Long (27-nucleotides) small inhibitory RNAs targeting E6 protein eradicate effectively the cervical cancer cells harboring human papilloma virus

OBJECTIVE: This study was to identify small inhibitory RNAs (siRNAs) that are effective in inhibiting growth of cervical cancer cell lines harboring human papilloma virus (HPV) and to examine how siRNAs interact with interferon beta (IFN-beta) and thimerosal. METHODS: The HPV18-positive HeLa and C-4I cell lines were used. Four types of siRNAs were designed according to their target (both E6 and E7 vs. E6 only) and sizes (21- vs. 27-nucleotides); Ex-18E6/21, Ex-18E6/27, Sp-18E6/21, and Sp-18E6/27. Each siRNA-transfected cells were cultured with or without IFN-b and thimerosal and their viability was measured. RESULTS: The viabilities of HPV18-positive tumor cells were reduced by 21- and 27-nucleotide siRNAs in proportion to the siRNA concentrations. Of the two types of siRNAs, the 27-nucleotide siRNA constructs showed greater inhibitory efficacy. Sp-18E6 siRNAs, which selectively downregulates E6 protein only, were more effective than the E6- and E7-targeting Ex-18E6 siRNAs. siRNAs and IFN-beta showed the synergistic effect to inhibit HeLa cell survival and the effect was proportional to both siRNA and IFN-beta concentrations. Thimerosal in the presence of siRNA exerted a dose-dependent inhibition of C-4I cell survival. Finally, co-treatment with siRNA, IFN-beta, and thimerosal induced the most profound decrease in the viability of both cell lines. CONCLUSION: Long (27-nucleotides) siRNAs targeting E6-E7 mRNAs effectively reduce the viability of HPV18-positive cervical cancer cells and show the synergistic effect in combination with IFN-b and thimerosal. It is necessary to find the rational design of siRNAs and effective co-factors to eradicate particular cervical cancer.

Expression of leptin receptors and the antiapoptotic effect of leptin on epithelial ovarian cancer cell lines / 대한산부인과학회지

OBJECTIVE: The potential role of leptin as an endocrine regulator is unknown in ovarian cancer. In the present study, we investigated the expression of letpin receptors in IOSE (Immortalized ovarian surface epithelium) and ovarian cancer cell lines, and potential role of leptin on the cell growth and taxol induced apoptosis. METHODS: To check the presence of leptin receptors in 4 human epithelial ovarian cancer cell lines (SK-OV-3, R182, A2780 and CP70), RT-PCR was done. In the RT-PCR, 2 primers were used; primers for short form of leptin receptor and for long form of leptin receptor. Cancer cell lines were treated with leptin and the cell viability was measured using the cellTiter 96 Aqueous One Solution Cell Proliferation Assay Kit. The antiapoptotic effect of leptin against taxol induced apoptosis on ovarian cancer cell lines was evaluated by checking caspase 3/7 activity. RESULTS: Leptin receptors on ovarian cancer cell lines were expressed differentially according to the type of isoform. There was long form leptin receptor on CP70, but no short form receptor. All other cell line showed both short and long form receptors. Leptin increased cell viability in all cell lines in a dose-dependent manner and reduced the number of apoptotic cells in A2780. CONCLUSIONS: There were leptin receptors in IOSE and some ovarian cancer cell lines. Chronic increase in leptin concentration may enhance the growth of ovarian cancers. In part, the increased cell growth after leptin treatment seemed to be due to the antiapoptotic effect of leptin.

Third trimester listeriosis in twin pregnant woman with multiple organ dysfunction syndrome and combined endocarditis: A case report / 대한산부인과학회지

Human listeriosis is a relatively rare but serious disease with mortality rate 20~40%. Listeria monocytogenes affects patients with decreased cell mediated immunity such as the elderly, transplant recipients, cancer patients, renal failure, diabetes, HIV, pregnant women and unborn child, neonate. We experienced a case of listeriosis in twin pregnant woman at 35th weeks without preterm labor. The pregnant woman present sepsis with fever at first time. Sepsis progress to MODS (multiple organ dysfunction syndrome) and combined endocarditis. We reported it with brief of literatures.

