BACKGROUND: Although the mechanism of the increase in bone resorption induced by estrogen deficiency is still controversial, recent studies have suggested that estrogen may modulate the secretion of bone resorption cytokines that are produced in the bone microenvironment and influence bone remodeling. Among them, IL-1 and TNF-a promote bone resorption by stimulating the activity of mature osteoclasts and the differentiation of osteoclast precursors and the production of these cytokines are mediated by estrogen. We performed this study to evaluate the effect of ovariectomy on bone mineral density and levels of cytokines in the culture media of bone marrow monocytes. METHODS: The experimental animals were 23 female Sprague-Dawley rats that were 8 weeks of age and weighed an average of 176.8 gm at the beginning of the study. Bilateral ovariectomy (n=13) and sham-operation (n=10) were performed in all rats from a ventral approach. Bone mineral density (BMD) of the total body and levels of IL-1 and TNF-a of culture media of bone marrow monocytes were measured before and 8 weeks after operation with using DPX-L and ELISA assay, respectively. Serum levels of LH, FSH, E2 were measured by RIA assay. RESULTS: BMD of total body was lower after ovriectomy (0.24+-0.04g/cm) than before ovariectomy (0.27+-0.03g/cm), but there was no statistically significant difference in sham-operation group. Serum levels of LH, FSH were higher after ovariectorny (0.87+-0.36 mIU/mL, 9.47+-1.26 mIU/mL) than before ovariectomy (0.10+-0.06mIU/mL, 2.09+-0.41mIU/mL) (p<0.01) and serum level of E was lower after ovariectomy (10.98+-8.71pg/mL) than before ovariectomy (7350.77+-417.29 pg/mL) (p<0.01), respectively. Levels of IL-1 and TNF-a in culture media of bone marrow monocytes were higher after ovariectomy (23.48+-3.98pg/mL, 52.64+-5.31 pg/mL) than before ovariectomy (9.72+0.94pg/mL, 24.37+-3.39pg/mL) (p<0.01), but there were no statistically significant differences in the sharn-operation group. CONCLUSION: It is possible that increased production of IL-1 and TNF-a in estrogen deficiency induced by ovariectomy occures in the bone microenvironment and these cytokines may play a critical causal role in inducing bone loss.
Animals ; Bone Density* ; Bone Marrow* ; Bone Remodeling ; Bone Resorption ; Culture Media* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Estrogens ; Female ; Humans ; Interleukin-1 ; Monocytes* ; Osteoclasts ; Ovariectomy* ; Rats* ; Rats, Sprague-Dawley

OBJECTIVE: Oxygen free radical activity is elevated in diabetes mellitus and has been implicated in the etiology of vascular complications and diabetic nephropathy is a serious microvascular complication in patients with IDDM. Despite intensive investigation, the pathophysiology of diabetic renal disease has not been fully elucidated. However, several clinical and experimental studies have suggested that endothelial dysfunction and changes of peritubular microcirculation. I performed this study to examine the oxidative stress in IDDM patients with diabetic nephropathy. METHODS: Nine patients with IDDM (diabetic duration>5 years) and persistent albuminuria (albumin excretion<100mg/day) and 15 normal healthy controls were investigated prospectively for MDA (thiobarbituric acid assay), and antioxidant enzymes [SOD (Hyland et al.), catalase (Nelson and Kiesow), GPX (Palgia and Valentine)]. RESULTS: In RBC, levels of MDA were significantly higher in patients with diabetic nephropathy than in normal healthy controls and levels of antioxidant enzymes were significantly lower in patients with diabetic nephropathy than in normal healthy controls. In plasma, levels of MDA were significantly higher in patients with diabetic nephropathy than in normal healthy controls and levels of antioxidant enzymes except GPX were significantly lower in patients with diabetic nephropathy than in normal healthy controls. CONCLUSION: We conclude that increased oxidative stress and decreased antioxidative defense mechanism may be factors in the initiation of diabetic nephropathy.
Albuminuria ; Catalase ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies* ; Humans ; Malondialdehyde* ; Microcirculation ; Oxidative Stress ; Oxygen ; Plasma ; Prospective Studies

