Comparison of IVF-ET Outcome after Various Therapeutic Approaches for Ovarian Endometriomas / 대한불임학회지

OBJECTIVE: To compare COH characteristics and IVF outcomes among IVF-ET patients who were treated with various therapeutic modalities for ovarian endometriomas and to propose effective pre-cyclic therapeutic modalities to improve IVF-ET outcomes in the patients with ovarian endometriomas. METHODS: All cases that had undergone IVF-ET after laparoscopy between January 1997 to August 2003 were reviewed. Forty-eight patients with tubal factor were assigned to Group I. Twenty seven, 22 and 38 patients diagnosed as severe pelvic adhesion with ovarian endometriomas by laparoscopy received only medical therapy (Group II), cyst aspiration (Group III), and sclerotherapy (Group IV), respectively. Laparoscopic cystectomy was performed in 20 patients (Group V). Resistance index was measured on day administering hCG. RESULTS: As compared with Group I, in Group II resistance index increased (p<0.05) but number of oocytes, good-quality oocyte ratio (mature and intermediate oocytes/total retrieval oocytes), fertilization rate, and embryo development rate decreased (p<0.05). In Group III fertilization rate and embryo development rate decreased (p<0.05). There was no difference between Group IV and Group I in all parameters except basal FSH which increased (p<0.05). In Group V basal FSH, and resistance increased (p<0.05) and number of oocytes and good-quality oocytes ratio decreased (p<0.05). CONCLUSION: Sclerotherapy is an effective therapeutic option which can be done prior to IVF-ET cycles in the patients with ovarian endometriomas. Further studies on a large scale are necessary to confirm these data.

Anesthetic Management of a Pregnant Patient with Severe Form of Preeclampsia and Cardiac Tamponade associated with Hypothyroidism for Emergency Cesarean Section: A case report / 대한마취과학회지

A 29-year-old gravida 1, para 0 patient was admitted at 31 weeks gestation with hypertension, proteinuria and generalized edema. Three days after admission, she developed cardiac tamponade, a severe form of preeclampsia, and premature labor. Anesthesia for pericardiocentesis consisted of local anesthetic infiltration of the anterior chest wall, supplemented with an oxygen mask(5 L/min). After drainage of pericardial fluid, emergency cesarean section was performed under general anesthesia. After surgery, she was studied for the cause of the cardiac tamponade, and subsequently was diagnosed to have hypothyroidism. Pericardial effusion as a hypothyroidism associated sign, is something that is frequently found; nevertheless, cardiac tamponade as the first sign of this disease may be considered exceptional especially in a pregnant woman. We exprienced a case of hypothyroidism during a 29-year-old woman's first pregnancy, complicated by a severe form of preeclampsia and pericardial effusion.

Identification of High Risk Group of HPV associated with Cervical Cancer in Korean Women / 대한산부인과학회잡지

OBJECTIVE: To identify genital HPV types and high risk group of HPV associated with cervical cancer in Korean women. METHODS: Both Pap test and HPV-DNA test using PCR assay were performed as screening test for cervical cancer in this clinic. When patients were positive in HPV-DNA test, HPV genotyping using sequencing method and cervical biopsy were performed. RESULTS: Frequent age group of HPV infection was 40 yrs (34.3%) and prevalence of HPV infection was 9.8%. Twenty-three types of HPV were detected. HPV 16 and 58 were detected in invasive cancer. HPV 16, 31, 33, 45, and 58 were detected in HSIL. HPV 6, 11, 18, 53, 59, and 66 were detected in LSIL. HPV 16 was most commonly detected in HSIL and invasive cancer. CONCLUSION: HPV 16, 31, 33, 45, and 58 are included in high risk group of HPV in Korean women. It may be very effective in early detection of cervical cancer to classify HPV types included in high risk group of cervical cancer in Korean women and to perform cervical biopsy in the patients who have high risk types of HPV infection.

Identification of High Risk Group of HPV associated with Cervical Cancer in Korean Women / 대한산부인과학회잡지

OBJECTIVE: To identify genital HPV types and high risk group of HPV associated with cervical cancer in Korean women. METHODS: Both Pap test and HPV-DNA test using PCR assay were performed as screening test for cervical cancer in this clinic. When patients were positive in HPV-DNA test, HPV genotyping using sequencing method and cervical biopsy were performed. RESULTS: Frequent age group of HPV infection was 40 yrs (34.3%) and prevalence of HPV infection was 9.8%. Twenty-three types of HPV were detected. HPV 16 and 58 were detected in invasive cancer. HPV 16, 31, 33, 45, and 58 were detected in HSIL. HPV 6, 11, 18, 53, 59, and 66 were detected in LSIL. HPV 16 was most commonly detected in HSIL and invasive cancer. CONCLUSION: HPV 16, 31, 33, 45, and 58 are included in high risk group of HPV in Korean women. It may be very effective in early detection of cervical cancer to classify HPV types included in high risk group of cervical cancer in Korean women and to perform cervical biopsy in the patients who have high risk types of HPV infection.

