OBJECTIVE: to determine whether ovarian steroids directly regulate FSH release and B subunit synthesis at the pituitary level METHODS: In vitro study. After applying ovarian steroids in cultured rat anterior pituitary cells, we evaluate the amount of relesed FSH and FSH B subunit using dot-blot hybridization. RESULTS: Estradiol alone or GnRH-induced did not modulate FSH release and B ubunit synthesis. Although progesterone alone did not alter FSH release, GnRH-induced FSH release was significantly augmented by the treatment of progesterone. Progesterone alone stimulated FSH B mRNA level. Significant increase in FSH B mRNA level was also observed by the combined treatment of progesterone and GnRH. The effects of progesterone on GnRH-induced FSH release was significantly reduced by the treatment of progesterone antagonist, RU 486. The treatment with progesterone antagonist, RU 486 also abolished progesterone-induced FSH B subunit mRNA biosynthesis. CONCLUSION: From these results, it is, therefore, concluded that estradiol does not seem to be a major regulator for FSH synthesis but progesterone may exert its action at the pituitary level for the synthesis and release of FSH.
Animals ; Estradiol ; Estrogens ; Gonadotropin-Releasing Hormone ; Mifepristone ; Progesterone ; Rats* ; RNA, Messenger ; Steroids

OBJECTIVE: To evaluate prospectively the efficacy and accuracy of transvaginal sonography(TVS), saline infusion sonohysterography(SIS) and hysteroscopy in the exploration of the uterine cavity. METHODS: 71 consecutive patients were evaluated with SIS who showed abnormal TVS findings, using saline instilled through endocervically placed balloon catheter with concurrent vaginal sonography. Among them, 41 patients also underwent hysteroscopy and surgery. Transvaginal sonography, sonohysterography, hysteroscopy were compaired with pathologic reports. RESULTS: Fifty-five of 71 sonohysterogram(77.5%) showed abnormal findings, Among them 41 patients have done hysteroscopy and biopsy. According to pathologic reports, sixteen patients were noted to have myoma(39.0%), twelve patients had polyps (21.3%), and both showed most frequent lesions. TVS, SIS, and hysteroscopy had a sensitivity of 94.4%, 91.1%, 94.4%, and a specificity of 40%, 42.8%, 60.0%, respectively and showed not so much different in detection rate. In case of submucosal myoma and polyps, hysteroscopy showed 100% sensitivity, and 92% specificity and showed much higher detection rate compared with SIS (81.2%, 92.0%). CONCLUSION: Transvaginal sonography and sonohysterography are good office diagnostic test in case of detecting variable gynecologic intrauterine abnormalities.
Biopsy ; Catheters ; Diagnostic Tests, Routine ; Humans ; Hysteroscopy* ; Myoma ; Polyps ; Prospective Studies ; Sensitivity and Specificity ; Uterine Hemorrhage*

Extraskeletal Neoplasm Resembling Ewings Sarcoma was firstly reported with comprehensive review of 39 cases by L. Angervall and F.M. Enzinger in 1975. The tumors chiefly affected young adults and most commonly involved the soft tissue of lower extremity. Microscopically, they were consisted of solidly packed small, round or ovoid cells arranged in sheets or lobules, which were indistinguishable from those of the Ewings sarcoma of bone. The authors recently experienced a soft tissue sarcoma occurring in deltoid area of young male patient, which was diagnosed extraskeletal neoplasm resembling Ewings sarcoma. The case review is presented.
Humans ; Lower Extremity ; Male ; Sarcoma ; Sarcoma, Ewing ; Young Adult

Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

PURPOSE: Patients with canalicular or common canalicular obstruction have been treated by carrying out conjuctivodacryocystorhinostomy mainly through skin or the nasal cavity, but all sorts of defects attendant on an operation have been indicated. At this, the authors inquired into a result of a surgery and their satisfaction in a different viewpoint for silicone intubation. METHODS: We inquired into a result of a surgery and their satisfaction in a different viewpoint for 68 patients' 72 eyes who can be observed over 3 months among patients diagnosed as canalicular or common canalicular obstruction and operated on with silicone intubation as subject. RESULTS: After surgery, silicone tube was removed at average postoperative 5.8 months and we observed them for average 10.5 months. The result of operations showed that successful cases are 72.2% (52 eyes) and failing cases are 28.8% (20 eyes). CONCLUSION: For the cases with canalicular obstruction, especially common canalicular obstruction for short period, primary silicone intubation would be one of the ideal lacrimal surgery that should be explained the possible secondary conjuctivodacryocystorhinostomy later.
Adult* ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Nasal Cavity ; Silicones* ; Skin

