No abstract available.

No abstract available.
Aged* ; Humans ; Nursing Homes* ; Nursing*

No abstract available.
Chromosome Aberrations* ; Ethylene Oxide* ; Lymphocytes* ; Transferases*

OBJECTIVE: We investigated the expression of TSP-1 and -2 in eutopic endometrium of advanced endometriosis and control patients. METHODS: The 33 endometriosis patients and 32 controls were enrolled. Endometrial samples were obtained from 65 premenopausal women aged 29-44 years, undergoing laparoscopic surgery or hysterectomy for non-malignant lesions. Sufficient samples were collected from 33 patients with endometriosis stage III and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression from eutopic endometrium for TSP-1 and -2 were analyzed by RT-QC PCR. RESULTS: The mRNAs of TSP-1 and -2 were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. There were no significant differences in expression of TSP-1 and TSP-2 in eutopic endometrium between controls and endometriosis patients. CONCLUSION: Our results indicated that TSP-1 and -2 had no crucial role compared to other molecules in the regulation of angiogenesis. These findings also suggest that dysregulation of other angiogenic regulators would be concerned in pathophysiologic role in endometriosis development.
Endometriosis* ; Endometrium ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Menstrual Cycle ; Polymerase Chain Reaction ; RNA, Messenger* ; Thrombospondin 1 ; Thrombospondins

OBJECTIVE: We investigated the expression of uPA and uPAR in eutopic endometrium of advanced stage endometriosis and control patients. METHODS: The 33 endometriosis patients and 32 controls were enrolled. Endometrial samples were obtained from 65 premenopausal women aged 29~44 years, undergoing laparoscopic surgery or hysterectomy for non-malignant lesions. Sufficient samples were collected from 33 patients with endometriosis stage III and IV and 32 controls without endometriosis confirmed by laparoscopic surgery. The mRNA expression of uPA and uPAR from eutopic endometrium were analyzed by RT-QC PCR. RESULTS: The mRNAs of uPA and uPAR were expressed in eutopic endometrium from endometriosis and normal controls throughout the menstrual cycle. Uterine endometrium from women with endometriosis expresses significantly (p<0.05) higher levels of u-PA mRNA than endometrium from normal women without endometriosis in the proliferative phase. There were no significant differences in expression of uPAR in eutopic endometrium between controls and endometriosis patients. CONCLUSION: These results suggest that eutopic endometrium from endometriosis patients may be more invasive and prone to peritoneal implantation because of greater u-PA mRNA expression than endometrium from women without endometriosis. Thus, increased proteolytic activity may be one etiology for the invasive properties of the endometrium resulting in the development of endometriosis.
Endometriosis* ; Endometrium* ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Menstrual Cycle ; Polymerase Chain Reaction ; Proteolysis ; RNA, Messenger* ; Urokinase-Type Plasminogen Activator

A uremic patient on hemodialysis, who had concurrent cardiomyopathy showed intense myocardial uptake of (99m)Tc-methylene diphosphonate (MDP). The presumed cause of Uptake in the myocardium is metastatic calcification due to hypercalcemia secondary to the renal failure. However, supplementary mechanism caused by cardiomyopathy should be considered. We describe a case with bone tracer uptake in the myocardium in the absence of infarction in a patient with chronic renal failure,
Cardiomyopathies* ; Humans ; Hypercalcemia ; Infarction ; Kidney Failure, Chronic* ; Myocardium ; Renal Dialysis ; Renal Insufficiency ; Technetium Tc 99m Medronate*

