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Pediatric humeral medial condyle fracture (HMCF) is a rare condition and is difficult to detect, especially in young children. The management of late presentation of HMCF is challenging and lacks consensus. Herein, we reported four cases of HMCF nonunion received open reduction and internal fixation (ORIF) or supracondyle osteotomy from our institution. In addition, 12 cases of ORIF and 4 cases of osteotomy reported in the previous studies were also reviewed. The HMCF nonunion can heal after ORIF, but the indication and the optimal techniques need to be clarified. Supracondylar osteotomy alone is an effective and safe treatment option to improve the functional and cosmetic outcomes of HMCF nonunion.

We synthesize a NIR MHI-148 dye, a lipophilic heptamethine cyanine, with capability in tumor-targeting property to accumulate in the mitochondria of tumor. In the context of MHI-148 dye, we demonstrate effective tumor targeting and NIR fluorescence in vitro and in vivo for MHI-148 as compared to ICG. A series of porous Gd silicates related nanoparticles, i.e. Gd silicate, Gd silicate@mSiO(2) (mSiO(2): mesoporous silica shell), and Gd(3+)-chelated Gd silicate@mSiO(2) (Gd(3+)-DOTA chelated on the mSiO(2)) are fabricated to demonstrate their magnetic resonance (MR) contrast imaging effects. Those Gd silicates related nanoparticles exhibit dual MR effect, expressing T(1)-brightened and T(2)-darkened effects, in lower magnetic field. In high magnetic field, an abnormal enhanced transverse relaxivity (r(2)) appears, showing an effective T(2)-lowering effect, possibly due to concentrated Gd amount and porous architecture. The r(2) value increases 4-5 times as the field strength increased from 3T to 7T. The Gd(3+)-chelated Gd silicate@mSiO(2) has given large r(2) (T(2)-lowering effect) up to 343.8 s(-1) mM(-1), which is even larger than the reported magnetic Fe(3)O(4) nanoparticles measured at the same field. Using a 9.4T animal micro MRI system we have seen effectively darken in signal for those porous Gd silicates related NPs, while no such phenomenon appears in commercial Gd-DOTA agent. The MHI-148 is then conjugated on the porous Gd silicate@mSiO(2) nanoparticles for a new paradigm with three functionalities for in vivo tumor targeting, near-infrared fluorescent and MR imaging by means of only using MHI-148 dye.

Background The World Health Organization reported that more than 10 % of women are severely affected by infertility, making the condition a major worldwide public health problem. Lead (Pb), cadmium (Cd), and arsenic (As) are environmental pollutants that may contribute to reproductive disorders. This cross-sectional study investigated the association between blood concentrations of Pb, Cd, and As and risk factors for infertility in women. Methods Women who were infertile (N = 310) or pregnant (N = 57) were recruited from the gynecology and obstetrics department of a hospital. The participants were interviewed to obtain their sociodemographic, reproductive, and lifestyle information. The concentrations of Pb, Cd, and As in their blood samples were measured using inductively coupled plasma mass spectrometry. Results Our findings suggested that the concentrations of Pb and As, but not Cd, were significantly higher in the blood of infertile women than in that of pregnant women. A higher percentage of the infertile women consumed more alcohol, used Chinese herbal medicine more frequently, and lacked physical activity compared with the pregnant women. After accounting for potentially relevant predictors, we observed that blood Pb levels might be elevated by using Chinese herbal medicine 1–6 times per week (aOR = 2.82, p = 0.05). In addition, engaging in physical activity 1–2 times per week (aOR = 0.37, p = 0.05) might assist in reducing Pb accumulation in infertile women, though the p value was borderline. Conclusions Lack of physical activity and frequent use of Chinese herbal medicine may be associated with elevated blood Pb levels in infertile women. Chinese herbal medicine use was observed to increase the Pb body burden of both infertile and pregnant women in this study. The risk–benefit for Chinese herbal medicine intake should be evaluated by women of childbearing age.

