The genome of Hantaan virus, the prototype of the hantavirus genus, is composed of three segmented, single stranded negative sense RNA genome. The 5' and 3' termini of the Hantaan virus RNA genome contain noncoding regions (NCRs) that are highly conserved and complementary to form panhandle stuctures. There are some reports that these NCRs seems to control gene expression and viral replication in influenza virus and vesicular stomatitis virus. In this study, we examined whether NCRs in Hantaan virus play a role in expression of the viral nucleocapsid protein (Np) and foreign (luciferase) gene. The 5' and/or 3' NCR-deleted mutants were constructed and analysed. The Np expression of 5' NCR-deleted clone, it showed 40% reduction. To investigate the role of NCR in foreign gene expression, the clones which are replaced ORF of Hantaan viral Np gene with that of luciferase gene were constructed. The results were similar to those of the experiments using Np gene. These results suggest that 3' NCR is more important than 5' NCR in protein expression. To find out a critical region of 3' NCR in more important than 5' NCR in protein expression. To find out a critical region of 3' NCR in protein expression, several clones with a deleted part of 3' NCR were constructed and analyzed. The deletion of the conserved region in 3' NCR showed 20~30% decrease in Np expression. However there were no change in luciferase activities between clones with or without non-conserved region of 3' NCR. These results suggest that the 3' NCR of Hantaan virus S genome, especially conserved region in 3' NCR, plays and important role in the expression of Hantaan viral Np and foreign genes.
Animals ; Clone Cells ; Ecthyma, Contagious ; Gene Expression ; Genome* ; Hantaan virus ; Hantavirus ; Luciferases ; Nucleocapsid Proteins* ; Nucleocapsid* ; Orthomyxoviridae ; RNA ; Vesicular Stomatitis

PURPOSE: To evaluate the clinical significance of angle-opening distance 500 (AOD500) using ultrasound biomicroscopy (UBM) in the early stage of traumatic hyphema. METHODS: The participants of this study were 46 hospitalized traumatic hyphema patients. We measured the quantity of initial blood clotting using a slit-lamp and the range of angle recession, AOD500 using UBM and then reviewed the relationship between the two. RESULTS: The difference of AOD500 in the traumatic and the non-traumatic eye measured by UBM at admission increased significantly in the wider recessed angle group (p=0.008), but did not increase at a statistically significantly level in the larger initial blood clot grade group (> or =Grade 2). CONCLUSIONS: These results suggest that the measurement of the angle-opening distance of both eyes using UBM will aid in evaluating the range of angle recession in patients in the early stage of traumatic hyphema.
Blood Coagulation ; Eye ; Humans ; Hyphema ; Microscopy, Acoustic

PURPOSE: Locoregional recurrence of breast cancer after surgery has been regarded as a harbinger of distant metastases. The present study was undertaken to determine survival following surgical excision of isolated locoregional recurrence and to analyze prognostic factors for impact on survival after locoregional recurrence. Also, this study may provide information on the benefit group from surgical management. METHODS: From March 1993 to December 1998, of 43 patients with isolated locoregional recurrence after breast cancer surgery, 26 patients were treated with surgical excision with or without irradiation. Survival was analyzed according to prognostic factors retrospectively. RESULTS: The median follow-up was 15 months. the 3-year disease-free and overall survival was 50% and 63% for locoregional recurrences treated with surgical resection, and 6% and 14% for patients without surgery, respectively(p=0.04, p=0.07). Univariative analysis demonstrated that the initial axillary node status and the disease-free interval were found to be significant prognostic factors for overall survival(p=0.04, p=0.06). The disease-free interval from surgery to recurrence was also a significant prognostic factor for disease-free survival(p=0.03). CONCLUSION: These results suggest that isolated locoregional recurrence of breast cancer with a long disease-free interval and an initial node negative status may survived for long periods of time with aggressive surgical treatment.
Breast Neoplasms* ; Breast* ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Survival Rate

