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Han, Li. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 132-140). / Abstract and appendixes also in Chinese. / Chapter 1.1 --- BACKGROUND & SIGNIFICANCE OF THE STUDY --- p.1 / Chapter 1.2 --- STRUCTURE OF THE THESIS --- p.4 / Chapter 2.1 --- BPH --- p.6 / Chapter 2.1.1 --- PREVALENCE OF BPH --- p.6 / Chapter 2.1.2 --- IMPACT OF BPH SYMPTOMS ON PATIENTS --- p.9 / Chapter 2.1.2.1 --- CLINICAL SYMPTOMS OF BPH --- p.9 / Chapter 2.1.2.2 --- IMPACT OF CLINICAL SYMPTOMS ON QUALITY OF LIFE --- p.10 / Chapter 2.1.3 --- IMPACT OF BPH MEDICAL MANAGEMENT ON PATIENTS --- p.11 / Chapter 2.1.3.1 --- MEDICAL MANAGEMENT OF BPH --- p.11 / Chapter 2.1.3.2 --- SIDE EFFECTS OF PHARMACOLOGICAL AND SURGICAL THERAPIES --- p.15 / Chapter 2.1.4 --- USE OF COMPLEMENTARY AND ALTERNATIVE THERAPY AMONG BPH PATIENTS --- p.19 / Chapter 2.1.4.1 --- PREVALENCE --- p.19 / Chapter 2.1.4.2 --- REASONS FOR TURNING TO CAM --- p.20 / Chapter 2.2 --- ISOFLAVONES --- p.43 / Chapter 2.2.1 --- ISOFLAVONES FUNCTION --- p.43 / Chapter 2.2.1.1 --- STRUCTURE --- p.43 / Chapter 2.2.1.2 --- FOOD SOURCES --- p.45 / Chapter 2.2.2 --- APPLICATION OF ISOFLAVONES IN BPH --- p.46 / Chapter 2.2.2.1 --- DOCUMENTED MECHANISM OF BPH --- p.46 / Chapter 2.2.2.2 --- STUDIES IN VITRO --- p.47 / Chapter 2.2.2.3 --- STUDIES IN VIVO --- p.48 / Chapter 2.2.2.4 --- EPIDEMIOLOGIC EVIDENCE --- p.49 / Chapter 2.3. --- RESEARCH GAP IN HUMAN STUDY --- p.50 / Chapter 3.1 --- STUDY DESIGN --- p.51 / Chapter 3.2 --- AIM --- p.51 / Chapter 3.3 --- STUDY POPULATION --- p.52 / Chapter 3.3.1 --- INCLUSION CRITERIA --- p.52 / Chapter 3.3.2 --- EXCLUSION CRITERIA --- p.52 / Chapter 3.3.3 --- SAMPLE SIZE ESTIMATION --- p.53 / Chapter 3.4 --- RANDOMIZATION --- p.54 / Chapter 3.4.1 --- GENERATION THE RANDOM ALLOCATION SEQUENCE AND DETAILS OF RESTRICTION OF RANDOMIZATION --- p.54 / Chapter 3.4.2 --- IMPLEMENTATION OF RANDOMIZATION --- p.54 / Chapter 3.5 --- BLINDING --- p.55 / Chapter 3.5.1 --- WHO WERE BLINDED --- p.55 / Chapter 3.6 --- INTERVENTION --- p.55 / Chapter 3.6.1 --- STUDY MEDICATIONS AND DOSAGE --- p.55 / Chapter 