Alkali-pretreated cobia (Rachycentron canadum) skin was extracted in a retort (121°C) for 30min to obtain a retorted skin gelatin hydrolysate (RSGH). The molecular mass distributions and antioxidant activities of cobia RSGH and enzyme-treated RSGHs (ET-RSGHs) derived from bromelain, papain, pancreatin, and trypsin digestion were then characterized. The molecular mass distribution of the RSGH ranged mainly between 20,000 and 700Da and those of ET-RSGHs ranged between 6500 and 700Da. The DPPH (α,α-diphenyl-β-picrylhydrazyl) radical scavenging effects (%) of 10mg/ml of RSGH and 10mg/ml of the four ET-RSGHs were 55% and 51-61%, respectively. The lipid peroxidation inhibition (%) of RSGH and ET-RSGHs (10mg/ml) were 58% and 60-71% on the fifth day in a linoleic acid model system, respectively. The 3Kd-ET-RSGHs, obtained by using a series of centrifugal ultrafiltration filters (molecular weight cut-offs of 10, 5, and 3kDa done sequentially with decreasing pore size), exhibited dramatically improved antioxidant activity, with most of the molecular mass ranging below 700Da. Compared to 10mg/ml of the RSGH, 10mg/ml of 3Kd-ET-RSGHs exhibited 45-65% more scavenging of DPPH radical and 24-38% more inhibition of lipid peroxidation. The peptides with molecular masses below 700Da in the ET-RSGHs or 3Kd-ET-RSGHs significantly affect the antioxidant properties. These peptides are composed of a small number of amino acids or free amino acids and have the potential to be added as antioxidants in foods.

To analyze the gap junction proteins connexin 37 (Cx37) and connexin 43 (Cx43) after subcutaneous transplantation of cryopreserved mouse ovarian tissue.Expression of gap junction genes was assessed by immunohistochemistry and real-time polymerase chain reaction (PCR) in transplanted cryopreserved ovarian tissue compared with that of normal ovarian tissue. Apoptosis of ovarian cells was evaluated by using the terminal deoxynucleotidyl transferase-mediated biotinylated deoxyuridine triphosphates nick end-labeling method.After subcutaneous transplantation, Cx37 and Cx43 mRNA and protein expression were significantly lower in cryopreserved than in normal ovarian tissue. Apoptosis was increased in granulosa cells from antral follicles of the cryopreserved tissue.After cryopreservation and subcutaneous transplantation of ovarian tissue, proteins forming gap junctions between oocytes and granulosa cells are under-expressed compared with normal controls.

Embryonic stem (ES) cells are genetically normal, continuous cell lines that can give rise to a variety of somatic cells in culture. These include the midbrain dopaminergic neurons, a major cell type lost in Parkinson’s disease. With the promising outcome of mesencephalic fetal transplantation in some Parkinson’s disease patients, the establishment of human ES cells has sparked much attention in both the scientific and general community regarding their potential as an alternative to aborted fetal tissue for cell replacement therapies. There is also great interest in developing the ES cell system as a platform for pharmaceutical and toxicological screening. Progress has been made in developing protocols for dopaminergic neuronal specification in ES cell development. Research to define the criteria for the ‘right’ category of therapeutic dopaminergic cells is underway. However, the promise of human ES cells rests largely on our ability to expand stem cells without genetic and epigenetic compromise, and to direct stem cell differentiation with absolute phenotypic fidelity. The delivery of these goals will require a much better understanding of the control of ES cell self-renewal, proliferation and the commitment of differentiation.

Altitude training is a frequently used method for enhancing endurance performance in athletes. But its acute effect on carbohydrate metabolism in cardiac muscle is unknown. In this study, we determined the acute effect of an exercise-hypoxia challenge on glycogen storage and GLUT4 protein expression in heart muscle. Sixteen male Sprague-Dawley rats were assigned to one of two groups: control (CTRL) and exercise-hypoxia (EX+HY). The exercise protocol consisted of swimming for 180 min twice, with a 45-min rest interval. Five hours after the exercise, the EX+HY rats were exposed to a 14% O(2) systemic hypoxia under normobaric condition for 12 h. After this hypoxia exposure, the EX+HY and control rats were given glucose orally (1 g/kg body weight) with stomach tube and recovered under normal condition for 16 h. Ventricular portion of the heart was used to determine the levels of glycogen, GLUT4 mRNA, and GLUT4 protein after recovery. We found that myocardial glycogen level was lowered by the exercise-hypoxia challenge (51% below control, p0.05), while GLUT4 mRNA was dramatically elevated (approximately 400% of the control level, p0.05). The acute exercise-hypoxia treatment did not affect GLUT1 protein level in the same tissue. The novel finding of the study was that the exercise-hypoxia treatment significantly induced GLUT4 gene expression in the cardiac muscle. This acute response appears to be associated with a sustained glycogen depletion of the muscle.

