The incidence of adenocarcinoma of the uterine cervix had shown an increasing tendency, and which is related to the increased use of oral contraceptives or prevalent in human papillomavirus infection. Endocervical glandular dysplasia or adenocarcinoma in situ are occasionally associated with squamous neoplasms of the uterine cervix. This study was aimed to evaluate the histologic features and the incidence of endocervical glandular lesions associated with squamous neoplasms, the presence of human papillomavirus infection-suggesting histologic findings in adjacent squamous neoplasms and the immmunohistochemical findings of endocervical glandular lesions for carcinoembryonic antigen. The materials used were 105 cases of microinvasive and invasive squamous cell carcinoma, and 83 cases of squamous intraepithelial lesions which are consisted of 142 radical or total hystrectomy products and 46 conization or loop excision products. The results are as follows; 1. Among 188 cases, six cases(3.2%) had shown foci of high grade glandular dyaplasia, and 19 cases(10.1%) revealed the areas of low grade glandular dysplasia. There was no adenocarcinoma in situ case. 2. In four of six high grade glandular dysplasia cases, microinvasive or invasive squamous cell carcinomas were associated. In low grade glandular dysplasias, sqaumous intraepithelial lesions were occcupying 68.4%. 3. HPV infection-suggesting histologic findings had accompanied all high grade glandular dysplasia cases and in 17 cases(89.5%) of 19 low grade glandular dysplasias. 4. In 2 of 5 high grade glandular dysplasias and in 1 of 19 low grade glandular dysplasias, the immunohistochemical reaction for carcinoembryonic antigen was similar to that of adenocarcinoma. In conclusion, the clinicopathologic importance of endocervical glandular lesions associated with squamous neoplasms of the uterine cervix should be kept in mind, and further study for the relationship between endocervical glandular lesions and human papillomavirus infection or hormonal influence will be continued.
Humans ; Incidence ; Adenocarcinoma

Detailed mechanism of uterine cervical cancer progression still remains unclear. Altered programmed cell death (apoptosis) and cellular proliferation are associated with the development of neoplasia. The authors investigated the expressions of bcl-2, which inhibit apoptosis, and caspase-3, which is involved in the induction of apoptosis and has been considered to be correlated with apoptosis, and proliferating activity according to the degree of malignancy in the squamous neoplasia of the uterine cervix. Correlation between bcl-2 and caspase-3 expression and proliferating activity was done. The materials were low grade squamous intraepithelial lesions (LSIL, n=15), high-grade squamous intraepithelial lesions (HSIL, n=15), microinvasive squamous cell carcinoma (n=15), and squamous cell carcinoma (n=15). Immunohistochemical stainings for bcl-2, caspase-3, and MIB-1 were done. bcl-2 and MIB-1 expressions were progressively increased in accordance with the increasing degree of malignancy, but caspase-3 immunoreactivity was higher in LSIL than invasive cancers. There was an inverse relationship between bcl-2 and caspase-3 expression, but the difference did not reach statistical significance. No significant correlation between MIB-1, bcl-2, and caspase-3 expressions was observed. These results suggest that an inhibition of apoptosis and the augmentation of proliferating activity of tumor cells might be separately involved in the development of the cervical squamous neoplasia.
Apoptosis ; Carcinoma, Squamous Cell ; Caspase 3* ; Cell Death ; Cell Proliferation ; Cervix Uteri* ; Female ; Uterine Cervical Neoplasms

PURPOSE: Henoch-Schonlein purpura nephritis(HSPN) accompanied by nephrotic syndrome(NS) is known to have a poor prognosis and effective treatment is still controversial, even though both corticosteroids and immunosuppresant have been used for therapy. Cyclosporine A(CsA) is a well known immunosuppresant and widely used in renal transplantation and glomerular diseases especially steroid resistant. The aims of this study was to evaluate the therapeutic effect of CsA and to compare CsA with previously reported our data of rifampin(RFP) and azathioprine(AZA) in children with HSPN accompanied by NS. METHODS: 37 HSPN patients with NS confirmed by renal biopsy were selected. Of these, 17 patients were treated with CsA(5 mg/kg/day) for 6-8 months, 7 children were treated with RFP(10-20 mg/kg/day) for 9-12 months and 13 patients were treated with AZA(2 mg/kg/day) for 8 months. Along with these regimens, low dose oral prednisolone(0.5-1 mg/kg, qod) was also used. Sequential renal biopsy was done in all patients 1 month after termination of treatment. RESULTS: Complete remission rate of nephrotic syndrome was 5S.8% in CsA, 57.1% in RFP and 38.4% in AZA group after 17, 22, 11 months of mean follow-up period. Overall remission rate including partial remission was 88.2% in CsA, 85.7% in RFP and 84.6% in AZA group. Disappearance rate of hematuria was 58.8% in CsA, 57.1% in RFP and 46.2% in AZA group. Improvement of grade of clinical status was observed in 17 out of 17 CsA, 7 out of 7 RFP and 10 out of 13 AZA group. Improvement of pathologic class on sequencial renal biopsy was shown in 5 CsA(29.4%), none RFP(0%) and 2 AZA group(12.4%). Improvement on histologic immune-deposition was seen in 15 CsA(88.2%), 6 RFP(85.9%) and 4 AZA group(30.8%). CONCLUSION: In conclusion, Both CsA and RFP treated groups showed better result in complete remission rate of nephrotic syndrome and significant inprovement of histologic immune-deposition compared with AZA treated group(p=0.004). So, we recommend CsA and RFP rather than AZA for immunosuppresant treatment in HSPN with nephrotic syndrome.
Adrenal Cortex Hormones ; Biopsy ; Biopsy, Fine-Needle* ; Breast* ; Child ; Cyclosporine ; Diagnosis* ; Follow-Up Studies ; Hematuria ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Nephrotic Syndrome ; Prognosis ; Purpura, Schoenlein-Henoch

