No abstract available.
Epithelium* ; Humans* ; Insulin*

OBJECTIVES: The purposes of this study were to determine the usefulness of transvaginal ultrasonographic assessment of the uterine cervix and to compare the diagnostic performance of ultrasonographic and digital examination of the cervix in predicting a successful induction of labor. STUDY DESIGN: One hundred-one singleton term pregnancies without ruptured membranes admitted for the labor induction were included in this study. Digital examination and transvaginal ultrasonography of the uterine cervix were performed at the time of admission. Cervical parameters evaluated included cervical length, presence of funneling, funnel length, and funnel width. Labor induction was underwent by prostaglandin E2 (PGE2) vaginal suppository and/or pitocin intravenous infusion. Outcome variable was a successful labor induction within 48 hours after beginning of the induction. RESULTS: The prevalence of induction failure was 10.9% (11/101). Receiver-operator characteristic (ROC) curve and multiple logistic regression analysis indicated a significant relationship between the successful induction of labor and cervical length <3.1 cm. The diagnositic indices of endocervical length was superior to those of Bishop's cervical score in predicting a successful induction of labor. In patients with cervical length <3.1 cm, the labor was induced successfully with fewer tablets of PGE2, less use of pitocin infusion, and shorter induction-delivery interval. CONCLUSION: Transvaginal ultrasonographical examination of the uterine cervix is more accurate than digital examination of the cervix in the prediction of a successful induction of labor in term gestation.
Cervix Uteri* ; Dinoprostone ; Female ; Humans ; Infusions, Intravenous ; Logistic Models ; Membranes ; Oxytocin ; Pregnancy* ; Prevalence ; Suppositories ; Tablets ; Ultrasonography

OBJECTIVE: The involvement of IGF system in hyperandrogenism and abnormal follicular development is controversial. This study is to assess whether IGF system contribute to it in the women with polycystic ovary(PCO). METHODS: Baseline serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (ADD), prolactin, thyroid stimulating hormone (TSH), free insulin-like growth factor(IGF)-I, free IGF-II, insulin-like growth factor binding protein(IGFBP)-1, and IGFBP-3 were measured in twelve healthy regularly cycling volunteers and forty-two women with PCO then, the changes of baseline serum levels were evaluated after laparoscopic ovarian electrocauterization in nine PCO patients. In addition, the expression pattern of IGF-I and IGF-II was examined in the ovary of control and PCO group. RESULTS: Baseline levels of LH, ADD, free IGF-II, and IGFBP-3 were significantly higher in PCO group. However, there were no significant differences in the levels of free IGF-I and IGFBP-1, although free IGF-I showed decreasing tendency in PCO group. And there was a significant positive correlation between the LH and free IGF-II level in the PCO(P=0.011, r2=0.3899), but not in the control. After ovarian electrocauterization, LH, T, and ADD levels decreased, and free IGF-I and IGFBP-3 level increased. While free IGF-II and IGFBP-1 level showed no significant changes. In the ovary, expression of both IGFs showed similar pattern in normal and PCO ovaries. CONCLUSIONS: The elevated IGFBP-3 level may alter the bioavailability of IGF(s) in the PCO. The change in IGF-I level and resumption of ovulation after electrocauterization, suggest a possible role of IGF system in the impairment of follicular development in the PCO.
Androstenedione ; Biological Availability ; Carrier Proteins* ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hyperandrogenism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Luteinizing Hormone ; Ovary* ; Ovulation ; Prolactin ; Somatomedins* ; Testosterone ; Thyrotropin ; Volunteers