A previous study has shown that former elite power athletes exhibited significantly greater relative risk in diabetes than that of former elite endurance athletes. It is unknown whether insulin sensitivity in elite young healthy power athletes is lower than that in elite young endurance athletes. This study includes two parts, part I and part II. In the part I of this study, an oral glucose tolerance test was performed in all of the elite juvenile track athlete subjects, specializing either in short-distance racing (jSD, N = 13, aged 12.5 +/- 0.37 years) or in long-distance racing (jLD, N = 13, aged 12.6 +/- 0.42 years). In the part II of this study, we recruited elite adult swimmers and divided them into two groups according to their specialty in swimming race distance: long-distance (aLD, N = 10, age 20.3 +/- 1.32) and short-distance groups (aSD, N = 10, age 20.2 +/- 1.31). Insulin sensitivity was significantly lower in the jSD group than that in the jLD group, as indicated by the area under the curves of insulin and glucose following a 75-g oral glucose load. Fasting plasma LDL-C and total cholesterol levels in the jSD group were significantly greater than those in the jLD group. The result of the part II of this study, similar to the result of the part I, shows that insulin sensitivity in aSD swimmers was significantly lower than that in aLD swimmers. LDL-C, total cholesterol, and triglyceride levels were also found higher in aSD swimmers than in those of aLD swimmers. These new findings implicate that the genetic makeup associated with exceptional power or endurance performance of elite athletes could also reflect on their metabolic characteristics; elite power athletes appear to be more insulin resistant than elite endurance athletes.

Altitude training is a common method used to enhance endurance performance in athletes. We have examined the interactive effect of exercise training and chronic hypoxic on glycogen storage and GLUT4 protein expression in cardiac muscles. Thirty-two male Sprague-Dawley rats were weight balanced and assigned to one of the following four groups: control, exercise, hypoxia, and hypoxia-exercise. Rats with hypoxic treatment (breathing 14% O(2) for 12 hr/d) were exposed under normobaric conditions. The training protocol consisted of swimming for two 3-hr periods per day for 4 weeks. Glycogen content, GLUT4 protein, and mRNA of all rats were determined 16 hr after treatments. Four-week exercise training without hypoxia significantly elevated myocardial glycogen level by 45%. The chronic hypoxic-exercise training elevated the myocardial glycogen level by 67% above control level, significantly greater than the exercise group. Chronic hypoxia, exercise training, and hypoxia-exercise training significantly elevated GLUT4 protein by 40-70% in cardiac muscles. Chronic hypoxia significantly elevates the GLUT1 protein level independent of exercise training. The new finding in this study was that GLUT4 gene expression in cardiac muscle can be stimulated by exercise training with hypoxia treatments. This molecular adaptation appears to be associated with the observed increase in glycogen storage of the muscle.

The aim of this study was to investigate the effect of mountain living conditions and high altitude hiking activities on glucose tolerance. In study I, we performed an oral glucose tolerance test on nine untrained subjects before and after 3 days of mountain living. In study II, the same measurement was used to determine the effect of high altitude hiking in two distinct geographic environments; participants included 19 professionally trained mountaineers. We found that trained mountaineers displayed significantly better sea-level glucose tolerance than sedentary subjects of a similar age (p < 0.05). This result suggests that mountaineering training could produce a beneficial effect on glucose tolerance. More importantly, in study I we demonstrated that 3 days of high altitude living (altitude approximately 2400 m) was sufficient to improve glucose tolerance. Furthermore, hiking in a relatively flat plateau area (Pamirs highland area, China, altitude approximately 4000 m) generated significantly better improvement in glucose tolerance than hiking in a mountain that contained many rough hills at a similar altitude (Mountain Snow, Taiwan, altitude approximately 3800 m). In conclusion, we found that living at a high altitude for the short term can significantly improve glucose tolerance. Additionally, the improving effect of hiking at high altitudes on glucose tolerance appears to be influenced by the geographic environment. These preliminary results suggest that high altitude living conditions and activities may possibly be developed as potential natural medicines for the prevention and treatment of type II diabetes in the future.

Ectopic and heterotopic pregnancy may occur with increased frequency following assisted reproductive technology (ART) procedures. In addition, there may be unusual sites of implantation, which may cause atypical and confusing clinical manifestations. We present a case of tubal pregnancy after tubal embryo transfer (TET) to the contralateral fallopian tube. Four embryos were transferred to the left fallopian tube by laparoscopy, but the patient developed a right tubal pregnancy, possibly as a result of intrauterine or intra-abdominal migration of the embryo. ART patients must be followed closely soon after the procedure, and there should be a high index of suspicion for an unusual implantation site.