Injury of the ankle ligaments is one of the most common sports-related injuries. Although there are some debates as to the best initial treatment for an acute tear of a lateral ligament, persistent functional instability of the ankle develops in approximately 20% of patients regardless of the type of initial treatment. In these patients, late reconstruction of the lateral ankle ligaments may become necessary. Among 13 cases which have been operated with Larsen procedure using peroneus brevis tendon from March 1991 to February 1993, the 11 cases followed up over 1 year were examined clinically and radiologically. We introduced the clinical analysis and results with the brief review of the literatures. 1. The indication of surgical treatment was the ankle instability which had differences over 10° in talar tilting angle or over 3mm in anterior displacement compared wit the uninjured site. 2. The postoperative results were 5 cases in excellent and 4 in good. 3. The Larsen procedure was considered a good method to anatomically and simply stabilize both the ankle and subtalar joint and to fix tendon depending on the type of instability.
Ankle ; Collateral Ligaments ; Humans ; Ligaments ; Methods ; Subtalar Joint ; Tears ; Tendons

PURPOSE: Although the data of radiofrequency catheter ablation (RFCA) of supraventricular tachycardia in adults has been accumulated in several centers in Korea, few data are available on its efficacy and safety in pediatric ages. We reviewed the data in young patients who underwent this procedure in a pediatric cardiology center, to evaluate the indications, early results, complications, and short-term follow-up data. METHODS: We retrospectively reviewed the medical records and RFCA procedure reports of 17 children who underwent this procedure in pediatric cardiology center, Asan Medical Center, Seoul, Korea from January 1992 to July 1996. The mean follow-up periods was 17.8 months. RESULTS: 1) The median age of the patients was 12.3 years and all of them except two patients had structurally normal hearts. The indications of RFCA were preoperative open heart surgery in a patient, drug refractory tachycardia in 4 patients and patient's choice in other 12 patients. 2) The mechanisms of supraventricular tachycardia were 9 atrioventricular reentrant tachycardia, 6 atrioventricular nodal reentrant tachycardia (AVNRT), 1 atrial flutter and 1 atrial ectopic tachycardia (AET). Among accessory pathways, preexcitation was in 6 patients and accessory pathway located in the right side in 7 patients. In all patient with AVNRT except one, slow pathway was ablated. In the case of AET, ectopic focus located in the left atrium near the orifice of right lower pulmonary vein. 3) 16 of 18 procedures (88.9%) were successful and in 2 occasions with right sided accessory pathway and AET, the procedure failed. Ectopic focus was successfully ablated at the second attempt. The mean total procedure time was 2.7 hours (n=16) and the mean fluoroscopic time was 45.3 minutes (n=12). The average number of RF application was 11 times. There was no significant complications related with procedures. 4) There were 5 recurrences (29.4%), in 2 patients with accessory pathway and 2 patients with AVNRT. Most recurrences occured in 6 weeks after procedure. CONCLUSIONS: RFCA is a good alternative for the treatment of supraventricular tachycardia also in young patients as in adults. Early results of RFCA shows resonably good success rate but somewhat higher rate of recurrence in our center. We expect the results of RFCA in children will be improved in near future after some period of learning curve.
Adult ; Atrial Flutter ; beta-Aminoethyl Isothiourea ; Cardiology ; Catheter Ablation* ; Child* ; Chungcheongnam-do ; Follow-Up Studies ; Heart ; Heart Atria ; Humans ; Korea ; Learning Curve ; Medical Records ; Pulmonary Veins ; Recurrence ; Retrospective Studies ; Seoul ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ectopic Atrial ; Tachycardia, Supraventricular* ; Thoracic Surgery

