OBJECTIVE: Some growth factors may promote tumor growth by affecting tumor angiogenesis. Midkine(MK) are polypeptides that belong to a new family of heparin-binding growth/differentiation factor and has also been reported to be angiogenic. In various tumor tissues, MK was highly expressed between tumor and normal tissues; however, the pattern of MK expression in normal cervix and cervical cancer has not been established. The aim of this study was to determine the MK mRNA expression in cervical cancer. And we questioned whether its expression is related to cancer stages and prognostic factors. METHODS: The cervical and cervical cancer tissues were taken from patients; healthy women(n=15), and the patients with cervical cancer(n=29). The MK mRNA expression was examined by quantative competitive PCR after polymerase chain reaction amplification of reverse transcriptase copies of RNA transcripts(RT-PCR). RESULTS: The cervical cancer expressed higher levels of MK mRNA than normal cervix(p<0.05). The MK mRNA expression was not correlated with the cervical cancer stage and histopathologic type(p>0.05). CONCLUSION: These results suggested that increased MK mRNA expression is associated with the development of cervical cancer.
Cervix Uteri ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; Peptides ; Polymerase Chain Reaction ; RNA ; RNA, Messenger* ; RNA-Directed DNA Polymerase ; Uterine Cervical Neoplasms*

Primitive neuroectodermal tumor (PNET) is a rare tumor derived from fetal neuroectodermal cells. These tumors occur in the central nervous system and peripheral locations, but the occurrence of primitive neuroectodermal tumors located in the uterus is extremely rare. We present a 53-year-old woman with primitive neuroectodermal tumor of the uterus confirmed by immunohistochemical staining. We have experienced one case of PNET of the uterus and wish to report with brief review of concerned literature.
Central Nervous System ; Female ; Humans ; Middle Aged ; Neural Plate ; Neuroectodermal Tumors, Primitive* ; Uterus*

OBJECTIVE: The aim of this study was to analize the biologic and molecular genetic characteristics of Lactobacillus spp. isolated from vagina of Korean healthy women and to perform a pilot clinical study on the treatment of vaginitis using the best Lactobacillus strain KLB 46. METHODS: Vaginal specimens were obtained from 205 Korean women with healthy vaginal ecosystems. 155 lactobacillus strains were used for catalase test, cell surface hydrophobicity (CSH) test and antimicrobial activity test. Also we identified the species prevalence by PCR-RFLP analysis of 16S rDNA gene and performed the minimal inhibitory concentrationtest using14 antibiotics to determine their patterns of antibiotic susceptibility. A pilot clinical trial of 8 bacterial vaginosis, 1 trichomonas vaginitis and 6 atrophic vaginitis using Lactobacillus crispatus KLB 46 was done by vaginal instillation (10(10)-10(11) cells/mL). RESULTS: 155 lactobacilli strains were isolated and all isolates showed high CSH and 61% of the isolates had higher CSH. L. acidophilus and L. crispatus were the most prevalent species by PCR-RFLP analysis of their 16S rDNA gene. And PCR-RFLP analysis suggested that KLB 46 was L. crispatus. The clinical study showed that the vaginal epithelial adherence rate was high as 77% for bacterial vaginosis and 33.3% for atrophic vaginitis. CONCLUSION: The predominating lactobacilli were L. crispatus and L. acidophilus in Korean women's vaginas. Although further study would be needed, L. crispatus KLB 46 is a good candidate of suitable probiotics for bacterial vaginosis.
Administration, Intravaginal ; Anti-Bacterial Agents ; Atrophic Vaginitis ; Catalase ; DNA, Ribosomal ; Ecosystem ; Female ; Humans ; Hydrophobic and Hydrophilic Interactions ; Lactobacillus* ; Molecular Biology* ; Prevalence ; Probiotics ; Trichomonas Vaginitis ; Vagina* ; Vaginitis* ; Vaginosis, Bacterial

Heterotopic pregnancy is rare event and the risk is increased with assisted reproductive technology procedures. Heterotopic cervical pregnancy is even more unusual. We report a rare case of heterotopic cervical pregnancy that was managed successfully. A 36-year-old women who conceived by IVF-ICSI was diagnosed with heterotopic cervical pregnancy. She visited the emergency room with vaginal bleeding at 5 weeks of gestation and underwent careful intracervical gestational sac reduction with forceps under abdominal guidance the next day. The postoperative course was uneventful and with regular check-ups, the intrauterine pregnancy (IUP) progressed unremarkably through 41 weeks with delivery of a healthy newborn. We reviewed a total of 37 cases of heterotopic pregnancy that have been reported in the English language literature. There have been many attempts to eliminate the cervical embryo while preserving the IUP, and complete cervical evacuation is important in order to avoid infection, bleeding, and premature birth.
Embryonic Structures ; Emergencies ; Female ; Gestational Sac ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy, Heterotopic ; Premature Birth ; Reproductive Techniques, Assisted ; Surgical Instruments ; Uterine Hemorrhage

