The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary, accounting for less than 0.5% of all primary ovarian neoplasm. This tumor is the most common type of all virilizing ovarian tumors. However, only one-third of patients develop virilization. Recently, we experienced a case of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.
Amenorrhea ; Female ; Humans ; Ovarian Neoplasms ; Ovary ; Sertoli-Leydig Cell Tumor* ; Sex Cord-Gonadal Stromal Tumors ; Virilism

OBJECTIVE: The purpose of this study is to reevaluate the prognostic factors by investigating the clinical and biological parameters concerned malignant gestational trophoblastic tumor in patients with hydatidiform mole. METHODS: From March 1995 to February 2000, 41 patients admitted to department of the Obstetrics and Gynecology, Yonsei University College of Medicine who were diagnosed with pathologically-proven gestational trophoblastic disease were selected. Parameters such as age, gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction were compared between malignant gestational trophoblastic tumor group and spontaneous remission group. RESULTS: Considering the clinical prognostic factors, the patients were divided into two age groups; the first group consisted of those older than 40 years of age and the second control group consisted of those under 40. The number of patients older than 40 in the spontaneous remission group and malignant gestational trophoblastic tumor group were 4(15.4%) and 7(46.7%), respectively, showing a significantly higher number in the group over 40years. Other parameters such as gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction showed no statistically significant difference between the two groups. CONCLUSION: The progression rate from hydatidiform mole to malignant gestational trophoblastic tumor was significantly higher in patients over 40 years of age. Therefore, more aggressive therapeutic approach should be considered in such patients.
DNA ; Female ; Gestational Age ; Gestational Trophoblastic Disease ; Gynecology ; Humans ; Hydatidiform Mole* ; Lutein ; Obstetrics ; Parity ; Ploidies ; Pregnancy ; Remission, Spontaneous ; Trophoblastic Neoplasms* ; Trophoblasts*

Four cases of atypical chronic myeloid leukemia (aCML), which were compatible with the FAB guideline for the classification of chronic myeloid leukemia (CML), are presented. All 4 patients showed the onset in old age, leukocytosis with an increase in the number of immature granulo-cytes, monocytosis, a low basophil count, and a dysgranulopoiesis in the peripheral blood, a nega-tivity of the bcr-abl gene rearrangement, and a hypercellular marrow with marked granulocytic hyperplasia and dyshemopoietic features. Two patients died within 3 months and the other 2 are currently under observation after a partial response to hydroxyurea. aCML is known to have a poor therapeutic response and outcome without a blastic crisis. A greater deal of concern regarding aCML is required for an accurate diagnosis and classification.
Basophils ; Bone Marrow ; Classification ; Diagnosis ; Gene Rearrangement ; Humans ; Hydroxyurea ; Hyperplasia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative* ; Leukocytosis

47,XYY is a rare sex chromosomal disorder. Approximately 1.45 per 1,000 live births have on XYY chromosome pattern. The extra Y chromosome is paternal in origin and RESULTS: from nondisjunction in the second meiotic division. Although the phenotype is normal on the newborn, an increased incidence of minor anomalies has been reported. Recently, a 37-year-old primigravid woman received amniocentesis at 17 weeks gestation at a private clinic and was diagnosed as having a fetus with 47,XYY. We performed amniocentesis again at 20 weeks of pregnancy and confirmed fetal karyotype to be 47,XYY using the conventional cytogenetics and fluorescence in situ hybridization (FISH) techniques. As she did not want to terminate her pregnancy, she was put under antenatal care but ended up in vaginal delivery in 40 weeks. As a result of physical examination, the neonate showed a normal phenotype except for a mild hypospadia and a simian crease.
Adult ; Amniocentesis ; Child* ; Chromosome Disorders ; Cytogenetics ; Female ; Fetus ; Fluorescence ; Humans ; Hypospadias ; In Situ Hybridization ; Incidence ; Infant, Newborn ; Karyotype ; Live Birth ; Male ; Phenotype ; Physical Examination ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis* ; Y Chromosome

PURPOSE: Adjuvant chemotherapy is routinely recommended for locally advanced colorectal cancer (CRC). There are very few data for the optimal starting date of adjuvant chemotherapy after the surgery. This study aimed to evaluate the effectiveness of earlier adoption of adjuvant chemotherapy after curative surgery for stage III CRC. METHODS: In this study, 159 patients with stage III CRC, who had undergone a curative resection, were enrolled retrospectively. Patients were categorized into 3 groups representing different timings to initiate the chemotherapy; less than 2 weeks (group 1), 3 to 4 weeks (group 2), and more than 5 weeks (group 3). The overall survival rate (OS) and the relapse-free survival rate (RFS) were analyzed to evaluate the effectiveness of adjuvant chemotherapy. RESULTS: The 5-year OSs of the patients were 73.7% in group 1, 67.0% in group 2, and 55.2% in group 3. The 5-year RFSs of the patients were 48.8% in group 1, 64.7% in group 2, and 57.1% in group 3. There were no significant differences in either the OS or the RFS (P = 0.200, P = 0.405). CONCLUSION: Starting chemotherapy earlier than 6 weeks after surgery does not show any significant difference. Thus, although adjuvant chemotherapy should preferably begin within 6 weeks, the starting date should not necessarily be hastened, and the patient's general condition should be taken into consideration.
Chemotherapy, Adjuvant ; Colorectal Neoplasms ; Humans ; Prognosis ; Retrospective Studies ; Survival Rate

