OBJECTIVE: To investigate the basal bone mineral density(BMD)s of the lumbar spine and femur of patients with endometriosis, and the changes of BMDs and biochemical bone markers after 6 months of gonadotropin releasing hormone(GnRH) agonist treatment. METHODS: The initial BMDs of 35 women with endometriosis were measured by dual energy x-ray absorptiometry at department of obstetrics & gynecology Yongsan Hospital, College of Medicine, Chung Ang University from April 1996 to May 1999. 19 patients of these group was repeatedly measured after 3.6mg subcutaneous depot injection of goserelin(Zoladex) every 4 weeks for 24 weeks. Osteocalcin and Deoxypyridinoline were measured before goserelin treatment, at 3 months, and at 6 months completion of goserelin treatment. RESULTS: Patients with endometriosis did not show the significant difference in mean BMD of lumbar spine and femur in comparison with age matched normal women. Patients treated with goserelin for 6 months showed 0.064+/-0.030g/cm2(5.56%) decrease of BMD in lumbar spine, 0.038+/-0.040g/cm2(3.85%) decrease in femur neck, 0.055+/-0.047g/cm2(6.10%) decrease in Ward triangle, 0.041+/-0.031g/cm2(5.19%) decrease in femoral trochanter. These data had statistical significance(p<0.001). At first 3 months and on completion of 6 months goserelin treatment, there were increase of 66.1%, 122.3% in serum osteocalcin respectively, and increase of 35.2%, 39.6% in urine deoxypyridinoline respectively, compared with pretreatment value. CONCLUSION: From these results, it is concluded that the BMDs of patients with endometriosis were normal, and after 6 months GnRH agonist treatment, bone loss was 3.85%-6.10%, and the values of biochemical bone markers were increased.
Absorptiometry, Photon ; Bone Density* ; Endometriosis* ; Female ; Femur ; Femur Neck ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Goserelin ; Gynecology ; Humans ; Obstetrics ; Osteocalcin ; Spine

No abstract available.
Embryonic Structures* ; Extremities*

OBJECTIVE: To evaluate the current status and new trends in gynelcological pelviscopy in Korea. METHODS: A survey was conducted and analyzed based on 20997 cases of operative pelviscopy hom May, 1985 to February, 1998 reported from twenty four university hospitals in Korea. RESULTS: The results obtained were ss followings; 1) 45.9 % of the total cases was 30 to 39 years old age group and it was the most dominant age group, 2) The previous operative history was found in 10.9% of the tota1 cases and included cesarean section(30.0%), ectopic pregnancy(20.3%), etc. 3) The operative indications were diagnostic(26.2%), myoma uteri(23.1%), ectopic pregnancy(21.4%), adnexal mass(18.4%), etc. In cases of diagnostic indication, the most common post-operative diagnosis of pelviscopic surgery was tubal pregnancy(30,6%). 4) The operative titles were salpingectomy(25.1%), hysterectomy(19.9%), salpinghorectomy(19.8%), etc. 5) The complications of operative pelviscopy were composed of subcutaneous emphysema(0.58%), preperitoneal bleeding(0.3%), bladder injury(0,3%), bowel injury(0.3%), etc. 6) lhe survey showed that 57.1% of the respondents desired more than 1 year of period for well peration between the operator and the assistant. 56.7% of respondents indicated that the surgical technique of the operator was the most important factor for a successful pelvisocopic surgery. 7) The most beneficial effect of the pelviscopy included the comfortableness of the patient(40.0%), cosmetic effect(22.8%), decrease of complications(14.2%), etc. CONCLUSION: The modem methods of operative pelviscopy have been successfully used in the treatment of gynecological disease. Today, pelviscopic surgery is being applied in almost all the cases of gynecological disease. Hence, the majority of pelviscopy techniques and pracedures being performed by surgeon must be taught in the controlled setting of a residency or a fellowship training program.
Adult ; Surveys and Questionnaires ; Diagnosis ; Education ; Fellowships and Scholarships ; Hospitals, University ; Humans ; Internship and Residency ; Korea* ; Modems ; Myoma ; Urinary Bladder