A total of 420 cases of tumors of bone and cartilage were seen and treated at our department during the 19 years period from January, 1957 to November, 1975, This studies reviewed and analysed clinically, radiologically and pathologically. One hundred fifty-three cases (36.4%) were benign tumors. These included osteochondroma-54 cases (35.3%), benign giant cell tumor-18 cases (11.8%), enchondroma and osteoma-15 cases (9.8%) each, fibrous dysplasia-14 cases (9.2%), solitary bone cyst-13 cases (8.5%), osteoid osteoma-11 cases (7.2%),aneurysmal bone cyst and non-ossifying fibroma-5 cases (3.2%) each, chondroblastoma-2 cases (1.3%), and chondromyxoid fibroma 1 case (0.6%). Two hundred sixty-seven cases (63.6%) were malignant tumors. Among these cases, one hundred forty-nine cases (55. 9%) were metastatic bone tumors and one hundred eighteen were primary malignant bone tumors. The latter included osteogenic sarcoma 54 cases (46.0%), chondrosarcoma-19 cases (16.1%), reticulum cell sarcoma-9 cases (7.6%), multiple myeloma and malignant giant cell tumor-8 cases (6.7%) each, Ewings sarcoma-7 cases (6.0%), fibrosarcoma-5 cases (4.2%), juxtacortical osteogenic sarcoma and liposarcoma-3 cases (2.5%) each, and lymphosarcoma 2 cases (1.7%). a greated incidence of malignant tumors. The result led us to conclude that; 1. In this study of bone tumors, the ratio between benign and malignant tumors was around 1: 1. 7, a greater incidence of malignant tumors. 2. Osteochondroma was the most frequently encountered benign bone tumor (35.3%), and followed by benign giant cell tumor (11.8%). 3. Excluding metastatic bone tumor, osteogenic sarcoma was the most frequently encountered malignant bone tumor (46.0%), and followed by chondrosarcoma (16.1%). 4. The most common site of solitary osteochondroma was around knee joint including the distal femur and the proximal tibia in 15 cases (45.5%). The peak age incidence was in the second decade of life and 43 cases were solitary and 11 cases were multiple lesion. 5. In 15 cases of enchondroma, 10 cases were solitary and 5 cases were multiple lesions. The common site was phalanges of the hand. 6. Giant cell tumor was 26 eases and to be divided into pathologically Grade I & II 18 cases (69%) and Grade III 8 cases (31%). 7. The average age of giant cell tumor was 33.8 years with the peak incidence in the third and forth decade of life. 8. The common sites of giant cell tunior were the distal femur in 8 cases and proximal tibial in 4 cases and distal radius in 6 cases. More than half of these series, the tumor occurred around the knee. 9. The sex distribution of chondrosarcoma showed 4 times of the male predominence. The 2 cases of secondary chondrosarcoma arose from osteochondroma and multiple osteochondromatosis. 10. The average age of osteogenic sarcoma was 25. 5 years with the peak incidence in the second decade of life. 11. The sex distribution of osteogenic sarcoma 42 males (77.8%) and 12 females (22.2%), a male predominance. 12. The common sites of osteogenic sarcoma were distal femur and the proximal tibia and proximal humerus in 42 cases (77.8%). 13. In metastatic bone tumor, male was predominent; 90 males (60.4%) and 59 females (39.6%), and common primary site of cancer included stomach (13.4%), lung (12.8%), breast (6.0%), liver (4.7%) and female genital organ (4.7%). 14. The most common sites of metastatic tumor to bone was spine in 46.3%, and followed by pelvis, ribs, femur and skull.
Bone Cysts ; Breast ; Cartilage ; Chondroma ; Chondrosarcoma ; Exostoses, Multiple Hereditary ; Female ; Femur ; Fibroma ; Genitalia ; Giant Cell Tumors ; Giant Cells ; Hand ; Humans ; Humerus ; Incidence ; Knee ; Knee Joint ; Liver ; Lung ; Lymphoma, Non-Hodgkin ; Male ; Multiple Myeloma ; Osteochondroma ; Osteosarcoma ; Pelvis ; Radius ; Reticulum ; Ribs ; Sex Distribution ; Skull ; Spine ; Stomach ; Tibia

