OBJECTIVE: To understand the crucial requirement for the normal early folliculogenesis, we evaluated molecular as well as physiological differences during in vitro ovarian culture. Among the important regulators for follicle development, anti-Mullerian hormone (AMH) and FSH Receptor (FSHR) have been known to be expressed in the cuboidal granulosa cells. Meanwhile, it is known that c-kit is germ cell-specific and GDF-9 is also oocyte-specific regulator. To evaluate the functional requirement for the competence of normal follicular development, we investigated the differential mRNA expression of several factors secreted from granulosa cells and oocytes between in vivo and in vitro developed ovaries. MATERIALS AND METHODS: Ovaries from ICR neonates (the day of birth) were cultured for 4 days (for primordial to primary transition) or 8 days (for secondary follicle formation) in alpha-MEM glutamax supplemented with 3 mg/ml BSA without serum or growth factors. The mRNA levels of the several factors were investigated by quantitative real-time PCR analysis. Freshly isolated 0-, 4-, and 8-day-old ovaries were used as control. RESULTS: The mRNA of AMH and FSHR as granulosa cell factors was highly increased according to the ovarian development in both of 4- and 8-day-old control. However, the mRNA expression was not induced in both of 4- and 8-day in vitro cultured ovaries. The mRNA expression of GDF-9 known to regulate follicle growth as an oocyte factor was different between in vivo and in vitro developed ovaries. In addition, the transcript of GDF-9 was expressed in the primordial follicles of mouse ovaries. The mRNA expression of c-kit was not significantly different during the early folliculogenesis in vitro. CONCLUSION: This is the first report regarding endogenous AMH and FSHR expression during the early folliculogenesis in vitro. In conclusion, it will be very valuable to evaluate cuboidal granulosa cell factors as functional marker(s) for normal early folliculogenesis in vitro.
Animals ; Anti-Mullerian Hormone ; Female ; Granulosa Cells ; Growth Differentiation Factor 9 ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Mental Competency ; Mice ; Oocytes ; Ovary ; Real-Time Polymerase Chain Reaction ; Receptors, FSH ; RNA, Messenger*

PURPOSE: This study validated the musculoskeletal model of the human lower extremity by comparative study between calculated muscle parameters through simulation using modified hill-type model and measured muscle parameters through isokinetic exercise. The relationship between muscle forces and moments participated in motion was quantified from the results of simulation. MATERIALS AND METHODS: For simulation of isokinetic motion, a three-dimensional anatomical knee model was constructed using gait analysis. The EMG-force model was used to determine muscle activation level exciting muscles. The modified Hill-type model was used to calculate individual muscle force and moment in dynamic analysis. This method was validated by comparing analytical data with experimental data. RESULTS: The results showed that there was a significant correlation between calculated torques from simulation and measured torque from isokinetic motion experiments (R=0.97). We also found that muscle forces and moments during knee flexion and extension have nonlinearly proportional or inversely proportional relationship, since lower extremity muscles were simultaneously involved in flexion/extension motion and inner/outer rotation. CONCLUSION: We concluded that the simulation by using musculoskeletal model may be a useful mean to predict and recover musculoskeletal-related diseases, and analyze complicated experiment such as clash condition.
Gait ; Humans ; Knee Joint* ; Knee* ; Lower Extremity ; Muscles ; Torque

BACKGROUND: Surgical procedures carried out under local anesthesia are associated with patient discomfort and apprehension. The purpose of this study is to compare propofol and midazolam with regard to their suitability for the patient controlled sedation (PCS) technique during local anesthesia. METHODS: Forty unpremedicated, ASA physical status I day surgery patients undergoing elective minor surgery were randomly divided into two equal groups of patients who self-administered either propofol or midazolam intraoperatively. All patients initially received 0.5 g.kg-1 fentanyl. The bolus dose was either 20 mg (2 ml over 25 sec) of self-administered propofol or 0.5 mg (2 ml over 25 sec) of midazolam and lock-out period was 1 min. RESULTS: The onset of sedation following propofol was significantly faster than midazolam (p<0.05) and demands of propofol was significantly less than midazolam (p<0.05). There were no significant differences for postoperative recovery, sedation and comfort scale. CONCLUSIONS: Propofol was judged the more suitable agent for PCS than midazolam, because of its more rapid onset of sedation and less demands of drug.
Ambulatory Surgical Procedures ; Anesthesia, Local* ; Anesthetics ; Fentanyl ; Humans ; Midazolam* ; Propofol* ; Surgical Procedures, Minor

