No abstract available.
Parturition*

OBJECTIVES: To evaluate the intra- and post-operative risks of myomectomies during cesarean section. MATERIALS AND METHODS: This study is a retrospective review of myomectomy during cesarean section performed from January 1, 1998, to December 31, 2000, at the Department of Obstetrics and Gynecology, School of Medicine, Pochon CHA University, Seoul, Korea. The subjects were 88 pregnant women diagnosed with leiomyoma. The outcome measures were hemoglobin drop, blood loss, need for blood transfusion, intra- and post- operative complications. RESULTS: The mean age of the patients was 32.5 +/- 4.4 and nulliparas(84.1%) were prevalent. The mean gestational age was 38 +/- 1.19 wks. Single myoma was found in 67% of cases, 50% located in the uterine corpus and 50% of cases were subserosal. type. The mean blood loss was 731.5 +/- 238ml range 400-2500. Twelve patients(13.6%) had blood transfusion. There was one case of re-operation because of post-operative bleeding. But there was no case of severe hemorrhage necessitating hystrectomy. CONCLUSION: Myomectomy during cesarean section is not such a hazardous procedure as many now believe.
Blood Transfusion ; Cesarean Section* ; Female ; Gestational Age ; Gynecology ; Hemorrhage ; Humans ; Korea ; Leiomyoma ; Methods ; Myoma ; Obstetrics ; Outcome Assessment (Health Care) ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Seoul

5% of ovarian neoplasms consist of granulosa cell tumors. 10% of cases coexist with pregnancy2. We report on delivery of normal infant in young woman with granulosa cell tumor diagnosed and treated during pregnancy. At laparotomy a large right ovarian granulosa cell tumor was found and right salpingo- oophorectomy was performed. A normal infant was delivered by cesarean section at full term.
Cesarean Section ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Infant ; Laparotomy ; Ovarian Neoplasms ; Ovariectomy ; Ovary* ; Pregnancy*

No abstract available.
Alopecia* ; Minoxidil*

To report cases of metastasectomy for metastatic gynecologic malignancies, we reviewed the medical records of all patients who have undergone metastasectomy for metastatic gynecologic malignancies in Center for Uterine Cancer from June 2001 to October 2002. Six patients were identified with median age of 55 years (range 52-66 years). The metastatic sites and primary sites were as follows: 3 liver metastasis from ovary; 1 abdominal wall metastasis from uterus (endometrial cancer), 1 brain metastasis from ovary, 1 lung metastasis from uterus (sarcoma). The median disease free interval was 48 months (range 10 months-13 years). There was no perioperative mortality. Postoperative morbidity was tolerable with 1 case of bile leakage. In three patients with hepatectomy, one patient was dead of disease after 15 months, one patient is alive with disease at 20 months of follow up, one patient have no evidence of recurrence at 7 months follow up. The patient with brain metastasis was dead due to lung metastsis after 9 months later postoperatively. Remaining two patients with abdominal wall and lung metastasis have no evidence of tumor recurrence at 4, 7 months follow up respectively. Metastasectomy for metastatic gynecologic malignancies can be performed safely and may help prolong survival in carefully selected patients.
Abdominal Wall ; Bile ; Brain ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver ; Lung ; Medical Records ; Metastasectomy ; Mortality ; Neoplasm Metastasis ; Ovary ; Recurrence ; Uterine Neoplasms ; Uterus

