Subcutaneous Interleukin-2 Monotherapy for Metastatic Renal Cell Carcinoma in Korean Patients

Purpose@#This study was a prospective single-arm clinical trial aimed at assessing the efficacy and toxicity of subcutaneous interleukin (IL)-2 monotherapy in patients with metastatic renal cell carcinoma (RCC). @*Materials and Methods@#We enrolled 26 patients with metastatic RCC in this multicenter controlled trial. The patients received subcutaneous injections of recombinant IL-2 (BMI-rh-IL2, an aldesleukin biosimilar, BMIKOREA Co., Ltd.) in 5-week cycles. In the first week, the patients received a subcutaneous IL-2 loading dose of 18×106 IU once on treatment days 1–5, followed by 2 days of rest. In the following 3 weeks, they received a dose of 18×106 IU via subcutaneous injection once on treatment days 1 and 2. Then, the patients received a dose of 9×106 IU via subcutaneous injection once on treatment days 3, 4, and 5, followed by 2 days of rest. The primary end point was the objective response rate; the secondary end points were progressionfree survival (PFS) and safety. @*Results@#Overall, 22 patients were included in the final per-protocol analysis. The objective response and the disease control rates were 13.64% (3 of 22), and 90.9% (20 of 22), respectively. The mean PFS was 5.55 months (95% confidence interval, 2.71–8.4). The proportion of patients who experienced a treatment-related grade 3 or 4 adverse event was 3.85% (1 of 26). There were no treatment-related deaths. @*Conclusions@#In this study, the subcutaneous IL-2 monotherapy regimen demonstrated efficacy and safety comparable to those reported in previous studies of subcutaneous IL-2 monotherapy and was effective in Korean patients with metastatic RCC.

Clinicopathologic Characteristics and Treatment Outcomes of Penile Cancer

PURPOSE: The aim of this study was to assess the clinicopathologic characteristics of penile cancer, including patterns of therapy, oncologic results, and survival. MATERIALS AND METHODS: Between January 2005 and July 2015, 71 patients at 6 institutions who had undergone penectomy or penile biopsy were enrolled. Their medical records were reviewed to identify the mode of therapy, pathology reports, and cancer-specific survival (CSS) rate. RESULTS: Clinicopathologic and outcome information was available for 52 male patients (mean age, 64.3 years; mean follow-up, 61.4 months). At presentation, 17 patients were node-positive, and 4 had metastatic disease. Management was partial penectomy in 34 patients, total penectomy in 12 patients, and chemotherapy or radiotherapy in 6 patients. The pathology reports were squamous cell carcinoma in 50 patients and other types of carcinoma in the remaining 2 patients. Kaplan-Meier survival analysis showed a 5-year CSS rate of 84.0%. In univariate and multivariate analyses, the American Joint Committee on Cancer (AJCC) stage and pathologic grade were associated with survival. CONCLUSIONS: Partial penectomy was the most common treatment of penile lesions. The oncologic outcomes were good, with a 5-year CSS of 84.0%. The AJCC stage and pathologic grade were independent prognostic factors for survival.

Symptom and Differences in Medication Adherence in Method of Administration of Tamsulosin, Finasteride Combination Therapy in Benign Prostatic Hyperplasia

PURPOSE: It has been reported in several for factors on the drug compliance of patients, number of drug being taken, symptom, and pharmaceutical dosage form. However, Studies of drug compliance by dosing methodologies of tamsulosin, finasteride combination therapy and symptom relief for benign prostatic hyperplasia has not been performed. Therefore, we studied for symptom and differences in medication adherence in method of administration of tamsulosin, finasteride combination therapy. MATERIALS AND METHODS: The groups were consisted in need of combination therapy of tamsulosin, finasteride on benign prostatic hyperplasia, one had packaged both drugs together (Group A, n=30) and the other were individually packaged both agents (Group B, n=30). International Prostatic Symptom Score (IPSS) were checked on first, 4weeks, and 8weeks. The evaluation was carried out of medicine compliance by checking the number of drugs 4weeks-interval. which was every 4weeks during 8weeks. RESULTS: The properties other than the PSA in both groups, there was no statistically significant differences between patients. In first 4weeks, drug compliance of each Group A and B had tamsulosin 82.6%, 93.3% (p=0.033), finasteride 80.1%, 93.3% (p=0.042), and last 4weeks tamsulosin 80.6%, 93.7% (p=0.013), finasteride 79.5%, 93.7% (p=0.002) were checked. Group C, D had 81.4%, 96.4% (p=0.021) on 4weeks, 80.6%, 97.2% (p=0.011) on 8weeks. CONCLUSIONS: For co-administration of finasteride and tamsulosin are required in patients with benign prostatic hyperplasia, in order to enhance drug compliance, both tablets have to prescript together in one package to be taken at one time is useful.

