The Increasing Frequency of Cervical Cancer in Korean Women under 35 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The goal of this study was to determine the clinical and epidemiological trends of cervical cancer in young Korean women. Social behavior including sexual habits has changed in Korean women, with sexual activity commencing at a younger age. These changes are likely to influence certain risk factors of cervical cancer, resulting in changing trends in the occurrence of the disease. MATERIALS AND METHODS: The incidence of cervical cancer in women less than 35 years-old between January 1990 and December 2006 was analyzed, and available medical records from January 1996 to December 2006 were reviewed. The clinical, pathological and epidemiologic characteristics and changing trends among these young patients were analyzed. RESULTS: Over the last two decades, the incidence of young (< 35 years) cervical cancer patients increased, more patients had an aggressive form of the disease, and there was a higher rate of women with more advanced education. Human papillomavirus (HPV) infection was detected in 94.0% of the women (63/67) tested. HPV 16 (82.5%) and HPV 18 (12.7%) were the two most common viral infections detected throughout the study period. CONCLUSIONS: The changing trends and risk factors identified suggest a need for more active education of young women about cervical cancer prevention strategies. In addition, young women are strongly recommended to undergo a regular screening test and HPV vaccination.

A case of mucinous borderline tumour showing persistently elevated tumor markers progressed into invasive mucinous cystadenocarcinoma / 부인종양

Mucinous tumors account for 10-15% of all epithelial of ovarian tumors, and 40% of them are borderline. Not many factors are known about progression into mucinous carcinoma of borderline ovarian tumors. The incidence of progression into invasive carcinoma is reported about 2.4% for borderline serous tumous, and 1.6% for borderline mucinous ovarian tumors. Mucinous tumors often exhibit a morphologic continuum of beningn, borderline, and invasive, so a pathologist should pay attention when examine the pathologic specimen not to miss carcinoma. This is the case of 54 female patients who developed invasive mucinous ovarian carcinoma 6 months after surgical treatment of borderline mucinous ovarian tumour.

Association of LRP5 gene polymorphisms with bone mineral density and bone responsiveness to hormone therapy in postmenopausal Korean women / 대한산부인과학회지

OBJECTIVE: To evaluate the association of LRP5 gene polymorphisms with bone mineral density (BMD) and bone responsiveness to hormone therapy (HT) in postmenopausal women. DESIGN AND METHODS: The LRP5 gene polymorphisms were analyzed by restriction fragment length polymorphism (RFLP) in 229 postmenopausal women receiving HT for 1 year. The BMD before HT was check using dual-energy x-ray absorptiometer (DEXA) at lumar spine, femur neck, Ward's triangle, and greater trochanter of femur, and women in the study were classificed into 3 group, normal, osteopenia and osteroporosis according to their BMD. RESULTS: The frequency of genotype C/C of C1677A was significanty high in osteoporosis group, and that of C/A was much low in osteoporosis group. The frequency of genotype T/C of T2268C was high in osteoporosis group, while that of C/C was low in the same group. There was no significant relationship between LRP5 polymorphisms and BMD before HT. In patients whose genotype was A/A of C3405G, C/C of T2268C, or C/C of T4037C had meaningful responsiveness to HT at the lumbar spine, regardless of their initial BMD. The Genotype C/A of C1677A also had great responsiveness to HT at the greater trochanter of femur in both osteopenia and osteoporis group. CONCLUSION: The LRP5 gene polymorphisms were not associated with the BMD before HT, but there were some reponsiveness to HT at specific site according to genotypes of the gene.

Prognostic outcome of patients with clinical stage I-II endometrial cancer according to bilateral salpino-oophorectomy / 대한산부인과학회지

OBJECTIVE: The aim of this study is to verify the clinical outcome of staging surgery with and (or) without bilateral salpingo-oophorectomy (BSO) in clinical stage I-II endometrial cancer patients. METHODS: We reviewed the medical records of 178 surgically treated patients in clinical stage I-II endometrial cancer between January 1994 and December 2004. Overall survival (OS) and disease free survival (DFS) were analyzed by using data gathered from the National Statistics Office. The clinical outcome was compared between patients who underwent hysterectomy with and without BSO. RESULTS: One hundred sixty patients were in clinical stage I, and 18 patients were in clinical stage II. Most of the cases showed endometrioid (93.8%) in histology and G1 (56.1%) in differentiation. BSO was performed in 142 patients. Surgico-pathological features of two group are not different but the group without BSO were younger (40.7 vs. 55.8 years old) and less myometrial invasion than the group with BSO. After mean 39.27 months follow up, we found no difference in OS and DFS between the two groups with BSO and without BSO. No factors except stage were significantly related with OS and DFS by multivariate Cox regression analysis. The rate of pelvic and paraaortic lymph node metastasis was not different between two groups. CONCLUSION: The retrospective data in the study reveals that staging surgery with and without BSO does not affect OS and DFS in clinical stage I-II endometrial cancer patients. In limited cases, such as young women, omitting BSO can be considered carefully.