BACKGROUND: Cat scratch disease (CSD) is an emerging disease worldwide and is mainly caused by Bartonella henselae, a gram-negative bacterium. The most common clinical manifestation is regional lymphadenopathy, though clinical recognition may be difficult, as atypical manifestations occur. The condition can be complicated by neuroretinitis, endocarditis, and sometimes fatal encephalopathy. The reservoir of B. henselae is the cat, and the prevalence rates of B. henselae infection in cat populations range from 4 to 70%. The prevalence of Bartonella infection in Korea has not been studied, thus, in this study Bartonella infection was investigated in cats captured in the Inchon and Ansan areas. METHODS: Twenty wild cats were captured and their livers and spleens were examined by polymerase chain reaction (PCR), bacterial culture, and histopathologically. PCR used two primers: Cat (sense:5'-GAT TCA ATT GGT TTG AA(G/A) GAG GCT-3', antisense:5'-TCA CAT CAC CAG G(A/G)C GTA TTC- 3') and Barto (sense:5'-(C/T) CT TCG TTT CTC TTT CTT CA-3', antisense:5'-AAC CAA CTG AGC TAC AAG CC-3'). Culture was performed by inoculating sliced spleen and liver into the ECV304 cell line and bacterial growth was observed over a period of 3 weeks. If no visible bacterial growth was identified, the presence of bartonella was examined by DNA staining, indirect immunofluorescent staining, and PCR. Liver and spleen were stained with H&E and scrutinized under the light microscope. RESULTS: Nine pairs of culture cells inoculated with liver and spleen were examined by indirect immunofluorescent staining and PCR; no positive case was found. In addition, no positive case was identified by PCR in the liver and spleen specimens of eleven cats. Spleen and liver specimens of eleven cats were examined by light microscopy and none showed granuloma. CONCLUSION: This preliminary study suggests that the Bartonella infection is probably uncommon in the cat population of the Inchon and Ansan areas. Further studies should be undertaken to detail the prevalence of Bartonella infection in other areas and in human.
Animals ; Bartonella henselae* ; Bartonella Infections ; Bartonella* ; Cat-Scratch Disease ; Cats* ; Cell Line ; DNA ; Endocarditis ; Granuloma ; Gyeonggi-do ; Humans ; Incheon ; Korea ; Liver ; Lymphatic Diseases ; Microscopy ; Polymerase Chain Reaction ; Prevalence* ; Retinitis ; Spleen

OBJECTIVES: The purpose of this study was to determine whether women with PCOS have greater subclinical atherosclerosis and evaluate the relationship to risk factors for atherosclerosis. METHODS: Women with PCOS(n=24) and age and body mass index(BMI)-matched cycling women(n=16) as control group underwent carotid scanning for the measurement of the IMT. We compared IMT and plaque between cases and controls, assessed some risk factors for atherosclerosis, and analyzed factors affecting IMT. RESULTS: There was no difference between the groups in waist-hip ratio(WHR) and in the levels of total cholesterol, triglyceride(TG), LDL, Lp(a), fibrinogen, homocystein, plasminogen activator inhibitor 1. However, HDL was significantly lower, and systolic and diastolic blood pressure, fasting blood sugar or insulin concentration and IMT was significantly higher in PCOS group than control group (51.1+/-11.6 vs 60.4+/- 10.0mg/dl, 119.4+/-12.5 vs 109.0+/-11.6mmHg, 79.1+/-11.1 vs 68.9+/-7.8mmHg, 93.6+/-11.1 vs 85.0+/-5.9 mg/dl, 8.9+/-5.2 vs 5.0+/-3.3milliunit/ml, 0.57+/-0.12 vs 0.49+/-0.11mm respectively, all p<.05). In the analysis of correlation between the IMT and clinical characteristics, PCOS status, BMI, systolic and diastolic blood pressure, fasting blood sugar or insulin concentration, TG, HDL, fibrinogen were significantly independent variables (Coefficients of correlation were 0.358, 0.461, 0.452, 0.349, 0.405, 0.466, 0.478, -0.433, 0.349 respectively, all p<.05). The factors affecting IMT by multivariate regression were PCOS status and fasting insulin concentration. CONCLUSIONS: We concluded that women with PCOS might have an increased risk of subclinical atherosclerosis and insulin resistance was assumed to be the main risk factor of atherosclerosis.
Atherosclerosis* ; Blood Glucose ; Blood Pressure ; Cholesterol ; Fasting ; Female ; Fibrinogen ; Humans ; Insulin Resistance* ; Insulin* ; Ovary* ; Plasminogen Activator Inhibitor 1 ; Polycystic Ovary Syndrome ; Risk Factors

