The Apoptotic Effect of the Hexane Extract of Rheum undulatum L. in Oral Cancer Cells through the Down-regulation of Specificity Protein 1 and Survivin / 한국실험동물학회지

The hexane extract of Rheum undulatum L. (HERL) has been shown to have anti-cancer activity in several cancers in vivo and in vitro. However, the anti-cancer activity of HERL and its molecular mechanism in human oral cancer cells has not been explored. Thus, the aim of this study was to elucidate the growth-inhibitory and apoptosis-inducing effects of HERL in HN22 and SCC15 oral cancer cell lines. This study shows that HERL inhibits oral cancer growth, decreases cell viability, and causes apoptotic cell death in HN22 and SCC15 cells, as characterized by morphological changes, nuclear condensation and fragmentation, the cleavage of PARP and the accumulation of cells in the sub-G1 phase. The treatment of oral cancer cells with HERL also resulted in decreased expression of specificity protein (Sp1) and its downstream protein, survivin. Therefore, our results suggest that the regulation of Sp1 and survivin plays a critical role in HERL-induced apoptosis in human oral cancer cells.

Clinical analysis of chorionic villus sampling / 대한주산의학회잡지

OBJECTIVE: The aims of this study were 1) to evaluate the indications of chorionic villus sampling CVS) and the positive predictive value for fetal chromosomal abnormalities, 2) to evaluate the reliability of CVS at Asan Medical Center, 3) to find out the risk factors of procedure-related fetal loss, 4) to find out the risk factors of culture failure, and 5) to compare transabdominal with transvaginal approaches. METHODS: Medical records of the 429 out of 461 patients in whom the CVS for prenatal cytogenetic diagnosis were performed were reviewed retrospectively for the period of June 1998 to June 2006. RESULTS: (1) The most common indications of CVS were abnormal ultrasonic findings including increased nuchal translucency (153/429, 35.7%), a previous history of cytogenetically abnormal baby (125/429, 29.1%), old maternal age (100/429, 23.3%), family history of genetic disease (22/429, 5.1 %), and parental abnormal karyotype (11/429, 2.6%). (2) The positive predictive value of abnormal karyotyping according to the indication of CVS was highest in the cases showing abnormal USG findings, including increased fetal nuchal translucency (28.3%). (3) The trial success rate of CVS was 99.5%(427/429). Culture failure rate was 1.9%.(4) Of the 427 cases, normal karyotype was revealed in 349 cases (81.7%), abnormal karyotype in 66 cases (15.2%), maternal cell contamination in 6 cases (1.4%), and pseudomosaicism and confined placental mosaicism (CPM) in 6 cases (1.4%). (5) Procedure-related fetal loss rate was 1.6% (7/419). (6) The significant risk factor of fetal loss was presence of preprocedure vaginal bleeding. (7) The significant risk factor of culture failure was a small amount (less than 10 mg) of tissue. (8) The gestational age at procedure was significantly different between transabdominal and transvaginal methods. In the transabdominal approach group, the incidence of fundal location of placenta was significantly more common. CONCLUSION: If CVS is performed by an expert operator and at a good quality of genetic laboratory, CVS is a very safe and reliable procedure for prenatal genetic diagnosis.

Mutation Screening of HNF-1alpha Gene in Korean Women with Gestational Diabetes Mellitus / 당뇨병

BACKGROUNDS: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset or first detection during pregnancy and mostly caused by insulin resistance and beta-cell dysfunction like type 2 diabetes. However, autoimmune or monogenic diabetes can contribute to GDM. Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes characterized by an early age of onset and an autosomal dominant pattern of inheritance. Most MODY cases are attributable to mutations in HNF-1alpha gene, also known as MODY3. We investigated whether mutations in HNF-1alpha gene are present in Korean women with GDM. METHODS: A total of 96 Korean women with GDM who have a family history of DM were screened for mutations in the HNF-1alpha gene. We evaluated the clinical characteristics of GDM women with HNF-1alpha gene mutations. RESULTS: Five of 96 patients (5.2%) were found to have a mutation in HNF-1alpha gene. Four of those (-23C > G, 833G > A (Arg278Gln), 923C > T, IVS5 + 106A > G) were novel and one (-124G > C) in promoter region was reported in previous study. The mean age of GDM women with mutations of HNF-1alpha gene was 34 years. Four women with MODY3 gene mutations required insulin therapy during pregnancy. GDM women with MODY3 gene mutations appeared to be decreased insulin secretion (HOMA-%B) than those without mutations. CONCLUSIONS: We have found the existence of MODY3 as well as novel HNF-1alpha gene mutations in Korean women with GDM.