Purpose : To investigate the estradiol (E2) level in the mid-follicular phase during controlled ovarian hyperstimulation (COH) and evaluate it as a predictor of a high risk for ovarian hyperresponse. Methods : From January 1996 to October 2001, the records of a total of 146 patients undergoing 164 COH cycles were retrospectively reviewed. All patients received the long protocol of GnRH agonists from the previous mid-luteal phase and then hMG or FSH from day 3 of the menstrual cycle. The E2 level was evaluated on day 9. Ovarian hyperresponse was defined as 1) an E2 level on the day of hCG injection was >4000 pg/mL, or 2) the necessity for coasting during COH to decrease the risk of ovarian hyperstimulation syndrome (OHSS). Results : Of the 52 cycles in which day 9 E2 level was >800 pg/mL, 29 (55.8%) fulfilled the criteria for ovarian hyperresponse. None of patients whose day 9 E2 level was 800 pg/mL, 32.7%. The corresponding implantation rates were 18.8, 28.0, and 17.0%. The E2 level on day 9 did not correlate with clinical pregnancy rates or implantation rates. Conclusions : A high E2 level in the mid-follicular phase was predictive of patients with a high ovarian response. An E2 level on day 9 of menstrual cycle of >800 pg/mL suggests an increased risk for ovarian hyperresponse, and appropriate management should be instituted to decrease the risk of OHSS.

The objective of this study was to investigate the predictive value of Kruger's criteria for sperm morphology on intrauterine insemination (IUI) outcome. A total of 209 infertile patients underwent 244 IUI treatment cycles. These include 75 couples (80 cycles) with teratozoospermia and 134 couples (164 cycles) with unexplained infertility. The pregnancy rates per IUI cycle were 3.8 (1/26), 18.5 (10/54) and 29.9% (49/164) in patients with sperm morphology with4, 4-9 and9% normal forms, respectively, according to Kruger's criteria. A statistical difference in outcome was seen between couples with4 and9% normal forms (p = 0.005). Although the difference in pregnancy rates between those with 4-9 and4% normal forms was not statistically significant, the pregnancy rate for those with 4-9% normal forms was acceptable and still higher than in those with4% normal forms. Therefore, we suggest that IUI is a reasonable first-line therapy for patients with sperm morphology4% normal forms, while couples with4% normal forms should be advised to use in vitro fertilization with intracytoplasmic sperm injection instead of IUI.

Purpose: To compare ovarian response to controlled ovarian hyperstimulation (COH) between normal ovaries and ovaries previously treated surgically for unilateral ovarian endometrioma.

Nausea and vomiting are common chief postoperative complaints. The clinical literature indicates that postoperative nausea and vomiting (PONV) is common after orthopedic surgery. This study examines the clinical therapeutic efficacy of Ondansetron injected intravenously before the end of shoulder arthroscopy as antiemetic prophylaxis to help reduce the incidence of PONV.Participants were identified through retrospective chart review and patients undergoing shoulder arthroscopy performed by the same orthopedic surgeon at the same hospital from 2005 to 2009 were analyzed. Subjects were classified into two groups based on whether Ondansetron was given. Differences in the incidence of PONV among the two groups were compared. Basic patient information, anesthesia records, and surgical records were obtained, as well as records on PONV, postoperative pain intensity, and postoperative analgesic injections within 24 hours after surgery.The study involved 90 patients. The Group A contained 34 patients who did not receive Ondansetron, and the Group B contained 56 patients who were given Ondansetron. Analytical results for the postoperative 24 hour period showed a significant difference in the incidence of vomiting between the two groups, with a lower incidence (p0.05) for the. Group B. However there was no significant difference in the incidence of nausea between the two groups in the same postoperative 24 hour period, although there was a trend of a lower incidence in the Group B (p = 0.17). The overall incidence of PONV during the 24-hour period was lower in the Group B (14%) than the Group A (32%), and the Group B demonstrated lower pain intensity and lower analgesic injection needs.Routine intravenous injection of Ondansetron 30 minutes before completion of shoulder arthroscopy can reduce the incidence of vomiting and overall PONV in patients. Additionally, the patients using Ondansetron demonstrated lower pain intensity and lower analgesic injection needs than the control group.

