OBJECTIVE: To study the clinical characteristics on translocation of intrauterine device and the methods of removal. METHODS: A retrospective review was performed on 77 cases of translocation of intrauterine device from June 1994 to December 2002. RESULTS: Among 77 cases undergoing removal of intrauterine device, 17 cases (22.1%) were translocted intraperitoneally. Fifteen cases were removed by laparoscopy, 2 cases were by laparotomy and there was no specific postoperative complication. The incidence of intraperitoneal translocation was not related to the type of IUD. Between intrauterine and extrauterine translocation, the incidence of symptoms were not different, but low abdominal pain were slightly increased in extrauterine (35.3%) than intrauterine (10.0%) group. The time lapse after insertion of IUD was ranged from 1 month to 35 year, the mean duration was 9.39 year, that was not related to the incidence of intraperitoneal translocation. In the cases of extrauterine translocation, the mean hospital day was significantly increased (p=0.001), the mean duration was 2.5 day (1-7 day), compaired with 0.7 day (0-6 day) of the cases of not translocated. CONCLUSION: As the type of IUD or symptoms, it is difficult to anticipate the possibility of the intraperitoneal translocation of IUD. But, in cases of extrauterine translocation of intrauterine device, the incidence of low abdominal pain was slightly increased, and ring type IUD was rarely extrauterne translocated. So, it is necessary to further study what factors contribute the extrauterine translocation of IUD.
Abdominal Pain ; Incidence ; Intrauterine Devices* ; Laparoscopy ; Laparotomy ; Postoperative Complications ; Retrospective Studies

BACKGROUND: To predict the therapeutic efficacy of osteoporosis, one or two years is needed to evaluate the therapeutic effect by the measurement of bone mineral density(BMD), whereas three to six months is sufficient with bone markers. Using this information, we can change therapeutic plan or modulate drug dosage if necessary. This approach would provide appropriate therapy for osteoporosis. The purpose of this study is to evaluate the association between the percentage change of BMD which was measured by peripheral quantitative computed tomography(pQCT), and bone markers after 1 year of hormone replacement therapy(HRT) in healthy postmenopausal women. METHODS: Bone mineral density of nondominant distal forearm in 89 postmenopausal women was measured by pQCT. We measured serum alkaline phosphatase(ALP) and intact osteocalcin(iOC, Novocalcin) as bone formation markers, urinary deoxypyridinoline(dPyr, PyriLinks-D(TM)) as bone resorption marker by using enzyme immunoassay. After 1 year of HRT, 54 subjects dropped out and 33 subjects were reevaluated. RESULTS: After 1 year of HRT, the drop-out rate was 61%. There was no significant difference in age, age of menopause, years since menopause, initial BMD, initial bone markers between remained and drop out groups. But osteocalcin level was significantly high in remained group(p=0.02). ALP(-27.6 %), iOC(-29.9%), dPyr(-25.2%) were significantly decreased after 1 year of HRT(p<0.001). Trabecular BMD was increased by 2.4%(p=0.003), but the percentage change of total and cortical BMD was not significant(p>0.05). The levels of BMD and bone markers between before and after was significantly correlated, demonstrating the homogeneity of response to HRT. The percentage change of trabecular BMD was negatively correhted with the percentage change of dPyr after HRT(r=-0.45, p=0.01). The variance of the percentage change of dPyr contributed to the percentage change of trabecular BMD by 20%. There was no correlation between the percentage change of total BMD or cortical BMD and the change of ALP, iOC, or dPyr after HRT. CONCLUSIONS: After 1 year of HRT in postmenopausal women, all biochemical bone markers were decreased significantly, whereas only trabecular BMD measured by pQCT was increased significantly. This result suggests that bone markers was more sensitive than BMD to monitor the therapeutic efficacy of HRT. The percentage change of trabecular BMD was correlated with the change of dPyr after HRT only. dPyr might be the most sensitive marker among bone markers tested. Therefore, we can predict the change of BMD after HRT through monitoring the levels of dPyr.
Bone Density* ; Bone Resorption ; Female ; Forearm ; Hormone Replacement Therapy* ; Humans ; Immunoenzyme Techniques ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis

