• Clinical and Experimental Reproductive Medicine
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• v.36 no.4
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• pp.301-310
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• 2009

Objective: To compare the embryonic development and pregnancy results using sperms retrieved from fresh and frozen-thawed testicular tissue in patients with obstructive (OA) and non-obstructive azoospermia (NOA). Methods: A total two hundred twenty-two cycles of TESE-ICSI were performed in OA and NOA. Sperms were retrieved from fresh and frozen-thawed testicular tissue. ICSI was performed patient's own sperm. Fertilization was assessed 16~18 hrs after ICSI. Embryo development and pregnancy rates were analysed. Results: The fertilization rates were significantly different between OA and NOA patients (75.2% vs. 56.7%, p<0.05), however, embryo development did not differ between the groups (96.9% vs. 98.0%). Likewise, OA and NOA groups had no differences in their clinical pregnancy and delivery rates, 33.9% vs. 36.0% and 28.1% vs. 28.0%, respectively. With regard to sperm retrieved from fresh testicular tissue, fertilization rates were significantly different between the OA and NOA groups (76.4% vs. 52.9%, p<0.05); however, embryo development, clinical pregnancy and delivery rates were not different. For sperm retrieved from thawed testicular tissue, the fertilization rates were significantly different between the two groups (74.7% OA group vs. 65.6% NOA group, p<0.05); however, embryo development, clinical pregnancy and delivery rates were not different. Conclusions: Embryo development and clinical pregnancy did not differ in patients with obstructive and non-obstructive azoospermia, whether sperm retrieved from fresh and thawed testicular tissue were used, although the fertilization rates were different. Therefore, ICSI with sperm retrieved from fresh and thawed testicular tissue could achieve relevant clinical pregnancy results in patients with azoospermia.

• Clinical and Experimental Reproductive Medicine
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• v.31 no.4
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• pp.253-260
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• 2004

Objectives: Klinefelter syndrome is the most common genetic cause of male infertility and presents with 47, XXY mainly or 46, XX/47, XXY mosaicism. It is characterized by hypogonadism and azoospermia due to testicular failure, however, sporadic cases of natural pregnancies have been reported. With the development of testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI), sperm can be retrieved successfully and ART is applied in these patients for pregnancy. It has been suggested that the risk of chromosome aneuploidy for both sex chromosome and autosome is increased in the sperms from 47, XXY germ cells. Considering the risk for chromosomal aneuploidy in the offspring, preimplantation genetic diagnosis (PGD) could be applied as a safe and more effective treatment option in Klinefelter syndrome. The aim of this study is to assess the outcome of PGD cycles by using FISH for sex chromosome and autosome in patients with Klinefelter syndrome. Materials and Methods: From Jan. 2001 to Dec. 2003, PGD was attempted in 8 cases of Klinefelter syndrome but TESE was failed to retrieve sperm in the 3 cases, therefore PGD was performed in 8 cycles of 5 cases (four 47, XXY and one 46, XY/47, XXY mosaicism). In one case, ejaculated sperm was used and in 4 cases, TESE sperm was used for ICSI. After fertilization, blastomere biopsy was performed in $6{\sim}7$ cell stage embryo and the chromosome aneuploidy was diagnosed by using FISH with CEP probes for chromosome X, Y and 17 or 18. Results: A total of 127 oocytes were retrieved and ICSI was performed in 113 mature oocytes. The fertilization rate was $65.3{\pm}6.0%$ (mean$\pm$SEM) and 76 embryos were obtained. Blastomere biopsy was performed in 61 developing embryos and FISH analysis was successful in 95.1% of the biopsied blastomeres (58/61). The rate of balanced embryos for chromosome X, Y and 17 or 18 was $39.7{\pm}6.9%$. The rate of aneuploidy for sex chromosome (X and Y) was $45.9{\pm}5.3%$ and $43.2{\pm}5.8%$ for chromosome 17 or 18, respectively. Embryo transfer was performed in all 8 cycles and mean number of transferred embryos was $2.5{\pm}0.5$. In 2 cases, clinical pregnancies were obtained and normal 46, XX and 46, XY karyotypes were confirmed by amniocentesis, respectively. Healthy male and female babies were delivered uneventfully at term. Conclusion: The patients with Klinefelter syndrome can benefit from ART with TESE and ICSI. Considering the risk of aneuploidy for both sex chromosome and autosome in the sperms and embryos of Klinefelter syndrome, PGD could be offered as safe and more effective treatment option.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.63-68
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• 2000

