Post-hysterectomy vaginal vault prolapse is rare complication. There are many surgical procedures to correct this problem. But abdominal colposacropexy, using Marlex mesh or Gore-Tex graft is standard procedure. We experienced one case who had repair of post-hysterectomy vaginal vault prolapse by transabdominal sacral colpopexy using Gore-Tex graft and report with brief review of literatures.
Hysterectomy* ; Pelvic Organ Prolapse* ; Polypropylenes ; Polytetrafluoroethylene* ; Transplants*

OBJECTIVE: Telomerase is a ribonucleoprotein enzyme which stabilizes chromosomal structure, thereby inducing cellular immortality. We investigated telomerase activity and human telomerase reverse transcriptase (hTERT) mRNA expression in relation to high-risk human papillomavirus (HPV) DNA presence in cervical carcinomas. METHODS: From December 1995 to December 1999, at the department of obstetrics and Gynecology of Kyung-Hee University Hospital, 32 cervical carcinomas and 5 corresponding nontumor cervical tissues were obtained and the samples were immediately frozen and stored at -70 degree C. Telomerase activity was measured by using telomerase PCR ELISA, a modified version of the TRAP. Analysis of the expression of hTERT mRNA was performed by quantitative RT-PCR and the analysis of the HPV E6 gene was performed by DNA-PCR. RESULT: All of the carcinomas examined exhibited strongly positive for telomerase activity (OD>0.24), whereas telomerase activity was week or not found in the 5 corresponding nontumor cervical tissues. Quantitative RT-PCR analysis demonstrated significantly increased hTERT mRNA expression levels (>0.024) in most carcinomas comparing to control groups. There was no obvious relationship between telomerase activity levels and the clinical parameters examined including age, clinical stage, pathology, differentiation, tumour size, LN involvement and invasion depth except lymphovascular space invasion (p=0.03). In the correlation between the levels of hTERT mRNA expression and telomerase activity, correlation index which was 0.916, shows high correlation (p=0.01). According to the analysis of HPV E6 gene, 29 of 32 (90.6%) carcinomas showed HPV E6 positivity. CONCLUSION: There is a strong association between telomerase activity and hTERT mRNA expression, and up-regulation of hTERT probably plays a role in the progression of cervical carcinomas. Telomerase is at least partially activated by viral oncogenes of high-risk types. There is no obvious relationship between telomerase activity levels and the clinical parameters except LSVI (p=0.03). These findings provides that telomerase may play an important role in the early stage of carcinogenesis.
Carcinogenesis ; DNA ; Enzyme-Linked Immunosorbent Assay ; Gynecology ; Humans ; Obstetrics ; Oncogenes ; Pathology ; Polymerase Chain Reaction ; Ribonucleoproteins ; RNA, Messenger* ; Telomerase* ; Up-Regulation ; Uterine Cervical Neoplasms*

PURPOSE: Although sentinel lymph node biopsy (SLNB) can accurately represent the axillary lymph node (ALN) status, the false-negative rate (FNR) of SLNB is the main concern in the patients who receive SLNB alone instead of ALN dissection (ALND). MATERIALS AND METHODS: We analyzed 1,886 patientswho underwent ALND after negative results of SLNB, retrospectively. A logistic regression analysis was used to identify risk factors associated with a false-negative (FN) result. Cox regression model was used to estimate the hazard ratio of factors affecting disease-free survival (DFS). RESULTS: Tumor located in the upper outer portion of the breast, lymphovascular invasion, suspicious node in imaging assessment and less than three sentinel lymph nodes (SLNs) were significant independent risk factors for FN in SLNB conferring an adjusted odds ratio of 2.10 (95% confidence interval [CI], 1.30 to 3.39), 2.69 (95% CI, 1.47 to 4.91), 2.59 (95% CI, 1.62 to 4.14), and 2.39 (95% CI, 1.45 to 3.95), respectively. The prognostic factors affecting DFS were tumor size larger than 2 cm (hazard ratio [HR], 1.86; 95% CI, 1.17 to 2.96) and FN of SLNB (HR, 2.51; 95% CI, 1.42 to 4.42) in SLN-negative group (FN and true-negative), but in ALN-positive group (FN and true-positive), FN of SLNB (HR, 0.64; 95% CI, 0.33 to 1.25) did not affect DFS. CONCLUSION: In patients with risk factors for a FN such as suspicious node in imaging assessment, upper outer breast cancer, less than three harvested nodes, we need attention to find another metastatic focus in non-SLNs during the operation. It may contribute to provide an exact prognosis and optimizing adjuvant treatments.
Biopsy* ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Humans ; Logistic Models ; Lymph Nodes ; Odds Ratio ; Prognosis ; Retrospective Studies ; Risk Factors* ; Sentinel Lymph Node Biopsy

