Carcinoma of the uterine cervix is the most common malignant tumor in Korean women. It is well known that carcinogenesis is a multi-step event involoving the inactivation of tumor supressor genes, such as p53 gene and RB gene. The inactivation of the normal functions of the tumor-suppressor proteins pRB and p53 are important steps in human cervical carcinogenesis, either by mutation or from complex formation with the HPV E6 and E7 oncoproteins. The pRB protein regulates early cell cyle progression by controlling transit through the G1 phase of the cell cyle. The p53 tumor suppressor gene product also plays a role in cell cycle control by the transcriptional regulation of cyclin-CDK inhibitor. Cervical carcinoma is an excellent model for studying the stepwise progression of cell transformation because this is reflected morphologically by the increasing dysplasia of the squamous cells before it becomes and invasive squamous cell carcinoma. The aim of this study was to examine the expression of pRB and compared that with overexpression of p53 in a series of cervical lesions including normal tissuess, dysplasias, carcinoma in situ and carcinomas by immunohistochemical staining with monoclonal antibody to elucidate the role of these tumor suppressor genes. The result were as follows: 1. In normal cervical mucosa and CIN I , a few positively stained cells for pRB were seen in basal and parabasal layer. 2. An abnormality of pRB, loss of expression was seen in 23.8% of CIN III and in 10.8% of invasive carcinoma. 3. Overexpression of p53 was demonstrated in 14.3% of CIN III and in 59.5% of invasive carcinoma. 4. The immunoreactivity of p53 was significantly increased (p<0.05) in stage II, III than stage I , whereas downregulation of pRB and tumor stage was not correlated. 5. The immunoreactivity of p53 was significantly increased (p<0.05) in squamous cell carcinoma than in adenocarcinoma, adenosquamous carcinoma and CIN III. These result suggest that an alteration of pRB is more frequently implicated in CIN III than invasive carcinoma, whereas overexpression of p53 may be involevd in late progression of uterine cervical carcinoma.
Adenocarcinoma ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Cell Cycle Checkpoints ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Down-Regulation ; Female ; G1 Phase ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Humans ; Mucous Membrane ; Oncogene Proteins ; Retinoblastoma Protein*

OBJECTIVE: To evaluate the safety and efficacy of the silicone ring pessary in the management of pelvic organ prolapse. METHODS: This study was evaluated for the clinical analysis of 58 pelvic organ prolapse patients who visited our hospital and weared silicone ring pessary from January 1997, to December 1998. RESULTS: Among 58 patients, failure rate was 13.7%(8/58) and complication rate was 50%(29/58). Main causes of failure were vaginal ulcer(4 cases) and recurrent falling out of pessary(3 cases). Most common problems were recurrent falling out of pessary(10 cases) and vaginal erosion with or without ulcer(9 cases), vaginitis(6 cases). There was no significant difference of failure rates and complication rates between hysterectomized patients and the non-hysterectomized patients. CONCLUSION: In management of pelvic organ prolapse which unsuitable for operation, pessary is noninvasive, simple and effective alternative method.
Humans ; Pelvic Organ Prolapse* ; Pessaries* ; Silicones*

OBJECTIVE: The objective of this survey is to introduce the recent adolescent sexuality, such as the level of sexual knowledge of adolescent, their actual state for the attitudes and behaviors toward sex, and in Korea in comparison with the past and to seek the answers to the improvement of the teproductive health statos of the adolescents. METHOD: The total number of 11,433 girls was drawn fiom middle and high schools girls in Seoul, Pusan, Incheon, Kwangju, Taegu, Taejeon and Ansan. Among them, the number of 82 girls was drawn fiom factory workers in Ansan. For the data collection, the survey was conducted during the period fiom Feb 15, 1994 to May 23, 1995 by using prepared questionaire. RESULT: Of those who respond to this study, 37.6% had sexual problems, which was that of acquaintance of the opposite sex(44.7%), menstruation(33.1%), and sexual maturity(13.1%). Among them, only 5.5% had a feeling of satisfaction about sex education. In regard to the attitude toward the friendly relationsbip with the oppasite sex, the approval rate respondents was 80.4%. Many respondents felt chastity and a virtue, but only 60.1% answered that pemarital chastity should be kept. For the each age group, age at sexual intercourse is revealed that among the respondents about 31.5% are experienced sexual intercourse for under 14 yearss old group, 25.3% for 15 years old, 26.3% for 16 years old, 12.6% for 17 years old, 3.3% for 18 years old, 1.0% for 19 years old. The major information source of knowledge source was school(38.4%), mass-media such as TV/radio(22.6%), book and magazine(19.9%), friends(16.2%), and parents (1.5%). CONCLUSION: In order to cope with the problems of adolescent sexuality, a drastic and strong policy measures should be taken by the government. At the same time, the public should be aware of the urgency of adolescent sexual problems. The most effective countermeasures appear to be education. Sexual education is necessary for the youth that they should bave an adequate sexual knowledge, attitudes and behaviors in their adolescent period.
Adolescent* ; Busan ; Coitus ; Daegu ; Daejeon ; Surveys and Questionnaires ; Education ; Female ; Gwangju ; Gyeonggi-do ; Humans ; Incheon ; Korea ; Parents ; Seoul ; Sex Education ; Sexuality* ; Virtues ; Young Adult

