• Title/Summary/Keyword: SIM Protocol

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Minimal Stimulation using rhFSH and GnRH Antagonist for IVF Treated Patients of Advanced Age (고령 불임여성의 체외수정술시 최소자극법의 효용성)

  • Kim, So-Ra;Kim, Chung-Hoon;Lee, Jin-Kyoung;Jeon, Gyun-Ho;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.1
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    • pp.63-70
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    • 2009
  • Objective: This study was performed to investigate the effectiveness of minimal stimulation using rhFSH and GnRH antagonist compared with GnRH antagonist multidose protocol (MDP) in IVF treated patients with aged 40 and above. Methods: Seventy-five patients with aged 40 and above were equally randomized to minimal stimulation group (n=37) or GnRH antagonist MDP group (n=38). For minimal stimulation group, ultrasound monitoring was started on cycle day 7 or 8. Daily injections of 0.25 mg cetrorelix together with 150 IU rhFSH were started from the day at 13${\sim}$14 mm of a leading follicle diameter. For GnRH antagonist MDP group, daily injections of 225 IU rhFSH were initiated from cycle day 2 and GnRH antagonist was started at a dose of 0.25 mg/day on rhFSH stimulation day 6 or the day at 13${\sim}$14 mm of leading follicle diameter. In both groups, transvaginal ultrasound-guided oocyte retrieval was performed. According to cleavage and morphologic characteristics of embryos, embryos were transferred 3 to 5 days after oocyte retrieval. Results: There were no differences in patients' characteristics and cycle cancellation rate between the two groups. Total dose and duration of rhFSH used were significantly fewer and shorter in minimal stimulation group than those in GnRH antagonist MDP group. The numbers of oocytes retrieved, mature oocytes and transferred embryos were also lower in minimal stimulation group. However, there were no significant differences in the clinical pregnancy rate and miscarriage rate between the two groups. Conclusions: This study demonstrates that minimal stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP with fewer dose and days of rhFSH used, and thus can be a cost-effective alternative in women aged 40 and above.

Comparison of Urine Iodine/Creatinine ratio between Patients following Stringent and Less Stringent Low Iodine Diet for Radioiodine Remnant Ablation of Thyroid Cancer (갑상선암의 방사성요오드치료를 위한 저요오드식이 방법 차이에 따른 소변 중 요오드/크레아티닌 비의 비교)

  • Roh, Jee-Ho;Kim, Byung-Il;Ha, Ji-Su;Chang, Sei-Joong;Shin, Hye-Young;Choi, Joon-Hyuk;Kim, Do-Min;Kim, Chong-Soon
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.322-326
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    • 2006
  • A low iodine diet (LID) for $1{\sim}2$ weeks is recommended for patients who undergoing radioiodine remnant ablation. However, the LID educations for patients are different among centers because there is no concrete recommendation for protocol of LID. In this investigation, we compared two representative types of LID protocols performed in several centers in Korea using urine iodine to creatinine ratio (urine I/Cr). Methods: From 2006, April to June, patients referred to our center for radioiodine remnant ablation of thyroid cancer from several local hospitals which had different LID protocols were included. We divided into two groups, stringent LID for 1week and less stringent LID for 2 weeks, then measured their urine I/Cr ratio with spot urine when patients were admitted to the hospital. Results: Total 27 patients were included in this investigation (M:F=1:26; 13 in one-week stringent LID; 14 in two-week less stringent LID. Average of urine I/Cr ratio was $127.87{\pm}78.52{\mu}g/g$ in stringent LID for 1 week, and $289.75{\pm}188.24{\mu}g/g$ in less stringent LID for 2 weeks. It was significantly lower in stringent LID for 1 week group (p=0.008). The number of patients whose urine I/Cr ratios were below $100{\mu}g/g$ was 6 of 13 in stringent LID for 1 week group, and 3 of 14 in less stringent LID for 2 weeks group. Conclusion: Stringent LID for 1 week resulted in better urinary I/Cr ratio in our investigation compared with the other protocol. However it still resulted in plenty of inadequate range of I/Cr ratio, so more stringent protocol such as stringent LID for 2 weeks is expected more desirable.