Comparison of General and Spinal Anesthesia and Their Effect on Hemostasis using the Thromboelastography in Patients Undergoing Total Knee Arthroplasty: Preliminary report / 대한마취과학회지

BACKGOUND: General anesthesia was known to induce hypercoagulable status during major orthopedic surgery. This study was designed to analyze effects on hemostatic reponse in patients receiving general or spinal anesthesia for total knee arthroplasty, using the thromboelastography (TEG). METHODS: Among women that were scheduled to total knee arthroplasty without both no medical or surgical history and no chronic systemic disorder, ten patients were selected at each group (general or spinal anesthesia). TEG was measured at 4 times around the each surgery (before skin incision after induction, before bone manipulation, after bone manipulation, 1 hour after operation). RESULTS: There was no difference statistically between two groups in first and second measures of TEG. But, significantly different r time, k time, alpha angle, and maximum amplitude was noted between two groups after bone manipulation and 1 hour after operation (P < 0.05). Conculusions: After the release of tourniquet following bone procedures the patients receiving general anesthesia had relatively high hemostasis compared with the spinal anesthesia group. This phenomenon was also noted in 1 hour after operation.

The expression of isoforms of peroxiredoxin in normal ovary & epithelial ovarian tumor / 대한산부인과학회지

OBJECTIVE: To assess the expression pattern of all six Prxs in normal ovarian tissue and epithelial ovarian tumor cell using immunohistochemical staining. METHODS: Patients were retrieved from those who had undertaken operation in Obstetrics and Gynecology of our hospital from January 1995 to June 2005. According to the pathologic result, five patients were allocated randomly in each group of malignant serous, malignant mucinous, benign serous and benign mucinous ovarian tumor. And another five with normal ovarian epithelial cell were included for the comparison. Immunohistochemical staining was performed with Prx I to VI antibodies. Using microscopy, we evaluated the immunoreactivities of nucleus and cytoplasm semiquantitatively by dividing into four categories : -; no immunoactivity present, +; weak, ++; moderate, +++; strong staining. RESULTS: The immunopositivity of Prx III in cytoplasm shows weak to moderate and Prx VI moderate to strong in normal ovarian tissue. In mucinous epithelial ovarian tumor cell, cytoplasmic Prx IV shows stronger activity than in normal epithelial cell or serous tumor cell. In malignant epithelial cell, Prx V shows stronger activity in cytoplasm than normal epithelial cell. It shows characteristically granular pattern. Prx VI shows stronger activity in the nucleus of malignant epithelial cell compared to normal epithelial cell or benign tumor epithelial cell. CONCLUSION: Normal ovarian tissue showed higher affinity for Prx III and VI. In epithelial ovarian tumor, cytosolic Prx IV in mucinous tumor, cytosolic Prx V and nuclear Prx VI in malignant tumor were overexpressed.

FIGO stage IB clear cell carcinoma and adenocarcinoma of uterine cervix / 부인종양

OBJECTIVE: To compare the clinical features and prognosis of patients with clear cell carcinoma (CCA) and adenocarcinoma (ACA)of the uterine cervix. METHODS: We have performed retrospective clinical study on 5 patients diagnosed as CCA and 55 patients diagnosed as ACA from November 2000 to December 2004. Demographic data, pathologic findings, treatments and survival time were reviewed. RESULTS: The mean age of patients with CCA and ACA was 31.5 or 30.4 years respectively and all patients were FIGO stage IB. Among the 5 patients of CCA, 4 patients have underwent radical hysterectomy (RH) and one patient have treated with radiotherapy only. Among the 55 patients of ACA, 50 patients have underwent RH and pelvic lymph node dissection (PLND), paraaortic lymph node sampling (PALNS) and the other have underwent only bilateral salphingoophorectomy (BSO) and PLND. There are no significant difference on age, tumor size, depth of invasion, parametrial involvement, vaginal involvement and pelvic lymph node metastasis (p>0.05). The mean survival time of CCA and ACA was 42.5 and 43.2 months respectively (p=0.32). The recurrent rate of CCA and ACA are 25% and 5.45% (p=0.30) and the disease free survival of CCA and ACA are 18.7 months and 43.6 months respectively (p=0.054). CONCLUSION: There were no significant difference on clinical features and prognosis of FIGO stage Ib CCA and ACA. Large scaled prospective multicenter trials will be able to provide a decision for prognosis and proper therapy.

