OBJECTIVE: Uterine sarcomas are rare and characterized by rapid clinical progression and poor prognosis. The manegement of uterine sarcoma has been challenged. The purpose of this study was to investigate the clinicopathologic findings and outcome of patients with uterine sarcoma METHODS: From Sep. 1990 to July. 1999, 8 patients with histologically proven uterine sarcoma at department of obstetrics and gynecology of Chonbuk University Hospital were evaluated for their clinical profiles and survival retrospectively RESULTS: The age of patients with uterine sarcoma ranged 31 to 60, and the mean age was 46 years. The most common pathologic type of uterine sarcoma was leiomyosarcoma. The common presenting symptom were irregular uterine bleeding, hypermenorrhea and lower abdominal palpable mass. The patients with uterine sarcoma were treated by surgery, post-operative radiotherapy and adjuvant chemotherapy. The mean follow up duration was 34.1 months. The 2 year survival rate was 50%. Distant metastasis were reveled at two patients, and the sites are lung and brain. CONCLUSIONS: Uterine sarcomas are aggressive tumor with a poor prognosis. The Major treatment is surgery and the effect of chemotherapy and radiotherapy were undetermined.
Brain ; Chemotherapy, Adjuvant ; Drug Therapy ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Jeollabuk-do ; Leiomyosarcoma ; Lung ; Menorrhagia ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Radiotherapy ; Retrospective Studies ; Sarcoma* ; Survival Rate ; Uterine Hemorrhage

Authors found a case of anti-Wr(a) with anti-E antibody in 67 years old female patient. Anti-Wr(a) in Korea was reported for the first time in 2005. Anti-Wr(a) has been associated with hemolytic transfusion reaction (HTR) and hemolytic disease of the newborn (HDN). It is necessary to study the incidence of Wr(a) antigen and anti-Wr(a) in Korea.
Aged ; Blood Group Incompatibility ; Female ; Humans ; Incidence ; Infant, Newborn ; Korea

The use of steroid preparations by the external route was first employed in 1953 by Lievre. Since then a number of similar series have been published which confirm the value of the method. The present study was carried out in Wonju Christian hospital over a 4 year period. Of a total of 141 patients complaining of back pain and sciatica were treated by epidural in-jection .of methyl-prednisolone acetate(Depo-Medrol). The results were encouraging and this treatment seems to be a valuable adjunct to the management of lumbosciatic syndrome.
Back Pain* ; Epidural Space* ; Gangwon-do ; Humans ; Sciatica*

To compare the two previous reports of anesthetic experiences (1959-1977 and 1978-1982) at Wonju Christian Hospital, Wonju Medical College, Yonsei University, Wonju, Korea, anesthetic experiences of 23,524 reported cases, performed from January 1983 to December 1987, were analyzed statistically. There were no iclusions of cases performed through local anesthesia. The results were as follows: 1) The number of anesthetic cases increased on a year by year basis. 2) Sexual categorization was as follows: male 49.3%, female 50.7%. 3) According to the age category, the second to fourth decades of life occupied 41.9% of the these cases, and ifants occupied less than 0.3%. 4) According to prescribed anesthetic method, general inhalation anesthesia was performed in 75. 6% of these cases and regional anesthesia was performed in the other cases. 5) With respect the main anesthetic agent, halothane was utilized in 52.4%, while local anesthetics were used in 22.4% and Ethrane was used in 15.4% of the above cases. 6) Recording the preoperative A.S.A. physical status, class I was predominant over class II in elective operation, but class II was more apparent in emergent operations. 7) Among departmental emergent operations which accounted for 25% of all total cases, OB & GY accounted for 35% while General Surgery accounted for 28.9%. 8) Medical insurance patients were the most common.
Anesthesia, Conduction ; Anesthesia, Inhalation ; Anesthesia, Local ; Anesthetics, Local ; Enflurane ; Female ; Gangwon-do ; Halothane ; Humans ; Insurance ; Korea ; Male