OBJECTIVE: The aim of the present study was to evaluate the E-cadherin expression in normal cervical epithelium, carcinoma in situ of the cervix, and invasive carcinoma of the cervix, and to define the role of E-cadlherin expression in tumor invasion with respect to clinicopathologic parameters. METHODS: We conducted immunodetection of E-cadherin in 58 cases of cervical carcinoma using immunohistochemistry in formalin-fixed, paraffin-embbeded sections, RUSULTS: E-cadherin expression was different between normal cervical epithelium and carcinoma in situ of the cervix, and between normal cervical epithelium and invasive carcinoma of the cervix(p<0.05). However, there was no difference in E-cadherin expression between carcinoma in situ and invasive carcinoma of the cervix. In invasive cervical carcinomas, expression of E-cadherin and the intensity of cytoplasmic E-cadherin expression did not correlate with histologic type, lymphvascular space invasion, lymph node metastasis, and stage of disease. CONCLUSION: It is mncluded that expression of E-cadherin is related to tumor invasion in cervical tissues, but further studies with regard toE-cadherin/catenin/cytoskeleton complex are needed to clarify the prognostic role of E-cadherin with respect to clinicopathologic parameters in invasive cervical carcinoma,
Cadherins ; Carcinoma in Situ ; Cervix Uteri* ; Cytoplasm ; Epithelium ; Female ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Uterine Cervical Neoplasms

No abstract available.
Humans ; Hysterectomy* ; Lymph Node Excision* ; Lymph Nodes* ; Uterine Cervical Neoplasms*

CD44 is a cell-surface glycoprotein postulated to play a role in tumor cell metastasis. Aberrant expression of the cell adhesion molecule CD44 has been detected in human tumors and the expression of specific isoforms(splice variants) has been shown to be associated with metastasis and poor prognosis in human malignancies. We used variant exon sequence-specific monoclonal antibody to epitope encoded by exon v6 of human variant CD44 to study the expression of CD44 splice variant by immunochemistry in fifty nine samples of human cervical cancer. twenty seven tissue samples of cervical intraepithelial neoplasia(CIN) and normal cervix were included in this study. CD44v6 was stained positive in the basal and parabasal layer of normal epithelial cells homogenously but was absent in the stromal cells. The intensity of CD44v6 staining was the strongest in invasive squamous cell carcinoma followed by normal cervical epithelium, CIN, adenocarcinoma. In the malignant samples, heterogeneity in staining intensity among different clusters of tumor cells was observed. Furthermore the intensity of staining was stronger in proportion to stage, depth of invasion, lymphovascular invasion(p<0.05), and lymph node metastasis(p=NS). This study suggest that the expression of CD44v6 adhesion molecule may be useful value in predict the high stage, depth of invasion, lymphovascular invasion and lymph node metastasis probably.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Adhesion ; Cervix Uteri ; Epithelial Cells ; Epithelium ; Exons ; Female ; Glycoproteins ; Humans ; Immunochemistry ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Population Characteristics ; Prognosis ; Stromal Cells ; Uterine Cervical Neoplasms*