3.6.2 --- STUDY REGIMEN --- p.56 / Chapter 3.7 --- DATA COLLECTION --- p.56 / Chapter 3.8 --- OUTCOME MEASUREMENTS --- p.58 / Chapter 3.8.1 --- PRIMARY OUTCOME --- p.58 / Chapter 3.8.1.1 --- UROFLOWMETRY： PEAK URINE FLOW RATE (QMAX) --- p.58 / Chapter 3.8.2 --- SECONDARY OUTCOMES --- p.59 / Chapter 3.8.2.1 --- BLADDER SCAN： POST-VOIDING RESIDUAL VOLUME (PVR) --- p.59 / Chapter 3.8.2.2 --- SYMPTOMS SCORE (IPSS) --- p.60 / Chapter 3.8.2.3 --- QUALIFY OF LIFE --- p.61 / Chapter 3.8.2.4 --- SERUM PSA LEVEL --- p.62 / Chapter 3.8.2.5 --- URINALYSIS TEST --- p.62 / Chapter 3.8.3 --- AE/SAE --- p.63 / Chapter 3.8.3.1 --- SELF REPORTED AE/SAE --- p.63 / Chapter 3.8.3.2 --- SEXUAL HORMONE LEVEL --- p.64 / Chapter 3.8.3.3 --- SEXUAL RELATED QUALITY OF LIFE --- p.64 / Chapter 3.9 --- STATISTICAL ANALYSIS --- p.65 / Chapter 3.9.1 --- DESCRIPTIVE ANALYSIS --- p.65 / Chapter 3.9.2 --- COMPARATIVE ANALYSIS --- p.65 / Chapter 4.1 --- PARTICIPANTS FLOW --- p.67 / Chapter 4.2 --- DEMOGRAPHICS --- p.69 / Chapter 4.3 --- BASELINE CHARACTERISTICS COMPARISON --- p.70 / Chapter 4.3.1 --- IPSS --- p.72 / Chapter 4.3.2 --- QMAX AND PRV --- p.73 / Chapter 4.3.3 --- QUALITY OF LIFE --- p.73 / Chapter 4.3.4 --- SERUM PSA LEVEL --- p.74 / Chapter 4.4 --- EFFICACY OUTCOMES --- p.74 / Chapter 4.4.1 --- QMAX AND PVR --- p.74 / Chapter 4.4.1.1 --- QMAX --- p.74 / Chapter 4.4.1.2 --- PVR --- p.75 / Chapter 4.4.2 --- IPSS --- p.79 / Chapter 4.4.2.1 --- TOTAL IPSS --- p.79 / Chapter 4.4.2.2 --- IPSS SUB SCORE 1_ INCOMPLETE EMPTYING --- p.79 / Chapter 4.4.2.3 --- IPSS SUB SCORE 2_ FREQUENCY --- p.80 / Chapter 4.4.2.4 --- IPSS SUB SCORE 3_INTERMITTENCY --- p.81 / Chapter 4.4.2.5 --- IPSS SUB SCORE 4_ URGENCY --- p.82 / Chapter 4.4.2.6 --- IPSS SUB SCORE 5_ WEAK STREAM --- p.82 / Chapter 4.4.2.7 --- IPSS SUB SCORE 6_ STRAINING --- p.83 / Chapter 4.4.2.8 --- IPSS SUB SCORE 7_ NOCTURIA --- p.84 / Chapter 4.4.3 --- QOL --- p.90 / Chapter 4.4.3.1 --- QOL IN IPSS Q8_QOL_URINATION --- p.90 / Chapter 4.4.3.2 --- QOL IN SF-36 --- p.91 / Chapter 4.4.3.2.1 --- PHYSICAL FUNCTIONING --- p.91 / Chapter 4.4.3.2.2 --- ROLE-PHYSICAL --- p.92 / Chapter 