OBJECTIVE: To determine the differences of expression of Transforming Growth Factor (TGF)-beta1 and TGF-beta2 in the human proliferative, secretory, menopausal endometrium, and in hyperplasia and adenocarcinoma of the endometrium. MATERIALS AND METHODS: Fifty patients were divided into 5 groups. Twenty samples were collected from patients with endometrial hyperplasia (n=l0) and adenocarcinoma(n=10) after hysterectomy. Thirty samples were collected from the normal menstrual cycle and the menopausal women as a control group. The histological types of endometrium were proliferative(n=10), secretory(n=10), menopausal(n=10). Immunohistochemical staining was performed through the use of monoclonal antibodies against anti-human TGF-beta1/ beta2 polycolonal IgG rabbit antibody. Expression of TGF-beta1 and TGF-beta2 were judged positive when the staining revealed color development in 5% or more. Specimens were rated absent, trace, weak, moderate and intense. Then, they were scored 4 in case of intense positive for TGF-beta1 and TGF-beta2, and '0' in case of absent for TGF-beta1 and TGF-beta2 . RESULTS: Mean scores of TGF-beta1 in glandular cell were proliferative(1.0), secretory (2.3), menopausal endometrium(1.0), endometrial hyperplasia(0) and adenocarcinoma(0). Expression of TGF-beta2 in glandular cell were proliferative(3.8), secretory(3.3), menopausal endometrium(2.8), endometrial hyperplasia(0.3) and adenocarcinoma(0.3). No specific different expression of TGF-beta1 and TGF-beta2 was found between stromal, vascular and myometrium. However, there was similar expression of TGF-beta1 and TGF-beta2 in endometrial hyperplasia and adenocarcinoma gmup. CONCLUSIONS: TGF-beta1 and TGF-beta2 may have important roles to suppress the development of the precancerous or cancerous lesions in endometrial glandular cells.
Adenocarcinoma* ; Animals ; Antibodies, Monoclonal ; Endometrial Hyperplasia ; Endometrium* ; Female ; Humans* ; Hyperplasia ; Hysterectomy ; Immunoglobulin G ; Menstrual Cycle ; Mice ; Myometrium ; Transforming Growth Factor beta1 ; Transforming Growth Factor beta2 ; Transforming Growth Factors*

One of the most important aspect of hemophilia is repeated bleeding into the joint. The frequency of such hemorrhages varies with the severity of the disease. In moderate or severe cases, repeated hemorrhages result in considerable impairment of joint structure and function: Contractures and gross deformity are frequent end result. This paper described a case of hemophilia A, 24-year-old male, who developed deformity of the shoulder, elbow, ankle and knee joint because of repeated hemoarthrosis. Author attempted to treat this patient by transfusion of fresh whole blood and traction, which resulted in some clinical improvement.
Ankle ; Congenital Abnormalities ; Contracture ; Elbow ; Hemophilia A ; Hemorrhage ; Humans ; Joints ; Knee Joint ; Male ; Shoulder ; Traction ; Young Adult

No abstract available.
Pregnancy*

BACKGROUND: Electroconvulsive therapy (ECT) that works by electrically inducing grand mal seizure is an effective therapy for patients with major psychosis and affective disorders. But ECT may produce intense stimulation of the central nervous system resulting in hypertension and tachycardia. Such an acute hyperdynamic state may be undesirable because of possible cardiovascular complications. We compared the ability of different bolus doses of esmolol to blunt the hemodynamic effects of ECT. METHODS: Twenty ASA physical status 1~2 patients were enrolled in a crossover design study to determine the effects of two standard esmolol bolus doses (0.5 mg/kg and 1.0 mg/kg) on the hemodynamic response and seizure duration during ECT. In each patients receiving esmolol or placebo, arterial pressure, heart rate, seizure duration and peripheral oxygen saturation (SpO2) were recorded. RESULTS: The seizure duration with placebo was 43 +/- 9 sec, esmolol 0.5 mg/kg bolus dose was 39 +/- 14 sec and esmolol 1.0 mg/kg bolus dose was 39 +/- 12 sec, but it was not significant. Compared with esmolol 0.5 mg/kg bolus dose, esmolol 1.0 mg/kg bolus dose decreased blood pressure and heart rate during ECT more effectively. CONCLUSIONS: Esmolol 1.0 mg/kg bolus dose was considered to be the better dose in blunting the hyperdynamic response during ECT without shortening of seizure duration.
Arterial Pressure ; Blood Pressure* ; Central Nervous System ; Cross-Over Studies ; Electroconvulsive Therapy* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypertension ; Mood Disorders ; Oxygen ; Psychotic Disorders ; Seizures ; Tachycardia

The mechanism of development of pulmonary edema associated with -sympathomimetic agent is still not fully understood. 2-sympathomimetic drugs such as ritodrine, terbutaline, and fenoterol are widely used for the treatment of premature uterine contraction. We describe a case of pulmonary edema that occurred suddenly during Cesarean section in a previously healthy parturient, associated with ritodrine pretreatment for 5 days in an attempt to arrest preterm labor. Pulmonary edema was completely treated with mechanical ventilation and diuretic therapy.
Cesarean Section* ; Female ; Fenoterol ; Humans ; Obstetric Labor, Premature ; Pregnancy ; Pulmonary Edema* ; Respiration, Artificial ; Ritodrine* ; Terbutaline ; Uterine Contraction