Apoptosis is an intrinsic and fundamental biological process that plays a critical role in the normal development of multicellular organisms and in maintaining tissue homeostasis. Some of the well known regulators of apoptosis are cytokines of the tumor necrosis factor(TNF) ligand family, such as Fas ligand(Fas L) and TNF, which induce apoptosis by activation of their corresponding receptors, Fas and TNFR-1. Recently, a new member of the TNF family known as TRAIL (TNF-related apoptosis-inducing ligand) was identified and shown to induce p53-independent apoptosis in a variety of tumor cell lines but not in normal cells, Four human receptors for TRAIL were also recently identified and designated TRAIL-R1, -R2, -R3, and -R4. The aim of this study is to examine whether TRAIL and TRAIL receptots(-R1, -R2, -R3) are expressed in uterine cervical cancer and whether it is correlated with apoptosis, TRAIL and TRAIL receptors. The subjects were 20 patients who were diagnosed with cervical cancer. Western blotting was performed in 9 cases, immunohistochemical staining for TRAIL and TRAIL receptors(-R1, -R2, -R3) and TUNEL method for detection of apoptosis in 11 cases. There were proteins for TRAIL, TRAIL-R1, -R2, and -R3 in tissues from cervical cancer. All TRAIL receptors were expressed in both normal cervical epithelium and tumor cells, and TRAIL-Rl and -R2 were more strongly expressed in tumor cells than normal epithelium(p<0.05). Apoptosis correlated with expression of TRAIL-Rl and -R2(p<0.05). This study suggests that TRAIL induces apoptosis in cervical cancer through its receptors.
Antigens, CD95 ; Apoptosis ; Biological Processes ; Blotting, Western ; Cell Line, Tumor ; Cytokines ; Epithelium ; Homeostasis ; Humans ; In Situ Nick-End Labeling ; Necrosis ; Receptors, TNF-Related Apoptosis-Inducing Ligand* ; Uterine Cervical Neoplasms*

The superoxide anion, hydrogen peroxide, and hydroxyl radical are oxygen free radicals which arise in cell metabolism and which are toxic to cells, with an important role in carcinogenesis. The measurement of the oxygen free radical is a problem due to the instantaneously changing nature, and therefore the superoxide dismutase(SOD) is employed which act as an oxygen free radical scavenger. The authors quantitatively analyzed the SOD levels in normal uterine cervix epithelium, cervical intraepithelial neoplasia, and in invasive cervical cancer patients by the SOD-525R spectrophotometric assay and compared the results between each group with respect to prognostic variables such as stage of disease, cell type, lymph node involvement, and SCC Ag(TA-4 Ag) levels. The mean SOD levels were 0.41U/ml, 0.39U/ml and 0.73U/ml in the normal uterine cervix, intraepithelial neoplasia, and invasive cervical cancer groups, respectively, showing statistically significant difference by the Oneway anova test(p=0.05). The mean SOD levels according to the stage of disease were 0.5U/ml, 0.62U/ml, and 1. 15U/ml for stages I a, I b, and stage II and above(p=0.029). For the cell type the SOD levels were 0.77/ml for squamous cell carcinoma and 0.57U/ml for adenocarcinoma(p=0.15). For cancer cell lymph node involvement cases, the mean SOD levels were 0.75U/ml and 0.57U/ml for lymph node involvement and no involvement respectively(p=NS). The mean SOD levels also did not show any significance when compared with SCC Ag levels where SOD was 0.78U/ml for SCC Ag levels of more than 2.0ng/ml, and 0.77U/ml for SCC Ag levels of less than 2.0ng/ml. From the above results the authors conclude that SOD levels were higher in invasive cervical cancer tissues compared to intraepithelial neoplasia and normal cervical tissues, that SOD levels increased with higher stage of disease, and that there was no relationship between SOD levels and known prognostic variables such as cell type, lymph node involvement and SCC Ag level.
Carcinogenesis ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Epithelium ; Female ; Free Radicals ; Humans ; Hydrogen Peroxide ; Hydroxyl Radical ; Lymph Nodes ; Metabolism ; Oxygen* ; Superoxides* ; Uterine Cervical Neoplasms

It is a rare occurrence that cervical cancer and aplastic anemia are combined, but eight cases were reported since Fujiu's report in 1968. There has been no one who have reported the case of like this in Korea. And so, we report this case for the support of idea of treatment in aplastic anemia patient combined with cervical cancer. The knowledges required are early detection of malignancy and the individualization of the treatment according to the status of the patient, the bone marrow function saving procedure and the prevention of the patient from death involved with bleeding and sepsis induced by infection.
Anemia, Aplastic* ; Bone Marrow ; Hemorrhage ; Humans ; Korea ; Sepsis ; Uterine Cervical Neoplasms*

