OBJECTIVE: To analyze the clinical characteristics of obese infertile women. MATERIAL AND METHOD: Height, weight, body mass index, menstrual pattern, glucose, insulin, glucose / insulin ratio, dehydroepiandrosterone sulfate (DHEA-S), testosterone, free testosterone and plasminogen activator inhibitor (PAI-1) of 15 obese infertile women were tested. RESULTS: Of 15 obese infertile women, the number of diabetes mellitus, hyperinsulinemia, and insulin resistance was 2 (13%), 2 (13%), 2 (13%), respectively. The incidence of increased DHEA-S, testosterone, and free testosterone was 7 (47%), 1 (7%), 6 (40%), respectively. Notably, all patients showed increased PAI-1. CONCLUSIONS: Obesity is associated with infertility as well as many kinds of health problems. Obesity is closely related to insulin resistance and it also causes hyperandrogenism. Increased PAI-1 is one of the important causes of thrombophilia. Consequently, in the workup of obese infertile patient, many aspects of health problems should be considered.
Body Weight ; Dehydroepiandrosterone Sulfate ; Diabetes Mellitus ; Female ; Glucose ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Incidence ; Infertility ; Insulin ; Insulin Resistance ; Obesity ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Testosterone ; Thrombophilia

This retrospective study evaluated possible rupture of silicone gel breast implants in 92 patients. the series included patients undergone augmentation mammoplasty(n=59), and reconstructive mammoplasty(n=23) from Sep. 1993 to Aug. 1996. the age of implants ranged from 4 months to 8 years(mean:23.1months). of these, 19 cases displayed Ultrasonographic sings of rupture. of 13 implants removed, 7 were intact and 6 were ruptured. Implant contour deformities and radial folds are often seen in both ruptured and intact silicone implants and therefore cannot serve as reliable signs of rupture. A stepladder sign in intact implant is believed to be the result of reverberation artifacts within the interior of the implant. Due to these false-positive ultrasonographic findings, ultrasonographiy is not as absolutely reliable tool for the diagnosis of implant rupture. Alternative imaging methods(CT, MRI) are required to establish an accurate preoperative diagnosis.
Artifacts ; Breast Implants* ; Breast* ; Congenital Abnormalities ; Diagnosis ; Humans ; Retrospective Studies ; Rupture* ; Silicone Gels*

The incidence of the femoral neck fracture is increasing, and the mechanism of the injuries is quite different in the young and elderly groups (high energy injury and osteoporosis, respectively). In the young group, early anatomical reduction and rigid fixation by such measures as multiple cannulated screws are mandatory to decrease the complications. In the elderly group, hip arthroplasty is recommended to decrease the complications due to early mobilization.
Aged ; Arthroplasty ; Early Ambulation ; Femoral Neck Fractures ; Femur Neck ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Osteoporosis

Chromosomally derived sterility has long been recognized. A review of the literature of somatic chromosome investigations in infertile males has shown that 13.7% of azoospermic males and 4.6% of oligozoospermic males have an abnormal karyotype. In the first group, sex chromosome abnormalities predominate (mainly 47,XXY), whereas in the latter, autosome anomalies (i.e. Robertsonian and reciprocal translocations) are the most frequent. A similar review on meiotic studies revealed that meiotic chromosome anomalies can explain male infertility in 4.3-40.4% of patients. Recently, fluorescent in-situ hybridization studies on spermatozoa from infertile men were published; it was suggested that both X-Y pairing and pairing of the autosomes were impaired, resulting in spermatogenic disruption. It is estimated that there are 2,000 genes that regulate spermatogenesis, most of these being present on the autosomes, but there are approximately 30 genes on the Y chromosome. In general, autosomal genes that regulate spermatogenesis are concerned with regulation of metabolic processes in other cells in the body as well as in the cells of spermatogenesis, whereas Y genes are not essential for vital functions related to reproduction. To be able to provide proper counseling for those couples whose male infertility can now be treated by intracytoplasmic sperm injection, it is suggested that clinical investigations should include mitotic and meiotic studies, an analysis of the chromosome content of individual spermatozoa and a DNA analysis of blood and spermatozoa to detect partially deleted Y chromosome material. We have experienced a case of azoospermia associated with inversion of chromosome 1. So we report this case with a brief review of literatures.
Abnormal Karyotype ; Azoospermia* ; Chromosomes, Human, Pair 1* ; Counseling ; DNA ; Family Characteristics ; Humans ; Infertility ; Infertility, Male ; Male ; Metabolism ; Reproduction ; Sex Chromosome Aberrations ; Sperm Injections, Intracytoplasmic ; Spermatogenesis ; Spermatozoa ; Y Chromosome