Clinical Characteristics of Habitual Abortion According to the Etiological Classification / 대한산부인과학회지

OBJECTIVE: To determine the frequency of factors associated with habitual abortion in 198 Korean couples. METHODS: A total of 198 cases at the department of Obstetrics and Gynecology, Asan Medical Center, Korea from July 1989 to December 2001 that were diagnosed as habitual abortions were included in this study. The cases were divided into 2 main groups; a primary habitual abortion group and a secondary habitual abortion group. They were classified according to etiology. RESULTS: The number of primary habitual abortion cases was 157 (79.3%) and that of secondary habitual abortion cases was 41 (20.7%). The mean age and number of previous abortions were not different between the two groups. The etiologic factors of the primary habitual abortions were anatomical (31.8%, 42/132), immunologic (24.2%, 32/132), unexplained (23.5%, 31/132), endocrinologic (15.2%, 20/132), genetic (12.9%, 17/132), and infection (1.5%, 2/132). The factors of the secondary habitual abortions were immunologic (36.8%, 14/38), unexplained (28.9%, 11/38), anatomical (21.1%, 8/38) and endocrinologic (13.2%, 5/38). The successful pregnancy rate following secondary habitual abortion was 42.0% (17/38), significantly higher than that following primary habitual abortion which was 34.8% (50/132) (p-value<0.05). CONCLUSION: The differences in etiologic factors between primary and secondary habitual abortions are statistically significant. The prognosis of a later successful pregnancy was significantly better in cases of secondary habitual abortion.

Effects of Pioglitazone on Insulin Sensitivity, Ovarian Function and Intraovarian Stromal Blood Flow in Women with Polycystic Ovary Syndrome / 대한불임학회지

OBJECTIVE: This study was performed to investigate the effects of pioglitazone, an insulin sensitizing agent, on insulin resistance, ovarian function and intraovarian stromal blood flow in patients with polycystic ovarian syndrome (PCOS). MATERIAL AND METHODS: Thirty patients with PCOS, aged 18~34 years, were recruited. Criteria for diagnosis of PCOS were as defined in 2003 Rotterdam consensus. They were treated for 6 months with pioglitazone at a dose of 30 mg/day orally. The hormonal blood profile, fasting serum glucose levels, a glycemic response to 75 g oral glucose tolerance test (OGTT), and an ovarian stromal artery (OSA) blood flow were assessed at baseline and after 6 months of treatment. RESULTS: Eighteen (60.0%) of 30 patients treated with pioglitazone demonstrated a spontaneous ovulation After pioglitazone treatment, fasting insulin concentrations, serum glucose levels after 75 g OGTT significantly decreased (p=0.001, p=0.04, respectively), and fasting glucose to insulin (G/I) ratio significantly increased (p<0.001). The pioglitazone treatment induced a significant reduction in serum LH, testosterone (T) and free T levels (p<0.001, p=0.02, p=0.002, respectively). The resistance index (RI) values of OSA significantly increased after treatment (p<0.001). In analyzing pioglitazone-treated patients according to their body mass index (BMI), nonobese group as well as obese group showed a significant improvement in fasting G/I ratio (p<0.01). The pioglitazone treatment induced a significant reduction in serum LH and free T levels in nonobese group (p<0.001, p<0.05, respectively) as well as obese group (p=0.001, p<0.05, respectively). The RI values of OSA significantly increased in both nonobese and obese groups after pioglitazone treatment (p<0.001, p=0.003, respectively). CONCLUSIONS: Pioglitazone could ameliorate the glycoinsulinemic metabolism, and this beneficial effects of this drug could improve the endocrine-reproductive condition associated with the decrease of ovarian stromal artery blood flow, in both nonobese and obese patients with PCOS.

