OBJECTIVES: Angiogenesis is a critical factor in the growth, progression, and metastatic spread of solid tumors. Angiogenic factors are soluble molecules released by the tumor itself and are able to induce an angiogenic response. Vascular endothelial growth factor(VEGF) is a multifunctional cytokine that has been shown to be an important regulator of tumor angiogenesis. The aim of this study was to determine the value of serum VEGF levels in the diagnosis of ovarian cancer and in the differential diagnosis of adnexal masses. And we questioned whether the serum VEGF levels are related to cancer stages and prognosis of patients. METHODS: Serum samples were taken from 85 patients; healthy women(n=15), the patients with benign ovarian cyst(n=36), and the patients with ovarian cancer(n=34). The concentration of VEGF, CA-125, and CA 19-9 were determined in the serum of each patients before and after treatment with an enzyme linked immunoassay(EIA), RESULTS: There are statistical differences among the serum VEGF levels in patients with ovarian cancer(491.5+/-335.6 pg/ml), and benign ovarian cyst (247.7+/-183.6 pg/ml)(p<0.05). The patients undergoing cancer therapy had lower values than those without cancer therapy(p<0.05). The serum VEGF levels were not correlated with the cancer stages and histologic types(p>0.05) CONCLUSION: The serum VEGF level appears to be a helpful tool in the differential diagnosis of ovarian cancer and may help in predicting the therapeutic effects of patients with ovarian cancer.
Angiogenesis Inducing Agents ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Ovarian Cysts ; Ovarian Neoplasms* ; Prognosis ; Vascular Endothelial Growth Factor A*

OBJECTIVES: The TGF-Beta1 (transforming growth factor-Beta1 ), which has been shown to inhibit cellular proliferation in vitro as a growth regulator, has been demonstrated to enhance tumori-genicity in vivo. The proteolytic processes of cancer are thought to be the crucial point in tumor invasion and metastasis, mainly by matrix metalloproteinases.(MMPs) We investigated the serum TGF-Beta1 and MMP-2 levels in patients with cervical cancer in contrast to those of normal, patients with benign myoma, and cervical intraepithelial neoplasia (CIN). And we questioned whether these serum levels are different according to the therapy of cancer or not. METHODS: We measured serum TGF-Beta1, MMP-2 concentrations by ELISA in 34 patients with cervical cancer, as well as 5 normal volunteers, 14 patients with benign myoma and 23 patients with CIN. Especially in 7 patients with cervical cancer, we measured serum TGF-Beta1, MMP-2 levels before and after therapy. RESULTS: The serum TGF-Beta1 levels in patients with cervical lancer(37.8 +/-15.4pg/ml) were significantly lower than those of the patients with CIN(46.2+/-9.2pg/ml)(p<0.05). But there is no differences among the serum MMP-2 levels in the patients with cervical cancers(680.30+/-116.6pg/ml), CIN(715.2+/-150.0pg/ml), and benign myoma(682.4+/-112.5pg/ml)(p>0.05). Patients undergoing cancer therapy did not have different values of serum TCF-Beta1 and MMP-2 levels as those without cancer therapy.(p>0.05) CONCLUSION: So we suggest that serum TGF-Beta1 may be helpful in differential diagnosing cervical cancers from CIN.
Cell Proliferation ; Cervical Intraepithelial Neoplasia* ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Humans ; Myoma ; Neoplasm Metastasis ; Transforming Growth Factor beta1* ; Uterine Cervical Neoplasms*

BACKGROUND: EGF and TGF-a are ligands for the EGF-receptor and act as mitogens for a variety of tissues. TGF-a, in particular, has been implicated as an autocrine growth factor for several cancer cell lines. TGF-B exerts an inhibitory effect on the growth of most epithelial cell types, and the loss of responsiveness to this growth inhibition has been implicated in the development of a variety of human cancers. In the present study, we evaluate whether EGF, TGF-a and TGF-B modulate apoptosis and cell cycle progression in cervical cancer cell lines. MATERIALS & METHODS: The effect of EGF, TGF-a and TGF-B on apoptosis and cell cycle such as CaSki and HeLa cell lines was analysed by flow cytometry RESULTS: 1. TGF-B did not induce apoptosis in CaSki and HeLa cell lines. 2. TGF-B as well as EGF, TGF-a, did not affect the process of apoptosis significantly. 3. The time to occur apoptosis was different between CaSki and HeLa cells treated by growth factots. 4. G1 phase was the checkpoint in CaSki and HeLa cells treated with TGF-B. CONCLUSION: These results suggest that TGF-B as well as EGF, TGF-a does not induce apoptosis and cell growth inhibition.
Apoptosis* ; Cell Cycle Checkpoints* ; Cell Cycle* ; Cell Line* ; Epidermal Growth Factor* ; Epithelial Cells ; Flow Cytometry ; G1 Phase ; HeLa Cells ; Humans ; Ligands ; Mitogens ; Uterine Cervical Neoplasms*

