BACKGROUND: Uterine leiomyoma is the most common pelvic tumor, occurring in 20-25% of women in reproductive age. Gonadotropin releasing hormone agonist (GnRHa) has been reognized as a temporary medical management for this disorder. The etiology of these tumors is unknown but it has been shown that the insulin-like growth factors (IGF-I, IGF-II) are promoters of growth in nongynecologic tumors. Several recent studies have suggested the possible role of IGFs in human leiomyoma growth. The IGF binding proteins (IGFBPs) are believed to modulate actions of IGF and to have IGF-independent actions. The purpose of this study was to evaluate the type of IGF and IGFBP which may be involved in leiomyoma growth and to investigate a possible IGF related mechanism of action of GnRHa. METHOD: The IGFs and IGFBPs were measured by double antibody radioimmunoassay, western ligand blot and immunoprecipitation in the tissue cytosols of normal uterine myometria (n=15), nontumorous myometria adjacent to a leiomyoma and leiomyoma from patients nontreated (n=15) and treated (n=10) with GnRHa. RESULTS: The mean IGF-I and IGF-II level were significantly higher in leiomyoma from untreated patients than in the adjacent myometrium and normal myometrium but no significant differences in these IGF levels between normal myometrium and adjacent myometrium were noted. The IGFBP-2, IGFBP-3 and 26kDa IGFBP were detected variably but IGFBP-4 was consistently present in all tissues. There were no significant differences in the relative intensity for IGFBP-4 and the frequency of IGFBPs between leiomyoma, adjacent myometrium and normal myometrium from untreated patients. The IGF-I, IGF-II levels and the relative intensity of IGFBP-4 in leiomyoma from GnRHa-treated patients were significantly lower than those in untreated patients, but these levels in the adjacent myometrium were comparable. The frequency of each IGFBP in leiomyoma and the adjacent myornetrium from GnRHa-treated patients did not significantly differ from untreated patients. CONCLUSION: Both IGF-I and IGF-II are involved in the growth of leiomyoma and GnRHa may in part act to decrease size of leiomyoma by regulating the local levels of IGF-I, IGF-II and IGFBP-4.
Animals ; Cytosol ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Immunoprecipitation ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Leiomyoma* ; Mice ; Myometrium ; Radioimmunoassay ; Somatomedins*

STUDY DESIGN: Ninty eight patients with multilevel spinal stenosis who were treated with posterior decompression and instrumented posterolateral fusion were reviewed retrospectively. All patients were divided two groups by pathologic level and surgery level. One is complete level decompression group (whole pathologic levels were decompressed) and the other is limited level decompression group (less than pathologic levels were decompressed). SUMMARY OF BACKGROUND DATA: Many patients with spinal stenosis haute multilevel pathology, which is very difficult problem to make surgical strategy for determination of decompression level. METHOD: Patients were reviewed using combination of clinical records, follow-up examinations and radiographs. Posterior decompression and instrumented posterolateral fusion were performed in all patients using pedicle screw fixation (TSRH 49 cases, Diapason 37 cases, CCD 12 cases) and either autogenous bone graft alone or autograft with allograft. The average follow-up period was 19.7 months. RESULTS: In the clinical results by the criteria of Kirkalldy-Willis, there was no difference between complete level decompression group and limited level decompression group. By the bone graft mothorts, fusion rate was no difference between autograft alone group and autograft with allograft group, but fusion periods were more shorter in autograft alone group than in autograft with allograft group(P>0.05). CONCLUSION: In multilevel spinal stenosis, the segments that associated with neurologic symptoms or seyeie stenosis on radiograph must be decompressed but the segments that not associated with neurologic symptoms and mild stenosis on radiograph do not need preventive decompression.
Allografts ; Autografts ; Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Humans ; Neurologic Manifestations ; Pathology ; Retrospective Studies ; Spinal Stenosis* ; Transplants*