Purpose: MCDK is regarded as a common cause of abdominal masses in children. And the presentation of the MCDK is usually a unilateral flank mass in the a newborn. Bialteral disease results in either fetal demise or necessity fer renal replacement therapy at birth. This study is designed to assess the clinical features and natural history of the unilateral multicystic dysplastic kidney. Patients and Methods: From January 1987 to January 2000 data were obtained retrospectively on 57 patients (28 boys and 29 girls, age ranged 1day-11years) who had a diagnosis of multicystic dysplastic kidney. The diagnosis of multicystic dysplastic kidney was confirmed by a combination of ultrasonography and radionuclide scan. Voiding cystourethrogram study in 31 patients were done to determine the condition of the contalateral kidney. Restllts: $84\%$ of the patients were diagnosed before birth by antenatal ultrasonography Clinical manifestations of children with postnatal diagnoses were palpable abdominal mass($3.5\%$), abdominal distension($17\%$), and incidental($10.5\%$). The abnormalities in contralateral kidney were hydronephrosis($21\%$), compensatory hypertrophy($12\%$), simple cyst($2\%$), bifid pelvis($2\%$). Surgical management was performed in 20 patients($35\%$) due to recurrent infection, for diagnostic purpose to differentiate from malignancy and abdominal distention. Follow-up in the remaining 37 patients continued (mean 18 months) and results of sonogram findings were involution change in 23 patients($40\%$) and no interval changes in 13 patient($23\%$). Conclusions : The apparent tendency to regression of the dysplastic kidney and no difference in the number of complications justify a conservative management rather than operative intervention except in associated severe complications such as urinary tract infection or rupture of cysts.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.8
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• pp.1294-1301
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• 2004

Soy foods are a unique dietary source of isoflavones, which have effects relevant to prostate cancer prevention. The present study determines the effects of a short-term isoflavone supplement on serum PSA (prostate specific antigen), lipid profile, antioxidant status, and immune system in prostate cancer patients. Ten prostate cancer patients were supplemented daily with 150 mg of isoflavone for 2 months. Blood samples were collected baseline and 2 month after for analysis of PSA, serum lipid profiles, total antioxidant status (TAS), grade of DNA damage in lymphocytes, IL-6, VEGF and TNF -$\alpha$. After 2 month isoflavone supplementation, increased significantly a total of estimated urinary isoflavone excretion and did not change PSA. Serum lipid profiles showed significant change in serum total cholesterol level (p=0.007). However, there was no significant change in HDL- and LDL-cholesterol levels. TAS was increased but not significant after isoflavone supplementation. Tail moment (TM) was decreased and especially tail length (TL) was decreased significantly (p=0.043). IL-6 level was decreased but VEGF level and TNF -$\alpha$ level were increased. The results of the present study led to the conclusion that the isoflavone dosage (150 mg) in supplement had positive effects on the serum total cholesterol level and DNA damage.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.229-234
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• 2009

