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This study aimed to determine the role of asymptomatic bacterial sexually transmitted infections (STIs), such as Chlamydia trachomatis ( Ct ), Mycoplasma genitalium ( Mg ), Mycoplasma hominis (Mh) , and Ureaplasma urealyticum ( Uu ) in human papillomavirus (HPV) infection. In total, 264 asymptomatic outpatients aged between 21 and 80 years were prospectively enrolled in this study during routine gynecological screening tests. Specimens collected with a Cervex Brush were routinely analyzed with the Hybrid Capture 2 assay for HPV. Simultaneously, a specimen obtained with an endocervical swab was used to detect Ct and Mg with a monoplex real-time polymerase chain reaction (PCR) and to confirm Mh and Uu with a Mycoplasma IST 2 kit. The detection rates (%) of HPV, Ct , Mg , Mh , and Uu were 82/264 (31.1), 6/264 (2.3), 5/264 (1.9), 16/264 (6.1), and 95/264 (36.0), respectively. Of 95 Uu , 32 (33.7%) showed high density colonization (HDC, ≥10 4 color-changing units/mL). HDC- Uu was significantly associated with HPV infection ( p =0.014, chi-square test). Mg infection and Mh infection were not associated with HPV infection ( p =0.981 and p =0.931, chi-square test). Age was not associated with HPV infection or bacterial infection. Our data suggested that asymptomatic HDC- Uu was closely associated with HPV infection. Therefore, simultaneous evaluation for Uu and HPV should be performed during gynecological screening, even in asymptomatic individuals., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.

To evaluate a possible correlation between bone mineral density (BMD) and age at menarche, the present study used the BMD dataset of the Korea National Health and Nutrition Examination Survey IV-V (KNHANES IV-V). Age at menarche had a small but significant association with BMD of the lumbar spine in premenopausal Korean females, aged 20-50 years., Introduction: To investigate any correlation between bone mineral density (BMD) and age at menarche in Korean females using data from the fourth and fifth Korea National Health and Nutrition Examination Survey (KNHANES IV-V; 2008-2011)., Methods: In total, 37,753 individuals participated in health examination surveys between 2008 and 2011. A total of 5032 premenopausal females aged 20-50 years were eligible. Age, height, weight, and age at menarche were assessed., Results: Results from the univariate linear regression and analysis of covariance (ANCOVA) indicated that age (per 1 year), height (per 1 cm), weight (per 1 kg), exercise (per 1 day/week), familial osteoporosis history (yes), parity (n = 0 to ≥4), and menarche age distribution were associated with BMD of the total femur, femur neck, and lumbar spine. After stratifying the bone area and adjusting for age, parity, alcohol intake, smoking, exercise, and familial osteoporosis history, no effect was seen for the total femur or femur neck. Age at menarche 16~17 and ≥18 years groups were associated with BMD of the lumbar spine only., Conclusions: Age at menarche had a small but significant association with BMD of the lumbar spine in premenopausal Korean females, aged 20-50 years. Females with late menarche may achieve lower peak bone mass at some skeletal sites, which may put them at greater risk for osteoporosis in later life.

Objectives: Despite the possibility of early detection of cervical cancer, participation in screening programmes among young Koreans is low. We sought to identify associations between risk factors and participation in screening for cervical cancer among young Koreans., Design: Nationwide cross-sectional study., Setting: Republic of Korea., Participants: 3734., Main Outcome Measures: The Korea National Health and Nutrition Examination Survey (KNHANES V: 2010-2012) was used to evaluate factors associated with attendance for cervical cancer screening among women aged 15-39. After excluding those who were previously diagnosed with cervical cancer and those with incomplete responses to questionnaires, a total of 3734 subjects were eligible. Multi-dimensional covariates as potential predictors of cervical cancer screening were adjusted in multiple logistic regression analysis., Results: The participation rate for cervical cancer screening was 46% among women aged 40 or younger. The logistic analyses showed that age, education, total household income, smoking and job status among women aged 15-39 were associated with participation in cervical cancer screening (p<0.05). After age stratification, the associated factors differed by age groups. Moreover, a dose-response between participation in cervical cancer screening and high total household income in the 30-39 age group was seen., Conclusions: Predictive factors differed among young women (aged 15-29 vs 30-39). Thus, age-specific tailored interventions and policies are needed to increase the participation rate in screening for cervical cancer., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