No abstract available.
Glomerular Filtration Rate* ; Kidney*

PURPOSE: Adrenocortical tumors are uncommon in children and comprise only a small proportion of primary adrenal neoplasms. The biologic behavior of these tumors may be very difficult to predict, and their rarity has hindered identification of clinical characteristics. Patients with functioning tumors have excessive steroid hormone production, and the clinical manifestation depends on the predominant hormone produced. The detection of nonfunctioning tumors is not easy and the diagnosis may be delayed. Benign tumors can be cured by complete surgical excision, but malignant cases have poor response to treatment and worse prognosis. Early diagnosis and proper management are very important because of the large proportion of functioning malignant tumors in children. We report clinical features of adrenocortical tumors in children that may be of help in the early detection, proper management, and assessment of prognosis of patients. METHODS: We reviewed the clinical characteristics of 14 cases of adrenocortical tumors, among 85 children diagnosed with adrenal tumors, who visited the Severance Hospital, College of Medicine, Yonsei University, from January 1970 to July 1996. RESULTS: 85 Patients were diagnosed with adrenal tumors. Among them, 71 cases 83.5%) were tumors of the adrenal medulla, neuroblastoma and pheochromocytoma, and 14 cases (16.5%) were adrenocortical tumors, consisting of 5 cases of adenoma, 7 cases of carcinoma, and 2 cases unspecified. The age distribution ranged from 16 months to 14 years of age, and the mean was 5 years & 11 months (median 4 years & 2 months). Sex distribution revealed a male to female ratio of 1:1.33. The left to right ratio was 3.7:1, showing a left side predominance. 13 Cases (92.9%) were functioning tumors: 12 cases (92.3%) had clinical evidence of androgen excess, among which 6 cases (46.2%) were associated with Cushing's syndrome, and 1 case was compatible with primary aldosteronism. Serum cortisol, urinary 17-ketosteroids and 17-hydroxycorticosteroids concentrations were measured in 11 cases and urinary concentrations of 17-ketosteroids were elevated in all 11 cases (100%), while 17-hydroxycorticosteroids were elevated in 4 cases (36.4%). Abnormalities of serum cortisol were found in all cases except 1: serum cortisol concentrations were abnormally elevated in 5 cases (45.5%), and the remainder (5 cases, 45.5%) showed loss of diurnal variation. Dexamethasone suppression test was performed in 9 cases, and all (100%) showed no suppression. Preoperative radiologic studies included abdominal sonograms, CT or MRI scans, and angiography. Histology showed carcinomas to be bigger and heavier than adenomas, and microscopically carcinomas had necrosis, calcifications, and invasions of vessels. Distant metastases were found in 4 cases (12.7%). Adrenalectomy with complete surgical excision was performed in 12 cases. Long-term follow-up was possible in 10 patients after operation: 3 patients initially diagnosed with adenoma survived without tumor recurrence over a year, and among 6 carcinoma patients, 4 expired within a year, and 2 survived, with one patient currently undergoing postoperative chemotherapy. Of the 10 patients currently under going follow-up, one patient was initially diagnosed with a histologically unspecified tumor, and has survived 4 years after operation. CONCLUSIONS: When adrenocortical neoplasms are suspected by clinical symptoms and laboratory findings, abdominal ultrasonogram, CT or MRI scans must be performed immediately. Early detection and proper management are important for better prognosis, but are often delayed in the majority of cases. Ultimately, pediatricians need to be familiar with clinical characteristics and laboratory findings of adrenocortical tumors, bearing in mind the possibility of diagnosis in children.
17-Hydroxycorticosteroids ; 17-Ketosteroids ; Adenoma ; Adrenal Gland Neoplasms ; Adrenal Medulla ; Adrenalectomy ; Age Distribution ; Angiography ; Child ; Cushing Syndrome ; Dexamethasone ; Diagnosis ; Drug Therapy ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hydrocortisone ; Hyperaldosteronism ; Magnetic Resonance Imaging ; Male ; Necrosis ; Neoplasm Metastasis ; Neuroblastoma ; Pheochromocytoma ; Prognosis ; Recurrence ; Sex Distribution ; Ultrasonography

The diagnostic work-up of renal mass should be carried out in an accurate, rapid, noninvasive and cost effective way. We retrospectively analyzed the diagnostic accuracy of ultrasonography, computerized tomography and renal angiography in 33 patients with renal mass from July 1984 to June 1987. The results were as follows : 1. The sex distribution of renal masses were 22 cases in male and 11 cases in female, and mean age of male patients were 43.8 years and female were 44.3 years. 2. The most common presenting symptom was flank pain in 28 cases(82.4%) and 17 cases (50.0%) presented with painless gross hematuria and one patient had no symptom. 3. Diagnostic accuracy of ultrasonography, computerized tomography and renal angiography of 27 cases of renal mass, were 70.6%, 83,3% and 63.3%, respectively. 4. Among 33 cases of renal mass, operation was done in 27 cases and 7 cases were misdiagnosed. 5. Therefore, we think that current uroradiologic studies are not sufficiently accurate in the diagnosis of renal mass and that exploration should be done whenever the diagnosis of renal mass is equivocal by radiologic study.
Angiography ; Diagnosis ; Female ; Flank Pain ; Hematuria ; Humans ; Male ; Retrospective Studies ; Sex Distribution ; Ultrasonography

The diagnostic work-up of renal mass should be carried out in an accurate, rapid, noninvasive and cost effective way. We retrospectively analyzed the diagnostic accuracy of ultrasonography, computerized tomography and renal angiography in 33 patients with renal mass from July 1984 to June 1987. The results were as follows : 1. The sex distribution of renal masses were 22 cases in male and 11 cases in female, and mean age of male patients were 43.8 years and female were 44.3 years. 2. The most common presenting symptom was flank pain in 28 cases(82.4%) and 17 cases (50.0%) presented with painless gross hematuria and one patient had no symptom. 3. Diagnostic accuracy of ultrasonography, computerized tomography and renal angiography of 27 cases of renal mass, were 70.6%, 83,3% and 63.3%, respectively. 4. Among 33 cases of renal mass, operation was done in 27 cases and 7 cases were misdiagnosed. 5. Therefore, we think that current uroradiologic studies are not sufficiently accurate in the diagnosis of renal mass and that exploration should be done whenever the diagnosis of renal mass is equivocal by radiologic study.
Angiography ; Diagnosis ; Female ; Flank Pain ; Hematuria ; Humans ; Male ; Retrospective Studies ; Sex Distribution ; Ultrasonography