BACKGROUND: A number of reports have been published regarding the use of imiquimod for the treatment of melanoma in situ and metastatic melanoma. Essential steps in the process of melanoma invasion and metastasis include degradation of basement membranes and remodeling of the extracellular matrix by proteolytic enzymes, including matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). OBJECTIVE: To evaluate the antiinvasive effect of imiquimod in human malignant melanoma cell lines, SK-MEL-2 and SK-MEL-24, in vitro, and to investigate imiquimod-induced changes in the expression of MMPs and TIMPs. METHODS: Invasiveness of melanoma cell lines following imiquimod treatment was evaluated by invasion assays. In order to investigate the mechanism of the anti-invasive effect of imiquimod, mRNA and protein levels of MMP-2, -9, membrane type 1 (MT1)-MMP, TIMP-1, and -2 were assessed by real-time reverse transcription-polymerase chain reaction, gelatin zymography, and western blotting. RESULTS: Imiquimod treatment decreased in vitro viability of melanoma cells in a concentration-dependent manner. Imiquimod also elicited a concentration-dependent suppression of invasion in both melanoma cell lines. A concentration-dependent decrease in MMP-2 and MT1-MMP protein levels and a concentration-dependent increase in TIMP-1 and -2 protein levels by imiquimod was observed in both melanoma cell lines. However, expression of MMP-9 protein was increased in SK-MEL-2 but decreased in SK-MEL-24 with increasing imiquimod concentrations. Imiquimod elicited alterations in MMPs and TIMPs mRNA levels that parallel the observed changes in protein levels. CONCLUSION: Imiquimod may elicit an anti-invasive effect on human melanoma cells by regulating MMPs and TIMPs.
Basement Membrane ; Blotting, Western ; Cell Line ; Extracellular Matrix ; Gelatin ; Humans ; Matrix Metalloproteinase 14 ; Matrix Metalloproteinases* ; Melanoma* ; Membranes ; Metalloproteases* ; Neoplasm Metastasis ; Peptide Hydrolases ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1

No abstract available.
Onycholysis*

Xanthogranulomatous cholecystitis (XGC) is an uncommon, focal or diffuse destructive inflammatory process of the gallbladder that is assumed to be a variant of chronic cholecystitis. XGC is characterized grossly by irregular thickening of the gallbladder wall with the formation of a yellow mass (xanthogranuloma). Histologically the xanthogranuloma appears as yellow nodules or streaks in a thickened gallbladder wall and is composed of predominantly lipid-laden macrophages, inflammatory cells, and fibroblasts. These xanthogranulomatous foci may extend into adjacent structures, adhesions or ulcerations are often present, and fistula formation may occur. Although the pathogenesis of XGC is unclear, recurrent inflammation in the presence of calculi and biliary stasis are thought to be the main etiological factors because of the histologic evidence of chronic inflammation and the presence of gallstones in a majority of cases. XGC may lead to associated complications such as perforation, abscess, and fistula, and sometimes closely mimics a gallbladder carcinoma. During an operation for XGC, careful surgical technique is required to dissect the gallbladder and to excise the adjacent xanthogranulomatous tissue. Also a careful investigation to find the coincident gallbladder carcinoma is necessary. We report a case with XGC in a hemophilia A patient and a review of the clinical literatures.
Abscess ; Calculi ; Cholecystectomy ; Cholecystitis* ; Cholestasis ; Fibroblasts ; Fistula ; Gallbladder ; Gallstones ; Hemophilia A* ; Humans ; Inflammation ; Macrophages ; Ulcer

