Dexamethasone effects on survival, differentiation, and proliferation of peritoneal (or B-1 cells) and splenic B cells / 대한산부인과학회지

OBJECTIVE: Although the characteristic feature and function of peritoneal B (B-1) cells are very different from splenic B (B-2) cells, peritoneal B cell study is not known well. The aim of this study is to investigate the effects of dexamethasone on peritoneal (or B-1 cells) and splenic B cells (or B-2 cells). METHODS: The synthetic corticosteroid, dexamethasome, was injected to BALBc mice intraperitoneally or subcutaneously at 4-5 pm for 7 days. Expression level of B cell surface marker analyzed by flow cytometry. The purified peritoneal B cell and splenic B cells were obtained and cell survival rate was analysed by flow cytometry. Isolated B cells were cultured in medium with different concentration of dexamaethasone. During the culture of these cells, immunoglobulin secreted into the culture supernatants was evaluated by enzyme-linked immunosorbent assay. Entering of S phase was measured by proliferative assay. RESULTS: Subcutaneous injection of high dose of Dexamethasone for 7 days did not affect cell surface markers of peritoneal and splenic B cells. However, all cell surface markers of peritoneal B cell after the treatment of dexamethasone are reduced by daily intraperitoneal injection of dexamethasone for 2 days. The survival rate of peritoneal and splenic B cell decrease with increasing concentration of dexamethasone. Proliferation of peritoneal B cells was less affected by dexamethasone than that of splenic B cells (p<0.05). CONCLUSIONS: Dexamethasone induced apoptosis in both peritoneal and splenic B cells. Proliferation and differentiation of splenic B cells were affected by dexamethasone, but peritoneal B cells are less sensitive to dexamethasone.

The correlation of clusterin binding affinity to chemotherapeutic agents with chemoresistance in ovarian cancer cells / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to determine the mechanism of action of clusterin?known as a chemo-resistance protein?by analyzing its binding with chemotherapeutic agents and elucidating its relation with drug resistance. METHODS: Chemotherapeutic agents were diluted with coating buffer and coated onto 96 well plates. We then had these agents cross-react with purified clusterin and wash the wells to remove residual clusterin. We quantified the amount of clusterin with optical density (OD) measured by binding peroxidase-conjugated secondary antibody associated with mouse monoclonal clusterin antibody. To determine if anticancer drug-clusterin binding is related to chemotherapeutic agent resistance, we compared survival rates in the SKOV-3 cell line, which rarely secretes clusterin. We compared a group of SKOV-3 cells treated with a chemotherapeutic agent and a group treated with both the agent and clusterin, by means of XTT. RESULTS: In binding tests using ELISA OD, ratios of paclitaxel, cisplatin, carboplatin, topotecan, Adriamycin, etoposide, and 5-fluoruracil (5-FU) were 2.34, 2.40, 0.52, 2.44, 1.602, 1.14, and 1.13, respectively. Topotecan, cisplatin, and paclitaxel showed relatively higher binding. In addition, when these drugs were treated with clusterin in SKOV-3 cells, anticancer resistance increased (P<0.05). CONCLUSIONS: The anticancer drug resistance endowed by clusterin is considered to be related to its binding with chemotherapeutic agents.

Surgical repair of recurrent cervical cancer at a skin incision site with using a Gore-Tex(R) Patch: A case report / 대한산부인과학회지

Recurrence of cervical cancer at a skin incision site is uncommon. We met a patient who received an incomplete operation for cervical cancer and she was transferred to our hospital. When she underwent the first operation she was misdiagnosed as having a benign uterine mass and she received an abdominal total hysterectomy. But the postoperative pathologic finding was cervical cancer. Therefore she was then referred for postoperative cisplatin-5FU concurrent chemo-radiotherapy. Five months after the concurrent chemo-radiotherapy, one solitary metastatic mass was found in the abdominal scar. We performed wide excision. The fascia defect at the excision site was so wide we could not perform the primary closure. Therefore, we used a polytetrafluoroethylene (Gore-Tex(R)) patch as a fascia substitute and we reconstructed the abdominal wall with a fasciocutaneous flap. Then she received cisplatin concurrent chemo-radiation therapy.

A case of successful laparoscopic surgical staging in patient of Sertoli-Leydig cell tumor / 대한산부인과학회지

Sertoli-Leydig cell tumors are rare sex cord-stromal tumors. These tumors account for less than 0.5% of all ovarian tumors. Because these tumors appear predominantly in young women (between the age of 30 and 40) and are bilateral in less than 1% of cases, conservative removal of the tumor and adjacent fallopian tube is justifiable. Recently, we experienced a case of successful laparoscopic surgical staging in patient of Sertoli-Leydig cell tumor which was previously incompletely evaluated in local OBGY clinic. There are no solid data to suggest that usefulness and risk of laparoscopic surgical staging and adjuvant therapy with stage I disease of these tumors until now. So we present it with a brief review of literature.

