No abstract available.
Blindness, Cortical* ; Diagnosis* ; Magnetic Resonance Imaging* ; Pregnancy*

It has been known that estradial(E2) level is concerned with the quality, number and growing of follicles. Determination of the serum levels of E2 has been used to predict the oocyte maturity. We experienced the rare case who has significantly low serum E2 level(551.26 pg/ml) in spite of multiple ovarian responses by sonographic finding, but from her we obtained 23 oocytes on MCD#16 after COH with ultrashort protocol(HP-FSH 150 IU, daily). The numbers of retrieved oocyte were 23 and fertilization rate was 56.6%, so the result of IVF-ET was successful twin pregnancy. Serum estradiol level and sonographic finding are essential to measure the number and growing of follicles, but E2 levels may be too unreliable to be used as sole parameter for the number and maturity of oocytes.
Estradiol* ; Fertilization ; Humans ; Oocytes ; Pregnancy ; Pregnancy, Twin ; Ultrasonography

No abstract available.
Sertoli-Leydig Cell Tumor*

Ceftriaxone is a commonly used antibiotic due to some of its advantages. Reversible gallbladder (GB) sludge or stone has been reported after ceftriaxone therapy. Most of these patients have no symptom, but the GB sludge or stone can sometimes cause cholecystitis. We experienced two patients who had newly developed GB stones after ceftriaxone therapy for diverticulitis and pneumonia, and this resolved spontaneously 1 month after discontinuation of the drug. Awareness of this complication could help to prevent unnecessary cholecystectomy.
Ceftriaxone ; Cholecystectomy ; Cholecystitis ; Cholecystolithiasis ; Diverticulitis ; Gallbladder ; Gallstones ; Humans ; Pneumonia ; Sewage ; Young Adult

The role of amino acids in culture media for IVF-ET was examined in a total of 76 cycles. Patients received clomiphene citrate (CC) followed by hMG or GnRH-a combined with gonadotropins (FSH/hMG) for controlled ovarian hyperstimulation. Severe male (<4 x10(6) motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. No significant differences were found in age, duration of infertility, follicle size, the level of E2 on the day of hCG injection, the mean number of oocytes retrieved, total motile sperm count, fertilization rate and the mean number of embryos transferred between bHTF (without amino acids) and mHTF (with amino acids) groups. However, total ampules of gonadotropins were higher (p<0.01) in mHTF group than bHTF group. Significantly (p<0.05) more clinical pregnancies were recorded in mHTF group (13/30) compared with bHTF group (9/46). The multiple pregnancy rates were 11.1% in bHTF group and 77% in mHTF group. There were one ectopic pregnancy in mHTF group and one heterotopic pregnancy in bHTF group. Abortion rates were 22.2% in bHTF group and 7.7% in mHTF, respectively The ongoing pregnancy or livebirth .ate was significantly (p<0.05) higher in mHTF group (12/30) than bHTF group (7/46). These results suggest that the addition of amino acids in culture media is essential for culture of zygotes in vitro and adjustment of energy substrates in phosphate-free culture media appears to be beneficial for human IVF-ET procedure.
Abortion, Induced ; Age Factors ; Amino Acids* ; Clomiphene ; Culture Media ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Gestational Sac ; Gonadotropins ; Humans* ; Infertility ; Male ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Multiple ; Sperm Count ; Ultrasonography ; Zygote