In this study, we examined whether the peroxisome proliferator-activated receptor γ (PPARγ) agonists, ciglitazone (CGZ) and troglitazone (TGZ), induce cell death in human cervical cancer HeLa cells. The cells were treated with a range of CGZ or TGZ doses for 24 or 48 h. Low concentrations of CGZ (≤10 μM) or TGZ (≤20 μM) had no effect on cell viability whereas higher doses induced cell death in a time- and dose-dependent manner as evidenced by the detection of activated caspase-3 and PARP cleavage. Treatment with the PPARγ antagonist GW9662 followed by PPARγ agonists did not increase CGZ- or TGZ-induced cell death, indicating that PPARγ agonists induced HeLa cell death independently of PPARγ. Moreover, ERK1/2 activation was observed at a CGZ concentration of 25 μM and a TGZ concentration of 35 μM, both of which induced cell death. To elucidate the role of ERK1/2 activated by the two PPARγ agonists, the effect of U0126, an inhibitor of ERK1/2, on PPARγ-agonist-induced cell death was examined. Treatment with 10 or 20 μM U0126 followed by CGZ or TGZ induced the down-regulation of ERK1/2 activity and a decrease in Bcl-2 expression accompanied by the collapse of mitochondrial membrane potential, which in turn significantly enhanced CGZ- or TGZ-induced apoptotic cell death. Our results suggest that PPARγ agonists are capable of inducing apoptotic cell death in HeLa cells independently of PPARγ and that inhibition of ERK1/2 activity offers a strategy to enhance the cytotoxicity of PPARγ agonists in the treatment of cervical cancer., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To conduct systematic analyses to evaluate the efficacy of progesterone therapy for the prevention of miscarriages in pregnant women experiencing threatened abortion., Methods: In November 2016, we performed a systematic literature search and identified 51 articles in PubMed, Embase, and Cochrane databases. We identified nine randomized trials that included 913 pregnant women (including 322 treated with oral dydrogesterone, 213 treated with vaginal progesterone, and 378 control subjects) who met the selection criteria., Results: The incidence of miscarriage was significantly lower in the total progesterone group than in the control group (13.0% versus 21.7%; odds ratio, 0.53; 95% confidence interval (CI), 0.36 to 0.78; P = 0.001; I 2 , 0%). Moreover, the incidence of miscarriage was significantly lower in the oral dydrogesterone group than in the control group (11.7% versus 22.6%; odds ratio, 0.43; 95% CI, 0.26 to 0.71; P = 0.001; I 2 , 0%) and was lower in the vaginal progesterone group than in the control group, although this difference was nonsignificant (15.4% versus 20.3%; odds ratio, 0.72; 95% CI, 0.39 to 1.34; P = 0.30; I 2 , 0%). However, the incidence of miscarriage was not different between the oral dydrogesterone and vaginal progesterone groups., Conclusion: Progesterone therapy, especially oral dydrogesterone, can effectively prevent miscarriage in pregnant women experiencing threatened abortion.

We compared results using unidirectional barbed sutures and conventional sutures for vaginal cuff closure during total laparoscopic hysterectomy (TLH).The electronic medical records and surgical videos of 170 patients who underwent TLH between January 2013 and March 2015 at Uijeong-bu St. Mary's Hospital of Catholic University of Korea were reviewed. Vaginal cuffs were closed using the 2-layer continuous running technique with unidirectional barbed sutures (V-Loc; Covidien, Mansfield, MA) in 64 patients and with polycolic acid Vicryl; Ethicon, Somerville, NJ sutures in 106 patients. Procedure time, clinical characteristics, and postoperative complications were compared between the 2 study groups. There were no differences in clinical characteristics (age, body mass index, and demographic data) between groups. The mean suturing time was significantly reduced in the barbed group (7.2 vs 12.2 minutes; P < 0.001), although the mean number of stitches was greater than in the Vicryl group (14.1 vs 12.3, P < 0.001). Perioperative complications, including episodes of vaginal bleeding, vaginal cuff cellulitis, and postoperative fever, did not differ between groups. There were no instances of vaginal cuff dehiscence in either group. Unidirectional barbed sutures can be used safely to reduce procedure time and surgical difficulty relative to conventional sutures in laparoscopic vaginal cuff closure., Competing Interests: The authors have no funding and conflicts of interest to disclose.

