No abstract available.
Humans ; Rectus Abdominis* ; Tissue Donors*

BACKGROUND: Mitral regurgitation is a valvular heart disease that produce complex hemodynamic alternations and myocardial dysfunction occurs subclinically, so result in a high incidence of left ventricular dysfunction that might affect postoperative result. In order to assess preoperative factors affecting the outcome of mitral valve replacement in patients with chronic mitral regurgitaion, we evaluated prognostic factors from preoperative clinical, laboratory, and echocardiographic findings in 71 patients with chronic mitral regurgitation who received mitral valve replacement. METHODS: From 1985 to 1994, 71 patients with chronic mitral regurgitation, who received mitral valve replacement, were included in this study. The patients were defined as group I who had improved symptom and / or decreased left ventricular end-diastolic dimension after operation, and group II who had persistent symptom and / or over 60mm of left ventricular end-diastolic dimension after operation. RESULTS: 1) In clinical findings, preoperative systolic blood pressure was higher in Group I patients(p<0.05). 2) Hemoglobin, serum creatinine, and blood urea nitrogen level were not significantly different in both groups. 3) In echocardigraphic findings, left atrial dimension, left ventricular end-systolic / end-diastolic dimension, and left ventricular volume index of Group II were much higher than those of Group I patients(p<0.05). 4) In the discriminant analysis, left ventricular end-diastolic dimension, age, NYHA functional class, and left ventricular mass index were defined as important prognostic factors. CONCLUSION: According to the above results, preoperative age, NYHA functional class are significant prognostic factors in clinical and laboratory findings. And left atrial dimension, left ventricular end-systolic and end-diastolic dimensions, left ventricular volume index, and left ventricular mass index are significant prognostic factors in echocardiographic findings.
Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Echocardiography ; Heart Valve Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Insufficiency* ; Mitral Valve* ; Ventricular Dysfunction, Left

OBJECTIVE: This study aimed to determine the safety and clinical effect of artificial shrinkage (AS) in terms of assisted hatching of fresh blastocysts. Also, we evaluated the correlation between patient age and the effect of AS on clinical outcome. METHODS: Two AS methods, using a 29-gauge needle and laser pulse, were compared. Seventy-three blastocysts were shrunk using a 29-gauge needle and the same number of other blastocysts were shrunk by a laser pulse. We evaluated the shrunken blastocysts hourly and considered them viable if they re-expanded >70%. Blastocyst transfer cycles (n=134) were divided into two groups: a control group consisted of the cycles whose intact embryos were transferred (n=100), while the AS group consisted of the cycles whose embryos were replaced following AS (n=34). The implantation and pregnancy rates of the control group and AS group were compared (p<0.05). RESULTS: The re-expansion rates of the 29-gauge needle and laser pulse AS groups were similar (56 [76.7%] vs. 62 [84.9%], respectively). All of the remaining shrunken blastocysts were re-expanded within 2 hours. There was no degeneration of shrunken blastocysts. The total and clinical pregnancy rate of the AS group (23 [67.6%]; 20 [58.8%], respectively) was significantly higher than that of the control group (47 [47.0%]; 39 [39.0%], respectively). In the older patient group, there was no difference in the clinical outcomes between the AS and control groups. CONCLUSION: These results suggest that AS of blastocoele cavity, followed by the transfer, would be a useful approach to improve the clinical outcome in cycles in which fresh blastocyst stage embryos are transferred.
Blastocyst ; Embryo Transfer ; Embryonic Structures ; Fertilization in Vitro ; Humans ; Needles ; Pregnancy Rate

OBJECTIVE: The aim of this study was to compare vitrification optimization of mouse embryos using electron microscopy (EM) grid, cryotop, and thin plastic strip (TPS) containers by evaluating developmental competence and apoptosis rates. METHODS: Mouse embryos were obtained from superovulated mice. Mouse cleavage-stage, expanded, hatching-stage, and hatched-stage embryos were cryopreserved in EM grid, cryotop, and TPS containers by vitrification in 15% ethylene glycol, 15% dimethylsulfoxide, 10 microg/mL Ficoll, and 0.65 M sucrose, and 20% serum substitute supplement (SSS) with basal medium, respectively. For the three groups in which the embryos were thawed in the EM grid, cryotop, and TPS containers, the thawing solution consisted of 0.25 M sucrose, 0.125 M sucrose, and 20% SSS with basal medium, respectively. Rates of survival, re-expansion, reaching the hatched stage, and apoptosis after thawing were compared among the three groups. RESULTS: Developmental competence after thawing of vitrified expanded and hatching-stage blastocysts using cryotop and TPS methods were significantly higher than survival using the EM grid (p<0.05). Also, apoptosis positive nuclei rates after thawing of vitrified expanded blastocysts using cryotop and TPS were significantly lower than when using the EM grid (p<0.05). CONCLUSION: The TPS vitrification method has the advantages of achieving a high developmental ability and effective preservation.
Animals ; Apoptosis ; Blastocyst ; Dimethyl Sulfoxide ; Embryonic Structures ; Ethylene Glycol ; Ethylenes ; Ficoll ; Mental Competency ; Mice ; Microscopy, Electron ; Plastics ; Sucrose ; Vitrification

