No abstract available.

No abstract available.
Animals ; Female ; Hysterectomy* ; Ovariectomy* ; Rats* ; Spine* ; Tibia*

In this experiment, pregnant Sprague-Dawley rats were treated with 100mg/kg of alltrans retinoic acid at 10th day of gestation. Pregnant rats were sacrificed at gestation day 14, 15, 16 and 18. Fetuses were delivered, and palatal processes were dissected. The specimens were prepared with fibronectin immunohistochemical stain, and mesenchymal changes were observed with electron microscope. The results were as follows. 1. In the findings fo fibronectin immunohistochemial stain, a part of the mesenchyme of the palatine process of the control group showed weak positive reaction at 14th gestation day, and the reactivity increased progressively by each day. In retinoic acid treated group, the positive reaction was trace at 14th day of gestation, and the reactivity increased progressively, but it was weaker than that of the control group. 2. Examination under transmission electron microscopy revealed well-developed rough endoplasmic reticulum, Goigi apparatus, mitochondrias which were found at the palatine process of the control group. In the retinoic acid treated group, at 16th and 18th day of gestation, the mesenchymal cells of the elevated palatine process had fragmented, sacculated rough endoplasmic reticulums, their mitochondrias were swollen and dissolved, In all cases with retinoic acid treated group, mitotic cells at various stages were more frequently found than in control group. In conclusion, the retinoic acid induces alterations of the intracytoplasmic organells. This finding suggests that retinoic acid is ditectly cytotoxic to mesenchymal cells. Positive fibronectin reaction was demonstrated before palatal elevation at th 15th day of gestation. Therefore, it could be postulated that mesenchymal cells synthesize and release the fibronectin. In the retinoic acid treated group, fibronectin showed positive reaction before and after palatal elevation, and it suggests that fibronectin would be involved in palatal elevation.
Animals ; Endoplasmic Reticulum, Rough ; Fetus ; Fibronectins ; Mesoderm* ; Microscopy, Electron, Transmission ; Mitochondria ; Pregnancy ; Rats* ; Rats, Sprague-Dawley ; Tretinoin*

BACKGROUND: Peak expiratory flow (PEF) provides a simple, quantitative, and reproducible measure of the existence and severity of airflow obstructions. Peak flow meters are designed to monitor the condition asthma patients. There are many reports showing the normal predicted value of PEF in other countries. studies on healthy Korean adults have been performed in a relatively small sample number and a lower limit for the normal value was not reported. therefore, an attempt to provide normal predictive PEF value with a lower limit was made. METHOD: The PEF(Mini-Wright peak Flow Meter) measurements and spirometry were done in 233 men and 631 woman without history of respiratory disease. all subjects were non-smokers with no respiratory symptoms. the normal predictive value and its lower limit were developed by multiple regression analysis. The result was compared with regression equations in other reports. RESULTS: The regression equation for the normal PEF predictive value(L/min) is 25.117+4.587×Age(year)-0.064×Age2+2.931×Height(cm) in men in men(R2=0.25), and 146.942-0.011×Age2+1.795×Height(cm)+0.836×Weight (kg) in women(R2=0.21). The regression equation for the lower limit of this value (L/min) is 25.117+4.587×Age(year)-0.064×Age2+1.936×Height (cm) in men, and 146.942-0.011×Age2+1.232× Height (cm)+0.481×Weight (kg) in women. The residuals were normally distributed. The PEF in Korean males was similar to those reported in British and Japanese subjects. The PEF in Korean females was similar to that in British subjects, But higher than the PEF in Japanese subjects. The lower limit of normal value was 71% of normal predictive PEF value in men and 76% in women. CONCLUSION: The normal predictive PEF value and its lower limit was measured from 233 male and 631 female asymptomatic, lifelong non-smoking participants. The normal predictive value was different from those of other studies on Korean subjects. Therefore, further studies are required.
Adult ; Asian Continental Ancestry Group ; Asthma ; Female ; Humans ; Male ; Reference Values ; Spirometry

