The vast majority of malignant tumors involving the vagina are secondary spread from primary malignant lesion of the cervix uteri, the sigmoid colon, the bladder and the vulva. Primary invasive carcinoma of the vagina remains among the rare gynecologic malignant tumor. The diagnosis of primary carcinoma of the vagina requires that the cervix and the vulva be intact and no clinical evidence of other primary tumors exist. Greater than 80-90% of all vaginal tumors are squamous cell type. We experienced two cases of primary vaginal cancer of 68 years old woman without any other gynecologic disease and 67 years old woman after hysterectomy for benign desease. We presented these cases with a brief review of related literatures.
Aged ; Cervix Uteri ; Colon, Sigmoid ; Diagnosis ; Female ; Genital Diseases, Female ; Humans ; Hysterectomy ; Neoplasms, Squamous Cell ; Urinary Bladder ; Vagina ; Vaginal Neoplasms* ; Vulva

Hydatid disease is Echinococcus granulosus infection in its larva form. It is endemic in many sheep- and cattle-raising countries throughout the world. In Korea seventeen cases have been reported but relapsed case is not. We report relapsed hydatid disease in pelvic cavity 10 years after primary surgery for Echinococcal cysts in the liver and pelvic cavity. The cysts were surgically removed and the patient was managed with postoperative adjuvant treatment with albendazole and followed with serologic test for anti-echinoccocus antibodies by ELISA.
Albendazole ; Antibodies ; Echinococcosis* ; Echinococcus ; Echinococcus granulosus ; Enzyme-Linked Immunosorbent Assay ; Humans ; Korea ; Larva ; Liver ; Serologic Tests

Uterine leiomyomas are the most common benign uterine tumors. They are estimated to be present in at least 20% of all women of reproductive age and may be asymptomatic in 40-50% of women older than 40 years of age. They may be subserosal, intramural, or submucosal in location within the uterus or located in the cervix, in the broad ligament, or on a pedicle. But it seems to be rare to experience a intraligamentary huge leiomyoma in the broad ligament.Recently we have experienced a case of intraligamentary huge leiomyoma with its weight of 3146 gm in 45 year-old primiparous woman. We present this case with a brief review of the literature.
Broad Ligament ; Cervix Uteri ; Female ; Humans ; Leiomyoma* ; Middle Aged ; Uterus

PURPOSE: Many men with a normal phenotype but decreased or absent production may have abnormalities of the androgen receptor (AR). Here, we investigated men with severe oligospermia and azoospermia to ascertain wether mutations of the AR gene are associated with male infertility having testicular causes. PATIENTS AND METHODS: A total of 43 infertile men with a normal phenotype and severe oligospermia or azoospermia and three normally fertile men entered this study. Included was one man with known incomplete androgen insensitivity syndrome (AIS). Deoxyribonucleic acid was isolated from peripheral blood samples of the subjects, and polymerase chain reaction (PCR) was carried out using sets of primers designed to amplify sequences of eight exons of the AR gene. For convenience and repidity of analyses, the multiplex PCR method was employed. RESULTS: PCR resulted in amplification of all eight exons. In all samples, amplified products were shown to be appropriate-sized bands on agarose gels. No gross abnormalities were found in most of the infertile patients. However, an increased number of CAG repeat in exon 1 of the AR gene and point mutations (T to C, nt 3897; A to T, nt 3903) in exon 7 were found in the AIS subject. CONCLUSIONS: Our results showed no gross deletions of the AR gene in most infertile subjects. However, point mutations may have been overlooked by the techniques used, as demonstrated in the AIS subject. Further study will be required to clarify expression and localization of AR I the testis and consequently to understand the precise roles of the AR in regulating the normal spermatogenesis.
Androgen-Insensitivity Syndrome ; Azoospermia ; DNA ; Exons ; Gels ; Humans* ; Infertility ; Infertility, Male ; Male ; Multiplex Polymerase Chain Reaction ; Oligospermia ; Phenotype ; Point Mutation ; Polymerase Chain Reaction ; Receptors, Androgen* ; Sepharose ; Spermatogenesis ; Testis