OBJECTIVE: The objective of this study was to establish a clinically applicable culture system by investigating the use of autologous cord blood plasma (ACBP) instead of fetal bovine serum (FBS) for the ex vivo expansion of umbilical cord blood (UCB) T-lymphocytes. METHODS: Fresh UCB mononuclear cell (MNC) fractions were isolated by Ficoll-Hypaque density centrifugation. The nonadherent MNC fractions were then cultured with the anti-CD3 antibody 5 microgram/mL plus IL-2 175 U/mL in the presence of 10% FBS, 10% ACBP or homologous cord blood plasma (HCBP). On day 8, proliferation rate, cell surface markers, cytotoxic assay of UCB T-lymphocytes according to the medium supplemented with FBS, ACBP or HCBP were evaluated. RESULTS: Proliferation studies demonstrated a significant increase in the proliferative ability of UCB T-lymphocytes incubated in anti- CD3 and IL-2 irrespective of the medium supplemented with FBS or ACBP. In the FBS supplemented medium, expressions of the activated T-lymphocytes were increased significantly after culture: CD3+CD8+, CD3+CD25+, CD3+CD38+, and CD45RO+ (p<0.05). Also in the ACBP supplemented medium, expressions of the activated T-lymphocytes were increased significantly after culture: CD3+ CD8+, CD3+CD25+, and CD45RO+ (p<0.05). In the HCBP supplemented medium, expressions of the activated T-lymphocytes were increased significantly after culture as in the ACBP: CD3+CD8+, CD3+CD25+, and CD45RO+ (p<0.05). Of the activated T-lymphocytes, increase of cytotoxic CD3+CD8+ cells increased significantly in the ACBP and HCBP groups compared to FBS group (p<0.05). CONCLUSION: These findings support the feasibility of ex vivo expansion of umbilical cord blood T-lymphocytes in the medium supplemented with autologous cord blood plasma, instead of fetal bovine serum, for future adoptive cellular immunotherapy.
Centrifugation ; Fetal Blood* ; Immunotherapy, Adoptive ; Interleukin-2 ; Plasma* ; T-Lymphocytes* ; Umbilical Cord*

OBJECTIVE: This study was aimed to investigate the vascular endothelial growth factor (VEGF) mRNA and angiopoietin (Ang) -1 and -2 mRNA expressions between cervical cancer and normal cervix, and to assess the relationships among their expression and other prognostic factors of invasive cervical cancer. METHODS: The tissues were obtained from 34 patients with cervical cancer and 14 patients with normal cervix undergoing hysterectomy. Total RNA was extracted and reverse transcribed into cDNA. RT-PCR and QC-PCR was performed to evaluate VEGF and Ang-1 and -2 mRNA expressions. Clinicopathologic factors of cervical cancer were reviewed with the patient's charts and results were analyzed with Mann-Whitney U test, Spearman correlation test and logistic regression analysis. RESULTS: VEGF, Ang-1 and -2 mRNA expression in cervical cancer was higher than that in normal cervix (p<0.05) and there were significant correlations between Ang-2 mRNA expression and VEGF mRNA expression in all stage of cervical cancer (p<0.05). A definite correlation was found between VEGF mRNA expression and clinical stage, SCC-Ag levels, lymph node metastasis of cervical cancer (p<0.05). Also, There was significant correlation among Ang-2 mRNA expression and clinical stage, tumor sizes, SCC-Ag levels, lymph node metastasis of cervical cancer (p<0.05). Ang-1 mRNA expression was significantly correlated with clinical stage of cervical cancer (p<0.05). CONCLUSION: The expression of VEGF mRNA, Ang-1 and -2 mRNA could be associated with the progression and metastasis of cervical cancer and might have a role as prognostic parameters in cervical cancer.
Angiopoietin-1* ; Cervix Uteri ; DNA, Complementary ; Female ; Humans ; Hysterectomy ; Logistic Models ; Lymph Nodes ; Neoplasm Metastasis ; RNA ; RNA, Messenger* ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

OBJECTIVE: The purpose of this study was to identify the relationship between metabolic syndrome and stress urinary incontinence. METHODS: Based form 362 case, the risk factors including the parameters of metabolic syndrome for stress urinary incontinence (SUI) were analyzed retrospectively: body mass index (BMI), hypertension, insulin resistance, triglyceride, HDL-cholesterol. RESULTS: The risk for metabolic syndrome were associated positively with SUI. Women with the risks for metabolic syndrome had 2.503 times of the odds for SUI compared without the risks for metabolic syndrome (95% CI 1.28-4.87, p<0.001). The independent risk factors for SUI were BMI (OR 3.574 ; 95% CI 0.09-0.31, p<0.001) and insulin resistance (OR 2.563 ; 95% CI 0.04-0.31, p=0.011) by multivariate analysis. CONCLUSION: Our results suggested that metabolic syndrome was the important factor of the stress urnary incontinence. And we confirmed the need for the treatment of metabolic disturbance and the prevention of metabolic syndrome aimed at correcting hormonal-metabolic disturbance in middle-aged and older women with SUI.
Body Mass Index ; Female ; Humans ; Hypertension ; Insulin Resistance ; Risk Factors ; Urinary Incontinence