4.4.3.2.3 --- BODY PAIN --- p.92 / Chapter 4.4.3.2.4 --- GENERAL HEALTH --- p.93 / Chapter 4.4.3.2.5 --- VITALITY --- p.94 / Chapter 4.4.3.2.6 --- SOCIAL FUNCTIONING --- p.95 / Chapter 4.4.3.2.7 --- ROLE-EMOTIONAL --- p.95 / Chapter 4.4.3.2.8 --- MENTAL HEALTH --- p.96 / Chapter 4.4.4 --- SERUM PSA LEVEL --- p.103 / Chapter 4.4.5 --- SUBGROUP ANALYSIS --- p.106 / Chapter 4.4.6 --- SELF-PREFERENCE EFFECT ANALYSIS --- p.107 / Chapter 4.4.7 --- DIARY ANALYSIS --- p.109 / Chapter 4.5 --- ADVERSE EVENTS --- p.113 / Chapter 4.5.1 --- SELF-REPORTED AE/SAE --- p.113 / Chapter 4.5.2 --- SEXUAL HORMONE LEVEL --- p.114 / Chapter 4.5.3 --- SEXUAL RELATED QUALITY OF LIFE --- p.114 / Chapter 4.5.3.1 --- SEXUAL LIFE UNSATISFACTORY --- p.114 / Chapter 4.5.3.2 --- LIBIDO DECREASE --- p.115 / Chapter 5.1 --- PRINCIPAL FINDINGS --- p.116 / Chapter 5.1.1 --- EFFICACY --- p.116 / Chapter 5.1.2 --- SAFETY --- p.117 / Chapter 5.2 --- STRENGH AND LIMITATIOINS --- p.117 / Chapter 5.2.1 --- STRENGTH --- p.117 / Chapter 5.2.1.1 --- BLINDING IS EFFECTIVE --- p.117 / Chapter 5.2.1.2 --- COMPLIANCE IS GOOD --- p.118 / Chapter 5.2.1.3 --- LONG TREATMENT PERIOD --- p.119 / Chapter 5.2.1.4 --- STUDY OUTCOMES INCLUDE BOTH OBJECTIVE OUTCOMES AND SUBJECTIVE OUTCOMES --- p.121 / Chapter 5.2.2 --- LIMITATIONS --- p.121 / Chapter 5.2.2.1 --- INSUFFICIENT SAMPLE SIZE --- p.122 / Chapter 5.2.2.2 --- POSSIBLY LOW DOSE --- p.122 / Chapter 5.2.2.3 --- LACK OF BASELINE DATA ON QUALITY OF SEXUAL LIFE --- p.123 / Chapter 5.2.2.4 --- "LACK OF DATA ON LIFESTY FACTORES INCLUDING DIETARY HABIT, PHYSICAL ACTIVITY, SMOKING STATUS AND ACOHOL CONSUMPTION" --- p.123 / Chapter 5.3 --- INTERPRETATIONS OF THE RESUTLS --- p.124 / Chapter 5.3.1 --- TWO POSIVE RESULTS IN EMPTYING FUNCTION AND QUALITY OF LIFE --- p.124 / Chapter 5.3.2 --- ONE NEGATIVE RESULT IN PEAK URINARY FLOW RATE --- p.127 / Chapter 5.3.3 --- QUALITY OF SEXUAL LIFE --- p.129 / Chapter 6.1 --- CONCLUSIONS --- p.130 / Chapter 6.2 --- IMPLICATIONS --- p.131

Thesis (doctoral)--Karolinska Institutet, Stockholm, 1986. / Extra t.p. with thesis statement inserted. Includes bibliographical references.