OBJECTIVE: This study is proposed to examine the relationship between bone loss after hormone replacement therapy for one year and initial bone markers. METHODS: One hundred postmenopausal women were studied for one year. At first visit, measurements were made of bone mineral density(BMD) at the lumbar spine and femoral neck, and of serum osteocalcin and urine deoxypyridinoline. After hormone replacement therapy was done for one year, BMD was rechecked. RESULTS: Serum osteocalcin was correlated with the rate of bone change(r=0.150, 0.262) and urine deoxypyridinoline was weakly correlated(r=-0.003, 0.038). The changes of femoral BMD in women with higher concentration of osteocalcin and deoxypyridinoline were significant different from those in women with normal concentration. At the lumbar spine, no significant differences were showed. In women with higher concentration of osteocalcin, the incidence of subjects with increased spine BMD was increased up to around 71.1%, which showed not significant increase compared with normal concentration of osteocalcin. And the incidence of increased spine BMD in women with higher concentration of osteocalcin was marked increased compared with the incidence of normal concentration. The level of the osteocalcin with increased spine BMD was 11.5+/-6.6 ng/ml, and the level with decreased spine BMD was 9.2+/-4.7 ng/ml, respectively. And the level of the deoxypyridinoline was 7.2+/-4.2 pmol/ mol cr in women with increased spine BMD and 7.2+/-2.7 pmol/ mol cr in women with decreased spine BMD, which was not statistically different. The concentration of deoxypyridinoline with increased and decreased in BMD in spine and femur was not statistically different. but the concentration of osteocalcin was 12.2 +/-5.5 ng/ml in significantly increased in BMD and 8.5 +/-4.5ng/ml in significantly decreased in BMD, which was showed significant different. CONCLUSION: Present study indicates that the serum osteocalcin more reflcets bone turnover changes at the menopause than deoxypyridinoline, however, the clinical utility of measurements of osteocalcin only to response to therapy is uncertain.
Bone Density* ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Incidence ; Menopause ; Osteocalcin ; Spine

No abstract available.
Endometriosis* ; Female

PURPOSE: To evaluate the effect of panretinal photocoagulation and additive intravitreal bevacizumab injections on central retinal vessel diameters and characteristic retinal vascular caliber changes in diabetic retinopathy. METHODS: Changes in central retinal vessel diameters were retrospectively analyzed before and 6 months after panretinal photocoagulation with or without additive intravitreal bevacizumab injections in 64 eyes first diagnosed with diabetic retinopathy. Vessel diameters and arteriovenous ratio (AVR) were measured using Interactive Vessel Analysis (IVAN) software and the Big six formula. RESULTS: There were significant decreases in central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) in both groups, with and without additive intravitreal bevacizumab injections, 6 months after completion of panretinal photocoagulation (p < 0.001, p = 0.008), but no significant change in AVR (p = 0.338). Additive intravitreal bevacizumab injections did not produce significant changes in central retinal vessel diameters after 6 months compared to vessel diameters treated with panretinal photocoagulation only. Retinal vascular caliber of progressed diabetic retinopathy showed smaller CRAE, larger CRVE, and smaller AVR compared to those of normal or diabetic Korean subjects in a previous study and showed no significant association with age. CONCLUSIONS: CRAE and CRVE decreased significantly 6 months after panretinal photocoagulation in diabetic retinopathy, but additive intravitreal bevacizumab injections did not cause significant additive changes to central retinal vascular calibers in this study. We established the standard retinal vascular caliber of Korean subjects in diabetic retinopathy and analyzed the effects of retinopathy on retinal vessel caliber.
Bevacizumab* ; Diabetic Retinopathy* ; Light Coagulation* ; Retinal Artery ; Retinal Vein ; Retinal Vessels ; Retinaldehyde* ; Retrospective Studies

