONCLUSION: These results suggest that apoptosis might play an important role in ADR-induced cardiotoxicity, and ADR-induced apoptosis was partially prevented by pretreatment of probucol. And ADR-induced apoptosis was not related with depression of bcl-2. Additionally, inhibition of bcl-2 gene expression of low-dose ADR treatment group by probucol suggests that another cell survival mechanism could be implicated in the action of probucol. (J Korean Pediatr Soc 2000;43:746-754)
Animals ; Apoptosis* ; Cardiomyopathies ; Cell Survival ; Depression ; Doxorubicin ; Genes, bcl-2 ; Immunohistochemistry ; In Situ Nick-End Labeling ; Myocytes, Cardiac* ; Probucol* ; Rats*

No abstract available.
Ascites* ; Pancreatitis, Chronic* ; Pleural Effusion*

Three cases of granular cell tumor in esophagus removed endoscopically are present. Immunohistochemical and electron microscopic studies confirmed that this tumor is originated from schwann cell.

No abstract available.
Tumor Lysis Syndrome*

Anisakiasis refers to the accidental infection of humans by a marine nematode as a result of eating a raw flsh which contains larval stages of the nematode sub-family Anisakidae. This patient developed acute epigastric pain three days after eating a raw flsh, Astroconcer myriaster. Gastrofiberscopy revealed Anisakis larva invading the stomach wall and the larva could be extracted using a biopsy forceps via gastrofiberscopy. The worm was identified as Terranova type A larva based on their morphologic features such as its length, width, intestinal cecum reaching to anterior one-third level of ventriculus and a mucron at posterior end.
Humans ; Biopsy

HIV-1 tat, a strong transactivator, is essential for the HIV-1 replication and AIDS progression. The Tat function is markedly inhibited by human anti-oncogene p53. This work was initiated to identify the p53-associated inhibitory mechanism on tat-mediated transactivation. Inhibitory function of P53 was confirmed by co-transfection of tat-expressing Jurkat cells with LTR-CAT plasmid, or H3Tl cells (LTR-CAT integrated HeLa cells) with different ratio of pSV-tat/pCDNA-p53 plasmids. Results from the direct protein-protein .interaction between soluble p53 and tat, and yeast two-hybrid experiments showed that the co-suppression mechanism is unlikely to be due to the direct interaction. CAT activity was not affected by tat in Jurkat cells which were transfected with p53-promoter-CAT or p53-enhancer-CAT, suggesting that the tat-mediated p53 suppression is not directly associated with p53-promoter. Finally, we have tested protein kinase activity in p53-tranfected Jurkat cells, which might phosphorylate HIV-1 tat, resulting in inhibition of tat function. Some of our data lead us to assume that the p53-mediated tat inhibition is likely to be associated with p53-associated, signaling-mediated phosphorylation of tat, resulting in the dysfunction of tat. This study is now under investigation.
Animals ; Cats ; Genes, Tumor Suppressor ; HIV-1* ; Humans ; Jurkat Cells ; Phosphorylation ; Plasmids ; Protein Kinases ; RNA Interference ; Trans-Activators ; Transcriptional Activation ; Yeasts