Background: Although rhythm control could be the best for symptomatic atrial fibrillation (AF), some patients fail to achieve sinus rhythm (SR). This study aimed to identify clinical risk factors of failed electrical cardioversion (ECV). Methods: A total of 248 patients who received ECV for persistent AF or atrial flutter (AFL) were retrospectivelyreviewed. Patients were divided into three groups: Group 1 maintained SR for > 1 year, group 2 maintained SR ≤ 1 yearafter ECV, and group 3 failed ECV. SR maintenance was assessed using regular electrocardiography or Holter monitoring. Results: Patients were divided into group 1 (73, 29%), group 2 (146, 59%), and group 3 (29, 12%). The mean ageof patients was 60 ± 10 years, and 197 (79%) were male. Age, sex, and baseline characteristics were similar amonggroups. However, increased cardiac size, digoxin use, heart failure (HF), and decreased left ventricular ejection frac‑ tion (LVEF) were more common in group 3. Univariate analysis of clinical risk factors for failed ECV was increasedcardiac size [hazard ratio (HR) 2.14 (95% confidence interval [CI], 1.06–4.34, p = 0.030)], digoxin use [HR 2.66 (95% CI, 1.15–6.14), p = 0.027], HF [HR 2.60 (95% CI, 1.32–5.09), p = 0.005], LVEF < 40% [HR 3.45 (95% CI, 1.00–11.85), p = 0.038], and decreased LVEF [HR 2.49 (95% CI, 1.18–5.25), p = 0.012]. Among them, HF showed clinical significance only by multivariate analysis [HR 3.01 (95% CI, 1.13–7.99), p = 0.027]. Conclusions Increased cardiac size, digoxin use, HF, LVEF < 40%, and decreased LVEF were related to failed ECV for persistent AF or AFL. Among these, HF was the most important risk factor. Further multi-center studies including greater number of participants are planned.

OBJECTIVE: To determine the effects of leukemia inhibitory factor (LIF) on embryonal development in in vitro culture. METHODS: This is designed in vitro model using eggs from mouse. The eggs from mouse were assigned 29 for control group, 53 for 20 ng/ml of LIF, 88 for 40 ng/ml of LIF, 68 for 80 ng/ml of LIF respectively for in vitro fertilization. And 26 fertilized eggs at 2 cell stage from mouse also were assigned. The mouse embryos of all groups were cultured in medium supplemented with LIF in different concentrations, whereas the eggs in control group was cultured in medium without supplement of LIF. RESULTS: At 72 hours culture of eggs from in vitro fertilization, there was a slight increas in rate of embryonal development to morula in both LIF-20 and LIF-40 as results of 64.15% and 75% respectively, while 42.65% in inferior rate of LIF-80, compare with 51.72% in control group. But the difference between these each groups were not significant in statistically (p< or =0.05). And after 96 hours culture of eggs, the rates blastocyst formation was significantly higher in both LIF-20 and LIF-40 as 56.6% and 63.63% than those in control and LIF-80 as 44.83% and 35.29% respectively. On culturing eggs from in vivo fertilization, the rates of blastocyst formation was significantly not only higher as 85% and 81.81% respectively in medium supplemented with LIF-40 and LIF-80 than 42.3% in LIF-20 but also embryonal cell viability were remakedly improved at 96 hours after culture. CONCLUSION: The LIF in low dose is embryotrophic, but LIF in high dose is embryotoxic on eggs from in vitro fertilization. Whereas on culturing eggs from in vivo fertilization, LIF is more beneficial with dose dependent in high concentration.
Mice ; Animals

Placental site trophoblastic tumor(PSTT) is a rare form of gestational trophoblastic disease. This rare tumor has the potential for metastasis and death. The average age at onset of PSTT is 28 years, and the second believed to be postmenopausal at the time of diagnosis. The most common presenting complaint is amenorrhea or abnormal vaginal bleeding and rare complaints are virilization, nephrotic syndrome, uterine rupture, etc. The treatment of choice is surgical removal of the tumor, that is total abdominal hysterectomy with both salpingo-oophorectomy. We present a case of placental site trophoblastic tumor associated with spontaneous uterine rupture that is rare complication with a brief review of literature.
Amenorrhea ; Diagnosis ; Female ; Gestational Trophoblastic Disease ; Hysterectomy ; Neoplasm Metastasis ; Nephrotic Syndrome ; Trophoblastic Tumor, Placental Site* ; Trophoblasts ; Uterine Hemorrhage ; Uterine Rupture ; Virilism