OBJECTIVE: The object of this study was to assess the accuracy of dipyridamole stress intravenous (IV) myocardial contrast echocardiography (MCE) using pulse inversion harmonic imaging and PESDA in the detection of perfusion defect in the patients with coronary artery disease in comparison with dipyridamole stress Tc-99m sestamibi SPECT. METHODS: Total 46 patients (29 males, mean age 64 years old) were consecutively enrolled. Patients with prior myocardial infarction were excluded. MCE and Tc-99m sestamibi SPECT were performed at the same day during rest and after 0.56 or 0.84mg/Kg dipyridamole infusion. Continuous IV infusion of PESDA (2-5 mL/min) was administered while obtaining triggered (1:1) end-systolic apical 2, 4 chamber and long axis views. Tc-99m sestamibi was injected 3 minutes after dipyridamole. Tc-99m sestamibi SPECT images were obtained one hour later. Coronary angiography was followed within two days in all patients. Tc-99m sestamibi SPECT images were matched to the sixteen segments of left ventricle according to American Society of Echocardiography for segmental comparison. Both images were analyzed visually. Results Using coronary angiography as the standard, MCE showed overall sensitivity of 70.7%, specificity of 95.8%, positive predictive value (PPV) of 87.8% and negative predictive value (NPV) of 88.5% in the detection of coronary atherosclerosis (70% stenosis). Tc-99m sestamibi SPECT showed sensitivity of 75.6%, specificity of 98.9%, PPV of 96.8% and NPV of 90.6%. The overall concordance rate between MCE and Tc-99m sestamibi SPECT for the detection of perfusion defects was 86.9% (Cohen's kappa value 0.63) according to the coronary territory and 86.8% (Cohen's kappa value 0.55) according to segmental analysis. CONCLUSION: Dipyridamole stress IV MCE using pulse inversion harmonic imaging and PESDA is feasible and comparable to Tc-99m sestamibi SPECT in identifying significant coronary stenosis and inducible myocardial perfusion defects in the patients with coronary artery disease. MCE using pulse inversion harmonic imaging seems to be a promising modality for assessing myocardial perfusion in the patients with suspected coronary artery disease.
Axis, Cervical Vertebra ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Dipyridamole ; Echocardiography* ; Heart Ventricles ; Humans* ; Male ; Myocardial Infarction ; Perfusion* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

It is not yet understood how the enhanced expression of pancreatic adenocarcinoma up-regulated factor (PAUF; a novel oncogene identified in our recent studies), contributes to the oncogenesis of pancreatic cells. We herein report that PAUF up-regulates the expression and transcriptional activity of beta-catenin while the suppression of PAUF by shRNA down-regulates beta-catenin. The induction of beta-catenin by PAUF is mediated by the activities of Akt and GSK-3beta, but inhibition of downstream ERK does not reduce beta-catenin expression. To test whether PAUF emulates either the Wnt3a-mediated or the protein kinase A-mediated signaling pathway for the stabilization of beta-catenin, we examined the phosphorylation status of beta-catenin in the presence of PAUF compared with that of beta-catenin during treatment with Wnt3a or dibutyryl cAMP, a cell permeable cyclic AMP analogue. PAUF expression induces phosphorylation at Ser-33/37/Thr-41 and Ser-675 of beta-catenin but no phosphorylation at Ser-45, indicating that a unique phosphorylation pattern of beta-catenin is caused by PAUF. Finally, the expression of PAUF up-regulates both cyclin-D1 and c-Jun, target genes of beta-catenin, leading to a rapid proliferation of pancreatic cells; conversely decreased PAUF expression (by shRNA) results in the reduced proliferation of pancreatic cells. Treatment with hexachlorophene (an inhibitor of beta-catenin) reduces the proliferation of pancreatic cells despite the presence of PAUF. Taken together, we propose that PAUF can up-regulate and stabilize beta-catenin via a novel pattern of phosphorylation, thereby contributing to the rapid proliferation of pancreatic cancer cells.
*Adenocarcinoma/metabolism/pathology ; Cell Line, Tumor ; Cell Proliferation ; Cyclin D1/metabolism ; Gene Expression Regulation, Neoplastic ; Glycogen Synthase Kinase 3/metabolism ; HEK293 Cells ; Humans ; Lectins/genetics/*metabolism ; *Pancreatic Neoplasms/metabolism/pathology ; Phosphorylation ; Proto-Oncogene Proteins c-akt/metabolism ; Proto-Oncogene Proteins c-jun/metabolism ; Signal Transduction ; *Up-Regulation ; beta Catenin/genetics/*metabolism