OBJECTIVE: To estimate the long-term skeletal responses to hormone replacement therapy(HRT) with or without active vitamin D(VD) by using short-term changes of bone markers in postmenopausal women (PMW). METHODS: Biochemical markers of bone formation(osteocalcin,OC) and (&) resorption(deoxypyridinoline, Dpd ) at 3 months & lumbar bone mineral density(BMD) at 1 year were measured in 64 natural PMW taking HRT(n=41) & HRT with calcitriol 0.25 microgram/day(n=23). The correlation of percent changes of bone markers after 3 months of Tx with those in lumbar BMD after 1 year was evaluated. RESULTS: 1. serum-OC & urine-Dpd showed decrease of 20.9% & 30.1% at 3months respectively & BMD increase of 3.8% after 1 year of Tx. 2. Among 58 PMW with decreased u-Dpd change, 49 (84.5%) revealed increase in BMD, while 40 (81.6%) among 49 PMW with decreased serum-OC change showed increased BMD. 3. Bone gainers showed significant decrease in changes of serum-OC(18.1% vs 9.2% p<0.05) & urine-Dpd(32.6% vs 20.4%, p<0.05) compared with those of bone losers. 4. No correlations of change of serum-OC (r=-0.174 p>0.05) & urine-Dpd (r=-0.091 p>0.05) at 3month with BMD changes at 1year were seen in total PMW, but urine-Dpd changes in HRT without active VD group revealed significantly inverse correlation(r=-0.376 p<0.05). CONCLUSION: Short-term changes of bone markers did not precisely predict the long-term changes of BMD in total PMW except urine- Dpd in HRT without active VD.
Biomarkers ; Bone Density* ; Calcitriol ; Estrogen Replacement Therapy* ; Female ; Humans ; Osteocalcin ; Vitamin D* ; Vitamins*

OBJECTIVE: To determine if birth weight greater than 4000gm can be predicted by ultrasound measurement of abdominal circumference(AC) and if shoulder dystocia in macrosomic infants can be predicted by ultrasound measurement of the difference between the abdominal diameter(AD) and biparietal diameter(BPD). METHODS: A Retrospective study was performed of births occuring from March, 1998 to August, 1999 at department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University. Among neonates of birth weight greater than 4000 gm, 50 cases in that ultrasound examination was done within 2 weeks before delivery were selected for macrosomic group and 50 cases were selected for control group during the same period, among neonate of birth weight from 3100gm to 3900gm. RESULTS: 1) Normal spontaneous vaginal delivery(NSVD) was 41 cases in control group and 30 cases in macrosomic group. Among NSVD, shoulder dystocia was 1 case in 41 cases of control group and was 7 cases in 30 cases of macrosomic group. 2) On ultrasound measurement, 6 cases had AC greater than 35 cm in control group and 45 cases in macrosomic group. Among 30 cases in NSVD was done in macrosomic group, difference between AD and BPD was 2.9 0.271 cm when shoulder dystocia was existed and was 2.1 0.409 cm when shoulder dystocia was not existed. Between the two groups, statistically significant difference was detected. 3) When AC(cutoff value of 35cm) was used for screening of macrosomia, sensitivity for macrosomia was 88.2% and specificity was 89.8% and when AD-BPD difference(cutoff value of 2.6cm) was used for prediction of shoulder dystocia, sensitivity for shoulder dystocia was 66.6% and specificity was 95.2%. CONCLUSIONS: In prenatal ultrasound measurement, AC measurement at third trimester of pregnancy will be a valuable indicator for macrosomia screening. The AD-BPD difference of shoulder dystocia group was greater than uncomplicated group in macrosomia and the AD-BPD difference cutoff value of 2.6cm was significant value statistically.
Birth Weight ; Dystocia* ; Female ; Gynecology ; Humans ; Infant ; Infant, Newborn ; Mass Screening ; Obstetrics ; Parturition ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder* ; Ultrasonography*

