OBJECTIVES: the aim of this study was to evaluate plasmin system in placenta fiom women with normal and preeclamptic pregnancy. METHODS: The levels of urokinase-type plasminogen activator(uPA), tissue-type plasrninogen activator(tPA), uPA receptor(uPAR) and plasminogen activatar inhibitor-1(PAI-1) mRNAs were measured by Northern blotting in placenta hom sixteen women with normal (n""8) and preeclamptic (n""8) pregnancy. The levels of tPA protein and PAI-1 protein were also measured by Westerrn blotting. RESULTS: Densitometric measurements revealed no difference in the levels of uPA mRNA, uPAR mRNA, tPA protein and PAI-1 protein in placentas fiom normal and preeclamptic pregnancies. There was, however, a significant decrease in the level of 3.2 kb PAI-I mRNA in placentas from preeclamptic women compared to normal pregnant women. CONCLUSION: To the contrary of our expectation, 3.2 kb PAI-1 mRNA level was significantly lower in placenta from women with preeclampsia compared to normal pregnancy. This seems to reflect differential accumulation of PAI-1 mRNAs due to environmental intluences or decreased differentiation potential of villous trophoblasts to invasive trophoblasts in placenta from preeclamptic women compared to normal pregnant women. The mechanism that regulates plasmin system in human placenta needs further investigations.
Blotting, Northern ; Female ; Fibrinolysin* ; Humans ; Placenta* ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women ; RNA, Messenger ; Trophoblasts

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.
Clomiphene* ; Estradiol ; Female ; Follicular Phase ; Humans ; Leptin* ; Menstrual Cycle ; Menstruation ; Ovulation Induction

There is the trend of increasing number of outpatients who are requiring surgical intervention because of medical insurance and general improvement of economic state. Ambulatory surgical clinics are prospering in the United States. Thus we have analyzed 1957 cases of outpatient anesthesia excluding local infiltration performed by surgeons from total of 4302 cases o fout patient surgery during the 5 year period between 1975 and 1979. The results of this analysis were as follows: 1) Ketamine IM or IV was used as a sole agent in 500 cases who were under 12 years of age and mean operation and recovery time were 19.95 and 58. 45 minutes, respectively. 2) Mean operation and recovery time for 1,125 cases of pentothal+N2O+O2, anesthesia were 15. 55 and 108. 23 minutes, respectively. 3) For 321 cases of halothane+N2O+O2, anesthesia, mean operation and recovery time were 40.67 and 145. 94 minutes, respectively. 4) During recovery period there were no serious complications or mortality. 5) The majority of 1,125 among 1,957cases were gynecological outpatients and the rest were distributed among the surgical departments and dermatology, 6) Pentothal, nitrous oxide, halothane and ketamine were used safely for the outpatient anesthesia according to our experiences.
Anesthesia* ; Clinical Study* ; Dermatology ; Halothane ; Humans ; Insurance ; Ketamine ; Mortality ; Nitrous Oxide ; Outpatients ; Surgeons ; Thiopental ; United States

OBJECTIVE: Endometriosis is a common and enigmatic disease affecting the reproductive life and health of women. Although the retrograde menstruation is a well established model for both transplantation and induction theories, the discrepancy between an incidence of retrograde menstruation and a prevalence for endometriosis suggests the possibility that the development and the progression of endometriosis is associated with individual susceptibility such as altered immune function. An impaired immune response may result in a defect in the ability to remove refluxed menstrual debris, thereby increasing the possibility of endometriosis. We carried out the study to elucidate the immunologic alteration in patients with endometriosis. MATERIALS and METHODS: Fifty-six patients undergoing pelviscopic surgery or open laparotomy for benign gynecological disease were enrolled in this study. The study groups consisted of group I (normal control patients, N=22), group II (endometriosis stage I and II, N 17), and group III (endometriosis stage III and IV, N=17). Lymphocyte subset including total T cell, helper T cell, suppressor T cell, B cell, helper/suppressor ratio, natural killer (NK) cell, monocyte population and cytokine profile including interleukin (lL)-1, soluble interleukin-2 receptor (slL-2R), IL-2, IL-6, IL-S, monocyte chemoattractant protein (MCP)-1 of peripheral blood and peritoneal fluid were analyzed using flow cytometry and enzyme-linked immunosorbant assay (ELISA) method respectively. RESULTS: Peripheral blood and peritoneal fluid lymphocyte subset were indistinguishable among the 3 groups (p>0.05). And there were no significant difference in peripheral blood and peritoneal fluid cytokine profile among the 3 groups except peripheral blood MCP-1 level. Group III showed higher peripheral blood level of MCP-1 than control patients (p<0.05). CONCLUSION: In this study, lymphocyte subset and cytokine profile except MCP-1 in peripheral blood and peritoneal fluid from patients with endometriosis did not differ from those of the control group. Immunologic alterations of patients with endometriosis might be resulted not from the changes of the number of lymphocyte subsets and cytokine, but from the modification of functions.
Ascitic Fluid* ; Endometriosis* ; Female ; Flow Cytometry ; Humans ; Incidence ; Interleukin-2 ; Interleukin-6 ; Interleukins ; Laparotomy ; Lymphocyte Subsets* ; Lymphocytes* ; Menstruation Disturbances ; Monocytes ; Prevalence

