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

Angiogenesis is an essential requirement for development, progression, and metastasis of malignant tumors. Vascular endothelial growth factor (VEGF) is one of the important angiogenic factors. Recently the role of angiogenesis has been known in premalignant lesions. This study was performed to determine whether the angiogenesis and VEGF expression were increased in association with histological grade of cervical intraepithelial neoplasia (CIN) and to see the relationship between the angiogenesis and VEGF. Immunostainings for factor VIII and VEGF were performed on 52 cases of cervical neoplasia (12 cases of CIN I, 11 cases of CIN II, 15 cases of CIN III, 7 cases of microinvasive squamous cell carcinoma, and 7 cases of invasive carcinoma) and 5 cases of normal cervix. The results showed a significant increase of microvessel count from normal cervix through CIN grades to invasive squamous cell cacinoma. VEGF expression was increased in proportion to the CIN grades. There was no significant correlation between microvessel count and VEGF expression. In conclusion, the tumor angiogenesis is an early event in tumorigenesis of uterine cervix. In addition, no significant relationship between the microvessel count and VEGF expression in CIN suggests the possibility of other growth factors affecting mainly angiogenesis of premalignant lesion of uterine cervix.
Angiogenesis Inducing Agents ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Factor VIII ; Female ; Intercellular Signaling Peptides and Proteins ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Pulmonary artery sling is a rare congenital condition in which the left pulmonary artery arises anomalously fmm the right pulmonary artery extrapericardially and encirdes the right main stem bronchus and passes between the trachea and esophaghus to reach the hilum of the left lung. Respiratory obstruction vesults from compression of the lower area of trachea and right main stem bronchus. It is rare cause of respiratory distress in the new bom and may be associated with significant morbidity and mortality. We experienced the case of pulmonary artery sling with diffuse trachea stenosis and congenital heart disease (pulmonary atresia and PDA) and confirmed the anomaly by bronchogram and MRI. The presumed cause of death was respiratory obsruction due to pulmonary artery sling.
Bronchi ; Cause of Death ; Constriction, Pathologic ; Heart Defects, Congenital ; Lung ; Magnetic Resonance Imaging ; Mortality ; Pulmonary Artery* ; Trachea ; Tracheal Stenosis*

Background: Fluvastatin is the first entirely synthetic 3-hydroxy-3-methylglutaryl-coenzyme A(HMG-CoA) reductase inhibitor. Clinical data indicate that this agent exhibits the proven efficacy of its class and also has some theoretical advantages in safety for long-term use because of its unique pharmacololgic property consistent with hepatoselectivity(i.e., low systemic exposure). This study is to evaluate efficacy and safety of fluvastatin in hypercholesterolemic patients in Korea. Methods: An open clinical trial with fluvastatin was conducted in 31 subjects who continued to have high blood cholesterol levels of 6.21 mmol/L(240 mg/dl) or greater after 1 month of lipid-lowering diet plus single blind placebo period. Fluvastatin was administered for 8 weeks with the initial dose of 20 mg per day and if serum cholesterol levels did not fall below 5.20 mmol/L(200 mg/dl) after 4 weeks the dose was increased to 40 mg per day for the second 4 weeks. On each visit every 4 weeks they underwent interview and laboratory tests about side effects and tolerability. Results: The mean % changes in plasma total cholesterol and LDL-cholesterol from baseline were
Cholesterol ; Creatine Kinase ; Diet ; Humans ; Hypercholesterolemia ; Korea ; Oxidoreductases ; Plasma ; Sleep Stages ; Triglycerides

We examined C3H pregnant mice at 15 days (70% gestation) after treatment of lipopolysaccaride (LPS) to observe the changes of IL-6 concentration in maternal serum and amniotic fluid and expression of IL-6, IL-13 & TIMP-3 in placenta, fetus and endometrium, and to investigate the correlation among IL-6, IL-13 and TIMP-3. The results were as follows: 1) IL-6 in serum and amniotic fluid after treatment of LPS was significantly elevated; peaked at 1, 2, 4, 5 hours and decreased to control level at 8 hours (P<0.05). IL-6 in placental disc, chorioamnionic membrane, fetus, decidua and endometrial epithelium was overexpressed significantly at 1, 2, 4 hours after treatment of LPS (P<0.05). IL-6 overexpression was more significantly increased in maternal tissue than fetal tissue (P<0.05). 2) Increased concentration of amniotic fluid IL-6 was equally originated from transplacental crossage of maternal serum IL-6, and direct local production of IL-6 from placenta, fetus and endometrium (P<0.05). 3) IL-13 in placental disc, chorioamnionic membrane, fetus, decidua and endometrial epithelium was overexpressed after treatment of LPS, but not significant statistically. 4) TIMP-3 was overexpressed in placental disc, chorioamnionic membrane, fetus and decidua. TIMP-3 overexpression was more significant in placental disc than other tissues (P<0.05). 5) Overexpressions in IL-13 and IL-6 revealed direct proportional correlation coefficient (Spearman correlation coefficient, 0.5212 ; P<0.05). IL-6 expression was a head of overexpression of TIMP-3, but not significant. In conclusion, all of IL-6, IL-13 and TIMP-3 relate with inflammatory response, especially IL-6 in maternal serum, amniotic fluid and tissue of placenta, fetus and endometrium was so sensitive that it can be an indicator for antenatal diagnosis of chorioamnonitis, and amniotic fluid IL-6 is equally originated from maternal serum and from tissue of placenta, fetus and endometrium. IL-13 and TIMP-3 may have parallel correlation to the IL-6 in fetal and maternal tissue after treatment of LPS.
Amniotic Fluid ; Animals ; Decidua ; Endometrium* ; Epithelium ; Female ; Fetus* ; Head ; Interleukin-13* ; Interleukin-6* ; Membranes ; Mice* ; Placenta* ; Prenatal Diagnosis ; Tissue Inhibitor of Metalloproteinase-3*

