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

PURPOSE: Hepatolithiasis results in septic cholangitis, biliary stricture, hepatic atrophy, hepatic abscess, irreversible liver cirrhosis, and cholangiocarcinoma. Hepatic resection for hepatolithiasis is regarded as a more effective treatment for achieving complete removal of stones and preventing recurrence. The purpose of this study was to determine the surgical outcome of hepatic resections for hepatolithiasis. METHODS: From March 2001 to December 2006, 54 patients underwent hepatic resections for hepatolithiasis at the Department of Surgery, Eulji University Hospital. A retrospective review of the surgical outcome was carried out. RESULTS: The hepatolithiasis was located in the left intrahepatic duct (34 cases), right intrahepatic duct (7 cases) or both (13 cases). The operative procedures were as follows: a left hepatectomy in 34 patients, a left lateral sectionectomy in eight, a right posterior sectionectomy in three, a left trisectionectomy in three, a right hepatectomy in five, and a segmentectomy in 1. The postoperative complications were intraabdominal abscess in 10 patients, wound infection in 4, pleural effusion in 3, internal bleeding in 2, T-tube site leakage in 2, hepatic failure and pneumonia in 1. The factors that affect these complications were analyzed. Preoperative percutaneous transhepatic biliary drainage (PTBD) and operative hepaticojejunostomy increased the frequency of postoperative complications; these findings were statistically significant (p=0.035, p=0.006, respectively). Two patients were diagnosed with cholagiocarcinoma. Five patients had remaining stones and five patients had recurrent stones. CONCLUSION: Hepatic resection is a safe and effective procedure for treating hepatolithiasis. If possible, bypass procedures such as hepaticoenterostomy should be avoided to reduce postoperative complications.
Abscess ; Atrophy ; Cholangiocarcinoma ; Cholangitis ; Constriction, Pathologic ; Drainage ; Hemorrhage ; Hepatectomy ; Humans ; Liver Abscess ; Liver Cirrhosis ; Liver Failure ; Mastectomy, Segmental ; Pleural Effusion ; Pneumonia ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Wound Infection

OBJECTIVE:To determine whether elevated or low levels of maternal serum alpha- fetoprotein(AFP) measured at 15-20 weeks of gestation predict increased risk of adverse pregnancy outcome, including preterm birth(before 36 weeks of gestation), fetal growth retardation(FGR), preeclampsia, placental abruption, FDIU, placenta previa and fetal anomaly. METHOD: Data of pregnancy outcomes in singleton pregnancies with elevated or low maternal serum AFP levels measured at 15-20 weeks of gestation were gathered retrospectively. As a part I study, case-control study including 106 women with maternal serum AFP) 2.0 MOM(Multiples of median) and matched control group of 212 women with 0.5 MOM Abruptio Placentae ; alpha-Fetoproteins* ; Case-Control Studies ; Female ; Fetal Development ; Follow-Up Studies ; Humans ; Mothers ; Placenta Previa ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Pregnant Women ; Retrospective Studies

In this study, we investigated the effects of chronic aluminum (Al) exposure for 10 weeks on cell proliferation and neuroblast differentiation in the hippocampus of type 2 diabetic rats. Six-week-old Zucker diabetic fatty (ZDF) and Zucker lean control (ZLC) rats were selected and randomly divided into Al- and non-Al-groups. Al was administered via drinking water for 10 weeks, after which the animals were sacrificed at 16 weeks of age. ZDF rats in both Al- and non-Al-groups showed increases in body weight and blood glucose levels compared to ZLC rats. Al exposure did not significantly affect body weight, blood glucose levels or pancreatic β-cells and morphology of the pancreas in either ZLC or ZDF rats. However, exposure to Al reduced cell proliferation and neuroblast differentiation in both ZLC and ZDF rats. Exposure to Al resulted in poor development of the dendritic processes of neuroblasts in both ZLC and ZDF rats. Furthermore, onset and continuation of diabetes reduced cell proliferation and neuroblast differentiation, and Al exposure amplified reduction of these parameters. These results suggest that Al exposure via drinking water aggravates the impairment in hippocampal neurogenesis that is typically observed in type 2 diabetic animals.
Aluminum/*toxicity ; Animals ; Blood Glucose/analysis ; Cell Differentiation/drug effects ; Cell Proliferation/drug effects ; Diabetes Mellitus, Experimental/pathology ; Diabetes Mellitus, Type 2/*pathology ; Disease Models, Animal ; Hippocampus/*drug effects ; Neurogenesis/*drug effects ; Random Allocation ; Rats, Zucker

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