5α-reductases (5αRs) catalyse reduction of 4-pregnene steroids, most notably the androgen testosterone to its more potent metabolite dihydrotestosterone (DHT). Well-characterised isozymes of 5αR are designated 5αR1 and 5αR2. Inhibitors of 5αR, finasteride (a 5αR2 inhibitor) and dutasteride (a dual 5αR1 and 5αR2 inhibitor), are utilised in conditions where a reduction in androgen action is desired, including benign prostatic hyperplasia. Although 5αR2 is predominantly expressed in reproductive tissues, both isozymes, but particularly 5αR1, are expressed in metabolic tissues including liver and adipose and both metabolise glucocorticoids as well as androgens; therefore inhibition of 5αR may have consequences for metabolic health. This thesis addresses the hypotheses that 5αR1 inhibition with dutasteride decreases insulin sensitivity and causes dysregulation of the HPA axis in humans. Metabolism and the HPA axis were studied in men prior to and following 3 months of dutasteride (0.5 mg daily; n=16), finasteride (5 mg daily; n=16) or control (tamsulosin MR; 0.4 mg daily; n=14). Glucose disposal during hyperinsulinaemia was the primary endpoint, measured during a hyperinsulinaemic euglycaemic clamp, with d2-glucose and d5-glycerol tracers. Peripheral insulin sensitivity for both glucose uptake and NEFA suppression decreased with dutasteride versus both finasteride and control, while hepatic insulin sensitivity was preserved. Body fat increased with dutasteride, though was not accompanied by changes in metabolic or inflammatory gene transcript abundance in subcutaneous adipose biopsies, nor any differences in abdominal adipose depots on post-treatment MRI. Subtle dysregulation of the HPA axis was evident with both 5αR inhibitors, though to a greater degree with dutasteride and changes were largely compensated for. In support of this study, this thesis also describes the development, validation and application of two novel liquid chromatography tandem mass spectrometry assays; establishing compliance by measuring serum drug levels, and demonstrating effects of 5αR inhibitors on androgen metabolism and adrenal steroidogenesis by measurement of testosterone, DHT and androstenedione. In conclusion, 5αR1 inhibition with dutasteride, but not finasteride, induces peripheral insulin resistance and increases body fat. Findings presented may have important implications for patients prescribed dutasteride for benign prostatic hyperplasia.

Thesis advisor: Charles S. Hoffman / The biological roles of the most recently discovered mammalian cyclic nucleotide phosphodiesterase (PDE) family, PDE11, are poorly understood, in part due to the lack of selective inhibitors. To address this need for such compounds I completed a ~200,000 compound high throughput screen (HTS) for PDE11 inhibitors using a yeast-based growth assay. Further characterization of lead candidates using both growth-based assays in the fission yeast Schizosaccharomyces pombe and in vitro enzyme assays identified four potent and selective PDE11 inhibitors. I examined the effect of these compounds on human adrenocortical cells, where PDE11 is believed to regulate cortisol levels. One compound, along with two structural analogs, elevates cAMP levels and cortisol production through PDE11 inhibition, thus phenocopying the behavior of adrenocortical tumors associated with Cushing syndrome. These compounds can be used as research tools to study the biological function of PDE11, and can also serve as leads to develop therapeutic compounds for the treatment of adrenal insufficiencies. This study further validates the yeast-based HTS platform as a powerful tool for the discovery of potent, selective and biologically-active PDE inhibitors. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Biology.

A hiperplasia do processo coronóide (HPC) é uma variação morfológica que causa limitação na abertura de boca interferindo na mastigação. Normalmente não apresenta sintomatologia dolorosa e o paciente só vai procurar tratamento quando houver dor ou problemas funcionais causados pela compressão do processo coronóide hiperplásico no osso zigomático. Muitos clínicos desconhecem esta alteração e adotam tratamento para disfunção da articulação temporomandibular (ATM). Neste trabalho propôs-se mostrar que a hiperplasia do processo coronóide pode ser observada em radiografias panorâmicas de forma a suspeitar da existência dessa alteração e, aliado aos dados clínicos, o cirurgião-dentista generalista possa encaminhar o paciente ao especialista para que sejam providenciados exames mais complexos que permitam a conclusão do diagnóstico. A amostra constituiu-se de 150 radiografias panorâmicas dentre as quais estavam incluídas imagens sugestivas da hiperplasia do processo coronóide (HPC). Estas radiografias foram submetidas à análise de 3 Radiologistas com um mínimo de 5 anos de experiência na especialidade. Ficou concluído que a radiografia panorâmica é um meio auxiliar para o diagnóstico inicial dessa alteração e o clínico deve estar atento aos possíveis indicativos que esta técnica radiográfica fornece para a sugestão do diagnóstico. / The Coronoid Process Hyperplasia is a morphologic variation, which reduces mouth opening and interferes on mastication. Normally, it doesn\'t have pain symtomatology, and the patient will only look for treatment when there is pain or functional problems caused by compression of the Hyperplasic Coronoid Process on the zygomatic bone. Many practitioners ignore this alteration, and do treatment for termporomandibular joint disorder. This work proposes to show that is possible to suspect the presence of Coronoid Process Hyperplasia on panoramic radiography, and allied with clinical information, general practitioners can forward their patients to a specialist, to make more complex exams which will allow the conclusion of the diagnosis. The sample was composed by 150 panoramic radiographys, where included some suggestive radiographs of Coronoid Process Hyperplasia. These radiographs were analyzed by 3 Radiologists with at least 5 years of experience on this activity. It was concluded that panoramic radiography is an auxiliary way for initial diagnoses of this alteration and practitioners should attent the possible indicatives that this radiograph technique brings for diagnoses suggestion.