OBJECTIVES: Leptin is known as an endocrinologic mediator which acts on the hypothalamic- pituitary-ovarian axis. This study was undertaken to evaluate whether the serum leptin level affects the menstrual cycles of adolescents and to analyze the clinical features of adolescents with abnormal serum leptin levels. METHODS: Seventeen normal controls and 118 patients with menstrual abnormalities were included in this study. The ages of patients ranged from 15 to 25 years. Patients with menstrual abnormality were divided into five subgroups according to the etiologies: group I; premature ovarian failure(n=8), group II; primary amenorrhea without congenital structural abnormality(n=14), group III; oligomenorrhea(n=12), group IV; secondary amenorrhea(n=53), group V; dysfunctional uterine bleeding(n=31). After collection of blood samples, the serum leptin levels were measured with a radioimmunoassay kit. The serum leptin level and the corrected leptin level(leptin/body mass index(BMI)) were compared and the clinical features of those with abnormal leptin concentration (>mean+standard deviation, Adolescent* ; Amenorrhea ; Axis, Cervical Vertebra ; Female ; Humans ; Leptin* ; Menstrual Cycle ; Radioimmunoassay ; Weight Loss

PURPOSE: To analyze the results of the foreign body reaction to polyethylene, polymethylmethacrylate, and metal debris and effect on bone by comparing histopathologic finding of pseudomembrane (interface membrane) which was obtained from failed cemented or cementless THA by aseptic loosening. MATERIALS AND METHODS: Of total 50 cases, we analyzed results between 25 cases of cemented THA and 25 cases of cementless THA. Follow-up period between primary and revision THA was average 8 years 5 months. Tissue specimens were harvested, stained with Hematoxylin-Eosin, and examined by light microscope. Histologic study of various items was done. RESULTS: The fibrous membrane between bone-to-cement or bone-to-metal could be roughly divided into three distinct histological layers in cross section histopathology. These tissues were characterized by histiocytes, infiltration of foreign body giant cells and fibrosis in all specimens, and infiltration of lymphocytes and plasma cells was relatively rare, and aggregation of polymorphonuclear leukocytes was invisible. CONCLUSION: Although there were no significant differences in histologic findings between the regions of ten tissue specimens, there was significant difference between the degree of polyethylene or cement debris in numbers and the degree of foreign body reaction associated with increased infiltrations of giant cells, and foreign body reaction to polyethylene debris seems to be main cause of aseptic loosening of prosthesis.
Arthroplasty, Replacement, Hip* ; Fibrosis ; Follow-Up Studies ; Foreign-Body Reaction ; Giant Cells ; Giant Cells, Foreign-Body ; Histiocytes ; Lymphocytes ; Membranes ; Neutrophils ; Plasma Cells ; Polyethylene ; Polymethyl Methacrylate ; Prostheses and Implants

BACKGROUND: The angiotensin coverting enzyme(ACE) gene(encoding kininase II, EC3.4.15.1) contains a polymorphism based on the presence(insertion [I]) or absence(deletion[D]) within an intron of a 287bp nonsense DNA domain, resulting in three genotypes(D/I) and I/I homozygotes, and I/D heterozygotes). Alu insertion is associated with lowerACE level than deletion allele(D) and it was observed that D/D individuals have twice theACE activity of I/I patients. Pregnancy induced hypertension(PIH) probably results fromdominating pressor systems owing to loss of antagonizing vasodilator autacoids. AngiotensinII is an extremely potent arteriolar vasoconstrictor. Overactivity or failure to supressresponsiveness to the increased activity of angiotensin II, which is generated by ACE,would seem to be a reasonable basis for the vasoconstriction of PIH. The aim of this studyis to evaluate the relationship between ACE genotype and PIH. METHODS: Blood sampling was taken from 39 patients with PIH. The hypertensivedisorders, confirmed at postpartum follow up, were classified as gestational hypertensionwithout proteinuria, preeclampsia(mild and severe) and eclampsia. The diagnosis ofpreeclampsia was made according to the American College of Obstetrics and Gynecology criteriaof hypertension and proteinuria(>300 mg/24 hr urine). Genomic DNA was extractedfrom blood sample. After PCR amplification of the respective fragments from intron 16 ofthe ACE gene, size fractionation and visualization by electrophoresis were performed. RESULTS: PIH group(including gestational hypertension, mild and severe preeclampsia: frequency of I allele 0.756 and D allele 0.244) had more I allele and less D allele whencompared with normal population(frequency of I allele 0.609 and D allele 0.391)(p < 0.05).And PIH group had more I/I homozygote individuals showing significant distortion fromHardy-Weinberg equilibrium of ACE genotype(p < 0.05). Moreover, severe preeclampsiagroup alon(frequency of I allele 0.759 and D allele 0.241) had more I allele and less Dallele when compared with normal population and had significantly more I/I homozygoteindividuals. CONCLUSION: As pregnancies with PIH had more ACE I allele and I/I homozygoteindividuals. PIH could be associated with I allele of the ACE gene. Considering the observedcodominant association between the D-I polymorphism and plasma ACE activity, our resultis in favor of the thesis that PIH primarily arises from defective synthsis of vasodilatingautacoids and renin-angiotensin system exerts secondary vasoconstrictive action. However,the relationship between ACE genotype and defective vasodilating mechanism during pregnancyis unknown at present.
Alleles ; Angiotensin II ; Angiotensins* ; Autacoids ; Diagnosis ; DNA ; Eclampsia ; Electrophoresis ; Female ; Follow-Up Studies ; Genotype ; Gynecology ; Homozygote ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Introns ; Obstetrics ; Peptidyl-Dipeptidase A ; Plasma ; Polymerase Chain Reaction ; Postpartum Period ; Pre-Eclampsia ; Pregnancy* ; Proteinuria ; Renin-Angiotensin System ; Vasoconstriction