Interfraction Prostate Movement in Bone Alignment After Rectal Enema for Radiotherapy

PURPOSE: To assess the effect of a rectal enema on interfraction prostate movement in bone alignment (BA) for prostate radiotherapy (RT), we analyzed the spatial difference in prostates in a bone-matched setup. MATERIALS AND METHODS: We performed BA retrospectively with data from prostate cancer patients who underwent image-guided RT (IGRT). The prostate was identified with implanted fiducial markers. The setup for the IGRT was conducted with the matching of three fiducial markers on RT planning computed tomography images and those on two oblique kV x-ray images. Offline BA was performed at the same position. The coordinates of a virtual prostate in BA and a real prostate were obtained by use of the ExaxTrac/NovalisBody system, and the distance between them was calculated as the spatial difference. Interfraction prostate displacement was drawn from the comparison of the spatial differences. RESULTS: A total of 15 patients with localized prostate cancer treated with curative hypofractionated IGRT were enrolled. A total of 420 fractions were analyzed. The mean of the interfraction prostate displacements after BA was 3.12+/-2.00 mm (range, 0.20-10.53 mm). The directional difference was profound in the anterior-posterior and supero-inferior directions (2.14+/-1.73 mm and 1.97+/-1.44 mm, respectively) compared with the right-left direction (0.26+/-0.22 mm, p<0.05). The required margin around the clinical target volume was 4.97 mm with the formula of van Herk et al. CONCLUSIONS: The interfraction prostate displacement was less frequent when a rectal enema was performed before the procedure. A rectal enema can be used to reduce interfraction prostate displacement and resulting clinical target volume-to-planning target volume margin.

A method for mandibular dental arch superimposition using 3D cone beam CT and orthodontic 3D digital model / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to develop superimposition method on the lower arch using 3-dimensional (3D) cone beam computed tomography (CBCT) images and orthodontic 3D digital modeling. METHODS: Integrated 3D CBCT images were acquired by substituting the dental portion of 3D CBCT images with precise dental images of an orthodontic 3D digital model. Images were acquired before and after treatment. For the superimposition, 2 superimposition methods were designed. Surface superimposition was based on the basal bone structure of the mandible by surface-to-surface matching (best-fit method). Plane superimposition was based on anatomical structures (mental and lingual foramen). For the evaluation, 10 landmarks including teeth and anatomic structures were assigned, and 30 times of superimpositions and measurements were performed to determine the more reproducible and reliable method. RESULTS: All landmarks demonstrated that the surface superimposition method produced relatively more consistent coordinate values. The mean distances of measured landmarks values from the means were statistically significantly lower with the surface superimpositions method. CONCLUSIONS: Between the 2 superimposition methods designed for the evaluation of 3D changes in the lower arch, surface superimposition was the simpler, more reproducible, reliable method.

Renovating the History of the Korean Journal of Orthodontics / 대한치과교정학회지

No abstract available.

Tamsulosin Monotherapy versus Combination Therapy with Antibiotics or Anti-Inflammatory Agents in the Treatment of Chronic Pelvic Pain Syndrome / 대한배뇨장애요실금학회지

PURPOSE: Chronic pelvic pain syndrome (CPPS) is treated by use of various protocols. We compared tamsulosin monotherapy with tamsulosin in combination with antibiotics or anti-inflammatory agents and evaluated the efficacy of these treatments in patients with CPPS. METHODS: Patients (n=107) who were younger than 55 years and diagnosed with CPPS were randomly assigned to treatment with tamsulosin at 0.2 mg (group A), tamsulosin at 0.2 mg plus anti-inflammatory drugs (group B) or tamsulosin at 0.2 mg plus antibiotics (group C) daily. We applied the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostate Symptom Score (IPSS) to evaluate 100 patients who were treated for 12 weeks (7 withdrew). Scores of the three groups were compared by analysis of variance and we also evaluated subscores, which included pain, voiding and quality of life (QoL). RESULTS: All three groups showed statistically significant decreases in NIH-CPSI score, IPSS and subscore scores (P<0.05). There were no statistically significant differences between the groups except for the QoL domain of the IPSS (group A vs. C; P<0.01). CONCLUSIONS: Tamsulosin monotherapy for 12 weeks was effective for treating patients with CPPS, compared with combination therapy with antibiotics or anti-inflammatory drugs.