Embryo Production in Superior Hanwoo Donors and Embryo Transfer (우수 한우의 수정란 생산 및 이식)

  • Son D.S.;Han M.H.;Choe C.Y.;Choi S.H.;Cho S.R.;Kim H.J.;Ryu I.S.;Choi S.B.;Lee S.S.;Kim Y.K.;Kim S.K.;Kim S.H.;Shin K.H.
    • Journal of Embryo Transfer
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    • v.21 no.2
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    • pp.147-156
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    • 2006
  • The objective of this study was to supply excellent genetic resources to livestock farms by transferring embryos produced by genetically superior Korean cows (Hanwoo). Eighty Hanwoo donors were superovulated with gonadotropin ($Folltrpin^(R)\;or\;Antorin^(R)$) for 4 days combined with or without progesterone releasing intravaginal device (CIDR) insertion. The collected fresh or frozen-thawed embryos were transferred to 226 farm recipients. In this study, the effect of CIDR insertion in combination with gonadotropin ($Folltrpin^(R)$) treatments initiated at the random stage of estrous cycle on embryo production was evaluated and compared to conventional superovulation protocol. Moreover, the effect of gonadotropin ($Antorin^(R)$) dose in CIDR-treated Hanwoo donors on the embryo yield was determined. In addition, the effects of embryos (fresh vs. frozen-thawed), embryo transfer person, seasons and farms on the pregnancy rate were evaluated. In Hanwoo donors, CIDR insertion in combination with $Folltrpin^(R)$ treatments regardless of estrous detection resulted in increased numbers of total ova (6.5 vs. 5.8) and transferable embryos (3.9 vs. 3.2) compared to the conventional superovulation protocol (p<0.01). In CIDR-treated Hanwoo donors, the higher dose of $Antorin^(R)$ (36 vs. 28 mg) resulted in the increased number of transferable embryos (8.3 vs. 5.4, p<0.05). The embryos (fresh 43.9% vs. frozen-thawed 23.1%) and embryo transfer person (53.9 vs. $0{\sim}16.7%$) significantly affected the pregnancy rate after embryo transfer (p<0.01). These results suggest that CIDR-based superovulation protocol may be effectively used for production of superior Hanwoo embryos and, multiple ovulation and embryo transfer in Hanwoo might be effectively applied for livestock improvement if pregmancy rate with frozen-thawed embryos and embryo transfer skill would be improved.

Bladder Preserving Treatment in Patients with Muscle Invasive Bladder Cancer (근침윤성 방광암 환자의 방광 보존적 치료 결과)

  • Yu, Jeong-Il;Oh, Dong-Ryol;Huh, Seung-Jae;Choi, Han-Yong;Lee, Hyon-Moo;Jeon, Seong-Soo;Yim, Ho-Young;Kim, Won-Suk;Lim, Do-Hoon;Ahn, Yong-Chan;Park, Won
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.70-78
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    • 2007
  • [ $\underline{Purpose}$ ]: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. $\underline{Materials\;and\;Methods}$: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range $38{\sim}86\;years$). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range $55.8{\sim}67\;Gy$). The survival rate was calculated by the Kaplan-Meier method. $\underline{Results}$: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range $3{\sim}91$ months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. $\underline{Conclusion}$: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.

IORT in Gastric Cancer (위암의 수술중 방사선 치료)

  • Kim Myung Se;Kang Cheol Hoon;Kim Sung Kyu;Song Sun Kyo;Kwan Koing Bo;Kim Heung Dae
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.87-91
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    • 1991
  • Total 28 patients with resectable, locally advanced gastric cancer were entered in our prospective randomized study from June 15, 1988 to Sep. 15, 1990 in Yeungnam University Hospital. This study consisted of curative resection, IORT, external irradiation and combination of chemotherapy. Twenty-four of 28 patients were treated with single dose of 1500 cGy with 9 MeV election intraoperatively. External irradiation of $4300\sim4500$ cGy with 180 cGy per fraction, 5 days per week was started within 4th weeks of postoperative days. Various chemotherapy with or without external irradiation were added for reducing hematogenous and/or peritoneal dissemination and determination of complication of each arm. Duration of follow up was $4\sim31$ months. No serious complication related with radiation were reported compare to resection and chemotherapy only group. Although our follow up period is too short to draw any conclusion, IORT appears to improve local control, hopely further survival. Continuous follow up should be needed for evaluation of real therapeutic gain such as complication vs. improved survival.