In comparison with normal cervix, mitosis occur more frequently in cervical intraepithelial neoplasia(CIN) and are seen at high levels, suggesting that CIN may be associated with a progressive dysfunction in proliferative activity of cervical cells. This study aims that expression of proliferative cell nuclear antigen(PCNA) was examined to determine proliferative activity at the cell of CIN. Sixty four colposcopic biopsies from patients with cytologically and/or colposcopically dtagnosed condyloma and CIN. The cases were classified as follows ; 19 as normal cervix and condyloma, 15 as CIN I, 16 as CIN II and 14 as CIN III. Immunohistochemical detection of PCNA was performed on paraffin sections by the streptavidin-biotin peroxidase method using the monoclonal antibody PC10. There was a statisically significant correlation between the CIN grade and the PCNA grade(p<0.05). In addition, the PCNA grade showed significant correlation with mitotic grade(p<0.05) and the CIN grade was also observed(p<0.05). This study suggests that the cell proliferation index as detected immunohistochemically using PCNA may be a useful adjunct to histopathological diagnosis of various grades of CIN.
Biopsy ; Cell Proliferation ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Diagnosis ; Female ; Humans ; Mitosis ; Paraffin ; Peroxidase ; Proliferating Cell Nuclear Antigen*

Stein-Leventhal syndrome is a clinicopathological entity characterized by chronic anovulation and sclerotic ovaries. Clinically, the affected patients typically present their third decade with a history of premenarchal obesity and postmenarchal onset of oligomenorrhea or amenorrhea, infertility, and clinical evidence of increased androgen production. In some patients, there are estrogenic phenomena such as menometrorrhagia with or without endometrial hyperplasia or carcinoma. Several studies have indicated that there may be an increased incidence of ovarian neoplasia in polycystic ovaries. Recently, we experienced two cases of polycystic ovaries assotiated with endometrial carcinoma in premenopausal women, who had clinical characteristics of Stein-Leventhal syndrome; one of the cases had additional serous cystandenofibroma.
Female ; Humans ; Incidence

OBJECTIVE: To evaluate the clinical effect and reproductive outcome of pelviscopic ovarian drilling in infertile patients with polycystic ovarian syndrome resistant to clomiphene citrate. METHODS: Twenty two patients involved in this study were taken pelviscopic ovarian drilling with needle electrocautery. Change of characteristic LH/FSH ratio before and after operative treatment, ovulation and pregnancy success were followed up. Paired t-test was applied for hormonal change (p<0.05). RESULTS: Thirteen of 14 patients (93%) treated only with pelviscopic ovarian drilling showed successful ovulation with or without clomiphene citrate and among these 10 patients (71%) were success in pregnancy and 9 patients delivered full term babies. When including patients who needed other assisted reproductive technique and specific medication of endometriosis 17 of 22 patients (77%) were successfully pregnant and 15 patients (68%) delivered healthy babies. The mean LH/FSH ratio 2.0+/-0.5 before treatment were decreased to 1.26+/-0.37 after treatment (p<0.05). Interestingly, among 22 patients, various degree endometriosis were found during pelviscopy and specific medication with GnRH analogue were followed. CONCLUSION: Pelviscopic ovarian drilling showed successful ovulation rate and effective reproductive outcome in clomiphene-resistant infertile patients with PCO. This surgical technique seems to be an alternative step for the management of clomiphene-resistant infertile patients with PCO and also for the diagnosis of possible high rate of endometriosis in these patents.
Clomiphene* ; Diagnosis ; Electrocoagulation ; Endometriosis ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Needles ; Ovulation ; Polycystic Ovary Syndrome* ; Pregnancy ; Reproductive Techniques, Assisted