BACKGROUND: Carcinoma of the uterine cervix is a theoretically preventable disease because its precursor lesions can be detected by cervical Papanicolau smears and appropriately treated, Although cervical cytology screening programmes have resulted in the redution of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. The focus of criticism has been the false-negative Pap smear, and the false-negative Pap smear is the major quality issue currently facing the physicians. To reduce the false-negative rate of Pap smear, it is essential to improve the accuracy of Pap smear. But false-negative rate of Pap smear has been reported variously. OBJECTIVE: This study was undertaken to evaluate accuracy of Pap smear by study false-negative and false-positive rate of Pap smear and to determine whether false-negative and false-positive rate had any correlations with clinical factors. STUDY DESIGN: The study population was comprised of 346 women, who were undertaken gynecologic operation at the Department of Obstetrics & Gynecology at Hanyang University hospital between March, 1997 and April, 1998. All patients were taken Pap smear before operation. In 93 women of these, preoperative diagnosis were cervical intraepithelial neoplasia and carcinoma in situ of uterine cervix, and in 253 women of these, preoperative diagnosis were benign disease as uterine myoma or adenomyosis, etc. All of their surgical specimen were examined. Pap smear, pathology, medical charts of all patients were reviewed retrospectively, and false-negative rate and false-positive rate were calculated. Clinical factors that associated with false-negative and false-positive rate were evaluated. Fishers exact test and Pearson chi-square test were used of statistical analysis, RESULTS: False-negative rate of Pap smear was 7.2%, false-positive rate was 4.6%, corresponding rate with histology was 88.2%. Sensitivity and specificity of PAP smear were 87.0% and 97.0% respctively. According to gross finding of uterine cervix, erosion was 46.6% in cervical intraepithelial neoplasia, 67.8% in carcinoma in situ, 66.6% in microinvasive carcinoma of uterine cervix and 55.3% of 103 erosion findings was cervical intraepithelial neoplasia, carcinoma in situ or microinvasive carcinoma. 23.1% of cervical lesion were normal gross finding. Menopause was associated with false-negative rate and previous vaginal infection history, previous cervical minor operation, delivery mode, contraception method, pelvic inflammatory disease history, vaginal bleeding at Pap smear and gross finding of cerbix were not associated. There were no clinical factors that were associated with false-positive rate. CONCLUSION: Compared with other reports, false-negative rate(7.2%) and false-positive rate(4.6%) of Pap smear was lower and corresponding rate(88.2%) was higher in Hanyand university hospital. Because of higher false-negative rate in menopausal women, it need more careful to take and interpretate Pap smear in these group.
Adenomyosis ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Contraception ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Leiomyoma ; Mass Screening ; Menopause ; Mortality ; Obstetrics ; Pathology ; Pelvic Inflammatory Disease ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Hemorrhage

BACKGROUND: The renin-angiotensin-aldosterone system is closely associated with volume status and vascular tone in septic shock. The present study aimed to assess whether plasma renin activity (PRA) and plasma aldosterone concentration (PAC) measurements compared with conventional severity indicators are associated with mortality in patients with septic shock. METHODS: We evaluated 105 patients who were admitted for septic shock. Plasma levels of the biomarkers PRA and PAC, the PAC/PRA ratio, C-reactive protein (CRP) level, and cortisol level on days 1, 3, and 7 were serially measured. During the intensive care unit stay, relevant clinical information and laboratory results were recorded. RESULTS: Patients were divided into two groups according to 28-day mortality: survivors (n = 59) and non-survivors (n = 46). The survivor group showed lower PRA, PAC, Acute Physiologic and Chronic Health Evaluation (APACHE) II score, and Sequential Organ Failure Assessment (SOFA) score than did the non-survivor group (all P < 0.05). The SOFA score was positively correlated with PRA (r = 0.373, P < 0.001) and PAC (r = 0.316, P = 0.001). According to receiver operating characteristic analysis, the areas under the curve of PRA and PAC to predict 28-day mortality were 0.69 (95% confidence interval [CI], 0.58 to 0.79; P = 0.001) and 0.67 (95% CI, 0.56 to 0.77; P = 0.003), respectively, similar to the APACHE II scores and SOFA scores. In particular, the group with PRA value ≥3.5 ng ml⁻¹ h⁻¹ on day 1 showed significantly greater mortality than did the group with PRA value <3.5 ng ml⁻¹ h⁻¹ (log-rank test, P < 0.001). According to multivariate analysis, SOFA score (hazard ratio, 1.11; 95% CI, 1.01 to 1.22), PRA value ≥3.5 ng ml⁻¹ h⁻¹ (hazard ratio, 3.25; 95% CI, 1.60 to 6.60), previous history of cancer (hazard ratio, 3.44; 95% CI, 1.72 to 6.90), and coronary arterial occlusive disease (hazard ratio, 2.99; 95% CI, 1.26 to 7.08) were predictors of 28-day mortality. CONCLUSIONS: Elevated PRA is a useful biomarker to stratify the risk of critically ill patients with septic shock and is a prognostic predictor of 28-day mortality.
Aldosterone* ; APACHE ; Arterial Occlusive Diseases ; Biomarkers ; C-Reactive Protein ; Critical Illness* ; Humans ; Hydrocortisone ; Intensive Care Units ; Mortality ; Multivariate Analysis ; Plasma* ; Renin* ; Renin-Angiotensin System ; ROC Curve ; Shock, Septic* ; Survivors