Effect of Practice based Program for Procedural Skills / 한국의학교육

PURPOSE: To evaluate the educational effectiveness of practice-based program for procedural skills at Kangwon National University College of Medicine. METHODS: In 2005, we conducted the training program composed of 19 procedural skills for third-year medical students during their first semester clerkship. The 14-week training used simulation models and was held for 3 hours per week, one hour for didactic session and 2 hours for practical exercise. A lecture was given only for wound dressing. OSCE, consisting of four 5-minute stations, was administered to analyze the students' achievement. 53 third-year students were given a survey following skills training and OSCE. RESULTS: Most students reported that the practice-based program was interesting and helpful in learning procedural skills. Students preferred practice to didactic medium. Students were satisfied with the faculty's instruction, but suggested that the training should be providedprior to clerkship. OSCE had an overall reliability coefficient (Cronbach's alpha) of 0.78. The mean score in the dressing case was lower than those in other cases. CONCLUSION: The practice-based program for procedural skills was effective in motivating students' learning as well as improving theirtechnical skills. Self-directed exercises and appropriate feedback are more effective training tools than lectures.

Small Bowel Herniation Through a 5 mm Trocar Site: A Case Report / 대한산부인과학회지

Incisional hernias occur in or =10 mm. Bowel herniation through 5 mm trocar site is more uncommon than that of 10 mm trocar site. So we present a case of small bowel herniation through a 5mm trocar site with a brief review of literature.

Placenta Increta Presenting as Postabortal Uterine Mass in the First Trimester: A Case Report / 대한산부인과학회지

Placenta increta is rare, but life-threatening complication of pregnancy characterized by invasion of placenta villi into the underlying myometrium. Placenta increta is usually diagnosed in the third trimester and is associated with significant blood loss and uterine perforation or rupture as well as an increased risk of infection. It also has been described as a complication of selective pregnancy termination and spontaneous pregnancy loss in the second trimester and rarely in the first trimester. We report a case of placenta increta which was presented as uterine mass after dilatation and curettage (D and C) due to missed abortion in the first trimester.

A case of fetal hydrops associated with maternal -D-/-D- phenotype / 대한산부인과학회지

Blood types are very important because they are associated with blood transfusion, the diagnosis of hematological diseases and the related diseases. Rh system is a major blood group system as ABO system. Major Rh antigen is Rh (D) antigen. Minor Rh antigens are Rh (C), (c), (E), (e) antigen. Most of people have Rh (C), (c), (E), (e) antigen but some people don't have these antigens. The hematologists call this blood type -D-/-D- blood phenotype. -D-/-D- phenotype is blood group that have (D) antigen without (C), (c), (E), (e) Antigen. This blood type is rare throughout the world. Especially, fetal hydops associated with anti-C,-c,-E,-e antibody is very rare. We experienced a case of fetal hydrops associated with anti-C,-c,-E,-e antibodies and report it with a brief of literatures.

Parovarian cyst torsion at pregnancy 29+4 wks / 대한산부인과학회지

Adnexal torsion in the third trimester is very rare. Because of changes in uterine size and anatomical position of abdominal organs, the diagnosis of adnexal torsion during pregnancy is difficult to establish on the basis of symptoms, physical findings, or radiologic technique. Delayed diagnosis and management can lead to serious complications, so a rapid, reliable, and accurate imaging is needed to evaluate pregnant women with acute abdomen. Ultrasonography has been the initial imaging modality of choice in evaluation of obstetric patient, but it is technically difficult in the third trimester. MR imaging can provide a broad evaluation of the pelvic organs and enables diagnosis of many causes of acute abdomen, especially in the third trimester. We have experienced a case of Parovarian cyst torsion at pregnancy 29+4 wks and reviewed it briefly.