IETF(Internet Engineering Task Force) proposed the Management Mechanism of NEMO (NEtwork MObility) to support network mobility. The mobility management of NEMO is an extension of Mobile IPv6 (MIPv6), and it inherits also all the drawbacks of MIPv6 such as inefficient routing, high handover latency, packet loss rate, and so on.The purpose of method which is based on the public transportations (e.g. Train, MRT, Bus etc.) with fixed path as NEMO application solved the handover latency problem and packet lost problem. We propose a seamless handover Scheme with Pre-registration to solve these problems. The proposed handover scheme can decrease handover latency and packet lost in session for NEMO. The aim is to procure seamless communication when the whole network is movement.KeyWords : NeMo, Pre-registration

Pitx3 is a bicoid like homeobox transcription factor of which deficiency in mice is linked with the aphakia phenotype. Mutation in human PITX3 gene is associated with autosomal dominant cataract with variable anterior segment mesenchymal dysgenesis. However, the molecular events causing the morphological changes in aphakia remains unknown. In this study we investigated the behaviour of GFP tagged Pitx3 null embryonic stem cells in chimeric lens, as well as the molecular features of the Pitx3-deficient lens of homozygous Pitx3 knockout mice. We show that the lack of colonisation of Pitx3-deficient ES cell derivatives in Pitx3 wild-type ↔ Pitx3 null chimeric lens was due to the depletion of the epithelial cells in lens epithelium manifested by aberrant cell cycle exit and precocious onset of fibre cell differentiation of the Pitx3 null cells at the lens vesicle stage. This was demonstrated by the early activation of the cell cycle inhibitors p27Kip1 and p57Kip2, and the expression of β-and γ-crystallins. These defects are at least partially attributed to the loss of FoxE3 and misexpression of Prox1 in the lens vesicle epithelial cells. Thus, Pitx3 is essential to maintain lens epithelial phenotype and prevent inappropriate fibre cell differentiation during lens development.

Purpose To investigate follicle survival and developmental potential with IVF of cryopreserved, subcutaneously transplanted mouse ovarian tissue. Methods Fresh and frozen mouse ovarian tissue was autologously transplanted into subcutaneous tissue. Two weeks after the transplantation, the morphology and histology of the fresh and frozen grafts were compared. Superovulation and IVF was performed to evaluate the fertility potential of the frozen ovarian graft. Results Both fresh and frozen grafts of ovarian tissue survived in 14 of 16 mice (88%). Morphologically, both types of grafts resembled fresh ovarian tissue and contained follicles at all stages of folliculogenesis. A total of 73% of follicles in fresh grafts and 62% in frozen grafts survived after transplantation compared with fresh ovarian tissue. Sixteen ICR mice underwent superovulation. A total of 56 oocytes from antral follicles were recovered from the subcutaneously transplanted cryopreserved ovarian tissue. Fourteen (25%) oocytes were in metaphase II stage, 6 were fertilized by IVF, and 2 progressed to the blastocyst stage. Conclusions Cryopreservation and subcutaneous transplantation of ovarian tissue provides a possible means of fertility preservation. The main loss of follicles occurred during grafting rather than during freezing and thawing.

We compared the chronic effect of intermittent hypoxia and endurance training on the glucose tolerance and GLUT4 protein expression in rat skeletal muscle. Thirty-two Sprague-Dawley rats were matched for weight and assigned to one of the following four groups: control, endurance training, hypoxia, or hypoxia followed by endurance training. Hypoxic treatment consisted of breathing 14% O2 for 12 h/day under normobaric conditions, and the training protocol consisted of making animals swim 2 times for 3 h/day. At the end of the 3rd week, an oral glucose tolerance test (OGTT) was performed 16 h after treatments. At the end of the 4th week, GLUT4 protein, mRNA, and glycogen storage in skeletal muscle were determined. Endurance training significantly improved OGTT results. Glycogen content and GLUT4 protein expression in the plantaris and red gastrocnemius, but not in the soleus or white gastrocnemius muscles, were also elevated. Chronic intermittent hypoxia also improved OGTT results, but did not alter GLUT4 protein expression. Additionally, hypoxia followed by exercise training produced significant increases in GLUT4 protein and mRNA in a greater number of muscles compared to endurance training alone. Both exercise training and hypoxia significantly reduced body mass, and an additive effect of both treatments was found. In conclusion, chronic intermittent hypoxia improved glucose tolerance in the absence of increased GLUT4 protein expression. This treatment facilitated the exercise training effect on muscle GLUT4 expression and glycogen storage. These new findings open the possibility of utilizing intermittent hypoxia, with or without exercise training, for the prevention and clinical treatment of type 2 diabetes or insulin resistance.