A balanced translocation in a parent may produce unbalanced gametes leading to abortions or defective liveborn children, or interval infertility. It also may give rise to a balanced gamete resulting in a balanced carrier, or it may produce a cytogenetically normal gamete. The incidence of balanced chromosomal translocations in couples with multiple abortions was reported as 0% to 31%. This wide variation is related to the heterogeneous criteria used for patient selection. Because parents with balanced chromosomal rearrangements and history of only repeated abortions have a significant chance with each pregnancy of having a child with normal or balanced karyotype, the usual criteria for investigation include at least two abortions or reproductive losses. There is no evidence from several reported series that increasing the number of losses to three or more leads to any change in the yield of chromosomal rearrangements detected.
Abortion, Spontaneous* ; Child ; Family Characteristics ; Female ; Germ Cells ; Humans ; Incidence ; Infertility ; Karyotype ; Parents ; Patient Selection ; Pregnancy ; Translocation, Genetic

Pulsatile secretion of GnRH from the hypothalamus is a prerequisite for both the initiation and maintenance of the reproductive axis in humans. Failure of this episodic GnRH secretion results in the clinical syndrome of hypogonadotropic hypogonadism. Deficient GnRH secretion may occur in isolation (idiopathic hypogonadotropic hypogonadism: IHH), in association with anosmia (Kallmann syndrome), or as a result of a variety of structural and functional lesions of the hypothalamic pituitary axis. The familial occurrence of hypogonadotropic hypogonadism associated with anosmia, color blindness, synkinesia, and mental defect is the classic Kallmann syndrome. Affected individuals respond readily to pulsatile administration of exogenous GnRH, and clearly this is the most physiologic approach to ovulation induction. For women not seeking pregnancy, replacement therapy with exogenous estrogen and progestin is indicated. We have experienced a case of Kallmann syndrome which was conceived by administration of gonadotropin. So we report this case with a brief review of literatures.
Axis, Cervical Vertebra ; Color Vision Defects ; Estrogens ; Female ; Gonadotropin-Releasing Hormone ; Gonadotropins* ; Humans ; Hypogonadism ; Hypothalamus ; Kallmann Syndrome* ; Olfaction Disorders ; Ovulation Induction ; Pregnancy

OBJECTIVE: To understand the crucial requirement for the normal early folliculogenesis, we evaluated molecular as well as physiological differences during in vitro ovarian culture. Among the important regulators for follicle development, anti-Mullerian hormone (AMH) and FSH Receptor (FSHR) have been known to be expressed in the cuboidal granulosa cells. Meanwhile, it is known that c-kit is germ cell-specific and GDF-9 is also oocyte-specific regulator. To evaluate the functional requirement for the competence of normal follicular development, we investigated the differential mRNA expression of several factors secreted from granulosa cells and oocytes between in vivo and in vitro developed ovaries. MATERIALS AND METHODS: Ovaries from ICR neonates (the day of birth) were cultured for 4 days (for primordial to primary transition) or 8 days (for secondary follicle formation) in alpha-MEM glutamax supplemented with 3 mg/ml BSA without serum or growth factors. The mRNA levels of the several factors were investigated by quantitative real-time PCR analysis. Freshly isolated 0-, 4-, and 8-day-old ovaries were used as control. RESULTS: The mRNA of AMH and FSHR as granulosa cell factors was highly increased according to the ovarian development in both of 4- and 8-day-old control. However, the mRNA expression was not induced in both of 4- and 8-day in vitro cultured ovaries. The mRNA expression of GDF-9 known to regulate follicle growth as an oocyte factor was different between in vivo and in vitro developed ovaries. In addition, the transcript of GDF-9 was expressed in the primordial follicles of mouse ovaries. The mRNA expression of c-kit was not significantly different during the early folliculogenesis in vitro. CONCLUSION: This is the first report regarding endogenous AMH and FSHR expression during the early folliculogenesis in vitro. In conclusion, it will be very valuable to evaluate cuboidal granulosa cell factors as functional marker(s) for normal early folliculogenesis in vitro.
Animals ; Anti-Mullerian Hormone ; Female ; Granulosa Cells ; Growth Differentiation Factor 9 ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Mental Competency ; Mice ; Oocytes ; Ovary ; Real-Time Polymerase Chain Reaction ; Receptors, FSH ; RNA, Messenger*

