PURPOSE: To demonstrate the characterization calretinin-immunoreactive displaced amacrine cells in the ganglion cell layer using immunohistochemistry and electron microscopy. METHODS: For immunohistochemistry, sections from guinea pig retina were incubated with mouse monoclonal antibody directed against calretinin. For double label studies, sections were incuated in mixture of mouse monoclonal anti-calretinin or rabbit polyclonal anti-calretinin with following antibodies: goat polyclonal anti-ChAT, rabbit polyclonal anti-GABA, mouse monoclonal anti-GABAA receptor alpha1, beta2/3. Sections were analyzed using Bio-rad Radiance Plus confocal scanning microscope. Stained sections from three guinea pig were observed with transmission electron microscope. RESULTS: Calretinin immunoreactivity was present in displaced amacrine cells and ganglion cells gaving rise to processes ramified in the inner part of the inner plexiform layer in stratum 4. The same stratum was also occupied by the dendrites of ON-cholinergic amacrine cells. Double-labeling demonstrated that dendrites and cell bodies of displaced amacrine cells colocalized with ON-cholinergic amacrine cells and dendrites of ganglion cells directly overlapped with dendrites of ON-cholinergic amacrine cells. The synaptic connectivity was identified by electron microscopy. Ganglion cell dendrites received synaptic input from ON-cholinergic amacrine cell. GABAA receptor beta2/3 subunit bands cofaciculates the dendrites of displaced amacrine cell and ganglion cell that are juxtapose to the alpha1 subunit of GABAA receptor. CONCLUSIONS: These results indicate that ON-cholinergic amacrine cells modulate calretinin-labeled ganglion cell via GABAA receptor beta2/3 in the guinea pig retina.
Amacrine Cells ; Animals ; Calcium-Binding Protein, Vitamin D-Dependent ; Dendrites ; Electrons ; Ganglion Cysts ; Goats ; Guinea ; Guinea Pigs ; Immunohistochemistry ; Mice ; Microscopy, Electron ; Retina

No abstract available.
Abortion, Spontaneous* ; Female ; Humans ; Incidence* ; Pregnancy

OBJECTIVE: The purpose of this study is to evaluate the clinicopathologic characteristics of the torsion of the ovarian tumor in postmenopausal women. METHODS: We reviewed the medical records of 20 postmenopausal patients with a postoperative diagnosis of torsion of the ovarian tumor in Department of Obstetrics and Gynecology, Hanyang University Hospital from January 1989 to December 1998. RESULTS: The postmenopausal patients with torsion of the ovarian tumor constitute 20/94 (21.3%) of all adnexal torsion patients encountered during this period. The mean (+/-SD) age of the 20 patients was 63.5+/-9.0 years, with a range of 52-90 years. The mean time since menopause was 16.5+/-10.3 years, with a range of 1-39 years. The mean parity was 5.4+/-2.0 (range of 3-10). Lower abdominal pain (65%) was the most frequently presenting symptom, palpable mass(20%) or diagnosed mass(15%) being the second. But, in 20% of cases there was no lower abdominal pain. The torsion occurred at the right side in 11cases (55%) and at the left side in 9 cases. The most frequent degree of torsion was those cases that was rotated twice (720 degrees). The neoplasms undergoing torsion ranged in diameter between 5cm and 30cm and the most prevalent size was 6 to 10 cm (8 cases). Most of the patients (17cases) were treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy. The tumors that produce torsion varied histologically and the most common type was cystic teratoma (in 5 cases), simple cyst(in 3 cases), serous cystadenoma(in 2 cases), mucinous cystadenoma(in 2 cases). CONCLUSIONS: In our study, ovarian tumor torsion occurring in postmenopausal patients constituted approximately 20% of all torsion patients, therefore adnexal torsion should be considered when a postmenopausal woman presents with lower abdominal pain. When torsion is diagnosed, total abdominal hysterectomy and bilateral salpingo-oophorectomy is the usual treatment for postmenopausal patients. Histologically, in more than 90% of cases, the tumors that produce torsion were benign. If cancer is evident, more extensive surgery is required.
Abdominal Pain ; Diagnosis ; Female ; Gynecology ; Humans ; Hysterectomy ; Medical Records ; Menopause ; Mucins ; Obstetrics ; Parity ; Teratoma

