• 대한약리학회지
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• 제19권1호
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• pp.37-60
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• 1983

The uterus receives adrenergic terminals from the mesenteric ganglia and considerably large amount of catecholamines have been shown to be contained in this organ. On the other hand, the activities of epinephrine, norepinephrine or adrenergic nerve on uterine motility is so complicated that many controversial results have been reporter. Recently, a large number of reports concerning the changes of uterine catecholamines content have appeared, but little is known about the role of uterine catecholamines in their activities on uterine motility. The present experiments were undertaken to determine the significance of the intrinsic uterine catecholamines in the physiology of uterus. Female albino rabbits weighing approximately 2 kg were employed in this experiment. uterine strip3 were prepared and suspended in a constant temperature $bath(38^{\circ}C)$ containing 100 ml of Locke's solution aerated with 95% oxygen and 5% carbon dioxide. Spontaneous motility was recorded on a smoked drum with an isotonic lever. The catecholamines concentration of the uterus was determined according to the Procedure described of Shore and Olin (1958). Human uterus obtained from patients was also used to determine the catecholam ines content of myometrium. Followings are summarized results. 1) On the non-pregnant rabbit uterine strips, epinephrine and norepinephrine significantly elevated the tonus and stimulated the spontaneous motility. Pretreatment with dichloroisoproterenol(DCI), an adrenergic beta-receptor blocker, enhanced the stimulatory activity of epinephrine or norepinephrine. On the other hand, pretreatment with dibenamine, an adrenergic alpha-receptor blocker, rendered the uterine muscle to exhibit inhibition after the administration of epinephrine or norepinephrine. Following the treatment with both DCI and dibenamine, epinephrine or norepinephrine produced no appreciable effects on the spontaneous motility of the uterus. These results suggest there exist both alpha and beta-adrenergic receptors in the uterine muscle and the response to epinephrine of the former is predominant over that of latter in the non-pregnant uterus of rabbits. The total catecholamines concentration of the non-pregnant uterus was $351\;m{\mu}g/g$ and the fractional concentrations of epinephrine and norepinephrine were $125\;m{\mu}g/g(35.7%)$ and $226\;m{\mu}g/g$ respectively. It is interesting to note that the catecholamines content of uterus was characterized by a high fractional corcentration of epinephrine relative to norepinephrine. 2) On the pregnant rabbit uterine strips, the effects of epinephrine and norepinephrine varied according to the period of pregnancy. The response to epinephrine of adrenergic beta receptor of uterus increased during pregnancy, and the effect of catecholamine was inhibitory in the early pregnancy but became stimulatory as the pregnancy progressed. This stimulating action on the uterine motility was found to occur through the action of norepinephrine. The uterine catecholamines concentration was markedly reduced during pregnancy. The catecholamines concentration was started to decrease in the early pregnancy, reached the lowest level in the mid-pregnancy and then started to increaae again in the late pregnancy when the total catecholamines content became the highest level of all. This increase of catefholamines in late pregnancy was chiefly due to the increase of norepinephrine. These results suggest that the uterine motility may be related to the catecholamines content, especially norepinephrine content in the uterus. 3) Bilateral oophorectomy of rabbits results in a marked shrink of the uterus in size. The spontaneous motility of the uterine segment of these animals was very weak and irregular. Norepinephrine produced inhibitory effect, whereas epinephrine was stimulatory or inhibitory effect on the uterine segment. The total catecholamines tontent in whole uterus was markedly reduced. The injection of estrogen into the oophorectornized rabbit increased the weight of uterus to approximately three times of that of oophorectornized animal. The apontaneous motility and the response to epinephrine and norepinephrine of the uterine segment were greatly enhanced. Both epinephrine and norepinephrine produced a marked stimulatory effects of the uterine motility. The uterine content of catecholamines, particularly epinephrine, was markedly increased. The injection of progesterone into the oophorectornized rabbit increaeed the weight of uterus to approximately 2.5 times of that of eophorectornized animal. The spontaneous motility of the uterine segment was weak and irregular. Epinephrine produced stimulatory effect at high concentrations but norepinephrine always prcdnced inhibitory effect on the uterine segment. The uterine content of catecholamines, particularly of norepinephrine, was markedly reduced. These results suggested that ovarian hormones play an important role not only on the growth and spontaneous norepinephrine of uterus but also on the catecholamines content and responee to epinephrine and norepinephrine of the uterus. 4) The intraperitoneal injection of reserpine(3 mg/kg) into the non-pregnant, pregnant and oophorectornieed rabbits markedly decreased the uterine content of catecholamines, particularly of the norepinephrine. The stimulatory response to epinephrine and. norepinephrine of the uterine segment of these reserpinized ratbits was markedly reduced whereas the inhibitory response to these catecholamines was enhanced. This finding further support the close relationship between the uterine catecholamines content and uterine response to epineptrire and norepinephrine. 5) In the human uterus, the concentration of epinephrine was actrally greater than that of norepinephrine and it was significantly greater during the proliferative phase of the menstrtal cycle. In the human pregnant uterus, the concentrations of toth epinephrine and ncrefinephrine were markedly reduced and showed about 45 percent rednction after 6-8 weeks of ectopic Pregnancy. At full term ana during labor, the concentrations of epinephrine and norepinephrine at placental sites were less than those found in the non-pregnant group. Of interest was the finding that the norepinephrine concentration of uterus from toxemic patients was two and half times higher than that of lower uterine segment of the nontoxemic pregnant individuals. Also the epinephrine concentraticn was slightly increaeed.