The Effects of the Induction of Anesthesia and Tracheal Intubation with Sevoflurane on Blood Pressure, Heart Rate and BIS Value in Adults / 대한마취과학회지

BACKGROUND: Sevoflurane permits the rapid induction and control of anesthetic depth, and its lack of pungency permits anesthesia to be induced by administering it using a face mask. The goal of this study was to evaluate the possibility of induction and tracheal intubation without neuromuscular blocking drugs in adult patients given high inspired concentrations of sevoflurane (8%). METHODS: Fifty adult patients received 8% sevoflurane with nitrous oxide (2 L/min) and oxygen (2 L/min) by face mask until tracheal intubation. Patients exhaled to residual volume and deeply inspired the gas mixture following introduction. The time of response loss from introduction was noted as the induction time. The change of blood pressure, heart rate and bispectral index (BIS) value during induction and tracheal intubation were also determinated. Jaw relaxation, vocal cords position, and intubating response were used to assess intubation condition. RESULTS: Mean time for induction of anesthesia was 42.4+/-4.7 seconds and mean time to acceptable intubating conditions was 300.5+/-32.7 seconds. The average BIS values at the time of induction and at the time of intubation were 79.3+/-22.0 and 23.8+/-10.6 respectively. The average time for a BIS value under 40 was 105.5+/-30.8 seconds. Systolic blood pressure, heart rate and BIS values were decrease significantly during the induction of anesthesia (P < 0.05). A significant increase was observed in systolic blood pressure, diastolic blood pressure, heart rate and BIS values were noted after tracheal intubation (P < 0.05). In response to intubation, the incidence of good tracheal intubation was 16%, acceptable 69% and poor 15%. CONCLUSIONS: The induction of anesthesia in adult patients administered sevoflurane at highconcentration (8%), by face mask, approached the speed of intravenous induction. But the technique did not always make produce satisfactory tracheal intubating conditions without neuromuscular blocking drugs.

Evaluation of rep-PCR Genomic Fingerprinting for the Molecular Systematics Study of Yersinia Species

No abstract available.

Analysis of the Process for Unrelated Stem Cell Donor Search / 대한혈액학회지

BACKGROUND: Between 1994 and 1999, 38,264 potential marrow donors typed for HLA- A, -B, and -DRB1 antigens had been recruited in the Korean registries. During the same period, 131 unrelated transplants have been carried out in Korea. In present study, the search procedure within the last two years for an unrelated donor at the Catholic University of Korea is analyzed. METHODS: The search for an unrelated donor for 287 patients was performed. Low resolutional HLA-A and -B typing was performed by serology and HLA-DRB1 typing was done by DNA-typing. We analyzed HLA match rate, the intervals between search activation and transplant, coordination success rate, and the reasons of coordination failure. We also investigated the RESULTS of donor search process through the Japan Marrow Donor Program (JMDP) and Tzu-Chi Taiwan Marrow Donor Registry (TCTMDR). RESULTS: At least one HLA-identical donor has been found for 54.7% of 287 patients in the first search using the Korean registries. As of the end of July 2000, 53 patients had received unrelated transplants and the coordination success rate was 33.8%. The average interval to transplant with the Korean registries was 128 days. The most common diagnosis in the patients who underwent transplantation was CML. Among 47 patients who registered in the JMDP, 25 patients found at least one HLA- identical donor. Twelve of them were transplanted. The average time to transplants was 149 days. Since February 2000, we have registered 22 patients in the TCTMDR. Four of them had one HLA-matched donor and transplants are now in progress. CONCLUSION: The donor pool is rapidly expanding and the patients who receive unrelated transplant are also increasing in Korea. From these data, we realized that the international collaboration of Asian countries would be very important for facilitating unrelated transplants for patients who could not find suitable donor in their national registries.