Atrial flutter is a potentially life threatening complication of repair or palliation of congenital heart disease and is frequently drug resistant. Recent studies in human have demonstrated that common type atrial flutter is due to macro-reentry in the right atrium and that the reentrant circuit may involve slow conduction in the low posteroseptal area of the right atrium. Catheter ablation of atrial flutter has been successful using radiofrequency energy. Application of radiofrequency energy at the isthmus between the inferior vena cava and tricuspid ring was effective in preventing recurrence of atrial flutter in a 6 year old boy after open heart surgery of common atrium. Despite concerns regarding ablation scar in growing children and persistence of underlying structural abnormalities in postoperative patients, radiofrequency ablation of atrial flutter appears to be another useful therapeutic option in management of this not so rare but potentially malignant and often resistant arrhythmia.
Arrhythmias, Cardiac ; Atrial Flutter* ; Catheter Ablation* ; Catheters* ; Child* ; Cicatrix ; Heart Atria ; Heart Defects, Congenital ; Humans ; Male ; Recurrence ; Thoracic Surgery ; Vena Cava, Inferior

PURPOSE: To analyze the gene expression profiles of uterine cervical cancer, and its variation after radiation therapy, with or without concurrent chemotherapy, using a cDNA microarray. MATERIALS AND METHODS: Sixteen patients, 8 with squamous cell carcinomas of the uterine cervix, who were treated with radiation alone, and the other 8 treated with concurrent chemo-radiation, were included in the study. Before the starting of the treatment, tumor biopsies were carried out, and the second time biopsies were performed after a radiation dose of 16.2~27 Gy. Three normal cervix tissues were used as a control group. The microarray experiments were performed with 5 groups of the total RNAs extracted individually and then admixed as control, pre-radiation therapy alone, during-radiation therapy alone, pre-chemoradiation therapy, and during-chemoradiation therapy. The 33P-labeled cDNAs were synthesized from the total RNAs of each group, by reverse transcription, and then they were hybridized to the cDNA microarray membrane. The gene expression of each microarrays was captured by the intensity of each spot produced by the radioactive isotopes. The pixels per spot were counted with an Arrayguage(R), and were exported to Microsoft Excel(R). The data were normalized by the Z transformation, and the comparisons were performed on the Z-ratio values calculated. RESULTS: The expressions of 15 genes, including integrin linked kinase (ILK), CDC28 protein kinase 2, Spry 2, and ERK 3, were increased with the Z-ratio values of over 2.0 for the cervix cancer tissues compared to those for the normal controls. Those genes were involved in cell growth and proliferation, cell cycle control, or signal transduction. The expressions of the other 6 genes, including G protein coupled receptor kinase 6, were decreased with the Z-ratio values of below -2.0. After the radiation therapy, most of the genes, with a previously increase expressions, represented the decreased expression profiles, and the genes, with the Z-ratio values of over 2.0, were cyclic nucleotide gated channel and 3 Expressed sequence tags (EST). In the concurrent chemo-radiation group, the genes involved in cell growth and proliferation, cell cycle control, and signal transduction were shown to have increased expressions compared to the radiation therapy alone group. The expressions of genes involved in angiogenesis (angiopoietin-2), immune reactions (formyl peptide receptor-like 1), and DNA repair (cAMP phosphodiesterase) were increased, however, the expression of gene involved in apoptosis (death associated protein kinase) was decreased. CONCLUSION: The different kinds of genes involved in the development and progression of cervical cancer were identified with the cDNA microarray, and the proposed theory is that the proliferation signal starts with ILK, and is amplified with Spry 2 and MAPK signaling, and the cellular mitoses are increased with the increased expression of Cdc 2 and cell division kinases. After the radiation therapy, the expression profiles demonstrated the evidence of the decreased cancer cell proliferation. There was no significant difference in the morphological findings of cell death between the radiation therapy alone and the chemo-radiation groups in the second time biopsy specimen, however, the gene expression profiles were markedly different, and the mechanism at the molecular level needs further study.
Apoptosis ; Biopsy ; Carcinoma, Squamous Cell ; Cell Death ; Cell Division ; Cell Proliferation ; Centers for Disease Control and Prevention (U.S.) ; Cervix Uteri ; Cyclic Nucleotide-Gated Cation Channels ; DNA Repair ; DNA, Complementary ; Drug Therapy ; Expressed Sequence Tags ; Female ; Gene Expression* ; GTP-Binding Proteins ; Humans ; Membranes ; Mitosis ; Oligonucleotide Array Sequence Analysis ; Phosphotransferases ; Protein Kinases ; Radioisotopes ; Reverse Transcription ; RNA ; Signal Transduction ; Transcriptome* ; Uterine Cervical Neoplasms*

No abstract available.
Humans