Radiofrequency Ablation of Renal Tumors: Our Experience

PURPOSE: To report our results of nephron-sparing radiofrequency ablation (RFA) of renal tumors. MATERIALS AND METHODS: Since August 2004, 49 patients with renal tumors were treated with either percutaneous or laparoscopic RFA. All patients underwent preoperative imaging with contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) and were suspected to have renal cell carcinoma. The follow-up for each patient included a physical examination, chest radiography, liver function tests, and a contrast-enhanced CT or MRI. To confirm the pathologic criteria of complete ablation, 30 patients underwent 6-month or 1-year follow-up biopsy. Recurrence was defined as growth of the tumor or any new enhancing portions at 3 months after confirmed nonenhancement of the initial RFA lesion. RESULTS: Technical success was achieved in 46/49 cases (94%). The mean tumor size was 2.4 cm and the mean follow-up period was 31.7 months (range, 6-68 months). Of 49 patients, repeated RFA was necessary in 7 patients (14%). Three patients were found to have recurrence at various follow-up intervals. Twenty-three patients (47%) experienced complications, and all but one necessitated intervention. No distant metastasis was found in any cases, and all patients are alive and are being serially followed up. CONCLUSIONS: Percutaneous or laparoscopic RFA is considered to be a useful treatment for selected patients with small renal masses and for nephron-sparing. With a mean follow-up of 31.7 months, our intermediate data suggest excellent therapeutic outcome with RFA with effective local tumor control and preservation of renal function. The ultimate role of this modality will continue to evolve and warrants further studies.

Menarcheal timing and growth curve shape during the adolescent growth spurt / 대한치과교정학회지

OBJECTIVE: This study investigated the onset, peak height velocity (PHV) and end of adolescent growth spurt as well as menarcheal timing deduced from surveying accumulative height growth over many years. METHODS: Ninety six students of Samgoe high school between 1st and 3rd grade that were in good health participated in the research. A survey questionnaire was distributed to examine the students' health status and menarche timing. RESULTS: Adolescent growth spurt typically began at the age of 9.9 and reached a PHV at the age of 11.6. The growth spurt ended at the age of 14.1 on average. The average age of menarche was 12.6 years, which was about one year after the PHV of adolescent growth spurt. In most cases, menarche came after PHV. But in 24% of the students, menarche and PHV was nearly coincident or menarche preceded PHV. The growth curves were classified into four types. A typical adolescent growth spurt showed one PHV on graph that drastically drops after the PHV. However, there were cases with two PHVs. CONCLUSIONS: The results indicate that individual growth patterns show large individual differences, however the categorization into the various growth curves may aid in predicting individual growth patterns.

Effects of compressive stress on the expression of M-CSF, IL-1beta, RANKL and OPG mRNA in periodontal ligament cells / 대한치과교정학회지

OBJECTIVE: The aim of this study was to determine if human PDL cells can produce osteoclastogenic mRNA and examine how compressive stress affects the expression of osteoclastogenic mRNA in human PDL cells. METHODS: Human PDL cells were obtained from biscupids extracted for orthodontic treatment. The compressive force was adjusted by increasing the number of cover glasses. PDL cells were subjected to a compressive force of 0.5, 1.0, 2.0, 3.0 or 4.0 g/cm2 for 0.5, 1.5, 6, 24 or 48 hours. Reverse transcription polymerase chain reaction (RT-PCR) analysis was performed to examine levels of M-CSF, IL-1beta, RANKL, OPG mRNA expression. RESULTS: Human PDL cells could produce M-CSF mRNA. Human PDL cells under compressive stress showed increased M-CSF, IL-1beta and RANKL mRNAs expression in a force (up to 2 g/cm2) and time-dependent manner. However, OPG mRNA expression was constant regardless of the level and duration of stress. CONCLUSIONS: Continuous compressive stress induced the mRNA expression of osteoclastogenic cytokines including M-CSF, RANKL, IL-1beta in PDL cells. Together with an unchanged OPG mRNA level, these results suggest that compressive stress-induced osteoclastogenesis in vivo is partly controlled by M-CSF, RANKL and IL-1beta expression in PDL cells.