• Clinical and Experimental Reproductive Medicine
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• 제33권4호
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• pp.237-243
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• 2006

목 적: 동결-융해 배아이식은 보조생식술에서 환자들에게 보다 많은 임신의 기회를 제공해줄 수 있는 방법으로 이용되고 있다. 본 연구에서는 예후가 좋지 않은 환자들에서 동결-융해 배아이식의 효용성을 알아보고자 하였다. 연구방법: 나이가 많은 고령 환자군 (38~44세)과 신선주기 배아이식에서 임신 실패군을 연구대상으로 하였다. 과배란 유도를 통해 채취한 난자를 일반적인 체외수정 또는 세포질내 정자주입술을 시행하여 수정을 유도하고, 잉여의 전핵 또는 난할 시기의 배아를 완만동결법으로 동결하였다. 동결보관 배아는 급속융해법으로 융해하여 호르몬요법을 시행한 환자의 자궁에 이식하였다. 신선 배아이식과 동결-융해 배아이식 과정에서의 배아 상태, 임신율, 착상률 등을 통계적인 방법으로 분석하였다. 결 과: 나이가 많은 고령군에서 신선 배아이식을 시행한 환자들과 동결-융해 배아이식을 시행한 환자들의 평균 연령은 $40.0{\pm}1.8$세 (n=206)와 $39.9{\pm}1.9$세 (n=69)로 통계적으로 유의한 차이가 없었으나, 임상적인 임신율과 착상률은 동결-융해 배아이식에서 29.0%와 11.2%로 신선 배아이식의 16.5%와 7.0%에 비해 통계적으로 유의하게 높게 나타났다. (p<0.05). 첫 번째 신선 배아이식에서 임신 실패군의 연속되는 신선 배아이식 환자군 ($31.2{\pm}2.3$, n=40)과 동결-융해 배아이식 환자군 ($31.9{\pm}3.1$, n=119)에서의 평균 연령은 차이가 없었으며, 임상적 임신율 (42.5% vs 40.3%)과 착상률 (22.6% vs 18.8%)도 유사하였다. 결 론: 본 연구에서는 동결-융해 배아이식이 고령 환자들에서 효과적으로 임신율과 착상률을 높일 수 있음을 보여주고 있다. 이러한 결과는 과배란 유도에 따른 자궁의 착상 환경 변화가 고령 환자들에서 임신율과 착상률을 저하시키는 것과 관련이 있을 것으로 생각된다.