A study in 51 healthy postmenopausal women was performed to assess the effect of estrogen replacement therapy continuously combined with progesterone for 6 months on bone mineral density and lipid metabolism.Seventeen hysterectomized women were treated with conjugated estrogen(0.625mg/D), 33 nonhysterectomized women with conjugated estrogen(0.625mg/D) and medroxyprogesterone(2.5mg/D), and 1500mg/day calcium supplementation was given to all patients.After 6 month-treatment, serum total cholesterol and LDL-cholesterol levels were reduced significantly (p<0.01) between the two groups. But lumber BMD and other lipid profiles were not changed significantly between the two groups. Our data suggest that continuously applied progesterone in combined hormone replacement therapy dose not annihilate the beneficial effects on bone mineral density and lipid metabolism induced by estrogen.
Bone Density ; Calcium ; Cholesterol ; Estrogen Replacement Therapy ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Lipid Metabolism ; Progesterone

Curschmann' spirals morphologically similar to those seen in sputum were found in cervico-vaginal smears of six patients ranged from 28 to 40 years of age, during 18 months from January. 1985 to June. 1986. The prevalence was 1 in 2147 smears in that period. All of them had gynecologic disorders without systemic effect such as chronic cervictis in three, leiomyoma in one, pelvic inflammatory disorder in one, and primary infertility in one. The Curshmann' spirals in the smear showed varying degrees of maturation from wavy incipient ones to highly coiled mature ones, admixed with thick mucinous background, suggesting of their production in the uterine cervix itself. Also the recent history of undergone cryocautery, electrocautery or parturition suggest its production in the endocervical gland due to mechanical obstruction and/or change in biochemical composition of mucus.
Cervix Uteri ; Electrocoagulation ; Female ; Humans ; Infertility ; Leiomyoma ; Mucins ; Mucus ; Parturition ; Prevalence ; Sputum

In order to evaluate the role of cytopathologic diagnosis of sputum, bronchial washing and bronchial brushing in the diagnosis of lung cancer, we performed this study. The patients included in this study had undergone sputum, bronchial washing and brushing cytology over the 20-month period of 1985 through 1987. The total number of specimens was 5,495 of 2,242 patients, including 4,830 sputa and 665 bronchial washing and brushings. The average number of sputa and bronchial washings and brushings per case was 2.4 and 1.2 respectively. Among them, about 10% were unsatisfactory specimen, and three-fourths were negative specimens. In sputum cytology, the diagnosis of "atypical cells" was given to 3%, "suspicious for malignancy" was given to 1 %, and "malignancy" was given to 13%. In bronchial washing and brushing cytology, the diagnosis of "atypical cells", "suspicious for malignancy" and malignancy" was given to 6%, 3%, and 20% respectively. The cases diagnosed as "atypical cells" in cytology were actually malignancy in 95% and 84.8% of sputum and bronchial washing and brushings respectively, and the "suspicious for malignancy" were actually malignancy in 100% in both methods. The detection rates of malignancy were 50.4% and 55.2% in sputum and bronchial washing and brushing respectively, and the specificity was 100% in both methods. The accuracy of cell typing was 92% in sputum and 89.7% in bronchial washing and brushing.
Diagnosis* ; Humans ; Lung Neoplasms ; Lung* ; Sensitivity and Specificity ; Sputum

No abstract available.
Bile* ; Diagnosis* ; Drainage*

Ischemic colitis still remains largely underdiagnosed despite the fact that it is one of the most common disorders of the large bowel. The aims of the present study were to evaluate the variable histologic findings of ischemic colitis and to find out helpful histopathological features in diagnosis. Retrospective review of the clinical symptoms, underlying diseases, endoscopic findings of 23 patients, and the histologic features of 37 biopsies was done. We analyzed the significant pathologic features in the histologically diagnosed ischemic colitis group and compared the biopsy time between the histologically diagnosed ischemic colitis group and the non-diagnosed group. Comparison of the endoscopic biopsy time between the group that showed significant histologic features and the group that showed no significant histologic features was also done. The age of the patients ranged from 27 to 87 years. Most patients had abdominal pain, hematemesis, and melena. Endoscopic differential diagnoses included ischemic colitis, ulcerative colitis, infectious colitis, tuberculous colitis, Crohn's disease, and pseudomembranous colitis. Histologic features and diagnoses were also variable. The coagulative necrosis of mucosa and the epithelial desquamation were frequently detected in the group pathologically diagnosed as ischemic colitis. The most pathognomonic finding was coagulative necrosis of the mucosa that was almost always detected within seven days after the onset of clinical symptoms. Recognition of variable patterns of ischemic colitis in a biopsy specimen will direct the clinician to evaluate the vascular system. Early endoscopic biopsy is essential for the precise diagnosis of ischemic colitis.
Abdominal Pain ; Biopsy* ; Colitis ; Colitis, Ischemic* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Enterocolitis, Pseudomembranous ; Hematemesis ; Humans ; Melena ; Mucous Membrane ; Necrosis ; Retrospective Studies