Maturation of cervical vertebrae in relation to menarche / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to investigate the relationship between menarche and cervical vertebral maturation. METHODS: Lateral cephalograms of 67 young korean girls within the range of 1 year before or after their menarche were gathered. The concavity of the cervical vertebrae base and the ratio of the base length to the 3rd and 4th cervical vertebrae anterior height were measured and analyzed. RESULTS: The mean measured values were as follows; concavity of the 3rd cervical vertebrae base: 1.27 (+/- 0.18) mm, concavity of the 4th cervical vertebrae base: 1.06 (+/- 0.15) mm, ratio of the base length to the 3rd cervical vertebrae anterior height: 0.73 (+/- 0.06) and ratio of the base length to the 4th cervical vertebrae anterior height: 0.70 (+/- 0.05). There was a significant increase in the ratio of the base length to the 3rd vertebrae anterior height and the base concavity of the 3rd and 4th cervical vertebrae during the period of 1 year before to 1 year after their menarche. CONCLUSIONS: These characteristics of the 3rd and 4th cervical vertebrae on the lateral cephalogram can provide useful clues on evaluating the growth stage.

The Efficiency of Laparoscopic Splenorenal Shunt: a Chronic Canine Model / 대한비뇨기과학회지

PURPOSE: Splenorenal bypass is a major surgical procedure that's used for the management of renal artery stenosis. Herein, we evaluate the feasibility and efficacy of performing laparoscopic splenorenal bypass in a chronic canine model. MATERIALS AND METHODS: A total of 12 animals were used for this study. The initial 6 acute animals were used to develop the technique. The remaining 6 surviving animals, which form the basis for this report, were used for a chronic study with up to 2 months follow-up. The renal artery and the distal splenic artery was dissected, its proximal end clamped and its distal end cut and spatulated. An end-to-end anastomosis of the splenic artery and renal artery was performed using only laparoscopic freehand suturing and knot-tying techniques. Upon revascularization, a laparoscopic doppler ultrasound probe was used to document blood flow in the renal artery. Three animals were each followed for 1 month and 2 months, respectively. RESULTS: The total operative time was 297+/-36 min. The mean number of suture bites per anastomosis was 14.3. The only intraoperative complication was hemorrhage from the anastomotic site. Intraoperative Doppler ultrasound documented good blood flow in all 6 animals upon releasing the clamp. At the time of euthanasia, intravenous pyelography (IVP) showed early visualization of the left kidney with prompt drainage in 5 of the 6 surviving animals. In one animal that had two left renal arteries, a distal thrombosis was found despite the patent anastomotic site. CONCLUSIONS: Laparoscopic splenorenal bypass can be performed in a reproducible fashion with using only intracorporeal techniques. We believe that with experience, complex urologic vascular procedures can be laparoscopically performed in the future.

Fibrous Pseudotumor in the Testicular Tunica / 대한비뇨기과학회지

Fibrous pseudotumor of the testicular tunics is uncommon lesion. They typically arise as painless scrotal masses that may be associated with a hydrocele or history of trauma or infection. Two-thirds involve the tunica vaginalis testis, with infrequent involvement of other scrotal structures. Once excised, these lesions behave in a benign fashion. Typically, these masses are multinodular, but in rare cases they are diffuse, band-like myofibroblastic proliferations that encase the testis. We report here on a case of fibrous pseudotumor of the tunica vaginalis in 76 year-old patient. (Korean J Urol 2006;47:1130-1132)

The effect of indomethacin on the matrix metalloproteinases in canine permanent tooth eruption / 대한치과교정학회지