• Clinical and Experimental Reproductive Medicine
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• 제35권4호
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• pp.285-291
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• 2008

목 적: 미성숙 난자의 체외성숙에 있어 난구세포의 양상 및 미성숙 난자의 크기가 영향 인자로 작용하는지를 알아보고자 하였다. 연구방법: 체외수정을 위한 과배란유도 후 난자채취를 시행한 21명의 환자로부터 41개의 난포 단계의 난자를 얻었다. Denudation 이전의 난구세포의 모양에 따라 dispersed 난구세포와 compacted 난구세포로 나누었다. Denudation 이후 투명대를 포함하는 난자외직경 (outer oocyte diameter)과 투명대를 포함하지 않는 난자내직경 (inner oocyte diameter)을 측정하고 체외성숙 배양액에서 체외성숙을 시도하였다. 난자의 성숙은 제1극체가 나온 경우로 정하였다. 성숙이 확인된 난자는 ICSI 방법을 이용하여 수정시키고 다음날 두 개의 전핵이 뚜렷이 보이는 경우에 수정된 것으로 간주하였다. 결 과: 전체적인 체외성숙률은 56.1%, 수정률은 73.9%이었다. Dispersed 난구세포 난자 중에서 성숙된 난자 비율 (91.3%)은 비성숙 난자 비율 (55.6%)보다 유의하게 높았다 (p=0.023). 성숙 또는 비성숙 난자에서 난자외경($155.7{\mu}m$ vs. $152.4{\mu}m$, NS)과 내경 ($114.3{\mu}m$ vs. $113.4{\mu}m$, NS) 및 투명대 두께 ($41.3{\mu}m$ vs. $39.1{\mu}m$, NS)는 차이가 없었다. 체외성숙률은 dispersed 난구세포 난자에서 compacted 난구세포 난자보다 의미있게 높았으나 (67.7% vs. 20.0%, p=0.044), 수정률에 있어 두 군간의 유의미한 차이는 없었다. 난자의 외경, 내경 및 투명대 두께에 따른 체외성숙률 및 수정률의 차이가 없었다. 결 론: Dispersed 난구세포를 가진 미성숙 난자가 compacted 난구세포를 가졌던 난자에 비하여 더 높은 체외수정능을 가진다는 결과는 dispersed 난구세포가 미성숙 난자의 체외성숙 예측을 위한 하나의 지표로 사용될 수 있음을 시사한다.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.249-260
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• 1986

1983년 5월부터 1986년 11월까지 영남대학교 의과대학 부속병원 산부인과에서 제절로 분만한 510예를 대상으로 임상적 관찰분석을 함으로써 다음과 같은 결론을 얻었다. 1. 제절발생빈도는 15.7%였으며 그중 일차제절은 10.9%, 반복제절은 4.7%였으며 제절수술이 점차 증가되는 경향이었다. 2. 연령분포는 26세에서 30세사이의 연령군에서 60.2%로 가장 높은 분포를 보였다. 3. 적응증은 기왕제절 30.2%, 아두골반불균형 26.9%, 이상태위 22.7%의 순이었으며, 일차초산 부제절은 아두골반균형이 일차경산부제절은 이상태위가 가장 많았다. 4. 제절시행 임신주수는 40주에 31.6%로 가장 많았다. 5. 신생아체중분포는 3,000~3,499gm군이 39.8%로 가장 많았으며 미숙아가 9.1%, 거대아는 5.6%였다. 6. 제절술식은 자궁협부횡절개술이 97.5%였다. 7. 제절술시 병행한 수술로는 난관결찰술, 난소낭종제거술, 자궁적출술, 충수제거술, 자궁근종제거술의 순이었다. 8. 마취방법으로 전신마취가 83.5%였다. 9. 모성이환율은 14.7%였으며 그 원인은 창상 감염, 요로감염, 불명열, 산후출혈의 순이었다. 10. 입원당시 빈혈의 정도별 모성이환율은 혈색소치가 10이하인 경우 18.4%의 모성이환율을 보였고, 낮을수록 모성이환율이 증가되었다. 11. 양수파막 24시간이상 경과군에서의 모성이환율이 44.4%였다. 12. 분만진통시간이 12시간이상군에서 24.6%의 모성이환율을 보였고, 진통시간이 길수록 되었다. 13. 자궁협부절개술에서 14.1%로서 가장 낮은 모성이환율을 보였다. 14. 응급수술시행군에서 선택적수술군보다 모성이환율이 2배정도 높았다. 15. 모성사망은 1예도 없었다.