No abstract available.
Purpura, Thrombocytopenic, Idiopathic ; Thymoma

Most submucosal tumors of the stomach are of mesenchymal origin. Gastric schwannoma, which is a subset of mesenchymal tumors, is a rare tumor taking origin from Schwann's cells. A 61-year-old woman whose endoscopy showed a well circumscribed submucosal mass measuring 2.5 cm on the midbody of the stomach. Endosonographically, the tumor was well circumscribed, low echoic submucosal mass with cystic lesion in the 4th layer of the gastric wall. The patient underwent wedge resection. Microscopically, the cells were made up of irregular fasciculating bundles of spindle cells featured with benign nuclear atypia and peripheral lymphoid cell cuffing, involving muscularis propria. Immunohistochemical staining showed positivity for S-100 protein and the neuron-specific enolase, but were negative to CD 34, desmin and smooth muscle actin. From these findings, this tumor was diagnosed as a schwannoma.
Actins ; Desmin ; Endoscopy ; Female ; Humans ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Neurilemmoma* ; Phosphopyruvate Hydratase ; S100 Proteins ; Stomach

No abstract available
Acoustics* ; Neuroma, Acoustic* ; Particle Accelerators ; Radiosurgery*

PURPOSE: The aim of this study is to analyze the clinical results of thermo-irradiation treatment for surgically unresectable advanced hepatoma with or without hepatic arterial chemo-embolization (HACE), chemotherapy (CT) and interferon (IFN) therapy. MATERIALS AND METHODS: Between February 1990 and December 1992, 45 patients with surgically unresectable advanced hepatomas were treated by thermo-irradiation with or without hepatic arterial chemo-embolization and other treatment modalities. Among them, We analyzed retrospectively 25 patients who received more than three times of hyperthermias. Mean age was 50 years (range: 18-71 years) and male to female ratio was 20:5. In the study, treatment was administered as follows: 3 patients received radiation therapy (RT) and hyperthermia (HT). 3 received RT+HT+CT. 3 received RT+HT+HACE. 1 received RT+HT+CT+HACE. 2 received RT+HT+CT+IFN. 10 received RT+HT+HACE+IFN. 3 received RT+HT+CT+HACE+IFN. Radiation therapy was done by a 6 MV linear accelerator. Patients were treated with daily fractions of 180 cGy to doses of 11 Gy-50Gy (median 30Gy). Local hyperthermia was done by HEH-500C(Omron Com Japan), 30-45 min/session, 2 session/wk and the number of HT sessions ranged from 3 to 17 (median 7 times). 15 patients of 25 were followed by abdominal CT scan or abdominal ultra-sonogram. The following factor were analyzed : Age, histologic grade, sex, number of hyperthermia, total RT does, hepatic arterial chemo-embolization. RESULTS: Of 25 patients. There were observed tumor regression (partial response and minimal response) in 6 (24%), no response in 8 (32%), progression in 1 (4%) and not evaluable ones in 10 (40%) radiographically. The over all 1-year survival was 25% with a mean survival of 33 weeks. The treatment modes of partial and minimal responsive patients (PR+MR) were as follows: Two were treated with RT+HT+HACE, 2 were done with RT+HT+HACE+IFN Remaining 2 were treated with RT+HT+CT+HACE+IFN. The significant factor affecting the survival rate were RT dose (more than 25Gy), HACE, number of HT (above 6 times), responsiveness after treatment (PR+MR). Age, sex, histologic differentiation, chemotherapy, interferon therapy were not statistically significant factors affecting the survival rate. Conclusion : Although follow-up duration was short, the thermo-irradiation with/without hepatic arterial chemo-embolization was well tolerated and there were no serious complications. In future, it is considered the longer follow up and prospective, well controlled trails should be followed to evaluate the efficacies of survival advantage.
Carcinoma, Hepatocellular* ; Drug Therapy ; Female ; Fever ; Follow-Up Studies ; Humans ; Hyperthermia, Induced ; Interferons ; Male ; Particle Accelerators ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed

PURPOSE: We evaluated the prognostic factors, survivals and patterns of failure of the patients with locally advanced cervical cancer who received radical radiotherapy alone and induction chemotherapy followed by radiotherapy respectively. MATERIALS AND METHODS: Between May 1985 to December 1992, one hundred and sixty three patients with locally advaneed cervical cancer received curative radiotherapy. Patients were divided into two groups: control group included 69 patients who received curative radiotherapy and combined group included 94 patients who received induction chemotherapy followed by curative radiotherapy. The curative radiotherapy consisted of external pelvic radiotherapy and intracavitary brachytherapy. Induction chemotherapy was delivered in VBP (vincristine, bleomycin, cisplatin) and FP (5-FU, cisplatin). Follow up period ranged from 2 months to 99 months with median of 50 months. RESULTS: The overall response rate was 94.2% in the control group and 89.4% in the combined group. The response rate by control group was 66.7% for CR (complete response), 27.5% for PR (partial response), 5.8% for NR (no response). The response rate by combined group of CR, PR, NR were 64.9%, 24.5%, 10.6%, respectively. There was no difference in response for control group and combined group (p> 0.05). The 5-year overall survival had no significant difference in between control group and combined group (54.6% vs. 57.3%). The 5-year disease free survival also had no significant difference (52.9% vs. 55.0%). In the control group, 23 patients (33.3%) had treatment failure: twelve (17.4%) at a local recurrence, 9 (13.0%) as distant metastasis, and 2 (2.9%) with both local recurrence and distant metastasis. In the combined group, Thirty patients (31.9%) failed therapy, with local recurrence in 21 patients (22.3%), distant metastasis in 7 patients (7.5%), and both in 2 patients (2.1%). The difference between the two groups was not significant in view of patterns of failure. The major toxicities were nausea/ vomiting, leukopenia, anemia, and diarrhea. The prognostic factors affecting were hemoglobin level, KPS (karnofsky performance status), and treatment response in both group by multivariate analysis. CONCLUSION: This study did not prove the efficacy of induction chemotherapy followed by radiotherapy in locally advanced cervical cancer.
Anemia ; Bleomycin ; Brachytherapy ; Diarrhea ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Induction Chemotherapy* ; Leukopenia ; Multivariate Analysis ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Treatment Failure ; Uterine Cervical Neoplasms* ; Vomiting