PURPOSE: Penicillin- and multidrug-resistant S. pneumoniae poses a serious threat to clinicians because the rate of resistance of S. pneumoniae to penicillin in Korea has surged up to the world's highest level. This study was performed to assess the carriage rate, serogroups and antimicrobial susceptibility of S. pneumoniae isolated from oropharynx in children. METHODS: From March to July 1998, 209 children under 5 years of age were recruited from five day care centers. The carriage rate for pneumococci was obtained. Antimicrobial susceptibilities were determined with the E-test and agar dilution methods. Serogrouping was performed on 48 of the pneumococcal isolates by the Quellung reaction. RESULTS: The carriage rate of S. pneumoniae was 30.1%. Antimicrobial susceptibility profiles were available for 59 of the isolates. Sixty-six percent of isolates were not susceptible to penicillin, and multidrug-resistance was observed in 76.3% of the isolates. A high proportion of the penicillin-resistant strains showed associated resistance to trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and oxacillin. The most prevalent oropharyngeal serogroups were 19, 6, 3, 23, and 29. Resistance of the pneumococcal isolates to penicillin was different according to the serogroups. All of the strains of serogroup 19, 23, and 29 was resistant to penicillin but 87.5% of serogroup 3 strains were susceptible to penicillin. CONCLUSION: The resistance rate of S. pneumoniae isolated from oropharynx in children was very high to penicillin and other antimicrobial agents. For the reduction of the drug-resistant rate of S. pneumoniae, clinicians should be required to be more judicious in their use of antimicrobial agents.
Agar ; Anti-Infective Agents ; Child* ; Day Care, Medical* ; Erythromycin ; Humans ; Korea ; Oropharynx* ; Oxacillin ; Penicillins ; Pneumonia ; Streptococcus pneumoniae* ; Streptococcus* ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

Background/Aims: Genome wide and candidate gene association studies have identified polymorphisms associated with the risk of lung cancer in never-smokers. This study was conducted to evaluate the association between 11 polymorphisms identified in female never smokers and the lung cancer risk in male smokers. Methods: This study included 714 lung cancer patients and 626 healthy controls. The polymorphisms were genotyped using SEQUENOM MassARRAY iPLEX assay or Taq-Man assay. Results: Two polymorphisms were associated with the risk of lung cancer in male smokers, as in female never smokers. Male smokers carrying the rs4975616 variant allele had a significantly decreased risk of lung cancer (in a codominant model: odds ratio, 0.77; 95% confidence interval, 0.61 to 0.96; p = 0.02). The rs9387478 polymorphism also reduced lung cancer risk in male smokers (in a codominant model: odds ratio, 0.85; 95% confidence interval, 0.73 to 0.997; p = 0.046). In a stratified analysis, the association between these polymorphisms and the risk of lung cancer was predominant in lighter smokers and for cases of adenocarcinoma. Conclusions These results suggest that a subset of polymorphisms known to be associated with the risk of lung cancer in female never smokers is also associated with the risk of lung cancer in male smokers.

Background: Neurogenic differentiation 1 (NeuroD1) is a representative small cell lung cancer (SCLC) transcription regulator involved in the carcinogenesis and behavior of SCLC.Histone modifications play an important role in transcription, and H3 lysine 4 trimethylation (H3K4me3) is primarily associated with promoter regions. Methods: We investigated the association between single nucleotide polymorphisms (SNPs) in NeuroD1 and H3K4me3 coincident regions, selected using ChIP sequencing (ChIP-seq), and the clinical outcomes of 261 patients with SCLC. Results: Among 230 SNPs, two were significantly associated with both the chemotherapy response and overall survival (OS) of patients with SCLC. RNF145 rs2043268A>G was associated with worse chemotherapy response and OS (under a recessive model, adjusted odds ratio [aOR], 0.50, 95% confidence interval [CI], 0.26–0.94, P = 0.031, and adjusted hazard ratio [aHR], 1.88, 95% CI, 1.38–2.57, P < 0.001). CINP rs762105A>G was also associated with worse chemotherapy response and OS (under a dominant model, aOR, 0.47, 95% CI, 0.23–0.99, P = 0.046, and aHR, 2.03, 95% CI, 1.47–2.82, P < 0.001). ChIP–quantitative polymerase chain reaction and luciferase assay confirmed that the two SNPs were located in the active promoter regions and influenced the promoter activity of each gene. Conclusion To summarize, among SNPs selected using ChIP-seq in promoter regions with high peaks in both NeuroD1 and H3K4me3, RNF145 rs2043268A>G and CINP rs762105A>G were associated with clinical outcomes in patients with SCLC and also affected the promoter activity of each gene.