• The Korean Journal of Physiology
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• 제2권1호
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• pp.23-30
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• 1968

Tissue homogenates of 12 kinds of human cancer tissues were incubated separately in medium containing $C^{14}-1-glucose$ and $C^{14}-6-glucose$ as a substrate in order to observe the oxidative pathway of glucose in the tumor tissues. At the end of 3 hours incubation in the Dubnuff metabolic shaking incubator, respiratory $CO_2$ samples trapped by alkaling which was placed in the center well of incubation flask were analysed for total $CO_2$ production rates and their radioactivities. The tissue homogenate samples after incubation were analyzed for their concentrations of glucose, lactate and pyruvate. Calculations were made on the glucose consumption rate and accumulation rates of lactate and pyruvate. Fractionation of oxidative pathway of glucose was carried out by calculating $C^{14}O_2 yields from C-1 and C-6 carbon of glucose. The following results were obtained. 1. In 12 kinds of human cancer, total $CO_2$ production rates were less than $8{\mu}M/gm$ except 2 cases. These lower values impressed that oxidative metabolism in the tumor tissues generally inhibited as compared with that in normal tissues. On the other hand, fractions of $CO_2$ derived from glucose to total $CO_2$ production rates (RSA) were less than 10% in every case. These facts showed that oxidation of glucose into $CO_2$ was remarkably inhibited in the tumor tissues. 2. Factions of glucose disappeared into $CO_2\;(RGD_{CO_2})$, lactate $(RGD_L)$, pyruvate $(RGD_P)$ to glucose consumption rates were as follows. $RGD_{CO_2}$ were less than 2% in cases of in this experiment and $RGD_L$ showed more than 5% except in 2 cases. These facts showed that anaerobic degradation of glucose into 3 carbon compounds was easily proceeded but further degradation into $CO_2$ via the TCA cycle was greatly inhibited resulting in accumulation of lactate. There are large variation in values of $RGD_P$ in different kinds of tumor tissue but relatively higher values in $RGD_{CO_2}$ were obtained in the tumor tissues as compared with those of normal tissues. 3. The oxidative pathway of glucose in tumor tissues were analyzed from the values of RSA which were obtained in $C^{14}-1\;and\;C^{14}-6-glucose$ incubation experiments. It was found that 3% of $CO_2$ derived from glucose were oxidized via the principal EMP-TCA cycle and the remainder were via alternate pathway such as HMP in the liver cancer and values in other cancer tissues were as follows; 4% in the tongue cancer, 6% in the colon cancer, 6% in the lung cancer, 9% in the stomach cancer, 11% in the ovarian cancer, 12% in the neck tumor, 22% in the uterine cancer, 22% in the bladder tumor, 32% in the spindle cell sarcoma and 65% in the brain tumor. These values except later 2 cases showed less than 30% which is the lowest value among the normal tissues. Even in the brain tumor in which showed highest value in the tumor group. It is reasonable to suppose that this fraction was remarkably decreased because values in normal brain tissue was more than 90%. From the above data, it was concluded that in tumor tissues, oxidation of glucose via TCA cycle was greatly inhibited but correlation between degree of inhibited oxidation of glucose via TCA cycle and malignancy of tumor were not clarified in this experiments.

• Current Research on Agriculture and Life Sciences
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• 제8권
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• pp.45-50
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• 1990

본 실험은 성선(性腺)자극호르몬과 우태아혈청(牛胎兒血淸) 첨가가 돼지 난포란(卵胞卵)의 체외성숙(體外成熟) 및 체외수정(體外受精)에 미치는 영향을 조사하기 위하여 실시하였다. 미경산돈(未經産豚)(체중 80~90kg)의 난소(卵巢)를 도살된 직후에 절취하여 $37{\sim}39^{\circ}C$의 보온병에 담아 실험실로 운반하여 난포(卵胞)직경이 3~5mm되는 것만을 골라 난포(卵胞)를 찔러서 난포란(卵胞卵)을 채취하였다. 성숙모돈(成熟牡豚)(체중 130~150kg)의 정소상체미부정자(精巢上體尾部精子)를 $4{\times}10^8cells/m{\ell}$ 농도로 희석하여 체외수정(體外受精)에 이용하였다. 본 실험의 경과를 요약하면 다음과 같다. 1. m-KRB와 10% FCS를 m-KRB에 첨가한 경우 성숙율(成熟率)은 82.37%이며, 10% FCS가 첨가된 배양액에 PMSG, hCG 그리고 PMSG와 hCG를 각각 $10IU/m{\ell}$ 첨가한 경우 66, 58, 68%로서 성숙율(成熟率)이 향상되었다. 2. 난구세포(卵丘細胞)의 팽화(膨化)는 m-KRB와 10% FCS가 첨가된 배양액에서 일어나지 않았으나 10% FCS가 첨가된 배양액에 PMSG, hCG 그리고 PMSG와 hCG를 각각 $10IU/m{\ell}$ 첨가시 92, 13, 91%로서 팽화율(膨化率)이 향상되었다. 3. m-KRB에서 성숙된 난포란(卵胞卵)의 체외수정(體外受精)에서 정자침입율과 웅성전핵(雄性前核) 형성율은 각각 93.7%였으나 FCS와 성선(性腺)자극호르몬을 첨가한 경우 각각 100, 80%로서 웅성전핵(雄性前核) 형성율이 향상되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.95-110
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• 2006