Orientador: Flávia de Rezende Eugênio / Banca: Renée Laufer Amorin / Banca: Maria Cecília Rui Luvizotto / Resumo: Ahiperplasiaprostática benigna(HPB) é a afecção mais comum da próstata canina, porém, a comparação dos diferentes métodos diagnósticos como o exame de palpação retal, citologia, histologia e imunoistoquímica é pouco estudada nesta espécie, diferentemente do que ocorre no homem. Este trabalho teve por objetivo estudar, em vinte cães idosos, as alterações cito e histológicas com emprego de imunomarcadores, na glândula prostática. Em todas as glândulas observou-se HPB cística, associada ou não à hiperplasia glandular ou estromal. A imunomarcação com citoqueratina (CK) AE1/AE3 foi relevante em ácinos com epitélio achatado ou com proliferação acentuada. A Vimentina (VIM) V9 teve expressão moderada em áreas com hiperplasia estromal acentuada. O toque retal e o lavado prostático mostraram ser métodos de auxílio no diagnóstico das prostatopatias, sendo indispensável o uso da histopatologia para um diagnóstico definitivo. O emprego de imunomarcadores teciduais prostáticos infere que próstatas com HPB demonstram alterações metabólicas que respondem à imunomarcação em células hiperplásicas. / Abstract: Benign Prostatic Hyperplasia (BPH) is the most common affection of the canine prostate, however, the comparison of different diagnostic methods for BPH through, digital rectal examination, cytology, histology and immunohistochemistry has a few studies in this specie, unlike man. The purpose of this study was understood, in twenty old dogs, cytology, histology alterations using immunomarkers in the prostate gland. All the glands showed the presence of cystic BPH, associated or not with glandular or stromal hyperplasia. The immunomarking with AE1/AE3 cytokeratine was relevant in alveoli with flat epytelium or with a strong proliferation. V9 Vimentine showed to be moderate in areas with a deep stromal hyperplasia. Rectal palpation and the prostatic washing product compose auxiliary diagnostic methods for prostatic diseases, being undismissable the use of histopathology for a conclusive diagnosis. Prostatic tissue immunomarkers employment to conclude that the prostate with HPB demonstrate metabolic changes which react with immunomarking in hyperplasic cells. / Mestre

Orientador: Wilter Ricardo Russiano Vicente / Banca: Elzylene Léga / Banca: Marcos Lania de Araujo / Resumo: Na prática da clínica de pequenos animais, os médicos veterinários são freqüentemente confrontados com o quadro ou com o diagnóstico diferencial da piometra em cadelas, e devem decidir rapidamente sobre a melhor forma de tratamento, pois se trata de uma situação de risco para a vida da paciente. Esta revisão tem como objetivo a descrição dos conceitos práticos e atuais da etiopatogenia da hiperplasia endometrial cística em cadelas, a qual precede o desenvolvimento do quadro de piometra. Abordam-se tanto a classificação quanto os sintomas, os achados clínicos, bem como aspectos diagnósticos dessa síndrome. Com relação ao tratamento, são consideradas tanto a abordagem cirúrgica quanto a medicamentosa, bem como as vantagens e desvantagens de cada opção. / Abstract: In clinics, pyometra in bitches is one of the most common disorders. Veterinarians must decide about the therapeutical approach and the best way to conduct treatment. So, it is important to know the complex physiopathogeny of this disorder, as well as the concomitant diseases, laboratorial alterations and types of treatment. The aim of this dissertation is to describe the new concepts of the etiopathogenia of the cystic endometrial hyperplasia-pyometra complex in bitches, evaluate the clinical and laboratorial alterations and also the options of the treatments found in animals consulted at the obstetrics department at the Veterinary Hospital "Governador Laudo Natel", FCAV-UNESP-Jaboticabal and confront them with the results published in literature and also with cases from other national and international universities. Thus, it was described the classification of clinical signs, diagnosis and therapeutics of this syndrome. / Mestre