Introduction: The aim of this study was to investigate the association between Toll-like receptor 2 (TLR2) gene polymorphisms and human papillomavirus (HPV)-related cervical neoplasia in Korean women., Material and Methods: Peripheral blood samples collected from 127 patients with HPV-related cervical neoplasia and 175 healthy women were genotyped for the TLR2 -16934, +1350, intron1, and 3' untranslated region (UTR) polymorphisms using the polymerase chain reaction and restriction fragment length polymorphism method., Results: The TLR2 -16934 A/A, intron1 A/A, and +1350 T/C genotypes were more frequent in patients than in controls [odds ratio (OR) = 2.1, 95% CI = 1.302-3.475, p = 0.002; OR = 1.9, 95% CI = 1.168-3.169, p = 0.010; and OR = 1.9, 95% CI = 1.211-3.123, p = 0.006, respectively]. The frequencies of the TLR2 + 1350 C and 3'UTR G alleles were also higher in patients (OR = 2.0, 95% CI = 1.236-3.121, p = 0.004 and OR = 1.7, 95% CI = 1.005-3.076, p = 0.046, respectively). The genotype frequencies of TLR2 -16934 A/A and intron1 A/A increased with increasing oncogenic risk of the HPV genotype, as follows. low-risk type < high-risk type < HPV-16 and/or HPV-18 type (p = 0.008)., Conclusions: Our study provides the first evidence that TLR2 gene polymorphisms are associated with high-risk type HPV-related cervical neoplasia and may play an important role in susceptibility to HPV infection. Further large-scale and functional studies are needed to confirm the role of TLR2 gene polymorphisms in HPV-related cervical neoplasia., (© 2016 Nordic Federation of Societies of Obstetrics and Gynecology.)

Objective: The goal of this study was to evaluate the efficacy, toxicity, and survival of patients in our institution treated by EMA (etoposide, methotrexate [MTX], and dactinomycin) chemotherapy for 3 groups of patients: ones that had low-risk gestational trophoblastic disease (GTD) that was resistant to MTX (group A), those with high-risk GTD (group B), and the group having low-risk GTD but the cancer being metastatic (group C)., Methods: The medical records of 58 patients who received EMA chemotherapy in groups A, B, and C in the 2000 to 2012 period at St Mary's Hospital were examined. Clinical characteristics, chemotherapy responses, causes of treatment failure, and cases of drug toxicity were analyzed retrospectively., Results: Treatment with the EMA regimen resulted in primary remission in 52 (96%) of 54 patients and resistance in 2 of the patients (3%). In the resistance group, one belonged to group B and was treated with etoposide, MTX, and actinomycin D with cyclophosphamide and vincristine (EMA-EP) and the other belonged to group A and died of refractory disease. World Health Organization (WHO) grade 4 leukocytopenia and thrombocytopenia with the EMA regimen occurred in 6% and 0.4% of the cycles, respectively; the other toxic effects were acceptable and manageable. Median cycles of EMA chemotherapy during the treatment were 7, 8, and 8 in groups A, B, and C, respectively. There was some reduction in total chemo cycle and toxicity, as compared with a previously reported study using the alternative cyclophosphamide and vincristine regimen. Among the EMA treated patients, 1 patient with a second malignancy of breast cancer was documented. In addition, 5 child births for the treated patients were recorded during the follow-up period of mostly 10 years., Conclusions: The EMA chemotherapy seemed to reduce treatment duration and the relapse rate without increasing the adverse effects in patients with MTX resistance and low-risk GTD, but having confirmed metastatic lesions. Although this study had some limitations regarding the high-risk GTD, our findings will provide a basis for the use of EMA chemotherapy when cyclophosphamide and vincristine is contraindicated due to toxicity.

Objective: To investigate the relationship between gonadotropin-releasing hormone (GnRH)/gonadotropin-releasing hormone receptor (GnRHR) signaling and progesterone receptors (PGRs)., Study Design: HTR-8/SV neo cells and JEG-3 cells were incubated for 24 hours with GnRH-I or -II. The expression of PGRs was measured by quantitative real-time reverse transcriptase-polymerase chain reaction and Western blotting., Results: In both cells lines after incubation with 1-1,000 nM/L GnRH-I or -II the ratio of PGR-B to PGR-AB mRNA level did not differ in any of the groups as compared to the control. Relatively higher expression of PGR-B than PGR-A mRNA and expression of only PGR-B protein without PGR-A protein were observed in all specimens. There were no significant differences in the expression of PGR-B protein in each group when compared to the control group after incubation with GnRH-I or -II at 0.001-1,000 mM/L in both cell lines., Conclusion: PGRs are expressed regardless of GnRH/GnRHR signaling in human trophoblasts, in which PGR-B expression is more dominant than PGR-A expression.

