Total vaginectomy for refractory vaginal intraepithelial neoplasia III of the vaginal vault

Vaginal intraepithelial neoplasia III, is a relatively rare disease. Consequently standard treatments for this disease were not established until recently. Although several convenient methods, such as laser ablation, 5-fluorouracil topical injection, and radiation therapy, have been applied for treating these lesions, surgical treatments, including vaginectomy, have not yet been attempted, as they would likely be accompanied by technical difficulties and various complications. Herein, we report a case of refractory vaginal intraepithelial neoplasia III in the vaginal vault that was successfully treated with a total vaginectomy.

Performance of the BacT Alert 3D System Versus Solid Media for Recovery and Drug Susceptibility Testing of Mycobacterium tuberculosis in a Tertiary Hospital in Korea / 결핵및호흡기질환

BACKGROUND: Tuberculosis (TB) is a major health problem, and accurate and rapid diagnosis of multidrug-resistant (MDR) and extended drug-resistant (XDR) TB is important for appropriate treatment. In this study, performances of solid and liquid culture methods were compared with respect to MDR- and XDR-TB isolate recovery and drug susceptibility testing. METHODS: Sputum specimens from 304 patients were stained with Ziehl-Neelsen method. Mycobacterium tuberculosis (Mtb) isolates were tested for recovery on Löwenstein-Jensen (LJ) medium and the BacT Alert 3D system. For drug susceptibility testing of Mtb, isolates were evaluated on M-KIT plates and the BacT Alert 3D system. RESULTS: The recovery rates were 94.9% (206/217) and 98.2% (213/217) for LJ medium and the BacT Alert 3D system, respectively (kappa coefficient, 0.884). The rate of drug resistance was 13.4% for at least one or more drugs, 6.0% for MDR-TB and 2.3% for XDR-TB. M-KIT plate and BacT 3D Alert 3D system were comparable in drug susceptibility testing for isoniazid (97.7%; kappa coefficient, 0.905) and rifampin (98.6%; kappa coefficient, 0.907). Antibiotic resistance was observed using M-KIT plates for 24 of the total 29 Mtb isolates (82.8%). CONCLUSION: The liquid culture system showed greater reduction in the culture period, as compared with LJ medium; however, drug susceptibility testing using M-KIT plates was advantageous for simultaneous testing against multiple drug targets.

Expression of MT1, 2, 3-MMP in invasive cervical cancer / 대한산부인과학회지

OBJECTIVE: Threre are several proteolytic enzymes such as Matrix Metalloproteinases (MMP), which are involved in tumor invasion and metastasis. The aim of this study was to determine the exprssion of Membranous Type MMPs (MT-MMPs) and investigate the relationship between their expression and questioned whether their expression is related to stages and other prognostic factors of cervical cancer. METHODS: The cervical and cervical cancer tissues were taken from the patients; healthy women (n=14), and the patients with cervical cancer (n=35). The protein expression of MT1, 2, 3-MMP with MMP-2 was examined using immunohistochemical staining and western blotting. MMP-2 activity was measured by zymogram. RESULTS: The expression of MT1, 2, 3-MMP was higher in cervical cancer than that of normal cervix (p0.05). But there were significant correlations between MT1-MMP, MT3-MMP and lymph node involvemen t (p<0.05). There was significant correlation between MT-MMPs and MMP-2 (p<0.05), too. CONCLUSION: According to the results, MT-MMP expression could be associated with the pathogenesis of cervical cancer. In addition, the evaluation fo MT-MMPs expression might be helpful to predict lymph node metastasis in cervical cancer. Further prospective study with a large number of cases is needed in future.

The expression of angiopoietin-1, angiopoietin-2, Tie-2 and vascular endothelial growth factor mRNA in normal ovary, benign ovarian cyst, and epithelial ovarian cancer / 부인종양

OBJECTIVE: Vascular endothelial growth factor (VEGF) increases angiogenesis. It is known that one of angiogenetic factors, angiopoietin-1 (Ang-1) stabilizes maturity of normal vessels and angiopoietin-2 (Ang-2) antagonizes the action of angiopoietin-1 by binding Tie-2 that is their receptor. Recently those factors are known to be involved in carcinogenesis. The aim was to investigate the mRNA expression of those factors in epithelial ovarian cancer including normal ovary and ovarian cyst and to evaluate their role in ovarian carcinogenesis. METHODS: The tissue samples of 16 ovarian cyst, and 29 epithelial ovarian cancer patients who were diagnosed at Ewha Woman's University MokDong Hospital from 1997 to 2003, and 18 normal ovary subjects who had hysterectomy and salpingoophorectomy due to uterine myoma and confirmed as normal controls, were obtained. The mRNA expressions of Angiopoietin-1, Angiopoietin-2, Tie-2 and Vascular endothelial growth factor were measured by Quantitative Competitive polymerase chain reaction (PCR). Their expressions were analyzed with ANOVA test and Spearman correlation test. RESULTS: The expressions of Ang-1 mRNA were higher in normal ovary than those of ovarian cyst and ovarian cancer (p<0.05). The expressions of Tie-2 mRNA were higher in ovarian cyst than those of normal ovary and ovarian cancer (p<0.05). The expressions of VEGF mRNA were higher in ovarian cancer than those of normal ovary and ovarian cyst (p<0.05). The expression of Ang-2 mRNA in ovarian cancer was related with the expression of VEGF and Tie-2 mRNA. CONCLUSION: The lower expression of Ang-1 mRNA and higher expression of VEGF mRNA might be a role in ovarian carcinogenesis. The expression of Ang-1, Tie-2 and VEGF might be related to ovarian carcinogenesis, together. However, this study is based on limited number of cases and short-term period of follow up, further prospective studies on a larger population should be done.