Background: We investigated the antidiabetic effects of DA-1241, a novel G protein-coupled receptor (GPR) 119 agonist, in vitro and in vivo. Methods: DA-1241 was administrated to high-fat diet (HFD)-fed C57BL/6J mice for 12 weeks after hyperglycaemia developed. Oral/intraperitoneal glucose tolerance test and insulin tolerance test were performed. Serum insulin and glucagon-like peptide-1 (GLP-1) levels were measured during oral glucose tolerance test. Insulinoma cell line (INS-1E) cells and mouse islets were used to find whether DA-1241 directly stimulate insulin secretion in beta cell. HepG2 cells were used to evaluate the gluconeogenesis and autophagic process. Autophagic flux was evaluated by transfecting microtubule-associated protein 1 light chain 3-fused to green fluorescent protein and monomeric red fluorescent (mRFP-GFP-LC3) expression vector to HepG2 cells. Results: Although DA-1241 treatment did not affect body weight gain and amount of food intake, fasting blood glucose level decreased along with increase in GLP-1 level. DA-1241 improved only oral glucose tolerance test and showed no effect in intraperitoneal glucose tolerance test. No significant effect was observed in insulin tolerance test. DA-1241 did not increase insulin secretion in INS-1E cell and mouse islets. DA-1241 reduced triglyceride content in the liver thereby improved fatty liver. Additionally, DA-1241 reduced gluconeogenic enzyme expression in HepG2 cells and mouse liver. DA-1241 reduced autophagic flow in HepG2 cells. Conclusion These findings suggested that DA-1241 augmented glucose-dependent insulin release via stimulation of GLP-1 secretion, and reduced hepatic gluconeogenesis, which might be associated with autophagic blockage, leading to improved glycaemic control.

PURPOSE: To evaluate prognostic factors and survival rates of the patients who received radiation therapy for locally recurrent uterine cervical cancer after curative surgery. MATERIALS AND METHODS: Between October 1983 and July 1996, fifty three patients who received radiation therapy for locally recurrent cervical cancer after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea were analysed retrospectively. Age at diagnosis ranged from 33 to 69 years (median 53 years). Pathological analysis showed that forty five (84.9%) patients had squamous cell carcinoma, seven (13.2%) patients had adenocarcinoma, and one (1.9%) patient had adenosquamous cell carcinoma. The interval between hysterectomy and tumor recurrence ranged from 2 months to 25 years (mean 34.4 months). The recurrent sites were vaginal stump in 41 patients (77.4%) and pelvic side wall in 12 patients (22.6%). Recurrent tumor size was devided into two groups : less than 3 cm in 43 patients (81.1%) and more than 3 cm in 10 patients (18.9%). External beam irradiation of whole pelvis was done first up to 46.8 Gy to 50.4 Gy in 5 weeks to 6 weeks, followed by either external beam boost to the recurrent site in 18 patients (34%) or intracavitary irradiation in 24 patients (45.3%). Total dose of radiation ranged from 46.8 Gy to 111 Gy (median 70.2 Gy). Follow up period ranged from 2 to 153 months with a median of 35 months. RESULTS: Overall response rate was 66% (35/53). Among them, six patients (17.1%) relapsed between 7 months and 116 months after radiation therapy (mean 47.7 months). Therefore overall recurrence rate was 45.3%. Overall five-year actuarial survival rate was 78.9% and distant failure rate was 10% (5/50). The significant prognostic factors affecting survival rate were interval between primary surgery and tumor recurrence (p=0.0055), recurrent tumor size (p=0.0039), and initial response to radiation therapy (p=0.0428). Complications were observed in 10 (20%) patients, which included mild to moderate lower gastrointestinal, genitourinary, or skin manifestations. One patient died of pulmonary embolism just after intracavitary irradiation. CONCLUSION: Radiation therapy is the effective treatment for the patients with locally recurrent cervical cancer after curative surgery. These results suggest that interval between primary surgery and tumor recurrence, recurrrent tumor size, and initial response to radiation therapy were significant prognostic factors for recurrent cervical cancer.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Hysterectomy ; Korea ; Pelvis ; Pulmonary Embolism ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Skin Manifestations ; Survival Rate ; Uterine Cervical Neoplasms*