The Effects of Succinylcholine on the Neuromuscular Block of Mivacurium / 대한마취과학회지

BACKGROUND: We studied the interaction between Succinylcholine (SCh) and mivacurium when mivacurium was administered during early and late recovery from SCh block was investigated. METHODS: Eighty patients undergoing elective surgery under general anesthesia were studied. General anesthesia was induced and maintained with propofol under TCI control. Neuromuscular function was measured in response to TOF stimulation of the ulnar nerve using an electromyographic method. The patients were allocated randomly to the following four groups; group 1 (n = 20): a bolus intravenous injection of 0.08 mg/kg mivacurium; group 2 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 2 minutes of 1 mg/kg SCh injection; group 3 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 25% recovery of initial twitch height from twitch height depression induced by 1 mg/kg SCh; group 4 (n = 20): intravenous injection of 0.08 mg/kg mivacurium after 75% recovery of initial twitch height from twitch height depression induced by 1 mg/kg SCh. The onset and duration of neuromuscular blockade, recovery rate and TOF ratio at T75% were measured. RESULTS: The onset of block in groups 3 and 4 were slower than in group 1 (5.2 +/- 0.7 and 2.3 +/- 0.6 vs 2.5 +/- 0.4 min P < 0.05). The clinical duration in groups 2 and 3 were longer than in groups 1 and 4 (12.5 +/- 2.1 min and 11.3 +/- 1.7 min vs 17.0 +/- 3.0 min and 18.5 +/- 2.6 min, p < 0.05). There was no difference in recovery index all groups. The TOF ratio of groups 2, 3 and 4 were smaller than for group 1 (38.2 +/- 5.3, 32.3 +/- 5.6 and 31.5 +/- 4.2 vs 56.0 +/- 7.3, P < 0.05). CONCLUSIONS: The Previous 1 mg/kg SCh injection was affected the time course of action of mivacurium 0.08 mg/kg-induced neuromuscular block.

The Effects of Mixture of Mivacurium and Vecuronium on Neuromuscular Blockade during General Anesthesia / 대한마취과학회지

BACKGROUND: This study was designed to examine the interactions between mivacurium and vecuronium when administered during a standardized technique. METHODS: Eighty patients (ASA physical status I or II) were randomly assigned to one of four groups (n=20). Their neuromuscular function was measured in response to ulnar nerve supramaximal square-wave TOF stimulation at 10-sec intervals. After the attainment of a stable baseline neuromuscular response, the patients were randomly assigned to receive a rapid iv bolus of either: (1) 3M group (n=20): mivacurium 0.21 mg/kg. Alone, or (2) 2M1V group (n=20): mivacurium 0.14 mg/kg plus vecuronium 0.05 mg/kg, or (3) 1M2V group (n=20): mivacurium 0.07 mg/kg plus vecuronium 0.10 mg/kg, or (4) 3V group (n=20): vecuronium 0.15 mg/kg alone. The onset time of the neuromuscular block, time of recovery of T1 to 25% and reblock time (the time from the reinjection of vecuronium at the time of recovery of T1 to 25% to the time of recovery of T1 to 25%: T25-25) were measured. The intubating condition was evaluated clinically with a scoring system. RESULTS: The onset of block in the 3M group was 33% slower than in the 3V group. The time durations until 25% recovery in the 2M1V, 1M2V and 3V groups were longer than in the 3M group, and the durations in the 1M2V and 3V groups were longer than in the 2M1V group. The T25-25 reblock times of the 2M1V, 1M2V and 3V groups were prolonged in comparison to that of the 3M group. There was no difference in intubating conditions between any of the groups. CONCLUSIONS: A combination of mivacurium with vecuronium provides rates of onset and duration of block which are more effective than an equivalent dose of mivacuriun alone as an additive reaction.

Postoperative Epidural Fibrosis: An Erroneous Diagnosis as Epidural Abscess after Epidural Block: A case report / 대한마취과학회지

The epidural abscess, while rare, should be taken seriously, as it can result in permanent neurological complications. Fever, back pain, leukocytosis and elevation of Erythrocyte Sedimentation Rate (ESR) are major signs and symptoms of epidural abscesses. But clinical recognition of such abscesses may be very difficult because of nonspecific symptoms or signs as well as previous or underlying painful disorders. Few cases has been reported of epidural abscess and epidural fibrosis associated with back surgery or temporary epidural blocks. In these cases, however, fever, low back pain, sciatica and elevation of ESR were the major findings. Magnetic Resonance Imaging findings after Gadolinium- diethylenetriaminopenta-acetic acid (Gd-DTPA) enhancement show central low signal intensity and surrounding high signal intensity at the anterior epidural space between the 5th lumbar and 1st sacral vertebrae. We suspected an epidural abscess caused by epidural block, and so operated. But our operative finding was epidural fibrosis without abscess. Our final pathological diagnosis was epidural fibrosis.