PURPOSE: Enterovirus (EV) infection in children can manifest various diseases from asymptomatic infection to nonspecific febrile illness, hand-foot-mouth disease, and aseptic meningitis. This study was aimed to investigate epidemiology and clinical significance of various genotypes of EV infections in pediatric inpatient. METHODS: We collected the stool samples from the admitted pediatric patients in Inha University Hospital from March 2014 to March 2015. EV detection and genotype identification were performed by real-time RT-PCR and semi-nested RT-PCR. Phylogenetic trees were constructed by neighbor joining method. RESULTS: A total of 400 samples were collected during study period and 112 patients (28%) were diagnosed with EV infections. The mean age of EV positive patients was 2.66 years (0.1-14) and sex ratio was 1.73:1. Genetic sequences of EVs were identified; coxsackievirus B5 (17, 15.2%), coxsackievirus A16 (13, 11.6%), enterovirus 71 (10, 8.9%), and coxsackievirus A2 (9, 8.0%). Nonspecific febrile illness (96, 86%) was the most common clinical manifestation and the duration of fever was 0-11 days (mean 3.1 days). Rash (44, 39%) and meningitis (43, 38%) were followed. Patients who were attending daycare center or had siblings accounted for 82.1%. Phylogenetic relationship tree revealed 6 distinct genogroups among 56 types of EVs. CONCLUSIONS: This study is the report of epidemiology, serotype distribution and clinical manifestations of children with EV infection in Incheon. This data will be helpful for further study about the epidemiology of EV infection in Korea.
Asymptomatic Infections ; Child ; Enterovirus* ; Epidemiology* ; Exanthema ; Fever ; Genotype ; Humans ; Incheon* ; Inpatients* ; Korea ; Meningitis ; Meningitis, Aseptic ; Sex Ratio ; Siblings ; Trees

OBJECTIVE: Appropriate placement of thoracic epidural catheter provides an adequate postoperative analgesia in chest and upper abdominal surgery. Usually, when thoracic epidural puncture is performed, both scapular lower tips and the thoracic (T)7 spinous process is assumed to be at the same horizontal level. The aim of this study is to identify the thoracic epidural puncture in the sitting position, with the neck flexed and arms crossed, may change the relationship between the thoracic vertebrae and the scapular lower tips. METHODS: One hundred patients with postoperative patient controlled epidural analgesia using thoracic epidural catheters were enrolled. It is presumed that the both scapular lower tips and T7 spinous process is at the equal level when performing thoracic epidural puncture. The actual insertion level of the Tuohy needle was examined by radiography when the patient was in the sitting position. RESULTS: Out of 100 patients, there were 62% that were in the same level as the scapular lower tips and T7 spinous process. However, 1% of the patients leveled at T4, 1% at T5, 25% at T6, 18% at T8, and 1% at T9. CONCLUSION: When performing the thoracic epidural puncture under the sitting position, the relationship of the T7 and the scapular lower tips may change. The change of position of scapular lower tips varied among T6.82+/-0.70. Therefore, to be precise, it is advised to utilize C-arm guide when epidural puncture is carried out.
Analgesia ; Analgesia, Epidural ; Arm ; Catheters ; Humans ; Neck ; Needles ; Punctures ; Thoracic Vertebrae ; Thorax

OBJECTIVE: To evaluate the effectiveness of CC+FSH or CC+hMG in intrauterine insemination (IUI) cycles for the treatment of infertility. METHOD: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days followed by hMG or FSH. A single IUI was performed at 36 h after hCG. Clinical pregnancy was classified if a gestational sac or fetal cardiac activity was seen on ultrasound. RESULTS: The overall clinical pregnancy rate was 19.1% per cycle (17/89) and 21.5% per patient (17/79). More clinical pregnancies were recorded in CC+FSH (23.1%, 6/26) than CC+hMG cycles (17.5%, 11/63), but this difference was not statistically significant. No differences were found in age, duration of infertility, follicle size, levels of estradiol (E2) on the day of hCG injection and total motile sperm counts between pregnant and non-pregnant groups. However, more ampules of gonadotropins were used in pregnant group than non-pregnant group (p<0.05). CONCLUSION: Combination of CC and hMG may economically be more effective to induce ovulation for IUI compared to CC and FSH.
Clomiphene* ; Estradiol ; Female ; Gestational Sac ; Gonadotropins ; Humans ; Infertility ; Insemination* ; Ovulation ; Pregnancy Rate* ; Pregnancy* ; Sperm Count ; Ultrasonography