Primary inoculation tuberculosis results from the direct inoculation of Mycobacterium tuberculosis into the skin of a person who has no natural or artificially acquired immunity to the organism. The pathogenesis requires a break in the skin from an abrasion or injury that allows entry of the tubercle bacilli. We report 3 cases of primary inoculation tuberculosis resulting from illegal acupuncture. Three patients over 70 years old presented with erythematous, ulcerative, indurated plaques on the back. Skin lesions had developed at the acupuncture sites 1 or 2 weeks after a session of acupuncture, which was intended to relieve back pain. An unlicensed, non-medically trained person conducted each session. The patients' past medical and family histories were unremarkable. Granulomatous inflammatory infiltration and acid-fast bacilli were observed histologically. M. tuberculosis was identified by mycobacterial culture and polymerase chain reaction. Nine months after the initiation of antituberculosis medication, skin lesions improved, and no evidence of recurrence or other organ involvement was observed at the 1-year follow-up visit.
Acupuncture ; Adaptive Immunity ; Back Pain ; Follow-Up Studies ; Humans ; Mycobacterium tuberculosis ; Polymerase Chain Reaction ; Recurrence ; Skin ; Tuberculosis ; Ulcer

PURPOSE: To compare the clinical and radiological results between the anterior and posterior screw fixation for the treatment of talar neck fracture. MATERIALS AND METHODS: Among 30 patients who received surgical treatment for talar neck fracture from 2001 to 2008. Twenty-seven patients with a follow-up period of more than 1 year were divided into two groups. Twelve patients were treated with anterior screw fixation and 15 patients with posterior approaches. We analyzed preoperative, postoperative and follow-up radiographs. Clinical results were evaluated by Hawkins criteria. RESULTS: The posteriorly inserted screws were placed across the more central portion of the talar neck and perpendicular to the plane of fracture (p<0.05). There were no difference in clinical results, the duration of union, and complications including avascular necrosis between two groups. However, 2 patients complained of pain around the talonavicular joint in the anterior insertion group. CONCLUSION: Although the clinical results were good irrespective of insertion methods, the posterior approach of screw fixation for talar neck fractures allows for a better mechanical advantage than anterioly placed screws. This may allow early motion with a reduced risk of failure of fixation or of displacement of the fracture.
Displacement (Psychology) ; Follow-Up Studies ; Humans ; Imidazoles ; Joints ; Neck ; Necrosis ; Nitro Compounds ; Talus

This study was carried out in order to study early histologic changes and repair reaction appling to extrusive force for 3rd premolar of adult dogs. After 1 week of extrusive force with elastic chain, one of dogs was sacrified and after 3 weeks retention period, another dog was sacrified. The paraffin sections of samples were stained with Hematoxylin - Eosin and Masson's Trichrome and were examed by light microscopy . The obtained results as follows. 1, In Hematoxylin - Eosin and Masson Trichrome stain of control group , the periodontal ligament width was constant from apical third to cervical third of the root and periodontal fiber arrangement was horizontal or oblique in cervical third, oblique in middle third, oblique in apical third of root. in alveolar bone, smooth appearance was shown. 2. In Group 1, all periodontal fiber arrangement was oblique toward tooth, and the periodontal ligament width increased . Partially PDL was ruptured in apex. In MT stain, immature bone formation was seen at alveolar crest area. Active bone formation was observed along the one side of alveolus, and apical portion of pulp was involved with blood vessel rupture , vacuolization of pulp tissue and hyperemia. 3. In Group 2, most periodontal ligament arrangement and PDL width was repaired and fiber density increased In MT stain, mineralization of immatuie bone on the alveolar crest was progressed. In pulp, vacuole and hyperemia was diminished and fibrotic change was diminished. 4. After 3 week periodontal ligament has more repair ability than pulp tissue. pulp was involved with vacuolization and fibrosis, so it takes more time for repair.
Adult ; Animals ; Bicuspid ; Blood Vessels ; Dogs* ; Eosine Yellowish-(YS) ; Fibrosis ; Hematoxylin ; Humans ; Hyperemia ; Microscopy ; Osteogenesis ; Paraffin ; Periodontal Ligament ; Rupture ; Tooth* ; Vacuoles ; Young Adult*