No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic* ; Statistics as Topic*

OBJECTIVES: To determine the level of mRNA expression of various members of the matrix metalloproteinase and tissue inhibitors in uterine leiomyoma compared with unaffected myometrium. Materials & Method: 30 cases of portions of leiomyoma and myometrium were collected immediately followimg hysterectomy. Thirteen cases were from proliferative phase and seventeen were from secretory phase of menstrual cycle. The mean age was 43.7years old. The level of expression of mRNAs of interstitial collagenase, gelatinase, stromelysin, TIMP-1,-2,-3 was determined by reverse transcriptase-polymerase chain reaction(RT-PCR) and normalized to GAPDH(glyceraldehyde-3-phosphate dehydrogenase) mRNA. RESULTS: Myometrium and leiomyoma expressed all the members of above mentioned matrix metalloproteinase family and tissue inhibitors. Leiomyoma expressed a significantly higher level of stromelysin-3 during secretory phase, an extremely lower level of 92kDa gelatinase and a significantly lower level of TIMP-3. The immunohistochemical localization of TIMP-3 was smooth muscle cell and arteriole wall of myometrium and leiomyoma. CONCLUSIONS: The increased expression of stromelysin-3 in uterine leiomyoma compared with myometrium suggests that this MMP may be involved in the formation of a more fibrous extracellular matrix in leiomyoma. The extremely lower expression of 92kDa gelatinase of leiomyoma means that leiomyoma do not invade myometrium and forms a separated mass. Decreased expression of TIMP-3 of leiomyoma suggests that TIMP-3 is required for differentiation and homeostasis of extracellular matrix of normal myometrium and function as a suppressive role of tumor development
Animals ; Arterioles ; Extracellular Matrix ; Female ; Gelatinases ; Homeostasis ; Humans ; Hysterectomy ; Leiomyoma* ; Matrix Metalloproteinase 1 ; Matrix Metalloproteinase 3 ; Menstrual Cycle ; Mice ; Myocytes, Smooth Muscle ; Myometrium* ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-3

Hormone replacement therapy combined with progestogens induces changes in effect of estrogen on serum lipid levels and it has been known that the changes depend on a type and dosage of progestogen. It is also known that progestational agent induces positive ch-ange in bone mineral density. To study the effects of progestogen on lipoprotein and bone metabolism, we administ- ered conjugated equine estrogen 0.625 mg alone to 50 postmenopausal women, in combinat- ion with medroxy- progesterone acetate 5 mg to 40 postmenopausal women. The data demonstrated a beneficial effect in lipoprotein profiles in both groups. Total cholesterol in two groups decreased from the baseline values, LDL-cholesterol decreased significantly by 4.8 % in group I and 16.2 % in group II(p < 0.05), HDL-cholesterol increa- sed significantly by 11.3 % in group I and 14.7 % in group II(p < 0.05), triglyceride incre- ased slightly in both groups. Bone mineral density of femur was maintained and BMD of vertebrae increased by 1.1 % in group I and 2.0 % in group II, but it is not statistically significant. The differences of changes between two groups were not statistically significa- nt. Our results suggest that medroxyprogesterone acetate have no adverse effect on HDL -cholesterol and have no additive effect on bone mineral density in hormone replacement therapy.
Bone Density* ; Cholesterol ; Estrogens* ; Female ; Femur ; Hormone Replacement Therapy ; Humans ; Lipoproteins ; Medroxyprogesterone Acetate ; Metabolism ; Progesterone ; Progestins ; Spine ; Triglycerides

The LH and FSH responses to synthetic LH-RH and the prolactin response to synthetic T-RH were evaluated during different phases of the mentrual cycle in order to understand secretory capacity of the pituitary during the menstrual cycle. Eleven regularly menstruating women between 22 and 35 years of age with a usual cycle length of 27 to 31 days volunteered for this Study. Volunteers received an intra-venous injection of 100 microgram synthetic LH-RH and 200 microgram synthetic T-RH during the early and the late follicular phases and during the early and midluteal phases of the menstrual cycle. LH-RH induced a prompt increase in circulating LH, reaching the peak concentration at 30 minutes following LH-RH administration in all phases of the cycle studied. A change in responsiveness with greater and more sustained LH release from the early to the late follicular phases was observed. The response during the luteal phase was significantly greater than the responses in both the early and the late follicular phases. A concomitant but a much smaller FSH response was observed. T-RH elicited a prompt increase in circulating prolactin within 30 minutes and decreased gradually thereafter, reaching the baseline level by 2 hours after T-RH administration. Maximum concentration of prolactin was reached in 30 minutes following T-RH during all phases of the menstrual cycle. No variation in pituitary responsiveness to T-RH, however, was observed during different phases of the menstrual cycle. These data indicate that the sensitivity of the pituitary gonadotrophs to LH-RH varies during different phases of the menstrual cycle.
Adult ; Female ; Follicle Stimulating Hormone/secretion ; Gonadorelin/pharmacology* ; Human ; Luteinizing Hormone/secretion ; Menstruation* ; Pituitary Gland/drug effects* ; Protirelin/pharmacology*