Prevalence and risk factors of chlamydia trachomatis and neisseria gonorrhea among Korean women / 대한산부인과학회지

OBJECTIVE: Through a large sample group, the prevalence and risk factors of Chlamydia and Gonorrhea infection in low risk Korean women were examined. METHODS: Among patients visited the department of obstetrics and gynecology of the secondary and tertiary hospital between September 2005 to January 2006, 2,410 women older than 18 years were selected as the determination sample recruitment method. In addition to their disease history and parity, the living standard, a vaginal specimen, it was examined by a polymerase chain reaction test method. Statistical analysis was performed with Chi-square and Fisher's test were used. RESULTS: Chlamydia infection was found to be closely associated with age (P=0.0485), the marital status (P=0.0086), smoking (P=0.0148), and drinking (P=0.0077), and additionally, the number of sex partners (P=<0.0001). Gonorrhea infection showed a significant difference according to the past history of venereal diseases (P=0.036), and a higher incidence was shown in the group with the past history of venereal diseases. The incidence of the simultaneous infection of Chlamydia and gonorrhea showed a significantly higher incidence in the cases with the past history of venereal diseases (P=0.0454), and a higher frequency of sexual intercourse (P=0.0306) and a larger number of sex partners (P=0.0009). CONCLUSION: It is thought that the urgent improvement of the lack of knowledge on Chlamydia and the early management considering the fact that the age of sexual contact is decreasing gradually are required, and based on the selected high risk factors, not only treatments in a wide range but also its prevention should be carried out simultaneously.

A case of sarcoma arising in ovarian mature cystic teratoma / 대한산부인과학회지

Benign cystic teratoma is the common ovarian tumor, and the incidence reported about 20%. Between 1 and 2% of mature cystic teratomas undergo malignant trasformation. This occurs most frequently in postmenopausal women, who account for only 10% of mature cystic teratomas. Among the malignant transformations, squamous cell carcinoma is the most common type (over 75%), and adenocarcinoma, undifferentiated carcinoma, malignant melanoma, thyroid adenocarcinoma, and sarcoma have been reported in the literature. Because of its rarity, the clinico-pathologic characteristics are not well established, and there is no consensus on optimal therapy. There is also no consensus regarding the efficacy of postoperative therapy. We experienced a case of sarcoma of the ovary arising in mature cystic teratoma, which is presented with a brief review of literature.

Inhibition of clusterin gene expression via shRNA increases chemosensitivity to paclitaxel in xenografted PEOH cells / 대한산부인과학회지

OBJECTIVE: To evaluate the inhibition of Clusterin gene expression via shRNA decreases proliferation and metastasis and increases chemosensitivity to paclitaxel in xenografted PEOH cells. METHODS: 1 x 10(6) paclitaxel resistant cell lines transduced with Clusterin shRNA in lentiviral inoculated subcutaneously into the flank region of 6 to 8 week-old female nude mice. Parental cells transduced with LacZ was used as a control. Tumor growth was measured twice every week and calculated by using the formula: length x width x depth x 0.5236. The mice were sacrificed and examined for Clusterin expression on tumor cells and counted the metastasis sites. RESULTS: shRNA for Cluaterin works in vivo and it is the in accord with the in vitro results. Although shRNA for Clusterin group showed decreased tumor growth and proliferation it has not statistical significance. But transfection of Clusterin shRNA on PEOH significantly increased paclitaxel-sensitivity (P<0.05). CONCLUSION: shRNA targeting of the Clusterin gene decreased the ovarian cancer cell's paclitaxel resistance.

Preoperative MR imaging for differentiation of immature from mature ovarian teratomas / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to differentiate immature from mature ovarian teratomas, using magnetic resonance (MR) imaging and to evaluate the MR imaging appearance of immature teratomas. METHODS: The patients with pathologic diagnosis of ovarian teratomas between January 1995 and December 2005 were restrospectively reviewed for clinicopathologic characteristics. RESULTS: Of the 787 patients studied, 773 (98.2%) patients were mature cystic teratomas and 14 (1.8%) patients were immature teratomas. Ten patients with immature teratoma (71.4%) were diagnosed preoperatively and 4 patients (28.6%) were diagnosed postoperatively. Preoperative MRI was performed in 4of 14 patients surgically proved immature teratomas. At MR imaging, the immature teratomas characteristically have a large, irregular solid component containing coarse calcifications and numerous variable-sized cysts. Small punctuate foci of fat help diagnosing these tumors. CONCLUSION: Preoperative MR imaging are relatively specific in the detection of immature teratomas. This suggests that preoperative MR imaging is helpful in differentiating immature from mature ovarian teratomas.