Introdução: A reestenose pós tratamento endovascular de lesões ateroscleróticas em artérias periféricas é a principal desvantagem desta técnica minimamente invasiva. A inflamação vascular após angioplastia com balão e/ou implante de stent desempenha um papel importante na proliferação de células do músculo liso vascular e posterior crescimento de uma neoíntima, e vários marcadores inflamatórios têm sido referidos como potenciais preditores dessa complicação, porém os fatores que contribuem para a estenose intra-stent no segmento vascular periférico não foram completamente elucidados. Recentemente, tem-se sugerido que a superfície revestida de stents recobertos possa impedir a reestenose de forma mais eficaz do que os stents convencionais. Objetivo: Avaliar o papel do sistema calicreína-cinina (SCC), do óxido nítrico (NO) e das metaloproteinases (MMP), mediadores inflamatórios importantes e que contribuem ativamente para a reparação de tecidos, no processo de reestenose arterial devido a hiperplasia intimal, pós angioplastia com stent recoberto no segmento fêmoro-poplíteo, com a intenção de contribuir com novas medidas terapêuticas. Método: Foi realizado um estudo prospectivo envolvendo 27 pacientes submetidos à angioplastia com stent revestido no segmento fêmoro-poplíteo, selecionados no Ambulatório de Cirurgia Vascular e Endovascular do HCFMRP/USP. Foram estudados os seguintes marcadores: sistema calicreína-cininas - com quantificação dos substratos (cininogênio de alto e baixo peso molecular - CAPM / CBPM) e da atividade das enzimas (calicreína plasmática e tecidual e cininase II); a determinação dos níveis de nitrito e nitratos para a avaliação de óxido nítrico; dosagem das MMPs 2 e 9 e dos níveis circulantes de seus inibidores (inibidores teciduais das metaloproteinases - TIMPs [1 e 2]). Amostras de sangue foram coletadas antes do implante do stent, 24 horas e seis meses após o procedimento. Foi realizado ultrasson Doppler após seis meses, e, na presença de alterações, realizada angiografia para comprovação da presença de reestenose. Resultados: Quatro (14,8%) dos vinte sete pacientes estudados desenvolveram reestenose (>= 50%) em seis meses. Esses pacientes tiveram níveis significativamente mais baixos de CAPM (24h, P <0,05) e de CBPM (antes - P <0,05; 24 horas P <0,01; 6 meses P <0,05); níveis mais baixos de TIMP 2 ( seis meses P<0,05) comparados ao grupo sem reestenose. As atividades da calicreína plasmática e tecidual, da cininase II, NO e MMPs tiveram comportamento semelhante entre os pacientes com e sem reestenose. Conclusão: As taxas de reestenose foram baixas com o uso de stents revestidos no segmento fêmoro-poplíteo comparativamente aos índices publicados de stents não revestidos. Os pacientes que desenvolveram reestenose mostraram níveis reduzidos de cininogênios e de TIMP-2 (seis meses após a angioplastia). Por outro lado, não foi possível demonstrar a participação do óxido nítrico e das metaloproteinases no processo de reestenose / Background: Restenosis after endovascular treatment of atherosclerotic lesions in the peripheral circulation is the major drawback of this minimally invasive technique. Vascular inflammation after balloon angioplasty or stent implantation plays an important role in smooth muscle cells proliferation and subsequent neointima growth, and various inflammatory markers have been reported as potential predictors of this complication, but the factors that contribute to the in-stent stenosis in peripheral vascular segment have not been fully elucidated. Recently, it has been suggested that the coated surface of stents grafts can prevent restenosis more effectively than conventional stents. Objective: The aim of this study was to evaluate the role of the kallikrein-kinin system (KKS), nitric oxide (NO) and metalloproteinases (MMPs), wich are important inflammatory mediators and actively contribute to tissue repair, in the process of arterial restenosis due to intimal hyperplasia, with the aim of developing new interventions. Method: Single-center prospective study with 27 patients with peripheral artery disease (PAD) requiring percutaneous transluminal angioplasty (PTA) and stenting, in the femoropopliteal segment, using coated stents