OBJECTIVE: the enzymes cyclooxygenase(COX)-1 and -2 are necessary for the synthesis of prostaglandins. COX-2 is usually absent in normal cells and is upregulated and expressed as a product of the "immediate early" gene during inflammatory processes. In previous studies, the expression of COX-2 has been shown to be induced by prointlammatory cytockines, and suggestions have been made that overexpression of COX-2 supresses apoptosis and is directly related to tumor growth. We the authors have attempted to determine a relationship between the tumor invasion and metastasis of uterine cervical cancer and COX and apoptosis by comparing the protein expression of apoptosis and COX-I and COX-2 in tumor tissues confirmed with cytokeratin, and therefe determine the clinicopathologic risk factors. MATERIALS AND METHODS: The subjects were 18 patients who were FIGO stage IB uterine cervical cancer patients who underwent surgery at the Ajou University Medical Center. The 18 cases were comprised of 12 cases of squamous cell carcinoma, 3 cases each of adenocarcinoma and adenosquamous carcinoma. There were 9 cases with lymph node or prarametrial involvement and 13 cases with lymphvascular space involvement. All tissues obtained from the cases were subject to immunohistochemical staining for COX-1, -2 and TUNEL method for apoptosis detection, and the following results were obtained. RESULTS: Tumor tissues confirmed by cytokeratin wae separated into tumor surface, tumor stroma, and invasion site portions, and in which increased apoptosis was observed in the tumor surface and tumor stmma, but not in the invasion sites. COX-2 expression was observed in all tumor tissues, which was especially strong in the tumor invasion site. Therefore, it is suggested that COX-2 expression may supress cell apoptosis at the site of tumor invasion. When COX-2 expression was investigated when the cases were divided into groups with regard to the presence or absence of lymph node or parametrial involvement, there was statistically significant (Mann-Whitney U test) COX-2 expression seen microscopically in the tumor stroma (p-value=0.028) and tumor invasion site (p-value=0.040) compared to the tumor surface (p-value=0.499). In other words, in surgically treated stage IB cervical cancer patients, COX-2 was significantly expressed when lymph node or parametrial involvement was present. CONCLUSIONS: These results suggest that the expression of COX-2 in stage IB cervical cancer patients may downregulate apoptosic processes and thus enhances tumor invasion and metastasis.
Academic Medical Centers ; Adenocarcinoma ; Apoptosis ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Humans ; In Situ Nick-End Labeling ; Keratins ; Lymph Nodes* ; Neoplasm Metastasis* ; Prostaglandin-Endoperoxide Synthases* ; Prostaglandins ; Risk Factors ; Uterine Cervical Neoplasms*

Osteogenesis imperfecta (OI) is an inherited disease of connective tissue disorder which represents a phenotypically heterogeneous group of conditions that results from a number of genetic defects in the synthesis of type I collagen. A pregnancy associated with osteogenesis imperfecta is considered a high risk pregnancy because the disease is associated with various metabolic and hematologic disorders, as well as well-recongnized skeletal abnormalities. In addition to the mother with OI, the offspring has about a 25% to 50% chance of being affected, therefore genetic counseling before conception and prenatal diagnosis should be offered to all affected mothers. Patients with OI present a series of problems and require a multidisciplinary approach in their management. We present a case of parturient with osteogenesis imperfecta with brief review of literature.
Collagen Type I ; Connective Tissue ; Fertilization ; Genetic Counseling ; Heredity ; Humans ; Mothers ; Osteogenesis Imperfecta* ; Osteogenesis* ; Pregnancy* ; Pregnancy, High-Risk ; Prenatal Diagnosis