No abstract available.
Animals ; Embryonic Structures* ; Mice*

Ticlopidine is widely used as an anti-platelet agent and taken by the patients with thrombotic occlusive vascular disease. The aim of this study was to investigate the alterations in platelet aggregation with 3 different methods ; optical method using platelet-rich-plasma (PRP), impedance method using both PRP and whole blood, following administration of ticlopidine. Sixteen healthy volunteers, 12 males and 4 females, aged 26 to 32 years (mean; 27.5 years), who had not taken any drugs interfering with platelet function for two weeks, were divided into two groups. Each subject in the one goup was given a 100mg ticlopidine twice a day, and the other group were given a 200mg ticlopidine twice a day for 1 week. The platelet function was measured by an optical method using PRP and an impedance method using both platelet-rich-plasma (PRP) and whole blood with ADP (1, 5, 10, 20uM) and collagen (1, 2ug/mL). Whatever the method used, significant inhibitory effects of platelet aggregation and changes of aggregation cureve patterns were observed in both groups. The degree of inhibitory effect depends on the types of aggregating agent and their final concentration in the sample. These preliminary results confirmed the inhibitory effect of ticlopidine, when platelet aggregation is induced by ADP, measured by optical method as well as by the impedance method. The ticlopidine of 200mg/day may be not sufficient dosage for platelet inhibition to prevent ischemic stroke recurrence. This inhibitory effect is more prominent in higher dose of ticlopidine and cannot be overcome by increasing the concentration of ADP.
Adenosine Diphosphate ; Blood Platelets* ; Collagen ; Electric Impedance ; Female ; Healthy Volunteers ; Humans ; Male ; Platelet Aggregation* ; Recurrence ; Stroke ; Ticlopidine* ; Vascular Diseases

A temporary balloon occlusion of internal carotid artery (ICA) was performed in 3 patients for carotid artery endarterectomy and 1 patient require sacrifice ICA with neck malignancy. EEG monitoring and neurologic evaluation was done during the test. In one patient who has bilateral ICA stenosis more than 95% shows slurred speech and aphasia during test. Another 3 patients shows no clinical change during test, and operation was done without shunt. There were no postoperative neurologic complication. We believe that preoperative balloon occlusion of ICA provide another helpful criteria to decide using shunt. But it needs another hemodynamic analysis tool according to other's report.
Aphasia ; Balloon Occlusion ; Carotid Arteries* ; Carotid Artery, Internal ; Constriction, Pathologic ; Electroencephalography ; Endarterectomy ; Hemodynamics ; Humans ; Neck

PURPOSE: The solid variety of cerebella r tumors in adult is relatively uncommon. This study is to describe the characteristic MR findings of various solid cerebellar tumors in adult. METHODS: Twenty three cerebellar solid tumors from 22 consecutive patients over age of 15 with surgical confirmations were retrospectively evaluated with MR imaging. H istologic diagnosis included hemangioblastoma (n=6), metastasis (n=6), high-grade astrocytoma (n=3), and medulloblastoma (n=8). The MR findings were reviewed with attention to the size, the signal intensity of the tumors, pattern of enhancement, tumoral margin, degree of peritumoral edema, signal void vascular structures within and/or around the tumor, and location in relation to attachment to the pial surface of the tumor. RESULTS: Solid hemangioblastomas consistently showed slightly low or iso signal intensity on T1 -weighted images and high intensity on T2-weighted images, dense homogeneous enhancement, and signal void vessels within and/or around the mass. Metastatic tumors showed various find ings with predominantly low or iso signal intensity on T2-weighted images. Medulloblastomas was midline and/or paramidline in location, and had larger mass formation. High-grade astrocytomas revealed nonspecific MR findings with no signal void vessels. CONCLUSION: Hemangioblastoma, metastasis, malignant astrocytoma, and medulloblastoma should be included in differential diagnosis of solid cerebellar tumors in adult. Dense homogeneous enhancement and signal void vessels are characteristic of hemangioblastoma. The signal intensity of the tumor, and presence of signal void vessels, location and enhancement pattern can be some value in differential diagnosis of solid cerebellar tumors in adult.
Adult* ; Astrocytoma ; Cerebellar Neoplasms* ; Diagnosis ; Diagnosis, Differential ; Edema ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging ; Medulloblastoma ; Neoplasm Metastasis ; Retrospective Studies

BACKGROUND/AIMS: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrast-enhanced magnetic resonance imaging (MRI). METHODS: Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC). RESULTS: Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P〈0.05) and the DWI set (FOM=0.682, 0.620, P〈0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (〈1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589). CONCLUSIONS: Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.
Humans ; Magnetic Resonance Imaging* ; Neuroendocrine Tumors* ; Sensitivity and Specificity

BACKGROUND: The use of caudal morphine for postoperative analgesia has been increased in popularity since 1981. The purpose of this study was to compare the effect of analgesia and incidence of side effects of a mepivacaine-morphine mixture with mepivacaine alone. METHODS: Forty patients were randomly divided into two groups. In group 1, caudal block was performed with 1% mepivacaine 1 ml/kg alone. In group 2, caudal block was performed with 1% mepivacaine 1ml/kg-morphine 0.03 mg/kg mixture. Postoperative five-point pain scores and side effects were measured. RESULTS: There were no significant differences in sedation dose, incidence of side effects and supplemental analgesics. Pain scores were significantly lower at postoperative 2 and 3 hours in mepivacaine-morphine mixture group. CONCLUSIONS: Caudal epidural mepivacaine-morphine (0.03 mg/kg) mixture is effective in children for control of postoperative pain without significant side effects.
Analgesia* ; Analgesics ; Child* ; Humans ; Incidence ; Mepivacaine ; Morphine* ; Pain, Postoperative