Decubitus ulcer is often seen in the skin and underlying tissue of debilitated or immobilized patients as the result of prolonged pressure and impaired circulation. It manifests chiefly as an ulcer over bony prominences, but tumefaction is an extremely unusual presentation. A 53-year old male, a paralytic of the lower extremity for 18 years, developed a recurrent decubital ulcer despite repeated surgical repair, from which a rapidly growing, large fungating mass grew within a month. The last resected mass was bosselated and measured 15x9x3 cm with a major area of cicatrix-like induration, interdigitated with skeletal muscle bundles at the central area. Microscopically, the mass was composed of an upper half of active granulation tissue layer and a deeper half of dense, poorly cellular, fibrocollagenous bundles admixed with florid proliferation of atypical fibroblasts, but the absence of mitosis and the multifocal admixture of active inflammatory process-granulation tissue formation seemed to help exclude genuine fibromatosis, nodular fasciitis or proliferative myositis. We assume that this rapidly growing pseudofibromatosis is an additional manifestation of a prolonged decubitus ulcer, possibly related to the modified reparative process of decubitus ulcer following repeated excisions, for which we propose a term of decubitoma.

Cytokeratins are a family of polypeptides of intermediate filaments which in diverse epithelia are expressed in diffeent, yet specific combinations. To evaluate the diagnostic value of keratin, immunohistochemical staining was done in formalin-fixed, paraffin-embedded normal and neoplastic tissues by PAP and StreptABC methods. The antiserum for cytokeratin in monoclonal antibody which gives the specificity for 40, 46, 50, 52, 56, 58, and 65-67 Kd keratin classes. The results are as follows: 1) The staining was positive for cytokeratin in all of the squamous epithelium, ductular epithelial cells of various glands, respiratory and urinary tract epithelium, and mesothelial cells. 2) No staining for cytokeratin was ovserved in respiratory alveolar epithelium, acinar cells of various glands, renal glomeruli, hepatocytes, and many mesoderm-derived tissues such as muscle, hematopoieitc and lymphoid tissues, nerve, bone, cartilage, and fibroblasts. 3) Squamous cell carcinomas, transitional cell carcinomas, mesotheliomas, and some of the adenocarcinomas (stomach, colon, uterine cervix, biliary tract and breast) exhibited positive staining for cytokeratin. Epithelial cells of thymoma, adenomatoid tumor, plemorphic adenoma of salivary gland, papillary carcinoma of thyroid, lymphoepithelioma, and craniopharyngioma were also positive. 4) Some of the adenocarcinomas (prostate and pancreas), renal cell carcinoma, ovarian stromal and germ cell tumors, hepatocellular carcinoma, malignant melanoma, and mesoderm-derived tumors including malignant lymphoma were uniformly negative for staining. 5) From the above results, the immunohistochemical study in paraffin-embedded tissues using monoclonal antibody for cyto keratin may be useful to differentiate various tumors, especially in differential of hepatocellular carcinoma from bile duct adenocarcinoma, lymphoepithelioma and other undifferentiated carcinomas from lymphoma, thymoma from lymphoma, and squamous cell carcinoma from melanoma. It will be helpful in the diagnosis of transitional cell carcinoma in which the differentiation from renal cell carcinoma and prostatic adenocarcinoma be difficult.
Adenocarcinoma ; Adenoma ; Carcinoma, Hepatocellular

Alzheimer's disease (AD) is an age-related disorder. Both the prevalence and the incidence of AD double approximately every 5 years after the age of 60. This is a particularly serious problem considering that the Korean elderly population is rapidly growing. We present three illustrative cases of AD in mild, moderate, and advanced stages, respectively. Their initial symptoms were memory impairment which was followed by language disturbance and visuospatial dysfunction. Abnormal behaviors such as delusion and aggression occurred in moderate and severe cases. The presence and severity of dementia in these cases were established by history taking, neurological examination, standardized mental status assessment, and neuropsychological test. Laboratory investigations showed no abnormalities that could account for the cognitive deficits. Brain CT or MRI findings of the patients wee not remarkable except for a diffuse atrophy demonstrated by increased ventricular volume, narrowed gyri, and widened sulci, As an addendum, risk factors, clinical symptoms, clinical diagnosis, and natural history of AD were reviewed.
Aged ; Aggression ; Alzheimer Disease* ; Atrophy ; Brain ; Cognition Disorders ; Delusions ; Dementia ; Diagnosis ; Humans ; Incidence ; Magnetic Resonance Imaging ; Memory ; Natural History ; Neurologic Examination ; Neuropsychological Tests ; Prevalence ; Risk Factors

No abstract available.
Mucocutaneous Lymph Node Syndrome* ; Thrombocytopenia*