No abstract available.
Social Workers

A case of isolated Crohn's disease of appendix is reported. It is a rare disease which commonly mimics the symptoms of acute appendicitis. Review of 221 identical cases previously reported in the world literature revealed slight male predominance(1.17:1) and peak age of incidence in the third decade(24.3 yrs). In contrast to typical Crohn's disease, the rate of postoperative fistula and recurrence was minimal; 1.0% and 3.8%, respectively. Due to these differences, many consider it to be a separate disease entity from Crohn, and a new diagnostic term - "Idiopathic Granulomatous Appendicitis" - has gained wide acceptance in recent years.
Appendicitis* ; Appendix* ; Crohn Disease* ; Fistula ; Humans ; Incidence ; Male ; Rare Diseases ; Recurrence

No abstract available.
Temporomandibular Joint*

No abstract available.
Temporomandibular Joint*

PURPOSE: This study was designed to identify the possible mechanism of insensitivity of DU145 prostate cancer cells to the transforming growth factor (TGF)-beta1-mediated growth inhibition. MATERIALS AND METHODS: DU145 cells were treated with 4, 40, 100 pM TGF-beta1 for 3, 6, 9 days. Initially we performed the growth assay. After that, we analysed the change of cell cycle using fluorescence flow cytometry. At each time point, Western blot analysis with cell pellets was performed to investigate the change of expressions of epidermal growth factor(EGF), TGF-alpha, EGF receptor(EGFR) and TGF receptorII(TbetaR-II) proteins. RESULTS: The growth rate of TGF-beta1-treated cells was initially suppressed, but over time returned to control level. Flow cytometric analysis revealed that TGF-beta1-treated cells showed an increase in apoptotic/G1 phases, and concurrent decrease in S, G2/M phases until 6days. On day 9, however, TGF-beta1-treated cells showed a persistent increase of apoptotic unclei in spite of recovery of apoptotic/G1, S and G2/M phases. Western blot analysis showed that the intensity of EGF or TGF-alpha band decreased in dose-sependent manner on day 6. However, the intensity of each band increased up to the control level on day 9. the expression of EGFR or TbetaR-II protein did not change after treatment of TGF-beta1. CONCLUSIONS: these results suggest that EGF and TGF-alpha sould mediate in part the escape fron the inhibitory effect of TGF-beta1 in DU145 cells.
Blotting, Western ; Cell Cycle ; Epidermal Growth Factor* ; Flow Cytometry ; Fluorescence ; Prostate* ; Prostatic Neoplasms* ; Transforming Growth Factor alpha ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; United Nations

Joints ; Mandible ; Maxilla ; Orthognathic Surgery ; Recurrence ; Skull

PURPOSE: The symptoms of female urethral syndrome (FUS) can originate from mechanical or functional obstructions of the bladder neck or urethra. From retrospective reviews of women referred for evaluation of lower urinary tract symptoms (LUTS), 2.7 to 23% had urodynamic evidence of a bladder outlet obstruction (BOO). However, few urodynamic studies (UDS) have been performed on the prevalence of BOO in FUS. This study was aimed at identifying the causative factors of FUS symptoms, including BOO, as evidenced by UDS. MATERIALS AND METHODS: One hundred and sixteen women with FUS were enrolled in our UDS evaluations. An additional 247 patients, presenting for evaluation of stress urinary incontinence (SUI), served as controls. Comparisons of the maximum flow rate (Qmax), voided volume, post-void residual, detrusor pressure at maximum flow rate (PdetQmax), maximum detrusor pressure (Pdetmax) were made between the FUS and SUI cases. By definition, the FUS cases were divided into normal, BOO, detrusor under activity, detrusor instability and low compliance. These sub-groups were compared with controls in a similar way. RESULTS: Women with FUS showed a lower Qmax (15.9 versus 23.8ml/sec, p<0.05), higher post-void residual (86 versus 22ml, p<0.05), PdetQmax (24.0 versus 18.0 cmH2O, p<0.05) and Pdetmax (33.3 versus 27.9cmH2O, p<0.05) compared to those with SUI. The incidence of BOO, detrusor under activity and detrusor instability were 31.9, 25 and 16%, respectively, in the FUS group. Only 22% of women with FUS showed normal UDS findings. CONCLUSIONS: These results indicated the importance of UDS in identifying the causative factors of the symptoms of FUS. Treatment of a BOO will help provide new treatment modalities for FUS.
Classification* ; Compliance ; Female* ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Neck ; Prevalence ; Retrospective Studies ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urodynamics*