Purpose : The aim of this study was evaluating the efficacy of endoscopic $Deflux^{(R)}$ submucosal injection in children with primary vesicoureteral reflux (VUR). Methods : Retrospective analysis of medical record was conducted on 38 children (59 ureters) who underwent endoscopic $Deflux^{(R)}$ injection due to primary VUR. Data were collected from March 2000 to February 2006. Mean infused amount of $Deflux^{(R)}$ was 0.77 cc. After $Deflux^{(R)}$ injection, patients were reassessed by voiding cystourethrogram (VCUG) 6 months later. Results : The success rate of endoscopic $Deflux^{(R)}$ submucosal injection 6 months later by VCUG was 100% for grade 1 VUR, 87.5% for grade 2, 60% for grade 3, 26.6% for grade 4, 16.6% for grade 5, respectively and there was negatively significant correlation between success rate and grade of VUR (P<.01). Degree of improvement of VUR by endoscopic $Deflux^{(R)}$ submucosal injection was not related to age at diagnosis, time to operation, existence of voiding dysfunction or constipation and infused amount of $Deflux^{(R)}$. However, group with anticholinergics medication had significantly lower success rate than non-medication group (P<0.047). Conclusion : Endoscopic $Deflux^{(R)}$ submucosal injection is effective therapy in patient with primary VUR, especially low grade VUR. It can be not only a useful substitute for prophylaxis with antibiotics, but also an effective management prior to ureteroneocystostomy in children with primary VUR.

• Health Policy and Management
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• v.15 no.1
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• pp.97-117
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• 2005

This study was designed to compare the differences m results of supervisor and subordinate rating. Data was collected from personnel evaluation and subordinate rating results for middle managers(n=68) in hospital from 3rd January to 20th March in 2004. Supervisor rating consisted of performance, ability and attitude evaluation. Subordinate rating consisted of leadership, ability and attitude evaluation. Collected data included sociodemographic characteristics, work department, work level, years of work, years at present level and whether working in a patient serving department. The difference of standardized supervisor and subordinate rating score was used to define groups as 'higher in supervisor rating group'. Groups were defined in total score, ability score and attitude score. Main results were as follows: 1. In total score, sectional chiefs were apt to be 'higher in subordinate rating group' while chief clerks were apt to be 'similar group' or 'higher in supervisor rating group'. Staffs in patient serving department were likely to be 'higher in supervisor rating group' and staffs in non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 2. In ability score, there were no statistically significant differences in age, sex, years of education, work department, work level, years of work and whether working in a patient serving department among 'higher in supervisor rating group', 'similar group' and 'higher in subordinate rating group'. 3. In attitude score, staffs in the department of medical affairs and the department of administration were apt to be 'higher in subordinate rating group'. Staffs in the department of nursing were apt to be 'higher in supervisor rating group'. Staffs in a patient serving department were likely to be 'higher in supervisor rating group' and staffs in a non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 4. Logistic analysis about total score showed that sectional chiefs had higher Odds Ratio(OR) to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. Both these results were statistically significant. 5. Logistic analysis about ability score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. These results were not statistically significant. 6. Logistic analysis about total score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group', but the difference was not statistically significant. Staffs in a non-patient serving department had significantly higher OR to be in 'higher in subordinate rating group'. In conclusion, there is no clear superiority between supervisor and subordinate rating in personnel evaluation. It would be better to use a mixed model. It's also suggested to use an intervening rate of application or scores considering work levels and work department in personnel evaluation. These results would be helpful for hospitals planning a supervisor and subordinate rating system for personnel evaluation.

• Clinical and Experimental Reproductive Medicine
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• v.30 no.3
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• pp.207-215
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• 2003

Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.4
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• pp.293-301
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• 2008