Tooth eruption requires remodeling of surrounding tissues. This study was aimed to investigate the effect of indomethacin on the dental follicle and paradental tissues during tooth eruption by observing the distribution and expression of MMP by the immunohistochemical method. Ten mongrel dogs of ten to twelve weeks old were divided into 5 groups; four experimental groups administered indomethacin 2 mg/Kg/day and 8 mg/Kg/day orally 2 times a day for 14 days and 7 days respectively, and the control group was administered a placebo. Permanent teeth before eruption and their surrounding tissues were selected and excised. H and E staining and immunohistochemical stainings of MMP-3 and -9 were performed and examined under the light microscope. Osteoclasts, osteoblasts, periodontal ligament cells, ameloblasts and odontoblasts of the control group all expressed MMP-3 and -9. In the experimental group, osteoclasts, osteoblasts and periodontal ligament cells showed reduced expression of MMP-3 and -9. Magnitude of MMP reduction in the experimental group showed a time and dose of indomethacin administration dependent manner. These results show that indomethacin inhibited MMP-3 and -9 expression in the dental follicle and surrounding tissues and suggest that when indomethacin is administered for long periods, tooth eruption could be delayed.

The objective and quantitative analysis of malocclusion: Part 2. Influence of malocclusion compenents to treatment difficulty / 대한치과교정학회지

As one of the variations in growth and development of the craniofacial complex, malocclusion shows lack of concordance in the recognition and severity of malocclusion for dentists as well as the acceptance and need of orthodontic treatment for the patient. The purposes of this study were 1) to examine the relationships between objective malocclusion severity and subjective treatment difficulty, 2) to evaluate the effect of malocclusion components to the subjective perceived difficulty of treatment, 3) to establish the weighted values of malocclusion components to reflect the treatment difficulty. 100 pairs of dental casts with the general characteristics of malocclusion, were selected from the orthodontic departments of Kyunghee University and Samsung Medical Center. The severity of malocclusion was evaluated by the author with the PAR index. The perceived treatment difficulty and the estimated treatment duration on these dental models were evaluated by 8 experienced orthodontists. The relationships between the objective malocclusion severity and the subjective treatment difficulty were statistically evaluated, and the weighted values of malocclusion components to reflect treatment difficulty were statistically formulated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty. The malocclusion components which significantly affected the treatment difficulty and their weighted values in parentheses were as follows; upper anterior alignment (1), overbite (2), buccal occlusion (3), midline (4), and overjet (5). This study provides the fundamental principle to evaluate the objective malocclusion severity which is reflected by the subjective treatment difficulty of Korean orthodontists.

The objective and quantitative analysis of malocclusion: Part 1. Objective malocclusion severity and subjective treatment difficulty / 대한치과교정학회지

The evaluation of malocclusion has to be done quantitatively and qualitatively. This will be lead toward an analysis of malocclusion severity as well as treatment difficulty. The method of proper evaluation of malocclusion severity and treatment difficulty is necessary to assess treatment effect and efficiency for the orthodontists and to establish fundamentals for planning and executing the health-related policies in private and public institutions. The purposes of this study as the first part of the objective and quantitative analysis of malocclusion were 1) to measure treatment difficulty based on the opinions of several orthodontists, and 2) to investigate the relationships between objective malocclusion severity and subjective treatment difficulty. 100 pairs of dental casts that had various types and severity of malocclusion were selected from the orthodontic departments of Kyunghee University and Samsung Medical Center. The objective malocclusion severity was measured with the PAR (Peer Assessment Rating) index and the subjective treatment difficulty was evaluated by 8 experienced orthodontists. The relationships between objective malocclusion severity and subjective treatment difficulty were statistically evaluated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty, especially in the measurements of the upper anterior alignment, the buccal occlusion, the overjet, the overbite and the midline discrepancy in the malocclusion components. The results of this study can provide the background knowledge to develop a new occlusal index, which contains both the malocclusion severity and treatment difficulty for Korean orthodontists.

Effects of Indomethacin on the physiologic root resorption of deciduous teeth in dogs / 대한치과교정학회지