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Variation of Dose due to the Wound Electrode of Ionization Chamber (굴곡이 있는 전리함 집전극에 기인한 선량 변화)

  • Lee, Byung-Koo;Kim, Jung-Nam
    • The Journal of the Korea Contents Association
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    • v.8 no.11
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    • pp.203-209
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    • 2008
  • Nowadays the risk of radiation is getting more serious, so we must know the exact dose that was irradiated, Because very high radiation dose is used in radiation therapy field. We used the ionization chamber which measure the radiation dose in this study. We tried to know the incorrect result from the distortion of geometric structure of ionization chamber and we studied how to find the distortion of geometric structure of ionization chamber. We used a radio fluoroscopy to find the wound degree of electrode of ionization chamber and a reconstructed 3D CT image to analyze the wound degree of electrode quantitatively. we measured degree of distortion by comparing with absorbed dose of normal electrode and wound electrode. The comparative result is not absolute dosimetry at specific point but relative dosimetry between thats. We measured 4 MV, 10MV photon with same absorbed dose and dose rate. The degree of distortion of wound electrode was totally $5.5{\sim}7.2%$, and there was no difference between two energies. The variation induced from radiation dose to be irradiated and dose rate, and the degree of distortion from wound direction also was almost similar value. We could find that the geometric structure of ionization chamber that can influence a basic measurement of radiation dose can be changed by old usage and inattention of management in this study, especially winding of electrode can be happened, in radiation therapy field, It is very important to keep precise radiation dose quantitatively.

Intraspecies Androgenesis in Mud Loach (Misgurnus mizolepis): I. Optimization of the Egg Inactivation and Haploid Androgenesis Using Transgene Marker (미꾸라지(Misgurnus mizolepis)의 웅성발생성 처녀생식: I. 형질전환 유전자 표지를 이용한 웅성발생성 반수체 유도의 최적화)

  • Nam Yoon-Kwon;Noh Choong-Hwan;Kim Dong-Soo
    • Journal of Aquaculture
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    • v.19 no.3
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    • pp.166-172
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    • 2006
  • Induced androgenesis, a form of artificial parthenogenesis is an important tool for the generation and use of genetically isogenic or clonal fish strain. An optimized protocol for the genetic inactivation of mud loach (Misgurnus mizolepis) oocytes (i.e. production of androgenetic haploid) was developed using UV-irradiation. Various dose levels of UV significantly affected the fertilizing capacity of the eggs, hatchability of embryos and incidence of haploidy. Based on the extensive examinations of treatment conditions on embryo viability and haploid incidence, the optimum dose level of UV irradiation was turned out to be $10,800ergs/mm^2$ with 56.9% of hatching success and 94.6% of haploidy. The overall yield of putative androgen under optimized treatment condition was more than 50% out of total eggs inseminated. The success of androgenetic reproduction of haploid genome was verified by flow cytometry and PCR amplification of transgene that is exclusive to either one of parental sexes. However, a small portion $(8\sim11%)$ of presumed androgenetic haploid larvae was proven to contain residual DNA fragment(s) from maternal parent.

Improvement of High Permittivity Pads for Areas with Generally Low Signal Sensitivity at 7T MRI (7T MRI에서 일반적으로 신호 감도가 낮은 영역에 대한 고유전율 패드 개선)

  • Yong-Tae, Kim;Hyeon-Man, Baek
    • Journal of the Korean Society of Radiology
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    • v.16 no.6
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    • pp.761-769
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    • 2022
  • Pads with high dielectric materials have been used in a variety of applications to locally improve the field sensitivity and homogeneity of RF pulses in clinical MRI studies. In this study, we aimed to improve such pads in consideration of the practical problems associated with the application of actual clinical images. A high permittivity pad to increase the attenuated B1 field strength was fabricated and tested in 7T MRI. Sim4Life simulation and experimental results show stronger and relatively uniform B1 near field. In order to improve the image quality in the whole cerebellum, known as a region with low sensitivity, a guide was made to reduce the mechanical change of the pad. In order to improve the wearing comfort, the pad was designed by dividing it into upper and lower parts. The facial pad showed an overall signal increase effect in areas such as the turbinate in the nasal cavity. Signal increase was expected in areas such as the frontal lobe and eyes, but the effect was either insignificant or it was difficult to see the effect in the imaging protocol. In conclusion, this paper showed a cerebellar-optimized pad with an improved nasal signal while maintaining its effectiveness.

