OBJECTIVE: Uterine cervical cancer is the most common malignant tumor in Korean women. Human papillomaviruses are associated in 85-90% of the cases. However, other cofactors are considered to be important in carcinogenesis. There is an evidence that the uterine cervix is the site of shedding of the Epstein-Barr viruses(EBV). Furthermore the virus has been detected in cervical intraepithelial neoplasia and invasive carcinoma of the uterine cervix. We studied to evaluate the role of EBV in cervical carcinogenesis. METHODS: Non-neoplastic cervices(12), carcinoma in situ(32), microinvasive squamous cell carcinomas(9), invasive squamous cell carcinomas(37) and adenocarcinomas and adenosquamous carcinomas(14) were studied for EBV infection. PCR and in situ PCR for EBNA-1 were done and subtyping was done using PCR for EBNA 3C. RESULTS: In non-neoplastic cervix, EBV was detected in 16.7% by PCR and found in normal epithelial cells and lymphocytes in in situ PCR. By PCR technique, EBV was detected in 65.6% of CIS, 66.3% and 51.4% of microinvasive and invasive squamous cell carcinomas, 57.1% of adenocarcinomas and adenosquamous carcinomas. EBV subtyping was done in EBV positive cases by PCR and all showed type 1. CONCLUSION: EBV was detected in higher frequency in cervical cancer than in non-neoplastic cervix. However the frequency was not correlated to the invasion depth and histologic types of cervical carcinomas. EBV was detected in tumor cells as well as normal epithelial cells and lymphocytes also. It was suggested that EBV may play a role in cervical cancers but the mechanism in carcinogenesis remains to be solved.
Adenocarcinoma ; Carcinogenesis ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Epithelial Cells ; Epstein-Barr Virus Infections ; Female ; Herpesvirus 4, Human* ; Humans ; Lymphocytes ; Polymerase Chain Reaction* ; Prevalence* ; Uterine Cervical Neoplasms*

No abstract available.
Alopecia

Pure ovarian choriocarcinoma of germ cell origin is exceedingly rare neoplasm, and even the presence of choriocarcinomatous elements admixed with other neoplastic germ cell elements is rare. In the most cases, the tumor is admixed with other neoplastic germ cell elemeats, and their presence is diagnostic of noagsatational choriocarcinoma, except for the remote of the tumor being a geatational choriocarcinoma metasttic to an ovarian germ cell tumor. We have experienced a case of nongestational ovarian choriocarcinoma in 10 year dld woman. So we report this case with a brief review of its literatures.
Choriocarcinoma* ; Female ; Germ Cells ; Humans ; Neoplasms, Germ Cell and Embryonal ; Pregnancy

Psoriasis is a multi-factorial disease with various clinical manifestations. We present a case of unilateral psoriasis associated with ipsilateral lymphedema that developed after mastectomy for breast cancer. A 42-year-old Korean woman was referred to our clinic with a 1-month history of multiple erythematous scaly patches on the right arm, back, and breast and was diagnosed with psoriasis by a skin biopsy. Three years previously, she had been diagnosed with breast cancer (T1N2), underwent a right quadrantectomy and axillary lymph node dissection, and completed adjuvant chemotherapy followed by high-dose adjuvant radiotherapy. She had started rehabilitation therapy on the right arm for secondary lymphedema 30 months previously. Because of the long interval between radiation and psoriasis, we speculated that changes in the local milieu caused by the lymphedema might be a causative factor. We hereby report a rare case of unilateral psoriasis following post-mastectomy lymphedema.
Adult ; Arm ; Biopsy ; Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Node Excision ; Lymphedema ; Mastectomy ; Psoriasis ; Radiotherapy, Adjuvant ; Skin

Multiple congenital melanocytic nevi (MCMN), defined as the distribution of more than three small- or medium- sized congenital melanocytic nevi (CMN) on the body without a giant CMN, is a rare disease comprising about 4% of patients with CMN. Because MCMN accompanies neurodevelopmental delay, including seizures in 25% of patients as well as the risk of malignant melanoma, it must be carefully followed-up. We report a case of MCMN with developmental delay in a 19-month-old Korean boy. He had a history of febrile seizure when he was 18 months old. He showed a speech delay after the 1-year-follow up, even though there was no evidence of neurocutaneous melanosis (NCM) on brain magnetic resonance imaging (MRI) at the first visit. As MRI has a low sensitivity for detecting NCM in patients with MCMN older than 4-months, close neurodevelopmental assessments should be considered to provide a chance for early rehabilitation.
Brain ; Humans ; Infant ; Language Development Disorders ; Magnetic Resonance Imaging ; Melanoma ; Melanosis ; Neurocutaneous Syndromes ; Nevus, Pigmented ; Rare Diseases ; Seizures ; Seizures, Febrile

BACKGROUND: Disordered lactate metabolism which is due to tissue hypoxia and hypoperfusion is frequently encountered in critically ill patients. These patients suffer from a high hospital mortality rate and are at great risk of developing multiple organ failure. The present study was designed to evaluate the prognostic value of blood lactate as a determinant of mortality in comparison with the APACHE II score. METHODS: 29 adult ICU patients participated in this study. Blood lactate concentrations, arterial blood gas analysis, hemodynamic data and APACHE II scores were collected on the first and last days of ICU stay. These data were compared between survivor and non-survivor groups. RESULTS: On the day of admission, blood lactate concentrations and APACHE II scores of non-survivors were 48.5 +/- 27.0 mg/dl and 18.5 +/- 5.9, while those of survivors were 23.7 +/- 12.9 mg/dl and 6.7 3.1. On the day of discharge, arterial blood lactate concentrations and APACHE II scores of non-survivors were 143.2 +/- 54.0 mg/dl and 28.2 +/- 6.0, while those of survivors were 14.9 +/- 7.1 mg/dl and 4.7 +/- 2.2. There was a significant positive correlation between high arterial blood lactate concentration and fatal outcome in critically-ill patients. There was also a significant positive correlation between arterial blood lactate concentration and APACHE II score. Furthermore, decreases in arterial blood lactate levels during the course of ICU stay may indicate a favorable outcome. The mortality increased abruptly in critically-ill patients with an initial arterial blood lactate concentration higher than 40 mg/dl. CONCLUSIONS: The result shows that arterial blood lactate concentration can serve as a reliable prognostic predictor and clinical guide to therapy in critically ill patients.
Adult ; Anoxia ; APACHE* ; Blood Gas Analysis ; Critical Illness* ; Fatal Outcome ; Hemodynamics ; Hospital Mortality ; Humans ; Lactic Acid* ; Metabolism ; Mortality ; Multiple Organ Failure ; Survivors

PURPOSE: Though the etiology of this cancer has not been elucidated, it has been suggested that certain types of human papillomavirus (HPV) and alteration of the p53 gene are closely associated with uterine cervical cancer. The aim of the study was to investigate the role of high risk HPV, p53 and p21 gene in cervical intraepithelial neoplasia III (CIN3) and invasive squamous cell carcinoma. MATERIALS AND METHODS: The presence of high-risk HPV DNA (16, 18, 31, 33, 35, 45, 51, 52, 56) were detected from cervical swab in 240 patients by hybrid capture method. Expression of p53 genes were studied in paraffin-embedded specimens by immunohisto- chemical staining and p53, p21 gene alteration by RT-PCR SSCP using fresh cervical tissues. RESULTS: High risk HPV DNA were detected in 34%, 74.3% and 75.7% in control, CIN3 and invasive squamaus cell carcinoma respectively. In patients with high risk HPV DNA, type 16 were detected of 5.9%, 30.8%, 47.2% respectively. Relative concentration of HPV DNA to control was 16.3+-27.4 in CIN3 and 30.4+-40.8 in invasive squamous cell cancer. Of patients with high risk HPV DNA, p53 expression was found in 42.9% of CIN3 immunohistochemically, while patients with invasive squamous cell carcinoma was de- tected in 50%. In patients without high risk HPV DNA, p53 expression was detected in 17.1% in CIN3, 15.7% in invasive squamous cell carcinoma. But the mutation of p53 and p21 gene by RT-PCR SSCP were not observed in CIN3 and invasive squamous cell carcinoma. CONCLUSION: These observations suggest that carcinogenesis of invasive squamous cell carcinoma from CIN3 may be concerned with high risk HPV concentration and may be occurred via another pathway without HPV and p53 or p21 mutation.
Carcinogenesis ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; DNA* ; Gene Expression* ; Genes, p53 ; Humans* ; Neoplasms, Squamous Cell ; Polymorphism, Single-Stranded Conformational ; Uterine Cervical Neoplasms*

PURPOSE: To determine the frequency and distribution of parenchymal changes on mammography before and after hormone replacement therapy. MATERIALS AND METHODS: Mammograms of 100 postmenopausal women who underwent hormone replacement therapy without breast disease were evaluated. Mammograms obtained annually after hormone replacement were analysed and compared with that of pretreatment. In addition, mammograms of control group and treatment group were compared. RESULTS: An increase in density of breast parenchyma was seen on the mammogram of 20 women(20%) receiving therapy. The mammograms from the control group showed no change. Mammographic changes were detected at first year in 13 women, 2nd year in 4 women, 3rd year in 2 women, and 4th year in 1 woman (average,19 months). CONCLUSION: We conclude that increase in mammographic density following postmenopausal hormone replacement therapy is not uncommon(20%).
Breast Diseases ; Breast* ; Estrogen Replacement Therapy* ; Female ; Hormone Replacement Therapy ; Humans ; Mammography*

BACKGROUND: Serum eosinophil cationic protein(ECP) level has been proposed as a indirect marker of eosinophilic inflammation of the airway in bronchial asthma. OBJECTIVE: To evaluate serum ECP against indirect clinical markers of disease, we compared bronchial obstruction, bronchial hyperresponsiveness and peripheral blood eosinophil counts, total IgE with serum ECP levels in patients with bronchial asthma and normal controls. METHOD: Fourty-two patients with bronchial asthma and twenty-six normal controls were enrolled. Measurement were made by spirometry, inhalation challenge with methacholine, peripheral blood eosinophil counts, total IgE and FEIA(fluoroenzymatic immunoassay) of serum ECP RESULT: Serum ECP levels were significantly higher in asthmatic patients than normal controls(p<0.0,5). Serum ECP levels were correlated with peripheral blood eosinophil counts(p<0.01, r=0.544) and bronchial hyperresponsiveness(PC,)(p<0.01, r=-0.456) in patients with bronchial asthma. Serum ECP levels were correlated with degree of bronchial obstruction(FEV, % to predicted value, FEV1/FVC%) in total subjects, but not in asthmatic patients. CONCLUSION: Serum ECP level may be used as indicator of disease activity in bronchial asthma and be helpful in differentiation between normal person and asthmatic patients on simple serological method. Further studies on the changes of serum ECP levels according to disease course and therapeutic responses are needed.
Asthma* ; Biomarkers ; Eosinophil Cationic Protein* ; Eosinophils ; Humans ; Immunoglobulin E ; Inflammation ; Inhalation ; Methacholine Chloride ; Spirometry

BACKGROUND: Endometrial carcinomas are pathogenetically classified into two major types; endometrioid carcinoma (EC) and serous carcinoma (SC). The most frequently altered gene in EC is the PTEN tumor suppressor gene (TSG). SC is usually associated with mutations in the p53 TSG. METHODS: To further determine the role of PTEN and p53 mutation in endometrial carcinogenesis, the analysis of 33 endometrial carcinomas, including 28 ECs and 5 SCs, for loss of heterozygosity (LOH) on 10q23 and for mutation in all 9 coding exons of PTEN and the 5-8 exons of p53, using SSCP-PCR methods was carried out. RESULTS: LOH was detected in at least one marker in 12 (54.5%) of 22 ECs, but in only one (20.0%) of 5 SCs. Somatic PTEN mutations were detected in 10 (35.7%) of 28 ECs. PTEN was altered in 67.9% of ECs and in 20.0% of SCs, including those with 10q23 LOH. No PTEN mutations were found among the SCs. Somatic p53 mutations were detected in 2 (7.1%) of 28 ECs and 3 (60.0%) of 5 SCs. CONCLUSIONS: PTEN gene alterations contribute to the pathogenesis of an endometrioid subtype of endometrial carcinoma, but not to the serous type. In contrast, p53 plays an important role in the pathogenesis of SCs.
Carcinogenesis ; Carcinoma, Endometrioid ; Clinical Coding ; Endometrial Neoplasms* ; Exons ; Female ; Genes, p53 ; Genes, Tumor Suppressor ; Loss of Heterozygosity