The treatment for oral and maxillofacial carcinoma with chemotherapeutic agents is evaluated by many effective methods to reduce the tumor mass and cancer cell proliferation. However these chemotherapy have many serious side effects, such as bone marrow suppression, renal toxicity, G-I troubles. Therefore a possible approach to develop a clinically applicable chemotherapeutic agent is to screen anticancer activity of Taxol which is known to have very little side effect and have been used to breast cancer and ovarian carcinoma. Taxol is a new anti-microtubular anti-cancer agent extracted from the bark of the Pacific yew, Taxus brevifolia. Paclitaxel(Taxol) acts by promoting tubulin polymerization and over stabilizing microtubules agianst depolymerization. Despite the constant improvements of methods of the cancer treatment especially chemotherapy, the rate of cancer metastasis and recurrent are not decreased. Thus the investigation of new drug which have very little side effect and a possible clinically application continues to be a high priority. Considering that the Taxol have shown very effective chemotherapeutic agent with relatively low toxicity in many solid tumors, it deserves to evaluate its efficacy in oral squamous cell carcinoma. In this study, to investigate the in-vivo and in-vitro anti-cancer efficacy of Taxol in oral squamous cell carcinoma and lastly, the potency of Paclitaxel in the clinical application for oral cancer was evaluated. In vivo study, after HN22 cell line were xenografted in nude mice, the growth of tumor mass was observed, 3 mg/Kg taxol was injected intraperitoneally into nude mice containing tumor mass. The methods of these study were measurement of total volume of tumor mass, histopathologic study, immunohistochemical study, drug resistance assay, growth curve, MTT assay, flow cytometry, cDNA microarray in vivo and in vitro. The results were obtained as following. 1. The visual inspection of the experimental group showed that the volume of the tumor mass was slightly decreased but no significant difference with control group. 2. Ki-67 index was decreased at weeks 4 in experimental group. 3. Microscopic view of the xenografted tumor mass showed well differentiated squamous cell carcinoma and after Taxol injection, some necrotic tissue was seen weeks 4. 4. The growth curve of the tumor cells were decreased after 1day Taxol treatment. 5. According to the MTT assay, HN22 cell line showed relative drug resistancy above $5\;{\mu}g/ml$ concentrations of Taxol. 6. In drug resistance assay, the decrease of cell counts was seen relatively according to concentration. 7. In Flow cytometry, G2M phase cell arrests were seen in low concentration of the Taxol, while S phase cell arrests were seen in high concentration of the Taxol. 8. Using cDNA microarray technique, variable gene expression of ANGPTL4, TXNRD1, FAS, RRAGA, CTGF, CYCLINEA, P19, DUSP5, CEBPG, BTG1 were detacted in the oral squamous cell carcinoma cell after taxol treatment. In this study paclitaxel is effective against oral squamous cell carcinoma cell lines in vitro, but week effect was observed in vivo. So we need continuous study about anticancer effect of taxol in vivo in oral squamous cell carcinoma.