OBJECTIVE: Proopiomelanocortin (POMC) gene is involved in various neuroendocrine reproductive activities and its principal areas of expression are hypothalamus and pituitary gland. However, as it is known as low copy gene, detection of its expression by in situ hybridization is challenging. This study was to examine the degree of basal expression of POMC mRNA and anatomic localization of its expression in rat hypothalamus and pituitary gland as a preliminary study for related reproductive endocrine researches. METHODS: Hypothalamus and pituitary gland of ovariectomized female Spraque-Dawley rat (weight: 250-300 g) was obtained by decapitation with preservation of POMC mRNA by cardiac perfusion of 4% paraformaldehyde. Then, coronal sections of hypothalamus and horizontal sections of pituitary gland were made after paraffin embedding. For in situ hybridization, 35S-labeled antisense RNA probe was used and after in situ hybridization reaction and serial washing procedure, detection of its signal was made by emulsion autoradiography of slide and dark field microscopic examination was done for photographic documentation. Anatomic localization of various nucleus of hypothalamus was done by method proposed by Paxinos and Watson1. RESULTS: Strong expression signal of POMC mRNA was detected in the intermediate lobe of pituitary gland. Less strong, but evenly distributed signals were also detected in the anterior lobe of pituitary gland. In hypothalamic sections, entire area of arcuate nucleus from rostral to caudal direction (between bregma -2.80 mm to bregma -4.30 mm area) showed clear and strong signal of POMC mRNA expression. CONCLUSION: Though POMC gene is known as low copy gene, its basal mRNA expression in pituitary gland and hypothalamus in ovariectomized rat were detectable by in situ hybridization technique. As subpopulation of arcuate nucleus are under complex differential regulation, this in situ hybridization model would be helpful for understanding the effects of various regulatory factors on expression of POMC gene in the specific anatomic area of hypothalamus and pituitary gland.
Animals ; Arcuate Nucleus ; Autoradiography ; Decapitation ; Female ; Humans ; Hypothalamus* ; In Situ Hybridization* ; Paraffin Embedding ; Perfusion ; Pituitary Gland* ; Pituitary Gland, Anterior ; Pituitary Gland, Intermediate ; Pro-Opiomelanocortin* ; Rats* ; RNA, Antisense ; RNA, Messenger

Since 1970, the group B streptococcus(GBS) has been a significant cause of neonatal sepsis in the West. Two distinct forms of disease occur in neonates. Early-onset disease which occurs within 7 days after birth is characterized by respiratory distress, apnea, shock, pneumonia, and occasionally meningitis. Late onset disease usually occurs at 3-4 weeks of age(ranging from 7 days to 3 months) and presents occult bacteremia or meningitis. The GBS is thought to be a rare causative agent for neonatal sepsis in Korea. Lately, we experience a case of early-onset GBS sepsis who died at 3rd day of life. We present this case with brief review of literatures.
Apnea ; Bacteremia ; Humans ; Infant, Newborn ; Korea ; Meningitis ; Parturition ; Pneumonia ; Sepsis* ; Shock

OBJECTIVES: The early detection of ectopic tubal pregnancy in unruptured state is increased as the transvaginal sonography and sensitive serum hCG test are available. For this unruptured tubal pregnancy, the medical treatment using methotrexate via various routes and dosage is being tried. Our study was to evaluate the efficacy of single systemic injection of methotrexate in the treatment of unruptured tubal pregnancies. Material and METHODS: From the January 1997 to July 1999, of 152 ectopic pregnancy patients, 22 patients who were diagnosed as unruptured tubal pregnancies were treated with single-dose systemic methotrexate injection (50 mg/m2/IM). Exclusion criteria were unstable vital signs with hemoperitoneum, adnexal mass > 5-6 cm. Serum hCG titers were checked before injection and 4, 7 day after injection. If serum hCG titer declined more than 15% on 7 day after injection compared with titer on 4 day, the weekly hCG titer was followed until it was <10 mIU/ml .If the hCG titer did not decline more than 15 %, a second dose was given. If hCG titer was not decreased or vital signs became unstable after 1-2 injections, the treatment was considered failure and surgery was done. RESULTS: 18 cases (82%) of 22 were successfully treated with single-dose methotrexate. The mean size of ectopic mass and initial serum hCG titers were 2.7+/-1.3 cm (range, 1.5-5.4 cm) and 3,298+/-1,007 mIU/ml (range, 132-12,239), respectively. Of 22, 6 cases (28%) needed second dose of methotrexate. The mean time to resolution of serum beta-hCG titer was 27.5+/-13.6 days (range, 8-53 days). Elevation of liver enzyme did not occurred in all cases during treatment. Initial hCG titer was more important prognostic factor than ectopic mass size for successful medical treatment. CONCLUSION: Single-dose methotrexate appears to be an effective medical treatment for the unruptured tubal pregnancy. However, patients selection using strict criteria is needed to increase its success rate.
Female ; Hemoperitoneum ; Humans ; Liver ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Vital Signs

The purpose of this study was to review the clinical features, histological types and the mode of treatment of malignant gynecologic tumors. Retrospective reviews of the medical recordings for 75 cases with malignant gynecologic tumors in department of Obstetrics and Gynecology, Kuri hospital Hanyang University from July. 1, 1995 to Jun. 30. 2000. We analysed clinical characteristics, stage, histopathologic type and treatment modality. Of 75 cases, 44 cases were carcinoma of the uterine cervix, 21 cases were ovarian cancer and 10 cases were uterine cancer. The mean age of cervix cancer is 53.3 years, ovarian cancer is 50.9 years and uterine cancer is 49.5 years old. The main treatment modality of cervix and uterine cancer were surgery followed radiotherapy and ovary cancer was surgery plus adjuvant chemotherapy. However, as the number of patients were small in our study, further study with large number of patients are warranted.
Cervix Uteri ; Chemotherapy, Adjuvant ; Female ; Gynecology ; Humans ; Medical Records ; Obstetrics ; Ovarian Neoplasms ; Radiotherapy ; Retrospective Studies ; Uterine Cervical Neoplasms ; Uterine Neoplasms