Mullerian adenosarcoma is an uncommon variant of MQllerian mixed tumors of the uterus and a mixed, biphasic neoplasia in which the mesenchymal component is malignant and the epithelial component is benign. In contrast to typical malignant Miillerian mixed tumor(MMMT), Miillerian adenosarcomas are usually tumors of low malignant potential. These tumom usually present as pedunculated endometrial masses in postmenopausal women with vaginal bleeding. We experienced a case of Miillerian adenosarcoma of the uterus with squamous cell carcinoma of the uterine cervix and report with a brief review of literatures.
Adenosarcoma* ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Humans ; Uterine Hemorrhage ; Uterus*

Intramural implantation is among the rarest forms of ectopic pregnancy.Since the first description by Perli, 21 cases were reported in worldwide literatures.The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament.The previous history of uterine injury or adenomyosis is known as possible etiology of intramural implantation. Because the early diagnosis is very difficult, most cases is found after onset of complication such as a uterine rupture or hemoperitoneum. We have recently experienced a case of intramural pregnancy diagnosed and treated by laparoscopy in a 9 weeks gestation nulliparous woman without previous history of uterine injury or disease, and report with a brief review of literatures.
Adenomyosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertilization ; Hemoperitoneum ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Uterine Rupture ; Round Ligaments

To investigate the correlation between EBV infection and p53 overexpression in laryngeal carcinomas (LC) and nasopharyngeal carcinomas (NPC) in Korea, we analyzed 37 laryngeal squamous cell carcinomas and 33 nasopharyngeal (11 squamous cell and 22 undifferentiated) carcinomas. We used the immunohistochemistry and polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) for p53 overexpression and p53 gene mutation, respectively, and EBER-1 in situ hybridization and PCR using primer for EBNA-1 and EBNA-2 type 1 and 2 for prevalence and the subtype of EBV. The results were as follows; 1) The p53 expression was found in 43.2% of squamous cell LCs, in 54.6% of squamous cell NPCs and in 22.7% of undifferentiated NPCs. The p53 gene mutation was detected in 6 of 23 squamous cell LCs and 3 of 14 undifferentiated NPCs. 2) EBV was detected more frequently in undifferentiated NPCs (95.5%) than in squamous cell NPCs (63.6%) and squamous cell LCs (37.0%). Only type 1 was found in squamous cell LCs and NPCs, whereas both type 1 and type 2 were detected in undifferentiated NPCs. 3) There was no difference according to EBV infection (EBV+ ; 7 cases, EBV- ; 7 cases) in the cases with p53 protein overexpression but mutaion. From the above results, it can be concluded that squamous cell LCs and NPCs are associated with both p53 and EBV, whereas undifferentiated NPCs are more closely associated with EBV than p53. In Korea, both type 1 and 2 are detected in undifferentiated NPCs. Also, our result suggests that EBV infection does not seem to contribute to p53 overexpression. The interrelationship between EBV infection and p53 remains to be further defined.
Carcinoma, Squamous Cell ; Epstein-Barr Virus Infections ; Genes, p53 ; Herpesvirus 4, Human* ; Immunohistochemistry ; In Situ Hybridization ; Korea ; Polymerase Chain Reaction ; Prevalence

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was performed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.
Actinomycosis ; Adult ; Bacteria ; Biopsy, Fine-Needle ; Breast ; Carcinoma, Hepatocellular ; Diverticulum* ; Drainage ; Fibroadenoma ; Flank Pain ; Gallbladder ; Humans ; Infarction ; Liver ; Monocytes ; Neutrophils ; Penicillins ; Physical Examination ; Vesico-Ureteral Reflux* ; Weight Loss

Paraneoplastic pemphigus is a distinct and rare autoimmune disease characterized by extensive and painful mucosal ulcerations and polymorphic desquamated skin lesions in the setting of an underlying neoplasm, typically of lymphoreticular origin. Thus difficulties in the management of anesthesia can be expected. A 66-years-old man was scheduled for removal of intraabdominal sarcoma associated with paraneoplastic pemphigus. Physical examination showed multiple erythematous bullae, crusts, plaques and target-like lesions on the whole body and desquamated erythematous skin lesions on the back and extremities. In the operating room, his right femoral artery was cannulated with a 20 G, 12.7 cm CVP catheter and left femoral and subclavian veins with 14 G, 20 cm CVP catheters, respectively. After application of 4 % lidocaine spray, his oropharynx and supraglottic area were evaluated under direct laryngoscopy and revealed multiple ulcerations on oral mucosa, but no distinct lesion on supraglottic area. Anesthesia was induced by rapid-sequence method with fentanyl, thiopental sodium and succinylcholine followed by endotracheal intubation. The endotracheal tube was held by a roll gauze around the neck and its cuff was minimally inflated to avoid overpressure against his tracheal wall. After the end of surgery, his oral cavity was suctioned with no remarkable bleeding, and tracheal wall including cuff-contacted area was evaluated under fiberoptic bronchoscopy, revealed intact wall without any bulla or ulceration. The patient was transferred to intensive care unit for proper postoperative management after extubation of endotracheal tube.
Anesthesia ; Autoimmune Diseases ; Bronchoscopy ; Catheters ; Extremities ; Femoral Artery ; Fentanyl ; Hemorrhage ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine ; Mouth ; Mouth Mucosa ; Neck ; Operating Rooms ; Oropharynx ; Pemphigus* ; Physical Examination ; Sarcoma ; Skin ; Subclavian Vein ; Succinylcholine ; Suction ; Thiopental ; Ulcer