Effects of the Specific COX-2 Inhibitor, Celecoxib, on Paclitaxel-Induced Apoptosis in SK-OV-3 Epithelial Ovarian Cancer Cell Line / 대한산부인과학회지

OBJECTIVE: In vitro studies have revealed that treatment of various human cancer cell lines with specific cyclooxygenase 2 (COX-2) inhibitors induces apoptotic cell death. The goal of this article is to investigate the benefits of combining COX-2 inhibitors with existing treatment modalities in the management of ovarian cancer. METHODS: In this study we sought to determine the effects of combining paclitaxel and the COX-2 inhibitor celecoxib on apoptosis of epithelial ovarian cancer (EOC) cells. SK-OV-3 cells were exposed to increasing concentrations of paclitaxel (10(-7) M, 10(-6) M and 10(-5) M) and celecoxib (10(-8) M, 10(-7) M, 10(-6) M, 10(-5) M and 10(-4) M) as well as a combination of both drugs. The activity of apoptosis was evaluated by the morphologic examination and the MTT assay. The pattern of apoptosis was also assessed by the caspase-3 activity and the fraction of cleaved PARP (poly ADP-ribose polymerase) protein. RESULTS: Single application of both drugs could significantly increase the rate of apoptosis after 24 hours of continuous exposure. But concomitant treatment of SK-OV-3 EOC cell line with paclitaxel and celecoxib resulted in marked impairment of paclitaxel-induced apoptosis. The pattern of apoptosis induced by paclitaxel on SK-OV-3 EOC cell line was caspase-3 independent. CONCLUSION: Combining COX-2 inhibitors and paclitaxel does not have an additive or synergistic tumoricidal effect. On the contrary, celecoxib treatment markedly inhibited the apoptotic effects of paclitaxel in SK-OV-3 EOC cell line.

In Vitro Responses of SK-OV-3 Ovarian Cancer Cell Lines to Tamoxifen and Celecoxib / 대한산부인과학회지

OBJECTIVE: There are some evidences that some epithelial ovarian cancer cells respond to hormonal therapy. And in vitro studies have revealed that treatment of various human cancer cell lines with selective cyclooxygenase 2 (COX-2) inhibitors induces apoptotic cell death. The goal of this article is to evaluate the effects of tamoxifen and celecoxib, a selective COX-2 inhibitor, on the ovarian cancer cells and the benefits of combining these agents in the management of ovarian cancer. METHODS: SK-OV-3 epithelial ovarian cancer cells were exposed to increasing concentration of tamoxifen (10(-8) M, 10(-7) M, 10(-6) M, 10(-5) M and 10(-4) M) and celecoxib (10(-8) M, 10(-7) M, 10(-6) M, 10(-5) M and 10(-4) M) as well as a combination of both drugs. The activity of apoptosis was evaluated by the morphologic examination and the MTT assay. The pattern of apoptosis was also assessed by the caspase-3 activity and the fraction of cleaved PARP (poly ADP-ribose polymerase) protein. RESULTS: Single application of both drugs could significantly increase the rate of apoptosis after 24 h of continuous exposure. Concomitant treatment of SK-OV-3 cells with tamoxifen and celecoxib induced significant increase in apoptosis, comparing with single drug exposure. The pattern of apoptosis induced by these agents on SK-OV-3 cells seemed to be caspase-3 dependent. CONCLUSION: Our data suggest that combining tamoxifen with selective COX-2 inhibitor seems to have at least an additive tumoricidal effect. A more definitive role for this combination therapy in clinical settings in ovarian cancer will need to be defined through the conduct of clinical trials.