OBJECTIVE: To evaluate the effect of serum obtained before and after treatment for endometriosis on in vitro fertilization and development of two cell mouse embryo. Design: Pretreatment and posttreatment comparoson of fertilization of mouse oocyte and embryo development in serum supplement form patients with endometriosis; result were compared using Stuent T-test analysis. METHOD: Infertility Clinic, Department of Obstetrics and Gynecology, Collage of Medicine, Won Kwang university, Korea. Patients was chosed eleven consecutive women with endometriosis. Interventions was all patient underwent laparoscopic or conservative surgery. This was followed by a 6-month course of burserelin acetate 900 microgram/d. Main outcome was measured total number of fertilization and embryo that was fertilization after 24 hours and reached blastocyst stage after 72 hours of incubation were compared before and after treatment. RESULT: Before treatment, 47% of the oocyte were fertilized and 31% of the embryo reached blastocyst stage. After treatment, Significantly more fertilized and Significantly more embryo developed to blastocyst on the stage I and II of endometriosis. CONCLUSION: The fertilization and embryo toxicity of serum samples from patients with endometriosis is lost after treatment.
Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures ; Endometriosis* ; Female ; Fertilization ; Fertilization in Vitro* ; Gynecology ; Humans ; Infertility ; Korea ; Mice* ; Obstetrics ; Oocytes* ; Pregnancy

OBJECTIVE: To study the clinical characteristics of pregnancy induced hypertension(PIH). METHODS: Five hundred seventy-five cases of PIH and 7,702 cases of normotensive pregnancies who were delivered their infants at Wonkwang University Hospital from January, 1994 to December, 1998 were selected for the study. The data were collected by review of the hospital record and the statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence of PIH was 7.1% of total deliveries. Among the PIH, the incidence of mild preedampsia was found in 59%, severe preeclampsia in 36%, and edampsia in 5%. The most prevalent gestational period was 38-42wks gestation in mild PIH and 33-37wks gestation in severe PIH & eclampsia. The incidence of cesarean section was significantly higher in severe PIH & eclampsia(72.2%) than in mild PIH(48.7%) and normotensive pregnancies(39.7%). The incidence of hypoalbuminemia, preterm labor, placental abruption, disseminated intravascular coagulation, and pulmonary edema were significantly higher in severe PIH & edampsia than in mild PIH and normotensive pregnancies. Compared with normotensive pregnancies or mild PIH, severe PIH & eclampsia had significantly elevated risks for low birth weight, intrauterine growth retardation, fetal distress, low apgar score, meconium stained, and neonatal deaths. CONCLUSION: The incidence of PIH is not decreasing and it still an important role in the cause of maternal and perinatal mortality and morbidity in Korea. So, further studies are necessary to prepare a guide for the treatment of PIH.
Abruptio Placentae ; Apgar Score ; Cesarean Section ; Disseminated Intravascular Coagulation ; Eclampsia ; Female ; Fetal Distress ; Fetal Growth Retardation ; Hospital Records ; Humans ; Hypertension, Pregnancy-Induced* ; Hypoalbuminemia ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Meconium ; Obstetric Labor, Premature ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy* ; Pulmonary Edema

OBJECTIVE: To ananlyze the direct effect of nitric oxide (NO), generated from sodium prusside (SNP) on the embryo developments in reproductive process. DESIGN: ova from mouse were treated to allow fertilization in in vitro culture. And the samples of fertilized ova were alloted into five alliqutos. Each alliquot was cultured in media treated with either concentration at 0 (n=92), 25microM (n=84), 50microM (n=80), 100microM (n=77), 500microM (n=54) of SNP. Main Outcome MEASURE: Rates of embryonal cell cleavages, viability and cell morphology were assessed during in vitro fertilization and culture. RESULTS: As analyse the cell cleavage at 24 hours after in vitro culture of fertilised egg in variuos NO concentration, all of egg cells of each alliquot were developed to 2~4 cell stage. But the alliquot of egg cells treated with 500microM, which were totally degenerated. And also all embryonal cells of each alliquot were developed to 8 cell stage and morula stage on culture continuosly. And the embryonal cells of each alliquot were analysed at 24 and 48 hours following the in vitro culture. The rates of cell fragmentation and fusion were 4.2+/-3.4% in control group which is not treated with NO, while experimental groups was high, as rated 23.4+/-6.2% in 25microM, 28.2+/-5.7% in 50microM and 32.1+/-6.4% in 100microM concentration of NO. Accordingly the rate of abnormal morphology of embryonal cell in control was lower significantly than that in each alliquot of experimental groups (p<0.05). And the degenerated rates of embryonal cells were 0% in control, 17.8+/-6.7% in 25microM, 23.6+/-4.7% in 50microM and 26.8+/-11.2% in 100microM at 8 cells and morula on culture of 48 and 72 hours. On the examination of embryonal cells developed to blastocyst through in vitro culture, the rates of degenerated cells were 16.8+/-7.2% in control, 37.5+/-6.2% in 25microM, 73.4+/-4.6% in 50microM, 100% in 100microM. CONCLUSION: This results suggeted that the No in any concentrations is harmful on embryos in view of morphology as well as viability of cell, and the toxicity of No on embryo is stronger at condition in higher concentration of NO.
Animals ; Blastocyst ; Embryonic Structures ; Fertilization ; Fertilization in Vitro ; Mice* ; Morula ; Nitric Oxide* ; Outcome Assessment (Health Care) ; Ovum ; Sodium