The efficacy of paclitaxel based combination chemotherapy in recurrent endometrial cancer / 부인종양

OBJECTIVE: This study was performed to evaluate the efficacy of paclitaxel based combination chemotherapy by response rate and survival time in the treatment of recurrent endometrial cancer. METHODS: From May 1995 to February 2004, 27 out of 301 cases of endometrial cancer treated at the Asan Medical Center in Seoul were recurrent. We identified 11 patients treated with paclitaxel based combination chemotherapy and 7 patents treated with other combination chemotherapy, and then retrospectively estimated the survival times from the chemotherapy after recurrence to the death or last visit. RESULTS: The non-paclitaxel based combination chemotherapy group showed partial response in 1 case (14.3%) and disease progression in 4 (57.1%). In contrast, the paclitaxel group showed 7 cases (63.6%) of partial response. The median survival time for total study patients was 18.0 months, 22.0 months for paclitaxel group and 15.0 months for the non-paclitaxel group, the difference being statistically significant (p=0.047). Side effect of chemotherapy such as leukopenia, neutropenia and thrombocytopenia showed no difference between the two groups. CONCLUSION: Paclitaxel-based combination chemotherapy may be the first-line chemotherapeutic agent in recurrent endometrial cancer patients if it's more effective than other combination chemotherapy in prolonging survival times.

Two Cases of Deep Vein Thrombosis Associated with Behcet's Disease / 대한피부과학회지

In Behcet's disease(BD), there is a marked increase in vascular complication. Venous thrombosis is a major feature of the disease, although arterial thrombosis is rarely described. In Behcet's disease, thrombosis occurs in 20 to 30% of patients. We present two cases of Behcet's disease admitted to our hospital whose chief complaint was progressive increases in swelling and pain in their legs. In the first case, routine coagulation tests and sero-immunological tests were within normal limits, however, protein C and S activity were significantly decreased in the patient. So these findings suggest that auto-immune acquired protein S deficiency may be involved in the pathogenesis of thrombotic events in BD.

Production and Characterization of Antibodies to Propionibacterium acnes from Immunized Chicken Eggs / 대한피부과학회지

BACKGROUND: Treatments inhibiting Propionibacterum acnes as like antibiotics for acne vulgaris can produce complications, and have their limited uses.OBJECTIVE: Antibodies reacting to P. acnes were produced from immunized chicken eggs, and were characterized by aggulutination test and inhibiting abilities to growth of P. acnes. METHODS: P. acnes were cultured, and their lipase were used as immunogen. Antibodies were purified from immunized chicken eggs by diafiltration. Their titers were measured by ELISA. Antigen-antibodies agglutination test was performed, and the ability of inhibitions of P. acnes grown in media was observed. RESULTS: Antibodies were well produced especially when 0.25 to 2 mg of immunogen were injected per one chicken. When antibodies were reacting to P. acnes, pellet formations were not shown because of agglutination above 17.8 pg concentration of antibodies, and acitivities of P. acnes were markedly suppressed on microscopic examination. Growth of P. acnes on media were also inhibited for quite a long time. CONCLUSION: Antibodies reacting to P. acnes were produced, and their abilities to inhibit the growth of P. acnes were confirmed. In future, produced antibodies from immunized chicken eggs would be hoped to be a main component of medication or cosmetics for improving or preventing acne lesions.

Four Cases of Pigmentary Dermacation Lines of Pregnancy with Erythema

Pigmentary dermarcation lines are boundaries between more deeply pigmented skin and areas of lighter pigmentation. We report 4 cases of pigmentary demarcation lines of pregnancy associated with erythema which developed in the third trimester of pregnancy and were symmetrically located in the buttock and posteromedial portion of the lower extremities. After delivery, the erythema disappeared within 3-7 days, followed by slow resolution of the brownish pigmentation.

