No abstract available.
Dinoprostone* ; Membranes* ; Rupture* ; Suppositories*

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

Familial Adenomatous Polyposis (FAP) is a rare and autosomal dominantly inherited disorder characterized by the development of hundreds to thousands of colorectal polyps. Korean Polyposis Registry was established in July, 1990 for early detection and management of the FAP patient. Recently, we have experienced in our institution a case of the FAP family kindred living in Jeju Island of Korea. Their relatives have been managed for the past 20 years and are listed in the Korean polyposis registry. Pathologic diagnosis of our proband was stage III (T3N1M0) rectal cancer with thousands of colonic polyps. Intrafamilial strife and psychologic distress was significant due to the late detection and progression to rectal cancer. Therefore, we reviewed our case of the FAP family with literature regarding the psychologic distress and the role of the regional registry.
Adenomatous Polyposis Coli ; Colonic Polyps ; Diagnosis ; Humans ; Korea* ; Pedigree* ; Polyps ; Rectal Neoplasms

PURPOSE: To evaluate lung parenchymal change as seen on chest radiographs and high-resolution CT (HRCT) afterthe resolution of adenovirus pneumonia (a common cause of lower respiratory infection in infants and children),and the usefulness of HRCT during follow-up. MATERIAL AND METHODS: Four to 13(mean, 8) months after recovery, tenpatients infected with adenovirus pneumonia underwent HRCT and chest radiographs. Eight were boys and two weregirls, and their mean age was 26(range, 14-45) monthes. Adenovirus pneumonia had been confirmed by viral isolationin culture or serologic test. CT scanning was performed during quiet breathing ; collimation was 2mm and theinterval from apex to diaphragm was 5-10mm. Lung settings were 1600 HU (window width) and -700 HU(level). CTfindings were assessed and compared with chest radiographs by two chest radiologists, who reached a consensus. Thepatients were clinically followed up for one year. RESULT: On chest radiographs, hyperlucent lung was seen in 8of 10 patients (80%) ; in one other there was partial collapse, and in one, findings were normal. The most commonHRCT finding was a mosaic pattern of lung attenuation with decreased pulmonary vascularity in the area of lowerattenuation ; this was seen in 8 of 10 patients (80%). Other findingss were partial collapse, bronchiectasis, andbronchial wall thickening, each seen in two patients, and reticulonodular density, seen in one. In two patientsHRCT findings were normal ; in one of these, chest findings were noraml but a mosaic pattern of lung attenuationwas found in all lobes. During follow-up, three patients wheezed continously. CONCLUSION: In cases of adenoviruspneumonia, HRCT demonstrated more specific parenchymal change than did chest radiographs ; a mosaic pattern oflung attenuation was seen, with decreased pulmonary vascularity in areas of lower attenuation ; bronchiectasis,bronchial wall thickening, and reticulo-odular density were also noted. These findings were presumably due tobronchiolitis obliterans, a well known complication of adenovirus pneumonia, and are prognostically helpful.
Adenoviridae* ; Bronchiectasis ; Bronchiolitis Obliterans ; Consensus ; Diaphragm ; Follow-Up Studies ; Humans ; Infant ; Lung* ; Lung, Hyperlucent ; Pneumonia* ; Radiography, Thoracic* ; Respiration ; Serologic Tests ; Thorax* ; Tomography, X-Ray Computed

PURPOSE: To evaluate late lung parenchymal change, as seen on high-resolution CT(HRCT) in children with mycoplasma pneumonia MATERIALS AND METHODS: Twenty-three patients [15 boys and 8 girls aged two to 13 (mean, 6) years] with mycoplasma pneumonia underwent HRCT four to 39 (mean, 10) months after initial infection. Using increased mycoplasma antibody titer(> 1:640) mycoplasma pneumonia was diagnosed, and patients were divided into two groups : high titer group (antibody titer>1: 5120), and lower titer group (<1:5120). CT scans were performed using 2mm collimation and 5-10mm interval from apex to diaphragm. In seven patients who were cooperative, both inspiratory and expiratory scans were obtained at a window width of 1600 HU and level of -700. HRCT findings of mosaic low attenuations and changes in bronchioles and bronchial walls were assessed by three radiologists and correlated with initial chest radiographic findings. RESULTS: On HRCT, 17 of 23 patients (74 %) demonstrated abnormal findings. These included mosaic attenuation of lung density alone in 11 of 17 patients (65%), mosaic attenuation associated with bronchiectasis in five ( 29 %), and bronchiectasis only in one (6 %). Mosaic attenuation was more accentuated on expiratory scans than on inspiratory. These findings were obtained in 10 of 12 high titer group and in 7 of 11 in the lower titer group. In 15 of 23 patients (65 %), involved ageas seen on HRCT exactly corresponded with initially involved areas seen on chest radiographs (CXR). Two patients in whom findings on initial CXR were normal showed mosaic attenuation on HRCT. Six patients in whom such findings were abnormal showed normal findings on HRCT, a fact which reflected their complete recovery. CONCLUSION: The most common late parenchymal change in mycoplasma pneumonia, as seen on HRCT, was mosaic attenuation of lung density followed by bronchiectasis. The latter is presumably due to bronchiolitis obliterans, a well-known complication. We believe that HRCT is very useful for the evaluation of long-term sequelae of mycoplasma pneumonia in children.
Bronchiectasis ; Bronchioles ; Bronchiolitis Obliterans ; Child* ; Diaphragm ; Female ; Humans ; Lung* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Radiography, Thoracic ; Tomography, X-Ray Computed

