Follicular Blood Flow and Follicular Fluid Concentrations of Vascular Endothelial Growth Factor and Nitric Oxide as Prognostic Factors of IVF Outcome / 대한산부인과학회잡지

OBJECTIVE: The aim of this study was to investigate the relationship between follicular blood flow and the follicular fluid vascular endothelial growth factor (VEGF), and nitric oxide (NO) concentrations, and to determine which factor might be a better predictor of the outcome of IVF-ET. METHODS: In our prospective study, forty-seven cycles who underwent in vitro fertilization with tubal factor (25 cycles) and male factor (22 cycles) at the infertility clinic of Pusan National University Hospital from Feb. 2002 to June 2002 were assessed. Follicular blood flow was estimated on the day of hCG administration. Each follicular fluid was collected at the oocyte retrieval and follicular fluid VEGF and NO concentrations were assessed. According to the age of patients, the cause of infertility, and pregnancy rate, follicular blood flow and follicular fluid VEGF and NO concentrations were measured. RESULTS: Of 47 cycles, 18 cycles were pregnant (38.3%). Follicular blood flow was significant higher in the pregnant group compared to the nonpregnant group (p<.05), but there was no statistical significantly difference in the age and infertility cause. Follicular fluid concentrations of VEGF and NO were not statistically different in age, infertility cause, and pregnancy outcome. As follicle size increases, the follicular blood flow and follicular fluid VEGF concentrations increased significantly, but follicular fluid NO concentrations decreased. There was no correlation between VEGF and NO concentrations in follicular fluid by linear regression analysis. CONCLUSION: Our present study showed that follicular blood flow was positively associated with outcome of pregnancy as well as size of follicles, follicular fluid VEGF, but NO had no correlation with patient's age and pregnancy outcome. These results suggest that follicular blood flow might be a more effective prognostic marker of the pregnancy outcome of in vitro fertilization rather than follicular fluid VEGF and NO concentrations.

Transrectal Sonographically Guided Drainage of Tuboovarian Abscess (TOA) / 대한산부인과학회잡지

OBJECTIVE: We report six patients with tuboovarian abscess (TOA) drained through sonographically guided transrectal route, in whom percutaneous or transvaginal approach was not accessible due to the risk of pelvic organ. METHOD: This procedure was performed under the guidance of transrectal ultrasound. Six patients with aged 25-42 years (mean 31.6 years), who had appendectomy(1), C/S(2), hyterectomy(1) and no operaion Hx(2). Size of abscess cavity was variable from three to eight centimeter. Catheter was removed when drainage amount was reduced less than 10 cc and the patient becomes afebrile. RESULT: Drainage was successfully done in all patients without any complication to the procedure. Fecal contamination was not occurred after transrectal drainage due to abdominal pressure and gravity ought to empty the abscess cavity. There was no problem in defecation due to the catheter and in its expulsion by defecation. Catheter was removed after 3-8 days (mean 6 days) without recurrent abscess. CONCLUSION: Transrectal drainage of abscess performed with ultrasound guidance is a safe, feasible procedure, which is well tolerated by patient and relatively easy procedure.

A Case of Internal Jugular Vein Thrombosis Accompanied by Deep Neck Infection / 대한이비인후과학회지

The diagnosis of internal jugular vein thrombosis (IJVT), a vascular disorder, can be easily overlooked. Disruption of blood flow through the internal jugular vein can take place in a variety of clinical settings. CT and ultrasonography are useful diagnostic tools. Recently, we experienced a case of IJVT after deep neck infection. This case showed sore throat, odynophagia and swelling of right submandibular area. CT scan revealed diffuse neck swelling and incomplete occlusion of the right internal jugular vein at the thyroid level. Treatment began with antibiotics and hydration. We present a case of IJVT after deep neck infection with literature review.