Fetal Macrosomia (> or = 4,500 g): A Clinical Study of 271 Cases according to the Mode of Delivery / 대한주산의학회잡지

OBJECTIVE: To determine obstetric outcome in infants > or =4,500 g according to delivery mode. METHODS: Records of 271 mothers and infants weighing > or =4,500 g over a 11-year period (1993~2003) were retrospectively reviewed. Maternal and perinatal outcomes were compared in relation to delivery mode. RESULTS: The frequency of macrosomia ranged 0.38% in 4,500 g or more. Vaginal delivery was achievable in 78/271 (28.8%) of women allowed to labor, of which 71.2% were operative. In macrosomia frequency correlations to parity showed 33.9% (92 cases) in primiparous women, 66.9% (179 cases) in multiparous women. According to the type of delivery, cesarean section has proven to be the most popular mode. The cesarean section group had a higher incidence of maternal BMI (> 25 kg/m2). The frequency of diabetes, hypertension, low Apgar score at 5 and 10 minutes was similar in both groups. CONCLUSION: It would be appropriate to have definite diagnostic schemes and adequate choice of delivery method for macrosomia. Maternal height, weight, BMI (body mass index) may associated with fetal body weight and delivery mode.

A clinical study on macrosomia / 대한산부인과학회지

OBJECTIVE: Macrosomia is one of the important problems in obstetrics and perinatology. This study was to investigate the changing trend in incidence, area distribution, and other relavant factors of macrosomia. METHODS: We studied 2,206 cases of large babies weighing 4,000 g or more among 72,084 deliveries at Catholic Medical College Hospital from Jan. 1, 1993 to Dec. 31, 2003. The cases were divided into two group, one group from 1993 to 1998 (group I), the other group from 1998 to 2003 (group II). RESULTS: The incidence of large babies weighing 4,000 g or more was 3.06%. The incidence of macrosomia in group I was 3.02%, and that from group II was 3.14% (P=0.149). The incidence of macrosomia throughout the country was 2.5-3.3%. The average body weight of macrosomia was raised by 30 g from 4,218 +/- 224 g in group I to 4,248 +/- 246 g. in group II (P=0.003). The average of maternal body weight was raised by 246 g from 73.12 +/- 9.08 kg in group I to 75.56 +/- 9.64 kg in group II (P<0.001). According to gestational age, the percentage of macrosomia less than 38 weeks was 5.0%, that during 38 weeks and 40 weeks was 39.4%, that during 40 weeks and 42 weeks was 53.4%, more than 42 weeks was 2.2% in group I, and that in group II was 6.2%, 46.1%, 44.1%, and 3.6%, respectively. Male fetuses were 927 cases (64.69%), and female fetuses were 506 cases (35.31) in group I, and those in group II were 520 cases (67.27%), and 253 cases (32.73%), respectively. CONCLUSION: There is no change in the incidence of macrosomia past 11 years. There is no significant difference in the incidence of macrosomia throughout the country. Maternal body weight may associated with fetal body weight. Gestational weeks in group II were earlier, that in group II. Sex ratio was similar in the two groups, and male was predominant.

Anti-tumor Effects of Epigallocatechin-3-gallate Extracted from Green Tea on Ovarian Cancer Cell Lines / 대한산부인과학회잡지

