No abstract available.
Endometriosis* ; Female ; Leiomyoma* ; Ovary*

Hereditary predisposition to breast and ovarian cancer and responsible for autosomal-dominant transmission, most commonly due to germline mutations in BRCA1 and BRCA2 has been recognized for many years. Hereditary breast cancer is characterized by early age at onset, bilaterality, vertical transmission through both maternal and paternal lines, and familial association with tumors of other organs, particularly the ovary and prostate gland. Most of the BRCA1 and BRCA2 mutations are predicted to produce a truncated protein product, supporting the hypothesis that they are tumor suppressor genes. Progress in determining the function of BRCA1 and BRCA2 suggests that they are involved in two fundamental cellular processes, DNA damage repair and transcriptional regulation. Several series have examined the prevalence of germline BRCA mutations in population or hospital based samples of breast cancer patients mainly European ancestry and studies have demonstrated BRCA1/2 mutation between 5% and 10% with early-onset breast cancer. The assessments of familial cancer risk are extremely varied, including families from different ethnic backgrounds with greater or less numbers of affective relatives at varying ages. And estimates of penetrance for BRCA1 and BRCA2 mutations range from 36% to 85% for breast cancer, and 16% to 60% for ovarian cancer. For molecular correlations, BRCA1 cancers were shown to be more often estrogen receptor negative, more high grade tumors and more frequent mutations in p53 than nonhereditary cancers. The phenotype for BRCA2-related tumor sappears to be more heterogeneous. The prognosis of BRCA related tumor is elusive, despite of a significantly increased risk of contralateral breast cancer. Surveillance recommendations for women with germline BRCA mutations are necessary and women are encouraged to learn and practice breast self-examination beginning at age 18 and to begin annual mammogram screening at age 25. A number of women with BRCA mutations may consider undergoing surgical procedures (mastectomy and salpingooophorectomy) in attempt to reduce their risk. Nonsurgical options (tamoxifen medication) for the prevention of hereditary breast cancer are currently limited. The choice of whether to undergo genetic testing is difficult one and should be made only after extensive consultation with a professional who is well versed in the counselling and management of families at hereditary risk. And psychological consequences of testing and the potential impact on family dynamics are important considerations that must be individually addressed. Most of above mentioned data are based on studies of European ancestry. To apply these results to Korean patients with breast cancer, we have to collect a lot of data specific to Korean patients. Therefore, it is needed to study many aspects of Korean breast cancer including age specific mutation prevalence, penetrance, molecular correlation, pathology, prognosis, surveillance and prevention options for women with BRCA mutations.
Breast Neoplasms* ; Breast Self-Examination ; Breast* ; DNA Damage ; Estrogens ; Female ; Genes, BRCA1* ; Genes, Tumor Suppressor ; Genetic Testing ; Germ-Line Mutation ; Humans ; Mass Screening ; Midazolam ; Ovarian Neoplasms ; Ovary ; Pathology ; Penetrance ; Phenotype ; Prevalence ; Prognosis ; Prostate

PURPOSE: To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radiotherapy, a retrospective analysis was undertaken. MATERIALS AND METHODS: I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radiotherapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dose rate intracavitary radiation. RESULTS: Overall 5 year survival rate and relapse free survival rate were 75.4%, 73.5%, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node metastasis, tumor size and vaginal resection margin involvement were significant prognostic factors.Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only 56% and nine of twenty two patients recurred. CONCLUSION: Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate, adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and /or othermethods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen.
Cervix Uteri ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Node Excision* ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Metastasis ; Particle Accelerators ; Radiotherapy ; Radiotherapy, Adjuvant* ; Recurrence ; Retrospective Studies ; Risk Factors ; Survival Rate ; Uterine Cervical Neoplasms*

Breast cancer is the most prevalent cancer in Asian females, and the incidence of breast cancer has been increasing in Asia. Because Asian patients develop breast cancer at a younger age than their Caucasian counterparts, the contributions of BRCA1 and BRCA2 (BRCA1/2) mutations in Asians are expected to be different than in Caucasians. The prevalence of BRCA1/2 mutations in the Asian population varies among countries and studies. Most Asian studies have reported more frequent mutations in BRCA2 than in BRCA1, with the exception of studies from India and Pakistan. In addition, the contribution of large genomic rearrangements of BRCA1/2 genes is relatively small in Asian populations in comparison to other ethnic populations. Various statistical models for the prediction of BRCA1/2 mutations have underestimated the risk of having these genetic mutations in Asians, especially in predicting BRCA2 gene mutation. Until recently, BRCA1/2 mutation analyses in Asia were mostly conducted by independent single institutions with different patient selection criteria and using various genotyping methods. However, a couple of Asian groups have initiated nationwide studies collecting BRCA1/2 mutational data. These national collaborative studies will help a comprehensive understanding of the prevalence of BRCA1/2 mutations in the Asian population.
Asia ; Asian Continental Ancestry Group* ; Breast Neoplasms* ; Breast* ; Female ; Genes, BRCA2 ; Humans ; Incidence ; India ; Methods ; Models, Statistical ; Pakistan ; Patient Selection ; Prevalence

