A Study on Lip Movements Area and Vowel Space Area According to the Depressive Disorders

Background and Objectives@#This study aims to investigate the lip movements area (LMA) and vowel space area according to depression.Materials and Method The participants diagnosed with voice disorders or thyroid cancer before treatment and surgery. All participants completed the depression questionnaire and recorded five vowels (/a, i, u, e, o/) phonation while shooting. Among the total 64 participants, there were 19 participants in the depressive disorders group and 45 participants in non-depressive group. The analysis parameters were LMA, vowel space areas (Area3 & Area5), formant centralization ratio (FCR), fundamental frequency (F0) and voice intensity (intensity). Multivariate analysis of variance (MANOVA) was applied, and age was treated as a covariate to correct for lip movement that could deteriorate as age increased. @*Results@#As a result of MANOVA, there was no significant difference between groups (p=0.517). Looking at the LMA, both male and female in the depressive disorder group showed a lower mean value than the non-depressive disorders group. The Area3 and FCR of the depressive disorder group were higher than those in the non-depressive disorders group, whereas for the Area5, the mean value of female in the depressive disorder group was higher than that of the non-depressive disorder group and the male’s non-depressive disorder group had a slightly higher mean value. @*Conclusion@#The voice intensity according to the presence or absence of depressive disorder was similar, but the depressive disorder group tended to show narrower oral area with smaller lip opening.

A Case of Elastosis Perforans Serpiginosa in a Patient with Down Syndrome / 대한피부과학회지

Elastosis perforans serpiginosa (EPS) is a rare condition that belongs to the group of acquired perforating dermatosis. It usually appears as keratotic papules in serpiginous configuration with central atrophy on the head, nape, and extremities. It is characterized by the transepidermal elimination of elastic fibers with clumping and vertical orientation of elastic fibers. In many cases, it is associated with genetic or connective tissue diseases. A 26-year-old female patient with Down syndrome presented with brownish keratotic papules on both arms. The lesion had been present for 2 years, but there were no symptoms. The biopsy specimen showed transepidermal elimination of the degenerated elastic fibers. Verhoeff elastic staining revealed an increased number of thick elastic fibers. Based on these findings, the patient was diagnosed with EPS. Treatment with CO 2 laser was performed with a successful outcome.

Learning Curve and Clinicopathologic Analysis in Transperitoneal Laparoscopic Adrenalectomy; Performed by a Single Young Surgeon with No Experience of Open Adrenalectomy / 대한내분비외과학회지

PURPOSE: Adrenalectomy is a very rare operation and its associated learning curve has not yet been studied. The objective of this study was to determine whether the operation time decreases with experience and to evaluate the safety and feasibility of laparoscopic adrenalectomy performed by a surgeon who is new to laparoscopic and open-surgical adrenalectomy. METHODS: This study is a retrospective analysis of laparoscopic adrenalectomies performed between April 2007 and September 2012. All surgeries were performed by a single young surgeon who had no experience in performance of open or laparoscopic adrenalectomy. All surgeries were performed using the transperitoneal approach. RESULTS: In total, 42 cases were included. The average tumor size was 4.7 cm. The mean operating time was 125 min. Mean duration of hospital stay was 8.7 days. None of the cases showed conversion to open surgery or perioperative mortality. The operator achieved mastery after performance of left laparoscopic adrenalectomy in 12 cases and right laparoscopic adrenalectomy in 11 cases. CONCLUSIONS: A new surgeon can perform laparoscopic transperitoneal adrenalectomy successfully, independently, and safely after having performed the surgery in 12 cases.

Percutaneous vertebroplasty at C7 for the treatment of painful metastases: A case report / 대한마취과학회지

The cervical spine is a less common site for metastatic disease than is the thoracolumbar spine. Percutaneous vertebroplasty (PVP) in the cervical spine can be performed using an anteromedial or lateral approach. A 51-year-old woman with breast cancer had been experiencing severe weight-bearing neck pain for 2 months, even after undergoing radiation therapy. Imaging studies revealed an osteolytic compression fracture in the C7 vertebra. For performing PVP at C7 using the anteromedial approach, a needle was inserted from the left side of the patient's neck. The needle was advanced to the anterior 1/3 anterior 1/3 or 1/2 of the vertebral body by hammering, and approximately 2 ml of cement was injected. Immediately after the operation, the patient could move her neck without pain. In conclusion, PVP using an anterolateral approach may be an option for treating metastatic osteolytic vertebral lesions in the cervical spine for alleviating intractable axial neck pain.

Searching for Hidden, Painful Osteochondral Lesions of the Ankle in Patients with Chronic Lower Limb Pain: Two Case Reports

It is easy to overlook osteochondral lesions (OCLs) of the ankle in patients with chronic lower limb pain, such as complex regional pain syndrome (CRPS) or thromboangiitis obliterans (TAO, Buerger's disease). A 57-year-old woman diagnosed with type 1 CRPS, and a 58-year-old man, diagnosed with TAO, complained of tactile and cold allodynia in their lower legs. After neurolytic lumbar sympathethic ganglion block and titration of medications for neuropathic pain, each subject could walk without the aid of crutches. However, they both complained of constant pain on the left ankle during walking. Focal tenderness was noted; subsequent imaging studies revealed OCLs of her talus and his distal tibia, respectively. Immediately after percutaneous osteoplasties, the patients could walk without ankle pain. It is important to consider the presence of a hidden OCL in chronic pain patients that develop weight-bearing pain and complain of localized tenderness on the ankle.