• 한국양식학회지
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• 제8권3호
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• pp.171-181
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• 1995

붕어의 년 생식주기를 밝히기 위해 1993년 2월부터 1994년 10월까지 gonadosomatic index (GSI)를 조사하였다. GSI는 4월부터 7월까지는 높은 수준을 나타내며 개체간에 편차가 큰 것으로 보아 이 기간이 산란기임을 보여준다. 8월부터 9월까지는 년중에서 가장 낮은 수준이며 이때 난소내 여포는 퇴화가 진행 중이었다 10월부터 GSI 값은 증가하여 이듬해 3월에 최대치를 보였다. Human chorionic gonadotropin (HCG 10 lU), $17\alpha$, 20\beta-dihydroxyprogesterone\;(1-100{\mu}g/ml)$ 및 phorbol 12-myristate 13-acetate (TPA, protein kinase C activator, 0.1-10${\mu}M$)는 인공배양 시 난모세포의 성숙을 유도하였으나 $4\alpha-phorbol$ 12, 13-didicanoate ($4\alpha-PDD$, phorbol ester analogue, $(25{\mu}M$)는 성숙을 일으키지 않았다. 또한, HCG (10 IU), prostaglandin $F_{2\alpha}$ (0.1-10${\mu}g/ml$) 및 TPA (0.1-10${\mu}M$)는 난모세포의 배란을 유도하였으나 $4\alpha-PDD$$(25\;{\mu}M)$에 의해서는 배란이 일어나지 않았다. 여포세포의 $17\alpha-hydroxyprogesterone$은 HCG (1 IU, 10 IU) 및 forskolin (adenylate cyclase activator, 0.1-10 ${\mu}M$)에 의해 생성이 촉진되었으며 HCG (10 IU) 및 forskolin $(10 {\mu}M)$에 의한 time course 는 3시간 내에 생성량이 증가하여 시간경과에 따른 유의한 차이는 보이지 않았다. 이러한 결과를 종합하면 cyclic AMP와 protein kinase C 는 어류의 난모세포의 성숙과 배란과정에 매우 중요한 역할을 담당하는 것으로 생각된다.

• 대한핵의학회지
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• 제36권1호
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• pp.1-7
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• 2002

Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

• Clinical and Experimental Reproductive Medicine
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• 제24권1호
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• pp.83-93
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• 1997

Although IVF-ET is widely applied in the treatment of couples with male factor infertility, it may fail in many infertile couples with normal semen parameters, and certain couples cannot be accepted for standard IVF-ET due to unfertilization or extremely low fertilization rate of oocytes. Recently, several procedures of microassisted fertilization (MAF) using micromanipulation have been introduced, and pregnancies and births have been obtained after partial zona dissection (PZD), subzonal insertion (SUZI), and intracytoplasmic sperm injection (ICSI). This clinical study was performed to develop and establish ICSI as an effective procedure of MAF in infertile couples who could not undergo standard IVF-ET repetitively because of failure in fertilization or extremely low fertilization rate of oocytes with the conventional fertilization technique in the previous IVF-ET cycles. From March, 1995 to May, 1996, 27 cycles of IVF-ET with ICSI in 19 infertile patients were included in study group, and the outcomes of ICSI were analyzed according to fertilization rate, cumulative embryo score (CES), and pregnancy rate. The number of oocytes retrieved after controlled ovarian hyperstimulation (COH) was $10.50{\pm}6.13$ in 30 previous cycles, and $10.57{\pm}5.53$ in 27 ICSI cycles. In ICSI cycles, the number of oocytes optimal for ICSI procedure was $7.89{\pm}4.30$, and the fertilization rate of $67.9{\pm}20.2%$ could be obtained after ICSI. The number of embryos transferred was $1.43{\pm}2.40$ in previous cycles, and $4.36{\pm}1.77$ with the mean CES of $41.8{\pm}27.4$ in ICSI cycles. In ICSI cycles, the overall pregnancy rate was 29.6% (8/27) per cycle and 42.1% (8/19) per patient with the clinical pregnancy rate of 22.2% (6/27) per cycle and 31.6% (6/19) per patient. In conclusion, MAF of human oocytes with ICSI is a promising fertilization method for IVF-ET patients, especially with the past history of failure in fertilization or low fertilization rate of oocytes in the previous IVF-ET cycles, and ICSI using micromanipulation procedures applied to human oocytes will provide a range of novel techniques which may dramatically improve the pregnancy rate in IVF-ET program and contribute much to effective management of infertile couples.