Amyloidosis is a disease characterized by the deposition of non-soluble fibrous protein in multiple tissues with a number of possible causes. This protein deposition can occur in any tissue, yet is most commonly seen in kidneys, heart, and gastrointestinal tracts. However, invasion to bone tissues is not often reported. The deposition of amyloid proteins in bone tissues may result in joint pain and pathological fractures; it is important to elucidate the causes and detect early to determine prognosis and treat optimally. In the present case report, with relevant literature review, the authors report a case of total hip arthroplasty in an amyloidosis patient.
Amyloid* ; Amyloidogenic Proteins ; Amyloidosis ; Arthralgia ; Arthroplasty, Replacement, Hip ; Bone and Bones ; Fractures, Spontaneous ; Gastrointestinal Tract ; Heart ; Hip Joint* ; Hip* ; Humans ; Kidney ; Multiple Myeloma* ; Prognosis

We observed how the hypothyroid state affects diabetic states and modifies cell proliferation and neuroblast differentiation in the hippocampal dentate gyrus (DG). For this, 0.03% methimazole, an anti-thyroid drug, was administered to 7-week-old, pre-diabetic Zucker diabetic fatty (ZDF) rats by drinking water for 5 weeks, and the animals were sacrificed at 12 weeks of age. At this age, corticosterone levels were significantly increased in the ZDF rats compared to those in the control (Zucker lean control, ZLC) rats. Methimazole (methi) treatment in the ZDF rats (ZDF-methi rats) significantly decreased corticosterone levels and diabetes-induced hypertrophy of adrenal glands. In the DG, Ki67 (a marker for cell proliferation)- and doublecortin (DCX, a marker for neuronal progenitors)-immunoreactive cells were much lower in the ZDF rats than those in the ZLC rats. However, in ZDF-methi rats, numbers of Ki67- and DCX-immunoreactive cells were similar to those in the ZLC rats. These suggest that methi significantly reduces diabetes-induced hypertrophy of the adrenal gland and alleviates the diabetes-induced reduction of cell proliferation and neuronal progenitors in the DG.
Adrenal Glands ; Animals ; Cell Proliferation ; Corticosterone ; Dentate Gyrus ; Drinking Water ; Hypertrophy ; Hypothyroidism ; Methimazole ; Neurons ; Rats

OBJECTIVES: The aim of this study is to evaluate the clinical characteristics of night eating syndrome(NES) in bipolar disorder outpatients. METHODS: The 14 items of self-reported night eating questionnaire(NEQ) was administered to 84 bipolar patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating & weight-related quality of life using Beck's Depression Inventory (BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. RESULTS: The prevalence of night eating syndrome in bipolar outpatients was 14.3%(12 of 84). Comparisons between NES group and non-NES group revealed no significant differences in demographic characteristics, BMI and clinical status except economic status and comorbid medical illnesses. However, compared to non-NES, patients with NES was more likely to have binge eating pattern and poorer weight-related quality of life. CONCLUSIONS: This study is to be the first to describe the clinical correlates of night eaters in bipolar outpatients. Although there were few significant correlates of NES in bipolar outpatients, relatively high prevalence of NES suggest that clinicians should be aware to assess the patients with bipolar disorder on NES, regardless of obesity status of patients.
Ambulatory Care Facilities ; Bipolar Disorder* ; Bulimia ; Depression ; Eating* ; Humans ; Obesity ; Outpatients* ; Prevalence ; Quality of Life