OBJECTIVE: Retinoic acids (RAs) and interferons (IFNs) have been implicated in the growth regulation of cervical cancer cells, which was suggested by clinical trials and in vitro experiments. However, the molecular mechanisms of growth regulation are not fully defined, The purpose of this study is to assess the effect of RA and/or IFN on human cervical carcinoma cells in vitro and to analyze their action mechanisms in HPV-positive cervical carcinoma cells by molecular biologic studies. METHODS: HPV-positive (CaSki, HeLa), HPV-negative (C33A, HT-3), and non-cervical cancer Cos-1 cell lines were treated with RA and/ar IFN. Their effects on cell growth were evaluated by the cell pmliferation assay and the following BrdU DNA incorporation assay. The molecular mechanism was further investigated by a series of immunoblottings and transient cotransfection assays, which were conducted in HeLa cells and C33A cells using the CAT reporter gene assay. To observe the down regulation of HPV E6/E7 gene expression by RA/IFN, reverse transcription-polymerase chain reaction (RT-PCR) was perforned. RESULTS: The powth of RA-treated cells was less suppressed than that of IFN-treated cells. Combined treatment of RA and IFN leads to additive effect on the growth suppression of HeLa and CaSki cells. The proliferation activity was most severely reduced in Hela cells by treatment of both all-trans-RA (AtRA) and IFN-r. Combined treatment of AtRA/IFN-r causes a great increase in the level of interferon regulatory factor-1 (IRF-1) protein in HeLa cells, whereas no induction of IRF-1 was observed in C33A cells. The CAT gene expression for IRF-1 was greatly induced by IFN-r in HeLa cells. Immunoblotting assays shows the concurrent induction of p21 CDK inhibitor and dephosphorylation of Rb protein in HeLa cells. In RT-PCR, an individual treatment of either RA or IFN reduced HPV E6/E7 mRNA levels and significantly cooperative when both RA and IFN were treated. By deaeasing E6 levels, the p53 level was increased in HeLs cells treated with RA and/or IFN. Transient cotransfection of IRF-1 and p53 as the transcription factors leads to the cooperative activation of a common p21 promoter to regulate the cell cycle. CONCLUSION: RA/IFN suppressed the growth of HPV-positive cervical cancer cells. When they were both treated, additive suppressive effects were observed in cellular proliferation as well as DNA synthesis. The growth suppressive effect is likely to be related to the increased expression of IRF-1 and p21 (antitumoral effect; p53-independent). The down regulation of HPV E6 gene suppression may account for the resultant increase of p53 levels (antiviral effect; p53-dependent). Both induced IRF-1 and p53 cooperatively augument tbe suppession of p21 CDK inhibitor, which results in dephosphorylation of pRb. Although clinical effects are likely complex and may include interactions of in vitro growth inhibitory effects with immunomodulatory and antiangiogeaetic effect, tbese results suggest the optimal clinical role for the combination of RA/IFN in the treatment of cervical canccers.
Animals ; Bromodeoxyuridine ; Cats ; Cell Cycle ; Cell Proliferation ; COS Cells ; DNA ; Down-Regulation ; Gene Expression ; Genes, Reporter ; HeLa Cells ; Humans ; Immunoblotting ; Interferon Regulatory Factor-1 ; Interferons* ; Retinoblastoma Protein ; RNA, Messenger ; Transcription Factors ; Tretinoin ; Uterine Cervical Neoplasms*

Primary peritoneal leiomyoma is histologically benign and rare non-neoplastic proliferation of smooth muscle that occurs in the peritoneal wall during the reprodutive years of women. A 51-year old patient had a solid tumor of 18cm diameter in the peritoneal wall, which was pathologically confirmed as a benign leiomyoma primarily originated from the retroperitoneal wall. Laparotomy revealed a solid tumor in the peritoneal wall, about 18cm, and histologically diagnosed as a leiomyoma. We report a case of primary peritoneal leiomyoma with a brief review of literatures.
Female ; Humans ; Laparotomy ; Leiomyoma* ; Middle Aged ; Muscle, Smooth