This study was aimed to investigate the effects of indomethacin on physiologic root resorption and to examine the dental pulp and tissue changes around the resorbing teeth. 13-14 week old six mongrel dogs were divided into 3 groups; two experimental groups administered indomethacin 2 mg/kg/day and 8 mg/kg/day orally two times a day for 14 days respectively, and control group administered a placebo. The deciduous incisors showing root resorption were selected, fixed for 24 hrs in 10% formalin solution, demineralized in 10% EDTA solution, invested in paraffin and sectioned in 5 micrometer thick sections. The preparations were stained with H and E staining and Masson's trichrome staining and examined under the light microscope. Observation revealed that deciduous root resorbing tissue resembles inflammatory tissue and accompanies bone remodelling. The dental pulp was normal except the area near root resorption, well organized columnar odontoblasts layer under the predentin, and the odontoblasts near root resorption were cuboidal or flat cells in the disrupted layer under the predentin. Indomethacin administered group showed a partial decrease in the number of odontoclasts and nucleus. But there was no sign of pulp change by indomethacin. These results suggest that indomethacin inhibits recruitment of odontoclasts partially and that of osteoclasts more, and so when it is administered for long periods, deciduous root resorption can be delayed and eruption of the successor can be delayed for a short period.

Effect of vitamin C deficiency on the rate of orthodontic tooth movement and alveolar bone remodeling / 대한치과교정학회지

This study was undertaken to investigate the effect of vitamin C deficiency on the orthodontic tooth movement and bony remodeling processes. Thirty six male guinea pigs were divided on the basis of the given amount of vitamin C (normal group: 5 mg/day, deficient group: 0.2 mg/day) and 75 gm of force was applied to the maxillary incisors. Experimental animals were sacrificed at day 0, day 1, day 3, day 5, day 7 and day 14 after force application and the amount of tooth movement was measured and tissues were studied histologically. The results showed that the amount of collagen fiber in the periodontal ligament and alveolar bone of the deficient group was less than that of the normal group. In the stretched side, the osteoblastic activity and alveolar bone formation of the normal group increased in a time dependent manner during experimental periods, but the deficient group showed less activity and formation. The amount of tooth movement in the deficiency group was more than in the normal group at day 0, day 1, day 3, day 5, and day 7. According to the above results, a deficiency of vitamin C resulted in a defect of collagen synthesis of the periodontium and inhibition of bone formation and stimulation of bone resorption with rapid tooth movement in early periods of force application.

The effects of indomethacin on distribution and expression of COX-2 and IGF-I in the mandibular condyle of growing dogs / 대한치과교정학회지

This study aimed to investigate the effects of indomethacin on distribution and expression of COX-2 and IGF-I in the mandibular condyle of growing dogs and to examine the number of chondroclasts around the mineralization zone. Indomethacin inhibits prostaglandin E2 production in the tissue by inhibiting synthesis of cyclooxygenase 2. Prostaglandin E2 stimulates insulin-like growth factor synthesis. Insulin-like growth factor stimulates growth of mandibular condylar cartilage. Eight mongrel dogs, aged 13 - 14 weeks, were divided into 4 groups. Group 1 and group 2 were administered indomethacin 2 mg/Kg/day orally two times a day for 7 days and 14 days respectively. Group 3 were administered indomethacin 8 mg/Kg/day orally 2 times a day for 14 days, and the control group were administered a placebo. The mandibular condyle heads were sectioned in 5 micrometer thickness. The specimens were stained with H-E staining, COX-2 immunohistochemical staining and IGF-I immunohistochemical staining and examined under light microscope. After TRAP staining, the number of chondroclasts were calculated. The observed results were as follows: Indomethacin inhibited expression and distribution of COX-2 and IGF-I on the proliferative zone of condylar cartilage. Indomethacin decreased the number of chondroclastes on the mineralization zone by a time-dependent manner (p < 0.05). Indomethacin inhibited expression and distribution of IGF-I by a dose- and time-dependent manner. These results show that indomethacin inhibited expression and distribution of COX-2 and IGF-I on the proliferative zone of condylar cartilage and decreased the number of chondroclasts and suggests that when indomethacin is administered for a long time, condyle growth could be delayed.

A Case of Huge Condyloma Acuminatum During Pregnancy / 대한산부인과학회잡지

Condyloma acuminatum is a manifestation of human papillomavirus (HPV) infection. The genital warts tend to occur in areas most directly affected by coitus, namely external genitalia, perineum and perianal areas. The warts are highly contagious; more than 75% of sexual partners develop when exposed. The warts frequently increase in number and size during pregnancy, sometimes filling the vagina or covering the perineum, making it difficult to perform vaginal delivery or episiotomy. Probably small number of infants and children born of women with genital warts will become infected and develop laryngeal papillomatosis. We have experienced one case of huge condyloma acuminatum during pregnancy and presented with a brief review of literature.