OBJECTIVES: The early detection of ectopic tubal pregnancy in unruptured state is increased as the transvaginal sonography and sensitive serum hCG test are available. For this unruptured tubal pregnancy, the medical treatment using methotrexate via various routes and dosage is being tried. Our study was to evaluate the efficacy of single systemic injection of methotrexate in the treatment of unruptured tubal pregnancies. Material and METHODS: From the January 1997 to July 1999, of 152 ectopic pregnancy patients, 22 patients who were diagnosed as unruptured tubal pregnancies were treated with single-dose systemic methotrexate injection (50 mg/m2/IM). Exclusion criteria were unstable vital signs with hemoperitoneum, adnexal mass > 5-6 cm. Serum hCG titers were checked before injection and 4, 7 day after injection. If serum hCG titer declined more than 15% on 7 day after injection compared with titer on 4 day, the weekly hCG titer was followed until it was <10 mIU/ml .If the hCG titer did not decline more than 15 %, a second dose was given. If hCG titer was not decreased or vital signs became unstable after 1-2 injections, the treatment was considered failure and surgery was done. RESULTS: 18 cases (82%) of 22 were successfully treated with single-dose methotrexate. The mean size of ectopic mass and initial serum hCG titers were 2.7+/-1.3 cm (range, 1.5-5.4 cm) and 3,298+/-1,007 mIU/ml (range, 132-12,239), respectively. Of 22, 6 cases (28%) needed second dose of methotrexate. The mean time to resolution of serum beta-hCG titer was 27.5+/-13.6 days (range, 8-53 days). Elevation of liver enzyme did not occurred in all cases during treatment. Initial hCG titer was more important prognostic factor than ectopic mass size for successful medical treatment. CONCLUSION: Single-dose methotrexate appears to be an effective medical treatment for the unruptured tubal pregnancy. However, patients selection using strict criteria is needed to increase its success rate.
Female ; Hemoperitoneum ; Humans ; Liver ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Vital Signs

Echocardiography has been the most widely applicable noninvasive cardiovascular imaging technique. Recent advances in this technique have extended its use into the operating room by development of transesophageal approach. Many anesthesiologists use transesophageal echocardiography (TEE) because it provides a more direct and rapid method of assessing cardiac anatomy and function. Intraoperative TEE done by anesthesiologists or cardiologists makes it possible for operation team to get useful informations such as cardiac filling, valvular function, cardiac contractility, intracardiac shunt, segmental wall motion abnormality and adequacy of coronary blood flow, etc. We analyzed our clinical experiences of forty six cases of TEE (6.0%) in 767 cases of anesthesia for open heart surgery at the Sejong General Hospital during the period from September 1993 to August 1994. 767 open heart surgical cases were divided into 4 groups by disease entity ; 498 cases of group I(congenital), 190 cases of group II(valvular), 63 cases of group III(ischemic) and 16 cases of group IV(miscellaneous). TEE was done for 22 cases of male patients and 24 cases of female patients. 32 cases of TEE were done for the age group between 21 to 30 years old. The number of TEE was 26 cases of group II, 11 cases of group I, 7 cases of group III and 2 cases of group IV, respectively. The main purpose of TEE in descending order was 27 cases for assessment of cardiac contractility, 18 cases for valvular function after valvuloplasty, 7 cases for the evaluation of low cardiac output syndrome(LCOS), and 7 cases for adequacy of coronary blood flow respectively. Two cases of Biopump in group I, 2 cases of Biopump in group II, 3 cases of intraaortic baloon pump(IABP) in group II, III and IV were applied after TEE. Two cases of mitral valvular replacement(MVR) were done immediately after confirmation of valvular insufficiency by TEE. These results have demonstrated that TEE is one of the useful monitoring devices for the anesthesia in open heart surgery by assessment of variable informations about patients' cardiac status.
Adult ; Anesthesia ; Cardiac Output, Low ; Echocardiography ; Echocardiography, Transesophageal* ; Female ; Heart* ; Hospitals, General ; Humans ; Male ; Operating Rooms ; Thoracic Surgery*

No abstract available.
Endometrium* ; Female ; Humans

BACKGROUND: It is stated that spinal anesthesia may alter susceptibility to the soporific effects of sedatives. In the geriatric patients who are susceptible to midazolam, the adequate dosage of midazolam for sedation was evaluated in spinal anesthesia. METHODS: ASA 1 or 2 50 elderly patients (over 65 years old) who were scheduled for lower abdominal or extremities operations, were randomly assigned into two groups. Midazolam 0.01 mg/kg was administered every 5 minutes until becoming sedated before general anesthesia in the control group, while 0.01 mg/kg was administered every 5 minutes after stabilized for 15 minutes after spinal anesthesia in the study group. RESULTS: It took 15 +/- 5.0 minutes for the control group to fall asleep while the spinal anesthesia group showed significantly less time with 11 +/- 4.2 minutes. The total amount of midazolam administered were 1.5 +/- 0.6 mg in the control group and 1.2 +/- 0.5 mg in the study group, which showed no significance. However, the amount of midazolam compared with the body weight revealed 0.031 mg in the control group and 0.023 mg in the spinal anesthesia group suggesting significantly decreased dosage in the study group. CONCLUSIONS: Midazolam revealed significant sensitivity as well as sedative susceptibility in the elderly patients who underwent spinal anesthesia. Therefore, the dosage titration of midazolam for the elderly patients in spinal anesthesia should be carefully considered.
Aged ; Anesthesia, General ; Anesthesia, Spinal* ; Body Weight ; Extremities ; Humans ; Hypnotics and Sedatives ; Midazolam*