Extremely elevated CA 125 due to an unruptured large endometrioma: A Case Report / 대한산부인과학회지

CA 125 is a high molecular weight glycoprotein expressed in the cell surface of some derivatives of embryonic coelomic epithelium. It presents in over 80% of non-mucinous epithelial ovarian carcinomas and it also occurs in the serum of healthy males and females at low concentrations (1,000 IU/mL) and after excision of the ovarian tumor, the CA 125 levels returned to normal. Our case further emphasizes the association of high levels of CA 125 with benign gynecologic conditions and we discussed the possible explanations for this abnormal elevation of CA 125 levels.

Clinical Analysis of Intramural Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The goal of this article is to analyze the clinical characteristics of intramural pregnancy through the review of currently available 36 case reports. METHODS: A comprehensive computer literature search was performed in MEDLINE and EMBASE database from 1966 to 2003. And domestic literature search was preformed in KSOG database. After data collection, we reviewed and analyzed meaningful clinical variables of each case report. RESULTS: 36 articles were included. The age at diagnosis ranged from 20 to 41 years old, and the mean age was 31.2 years (S.D.:5.6). The gestational period at diagnosis ranged from 6th to 30th weeks, more than half of the cases occurred from 6th to 10th week (58.3%). Significant risk factors were history of dilatation and curettage (47.2%) and history of cesarean section (25.0%). Common clinical symptoms and signs were vague abdominal pain (58.3%) and vaginal bleeding (54.2%) in unruptured case, and sudden onset of severe abdominal pain (100%) and muscle guarding (75.0%) in ruptured case. The preoperative diagnostic accuracy was 0% before introduction of ultrasonography into the clinical practice, 48.2% after ultrasonography was available. Of 36 patients, 27 patients (75.0%) were treated with laparotomy, and 5 patients (13.8%) were treated with methotrexate. Survival outcome of fetus was very poor. Only in 1 case, the pregnancy persisted beyond the 30th week, and the fetus survived after cesarean hysterectomy. CONCLUSION: With the advanced diagnostic tools and close monitoring of patients, we can improve the diagnostic accuracy and clinical outcome of intramural pregnancy.

Clinical efficacy of urgent cerclage in cervical incompetence predicted by transvaginal ultrasonography in second trimester / 대한산부인과학회잡지

OBJECTIVE: To investigate the clinical efficacy of urgent cerclage on perinatal outcome in cervical incompetence predicted by transvaginal ultrasonography in second trimester. METHODS: We reviewed the medical records of 27 pregnant women who received urgent cerclage at Asan Medical Center between January, 1998 and August, 2002. When the cervical length was less than 25 mm and abnormal cervical shape by transvaginal ultrasonography in second trimester, we performed urgent cerclage. Abnormal cervical shapes were categorized as U-shape, Y-shape and V-shape. These data were compared with those of 102 patients who received prophylactic cerclage and 25 patients who received emergent cerclage during the same period. Analysis of variance and chi-square test were used for statistical analysis. P<0.05 was considered statistically significant. RESULTS: In urgent cerclage, the mean gestational age at delivery was 35.1 +/- 4.4 weeks. The mean birth weight was 2524.2 +/- 860.8 gm and perinatal survival rate was 92.6% (25/27). We compared these data with the other two cerclages. In prophylactic cerclage, the mean gestational age at delivery was 36.2 +/- 4.6 weeks. The mean birth weight was 2711.5 +/- 860.8 gm and perinatal survival rate was 94.1% (96/102). There was no statistically significant difference between urgent cerclage and prophylactic cerclage. In emergent cerclage, the mean gestational age at delivery was 27.5 +/- 6.9 weeks. The mean birth weight was 1373.8 +/- 1196.7 gm and perinatal survival rate was 48.0% (12/25). There was statistically significant difference between urgent cerclage and emergent cerclage based on our finding, The gestational age, birth weight and perinatal survival rate in urgent cerclage were not different from prophylactic cerclage. However, in emergent cerclage, these data were different from the other two cerclages. CONCLUSION: These data suggest that perinatal outcomes after urgent cerclage were comparable to those of prophylactic cerclage. Urgent cerclage could be a valuable alternative to a policy of uniform prophylactic cerclage.