PURPOSE: One of the major medical treatments for benign prostatic hyperplasia is targeted toward reducing bladder outlet obstruction by alpha-adrenoceptor blockade to relax the smooth muscle tone of the prostate. Berberine and palmatine, an isoquinoline alkaloids, have varied pharmacological actions and have been extensively used in folk medicine. A previous large scale screening test revealed that berberine derivatives have antagonistic effects at the alpha1-adrenoceptors, although they are less potent than prazosin. The aim of this study is to investigate the effect of the berberine and palmatine on the contractility of the isolated prostate, urethral and vascular smooth muscle tissues of the rabbit. MATERIALS AND METHODS: Muscle strips of the prostate, urethra and renal artery were obtained from 10-week-old male New Zealand White rabbits. In vitro isometric contraction was measured using organ bath study. Cumulative concentrations of phenylephrine as an agonist were added to produce concentration-response relationships. Breberin (1-500 microM) and palmatine (1-500 microM) were added to the bath before the repeated phenylephrine-induced concentration-response curve was made. Responses of developed tension to phenylephrine were plotted as percentage of the maximal increase for each concentration-response curve in the prostate, urethra and renal artery strips. RESULTS: Phenylephrine produced concentration-dependent contractions on the rabbit prostatic and urethral preparations. Berberine and palmatine induced a dose-dependent rightward shift of the dose-response curve of phenylephrine-induced contraction of both prostate and urethra with a reduction of maximal response, indicating the interactions of the two agents with phenylephrine in noncompetitive antagonism. The rank order of potency of the inhibitory effect was palmatine > berberine in the urethral tissue, while there was no significant difference between the two agents in the prostatic tissue. In the renal artery strips, both berberine and palmatine did not significantly inhibited the maximal contractile response to phenylephrine (1-50 microM). Higher concentration of berberine (500 microM) and palmatine (100-500 microM) decreased maximal contractile response induced by phenylephrine (0-10 microM), while they paradoxically increased maximal contraction induced by higher concentrations of phenylephrine (50-100 microM). CONCLUSIONS: Our results indicated that berberine or palmatine inhibited phenylephrine-induced contractions in urethral and prostatic smooth muscles, with no significant inhibition in the renal artery smooth muscle at lower concentration ranges of berberine and palmatine. A deeper understanding of the action mechanisms of berberine and palmatine would widen our therapeutic options for voiding disorders.
Alkaloids ; Baths ; Berberine* ; Humans ; Isometric Contraction ; Male ; Mass Screening ; Medicine, Traditional ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Phenylephrine ; Prazosin ; Prostate ; Prostatic Hyperplasia ; Rabbits ; Renal Artery ; Urethra ; Urinary Bladder Neck Obstruction

PURPOSE: We aimed to investigate the relationships among age, International Prostate Symptom Score(IPSS), uroflowmetry and prostate volume in men with lower urinary tract symptom(LUTS). MATERIALS AND METHODS: Among the 847 men who participated in the BPH awareness program, 620 men(73.2%) who had not LUTS or had LUTS without concomitant conditions(except BPH) known to interfere with normal voiding were selected. All of them completed IPSS questionnaire, uroflowmetry and transrectal ultrasonography. We calculated correlation coefficient to investigate the association among age, maximal flow rate, mean flow rate, and prostate volume. Additionally, total men were stratified by 3 age groups and 3 IPSS groups, and we also evaluated relationships among the parameters according to these groups. RESULTS: The statistically significant correlations were found among the age, uroflowmetry and prostate volume. Total symptom score did not show significant correlation with age. However, irritative symptom score increased with increasing age in statistically significant manner. When we stratified men into three age groups, most of the correlations were stronger in the younger than 60 years old group than those observed in the entire population. According to a multivariate regression analysis, age and prostate volume did not show statistically significant correlation with IPSS. When the all men were classified according to the IPSS, there were significant differences between maximal flow rate, mean flow rate and prostate volume. CONCLUSIONS: Emerging from this analysis showed that age is the important factor influencing the relationship among symptom score, urinary flow rate and prostate volume. LUTS may be affected by some factor such detrusor tone as well as prostate volume. We suggest that the development of more objective and sophisticated studies such as urodynamic study, molecular biologic study for functional morphology of detrusor and community-based study with longitudinal measurements will be necessary to approach the pathogenesis of LUTS.
Humans ; Lower Urinary Tract Symptoms* ; Male ; Middle Aged ; Prostate* ; Surveys and Questionnaires ; Ultrasonography ; Urinary Tract ; Urodynamics

PURPOSE: There are few reports from Asian countries about the long-term results of aromatase inhibitor adjuvant treatment for breast cancer. This observational study aimed to evaluate the long-term effects of letrozole in postmenopausal Korean women with operable breast cancer. METHODS: Self-reported quality of life (QoL) scores were serially assessed for 3 years during adjuvant letrozole treatment using the Korean version of the Functional Assessment of Cancer Therapy-Breast questionnaires (version 3). Changes in bone mineral density (BMD) and serum cholesterol levels were also examined. RESULTS: All 897 patients received the documented informed consent form and completed a baseline questionnaire before treatment. Adjuvant chemotherapy was administered to 684 (76.3%) subjects, and 410 (45.7%) and 396 (44.1%) patients had stage I and II breast cancer, respectively. Each patient completed questionnaires at 3, 6, 12, 18, 24, 30, and 36 months after enrollment. Of 897 patients, 749 (83.5%) completed the study. The dropout rate was 16.5%. The serial trial outcome index, the sum of the physical and functional well-being subscales, increased gradually and significantly from baseline during letrozole treatment (p<0.001). The mean serum cholesterol level increased significantly from 199 to 205 after 36 months (p=0.042). The mean BMD significantly decreased from −0.39 at baseline to −0.87 after 36 months (p<0.001). CONCLUSION: QoL gradually improved during letrozole treatment. BMD and serum cholesterol level changes were similar to those in Western countries, indicating that adjuvant letrozole treatment is well tolerated in Korean women, with minimal ethnic variation.
Aromatase ; Asian Continental Ancestry Group ; Bone Density ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Cholesterol ; Consent Forms ; Female ; Humans ; Observational Study ; Quality of Life*