Laparoscopic finding of Acute Pelvic Inflammatory Disease / 대한산부인과학회지

OBJECTIVE: To analyze physical, laboratory and laparoscopic findings of suspicious cases of pelvic inflammatory disease (PID) and compare the group shown positive findings during laparoscopic surgery with that shown negative findings. METHODS: We selected 42 doubtful cases of PID that were treated by diagnostic laparoscopic surgery in St. Paul hospital of Catholic Medical Center from Jan. 2001 to Jun. 2003 and evaluated symptoms, duration of pain, and physical, laboratory, laparoscopic and histological findings. RESULTS: Of the 42 patients, we classified 22 patients shown pelvic inflammatory findings at laparoscopic surgery into the positive group and 20 patients shown non-specific or free-inflammatory findings into negative group. Between two groups, there were no significant differences in ages, parities and histories of PID. Number of intrauterine device (IUD) users was 5 and all of the five patients were positive group though none was belonged to negative group. Mean duration for developing acute pain was much shorter in positive group (3.1 days) than negative group (22.3 days). There were no meaningful differences in rise of body temperature and CRP level, but the degree of leukocytosis was greater in positive group (10,581/mm3) than negative group (7,720/mm3). Ratio of polymorphonuclear (PMN) leukocytes was higher in positive group (73.3%) than in negative group (59.7%) and number of cases those erythrocyte sedimentation rate (ESR) above 30 mm/Hr was larger in positive group (n=17) than in negative group (n=10). CONCLUSION: Of the suspicious cases of PID based on patient's symptoms and physical findings, the rate of the cases shown positive findings in laparoscopic surgery was 52.3%. Distinctive factors between two groups were usage of IUD, urgency of symptom, degree of leukocytosis, increase in ratio of PMN leukocytes and ESR. We suggest the exploration of more sensitive and specific diagnostic tools.

The prognostic factors and survival analysis of primary peritoneal carcinoma / 대한산부인과학회지

OBJECTIVE: To date, few attempts have been made at clinical features and prognostic factors of primary peritoneal carcinoma (PPC) because of low prevalence. The aim of this study is to evaluate the clinical characteristcs and determine the prognosis factors of PPC. METHODS: From March 1996 to March 2004, a total of 23 women newly diagnosed with PPC were recruited into the study. Overall survival and prognostic factors were evaluated using Kaplan-Meier method and Cox regression model. RESULTS: The mean age of patients was 58.7+/-7.6 years and the FIGO stage was advanced disease; stage IIIc (73%) and IV (27%). The mean survival time for patients enrolled was 26.0 months. By univariate analysis, tumor state (p=0.028), performance status (p=0.045), the presence of initial debulking operation (p=0.035), and normalization of CA125 at 3 months of treatment (p=0.003) were significantly correlated with survival. On multivariate analysis, only the normalization of CA125 at 3 months of treatment remained as the independent factor for survival (Odds ratio, 6.896; 95% Confidence interval, 1.504-31.623; p=0.013). CONCLUSION: The mean survival time for patients with PPC was 26.0 months, and the normalization of CA125 at 3 months of treatment was identified as the independent prognostic factor. From this study, we analysis the clinical characteristics of PPC and provide more precise understanding of this disease.

Effectiveness of sacrospinous colpopexy in vault prolapse patients / 대한산부인과학회지

OBJECTIVE: To evaluate the effectiveness of sacrospinous colpopexy in vault prolapse patients. METHODS: It is the retrospective study including 10 vault prolapse patients who received sacrospinous colpopexy at St. Paul Hospital, the Catholic University from July 1999 to April 2004. RESULTS: The 10 patients receiving sacrospinous colpopexy had the average age of 58.9 years, and the parity of 3.4. They were moderately overweighted with average BMI of 24.5. The average period from hysterectomy to diagnosis of vault prolapse was 11.1 years. Hypertension was noted on most of patients (70.0%). The average operation time was 68.5 minutes and postoperative hemoglobin decrement was 2.4 on average. During 2-month period of postoperative follow-up, there were no significant complications noted except one case of wound infection associated with diabetes and one case of transfusion due to anemia. After sacrospinous colpopexy, protruding mass out of vagina was resolved on 100% and urologic and other complications were improved over 50% of cases. CONCLUSION: Considering that several underlying medical conditions such as hypertension, obesity are associated with vault prolapse patients, sacrospinous colpopexy in case of vault prolapse is an excellent operative approach with low complication and recurrence rates.