Investigation into the Effects of Mosapride on Motility of Guinea Pig Stomach, Ileum, and Colon

Mosapride citrate (Mosapride) is a new prokinetic agent that enhances the gastrointestinal (GI) motility by stimulation of 5-HT4 receptors. This agent stimulates acetylcholine release from enteric cholinergic neurons in the GI wall. It was reported in several studies that mosapride selectively enhanced the upper, but not lower, GI motor activity. However, in these studies other 5-HT4 receptor agonists exerted stimulating effects on the motility of the colon. Moreover, it is well known that the receptors of 5-HT4 are also located in the colon. The purpose of this study was to estimate the effect of mosapride on the motility of the stomach, ileum and colon in the guinea pig and to investigate whether or not mosapride influenced the colonic motility. Mosapride significantly increased the amplitude of the contraction waves in the guinea pig stomach by electrical stimulation. In addition, it significantly increased the number of peaks, the area under the curve and the propagation velocity of the peristaltic contraction of the guinea pig ileum in a concentration dependent fashion. Mosapride also significantly shortened the transit time of the guinea pig colon. Accordingly, we concluded that mosapride exerted prokinetic effect on the entire GI tract of the guinea pig. Based on the possibility of similar results in humans, we suggest the potential use of mosapride for lower GI motor disorders such as constipation and upper GI motor disorders such as gastroesophageal reflex disease or gastroparesis.

A Clinical Study on the Effect of Transcatheter Arterial Embolization in the Treatment of Peptic Ulcer Bleeding / 대한소화기내시경학회지

BACKGROUND/AIMS: Transcatheter arterial embolization (TAE) has been increasingly used in the treatment of patients with gastrointestinal bleeding due to improved catheter and guidewire technologies and emergence of safer embolization materials. We evaluated the clinical characteristics of patients in whom TAE was performed and the outcome of the treatment. METHODS: Eleven patients (M:F=9:2, mean age=60.6 years) underwent TAE between April 2001 and August 2002. Causes of bleeding were gastric ulcer in 9 cases and duodenal ulcer in 2 cases. Seven patients had comorbid diseases, but 4 patients did not. RESULTS: Successful TAE without rebleeding was achieved in 10 of 11 patients (90.9%). One patient failed to respond to TAE and died due to multiorgan failure. Another patient died due to other causes despite a successful TAE. There were no TAE-related complications. CONCLUSIONS: TAE is a safe and effective modality in the treatment of patients with peptic ulcer bleeding who do not respond to endoscopic hemostasis. Thus, TAE seems to be included in the treatment algorithm of peptic ulcer bleeding regardless of surgical risks of patients and be placed before surgery, but prospective randomized studies are needed.

Successful Conservative Chemotherapy for Intramural Pregnancy: A Case Report / 대한산부인과학회잡지

More than 95% of ectopic pregnancies involve the fallopian tubes. Other sites of ectopic implantation are less frequent, and a pregnancy in the myometrium is extremely rare. Few cases are reported in the literature which satisfy the criteria required for the diagnosis of intramural ectopic pregnancy, and unequivocal diagnosis without extirpation of the ruptured uterus is difficult. Most of ruptured cases have been treated with surgical modality including hysterectomy, and for more conservative management early detection is important. MRI is a useful, noninvasive and confirmative imaging modality for the detection of intramural pregnancy. Chemotherapy with methotrexate is an effective treatment that allows preservation of reproductive potential in selected case. We described a case of unruptured intramural pregnancy diagnosed with MRI and successfully treated with methotrexate. Theoretical and possible pathophysiologic derangements of this rare pregnancy- related disorder are also reviewed.