OBJECTIVE: A constituent of green tea, (-)-epigallocatechin-3-gallate (EGCG), has been known to possess anti-diabetes, anti-hypertension and anti-cancer properties. In this study, we investigated the anticancer effects of EGCG on human ovarian cancer cell lines. The growth inhibitory mechanism(s) and regulation of cell cycle-related proteins by EGCG were also evaluated. METHODS: To carry out cell counting assay to observe the anti-proliferative effects, we treated 25, 50, and 100 uM EGCG to both ovarian cancer cell lines SKOV-3 and OVCAR-3, respectively. Also, we treated EGCG to PA-1 cells with 6.25, 12.5 and 25 uM, respectively. Six days later, we examined the characteristics of apoptosis and changes in cell cycle regulation by cell counting assay, Annexin V-FITC staining and DNA fragmentation assay, and FACS analysis. In addition, protein and gene expression patterns in SKOV-3 cell were investigated by using cell cycle cDNA chip, RT-PCR, and Western blot analyses. RESULTS: Inhibition of cell growth by cell counts showed in SKOV-3 cells with 48.8%, 82.5%, 99.2% after six days of the treatment with 25, 50, 100 uM of EGCG, respectively. OVCAR-3 cells showed 53.9%, 84.8%, and 97.7% growth inhibition patterns. And PA-1 cells showed 17.1%, 48.4%, and 74.1%, as compared to control. When SKOV-3 cells were tested for EGCG-induced apoptosis, apoptotic cells were observed with 8.6, 11.4, and 23.3-fold at 25, 50, 100 uM EGCG, respectively. And PA-1 cells showed 1.7, 2.4, and 4.2-fold, as compared to control. In contrast, OVCAR-3 did not show EGCG-induced apoptosis. When SKOV-3 cells were tested for their gene expression using cell cycle cDNA chip after treatment with 24.5 uM of EGCG, up-regulations of p21, Bax and cyclin G were shown, while down-regulations of CDK6, E2F-4, and cyclin A were shown. In Western blot assay, up-regulations of Bax and p21 proteins were shown, while down- regulations of cyclin D1, Bcl-XL, Rb, CDK2, E2F-1, E2F-4, PCNA proteins were shown. CONCLUSION: These data support that EGCG can inhibit ovarian cancer cell growth through induction of apoptosis and cell cycle arrest as well as regulation of gene and protein expressions. Thus, EGCG likely provides an additional option for a new and potential drug approach for ovarian cancer.

A case of MALT lymphoma of the thyroid accompanying Hashimoto's thyroiditis / 대한내과학회지

Primary thyroid lymphomas constitute of up to 5% of all thyroid malignancies. Recently, mucosa-associated lymphoid tissue (MALT) lymphoma are relatively recognized as a B cell subset of non-Hodgkin's lymphoma. MALT-lymphomas are thought to develop from acquired lymphocytic tissue during the course of a chronic inflammatory or autoimmune process. In the thyroid , which is normally devoid of lymphocytic tissue, chronic autoimmune thyroiditis (Hashimoto's disease) has been associated with an increased risk of lymphoma, including MALT type. The clinical presentations include the enlarging of the neck mass, dysphagia, hoarsenes and choking or cold thyroid nodule. We report a case of MALToma of the thyroid accompanied by Hashimoto's thyroiditis with a review of the literature.

Effect of vitamin C on plasma total antioxidant status(TAS) in patients with paraquat intoxication / 대한내과학회지

BACKGROUND: This study was undertaken to evaluate the effect of plasma concentration of vitamin C is on the plasma total antioxidant status(TAS) in patients with paraquat intoxication. METHODS: As a preliminary research for this study, we measured plasma vitamin C levels, uric acid, TAS, and bilirubin from 100 healthy Koreans aged between 25-55 years. Various concentrations of vitamin C were constructed in vitro with normal pooled plasma between 1mg/dl and 100 mg/dL and TAS was measured. Both vitamin C concentrations and TAS were measured from the blood samples, taken at 0.5, 1, 2, 3, 5, 7, 9 hours after a bolus injection of vitamin C(50 mg/kg) from 7 volunteers who had been recruited from medical students at our hospital. Various amounts of vitamin C were given to 10 patients with paraquat intoxication for 5 consecutive days in the morning : first day ; 100 mg single dose, second day; 500 mg single dose, third day ; 1,000 mg single dose, fourth day : 3,000 mg single dose, and fifth day ; 3,000 mg three times every 8 hours. RESULTS: The mean value of TAS and vitamin C measured in 100 healthy Korean adults was 2.22 +/-0.16 mmol/L and 0.48+/-0.10 mg/dL. Age and sex do not influence these levels(p> 0.05, data are not presented). A direct correlation was observed between TAS and vitamin C concentrations of 1 mg/dL and 100 mg/dL both in vivo and vitro. As the vitamin C concentration was increased gradually 5 consecutive days, the TAS values increased in the same way as follows : first day(vitamin C 100 mg) 2.26+/-0.98 mmol/L, second day(vitamin C 500 mg) 2.76+/-0.78 mmol/L, third day(vitamin C 1.000 mg) 2.81+/-0.68 mmol/L, fourth day(vitamin C 3.000 mg) 3.18 mmol/L. On the fifth day when 3.000 mg of vitamin C was given by bolus intravenous injection 3 times(every 8 hours for a day), the TAS values measured one hour after the injection was 3.58+/-0.37 mmol/L. CONCLUSION: When vitamin C is used as a free radical scavenger, the loading dose and maintenance dose should be around 2278 mg intravenous bolus and 146 mg/hour. High doses of vitamin C are effective and safe for patients with acute paraquat intoxication.

