BACKGROUND: Uterine leiomyoma is the most common pelvic tumor, occurring in 20-25% of women in reproductive age. Gonadotropin releasing hormone agonist (GnRHa) has been reognized as a temporary medical management for this disorder. The etiology of these tumors is unknown but it has been shown that the insulin-like growth factors (IGF-I, IGF-II) are promoters of growth in nongynecologic tumors. Several recent studies have suggested the possible role of IGFs in human leiomyoma growth. The IGF binding proteins (IGFBPs) are believed to modulate actions of IGF and to have IGF-independent actions. The purpose of this study was to evaluate the type of IGF and IGFBP which may be involved in leiomyoma growth and to investigate a possible IGF related mechanism of action of GnRHa. METHOD: The IGFs and IGFBPs were measured by double antibody radioimmunoassay, western ligand blot and immunoprecipitation in the tissue cytosols of normal uterine myometria (n=15), nontumorous myometria adjacent to a leiomyoma and leiomyoma from patients nontreated (n=15) and treated (n=10) with GnRHa. RESULTS: The mean IGF-I and IGF-II level were significantly higher in leiomyoma from untreated patients than in the adjacent myometrium and normal myometrium but no significant differences in these IGF levels between normal myometrium and adjacent myometrium were noted. The IGFBP-2, IGFBP-3 and 26kDa IGFBP were detected variably but IGFBP-4 was consistently present in all tissues. There were no significant differences in the relative intensity for IGFBP-4 and the frequency of IGFBPs between leiomyoma, adjacent myometrium and normal myometrium from untreated patients. The IGF-I, IGF-II levels and the relative intensity of IGFBP-4 in leiomyoma from GnRHa-treated patients were significantly lower than those in untreated patients, but these levels in the adjacent myometrium were comparable. The frequency of each IGFBP in leiomyoma and the adjacent myornetrium from GnRHa-treated patients did not significantly differ from untreated patients. CONCLUSION: Both IGF-I and IGF-II are involved in the growth of leiomyoma and GnRHa may in part act to decrease size of leiomyoma by regulating the local levels of IGF-I, IGF-II and IGFBP-4.
Animals ; Cytosol ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Immunoprecipitation ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Leiomyoma* ; Mice ; Myometrium ; Radioimmunoassay ; Somatomedins*

Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured in 46 patients treated with uncomplicated primary hip replacements, 39 total tip replacements and 7 bipolar hip replacements. In uncomplicated primary hip replacements, ESR levels were slightly elevated preoperatively and were variable postoperatively. But CRP was normal before surgery and elevated in postoperative course, but back to normal within three weeks in most cases. Early success of hip arthroplasty is in indicated by normalization of CRP within three weeks, regardless of ESR. Since ESR seems to react somewhat differently from the CRP, both methods are useful in the monitoring of complications after hip arthroplasty.
Arthroplasty* ; Blood Sedimentation* ; C-Reactive Protein* ; Erythrocytes* ; Hip* ; Humans

The authors reviewed the charts of 128 patients(160 eyes) who underwent vitrectomy for the proliferative diabetic retinopathy from January 1993 to December 1995 and the results were analyzed in terms of visual efficiency. At the conclusion of the study, visual acuity improved in 96 eyes(60%), unchanged in 33 eyes(21%) and in 31 eyes(19%) became worse. Visual efficiency was increased from 11.9% preoperatively to 37.2% postoperatively in all patients. Patients under the age of 40 showed better results than the patients above the age of 40. The factors which affected the change in visual efficiency were age and preoperative intraocular conditions. The patients who had non-clearing vitreous hemorrhage without proliferative membrane revealed better prognostic results than the other patients. In 50 eyes (31.3%) of cases, maximal postoperative visual acuity was achieved in 4 weeks to 3 months after operation.
Diabetic Retinopathy* ; Humans ; Membranes ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Thirty eyes of thirty patients with coexisting cataract and vitreoretinal disease underwent combined cataract extraction, pars plana vitrectomy and posterior chamber intraocular lens implantaion.Surgical procedures of cataract extraction included phacoemulsification(14 eyes), pars plana lensectomy(11 eyes) and extracapsular lens placed in the capsular bag in 19 eyes following phacoemulsification or extracapsular cataract extraction. Eleven eyes had sulcus fixation of posterior chamber lens following lensectomy.Postoperatviely visual acuity improved in 26 eyes(86.7%), unchanged in 3 eyes(10%) and decreased in 1 eye(3.3%). Final visual acuity was 20/200 or better in 26 eyes(86.75), and 20/40 or better in 11 eyes(36.7%). Postoperative complications included rhegmatogenous retinal detachment with proliferative vitreoretinopathy, neovascular glaucoma and endophthalmitis.Pars plana vitrectomy combined with cataract extraction with posterior chamber intraocular lens implantation maybe useful in reducing cost and providing rapid visual rehabilitation.
Cataract Extraction* ; Cataract* ; Glaucoma, Neovascular ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Phacoemulsification ; Postoperative Complications ; Rehabilitation ; Retinal Detachment ; Visual Acuity ; Vitrectomy* ; Vitreoretinopathy, Proliferative

