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

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

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*

Doppler sonography has been introduced to evaluate uterine and ovarian diseases. It has been reported to be used to distinguish benign from malignant adnexal masses. The purpose of this study was to assess the blood flow characteristics of adnexal masses and to determine the optimal cut-off points for the Doppler indices obtained, resistance index and pulsatility index, to best differentiate benign from malignant lesions. We performed pulsed Doppler ultrasound in seventy-eight adnexal masses between February 1989 and June 1994. The pulsatility and resistance index were calculated from the waveforms generated from blood flow within the ovary. There were 51 benign and 27 malignant histologically proved ovarian lesions. All women have been operated on. The results were as follows ; Benign tumors and cysts had a significantly higher pulsatility index(mean, 1.23+/-0.74; range, 4.46-3.36) and resistance index(mean, 0.64+/-0.19; range 0.34-1.43) than did malignant tumors(pulsatility index : mean, 0.87+/-0.49; range, 0.31-2.27; resistance index : mean, 0.50+/-17; range, 0.23-0.8). However, some overlap in individual values for benign and malignant lesions was found. In conclusion, our data suggest that high pulsatility and resistance indices may indicate benign adnexal masses ; however, considerable overlap in pulsatility and resistance indices between benign and malignant lesions were noted, and further work will be needed before the validity of these factors is proved.
Female ; Humans ; Ovarian Diseases ; Ovary ; Ultrasonography

PURPOSE: To evaluate preoperative and intraoperative factors affecting the clinical results and determine the effectiveness of the internal limiting membrane in surgery for long standing idiopathic macular holes (stage 2, 3, 4). METHODS: The data were reviewed from a retrospective study on 95 consecutive eyes with idiopathic macular holes undergoing vitrectomy, fluid gas exchange. Forty six of the 95 eyes underwent internal limiting membrane removal surgery additionally. Postoperative follow up was for 2 years. Wilcoxon matched pairs test, Wilcoxon rank test and multiple regression analysis were performed by using SPSS program. RESULTS: The surgery was anatomically successful in 74 of the 95 eyes (77.8%) and 30 of the eyes (31.5%) showed functional success. Preoperative visual acuity and internal limiting membrane removal were important factors affecting postoperative visual outcome in 2 years follow up of the vitrectomy for idiopathic macular holes. Preoperative factors such as age, sex, duration of visual complaints, stage were not found any association with postoperative visual acuity. CONCLUSIONS: Preoperative visual acuity and internal limiting membrane removal were good prognostic factors in idiopathic macular hole surgery. Functional success group showed constant improvement of visual acuity in postoperative 2 years.
Follow-Up Studies ; Membranes ; Retinal Perforations* ; Retrospective Studies ; Visual Acuity ; Vitrectomy

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

A rare case of spinal meningeal mesenchymal chondrosarcoma in 3 10/12 year old boy is reported. The tumor was located in lumbosacral region. Osteoplastic laminotomy was performed for total removal of tumor. The postoperative result was good and related literatures were reviewed.
Chondrosarcoma, Mesenchymal* ; Humans ; Laminectomy ; Lumbosacral Region ; Male