To evaluate the results of cardiac anesthesia during open heart surgery using cardiopulmonary bypass, the cases of 100 patients from December 1986 to May 1989 were reviewed. The results were as follows: 1) There were 56 patients with congenital heart disease (male 32, female 24) and 44 patients with acquired heart disease (male 14, female 30). 2) The mean age of patients with congenital heart disease was 17.0+/-10.0 years and the mean age of patients with acquired heart disease was 41.2+/-14.6 years. 3) There were 54 cases of acyanotic heart disease and 2 cases of cyanotic heart disease among congenital heart disease, and 41 cases of valvular heart disease. 4) Glycopyroolate and hydroxyzine were mostly used as premedicants and morphine was used in some cases of acquired heart disease. 5) Anesthesia was induced by morphine and diazepam mostly while ketamine was used in some congenital heart disease. 6) The periods of cardiopulmonary bypass and aortic cross clamp in acquired heart disease were twice as long as in congenital heart disease. 7) The lowest body temperature during cardiopulmonry bypass was 26.7+/-2.5 degrees C in congenital heart disease and 24.1+/-3.6 degrees C in acquired heart disease while mean arterial pressure was maintained between 50-80 mmHg. 8) There were 33 cases of complications in 19 patients in which wound infection and arrythmia were most predominant. Four fatalities resulted from 3 cases of low cardiac output syndrome and 1 case of cerebrovascular disease.
Anesthesia* ; Arrhythmias, Cardiac ; Arterial Pressure ; Body Temperature ; Cardiac Output, Low ; Cardiopulmonary Bypass ; Diazepam ; Female ; Heart Defects, Congenital ; Heart Diseases ; Heart Valve Diseases ; Heart* ; Humans ; Hydroxyzine ; Ketamine ; Morphine ; Thoracic Surgery* ; Wound Infection

PURPOSE: HPV (human papillomavirus) are known as the major causative agent for development of cervical cancer. High-risk HPVs, especially HPV-16 /18 DNA, are often found to be integrated into the human genome in high grade CINs as well as cervial cancer. Investigation of the relationship between the genomic states of HPV genes and their antibody response against the HPV-16 Ll/L2 virus-like particles (VLPs) and the in vitro translated E6 and E7 proteins may help to explain the mechanism of HPV-related cervical carcinogenesis and host immune responses. MATERIALS AND METHODS: Cervical cancer tissues obtained from 41 patients with cervical cancer were studied by PCR, Southern blot hybridization and the antibody response against HPV-16 Ll/L2 VLPs and HPV-16 E6, E7 proteins of serum were tested by ELISA and radioimmunoprecipitation assay (RIPA), respectively. RESULTS: Integrated forms of the HPV-16 DNA were found in 23 of the 38 patients (60.5%). The HPV-16 positive cervial cancer patients had a significantly higher prevalence (39.5%; 15/38) of antibodies to HPV-16 Ll/L2 VLPs than 8.7% (2/28) of the the control group (p<0.05). Antibodies to HPV-16 Ll/L2 VLPs were more detectable in 60% (9/15) of the cervical cancer patients with episomal forms of HPV-16 DNA than those who having only integrated HPV-16 (26.1%; 6/23) (p<0.05). Antibodies to E6 and E7 proteins were positive in 36.8% (14/38) and 50% (19/38) of the patients with HPV-16 positive cervical cancer. And those were siginificantly higher than the positivities for the control group (8.3% and 2.8%), (p<0.05). The difference between seroreactivities to E6 and E7 proteins in the patients with episomal forms of HPV-16 DNA (pure episomal and mixed forms) and those with integrated froms of HPV-16 DNA was not significant (P>0.05). CONCLUSION: Integrated forms of HPV-16 DNA were prevalent in most patients with cervical cancer. Antibodies to HPV-16 Ll/L2 VLPs, in vitro translated HPV-16 E6 and E7 proteins appeared in the significantly larger proportions of the HPV-associated cervical cancer patients than in the controls. Antibodies to HPV-16 Ll/L2 VLPs were more detectable in the cervical cancer patients with episomal form of HPV-16 DNA than those who having only integrated forms of HPV-16. Antibody responses to HPV-16 E6 and E7 proteins were not influenced by the different viral states. More numbers of studies would be necessary to determine the relationship between the genomic states of HPV and the immune responses to their proteins by the such genomic and serologic parameters.
Antibodies ; Antibody Formation ; Blotting, Southern ; Carcinogenesis ; DNA ; Enzyme-Linked Immunosorbent Assay ; Genome, Human ; Human papillomavirus 16 ; Humans ; Polymerase Chain Reaction ; Prevalence ; Radioimmunoprecipitation Assay ; Uterine Cervical Neoplasms*