Agenesis of the right lobe of the liver is such a rare congenital anomaly that only about 40 cases have been reported in the literature. This anomaly is considered to be caused by a developmental failure of the right portal vein or by an error of mutual induction between the primitive diaphragm and the endodermal diverticulum representing the primitive liver. When the absence or hypoplasia of the right lobe is found by radiological examinations, several condition, such as liver cirrhosis, a cholangiocarcinoma, and a previous hepatic resection, must be taken into a consideration for a differential diagnosis besides agenesis. Agenesis of the right lobe could be complicated by various biliary tract diseases, including cholelithiasis, a carcinoma of the gallbladder and Mirizzi syndrome, portal hypertension, and rarely volvulus of the stomach, and these complications usually draw clinical attention. We experienced a 58-year-old female who complained of intermittent fever, chills, and jaundice and who was diagnosed with agenesis of the right lobe of the liver with multiple intrahepatic stones by using abdominal CT and MRI. Percutaneous transhepatic biliary drainage was done to relieve the obstructive jaundice, and a percutaneous transhepatic cholangiogram revealed agenesis of the right lobe and abnormal course of the biliary tract. In operative findings, there was no right lobe, and the left lateral segment was markedly enlarged with compensatory hypertrophy. However, the medial segment of the left lobe and caudate lobe was relatively normal in size. The gallbladder was located on the right side of the liver retrohepatically. A cholecystectomy and a choledocholithotomy through a choledochotomy and a retrograde approach after a subsegmentectomy of segments II and III were done.
Bile Ducts, Intrahepatic* ; Biliary Tract ; Biliary Tract Diseases ; Chills ; Cholangiocarcinoma ; Cholecystectomy ; Cholelithiasis ; Diagnosis, Differential ; Diaphragm ; Diverticulum ; Drainage ; Endoderm ; Female ; Fever ; Gallbladder ; Humans ; Hypertension, Portal ; Hypertrophy ; Intestinal Volvulus ; Jaundice ; Jaundice, Obstructive ; Liver Cirrhosis ; Liver* ; Magnetic Resonance Imaging ; Middle Aged ; Mirizzi Syndrome ; Portal Vein ; Stomach ; Tomography, X-Ray Computed

BACKGROUND: The prognosis for a hepatocellular carcinoma (HCC) is very poor because of delayed diagnosis caused by the absence of specific clinical manifestations in the early stage, the limitation of the extent of resection, the high postoperative complication rate due to associated liver cirrhosis, and the high recurrence rate due to multifocal tumorigenesis. Among the various kinds of treatment modalities for HCC, surgical resection is still recognized as the first treatment method. However, it is true that surgical resection has many problems, such as a high operative risk and a high postoperative recurrence rate. Therefore, an evaluation of the factors associated with the overall survival rate and with the recurrence rate is very important for improving the results of operative therapy for HCC. METHODS: We retrospectively analyzed the clinical and the pathological results of 44 curative hepatic resections for HCC performed at Chonnam University Hospital from 1991 to 1997. We evaluated 19 clinical and pathological factors by univariate and multivariate analysis, and we calculated the survival rate by using the Kaplan-Meier method. RESULTS: The cumulative 1-, 3-, and 5-year survival rates were 81%, 66%, and 28%, respectively. In 25 of the 44 cases, recurrences developed, and the 1-, 3-, and 5-year recurrence rates were 38%, 60%, and 65%, respectively. Factors with an independent effect on the overall survival rates were multiplicity of tumors, HBs Ag status, and Child classification. However, liver cirrhosis, ascites, prothrombin time, AFP level, and portal vein invasion were not statistically significant. CONCLUSIONS: The significant prognostic factors detected by multivariate analysis were multiplicity of tumors, HBs Ag status and Child classification. A preoperative evaluation for these factors should be done. If early diagnosis and multidisciplinary therapies are done through frequent postoperative follow-up surveys in these high risk groups, we can anticipate better long-term survival rates after a hepatectomy.
Ascites ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Child ; Classification ; Delayed Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Hepatectomy ; Humans ; Jeollanam-do ; Liver Cirrhosis ; Multivariate Analysis ; Portal Vein ; Postoperative Complications ; Prognosis ; Prothrombin Time ; Recurrence ; Retrospective Studies ; Survival Rate*

No abstract available.
Chorionic Gonadotropin* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans* ; Progesterone* ; Superovulation*