grafts, was performed. The following markers were studied: kallikreinkinin system using the quantification of proteins (high and low weight Molecular kininogen HMWK / LMWK), verification of enzyme activity (tissue kallikrein, plasma kallikrein and kininase II), determination of nitrite and nitrates levels for evaluation of nitric oxide, MMPs 2 and 9 circulating levels and their inhibitors (tissue inhibitors of metalloproteinases [TIMPs 1 and 2]). Serum samples were collected before stent implantation, 24 h and six months after the procedure. Doppler ultrasound was performed after six months, and in the presence of any changes, an angiography was performed to prove the presence of restenosis. Results: Four (14,8%) of the treated patients developed restenosis (>50%) within 6 months. These patients had significantly lower levels of HMWK (24 hours, P < .05), LMWK (before - P < .05; 24 hours - P < .01; 6 months - P < .05) and lower levels of TIMP 2 (6 months < .05) compered to no restenosis group. The activities of plasma and tissue kallikrein, kininase II, NO and MMP had similar behavior among patients with and without restenosis. Conclusion: Restenosis rates were low with the use of coated stents in the femoropopliteal segment compared to published bare metal stents results. Patients with restenosis showed reduced levels of kininogens and TIMP-2 (six months after angioplasty) in patients who developed restenosis. Moreover, it was not possible to demonstrate the involvement of nitric oxide and metalloproteinases in the restenosis process

In recent years, domestic medicine companies limited by total value pay system can be regarded as depressing business. While some of medicine companies have been gradually losing their advantages, they, in addition to moving the production base to other countries, hope to find the suitable management system which completely subvert the way of thinking and traditional management skills as well for the purpose of improving the performance and competitiveness of company. Balanced Score Card (BSC) was proposed in 1990 by Kaplan & Norton. This set of management systems is to establish company's vision and mission. According to the survey, BSC has already been introduced by a lot of listed companies or non-listed companies to enhance the business performance. Therefore, we can know that BSC has deeply influenced the operation of Taiwan's companies of. BSC breaks through the traditional limitation to measure the performance in financial views , constructs four major aspects to inspect operation of companies in terms of financials, customers, business internal process and organization learning to grow, and gives consideration to balance between financial performance and non financial performance, balance between long-term goal and short-term goal, balance between internal and external of company, linkage between performance measurement and operation objective, improving management performance measurement system. Application of BSC would convert the organization vision into concrete goal, link the goal with cause-effect relationship, guide the behavior of staff and organization by the performance measurement and incentives, and combine personal goal with company goal. High ranking managers can not only easily communicate with staffs, but also trace back the effectiveness of company operation. However, It is still unable to find out whether the domestic medicine companies selling benign prostatic hyperplasia drugs could use BSC to improve its company performances or not. So, this research selects domestic medicine companies selling benign prostatic hyperplasia drugs as research object and investigates the effect of four major aspects such as financials, customers, business internal process and organization learning to grow, and influences of BSC on company's performance. Also, through qusetionaires and surveys, it would help domestic medicine companies selling benign prostatic hyperplasia drugs to set up the effective BSC system to raise company performance. The result of study can be offered to domestic medicine companies selling benign prostatic hyperplasia drugs as reference in the future.