It has been well known that ischemia reperfusion injury to skeletal muscle following an acute arterial occlusion causes significant morbidity and mortality. There are many causes of reperfusion injury, but the oxygen free radicals have a significant role. During ischemia the ATP is catalyzed to hypoxanthine anaerobically and hypoxanthine dehydrogenase is converted to xanthine oxidase under the presence of O2 resulting in the production of cytotoxic oxygen free radical, which are harmful to muscle. The reactivity of superoxide dismutase(SOD), one of the major antioxidant enzymes, is increased against the formation of the superoxide radical during reperfusion. SOD metabolyzes the superoxide radical to H2 O2 and O2.The severity of ischemic damage deports on the duration of muscle ischemia. The reversible changes in the muscle occur afar 2 hours of ischemia and recover within 24 hours after reperfusion. After 6 hours ischemia, irreversible damage occurs and causes necrosis of muscle. The authors performed the resent study to investigate the changes of Mn-SOD and the effects of allopurinol, the inhibitor of xanthine oxidase, by measuring the immunoreactivitiy of the ischemic reperfused rectus femoris muscle of rats after 2 hours and 6 hours ischemia and timely reperfusion. A total of 176 healthy spraque-Dawley rats weighing from 200 gm to 250 gm were used. Under urthane(3.0 gm/kg.,IP) anesthesia, a lower-abdominal incision was made and the left common iliac artery was ligated by using a vascular clamp for 2 hours and 6 hours. Rectus femoris muscle was obtained at 0 hour, 1 hour, 2 hours, 24 hours, and 48 hours after removal of the vascular clamp. The specimens were sectioned in 14micro miter thickness with a cryostat. The immunoreactivities of Mn-SOD were observed by using Mn-SOD antibodies. The result were as follows. 1. The immunoreactivies of Mn-SOD around sarcolemma were stronger than those on the sarcoplasm. 2. The immunoreactivities of Mn-S0D after 2 hours of ischemia increased to moderate or weak reactivities at 1 hour and 2 hours of reperfusion and returned to week or trace reactivities at 24 hours and 48 hours of reperfusion 3. The pretreatment of allopurinol decreased the immunoreactivies of Mn-SOD during reperfusion. The pattern of changes of SOD immunoreactivies were similar, but the range of changes significantly decreased. 4. The immunoreactivies of Mn-SOD after 6 hours of ischemia increased after 6 hours of ischemia increased after reperfusion and showed peak at 2 hours and 24 hours specimen. After 48 hours in the reperfused group, the reactivities slightly decreased. 5. After 6 hours in the ischemia-reperfused group, the pretreatment of allopurinol decreased the immunoreactivies of Mn-SOD during reperfusion, but the effects were weak. These results suggest that the immunoreactivities of the 6 hours ischemia reperfused group were higher than those of 2-hours ischemia reperfused group in the rectus femoris muscle of rats and that allopurinol pretreatment can be credited with decreasing ischemia reperfusion injury within a reversible period.
Adenosine Triphosphate ; Allopurinol ; Anesthesia ; Animals ; Antibodies ; Free Radicals ; Hypoxanthine ; Iliac Artery ; Ischemia ; Mortality ; Muscle, Skeletal ; Necrosis ; Oxygen ; Quadriceps Muscle* ; Rats* ; Reperfusion Injury* ; Reperfusion* ; Sarcolemma ; Superoxide Dismutase* ; Superoxides ; Xanthine Oxidase

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients, 24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 patients). The actuarial overall and relapse free 5 year survival rate were 71.0%, 68.3% respectively. The survival rates by stage were 79.1% in stage I, and 61.2% in stage II. Treatment failure was noted in 18 of 64 patients (28.1%), locoregional failure in 8(12.5%), distant metastasis in 8(12.5%), paraaortic node metastasis in 1 and one patient had concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thickness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level, resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24(33.3%), 5000-5500 cGy+ICR 3/7(42.9%), 5000-5500 cGy external RT only group 3/33(9.1%). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose not improve results but only increases complication.
Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Pelvis ; Radiation Oncology ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms*

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.
Clomiphene* ; Estradiol ; Female ; Follicular Phase ; Humans ; Leptin* ; Menstrual Cycle ; Menstruation ; Ovulation Induction

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: This study was done to analyze survivals, patterns of failure, and complications of early uterine cervix cancer after curative radiotherapy. METHODS AND MATERIALS: Eighty patients with uterine cervix cancer FIGO Stage IB (48 cases) and Stage IIA (32 cases) treated with radiotherapy were analyzed retrospectively. Patients were treated from November 1985 to May 1993, and minimum follow up period was 24 months. and 6 cases were lost to follow up. All of them were treated with external radiotherapy and different fractions of high dose rate intracavitary radiotherapy. Survival rates, failure patterns, complication rates and degrees of severity were analyzed according to several factors. RESULTS: Overall 5 year survival rate and relapse free survival rate were 72.3%, and 72.8% respectively. Prognostic factors were stage, size, pathology, RT response and there was no significant survival difference among the reasons of radiotherapy choice. There were 19 cases of treatment failure, another 3 cases were not tumor related death, and most of treatment related failure occurred within 24 months. Late complication rate of bladder and rectum were 8.8%, 15% respectively, frequency and severity of complication were correlated with ICR fractionation dose and total dose. CONCLUSION: These results showed that survival rates of early stage radiation treated cervix cancer patients were comparable to surgical series, but more aggressive treatment methods needed for stage IIA poor prognostic patients, To decrease late complication, choice of proper ICR dose and meticulous vaginal packing is needed.
Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Pathology ; Radiotherapy* ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Urinary Bladder ; Uterine Cervical Neoplasms

No abstract available.
Krukenberg Tumor*