Purpose: To identify the correlation between the pre-gravid maternal obesity and the uterine artery pulsatility index (UtA-PI) at 28-34 weeks' gestation, and to evaluate the predictive value of the UtA-PI for the occurrence of adverse outcomes depending on the maternal obesity., Methods: Between January 2010 and December 2011, 229 pregnant women were prospectively observed and analyzed. The UtA-PI during 28-34 weeks' gestation was estimated, with abnormal UtA-PI defined if the value was above the 95th centile for gestational age. The patients were classified, using a cut-off value for body mass index (BMI) of 25kg/m(2), into obese (pre-gravid BMI≥25kg/m(2)) and non-obese (pre-gravid BMI<25kg/m(2)) groups. We analyzed the association between the pre-gravid BMI and occurrence of abnormal UtA-PI and estimated their contributions to adverse outcomes using regression analyses., Results: The occurrence of abnormal UtA-PI in the women with pre-gravid BMI over 25kg/m(2) was significantly higher than those with normal pre-gravid BMI (OR: 2.49; 95% CI: 1.22-5.12). In multivariate analyses, the combination with abnormal UtA-PI and pre-gravid BMI over 25kg/m(2) contributed to the occurrence of preterm delivery (OR: 33.5; 95% CI: 7.63-147.21), gestational diabetes (OR: 3.98; 95% CI: 1.17-13.56) and pregnancy induced hypertension (OR: 12.71; 95% CI: 3.45-46.87), compared to the control group with pre-gravid BMI of 25kg/m(2) and less, and normal UtA-PI., Conclusion: Women with pre-gravid BMI over 25kg/m(2) show increased tendency of abnormal uterine artery pulsatility index during 28-34 weeks, which increases the risk of adverse pregnancy outcomes., (Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Objectives: To compare the characteristics of pregnant women with hyperglycemia according to the severity of glucose intolerance using the 100-g oral glucose tolerance test (OGTT) and to demonstrate the need to manage the condition of women with mild hyperglycemia., Materials and Methods: In this retrospective cohort study, a total of 258 women at high risk of gestational diabetes (GDM) based on a positive 50-g oral glucose challenge test (OGCT) were classified into 0+, 1+, 2+, 3+, and 4+ groups according to the number of abnormal plasma glucose values on the 100-g OGTT. The clinical characteristics of the groups were compared., Results: The rates of advanced maternal age (≥ 35 years), multiparity, prior history of GDM, preterm birth, cesarean delivery, and elevated body mass index were all positively correlated with the number of abnormal plasma glucose values on the OGTT (p < 0.05 for all variables). After adjusting for confounding factors, the fasting plasma glucose levels predicted birth weight in 44.4%, 48.4%, and 58.6% of the women in the positive 50-g OGCT group, the 0+ group, and the 1+ group, respectively. Weight gain during pregnancy predicted birth weight in 42%, 44.6%, and 37.6% of the women in the positive 50-g OGCT group, the 0+ group, and the 2+ group, respectively (p < 0.001 in each case)., Conclusions: These data demonstrate that the detection and management of mild hyperglycemia below the current diagnostic criteria of GDM as well as GDM diagnosed using the 100-g OGTT are necessary for improving pregnancy outcomes., (Copyright © 2015. Published by Elsevier B.V.)

Aims: The objective of the current study was to evaluate the efficacy and feasibility of fibrin sealant (Tisseel®) in the loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2 or 3)., Methods: We designed a single-blind, prospective, randomized study in 40 consecutive women undergoing LEEP for CIN 2 or 3 at our institute. Two milliliters of fibrin sealant (Tisseel) was applied to the uterine cervix of 20 women immediately after LEEP surgery (treatment group). We evaluated abdominal pain, vaginal bleeding, vaginal discharge and impairment in daily living after 1 week using visual analogue scale questionnaires and compared the results with those of 20 women who did not receive fibrin sealant (control group)., Results: Among 40 women who returned for a follow-up 1 week after LEEP, 25 women (62.5%) reported at least one moderate to severe postprocedural symptom. The mean duration of moderate to severe vaginal bleeding and impairment in daily living during postoperative week 1 for the treatment group and the control group was 0.3 ± 0.80 versus 1.7 ± 2.36 days (p = 0.015) and 0.9 ± 1.37 versus 3.00 ± 2.62 days (p = 0.060), respectively., Conclusion: Intraoperative application of fibrin sealant (Tisseel) in LEEP can decrease postoperative vaginal bleeding and impairment in daily living., (© 2015 S. Karger AG, Basel.)

Objectives: To compare fetal abdominal circumference and its relationship with birthweight at increasing gestational ages in the context of maternal hyperglycemia of varying severity., Design: Retrospective cohort study., Setting: Two centers participated in building one database., Population: A total of 1538 Korean pregnant women were subjected to a two-step approach to diagnose gestational diabetes mellitus., Methods: Pregnant women were classified into gestational diabetes mellitus, borderline gestational diabetes mellitus, and normal groups. Fetal abdominal circumferences, which were measured with ultrasound at 4-week intervals starting at 16 weeks of gestation and ending prior to delivery, were evaluated in the groups., Main Outcome Measure: The significance of fetal abdominal circumferences as predictors or risk factors of macrosomia/large-for-gestational age., Results: Fetal abdominal circumferences measured from 16 weeks of gestation until prior to delivery predicted birthweight in all groups with some exceptions. Fetal abdominal circumferences measured from 32 weeks of gestation until prior to delivery were predictive of macrosomia in all groups. Fetal abdominal circumferences measured from 28 weeks of gestation until prior to delivery were predictive of neonates being large-for-gestational age in all groups. Fetal abdominal circumferences measured at 16 and 24 weeks of gestation were also predictive of large-for-gestational age in the borderline gestational diabetes mellitus group. Fetal abdominal circumference measured at 24 weeks of gestation was also a predictor of macrosomia/large-for-gestational age in normal women., Conclusions: Fetal abdominal circumferences measured during the second and especially third trimesters were significantly associated with excessive birthweight, irrespective of the severity of maternal glucose intolerance., (© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.)

A woman in early pregnancy was referred due to severe pelvic pain. Vaginal examination showed a severely protruding left vaginal wall with severe tenderness. A transvaginal ultrasound showed a double uterus and a mixed echogenic mass next to the cervix of the left uterus. After creating an opening in the left vaginal wall and inserting a Foley catheter through the opening into the vaginal wall for drainage with antibiotic therapy, the patient's condition rapidly improved. A culture of the pus drained from the vaginal wall showed Pediococcus species. The patient delivered a healthy infant by cesarean section at term gestation without recurrence of pyocolpos. Ten months after delivery, resection of the vaginal septum was performed and the left cervix was exposed. Ultrasound revealed normal kidneys., (© 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.)

Objective: Autophagy plays a vital role in homeostasis by combining organelles and cellular proteins with lysosome under starvation conditions. In addition, autophagy provides tumor cells with a source of energy. Continued autophagy will induce cells death. Here we aim to see if autophagic induction has an effect on conventional chemotherapeutic agents., Methods: Rapamycin, or mammalian target of rapamycin and paclitaxel, apoptosis-inducing agents were used autophagy in HeLa cervical cancer cells., Results: Growth inhibition of cells was not observed after the application of 0, 10, 20 nM of paclitaxel with or without rapamycin. Using a 5 nM concentration of paclitaxel, rapamycin administration inhibited cell growth significantly compared to no treatment. This implies the synergic antitumor effect of paclitaxel and rapamycin. Paclitaxel itself did not show any autophagic effect on cells but did show cell apoptosis by flow cytometry. Light chain 3, a microtubule-associated protein, which reflect autophagy, was increased with 5 nM of paclitaxel after pretreatment with 10 nM of rapamycin., Conclusion: These findings suggest that the autophagic inducer, rapamycin, can potentiate autophagic cell death when added as an apoptosis-inducing chemotherapeutic agent. In conclusion, the control of autophagy may be a future target for chemotherapy.