Objective: The objective of the study was to compare the effects of long-term and short-term embryo culture to assess whether there is a correlation between culture duration and clinical outcomes. Methods: Embryos were divided into two study groups depending on whether their post-warming culture period was long-term (20–24 hours) or short-term (2–4 hours). Embryo morphology was analyzed with a time-lapse monitoring device to estimate the appropriate timing and parameters for evaluating embryos with high implantation potency in both groups. Propensity score matching was performed to adjust the confounding factors across groups. The grades of embryos and blastoceles, morphokinetic parameters, implantation rate, and ongoing pregnancy rate were compared. Results: No significant differences were observed in the implantation rate or ongoing pregnancy rate between the two groups (56.3% vs. 67.9%, p=0.182; 47.3% vs. 53.6%, p=0.513). After warming, there were more expanded and hatching/hatched blastocysts in the long-term culture group than in the short-term culture group, but there was no significant between-group difference in embryo grade. Regarding pregnancy outcomes, the completion of re-expansion was faster in women who became pregnant than in those who did not for both culture durations (long-term: 2.19±0.63 vs. 4.11±0.81 hours, p=0.003; short-term: 1.17±0.29 vs. 1.94±0.76 hours, p=0.018, respectively). Conclusion The outcomes of short-term culture and long-term culture were not significantly different in vitrified-warmed blastocyst transfer. Regardless of the post-warming culture time, the degree of blastocyst re-expansion 3–4 hours after warming is an important marker for embryo selection.

Multiple primary malignant neoplasm means that more than 2 cancers are independently developed in one individual. In general, the neoplasms are diagnosed simultaneously or within 6 month interval. Simultaneous presentation of carcinomas involving ovary and uterus is not a common event and presents a diagnostic dilemma when they are of the same histology. We experienced a rare case of multiple primary malignant neoplasm involving the uterine endometrium and the ovary synchronously. Thus we report this case with a review of literatures.
Endometrium* ; Female ; Ovary* ; Uterus

OBJECTIVE: To determine the effects of neoadjuvant chemotherapy (5-fluorouracil plus cisplatin) on tumor cell morphology and apoptosis by analyzing the consecutive changes of apoptotic index (AI) and histology observed in the serially obtained cervical cancer tissues during the chemotherapy. METHODS: Cervical cancer tissues were obtained by punch biopsy just before starting the each cycle of neoadjuvant chemotherapy from five patients with locally advanced disease (stage IIb-IIIb), but previously untreated squamous cell carcinoma of uterine cervix. All patients were treated with three cycles of 5-fluorouracil (1,000 mg/m2 at day #1-5) and cisplatin (60 mg/m2 at day #1) at 3 weeks interval. All H & E stained cervical cancer tissue slides were scored for apoptotic index and observed for microscopic changes of tumor cells by a pathologist. RESULTS: After the first cycle of chemotherapy, AI was significantly increased (from 2 times to 8 times). And widespread injury to cytoplasm was observed and followed by karyorrhexis and karyolysis of nucleus of tumor cells. The size of tumor nests was reduced and it was also noted that fibrosis and infiltration of inflammatory cells were increased. The parts of tumor nests were replaced by mature squamous cells and the changes in nuclear morphologic features pointing in a more differentiated direction. But after the second cycle of chemotherapy, only one patient showed an increase in AI by 1.2 times over that after the first cycle of chemotherapy. The rest showed slight decreases in AI compared to that after the first cycle of chemotherapy. In addition, fewer microscopic morphologic changes of tumor cells induced by chemotherapy were observed after the second cycle of chemotherapy compared to those after the first cycle of chemotherapy. CONCLUSION: We found that AI hardly increased or rather decreased, and that microscopic changes of tumor cells were fewer after the second cycle of neoadjuvant chemotherapy compared to the situation after the first cycle of chemotherapy. Thus, we could deduce that chemoresistance might rapidly develop in cervical cancer cells after the first cycle of neoadjuvant chemotherapy using 5-fluorouracil and cisplatin. So we need to consider this problem when we treat the locally advanced cervical cancer patients with neoadjuvant chemotherapy using 5-fluorouracil and cisplatin.
Apoptosis ; Biopsy* ; Carcinoma, Squamous Cell ; Cervix Uteri ; Cisplatin* ; Cytoplasm ; Drug Therapy* ; Female ; Fibrosis ; Fluorouracil* ; Humans ; Uterine Cervical Neoplasms*