Diagnostic Usefulness of Eedoscopic Ultrasongraphy for Extraluminal Compressions Mimicking Submucosal Tumors / 대한소화기내시경학회지

BACKGROUND/AIMS: When a submucosal lesion is discovered through an upper gastrointestinal endoscopy, it may be often difficult to differentiate an extra-gastric compression from a true submucosa1 tumor (SMT). An endoscopic ultrasonography (EUS) provides information about the relationship between a lesion and the gastric or esophageal wall. Furthermore, EUS helps in identifying the compression caused by surrounding organs. The diagnostic usefulness of EUS for extralumina1 compressed lesion was assessed. METHODS: The 261 patients who received an endoscopic diagnosis of submucosal tumors had EUS examinations performed. The results of EUS to additional diagnostic procedures such as UGI, USG, CT scan or tissue biopsy were then compared. RESULTS: Of 261 patients who received endoseopic diagnosis as SMT, extraluminal compression existed in 46 (17.6%) cases and true intramural lesion were found in 215 (82.4%) cases on EUS. The causes of extraluminal compression are lymph nodes (2 case.), the gallbladder (12 cases), the pancreas (9 cases), the spleen (6 cases), a pancreatic pseudocyst (5 cases), pancreatic cancer (2 cases), a hepatic cyst (2 cases), the left lobe of the liver (4 cases), hepatoma (1 case), a mesenteric tumor (2 caws) and a splenic vein (1 case). CONCLUSIONS: EUS is considered to be a useful diagnostic method not only for differential diagnosis of extraluminal compression from true SWT, but also for clarifying the cause of extraluminal compressed lesions.

Endosonographic Findings of Submucosal Tumor-like Gastric Lesion Caused by Fibrotic Ulcer Healing / 대한소화기내시경학회지

It is known that multiple ulcers of the gastric antrum are often accompanied by marked submucosal fibrosis during the healing process, and that this may result in a deformity of the gastric wall. Thus, benign antral ulcers may be misinterpreted as intramural tumors, or even malignant ulcers when the surrounding edema is pronounced and sharply defined. It is possible for an endoscopic ultrasonography (EUS) to detect which layer has a submucosal tumor (SMT) in the five-layer structures of the digestive tract wall. In the diagnosis of SMT of the upper digestive tract, EUS allows for the visualization of the structures underlying the gastrointestinal wall in a noninvasive manner and has a great advantage over conventional modalities such as endoscopy and X-ray examination. The EUS findings of 2 cases of submucosal tumor-like gastric lesion caused by fibrotic ulcer healing are herein reported with a brief review of relevant literature.

The Significance of Gastroesophageal Reflux Disease (GERD) Symptoms in Patients with Reflux Esophagitis / 대한소화관운동학회지

BACKGROUND/AIMS: The relationship between the symptoms and severity of GERD may be difficult to prove. The intensity and frequency of reflux induced symptoms are poor predictors of the presence or severity of an endoscopic mucosal break. The aim of this study was to determine which factors can be predicted by the presence of GERD symptoms among esophageal sensitivity to acid, abnormal acid reflux, and severity of esophagitis in pateints with reflux esophagitis. METHODS: Fourty-four patients who were diagnosed with reflux esophagitis by an endoscopy at a tertiary medical facility, were given a validated questionnaire, and underwent an acid perfusion test, 24 hr ambulatory esophageal pH monitoring, and esophageal manometry. These patients were divided into a symptomatic group and asymptomatic group according to the questionaire. Comparisons between the two groups for each factor were analyzed by Chi-square. RESULT: Of 44 patients, 26 had symptoms and 18 did not. The positive and equivocal rates of the acid perfusion test were not different between the symptomatic and asymptomatic groups (47% vs. 39%). The abnormal reflux rate (DeMeester score > 14.72) from pH monitoring was significantly higher in the symptomatic group than in the asymptomatic group (65% vs. 28%, p < 0.05). The severity of esophagitis, presence of a hiatal hernia, and abnormal esophageal manometric findings were not different between the two groups. CONCLUSION: It would be impossible to predict esophageal sensitivity to acid, severity of the esophagitis grade, and the presence of hiatal hernia with GERD symptoms, but it could be possible to predict abnormal gastroesophageal reflux.

Prevalence of hepatitis B surface antigen(HBsAg), anti-hepatitis C virus(HCV) antibody-treponemal antibody and anti-HIV-1 antibody in donor's bloods

No abstract available.