Pleomorphic xanthoastrocytoma(PXA) is a benign brain tumor with favorable prognosis in spite of its marked pleomorphism. We report a case with review of the literature. An eight-year-old boy presented with headache and vomiting. Plain skull X-ray showed findings of increased intracranial pressure. The MR imaging demonstrated superficially located large cystic mass with a Iobulated mural nodule in the left frontal lobe. The mural nodule abutting leptomeninges showed intense enhancement on postcontrast Tl-weighted images, but the cyst wall was not enhanced. Preoperative diagnosis of PXA with the MRI findings could lead to avoidance of more aggressive brain resection and therefore more favorable neurological outcome
Brain ; Brain Neoplasms ; Child* ; Diagnosis ; Frontal Lobe ; Headache ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Male ; Prognosis ; Skull ; Vomiting

Acute mobile thrombus of the abdominal aorta after chemotherapy is a very unusual finding, which can be a potential source of arterial embolism. We report here on a case of an acute mobile aortic thrombus with renal infarction. We successfully treated the patient with hybrid operation-open surgical and endovascular approach. Our case shows that hybrid treatment using wire-directed balloon catheter thrombectomy is a feasible, minimally-invasive treatment for a mobile aortic thrombus.
Angioplasty ; Aorta ; Aorta, Abdominal ; Catheters ; Chimera ; Embolism ; Humans ; Infarction ; Thrombectomy ; Thrombosis

A total of 212 cases of gastric carcinoma resected at Kang-Dong Sacred Heart Hospital during the period of 4 years from December 1986 to December 1990 were examined according to Borrmann, Mulligan-Rember, Ming and WHO methods based on histopathological investigations. In Mulligan-Rember (M-R) classification, intestinal cell type (IC) was frequently seen in Borrmann type I and II; pyloro-cardiac gland cell type (PC) in II and III, and mucous cell type (MC) in IV and III. Expanding growth pattern was more frequent in IC, infiltrative growth pattern in MC, and PC showed less infiltrative growth than MC. In gross type, the most expanding growth pattern was seen in Advanced gastric carcinoma type (AGC) I and the next one was in AGC II; the ratio of infiltrative versus expanding type was highest in AGC IV and next in AGC resembling early gastric carcinoma (EGC) and AGC III in order. On WHO classification except squamous type, all the papillary type showed expanding growth and infiltrative growth was frequently seen in signet-ring cell, undifferentiated, tubular and mucinous types in order. Lymphoid stroma was more frequently found in expanding type than infiltrative type. The frequency of angioinvasion of tumor cells observed was high in AGC resembling EGC, AGC II, III, IV, I and EGC in order. In WHO classification excluding squamous type, undifferentiated and signet-ring cell types occurred more frequently under the age of 60 and papillary type were more frequnetly seen over the age of 60. But tubular type had no difference between the two age groups. In Ming's classification, expanding type was more frequently seen than infiltrative type over the age of 60.

Purpose: To investigate the long-term clinical course and prognostic factors of branch retinal artery occlusion (BRAO). Methods: The medical records of patients diagnosed with BRAO were reviewed retrospectively. Visual acuity (VA) and central retinal thickness (CRT) at diagnosis were compared with those measured at the final visit. Patients with a decimal VA ≥ 0.6 (good prognosis group) were compared with those with a decimal VA ≤ 0.5 (poor prognosis group) at the final visit. Results: Fifty-five patients were enrolled and the mean follow-up period was 45.8 ± 27.8 months. The mean logarithm of minimum angle of resolution improved from 0.53 ± 0.57 at diagnosis to 0.36 ± 0.61 at the final visit (p = 0.026). The decimal VA was ≤ 0.1 in 13 (23.6%) patients, ≥ 0.2 and ≤ 0.5 in 16 (29.1%) patients, and ≥ 0.6 in 26 (47.3%) patients at diagnosis; the respective values were 9 (16.4%), 8 (14.5%), and 38 (69.1%) at the final visit. The mean CRT significantly decreased from 273.9 ± 34.7 µm at diagnosis to 248.9 ± 27.0 µm at the final visit (p < 0.001). The poor prognosis group (n = 17) was older (p = 0.044) and had a higher incidence of papillomacular bundle involvement (p < 0.001) than the good prognosis group (n = 38). Conclusions Patients with BRAO generally showed relatively favorable long-term outcomes. However, the final VA was ≤ 0.1 in 16.4% of them, suggesting the need for further treatment modalities to improve the outcome of patients with a poor prognosis.

PURPOSE: To report the usefulness of optical coherence tomography (OCT) for assessing postoperative visual acuity in macula-off retinal detachment. METHODS: This prospective study included 54 patients who were operated on for macula-off retinal detachment, and who could be followed up for at least 6 months, between September 2003 and July 2005. Patients were examined at 1 day before surgery and at 1, 3, and 6 months after surgery for best corrected visual acuity, intraocular pressure, by slit lamp examination, fundus examination, and OCT. RESULTS: Preoperative best corrected visual acuities improved at 1, 3, and 6 months after surgery (p<0.05). The average period of macular reattachment with fundus examination was found to be 24 days, but with OCT it was found to be 52 days. Improvement of best corrected visual acuity was found in 40 eyes (74.1%), and among these, reattachment of the macula on OCT was found in 36 eyes (90%). Postoperative visual acuity was better when there was better preoperative visual acuity, a shorter duration of macular detachment, and when the height of the detached macula on OCT was shorter. CONCLUSIONS: Macular reattachment as determined by OCT was related to the improvement of visual acuity after surgery. We suggest that OCT is useful in patients whose macular reattachment was seen on fundus examination but whose postoperative visual acuity had not improved.
Humans ; Intraocular Pressure ; Prospective Studies ; Retinal Detachment* ; Retinaldehyde* ; Tomography, Optical Coherence* ; Visual Acuity

No abstract available.
Sterilization, Tubal*