OBJECTIVE: This study was designed to evaluate the effects of endogenous LH surge, GnRH agonist (GnRH-a) or human chorionic gonadotropin (hCG) as ovulation trigger on pregnancy rate by intrauterine insemination (IUI). METHOD: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days stating on the third day of the menstrual cycle followed by human menopausal gonadotropin (hMG) for ovulation induction. Follicles larger than >16 mm in diameter were present in the ovary, frequent LH tests in urine were introduced to detect an endogenous LH surge. Final follicular maturation and ovulation were induced by GnRH-a 0.1 mg (s.c.) or hCG 5,000~10,000 IU (i.m.) administration except natural ovulation. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. RESULTS: There were no differences in age, duration of infertility and follicle size, but more ampules of hMG were used in GnRH-a group compared to hCG 10,000 IU treated group (p<0.05). Lower level of estradiol (E2) on the day of hCG or GnRH-a injection was observed in hCG 10,000 IU group than other treatment groups (p<0.01). The overall clinical pregnancy rate was 19.8% per cycle (32/162) and 22.2% per patient (32/144). Pregnancy rate was higher in natural-endogenous LH surge group (37.5%, 9/24) than GnRH-a (18.8%) or hCG treated group (20.9% & 13.9%), but this difference was not statistically significant. No patient developed ovarian hyperstimulation. Abortion rate was 22.2% (2/9) in hCG 5,000 IU group. Delivery or ongoing pregnancy rate was 37.5% (9/24), 18.8% (3/16), 16.3% (7/43) and 13.9% (11/79) in endogenous LH surge, GnRH-a, hCG 5,000 IU and hCG 10,000 IU treatment groups, respectively. CONCLUSION: These results support the concept that use of natural-endogenous LH surge in stimulated cycles may be more effective to obtain pregnancies by IUI than GnRH-a or hCG administration.
Abortion, Induced ; Chorionic Gonadotropin ; Clomiphene ; Estradiol ; Female ; Gestational Sac ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Infertility ; Insemination* ; Menstrual Cycle ; Ovary ; Ovulation Induction ; Ovulation* ; Pregnancy Rate* ; Pregnancy* ; Ultrasonography

PURPOSE: Radiotherapy for head and neck cancer does not impair the voice quality as much as laser treatment or surgery, but it can induce muscle wasting and fibrosis and symptoms of dry mouth. We investigated the effect of irradiation on the myosin heavy chain (MyHC) expression in laryngeal muscles. MATERIALS AND METHODS: Rats were irradiated with one dose of 10, 15, 20, 25, 30, or 35 Gy and other rats were irradiated with 20 Gy. The thyroarytenoid (TA), posterior cricoarytenoid (PCA), and cricothyroid (CT) muscles were subjected to reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Two weeks after irradiation with 10, 15, or 20 Gy, all the MyHC type expressions had decreased in a dose-dependent manner in the TA, PCA, and CT muscles, and especially the expression of MyHC IIa decreased much more than the expressions of the other MyHC isoforms in all muscles. In the 20 Gy-irradiated rats, almost all the MyHC isoform expressions declined over 12 weeks in the TA, PCA, and CT muscles, except for the MyHC I expression in the PCA and CT muscle. The MyHC IIa expression was markedly decreased in all the muscles. CONCLUSION: The laryngeal muscles responded differently to radiation, but they showed a time-dependent and long-lasting decrease in the expressions of all the MyHC isoforms in the TA, PCA, and CT muscles. In particular, the expression of the MyHC IIa isoform in all the muscles may be more sensitive to irradiation than the expressions of the other MyHC isoforms.
Animals ; Body Weight/radiation effects ; Gene Expression/radiation effects ; Laryngeal Muscles/*metabolism/*radiation effects ; Myosin Heavy Chains/*metabolism ; Protein Isoforms/*metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction