Verrucous carcinoma of the larynx is a distinct and uncommon variant of well-differentiated squamous cell-carcinoma. The authors hybridized in situ a case of laryngeal verrucous carcinoma with DNA prebes to humman papillomavirus (HPV) 6, 11, 16, 18, 31, 33 and 35. The DNAs from the verrucous carcinoma of larynx hybridized with mixed DNA probes HPV-16/18 and 31/33/35. In addition, there was an evidence of HPV infection based on hybridization with mixed DNA probe HPV-6/11 in the adjacent papilloma tissue. By in situ DNA hybridization techniques, we clearly demonstrated human papillomavirus (HPV-16/18, and 31/33/35) related sequences in this neoplasm. These findings suggest the role of HPV-6/11 in the development of laryngeal papilloma ad HPV-16/18 and 31/33/35 probably on the progression to verrucous carcinoma.
Humans

The authors examined 9 condylomas, 26 cervical intraepithelial neoplasms(CIN) and 22 invasive squamous cell carcinomas for the presence of human papillomavirus(HPV) DNA sequences by DNA-DNA in situ hybridization. In situ hybridization revealed target HPV DNA sequences mostly in the nuclei of the superficial cells from epithelium which contained either maturation or koilocytotic atypias. With the use of biotinylated HPV DNA probes 6/11, 16/18 and 31/33/35, 42 of the 57(73.7%) were positive with HPV-6/11, 23 with HPV-16/18, 32 with HPV-31/33/35 and 18 with two or more mixed probes. HPV-31/33/35 was wht most prevalent in CIN and invasive squamous cell carcinomas, follwed by HPV-16/18. The incidence of HPV DNA increased from 66.7% to 86.4% with increasing severity of the lesions from condylomas to invasive squamous cell carcinomas. Flat condyloma was most freuently accompanied by CIN.
Humans ; Incidence

OBJECTIVE: To investigate whether polymorphism of Catechol-O-methyltransferase (COMT) gene is associated with the risk of polycystic ovary syndrome (PCOS) in Korean women. METHODS: One hundred and thirty-six PCOS patients and eighty four controls were enrolled. Blood samples were collected from the patients diagnosed according to the 2003 revised criteria of the Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Age matched women with regular menstruation from same geographic region were recruited as control subject. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of PCR products were done to determine all individuals' genotype. RESULTS: In women with COMT(LL) genotype, there was decreased PCOS risk and this difference was statistically significant (OR 0.24, 95% CI 0.11~0.51). CONCLUSION: The results suggest that the COMT(LL) genetic polymorphism might be associated with PCOS risk in Korean women.
Catechol O-Methyltransferase ; Consensus Development Conferences as Topic ; Female ; Genotype ; Humans ; Menstruation ; Polycystic Ovary Syndrome ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

PURPOSE: Recently, COMMD1 has been identified as a novel interactor and regulator of hypoxia-inducible factor-1 and nuclear factor kappa B transcriptional activity. The goal of this study was to determine the difference of COMMD1 expression in the placentas of women with normal and preeclamptic (PE) pregnancies. MATERIALS AND METHODS: Immnoperoxidase and immunofluorescent staining for COMMD1 was performed on nine normal and nine severe PE placental tissues, and COMMD1 mRNA expression was quantified by quantitative reverse transcription polymerase chain reaction. RESULTS: The expression of mRNA of COMMD1 was significantly higher in the study group than in the control group. The immunoreactivity was higher especially in the syncytiotrophoblast of PE placentas than in the control group. CONCLUSION: This study demonstrated increased placental COMMD1 expression in women with severe preeclampsia compared to that found in women with normal pregnancies, and this finding might contribute to a better understanding of the pathophysiology of preeclampsia.
Adaptor Proteins, Signal Transducing/genetics/isolation & purification/*metabolism ; Adult ; Female ; Humans ; Placenta/*metabolism ; Pre-Eclampsia/*metabolism ; Pregnancy ; RNA, Messenger/metabolism