OBJECTIVE: The purpose of this study was to evaluate female victims of sexual assault and assess the similarities and differences between them. METHODS: Case files and photographs of 59 women examined at Holy Family hospital for sexual assault during Jan 1, 1991 to Dec 31 2001 were reviewed. RESULTS: The mean age of the patients was 17.12 (+/-11.50). 45 (76.3%) of assailants were strangers to the victims. 35 (59.3%) had genital injuries and 8 (13.6%) needed surgical treatments. No victim was pregnant and 17 (28.8%) was reported to police. CONCLUSION: Sympathetic concern in the treatment of women who come forward to report the experience of sexual assaults will result in more reporting of rape. The victims need to be educated at home, at school, and by their primary care providers to avoid situations in which they could make themselves vulnerable to sexual assault, and they should be taught the importance of immediately reporting their assault and seeking medical care.
Female* ; Humans ; Police ; Primary Health Care ; Rape

BACKGROUND: The purpose of this study was to investigate the electrophysiologic characteristics and result of radiofrequency catheter ablation of patients with Wolff-Parkinson-White (WPW) syndrome associated with Ebstein's anomaly. METHODS: After performed radiofrequency catheter ablation in five (1 male, 4 females, average age 40.6) patients, we then evaluated their clinical manifestation, echocardiography and electrophysiologic characteristics. RESULTS: All patients had palpitation and two patients showed dizziness. In transthoracic echocardiography, all of the patients had severe tricuspid regurgitation and the mean distance of the septal tricuspid valve leaflet from the right atrioventricular annulus was 2.3 cm. In electrophysiologic study, eight accessary pathways were found in the 5 patients and all pathways were located on the right-side of the heart. Five manifest accessary pathways were found (one on the anterolateral, two on the lateral, one on the posterior, one on the posteroseptal wall) and three concealed pathways were found at posteroseptal wall. Three patients (60%) had multiple accessary pathways. The most common combination pattern was the manifest right lateral wall and concealed right posteroseptal wall accessary pathway. Catheter ablation of the concealed right posteroseptal accessory pathway was not successful in one patient with multiple accessary pathway. The average time of radiation was 56.0 minutes and the average time of procedure was 141.3 minute. CONCLUSION: WPW syndrome associated with Ebstein's anomaly had a high frequency of multiple accessary pathways and there was much difficulty in catheter ablation because morphologic and anatomical change of the heart structure. Further study will be necessary on the role of arrhythmia in atrialized right ventricle.
Arrhythmias, Cardiac ; Catheter Ablation* ; Dizziness ; Ebstein Anomaly* ; Echocardiography ; Female ; Heart ; Heart Ventricles ; Humans ; Male ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Wolff-Parkinson-White Syndrome*

OBJECTIVE: To study the clinical outcomes of single frozen-thawed blastocyst transfer cycles according to the hatching status of frozen-thawed blastocysts. METHODS: Frozen-thawed blastocysts were divided into three groups according to their hatching status as follows: less-than-expanded blastocyst (≤EdB), hatching blastocyst (HgB), and hatched blastocyst (HdB). The female age and infertility factors of each group were evaluated. The quality of the single frozen-thawed blastocyst was also graded as grade A, tightly packed inner cell mass (ICM) and many cells organized in the trophectoderm epithelium (TE); grade B, several and loose ICM and TE; and grade C, very few ICM and a few cells in the TE. The clinical pregnancy and implantation rate were compared between each group. The data were analyzed by either t-test or chi-square analysis. RESULTS: There were no statistically significant differences in average female ages, infertility factors, or the distribution of blastocyst grades A, B, and C in each group. There was no significant difference in the clinical pregnancy and implantation rate of each group according to their blastocyst grade. However, there was a significant difference in the clinical pregnancy and implantation rate between each group. In the HdB group, the clinical pregnancy and implantation rate were similar regardless of the blastocyst quality. CONCLUSION: There was an effect on the clinical outcomes depending on whether the blastocyst hatched during single frozen-thawed blastocyst transfer. When performing single frozen-thawed blastocyst transfer, the hatching status of the frozen-thawed blastocyst may be a more important parameter for clinical outcomes than the quality of the frozen-thawed blastocyst.
Blastocyst* ; Embryo Transfer* ; Epithelium ; Female ; Humans ; Infertility ; Pregnancy ; Retrospective Studies* ; Single Embryo Transfer ; Vitrification

BACKGROUND AND OBJECTIVES: The optimal AV delay should allow for the completion of the atrial contraction prior to the ventricular contraction, and provide for the longest diastolic filling and maximal stroke volume. This study evaluated the effects of the AV delay on the changes in heart functions, in patients with a DDD pacemaker and normal systolic function. SUBJECTS AND METHODS: Nineteen patients were enrolled. The pacing rate was set at 70 beats/min. The AV delay was lengthened in 20-25 msec step, from 100 to 250 msec. The stroke volume and diastolic parameters were measured by echocardiography for each AV delay. RESULTS: The changes in the stroke volume associated with the changes in the AV delay were not statistically significant. However, when viewing each individual patient, the optimal AV delay for each patient could be found. When comparing the stoke volumes obtained just before, just after, and during the maximal AV delay, a statistically significant difference was found (p< 0.05). The absolute value of the E/A ratio was less than 1. The pulmonic vein flow pattern was dominated by the systolic flow, but the changes were not statistically significant. There was a tendency for the E wave propagation slope to decrease. However, the absolute value was less than 40 cm/s, and the E/E' absolute ratio was more than 8, but neither showed any significant differences. CONCLUSION: In patients with a DDD pacemaker and normal systolic function, the diastolic parameters were abnormal, and the stroke volume affected by the change in the AV delay.
Diastole ; Dichlorodiphenyldichloroethane* ; Echocardiography ; Heart ; Humans ; Stroke Volume ; Veins