Expression of Inducible Nitric Oxide Synthase in Rat and Guinea PigRespiratory Epithelium after Capsaicin Treatment / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) production in the respiratory epithelium and the demonstration of inducible nitric oxide synthase in ciliated epithelium of the upper airway have recently been reported. The aim of this study was to investigate the expression of inducible nitric oxide synthase in the nasal epithelium after capsaicin treatment, which stimulates the substance P innervation. MATERIALS AND METHODS: In vivo treatment -Capsaicin (112 nM) was applied to the nasal cavities of the rat and guinea pig, and 30 nl of normal saline was applied for the control groups. After 2 hours, animals were sacrificed with cardiac perfusion of 4% paraformaldehyde and septal mucosa were removed. The 8 nm serial frozen tissue sections were made, and the expression of inducible nitric oxide synthase was determined using nicotinamide adenine diphosphate-diaphorase histochemistry. In vitro treatment- The nasal septum of the rats and the trachea of the guinea pigs were incubated in DMEM culture media with or without 112 nM capsaicin for experimental or control groups. After 0, 30 or 120 minutes of incubation, the tissues were fixed and processed for nicotinamide adenine diphosphate-diaphorase histochemistry. RESULTS: Both in vivo and in vitro studies demonstrated that the strong positive histochemical reactivity were observed in the respiratory epithelium of the rats and guinea pigs after capsaicin treatment compared to control groups. CONCLUSION: These data imply that capsaicin induces the expression of inducible nitric oxide synthase and that the substance P innervation of the nasal mucosa may have a protective role in the airway defense mechanism through nitric oxide production.

Epidemiology of Low Back Pain / 대한척추외과학회지

STUDY DESIGN: The same contents of questionnaire about the low back pain(LBP) were conducted among the Korean and the Japanese hospital workers. OBJECTIVES: To compare the prevalence of LBP and the correlates of occupation and care-seeking. SUMMARY OF LITERATUR REVIEW: Previous epidemiological researches about LBP were usually performed within a country, Korean researches were for the Korean population and Japanese for the Japanese. MATERIAL & METHODS: The history, the cause, the frequency, the severity, and the method of treatment of LBP were compared between the Korean (N=336) and the Japanese (N=428) hospital workers RESULTS: The prevalence of past LBP history were higher in Korean (80%) than in Japanese case(68%), but the percentage of care-seeking (Japan: 64% & Korea: 49%) and lost workdays (9% & 7%) were inverted. The prevalence was the highest in nurse occupation (73% & 89%), and most of these cases reported the cause of LBP as work-related (72% & 71%), which was much higher than the other occupations (34% & 39%). Among the care-seeking (Japan: N=186, Korea: N=131), the percentage of hospital visit was higher in Japanese (43%) than in Korean case (24%). The other methods of care included pharmacy, massage, finger-pressure therapy, acupuncture and moxa, and these were similarly prefered by two countries. CONCLUSION: Epidemiology of LBP was compared between Japanese and Korean hospital worktors. Further study will be needed to compare the actual epidemiology of an LBP.(232 words)

A Case of Angiomyofibroblastoma of the Vulva / 대한산부인과학회잡지

Angiomyofibroblastoma is a recently described mesenchymal tumor characterized by unique morphologic features, a propensity to arise in the vulva, and a non-aggressive beni-gn biologic behavior. It is typically well circumscribed and superficially located tumor and its cellularity is variable with hypercellular and hypocellular areas composed of bland-looking, pump stromal cells showing the immunophenotype of vimentin-/desmin - positive, and muscle specific actin(MSA)-/alpha-smooth muscle actin(ASMA) - negative. Spindle or plasm-acytoid cells are the characteristic cell types of most tumors. It is similar to an aggressive pelvic angiomyxoma in histology. Because of histologic similarity and differences in the clinical course and treatment, distinction from aggressive angiomyxoma was needed. It rep-resents new type in the expanding spectrum of tumors of which myofibroblasts constitute an integral component. We experienced a case of angiomyofibroblastoma of the vulva occuring in a 42 years old woman. The lesion was relatively well encapsulated mass(3 X 1.5 X 0.9 cm in dimension), showing intimate admixture of hypercellular and hypocellular area. The tumor contained prominent, somewhat ectatic vessels surrounded by smooth muscle cells, some of which blend or fan out from the muscular walls of the vessels. The margin was relatively free from tumor cells. At immunohistochemical stain, vimentin and desmin was diffuse and weak positive, smooth muscle actin was very a few and weak positive in tumor cells.

A case of Sacrococcygeal Teratoma which was Antental Diagnosed by Ultrasonography / 대한산부인과학회잡지

Sacroccygeal teratoma(SCT) occurs in every 40,000 births and is the most common tumor in newborns. SCT predominantly develops in females and is almost always located in the gonadal or coccygeal region. Althoug the majority of tumors are usually benign, malignant degeneration is common and the prognosis is generally guraded. Therefore the early prenatal diagnosis and treatment are very important. The authors observed a case of SCT which was diagnosed by ultrasonagrapy at 30 weeks' gestation following IVF-ET procedure. Surgical removal of SCT of newborn was performed successfully following cesarean delivery at 38 weeks' gestation. The authors report this case with a brief review of the literatures.