BACKGROUND: The etiologies of ischemic cerebrovascular diseases are various-thrombosis or artery to artery embolism, cardiogenic embolism and lipohyalinosis. In the past embolic cerebral infarct was thought to occur uncommonly. But these days substantial portion of patients have been found to have potential embolic sources by transesophageal echo cardiography and carotid duplex doppler. As transesophageal echocardiography has a high yield for identification of potential sources of cardiac embolism in patients with ischemic cerbrovascular diseases, its use has been increasing. In Korea an increasing number of patients with ischemic cerebrovascular diseases have been examined by transesophageal echocardiography since 1990. But in all the previous studies transesophageal echocardiographic evaluation has been confined to the patients with high probability of embolic cerebral infarct. All kinds of ischemic cerebrovascular diseases patients have never been examined by transesophageal echocardiography and carotid duplex doppler and the prevalence of potential embolic sources in Korean ischemic cerebrovascular disease patients is not known. The aim of this study was to evaluate the prevalence of potential cardiovascular embolic sources by transesophageal echocardiography and carotid duplex doppler in unselected patients with ischemic cerebrovascular diseases. METHODS: We evaluated all kinds of ischemic cerebrovascular diseases patients admitted from 1994. 9. 1. until 1995 9. 31. to the Departments of Neurology and Internal Medicine of Kangnam General Hospital. We evaluated them by transesophageal echocardiography, carotid doppler, brain CT(or brain MRI). A significant carotid stenosis was defined as a duplex scandetected lesion producing at least 50% vessel narrowing. The following echocardiographic findings were defined prospectively as potential cardiac sources of embolism : atrial appendage or left atrial cavity thrombus, spontaneous echocardiographic contrast, atrial septal aneurysm, interatrial shunt, ventricular aneurysm, ventricular thrombus, myxomatous mitral valve and protruding atherosclerotic plaque in the ascending aorta or transverse aortic arch. RESULTS: Of 64 patients admitted during the study period, 30 were excluded(Three patients were critically ill, and twenty seven patients refused diagnostic work-up.). Thorough diagnostic work-up was performed in 34 patients. Transesophageal echocardiographic positive findings were present in six patients(17.6%). Of them four(4/34, 11.7%) had spontaneous echo contrast, two(2/34, 5.8%) had left atrial thrombi, one(1/34, 2.9%) had ascending aorta atheroma. Eleven patients(11/34, 32.3%) had abnormalities in carotid doppler study. Five patients(5/34, 14.7%) had abnormalities both in transesophageal echocardiography and carotid doppler study. CONCLUSIONS: The results suggest that among ischemic cerebrovascular diseases patients substantial portion of patients have potential embolic sources. The prevalence of potential embolic sources in Korea may be higher than previously expected. Because the relative small number of the patients studied make it difficult to generalize the results, further studies with a large number of patients are needed.
Aneurysm ; Aorta ; Aorta, Thoracic ; Arteries ; Atrial Appendage ; Brain ; Carotid Stenosis ; Critical Illness ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Hospitals, General ; Humans ; Internal Medicine ; Korea ; Mitral Valve ; Neurology ; Plaque, Atherosclerotic ; Prevalence ; Prospective Studies ; Thrombosis

PURPOSE: This study aimed to investigate the academic achievement and first-time experience with TBL in Year 1 medical graduate students through a medical dermatopathology lecture at Konkuk University School of Medicine. METHODS: 47 students prepared the objective-oriented assignment and completed an individual readiness assurance test, a group readiness assurance test, and a application exercise. Peer evaluation was done. At the completion of the lecture, the students were surveyed about their experiences. The scores from the TBL session activities and students' survey results were analyzed. The tutor's comment about TBL session was analyzed. RESULTS: Overall, TBL was helpful for the medical graduate students in understanding the dermatopathology lecture. Students' perception on their TBL experience was positive.They stayed focused on the activity and showed excellent teamwork. CONCLUSION: We allowed medical students to experience TBL through a dermatopathology lecture and then summarized their experience. This study demonstrates that TBL is an effective active teaching method for teaching dermatopathology.
Humans ; Learning* ; Students, Medical ; Teaching

BACKGROUND AND OBJECTIVES: The pathogenesis and etiology of inverted papilloma (IP) has not yet been clearly defined. The relationship between sinonasal IP and various strains of human papillomavirus (HPV) has been examined previously. Yet, there is little consensus regarding the incidence or role of HPV in IP. This study was performed to investigate the possible role of EBV in IP and to draw a relationship between histopathologic progression and EBV status. MATERIALS AND METHODS: This study is comprised of 19 cases of IP and 10 cases of turbinate mucosa as control. To find out the presence of EBV in paraffin block, we used PCR and ISH. Also, the author examined coexisting areas of dysplasia or malignant transformation and compared histologic findings with the results of molecular biologic studies. RESULTS: In PCR, the EBV genome was detected in 15 of 19 sinonasal IP (78.9%). By using ISH with the EBV oligonucleotide probe, EBV mRNA were found to be scattered throughout the epithelium in the IP with a similar incidence in PCR (13/19, 68.4.7%). One case of malignancy and all three dysplasia cases had EBV genome in PCR. In the middle turbinate mucosa which were used as control, 3/4 of the cases showed EBV genomes that are positive to PCR. CONCLUSION: The above results imply that EBV plays a role in the pathogenesis of IP and also indicate that the middle turbinate might be a site of viral persistence.
Consensus ; Epithelium ; Genome ; Herpesvirus 4, Human* ; Humans ; In Situ Hybridization* ; Incidence ; Mucous Membrane ; Papilloma, Inverted* ; Paraffin ; Polymerase Chain Reaction* ; RNA, Messenger ; Turbinates