Malignant transformation of benign cystic teratomas of the ovary is rare, with an incidence rate of 1-3%. The most common malignancy associated with benign cystic teratoma of the ovary is squamous cell carcinoma, which represents 90% of malignant transformations, followed by adenocarcinoma and carcinoid. Primary malignant neuroectodermal tumor in a mature cystic teratoma is extremely rare and microscopically can be subclassified as differentiated, primitive, and anaplatic. We experienced a case of primitive neuroectodermal tumor (PNET) associated with mature cystic teratoma of the ovary in a 11-year-old girl. Grossly, the ovary was a unilocular cyst which contained sebum material and disclosed several large, yellow to gray-tan polypoid excresences attached to the inner cystic wall. Except a large, fish-flesh, soft mass, the other polypoid masses were covered with sebum and contained small pieces of cartilage and tooth, and microscopically represented as mature teratoma. The large, fish-flesh, soft mass disclosed sheets and lobules of closely packed small cells with thin fibrovascular septa, which frequently replacing and encroaching the mature cystic teratoma. The small tumor cells were uniform and made up of round to oval nuclei with coarse chromatin and prominent nucleoli, very similar to those of PNET of the central nervous system.
Incidence ; Cysts ; Adenocarcinoma

In this study, the trypsin gene (bgtryp-1) from the German cockroach, Blattella germanica, was cloned via the immunoscreening of patients with allergies to cockroaches. Nucleotide sequence analysis predicted an 863 bp open reading frame which encodes for 257 amino acids. The deduced amino acid sequence exhibited 42-57% homology with the serine protease from dust mites, and consisted of a conserved catalytic domain (GDSGGPLV). bgtryp-1 was determined by both Northern and Southern analysis to be a 0.9 kb, single-copy gene. SDS-PAGE and Western blotting analyses of the recombinant protein (Bgtryp-1) over-expressed in Escherichia coli revealed that the molecular mass of the expressed protein was 35 kDa, and the expressed protein was capable of reacting with the sera of cockroach allergy patients. We also discussed the possibility that trypsin excreted by the digestive system of the German cockroach not only functions as an allergen, but also may perform a vital role in the activation of PAR-2.
Allergens/analysis/chemistry/*genetics ; Amino Acid Sequence ; Base Sequence ; Blattellidae/*genetics ; Blotting, Western ; Catalytic Domain/genetics ; DNA, Complementary/genetics ; Escherichia coli/metabolism ; Female ; *Genes, Insect ; Humans ; Male ; Molecular Sequence Data ; Molecular Weight ; Receptor, PAR-2/metabolism ; Recombinant Proteins/analysis/biosynthesis/chemistry ; Research Support, Non-U.S. Gov't ; Sequence Alignment ; Sequence Homology, Amino Acid ; Trypsin/analysis/chemistry/*genetics

Arteriovenous malformation of the uterus is rarely encountered. It is potentially lethal because of profuse, uncontrollable bleeding at the time of diagnostic dilatation and curettage. To our knowledge, only 38 cases of localized uterine arteriovenous malformation have been reported in English and Korean literature. Recently we experienced a case of uterine arteriovenous malformation in a 28-year-old multiparous woman. Under the clinical impression of uterine tumors or arteriovenous malformation, a total hysterectomy was done. Gross examination demonstrated a vascular nature of the mass in the posterior wall of the fundus. Microscopically, there was an ill-defined mass composed of numerous irregular, anastomosing large vessels with various diameters.
Female ; Humans

PURPOSE: A Phenomenological study was conducted to investigate the experiences of infertile women who had an unsuccessful in vitro fertilization (IVF) attempt and the structure of these experiences was identified in a socio-cultural context. METHOD: In-depth interviews were done with five participants from Nov. 1997 to Feb. 1998. Data was recorded and analyzed by Colazzi's method. RESULT: Significant statements were extracted from the data resulting in 4 themes and 11 concepts. The concepts were: 'lack of information', 'unable to anticipate the outcome', 'reaffirmation of need', 'financial strain', 'emotional suppression', 'change of social relationships', 'physical fatigue', 'blaming oneself or God', 'trying different ways', 'famous place shopping', and 'praying to God'. The significant themes of the participants' experiences with IVF emerged as: "uncertainty", "burden", "blaming" and "vigorous desire". CONCLUSION: The results indicate that the care of infertile women with an unsuccessful IVF attempt should be based on a deep understanding of their personal experiences. Also, information on alternative choices should be offered and supported.
Female ; Fertilization in Vitro* ; Humans ; Infertility ; Life Change Events