OBJECTIVE: This study was done to assess long-term survival and risk factors for recurrence after neoadjuvant chemotherapy and radical hysterectomy for locally advanced cervical cancer patients. METHODS: Between August 19S3 and May 1990, 80 cervical cancer stage IB-IIB patients with tumor diameter 4cm or more received neoadjuvant VBP chemotherapy and radical hysterectomy. After follow-up more than 10 years for these patients, survival rate and risk factors for recurrence were analyzed. RESULTS: Seventy eight of SO patients were followed for 10 years. During this period, 20,5% patients(16/78) had recurrences and all of them died of recurrence. Five and 10 year survival rates were 82%(64/78) and 79.4%(62/78), respectively. High risk factor for recurrence was pelvic lymph node invasion. However, clinical stage, initial tumor mass size, number of neoadjuvant chemotherapy, clinical response, or residual tumor size were not clinically significant risk factors for recurrence. Initial tumor size was correlated with pelvic lymph node metastasis. In recurrent patients, site of recurrence was not different according to pelvic lymph node status. For node positive patients, combination of chemotherapy and radiation seemed to be more effective in reducing recurrence compared to chemotherapy or radiation only. CONCLUSION: For locally advanced stage IB-IIB cervical cancer patients who received neoadjuvani chemotherapy and radical hysterectomy, pelvic lymph node metastasis was high risk factor for recurrence and initial tumor size was closely correlated with pelvic lymph node invasion even after neoadjuvant chemotherapy.
Drug Therapy* ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Recurrence* ; Risk Factors* ; Survival Rate ; Uterine Cervical Neoplasms*

Peritoneal pregnancies are classified as primary and secondary. Primary implantation on the peritoneum is extremely rare in extrauterine pregnancy and is a potentially life-threatening variation of ectopic pregnancy within the peritoneal cavity, representing a grave risk to maternal health. Secondary abdominal pregnancies are by far the most common and result from tubal abortion or rupture, or less often, after uterine rupture with subsequent implantation within abdomen. Early diagnosis and appropriate surgical management, regardless of stage of gestation, appear to be important in achieving good results. We report a case of primary peritoneal pregnancy in a 28-year-old woman, who had severe lower abdominal pain one day before laparotomy for a preoperative diagnosis of ectopic pregnancy. The conceptus was implanted on the left uterosacral ligament. A fresh embryo of approximately 8 weeks' gestation was found in the conceptus.
Adult ; Case Report ; Female ; Follow-Up Studies ; Hemoperitoneum/surgery ; Hemoperitoneum/diagnosis ; Hemoperitoneum/complications* ; Human ; Ligaments ; Ovum Implantation ; Peritoneum/pathology ; Pregnancy ; Pregnancy, Abdominal/surgery ; Pregnancy, Abdominal/pathology ; Pregnancy, Abdominal/diagnosis ; Pregnancy, Abdominal/complications* ; Rupture, Spontaneous/surgery ; Rupture, Spontaneous/diagnosis ; Sacrum ; Uterus/pathology

OBJECTIVE: The objective of this study was to evaluate clinical significance of endometrial and corporal extensions of Carcinoma of the uterine cervix. METHODS: The 273 patients with locally advanced cervical cancer who underwent radical hysterectomy after neoadjuvant chemotherapy between Jan 1983 to May 1998 were included in this study and endometrial and corporal extension was examined by pathologic report. Then, clinical characteristics such as age, stage, tumor size, geographic contour, the lymph node and parametrial invasions, recurrence rate, and 5 year-survival rate were compared between extension(n=30) and non-extension(n=243) group. Pearson chi-square test, Fisher's exact test, and Kaplan-mayer survival analysis were used for calculation of statistical significance between two group. p-value less than 0.05 was considered to be clinically significant. RESULTS: The incidence of endometrial and corporal extension in this locally advanced cervical cancer group was 11% (30/273). The endometrial and corporal extension were closely related with advanced stage, larger cervical tumor mass, endophytic type, and pelvic lymph node metastasis. However, 5-year disease free survival rates or 5-year actuarial survival rates did not show statistically significant differences between extension and non-extension group (7S% vs 83% and 81% vs 84%, respectively) CONCLUSION: The endometrial and corporal extension were closely associated to high risk factors of advanced cervical cancer. Though its clinical significance for poor outcome were not proved in this study, prospective study with more patients is needed to clarify its clinical significance.
Cervix Uteri* ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Risk Factors ; Survival Rate ; Uterine Cervical Neoplasms