Paroxymal nocturnal hemoglobinuria is a kind of intravascular hemolytic anemia due to acquired corpscular defects, and is not rare in this country. The corpscular defect is originated from hematopoietic stem cells, and white blood cells and platelets are also involved. Consequently, the major complications which might affect mortality and morbidity include thrombotic phenomena, especially hepatic and cerebral venous thrombosis. This is a case report of cerebral venous thrombosis with hemiparesis, seizure and change of consciousness in paroxysmal nocturnal hemoglobinuria accompanied by intravascular hemolysis. The diagnosis is confirmed by CT brain scan and cerebral angiography and the patient is effectively treated with antiplatelets, anticonvulsants and steroids.
Anemia, Hemolytic ; Anticonvulsants ; Brain ; Cerebral Angiography ; Consciousness ; Diagnosis ; Hematopoietic Stem Cells ; Hemoglobinuria ; Hemoglobinuria, Paroxysmal* ; Hemolysis ; Humans ; Leukocytes ; Mortality ; Paresis ; Seizures ; Steroids ; Venous Thrombosis*

No abstract available.
Observer Variation*

Evoked potentials(EP) are kinds of electrophysiological study to gauge the senosry system, which usually carmot be measured on clinical examination, objectively and quantitaively. The limitations of the electrophysiological study on clinical applicat!on include variations of results depending on not only technical and environmental factors but also various physiological factors such as sex, age and height. The effects of technical and environmental factors can be standardized in each laboratory, but not for physiological factors. The importance of physiological factors is emphasized on the posterior tibial nerve evoked potential study, because of long travelling course including both peripheral and central nervous system. There are several reports on this problem, but with a lot of controversies probably due to different point of view and statistical analysis. Furthermore, contrary to many authors, I think the effect of various physiological factors cannot be measured by simple regression analysis because of close correlations between each others. To analyse the complex effect of various physiological factors on posterior tibial nerve evoked potential study, 123 cases(male;55, female;68)of the age more than 20 years old and without definite neurological deficits are studied and analysed.
Central Nervous System ; Evoked Potentials ; Evoked Potentials, Somatosensory* ; Humans ; Tibial Nerve* ; Young Adult

Uterine fibroids are the most common benign tumor of the female genital organ. Menorrhagia is the most common symptom associated with uterine fibroid. Since the first suggestion that embolization of uterine arteries might have a role in the management of fibroids by Ravina et al (France) in 1995,3 uterine artery embolization for management of fibroids has been performed actively in United states, United Kindom and Japan, and excellent therapeutic results have been reported. We have performed uterine artery embolization on patients with symptomatic fibroids or adenomyosis since August 1998. There have been few case reports of expelled fibroids out of vagina after uerine artery embolization, so we present a case in which successful embolization in woman with submucosal myoma resulted in a subsequent vaginal expulsion.
Adenomyosis ; Arteries ; Female ; Genitalia ; Humans ; Japan ; Leiomyoma* ; Menorrhagia ; Myoma ; United States ; Uterine Artery Embolization* ; Uterine Artery* ; Vagina

Primary papillary serous carcinomas (PPC) of the peritoneum are very rare and classically present with widespread intraperitoneal dissemination, superficial invasion, and minimal ovarian stromal involvement. Because of clinically and histologically similar to advanced stage epithelial ovarian carcinoma the treatment has been a similar fashion-cytoreductive surgery followed by systemic chemotherapy. Histologic differentiation between papillary mesotheliomas, primary ovarian tumors, borderline tumors of the ovary with peritoneal deposits and primary peritoneal carcinoma may be difficult. The prognosis is very poor and the median lifespan 4 months. We experienced a case of primary peritoneal carcinoma and reported with the brief review of the literature.
Drug Therapy ; Female ; Mesothelioma ; Neoplasm Metastasis ; Ovary ; Peritoneum ; Prognosis

No abstract available.
Cicatrix* ; Endometriosis* ; Female

Thymectomy is considered as one of the important therapy for patients with myasthenia gravis(MG) for reducing the symptoms and hasting the time of remission. However, the efficacy of thymectomy in previous studies were not in concordant with each others. This study was designed to assess the effects of thymectomy in 84 MG patients. The patients were divided into two groups according to their medications before thymectomy : the patients who had been treated with anticholinesterase(ACE group) and the others who had been treated with both anticholinesterase and steroid(steroid group). The outcomes of thymectomy were divided into two group : ""success"" and ""failure"". The ""success"" outcomes included the patients with remission or improvements and the ""failure"" outcomes included the patients with improvement by immunosuppressive agents, unimprovement, and death. To find factors which might influence on the prognosis after thymectomy, the following variables were considered for statistics; The onset age of MG, gender, myasthenic crisis before operation, the clinical symptoms at the time of operation, and the pathologic findings of thymus. The results were as follows. Sixty-six patients were included in ACE group and 18 in steroid group. The success were occurred in 37 patients among ACE group(56%) and in 8 patients among steroid group(44.4%). In ACE group, the success more frequently occurred in the patients with thymic follicular hyperplasia(79.3%) than in those with thymoma(36%), and normal or atrophic thymus(41.7%). The Patients who had mild clinical symptoms at the operation also showed higher success rate. However, gender, the age of onset, and the presence of myasthenic cirsis before the operation did not influences on the results of the operation. In steroid group, the success rate was higher in the patients with shorter duration of steroid treatment before thymectomy(< 6 month) and follicular hyperplasia. In addition, the immunosuppressive treatments also gave symptomatic improvements in most patients with failure outcomes after thymectomy. In conclusion, thymectomy demonstrated beneficial effects in about half of MG patients. Follicular hyperplasia and mild symptoms at the operation were considered to be factors for predicting better results after thymectomy. Our findings also suggest that the longstanding steroid treatment before thymectomy may negatively affect on the successful thymectomy, especially on remission.
Age of Onset ; Humans ; Hyperplasia ; Immunosuppressive Agents ; Myasthenia Gravis* ; Prognosis ; Thymectomy* ; Thymus Gland