This study investigated whether killer-cell immunoglobulin-like receptor (KIR) genes and human leukocyte antigen (HLA)-C alleles, receptors and ligands of natural killer cells are associated with the development of human papillomavirus (HPV)-related cervical disease in Korean women. Blood samples from 132 women with HPV-related cervical disease and 159 women without HPV infection were collected for genotyping of KIR genes and HLA-C alleles. Although no relationship was found between KIR genes and HPV-related cervical disease, a significant relationship was found between HLA-C alleles as ligands of KIR and HPV-related cervical disease. Women with HPV-related cervical disease were found to be significantly more likely to carry HLA-C*0303, particularly those with HPV 16 or 18 infection, and less likely to carry HLA-C*01 compared to women without HPV infection. HLA-C*0303 was found to confer susceptibility to HPV-related cervical disease, whereas HLA-C*01 was found to confer a protective effect against HPV-related cervical disease., (© 2013 John Wiley & Sons A/S.)

Purpose: The aim of this study was to identify the adipocyte-specific gene expression patterns in chorion-derived mesenchymal stem cells during adipogenic differentiation., Materials and Methods: Chorionic cells were isolated from the third trimester chorions from human placenta at birth and identified morphologically and by fluorescence-activated cell sorting analysis. After inducing adipogenic differentiation for 28 days, cells at days 3, 10, 21 and 28 were analyzed by Oil red O staining and RNA extraction in order to assess the expression levels of adipocyte marker genes, including CCAAT-enhancer binding protein α (C/EBPα), peroxisome proliferator- activated receptor γ (PPARγ), fatty acid binding protein 4 (FABP4) and Glycerol-3-phosphate dehydrogenase (GPD2). Cells not induced for differentiation were compared with the induced cells as a control group., Results: Chorion-derived cells showed the same pattern as fibroblasts, and expressed CD73, CD105, and CD166 antigens, but not CD45, CD34, and HLA-DR antigens. On day 3 after differentiation, cells began to stain positively upon Oil red O staining, and continuously increased in lipid granules for 4 weeks. The expression level of C/EBPα increased 4.6 fold on day 3 after induction, and continued to increase for 4 weeks. PPARγ was expressed at a maximum of 2.9 fold on day 21. FABP4 and GPD2 were significantly expressed at 4.7- and 3.0-fold, respectively, on day 21, compared to controls, and further increased thereafter., Conclusion: Human chorion-derived mesenchymal stem cells exhibited the sequential expression pattern of adipocyte marker genes during differentiation, corresponding to adipogenesis.

Objective: This study aimed to determine the incidence and risk factors of lower-extremity lymphedema (LEL) in women who had radical surgery with or without adjuvant radiotherapy for International Federation of Gynecology and Obstetrics (FIGO) stage I to stage IIA cervical cancer., Methods: The medical records were reviewed retrospectively on patients with histologically confirmed FIGO stage I to IIA cervical cancer. Lower-extremity lymphedema-related medical problems such as peripheral vascular disease, congestive heart failure, or chronic renal disease were excluded. A logistic regression analysis was used to examine the relationship between variable clinical characteristics and development of LEL., Results: We evaluated 707 patients. Of the 707 patients evaluated, we excluded 92 patients who had received radiotherapy as the initial therapy and 19 patients with LEL related to medical problems. Seventy-five patients (12.6%) developed LEL. The incidence was high in patients with adjuvant radiotherapy (odds ratio, 3.47; 95% confidence interval, 2.086-5.788; P = 0.000), with 78.7% of the patients with LEL having developed the condition within 3 years after initial treatment., Conclusions: Adjuvant radiotherapy was significantly associated with development of LEL in women who had undergone radical surgery with lymphadenectomy for FIGO stage I to stage IIA cervical cancer. The possibility for the occurrence of LEL must be fully explained before treatment and patients should be provided with the appropriate preventive education. Further prospective studies are needed to confirm the incidence and risk factors for LEL.

Borderline ovarian tumor with sarcoma-like mural nodule is rare. Malignant mural nodules usually occur in the wall of an atypical proliferative mucinous tumor or a mucinous carcinoma. The authors report one case of unfavorably progressive borderline tumor of the ovary with sarcoma-like mural nodule that produced granulocyte colony-stimulating factor (G-CSF).