PURPOSE: Locoregional recurrence of breast cancer after surgery has been regarded as a harbinger of distant metastases. The present study was undertaken to determine survival following surgical excision of isolated locoregional recurrence and to analyze prognostic factors for their impact on survival after locoregional recurrence. Also, this study may provide information on the group that benefits from surgical management. METHODS: From March 1993 to December 1998, of 43 patients with isolated locoregional recurrence after breast cancer surgery, 26 patients were treated with surgical excision with or without irradiation. Survival was retrospectively analyzed according to prognostic factors. RESULTS: The median follow-up was 15 months. The 3-year disease-free survival rates were 50% for locoregional recurrences treated with surgical resection and 6% for patients treated without surgery (p=0.04), and the overall survival rates were 63% and 14%, respectively (p=0.07). Univariative analysis demonstrated that the initial axillary node status and the disease-free interval were significant prognostic factors for overall survival (p=0.04 and p=0.06, respectively). The disease-free interval from surgery to recurrence was also a significant prognostic factor for disease-free survival (p=0.03). CONCLUSION: These results suggest that patients suffering from isolated locoregional recurrence of breast cancer after a long disease-free interval and an initial node negative status may survive for long periods of time with aggressive surgical treatment.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Survival Rate

PURPOSE: In spite of improved local control and adjuvant therapy in breast cancer, many patients after a modified radical mastectomy suffer from locoregional or systemic failure. The purpose of this study was to assess both the patterns of failure following a mastectomy and the predictive factors affecting the risks of locoregional or systemic failure. METHODS: The study population consisted of 195 patients who developed locoregional or systemic failure from among 1,187 patients treated by using a modified radical mastectomy between July 1989 and October 1998 at the Asan Medical Center's Breast Clinic. The median follow-up time following the mastectomy was 41 months (range; 1-119 months). RESULTS: Isolated locoregional recurrence (LRR) developed in 46 patients (24%), LRR with distant metastasis in 43 (22%), and only distant metastasis in 106 (54%). The sites of LRR were as follows: the chest wall, 52%; the ipsilateral supraclaviclar node, 22%; and the axillary node, 15%; etc. The first sites of distant metastasis were as follows: bone, 46%; lung, 38%; liver, 12%; brain, 6%; and pleura, 6%; etc. Local or systemic failure appeared within the first 3 years following the mastectomy in 75-82% of the patients, and within 5 years in 95-98%. Multivariate analysis showed that increasing initial tumor size, increasing number of involved nodes, negative progesterone receptor, and increasing histologic grade were significant factors for increased risks of LLR or distant metastasis. CONCLUSION: Half of the locoregional recurrences following a mastectomy are isolated. T-stage, nodal status, progesterone receptor, and histo logic grade may help to identify patients at risk for locoregional or systemic failure after a mastectomy.
Brain ; Breast Neoplasms* ; Breast* ; Chungcheongnam-do ; Follow-Up Studies ; Humans ; Liver ; Logic ; Lung ; Mastectomy* ; Mastectomy, Modified Radical ; Multivariate Analysis ; Neoplasm Metastasis ; Pleura ; Receptors, Progesterone ; Recurrence ; Risk Factors* ; Thoracic Wall

OBJECTIVE: To determine whether severity of proteinuria or urinary protein fractional analysis correlates with adverse maternal and fetal outcomes in women with severe preeclampsia. METHODS: Thirty-six women diagnosed of severe preeclampsia from January, 2002 to April, 2003 were studied. The correlation between proteinuria or urinary albumin fraction, and maternal mean arterial pressure, neonatal birth weight, 1 minute apgar score were analyzed statistically. Thirty-six patients were divided into two groups according to the pattern of urinary protein fraction. One group was a selective proteinuria group if the albumin fraction was over 70%, and another was a non-selective proteinuria group if the fraction was below 70%. The maternal and neonatal outcomes were compared between the two groups. RESULTS: Significant positive correlation was observed between proteinuria and mean arterial pressure, between urinary albumin fraction and neonatal birth weight. Negative correlation was significantly present between proteinuria and neonatal birth weight, 1 minunte apgar score, between proteinuria and albunin fraction. Increased proteinuria, higher mean arterial pressure, higher serum uric acid level, lower creatinine clearance, lower neonatal birth weight, and lower 1 minunte Apgar score were observed in the non-selective proteinuria group than those in the selective proteinuria, although there was no statistical significance. CONCLUSION: With increasing proteinuria and decreasing albumin fraction, there is increased risk of adverse maternal and fetal outcome. Proteinuria fractional analysis by electrophresis might provide useful information regarding the prediction of pregnancy outcomes.
Apgar Score ; Arterial Pressure ; Birth Weight ; Creatinine ; Female ; Humans ; Pre-Eclampsia* ; Pregnancy ; Pregnancy Outcome ; Proteinuria ; Uric Acid