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
Classification* ; Constriction, Pathologic* ; Drug Therapy ; Fluorescein ; Fluorouracil ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Silicon ; Silicones ; Tears

Wolf-Hirschhorn syndrome is caused by a partial loss of the distal short arm of chromosome 4. Characteristic clinical features are severe growth retardation, mental retardation, seizures, congenital cardiac defects, urogenital abnormalities, microcephaly, hypertelorism, prominent glabella, cleft lip and palate and micrognathia. In 87% of cases, chromosome 4 deletion arises as a de novo event, whereas in the remaining cases it is derived from a familial balanced translocation. Chromosomal study of the patient showed 46 XX der(4)t(4;18)(p15.2;q23), and the patient's mother was found to have a balanced translocation, 46 XX t(4;18)(p15.2;q23).
Arm ; Chromosomes, Human, Pair 4 ; Cleft Lip ; Humans ; Hypertelorism ; Intellectual Disability ; Microcephaly ; Mothers ; Palate ; Seizures ; Urogenital Abnormalities ; Wolf-Hirschhorn Syndrome*

BACKGROUND: Left ventricular diastolic dysfunction may precede systolic dysfunction and play a major role in producing the signs and symptoms of congestive heart failure. Ischemic heart disease can cause impairment of left ventricular filling without any alteration in systolic function so it is very important to evaluate relationship of left ventricular diastolic dysfunction and ischemic heart disease. The purpose of this study is to investigate left ventricular diastolic dysfunction during transient myocardial ischemia caused by balloon occlusion. METHODS: We prospectively studied 20 patients(11 males and 9 females, mean age : 58.5+/-5.9 years) who had been undergone coronary angiography and confirmed significant luminal stenosis(> or =75%)in proximal or middle portion of left anterior descending artery. After coronary angiography, percutaneous transluminal coronary angioplasty were performed all patients. We measured early propagation slope of left ventricular inflow, time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip and normalized TD(nTD) which dividing TD by the distance of mitral opening to apical region using color M-mode Doppler echocardiography, peak earaly diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave using pulsed wave Doppler echocardiography, left ventricular end diastolic pressure using left heart catheterization. A color M-mode Doppler echocardiography, pulsed wave Doppler echocardiography and left ventricular end diastolic pressure were recorded before, during 30sec, 60sec & 90sec and after 60sec & 180sec balloon occlusion. RESULTS: Early propagation slope of left ventricular inflow was significantly decreased during 30sec & 60sec balloon occlusion and significantly increased after 60sec & 180sec balloon occlusion, respectively (64.45+/-28.23cm/sec, 39.37+/-11.77cm/sec, 32.78+/-11.77cm/sec, 51.86+/-19.78cm/sec, 65.05+/-29.99cm/sec, p<0.05). Time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(60+/-20msec, 90+/-30msec, 110+/-30msec, 80+/-20msec, 60+/-20msec, p<0.05). Normalized time difference(nTD) was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(11.24+/-3.87msec/cm, 17.76+/-6.67msec/cm, 21.51+/-6.67msec/cm, 15.22+/-4.00msec/cm, 12.63+/-3.59msec/cm, p<0.05). Left ventricular end diastolic pressure was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(9.70+/-3.88mmHg, 14.15+/-6.49mmHg, 17.00+/-7.14mmHg, 10.20+/-3.68mmHg, 8.75+/-3.16mmHg, p<0.05). Peak early diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave were not significantly different(p>0.05). CONCLUSIONS: These data suggest that transient myocardial ischemia can cause left ventricular diastolic dysfunction and color M-mode Doppler echocardiography is very sensitive diagnostic method to detect early diastolic dysfunction compare to other echocardiographic diastolic indices.
Acceleration ; Angioplasty, Balloon, Coronary ; Arteries ; Balloon Occlusion ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Angiography ; Deceleration ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Female ; Heart Failure ; Heart Ventricles* ; Humans ; Male ; Myocardial Ischemia* ; Phenobarbital ; Prospective Studies