PURPOSE: Nursing research is recognized as an essential basis for the continuous development of the scientific nursing knowledge and practice. An understanding of the barriers and attitudes to research among nurses is important to improve clinical nursing research activities. METHOD: Data were collected from nurses at a general hospital, located in D city, using a self-reported questionnaire, from March 15th to April 4th, 2003, and 133 questionnaires were used for the analyses. A 5 pointscale instrument was used to measure barriers and attitudes towards nursing research, with a Cronbach's alpha of .85 and .89, respectively. RESULTS: Nurses had limited experience in research and were not well prepared to conduct it. Lack of experience, training and time were the major barriers for conducting research. However, the nurses had positive attitudes toward research. There was a difference in barriers (t=2.68, p=.02) and research attitudes (t=-2.74, p=.00) according to the nurses' position. Also, the nurses' research experience influenced research attitudes (t=-3.27, p=.00). The degree of research preparation (F=6.98, p=.00) had an effect on the attitudes toward nursing research but not on the barriers. CONCLUSION: There is an urgent need to promote both the ability and environment for clinical nurses to actively participate in research. As the majority of nurses had little experience and low confidence in research and perceived many barriers, this promotion can be accomplished by enhancing their confidence in research through continuing education and by gradually eliminating the barriers to research.
Nursing Staff, Hospital/*psychology ; *Nursing Research ; Korea ; Humans ; Female ; *Attitude of Health Personnel ; Analysis of Variance

The author list should be corrected.

The assocication between human papillomavirus infection (HPV) and cervical lesionhas been well established. for detection and typing human papilloma virus deoxyribonucleic acid in cervical tissues, Southern blot hybridzation and polymerase chain reaction are commonly regarded as reference standard methods. However it has the limitation includeing technical difficulty, safety, subjectivey in result interpretation. Recently the chemilnuminescent molecular hybridization assay method has been windely used and it has been known that it can detect less hybridization assay method has been windely used and it has been known that it can detect less then 1 pg of DNA in a 100n1 aliquot of a crude specimen. This study was perfomed to determine the usefulness of hybrid capture HPV DNA assay for detecting low-risk and high-risk human papillomaviruses in histologically confirmed normal, cervical intraepithelial lesion(CIN) and invasive squamous cell carcinoma of the cervix, and to compare the correlation among cervical cytology, hiopsy finding and HPVs infelction ,and to detirmine whether the additon of the hybrid capture test to cytologic studies would improve the ability to identify signifcant lesions. Cervical cytologic smears, hybrid capture HPVs DNA assay, and pucnh bhiopsies were performed on 78 women who have normal cervix(28cases),cervical intraepithelila lesion (24cases), and invasive squamous cell carcinoma(26cases). At first the probes for low-risk HPV(6,11,42,43,44) and the proves for high-risk HPV(16,18,31,33,35,45,51,52,56)were used and secondly retyping was done for HPV 16 abd 18 in high-risk HPV positive cases.the results obtained were as follows; 1. Low-risk HPVs infections were 14.3% and 8.3% in normal cervix and cervical intraepithelial lesion respectively. High-risk HPVs infection were 7.1%, 70.8% and 73.1% in normal cervix, cervical intraeithelial lesion and squamous cell carcinoma respecitively. These was highly significant corelation between positive high-risk HPVs test, cervical intraepithelial lesion and squamous cell carcinoma. 2. Positivities of low and high-risk human papillomaviruses in patients with negative cytologic result were 9.1% and 15.1% respectinvely. 3. In patients with high-risk human papillomaviruses infection, human papilloma viurs 16 and 18 types were detected in 47.4% and 13.2%, respectinvely, and both HPV 16 and 18 positive and negative detention were 15.7% 23.7% respectinvely. Among 12patinent of cervical intraepithelial neoplasia with high risk HPVs infection, HPV 16 was detected in 66.6% and HPV 18 in 16.7% Among 24 squamous cell carcinomas with high risk HPVs infection, HPV 16was detected in 41.7% and HPV 16 in 12.5% and both HPV and 18 in 25% 4. In patients without koilocytosis by cervical tytology, low and high-risk human papillomaviruses or both were positive in 30.7% 5. In patients with positive high-risk HPVs, sensitivitives of koilocytosis were 64% and 69% in histologic and cytologc diagnosis, and specificities and specifictites were 58.5% and 62% respectively. Above result suggest that detection for high-risk human papilloma viruses type by hybrid capture assay improves the management of cervical intraepithelial neoplasia and is more useful method over cervical cytology only.
Blotting, Southern ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Diagnosis ; DNA ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Papilloma ; Papillomavirus Infections ; Polymerase Chain Reaction ; Wind