Transforming Growth Factor-alpha Regulation of Insulin-like Growth Factor-II, Insulin-like Growth Factor Binding Protein-1 and 3 secretion and Epidermal Growth Factor receptor expression in human luteinized granulosa cells / 대한산부인과학회잡지

OBJECTIVE: To investigate the effects of transforming growth factor (TGF)-alpha on insulin-like growth factor (IGF)-II, insulin-like growth factor binding protein (IGFBP)-1, and 3 secretion and epidermal growth factor (EGF) receptor expression in cultured human luteinized granulosa cells. MATERIALS AND METHODS: Human luteinized granulosa cells were obtained from follicular fluid by transvaginal oocyte aspiration from infertile patients undergoing in vitro fertilization and cultured for 72 hours with TGF-alpha at concentration of 1.0, 10.0, 100.0 ng/ml. The luteinized granulosa cells not treated with TGF-alpha served as control. The secretion of IGF-II, IGFBP-1 and 3 were determined in conditioned media by immunoradiometric assay (IRMA) and reverse transcription-polymerase chain reaction (RT-PCR) was performed for EGF receptor mRNA expression. RESULTS: The cell numbers of 1.0 and 10.0 ng/ml supplement groups were significantly decreased compared to control (p<0.05, p<0.05, respectively), although the cell viabilities were similar in all groups. IGF-II levels were significantly higher in TGF-alpha treatment group at 1.0 and 10.0 ng/ml (p<0.01, p<0.01, respectively), but lower in 100.0 ng/ml (p<0.01). However, the concentrations of IGFBP-1, and 3 per one granulosa cell in each group were no statistically significant differences among the groups. The mRNA concentration of EGF receptor in cultured human luteinized granulosa cells were not significantly different among the groups. CONCLUSION: This study suggests that TGF-alpha regulate intrafollicular bioavailable IGF-II levels, by which TGF-alpha might involved luteinizations. However, TGF-alpha may not directly regulate EGF receptor mRNA expression in cultured human luteinized granulosa cells.

Role of CT Scan in Gastric Cancer as a Diagnostic Tool

No abstract available.

A Case of Esophageal Achalasia with Epiphrenic Diverticulum / 대한소화관운동학회지

Epiphrenic diverticulum is a relatively rare condition resulting from mucosal herniation through the muscular wall of the esophagus. This pulsion diverticulum is often associated with abnormal esophageal motility such as esophageal achalasia. Although pneumatic dilatation is recommended as the initial treatment for patients with esophageal achalasia, some authors caution against the use of pneumatic dilatation when esophageal achalasia is complicated by epiphrenic diverticulum. A 49-year old female patient was admitted due to progressive dysphagia for both solid and liquid foods, and weight loss and frequent vomiting. She suffered from Heller's myotomy due to esophageal achalasia 8 years prior. She was diagnosed as having recurrent esophageal achalasia with epiphrenic diverticulum due to incomplete myotomy, using esophagography, esophagogastrodudenoscopy, esophageal manometry, and esopahgeal transit scan. The patient was successfully treated with pneumatic balloon dilatation, and her symptoms markedly improved.

A Case of Esophageal Achalasia with Epiphrenic Diverticulum / 대한소화관운동학회지

Epiphrenic diverticulum is a relatively rare condition resulting from mucosal herniation through the muscular wall of the esophagus. This pulsion diverticulum is often associated with abnormal esophageal motility such as esophageal achalasia. Although pneumatic dilatation is recommended as the initial treatment for patients with esophageal achalasia, some authors caution against the use of pneumatic dilatation when esophageal achalasia is complicated by epiphrenic diverticulum. A 49-year old female patient was admitted due to progressive dysphagia for both solid and liquid foods, and weight loss and frequent vomiting. She suffered from Heller's myotomy due to esophageal achalasia 8 years prior. She was diagnosed as having recurrent esophageal achalasia with epiphrenic diverticulum due to incomplete myotomy, using esophagography, esophagogastrodudenoscopy, esophageal manometry, and esopahgeal transit scan. The patient was successfully treated with pneumatic balloon dilatation, and her symptoms markedly improved.