The distinction between cholangiocarcinoma (CC) and metastatic colonic adenocarcinoma of the liver (MCA) is often difficult, particularly in needle biopsy and fine-needle aspiration specimens, if histologic features alone are used. To examine the differences in the expressions of the cytokeratin (CK) 7 and 20 in the CCs and MCAs, we performed immunohistochemical studies on surgically resected 19 CCs and 23 MCAs. We used monoclonal antibodies against CK 7 and CK 20, and applied microwave antigen retrieval technique on formalin-fixed, paraffin-embedded tissue. We interpreted diffuse cytoplasmic reactivity found in > or =5% of tumor cells as positive. CCs showed CK 7+/CK 20- immunophenotype in 63%, CK 7+/CK 20+ in 32%, CK 7-/CK 20+ in 5%, and CK 7-/CK 20- in 0%. MCAs exhibited CK 7-/CK 20+ immunophenotype in 87%, CK 7+/CK 20+ in 9%, CK 7-/CK 20- in 4%, and CK 7+/CK 20- in 0%. CK 20-reactive cells in CCs were frequently columnar in shape (p<0.05). In conclusion, the CK 7/CK 20 immunophenotype was useful in the differentiation of CCs from MCAs: the CK 7+/CK 20- immunophenotype strongly suggested CCs, whereas the CK 7-/CK 20+ immunophenotype strongly suggested MCAs.
Adenocarcinoma* ; Antibodies, Monoclonal ; Biopsy, Fine-Needle ; Biopsy, Needle ; Cholangiocarcinoma* ; Colon* ; Cytoplasm ; Keratin-20 ; Keratin-7 ; Keratins* ; Liver* ; Microwaves

Lymphocytic infiltration of the thyroid gland is a hallmark of the human thyroid autoimmune disease. Enhanced expression of immunoglobulin and adhesion molecules are consistently found in patients with autoimmune thyroid diseases. And cytokines are implicated in enhancing the expression of adhesion molecules.It has been suggested that adhesion-molecule expression within thyroid glands mediates lymphocyte homing events to the target of the autoimmune process. The expression of ICAM-1 was shown to be up-regulated on thyroidal perifollicular endothelial cells and thyrocytes in autoimmune thyroid diseases both in vitro and in vivo.Therfore, we investigated the correlation between thyroid hormone, TSH receptor antibodies, Interleukin-6 and soluble ICAM-1 in patients with Graves' disease before and 2 months after treatment with prophylthiouracil(PTU).Serum concentrations of soluble intercellular adhesion molecule-1(sICAM-1), T_3, T_4, TSH-receptor antibodies(TSH-R-Ab) and Interleukin-6(IL-6) of peripheral blood monocytes were measured in patients with Graves' disease.Serum levels of sICAM-1 were elevated in patients with Graves' disease before treatment with PTU, but serum levels of sICAM-1 did not correlate with the serum concentration of thyroid hormone and TSH-R-Ab before and after treatment. In addition, no correlation between serum levels of sICAM-1 and IL-6 of peripheral blood monocyte.We conclude that although the elevated serum levels of sICAM-1 may contribute to the autoimmune process in Graves' disease, we need more future studies for the role of sICAM-1 and correlation between adhesion molecule and thyroid hormone or cytokines in patients with Graves' disease.
Antibodies ; Autoimmune Diseases ; Cytokines ; Endothelial Cells ; Graves Disease ; Humans ; Immunoglobulins ; In Vitro Techniques ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Lymphocytes ; Monocytes ; Receptors, Thyrotropin ; Thyroid Diseases ; Thyroid Gland ; Thyroid Hormones

No abstract available.
Electrocardiography* ; Humans ; Pharynx* ; Sensation*