OBJECTIVE: This study was performed to investigate whether 1) estrogen induces the change of vascular tone in endothelium-denuded human uterine artery, and 2) endothelium-independent vascular reactivity may be mediated by intracellular calcium ion modulation. METHODS: The uterine arteries from 34 premenopausal women were obtained at the time of hysterectomy due to various indications and endothelium was denuded. Vascular reactivity was monitored by using Isometric force transducer and recorded by physiograph. Endothelial integrity was assessed by sequential administration of 1micrometer norepinephrine(alpha-adrenergic stimulant) and 10 micrometer acetylcholine (endothelium -dependent vasorelaxant). Integrity of smooth muscle was measured by administration of 10 micrometer sodium nitroprusside (endothelium - independent vasorelaxant) and 10 micrometer tamsulosin(alpha-adrenergic blocker). A dose-dependent action of estrogen was measured on denuded uterine arteries, pretreated with norepinephrine and potassium chloride. In media contained denuded uterine arteries pretreated with 70mM potassium chloride and estradiol(3X10-5M), nitric oxide and its inhibitor, N-nitro-L-arginine methyl ester(L-NAME) was administered, respectively, in order to verify the vasodilation effect. Statistical tests were performed at the 5% level of significance using the SPSS PC+ package. RESULTS: Acethylcholine has little effect but sodium nitroprusside & talmsulosin showed marked relaxation, which suggested loss of endothelial function and adequacy of smooth muscle function. The contraction by norephinephrine(1 M) revealed estrogen induced relaxation which was concentration-dependent from 3 10-8M to 3 10-5M in concentration of 17 -estradiol. The contraction by high potassium solution 70mM was also inhibited by estrogen in concentration-dependent manner. This vasorelaxant effect of estrogen on endothelium-denuded uterine artery was not affected by addition of nitric oxide(NO) precursor, L-arginine and nitric oxide synthase(NOS) inhibitor, L-NAME. CONCLUSION: The results of this study revealed that estrogen has vasorelaxant effect on endothelium endothelium-denuded uterine artery by calcium antagonistic property through direct inhibitory effect on receptor- and voltage dependent calcium ion channels of smooth muscles. This vasorelaxant effect of estrogen on endothelium-denuded uterine artery was NO independent.
Acetylcholine ; Arginine ; Calcium ; Calcium Channels ; Endothelium* ; Estrogens* ; Female ; Humans* ; Hysterectomy ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitroprusside ; Norepinephrine ; Potassium ; Potassium Chloride ; Relaxation ; Transducers ; Uterine Artery* ; Vasoconstriction* ; Vasodilation

Failure of a glaucoma filtering operation mainly results from scarring at the filtering wound, and postoperative proliferation and migration of fibroblasts play an important role histologically in the formation of scar tissue. As an inhibitory agent for fibroblast proliferation, gamma-interferon has been introduced, and the application of gamma-interferon following filtering surgery is now being made on a trial basis. We studied the effect of gamma-interferon histologically on the fibroblast proliferation and collagen synthesis occurring at the filtering site by comparing the effect of gamma-interferon on the experimental group with that of 5-fluorouracil on the control group, using 10 rabbits (20 eyes) after posterior lip sclerectomy. Both groups showed similar flat and diffused bleb grossly and also showed a similar inhibitory effect on fibroblast proliferation and collagen fiber synthesis histologically. Our findings seem to justify the clinical use of gamma-interferon. Further studies on adequate dosage, method of administration, and local and systemic complications would be desired.
Animals ; Anterior Chamber/drug effects ; Cell Division/drug effects ; Collagen/*biosynthesis ; Fibroblasts/drug effects ; Fluorouracil/pharmacology ; Glaucoma/pathology/*surgery ; Interferon-gamma/*pharmacology ; Rabbits ; Sclera/pathology ; *Sclerostomy