Prenatal diagnosis of large subamniotic cyst compressing the umbilical cord on umbilicoplacental junction : A case report / 대한산부인과학회지

Placenta surface cyst classified subamniotic hematoma, subchorionic hematoma and subchorionic cyst by histological finding. These cysts did not affect the obstetrical outcome according to the previous report. However, we experienced that the subamniotic cyst compressed the umbilical cord to result in fetal deceleration. We report this case with brief review of literature.

Isolated torsion of the hydrosalpinx after hysterectomy: A case report / 대한산부인과학회지

Isolated tubal torsion is a rare disease that causes acute lower abdominal pain. In most of cases, the ovary and the fallopian tube are together twisted due to an ovarian tumor, but the fallopian tube alone is rarely twisted. Tubal torsion mainly occurs in fertile women, and it rarely occurs prior to menarche and during menopause. We experienced a case where isolated tubal torsion occurred in a perimenopausal female with total abdominal hysterectomy, while the findings showed a normal ovary. We report this case with a brief review of related literature.

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.

Leptin-signal transduction pathways and relationship with cancer development / 부인종양

Leptin is a versatile 16 kDa peptide hormone, with tertiary structure resembling that of members of the long-chain helical cytokine family. It is mainly produced by adipocytes in proportion to fat size stores, and was originally thought to act only as a satiety factor. However, the ubiquitous distribution of leptin receptors in almost all tissues underlies the pleiotropism of leptin. This review will focus on the link between leptin, a cytokine that is elevated in obese individuals, and cancer development through clarifying the intracellular signaling pathways of leptin. First, I discuss the biological functions of leptin and its signaling pathways. Then, I summarize the effects of leptin on different cancer types in experimental cellular and animal models. Next, I analyze the relationship between obesity and the presence of cancer or cancer risk in patients. Finally, leptin as a target for cancer treatment in the future and prevention will be discussed.

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.

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.

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.

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.

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.

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.

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.

Analysis of in vitro, ex vivo and in vivo 1H Magnetic Resonance Spectroscopy Pattern in Squamous Cell Carcinoma of Uterine Cervix / 대한산부인과학회잡지

OBJECTIVE: To evaluate the potential value of in vitro, ex vivo, and localized in vivo 1H Magnetic resonance spectroscopy(MRS) for detecting and characterizing squamous cell carcinoma of uterine cervix. MATERIALS AND METHODS: Eleven cases of squamous cell carcinoma and 6 cases of normal cervical tissue underwent in vitro and ex vivo 1H MRS. In vitro analysis was carried out after processing the specimen with dual phase extraction method. In ex vivo test, at least 500microliter of tissue specimen was directly analyzed by 100.14 MHz NMR spectrometer (Bruker 11.7T AMX, Germany) without any processing procedure. In addition, 29 patients with squamous cell carcinoma of uterine cervix and 6 normal women were examined by in vivo 1H MRS. Localized in vivo 1H MR spectra of the human uterine cervix were obtained using PRESS sequence with homebuilt endovaginal surface coil. Surface coil T2 weighted images were used as the localizer images where voxel (1-3 mm3) was located to contain the cancer area only. The following spectral acquisition parameters were used: SW=2500 Hz, SI=2048, TR=3.0 sec, TE=20/135 msec, NEX=2, and NS=36. H2O signal suppressed down to 96-99% by 3-pulse CHESS technique. The spectra were processed with 0.5 Hz of exponential line broadening, zerofilling of 8K followed by linear phasing. RESULTS: The intense resonance signal at 0.9 ppm and 1.3 ppm by lipid component of triglyceride was visible in all cases (11/11) of squamous cell cancer of cervix both in vitro and ex vivo test. But in 6 normal cervical tissues, such peaks were not detected at all. The in vivo spectrum of the cervical cancer was comparable with that in in vitro and ex vivo spectrum. In the in vivo spectra of the cervical cancer, the resonance peaks at 0.9 ppm, 1.3 ppm, 3.0 ppm, and 3.2 ppm from CH3 and CH2 groups of neutral mobile lipid (triglyceride), creatine, and choline containing residues respectively, were consistent with results reported earlier. The resonance peak at 1.3 ppm which is from acyl chains of triglyceride was characteristically intense and seen in 25 of 29 cancer patients. But triglyceride peak at 1.3 ppm was not detected in normal cervix (sensitivity 86.2%; specificity 100%; positive predictive value 100%; negative predictive value 60%). CONCLUSION: The study shows that 1H MRS can effectively discriminate squamous cell cancer from normal cervix in most cases. It also demonstrates the feasibility of localized in vivo 1H MRS technique as a new diagnostic modality in the detection of squamous carcinoma of uterine cervix.