Prurigo Pigmentosa:A Report of 5 Cases with a Review of the Korean Literature

Prurigo pigmentosa(PP) is a rare dermatosis with an unknown cause characterized by intensely pruritic papules that resolve with reticulate pigmentation. It is a disease entitity commonly reported in Japan but seemingly rare in other parts of the world. We report 5 cases that clinically and histopathologically fulfilled the characterisitics of PP and were treated with dapsone resulting in significant clinical improvement.

The Effects of Education According to Constitution & Character of Patients Who have Stroke / 기본간호학회지

This study was designed to explore the effectiveness of education to improve self-care of stroke patients with three types of character health locus of control and constitution. A total of 56 patients were selected by convenience sampling at one oriental hospital. The teaching of self-care was conducted by the researcher. The self-care performance was measured for 10 days. The data were analyzed using t-test, ANOVA and Scheffe method as post hoc test. The result of this study are as follows : 1. The self-care performance by patients characteristics : Age and education had impact on the self-care performance. The level of self-care performance of young and high educated patients was high, gender, religion, occupation, monthly income, and the paralyzed side, however, didn't have influence on the self-care performance. 2.. The self-care performance of patients with three types of constitution : There was no statistical significance on the self-care performance of patients group by constitution, However, average score of self-care performance of patients with So-Um was high. 3. The self-care performance of patients with three types of health locus of control : There was no statistical significance on self-care performance of patient group by health locus of control. 4. The correlation between the constitution and the health locus of control : There was no statistical significance on the introverted and chance health locus of control of patients with three types of constitution. However, there was a statistically significant relationship between the powerful others health locus of control and So-Yang. Even though there was no statistically significant self-care performance of patients with So-Um, there was a clinical significance on the high score of self-care performance of patients with So-Um as compared with the self-care performance of the patients. The health locus of control didn't have influence on the self-care performance of patients. There was a statistically significant relationship between the powerful others health locus of control and So-Yang. Therefore, this study suggest the need to develop the nursing intervention to improve the self-care of stroke patients with the powerful others health locus of control and So-Yang, Furthermore, the longitudinal research is needed to determine the effectiveness of training to imp.

Epidermal Nevus Syndrome with Various Skin Manifestations

We report a case of epidermal nevus syndrome showing various skin manifestations improved with CO₂ laser and chemical peeling in a 11-year-old girl. Skin lesions were composed of linear verrucous plaques and numerous papillomatous papules on the face, neck, scalp and trunk, multiple congenital nevocellular nevi on the face, and extensive cafe au lait spots on the trunk. The associated findings of skeletal involvement were gingival hemihypertrophy and benign bone lesion of the 7th rib. CO₂ laser and chemical peeling MCA, 50% TCA) were applied to remove these skin lesions which improved considerably.

Epidermal Nevus Syndrome with Various Skin Manifestations

We report a case of epidermal nevus syndrome showing various skin manifestations improved with CO₂ laser and chemical peeling in a 11-year-old girl. Skin lesions were composed of linear verrucous plaques and numerous papillomatous papules on the face, neck, scalp and trunk, multiple congenital nevocellular nevi on the face, and extensive cafe au lait spots on the trunk. The associated findings of skeletal involvement were gingival hemihypertrophy and benign bone lesion of the 7th rib. CO₂ laser and chemical peeling MCA, 50% TCA) were applied to remove these skin lesions which improved considerably.

Noduloulcerative syphilis / 대한피부과학회지

A 26-year-old female presented herself to our clinic due to noduloulcerative lesions of one month duration on her face and trunk with accompaning headache and mild fever. In family history, her husband was reported to have a history of chaner. On physical examinat.ion, rice sized eythematous papules and bean sized nodules with central ulceration were seen on the face and trunk. VDRL was 1:31 positive. A skin biopsy iif a noduloulcerative lesion showed ulceration, vascular dilatation with fibrinoid changes and perivascular inflarnmatory cellu infilt.rations, especially plasma cells. Immunoperoxidase stain showed T. pallidum at the epidermis and papillary dermis. The diagnsis was made asecondary syphilis with unusual clinical presentation as noduloucerative skin lesions. The skin lesions completely disappeared one month after treatment with injection of benzathine pelnicillin G 2.4 million unit intramuscularly weekly for three times.