In order to elucidate the mechanism of oxidative damage of cadimu(Cd) on culturedmouse preimplantation embyors.The embryotoxocity of Cd was examined after cultured mouse preimplantation embryoswere exposed to various concentrations of CdCl2. In addition, the protected effect of antioxidant,catalase against Cd-induced embryotoxicity was investigated.CdCl2 decreased the development of cultured mouse preimplantation embryos in dose andtime-dependent manners, and also oxidative damage was involoved in Cd-induced embryotoxicityin mouse preimplantation embryos by the prevention of catalase on Cd-induced toxicity.
Animals ; Blastocyst ; Cadmium Chloride ; Cadmium* ; Catalase ; Embryonic Structures* ; Mice

In order to elucidate the mechanism of oxidative damage of cadimu(Cd) on culturedmouse preimplantation embyors.The embryotoxocity of Cd was examined after cultured mouse preimplantation embryoswere exposed to various concentrations of CdCl2. In addition, the protected effect of antioxidant,catalase against Cd-induced embryotoxicity was investigated.CdCl2 decreased the development of cultured mouse preimplantation embryos in dose andtime-dependent manners, and also oxidative damage was involoved in Cd-induced embryotoxicityin mouse preimplantation embryos by the prevention of catalase on Cd-induced toxicity.
Animals ; Blastocyst ; Cadmium Chloride ; Cadmium* ; Catalase ; Embryonic Structures* ; Mice

This study was undertaker to define the usefuness of preoperative CA-125 assay as a diagnostic bmor marker in differentiating malignancy from benign ovarian mass. Senun CA-125 were imneasured by Microparticle Enzyme Immunoassay(MEIA) in 94 patients with ovarian mass. The results were of follows ; 1. The mean value of preopentive senun CA-125 was 18.40u/ml in benign ovarian mass and 225.99u/ml in malignant ovarian mass (P<0.001). 2. The positive rete of Ca-125 in benign ovarian mass was 10%, compared 80% in malignant ovarian mass. 3. In analysis of histolovgic type, posisitive rate of serum CA-125 in malignant serous tumor was 82%, cornpared 50% in malignant mucinoins tumor. 2. No statistically significant correlation was observed between CA-125 value and patient's age. 5. The sensitivitiy, specifieity, positive predictive value & negative predictive value were 80%, 90%, 60% & 96%, respectively in cut off value, 35u/ml, And increasing cut off value 65u/ml, sensitivity, specificity, positive predictive value & negative predictive value were 40%, 96%, 67%, 90%, resqxetively. These data suggest the preperative serum CA-125 level correlate with maignant stattis in ovarian mass. And cut off value 35u/ml was better than 65u/ml in screening for ovarian cancer.
Humans ; Mass Screening ; Ovarian Neoplasms ; Sensitivity and Specificity

The cell cycle is composed of a series of steps which can be negatively or positively regulated by various factors. p53 gene aberrations are common in human malignancies, and recent studies suggest that in cervical carcinoma p53 function is inactivated either by complex formation wilh human papilloma virus (HPV) E6 product or by gene mutation. To study the expression of p53 gene in the cervical cancer and cervical intraepithebal neoplasia, immunohistochemistry for the p53 protein was done in the 47 cases of squamous cell carcinoma, 6 cases of adenocarcinoma and 32 cases of cervical intraepithelial neoplasia. I. The p53 protein was detected in the 31% of cervical intraepithelial neoplasia (10/32 cases). 2. The p53 protein was detected in the 55% of invasive cervical cancer (29/53 cases). 3. By the histologic type of cervieal cancer, the p53 protein was detected in the 57% of squamous cell carcinoma (27/47 cases) and 33% of(2/6 cases) adenocarcinoma. The p53 protein wes more frequently detected in the squamous cell carcinoma than in the adenocarcinoma. 4. By the staging in cervical cancer, the p53 protein was detected in the 31% of stage 0, 50% of Stage Ia, 50% of stage I b, 75% of IIa and 50% of stage II b.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Cycle ; Cervical Intraepithelial Neoplasia ; Genes, p53 ; Humans ; Immunohistochemistry* ; Papilloma ; Uterine Cervical Neoplasms*