Ectopic and heterotopic pregnancy may occur with increased frequency following assisted reproductive technology (ART) procedures. In addition, there may be unusual sites of implantation, which may cause atypical and confusing clinical manifestations. We present a case of tubal pregnancy after tubal embryo transfer (TET) to the contralateral fallopian tube. Four embryos were transferred to the left fallopian tube by laparoscopy, but the patient developed a right tubal pregnancy, possibly as a result of intrauterine or intra-abdominal migration of the embryo. ART patients must be followed closely soon after the procedure, and there should be a high index of suspicion for an unusual implantation site.

To investigate the estradiol (E2) level in the mid-follicular phase during controlled ovarian hyperstimulation (COH) and evaluate it as a predictor of a high risk for ovarian hyperresponse.From January 1996 to October 2001, the records of a total of 146 patients undergoing 164 COH cycles were retrospectively reviewed. All patients received the long protocol of GnRH agonists from the previous mid-luteal phase and then hMG or FSH from day 3 of the menstrual cycle. The E2 level was evaluated on day 9. Ovarian hyperresponse was defined as 1) an E2 level on the day of hCG injection was4000 pg/mL, or 2) the necessity for coasting during COH to decrease the risk of ovarian hyperstimulation syndrome (OHSS).Of the 52 cycles in which day 9 E2 level was800 pg/mL, 29 (55.8%) fulfilled the criteria for ovarian hyperresponse. None of patients whose day 9 E2 level was300 pg/mL met the criteria for hyperresponse. The pregnancy rate in the groups with day 9 E2 level300 pg/mL was 42.9%; for an E2 level = 300-800 pg/mL, 49.2%; and for an E2 level800 pg/mL, 32.7%. The corresponding implantation rates were 18.8,28.0, and 17.0%. The E2 level on day 9 did not correlate with clinical pregnancy rates or implantation rates.A high E2 level in the mid-follicular phase was predictive of patients with a high ovarian response. An E2 level on day 9 of menstrual cycle of800 pg/mL suggests an increased risk for ovarian hyperresponse, and appropriate management should be instituted to decrease the risk of OHSS.

The insulin-resistance effect of growth hormone (GH) administration has been frequently reported. The present study investigated the effect of GH administration on glucose tolerance and muscle GLUT4 protein expression in exercise-trained and untrained rats. Forty-eight rats were weight-matched and assigned to the following 4 groups: control, GH, exercise training, and exercise training + GH groups. After 2 weeks of GH injections (65 microg/kg/day) and exercise training, the glucose tolerance and insulin response were measured in these rats. The GLUT4 protein level, glycogen storage, and citrate synthase activity were determined in red gastrocnemius and plantaris muscles. Daily GH administration elevated the curves of the oral glucose tolerance test and insulin response compared with those of saline-injected control rats. Furthermore, exercise training completely eliminated this GH-induced insulin resistance as determined 18 h after the last bout of exercise training. Additionally, exercise training significantly increased muscle glycogen storage and GLUT4 protein levels. GH administration did not affect the GLUT4 protein and glycogen storage increases induced by exercise training, but the citrate synthase activity in the plantaris muscle was further elevated by GH administration to a level above that induced by training. In conclusion, this is the first study that demonstrates that regular exercise training prevents GH-induced insulin-resistance side effect in rats.

To compare ovarian response to controlled ovarian hyperstimulation (COH) between normal ovaries and ovaries previously treated surgically for unilateral ovarian endometrioma.From January 1996 to December 2001, 32 patients with unilateral ovarian endometrioma previously treated surgically underwent 38 cycles of COH. Their records were reviewed retrospectively. The number of dominant follicles observed on the day of hCG injection and the number of eggs retrieved from the diseased and the normal ovaries in each patient were compared.The numbers of dominant follicles from diseased and normal ovaries were 1.9 +/- 1.5 and 3.3 +/- 2.1, respectively (P0.001). During ovum pick up, the numbers of eggs retrieved from diseased and normal ovaries were 2.9 +/- 2.6 and 6.1 +/- 4.1, respectively (P0.0001). For diseased ovaries, 21.1% (8/38) had no dominant follicles, while only 7.9% (3/38) of normal ovaries lacked dominant follicles. The clinical pregnancy rate and the implantation rate per embryo transfer were 33.3 and 17.6%.Surgery for ovarian endometrioma may damage ovarian reserve. It potentially results in poor ovarian response to COH, compared to the response of the contralateral normal ovary in the same individual.