PURPOSE: We investigated the effects of all-trans-retinoic acid (ATRA) and/or interferon-gamma (IFN-gamma) on the growth of various cervical cancer cell lines and HPV E6/E7 expression. The relationships between the functional activities of HPV-URR and the growth inhibition were identified. MATERIALS AND METHODS: Four groups of cell lines were included; i) with integrated form of HPV-16 DNA (SNU-17, CaSki), ii) episomal form of HPV-16 (SNU-523), iii) integrated form of HPV-18 (SNU-1160, HeLa) and iv) episomal form of HPV-18 (SNU-1245). The promoter activity of HPV-URR was confirmed by transient transfection assay in C33A using the HPV-18 URR-CAT reporter plasmid. RESULTS: Selective mutation was detected in TEF-1 (transcriptional enhancer factor) binding site in SNU-17, and the activity of URR in SNU-17 was higher than that of the prototype. The proliferation was more inhibited in SNU-17 by IFN-gamma (10 ng/ml) than in SNU-902, CaSki and HeLa. The increase of the HPV-URR activity might play a role in the inhibition of growth by interferon-g. The expression of HPV-16 E6/E7 were significantly decreased by ATRA or IFN-gamma. CONCLUSION: Point mutation at TEF-1 binding site of SNU-17 was related with the increased transcriptional activity of URR. Mutation in the HPV-URR and alteration of HPV-URR activity in SNU-17 might be related with significant growth suppression by IFN-gamma.
Binding Sites ; Cell Line* ; DNA ; Human papillomavirus 16 ; Human papillomavirus 18 ; Interferon-gamma ; Plasmids ; Point Mutation ; Transfection ; Tretinoin ; Uterine Cervical Neoplasms*

BACKGROUNDS: Human papillomavirus (HPV) infection is known as the major causative phenomenon in the development of cervical cancer. E6 and E7 proteins of oncogenic HPV types can play critical roles in immortalization and malignant transformation of cervical epithelial cells. From the previous epidemiologic data, long term use of oral contraceptives may be one of the risk factor for cervical cancer. PURPOSE: Investigation of estrogenic and anti-estrogenic effects on the proliferation of cervical cancer cells and gene expression of HPV under the regulation of HPV upstream regulatory region (URR) would help to explain the role of estradiol in HPV-associated pathogenesis of cervical cancer. METHODS: Cervical cancer cells (HeLa, CaSki and C33A) were cultured in vitro in the presence of 17 beta-estradiol or tamoxifen and the numbers of cells were directly counted to observe the growth stimulatory or suppressive effect of the treatment. The correlation between the growth regulatory effect and HPV E6/E7 gene expression was determined by reverse transcription-polymerase chain reaction (RT-PCR). The estrogenic effect on the promoter activity of HPV URR was further confirmed by transient co-transfection assays, which were conducted in C33A cells using the HPV-18 URR-CAT reporter plasmid. Supplemental effect of estrogen receptor on the URR promoter activity was also evaluated. To analyze the growth suppressive function at the higher concentration of estradiol or tamoxifen in HeLa cells, DNA fragmentation assay was performed. RESULTS: The proliferation of HeLa and CaSki cells was stimulated by estradiol at the concentration of physiological level (< or =1 X 10-6M), reaching maximal growth at 0.5 X 10-6M. At concentration of 0.1 X 10-6M, tamoxifen also stimulated the proliferation of HeLa and CaSki cells. In contrast to HPV-positive cervical cells, C33A cells were not influenced to cell proliferation by addition of estradiol at the physiological level, indicating that HPV might play role in growth stimulatory effect of estrogen or tamoxifen. Interestingly, the proliferation of HeLa cells was totally suppressed by estradiol and tamoxifen at the higher concentration (5 and 10 X 10-6M), whereas those of CaSki and C33A cellswere not responded and little suppressed at the concentration, respectively. The levels of HPV-18 E6 and E7 mRNA were significantly increased after treatment of 0.5 X 10-6M estradiol as determined by RT-PCR. Furthermore, transient transfection experiments using the URR-CAT reporter plasmid indicated that the increased expression of HPV E6/E7 genes was related with the growth stimulatory effect of estradiol and tamoxifen. In addition, co-transfection of estrogen receptor (ER) leads to an over 4-fold increase in CAT activity after treatment of estradiol or tamoxifen with 0.5 X 10-6M. When estradiol or tamoxifen was treated at the concentration over 5 X 10-6M for 96 hr, a typical DNA ladder, a indicative of apoptosis, was observed in HeLa cells. However, DNA ladder was not detected in C33A cells of which growth was some suppressed under same concentration of estradiol. CONCLUSION: At the physiological levels, estradiol stimulated the growth of HPV-positive cervical cancer cells and tamoxifen also did at the concentration of 0.1 X 10-6M. The increased expression of HPV E6/E7 at the physiologic levels appeared to be related with the growth stimulation of HPV-positive cervical cancer cells. Growth suppression observed at the higher concentration (5 and 10 X 10-6M) might be a indicative of apoptosis shown by DNA fragmentation assay in HeLa cells. Taken together, these data suggested that the concentration of estradiol (< or =1 X 10-6M) could be a risk-factor in HPV-mediated cerivcal carcinogenesis.
Animals ; Apoptosis ; Carcinogenesis ; Cats ; Cell Proliferation ; Contraceptives, Oral ; DNA ; DNA Fragmentation ; Epithelial Cells ; Estradiol ; Estrogens* ; Gene Expression ; HeLa Cells ; Human papillomavirus 18 ; Humans ; Plasmids ; Regulatory Sequences, Nucleic Acid ; Risk Factors ; RNA, Messenger ; Tamoxifen ; Transfection ; Uterine Cervical Neoplasms*