Objective: To evaluate outcomes of patients with non-obstructive azoospermia (NOA) undergoing the testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection (ICSI) with different histopathologic subgroups. Method: A total of 122 embryo-transferred TESE/ICSI cycles were compared among NOA subgroups; Germ-cell aplasia (GA, 40 cycles), Maturation arrest (MA, 32 cycles) and severe hypospermatogenesis (S-HS, 50 cycles). Obstructive azoospermia (OA, 667 cycles) patients were served as a control. TESE/ICSI outcomes such as fertilization rate (FR), clinical pregnancy rate (CPR) and live birth rate (LBR) were evaluated. Results: The 2PN FR of embryo-transferred TESE/ICSI cycle was 58.1% in GA, 42.2% in MA and 48.0% in S-HS, which was significantly lower than that of OA (72.9 %, p<0.001). For ICSI-spermatozoa cycles, there were no significant differences in CPR (22.6%, 29.4% and 26.1%) and LBR (16.1%, 29.4% and 19.6%) among NOA subgroups. The CPR of ICSI-spermatid cycles was 0.0%, 9.1% and 0.0% without a live birth. For ICSI-spermatocyte cycles, no clinical pregnancies occurred in any group. Conclusion: There was no significant difference in the FR of embryo-transferred TESE/ICSI cycles among NOA subgroups. The FR among all NOA subgroups was significantly lower than that of OA. Testicular histopathology in NOA did not affect successful pregnancy if spermatozoa extraction from the testis is successful and embryo transfer is possible.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4773-4780
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• 2014

Background: To investigate the effects of small interference RNA (siRNA) targeting BCR/ABL mRNA on proliferation and apoptosis in the K562 human chronic myeloid leukemia (CML) cell line and to provide a theoretical rationale and experimental evidence for its potential clinical application for anti-CML treatment. Materials and Methods: The gene sequence for BCR/ABL mRNA was found from the GeneBank. The target gene site on the BCR/ABL mRNA were selected according to Max-Planck-Institute (MPI) and rational siRNA design rules, the secondary structure of the candidate targeted mRNA was predicted, the relevant thermodynamic parameters were analyzed, and the targeted gene sequences were compared with BLAST to eliminate any sequences with significant homology. Inhibition of proliferation was evaluated by MTT assay and colony-formation inhibiting test. Apoptosis was determined by flow cytometry (FCM) and the morphology of apoptotic cells was identified by Giemsa-Wright staining. Western blotting was used to analyze the expression of BCR/ABL fusion protein in K562 cells after siRNA treatment. Results: The mRNA local secondary structure calculated by RNA structure software, and the optimal design of specific siRNA were contributed by bioinformatics rules. Five sequences of BCR/ABL siRNAs were designed and synthesized in vitro. Three sequences, siRNA1384, siRNA1276 and siRNA1786, which showed the most effective inhibition of K562 cell growth, were identified among the five candidate siRNAs, with a cell proliferative inhibitory rate nearly 50% after exposure to 12.5nmol/L~50nmol/L siRNA1384 for 24,48 and 72 hours. The 50% inhibitory concentrations ($IC_{50}$) of siRNA1384, siRNA1276 and siRNA1786 for 24hours were 46.6 nmol/L, 59.3 nmol/L and 62.6 nmol/L, respectively, and 65.668 nmol/L, 76.6 nmol/L, 74.4 nmol/L for 72 hours. The colony-formation inhibiting test also indicated that, compared with control, cell growth of siRNA treated group was inhibited. FCM results showed that the rate of cell apoptosis increased 24 hours after transfecting siRNA. The results of annexinV/PI staining indicated that the rate of apoptosis imcreased (1.53%, 15.3%, 64.5%, 57.5% and 21.5%) following treamtne with siRNAs (siRNA34, siRNA372, siRNA1384, siRNA1276 and siRNA1786). Morphological analysis showed td typical morphologic changes of apoptosis such as shrunken, fragmentation nucleus as well as "apoptotic bodies" after K562 cell exposure to siRNA. Western blot analysis showed that BCR/ABL protein was reduced sharply after a single dose of 50nmol/L siRNA transfection. Conclusions: Proliferation of K562 cells was remarkbly inhibited by siRNAs (siRNA1384, siRNA1276 and siRNA1786) in a concentration-dependent manner in vitro, with effective induction of apoptosis at a concentration of 50 nmol/L. One anti-leukemia mechanism in K562 cells appeared that BCR/ABL targeted protein was highly down-regulated. The siRNAs (siRNA1384, siRNA1276 and siRNA1786) may prove valuable in the treatment of CML.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.129-135
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• 2017

Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.