Neuralgic amyotrophy is a syndrome with a broad range of clinical manifestations. It is characterized by acute, severe pain in the shoulder or arm lasting several days or weeks, followed by muscle weakness and atrophy as the pain diminishes. The diagnosis is based on typical clinical features, electromyography (EMG) and a nerve conduction study. The early and correct diagnosis is important to preclude unnecessary testing or surgical procedures. A 59-year-old female patient presented with pain and weakness involving her right palm and 1-3rd fingers. Three weeks before presentation, she noted the sudden onset of severe right shoulder and forearm pain. After the pain was reduced, she noted persistent right palm and 1-3rd finger pain and weakness. On cervical MRI, there was a mild central disc protrusion at C4-5 and C5-6. Electrodiagnostic testing was performed and she was diagnosed with neuralgic amyotrophy. One week after hospital treatment, her pain was relieved from VAS 10 to 3 and she was discharged with mild weakness of the thumb and index finger during pinch grips.
Arm ; Atrophy ; Brachial Plexus Neuritis ; Electromyography ; Female ; Fingers ; Forearm ; Hand Strength ; Humans ; Middle Aged ; Muscle Weakness ; Neural Conduction ; Radiculopathy ; Shoulder ; Thumb

OBJECTIVE: To analyze chromosomal abnormalities according to patient's age and indications of patients in midtrimester amniocentesis for prenatal genetic diagnosis. METHODS: We retrospectively analyzed 3,503 cases of midtrimester prenatal genetic amniocentesis cases which were done in the cytogenetic laboratory at Kangnam St. Mary's Hospital, Catholic University Medical College. RESULTS: In 3,503 cases, the most common maternal and gestational age distributions were 35 to 39 years old and 17 to 17 week 6 days (32.2% and 21.5%, respectively). Abnormal maternal serum markers was the most common indication for amniocentesis (46.4%), and followed by advanced maternal age (40.3%) and abnormal ultrasonographic findings (3.2%). The overall incidence of chromosomal abnormalities was 180 cases (5.1%), of which numerical abnormalities and structural abnormalities were 78 cases (2.2%) and 102 cases (2.9%), respectively. Among the autosomal abnormalities, Down syndrome was most common (33 cases, 0.9%), and followed by Edward syndrome (17 cases, 0.5%). Among the sex chromosomal abnormalities, 45,X was the most common (6 cases, 0.2%). Chromosomal abnormalities were most frequently noted in the maternal age 18-19 years old (14.3%), 40 to 44 years old (7.0%), 25 to 29 years old (6.1%), 30 to 34 years old (5.2%), and followed by 20 to 24 years old (4.1%). On the other hand, chromosomal abnormalities were most frequently noted in abnormal ultrasonographic findings (12.4%), previous history of aneuploidy (8.3%), and followed by family history of aneuploidy (7.0%). CONCLUSION: This study suggested that although advanced maternal age is still important indication in midtrimester amniocentesis for prenatal diagnosis, abnormal maternal serum markers and ultrasonographic findings might be also important as indications. Therefore, they should be considered in prenatal genetic counseling.
Adult ; Amniocentesis* ; Aneuploidy ; Biomarkers ; Chromosome Aberrations ; Cytogenetic Analysis* ; Cytogenetics* ; Diagnosis ; Down Syndrome ; Female ; Genetic Counseling ; Gestational Age ; Hand ; Humans ; Incidence ; Maternal Age ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Retrospective Studies ; Young Adult