The incidence of pulmonary leiomyosarcoma as primary lung tumor is very rare. Most of the primary leiomyosarcomas originate in the hilar region in relation to the main bronchus or pulmonary vessels and only a few originate more peripherally. This rare tumor can mimic bronchial carcinoma and present with local or systemic symptoms, or it may be discovered as an incidental finding on a routine chest X-ray. We report with review of literature, a case of incidental primary pulmonary leiomyosarcoma which originated peripherally. Huge mass was found on the left lung of a 61-year-old man on the chest X-ray peripherally. He underwent the surgical resection of the left pneumonectomy and the postoperative course was uneventful.
Bronchi ; Carcinoma, Bronchogenic ; Humans ; Incidence ; Incidental Findings ; Leiomyosarcoma* ; Lung ; Middle Aged ; Pneumonectomy ; Thorax

Secondary aortoenteric fistula is a rare but fatal complication of reconstructive aortoiliac surgery. This disease entity could be divided into true aortoenteric fistula and paraprosthetic enteric fistula. The prevention, diagnosis and treatment of this complication remains a challenging problem. We report a 39 year old man who was diagnosed as paraprosthetic enteric fistula in endoscopy and operated 41 months after reconstructive aortoiliac surgery due to the infected pseudoaneurysm.
Adult ; Aneurysm, False ; Aorta, Abdominal ; Diagnosis ; Endoscopy ; Fistula* ; Humans

Although pulmonary valvular stenosis with intact ventricular septum is a common congenital abnormality, critical pulmonary stenosis of its severe form in the neonate is rare and highly fatal. With the development of percutaneous balloon valvuloplasty, surgical treatment is even more rare. This report is on a 2 day old male neonate with a critical pulmonary stenosis with intact ventricular septum who suffered from severe cyanosis and hypoxemia. Oxygen was inhalated and Prostaglandin E1 was infused initially and then arterial PO2 was increased from 19 mmHg to 54 mmHg. Percutaneous balloon valvuloplasty was attemped; however, the guidewire could not pass through the stenotic pulmonary valve, and during the procedure right ventricular perforation was suspected due to the presence of dye in the pericardial space. Emergency transarterial pulmonary valvotomy was performed using normothermic cardiopulmonary bypass. Postoperatively, the patient was in fair condition in the ICU and presently is in good condition at 6 months postoperative follow up.
Alprostadil ; Anoxia ; Balloon Valvuloplasty ; Cardiopulmonary Bypass ; Congenital Abnormalities ; Constriction, Pathologic ; Cyanosis ; Emergencies ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Oxygen ; Pulmonary Valve ; Pulmonary Valve Stenosis* ; Ventricular Septum

Recently, Sun et al (2008) reported that the IL6R polymorphism is associated with schizophrenia. Therefore, to detect the association between polymorphisms of interleukin 31 receptor A (IL31RA) and schizophrenia, we genotyped 9 SNPs [rs9292101 (intron 1), rs1009639 (exon 2, Pro43Pro), rs2161582 (intron 2), rs68761890 (intron 5), rs16884629 (intron 6), rs11956465 (intron 12), rs12153724 (intron 12), and rs16884641 (intron 14)] using the Golden Gate assay on Illumina BeadStation 500 GX. Two hundred eighteen patients with schizophrenia and 379 normal subjects were recruited. Patients with schizophrenia were diagnosed according to DSM-IV, and control subjects without history of psychiatric disorders were selected. We used SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs for the evaluation of genetic data. Of nine polymorphisms, three SNPs (rs9292101, rs1009639, and rs11956465) were associated with schizophrenia. The rs9292101 and rs11956465 showed significant associations with the risk of schizophrenia in the codominant [rs9292101, odds ratio (OR)=0.74, 95% confidence interval (CI)=0.58~0.95, p=0.017] and recessive (rs11956465, OR=0.64, 95% CI=0.42~0.96, p=0.034) models, respectively. The rs1009639 also was statistically related to schizophrenia in both codominant (OR=0.76, 95% CI=0.60~0.97, p=0.025) and dominant (OR=0.66, 95% CI=0.44~0.98, p=0.035) models. Two linkage disequilibrium (LD) blocks were made. In the analysis of haplotypes, a haplotype (GCT) in block 1 and a haplotype (CCACAG) in block 2 showed significant associations between schizophrenia and control groups (haplotype GCT, frequency=0.509, chi square=4.199, p=0.040; haplotype CCACAG, frequency=0.289, chi square=5.691, p=0.017). The results suggest that IL31RA may be associated with risk of schizophrenia in Korean population.
Diagnostic and Statistical Manual of Mental Disorders ; Genes, vif ; Haplotypes ; Humans ; Interleukins ; Lidocaine ; Linkage Disequilibrium ; Odds Ratio ; Polymorphism, Single Nucleotide ; Schizophrenia ; Solar System