Target Word Selection Disambiguation using Untagged Text Data in English-Korean Machine Translation (영한 기계 번역에서 미가공 텍스트 데이터를 이용한 대역어 선택 중의성 해소)

  • Kim Yu-Seop;Chang Jeong-Ho
    • The KIPS Transactions:PartB
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    • v.11B no.6
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    • pp.749-758
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    • 2004
  • In this paper, we propose a new method utilizing only raw corpus without additional human effort for disambiguation of target word selection in English-Korean machine translation. We use two data-driven techniques; one is the Latent Semantic Analysis(LSA) and the other the Probabilistic Latent Semantic Analysis(PLSA). These two techniques can represent complex semantic structures in given contexts like text passages. We construct linguistic semantic knowledge by using the two techniques and use the knowledge for target word selection in English-Korean machine translation. For target word selection, we utilize a grammatical relationship stored in a dictionary. We use k- nearest neighbor learning algorithm for the resolution of data sparseness Problem in target word selection and estimate the distance between instances based on these models. In experiments, we use TREC data of AP news for construction of latent semantic space and Wail Street Journal corpus for evaluation of target word selection. Through the Latent Semantic Analysis methods, the accuracy of target word selection has improved over 10% and PLSA has showed better accuracy than LSA method. finally we have showed the relatedness between the accuracy and two important factors ; one is dimensionality of latent space and k value of k-NT learning by using correlation calculation.

Efficacy of Clomiphene Citrate Stimulated Cycle in Poor Responders in in vitro Fertilization (Poor Responder 환자에서 Clomiphene Citrate 주기와 Controlled Ovarian Hyperstimulation 주기의 체외수정 결과 비교)

  • Song, Ji-Hong;Koong, Mi-Kyoung
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.3
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    • pp.239-244
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    • 1998
  • The purpose of this study is compare IVF cycle outcome in poor responders between clomiphene citrate (CC) stimulated and controlled ovarian hyperstimulation (COH) protocol. A total of 94 patients responding poorly in previous IVF cycles (estradiol<600 pg/ml or less than 3 oocytes retrieved) subsequently underwent either COH (COH group: 122 cycles, 68 patients) or CC-stimulated cycles (CC group: 43 cycles, 26 patients). CC was administered for five consecutive days starting on cycle day 3 at a dose of 100 mg daily. Serial transvaginal ultrasound examination was done from cycle day 8. Urine was collected $3\sim4$ times before hCG injection for the detection of LH surge. The hCG was administered when serum estradiol reached greater than 150 pg/ml and mean follicle diameter>16 mm. In COH group, ovarian stimulation was done using short protocol (GnRH-a/FSH/HMG/hCG). No difference in age or number of transferred embryos was found between CC group and COH group. COH group had significantly (p<0.05) higher mean peak level of $E_2$ ($810{\pm}112$ vs $412{\pm}55$ pg/ml) and greater number of retrieved oocytes ($3.0{\pm}0.2$ vs $2.0{\pm}0.2$) than CC group. CC group had transferred embryos $(1.8{\pm}0.2)$ compared with $(2.1{\pm}0.2)$ in COH group. However, CC group had higher pregnancy rate than COH group per retrieval [26.9% (7/26) vs 6.2% (6/97)], or per transfer [31.8% (7/22) vs 7% (6/86)]. Although cycle cancellation rate in CC group (48.8%) was higher than that of COH group (21.3%), the pregnancy rate per cycle in CC group was still higher (16.3%) than COH group (4.9%). In addition, implantation rate in CC group was 17.5% (7/40), which was significantly (p<0.01) higher than 3.9% (7/180) in COH group. These data suggest that oocyte and embryo quality are lower in COH cycles of poor responders than CC cycles. We suggest that clomiphene citrate stimulated IVF cycle may be more efficient than COH IVF cycle in poor responders in terms of lower costs and higher pregnancy performance.

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