Previous studies have shown that the cancer cell lines secrete multiple cytokines, such as macrophage colony-stimulating factor(M-CSF), granulocyte-macrophage colony stimulating factor(GM-CSF), interleukin-l(IL-1), interleukin-2(IL-2), interleukin-6(IL-6), and tumor necrosis factor-alpha(TNF-alpha). We evaluated the levels of IL-2, IL-6, and TNF-alpha in the ascites of 23 patients with ovarian cancer. These levels were then compared with cytokine concentration found in 10 patients who had benign ascites and also studied the relation between levels of cytokines and clinical parameters. Enzyme-linked immunosorbent assay(ELISA) was used to determine the levels of cytokines in ascitic fluids. The median age of the group was 56, and the median follow-up time was 24 months. The levels of IL-2 was not elevated in ascites of ovarian cancer(30.5 vs 37.2 pg/ml, p=0.083), 1 he levels of TNF-alpha in the ascites with ovarian cancer were higher when compared with ascites of benign disease and was nearly approached statistically significant(91.0+/-20.7 vs 440.2+/-117.9pg/ml, p=0.058). Significantly higher IL-6 levels were detected in patients ascites compared with ascites with benign disease(354.3+/-42.9 vs 5,605+/-1,137pg/ml, p=0.006). IL-6 and TNF-a levels in ascites did not correlate statistically with tumor volume, histologic type or with survival time. IL-6 levels did not correlated statistically with volume of ascites. IL-6 and TNF-a levels did not correlated either. Circulating platelet counts in patients with ovarian cancer were significantly higher than in patients with benign conditions (282.6+/-5 vs 388.4+/-21.2x-10(9)/l, p=0.003). Thrombocytosis(platelet counts>400x10(9)/l) occured in 35%(8/23) of the cases with ovarian cancer. IL-6 levels in ascites correlated signi-ficantly with circulating platelet counts(R=0.427, p=0.042). This study showed that the patients with ovarian cancer have elevated levels of IL-6 in ascites. IL-6 levels were not correlate with disease status in patients with ovarian cancer. However, the correlation was found between IL-6 levels and thrombocytosis. This observation suggest a role for IL-6 in the development of tumor-associated thrombocytosis. A larger study would help in evaluating the potential biological roles and use of cytokines as tumor markers in ovarian cancer.
Ascites* ; Ascitic Fluid ; Blood Platelets ; Cell Line ; Cytokines ; Follow-Up Studies ; Humans ; Interleukin-2 ; Interleukin-6 ; Macrophages ; Necrosis* ; Ovarian Neoplasms* ; Platelet Count ; Thrombocytosis ; Tumor Burden ; Biomarkers, Tumor ; Tumor Necrosis Factor-alpha

No abstract available.
Ovarian Neoplasms*

The recent introduction of chemotherapy in the treatment of gynecological malignancies has gained wide acceptance along with prstoperative and prostperative adjuvant therapy and with preradiation and concurrent chemoradiation therapy. But, the side effects of chemotherapy including bleeding and infection due to, bone marrow suppression have reaulted in delayed treatment and a reduction in the chemotherspeutic agent used. Recent efforts overcome this bone marrow suppression have led to development of the various human colony-stimulating factor indluding recombinant granulocyte colony-stimulating factor. The author investigated the clinical benefita and toxicity of G-CSF used during chemotherapy of various gynecological malignancies at the Departent of Obstetrics & Gynecology at Hanyang University between August, 1991 and July, 1992. The results were as follows ; 1. An increase in the number of neutrophils following a single injection of G-CSF was noted in 19 out of 21 cases(600~1,000/mm3 before injection, 4,500~12,000/mm3 after injection). The remaining 2 cases showed an increase after 3~5 continuous injections. 2. To assess the increase in neutrophils according to the dosage of G-CSF given, 100 and 300microgram/m* of G-CSF were injected in each trial of chemotherapy in a single case of ovarian cancer. The results were a 1.5 time increase when injected when injected with 300microgram/m*. 3. After injecting into a patient with recurrent endometrial cancer who was managed with 15gm of ifosfamide, 50gm of cis-platinum, 50gm of adriamycin and 3gm of mesna following surgery, no evidence of neutropenia could be found after 4days of prophylactic G-CSF injections. 4. Patients with cervix cancer with metastasis to the lung were first treated with GM-CSF in one trial and G-CSF in the nest. Patients treated with Gm-CSF for a period of 7 days showed leukocytosis(3,600/mm3) but the number was reduced to 1,400/mm3 after 7 days. On the other hand, patients treated with G-CSF showed an increase of 5,700/mm3 within one day and this figure did not decrease until 20 days later. 5. The toxic effects of G-CSF included on case of severe back pain was easily managed by administration acetaminophen. Others were headache, chills, general weakness and redness of the oral mucosa and injection area. Most of these symptoms disappeared within 2 days. The G-CSF is effective in neutropenia during chemotherapy thereby decreasing the incidence of treatment delay or dose reduction. It also increases the amount of chemotherapeutic agent administered and its toxicity is more tolerable making a rigid systemic chemotherapeutic regime possible.
Acetaminophen ; Back Pain ; Bone Marrow ; Chills ; Cisplatin ; Colony-Stimulating Factors ; Doxorubicin ; Drug Therapy* ; Endometrial Neoplasms ; Female ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Gynecology ; Hand ; Headache ; Hemorrhage ; Humans ; Ifosfamide ; Incidence ; Leukopenia* ; Lung ; Mesna ; Mouth Mucosa ; Neoplasm Metastasis ; Neutropenia ; Neutrophils ; Obstetrics ; Ovarian Neoplasms ; Uterine Cervical Neoplasms

No abstract available.
Umbilical Cord*