Department of Protein-losing enteropathy is the manifestation of a diverse set of disorders, and it is characterized by the excessive loss of plasma proteins into the affected portions of the gastrointestinal tract, and this results in hypoalbuminemia. We report here on a case of severe protein-losing enteropathy with the typical clinical features of hypoalbuminemia, dependent edema and increased alpha 1-antitrypsin (alpha1-AT) clearance, as measured by using 24hr stool testing. The associated disorder with the protein-losing enteropathy of our case was radiation enterocolitis and lymphatic obstruction that was due to radiation treatment and lymph node dissection in the remote past for the treatment of uterine cervical carcinoma. Our case suggests that chronic radiation enterocolitis can result in irreversible injury to the intestinal mucosa and a protein-losing enteropathy, which can bring about a very poor quality of life and even the loss of life.
Aged ; Carcinoma/radiotherapy ; Cervix Neoplasms/radiotherapy ; Enterocolitis/complications/etiology ; Female ; Humans ; Lymph Node Excision ; Lymphatic Diseases/complications/etiology ; Protein-Losing Enteropathies/*etiology ; Radiotherapy/*adverse effects

BACKGROUND: Although the same treatment strategy has been applied for patients with aortic intramural hematoma (AIH) as typical aortic dissection (AD), the natural history of AIH with medical treatment is not known clearly. The purposes of this study were to test the hypothesis that absence of direct flow communication through intimal tear in AIH has different impact on clinical course compared with typical AD and to clarify the natural history of AIH. METHODS: Total 181 patients of acute aortic pathology (AD / AIH =57 / 124) were enrolled from 5 institutions. Patients received medical treatment without surgical intervention regardless of the affected site in acute stage, and follow-up imaging studies (FUIS) were performed in 105 patients with AIH. Clinical data of these patients were retrospectively analyzed. RESULTS: Fifty-four patients showed involvement of the ascending aorta (AD / AIH =13 / 41) and 127 revealed distal pathology (AD / AIH =44 / 83). Compared to the patients with AD, those with AIH were older regardless of the type and showed higher incidence of pleural effusion and mediastinal hemorrhage. In-hospital mortality of proximal AIH was 7 %, which was significantly lower than that of proximal AD (62 %); mortality of distal AIH was also lower than that of distal AD (1.2 Vs 9 %, p < 0.05). In proximal AIH, FUIS confirmed resorption of AIH in 67 %(24/36) and development of AD in 25 %(9/36). In distal AIH, resorption was confirmed in 78 %(54/69) and development of AD in 16 %(11/69). CONCLUSIONS: Patients with AIH showed excellent clinical course and high rate of resorption with medical treatment regardless of the affected site; typical AD developed only in limited cases. Absence of direct flow communication through intimal tear in AIH might explain more favorable response to medical treatment than typical AD.
Aorta ; Follow-Up Studies* ; Hematoma* ; Hemorrhage ; Hospital Mortality ; Humans ; Incidence ; Mortality ; Natural History ; Pathology ; Pleural Effusion ; Retrospective Studies

OBJECTIVE: The rates of participation in the Korean nationwide cervical cancer screening program and the rates of abnormal test results were determined. METHODS: The database of the National Health Insurance Service (NHIS) was used during the study period (2009–2014). RESULTS: The participation rate increased from 41.10% in 2009 to 51.52% in 2014 (annual percentage change, 4.126%; 95% confidence interval [CI]=2.253–6.034). During the study period, women ≥70 years of age had the lowest rate of participation (range, 21.7%–31.9%) and those 30–39 years of age the second-lowest (27.7%–44.9%). The participation rates of National Health Insurance beneficiaries (range, 48.6%–52.5%) were higher than those of Medical Aid Program (MAP) recipients (29.6%–33.2%). The rates of abnormal results were 0.65% in 2009 and 0.52% in 2014, with a decreasing tendency in all age groups except the youngest (30–39 years). Every year the abnormal result rates tended to decrease with age, from the age groups of 30–39 years to 60–69 years but increased in women ≥70 years of age. The ratio of patients with atypical squamous cells of undetermined significance compared with those with squamous intraepithelial lesions increased from 2.71 in 2009 to 4.91 in 2014. CONCLUSION: Differences related to age and occurring over time were found in the rates of participation and abnormal results. Further efforts are needed to encourage participation in cervical cancer screening, especially for MAP recipients, elderly women and women 30–39 years of age. Quality control measures for cervical cancer screening programs should be enforced consistently.
Aged ; Atypical Squamous Cells of the Cervix ; Early Detection of Cancer* ; Female ; Humans ; Korea* ; Mass Screening* ; National Health Programs* ; Papanicolaou Test ; Quality Control ; Squamous Intraepithelial Lesions of the Cervix ; Uterine Cervical Neoplasms*