Pulmonary gangrene is a rare complication of severe pulmonary infection in which a pulmonary segment or lobe is sloughed. It is a part of a spectrum of disease in which lung tissue is devitalized(such as necrotizing pneumonia, pulmonary abscess), but apart from them, pulmonary gangrene has mo re extensive area of necrosis and thrombosis of large vessels plays a prominent role in the pathogenesis. We experienced a case of pulmonary gangrene in 71 year old female obstructive pneumonia patient with non-small cell lung carcinoma. She complained high fever, chill and despite treatment with antibiotics, pneumonia progressed to empyema. At that time chest radiograph showed a large cavity including sloughed lung tissue, freely moving to dependent position at both lateral decubitus view. RML and RLL were resected and compression of pulmonary vessels by enlarged lymph nodes was observed. Defervescence was obtained immediate postoperative period and the patient was discharged after infection control with antibiotics, chest tube drainage. The perivascular ly mph nodes dissected during lobectomy were proved to be reactive hyperplasias. We speculated that the carcinoma caused obstructive pneumonia, in turn, resulted in reactive hyperplasia of the draining lymph nodes surrounding the large vessels and finally the lung tissues supplied by them necrotized and sloughed.
Aged ; Anti-Bacterial Agents ; Chest Tubes ; Drainage ; Empyema ; Female ; Fever ; Gangrene* ; Humans ; Hyperplasia ; Infection Control ; Lung* ; Lymph Nodes ; Necrosis ; Pneumonia* ; Postoperative Period ; Radiography, Thoracic ; Thrombosis

Pulmonary gangrene is a rare complication of severe pulmonary infection in which a pulmonary segment or lobe is sloughed. It is a part of a spectrum of disease in which lung tissue is devitalized(such as necrotizing pneumonia, pulmonary abscess), but apart from them, pulmonary gangrene has mo re extensive area of necrosis and thrombosis of large vessels plays a prominent role in the pathogenesis. We experienced a case of pulmonary gangrene in 71 year old female obstructive pneumonia patient with non-small cell lung carcinoma. She complained high fever, chill and despite treatment with antibiotics, pneumonia progressed to empyema. At that time chest radiograph showed a large cavity including sloughed lung tissue, freely moving to dependent position at both lateral decubitus view. RML and RLL were resected and compression of pulmonary vessels by enlarged lymph nodes was observed. Defervescence was obtained immediate postoperative period and the patient was discharged after infection control with antibiotics, chest tube drainage. The perivascular ly mph nodes dissected during lobectomy were proved to be reactive hyperplasias. We speculated that the carcinoma caused obstructive pneumonia, in turn, resulted in reactive hyperplasia of the draining lymph nodes surrounding the large vessels and finally the lung tissues supplied by them necrotized and sloughed.
Aged ; Anti-Bacterial Agents ; Chest Tubes ; Drainage ; Empyema ; Female ; Fever ; Gangrene* ; Humans ; Hyperplasia ; Infection Control ; Lung* ; Lymph Nodes ; Necrosis ; Pneumonia* ; Postoperative Period ; Radiography, Thoracic ; Thrombosis