Objective: To identify characteristics of the cell-mediated immune (CMI) response to human papillomavirus-16 (HPV) E7 viral peptide pools to help the formulation of therapeutic vaccines., Design: Prospective study. Population. Korean women., Setting: University hospital., Methods: From December 2008 to August 2010, 33 HPV-16-positive patients, seven patients exhibiting a high-risk HPV infection other than HPV-16 with grade 2/3 cervical intraepithelial neoplasm (CIN2/3), and nine healthy control donors were enrolled., Main Outcome Measures: CMI response to synthetic HPV-16 E7 overlapping peptide pools using the IFN-γ ELISPOT assay., Results: The E7 sequence comprising amino acids 16-55 was a major immunogenic region. The CMI response to HPV-16 E7 is highly type-specific. The follow-up CMI response may last longer than expected after the lesion is resected., Conclusions: We found that the E7 sequence comprising amino acids 16-55 is a major immunogenic region that is critical for the T-cell-mediated immune response with CIN2/3 or cervical cancer. The identification of CMI responses to HPV-16 E7 peptide pools may provide insight into therapeutic vaccine trials for the control of HPV-associated diseases., (© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.)

Objective: In the present study the potential therapeutic effects of zinc-citrate compound (CIZAR®) in women infected with high-risk human papillomavirus (HR-HPV) was investigated., Methods: A total of 194 women diagnosed with HR-HPV infection using the Hybrid capture (HC) II assay with no evidence of high grade squamous intraepithelial lesions (HSIL) or worse by Pap smear and colposcopy were enrolled. Among them, 76 women were treated by twice weekly self administered intra-vaginal infusion of 0.5 mM zinc citrate solution containing CIZAR® for 12 weeks and were evaluated for clearance of the HR-HPV infection compared to 118 women without treatment (Control group)., Results: The 12 weeks zinc citrate solution treatment resulted in the elimination of HR-HPV in 49/76 (64.47%) patients compared to the spontaneous clearance of 15.25% (18/118) in the control group (p=0.000). By logistic regression analysis, the 12 week zinc citrate solution treatment reduced the risk of persistent HR-HPV infection significantly (OR 0.079; 95% CI 0.039-0.165; p=0.000)., Conclusion: The results of this study showed for the first time that treatment with intra-vaginal infusion of a zinc-citrate compound (CIZAR®) can result in elimination of HR-HPV infection from the uterine cervix., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Purpose: We compared the incidence of vaginal cuff dehiscence and other surgical complications after different modes of suturing during total laparoscopic hysterectomy (TLH), and reviewed the characteristics of patients with complications., Methods: We enrolled 248 patients undergoing TLH for benign diseases at Daejeon St Mary's Hospital of Korea from March 2007 through February 2009. We evaluated the clinical outcomes of different vaginal cuff suture techniques during TLH: the widely used interrupted figure-of-eight suture and a two-layer running suture., Results: All operations were completed successfully by laparoscopy. Three of 248 hysterectomies (1.2%) were complicated by vaginal cuff dehiscence. One of them belonged to the two-layer running suture group, and the others belonged to the interrupted figure-of-eight suture group. However, there was no statistically significant difference in outcomes between the suture methods. One case of trocar site incisional herniation occurred. No ureteral, bladder, or major vascular injury occurred. The overall major complication rate including vaginal bleeding was 2.0% (5/248)., Conclusions: The two-layer running suture technique was safe and effective for vaginal cuff suture during TLH, but there was no statistically significant advantage over the widely used figure-of-eight suture method. Diabetes, cigarette smoking and pelvic adhesions produced statistically significant increased risks of complication.

Purpose: Partial nephrectomy (PN) for patients with T1a renal cell carcinoma (RCC) has increasingly become accepted, although its role for patients with T1b RCC remains controversial. We retrospectively evaluated and then compared the oncologic and functional outcomes of patients with pT1b RCC who were treated with PN or radical nephrectomy (RN)., Materials and Methods: A total of 70 patients who were diagnosed with pT1bN0M0 RCC between January 1995 and December 2004 were included. The 5-year overall survival (OS), the 5-year recurrence-free survival (RFS), and the 5-year cancer-specific survival (CSS) were compared between the groups. Preoperative and postoperative serum creatinine and estimated glomerular filtration rate (GFR) levels were analyzed to assess renal function., Results: The 5-year OS (92.3% vs. 87.8%, p=0.501), RFS (92.3% vs. 77.8%, p=0.175), and CSS (92.3% vs. 94.5%, p=0.936) of the PN and RN groups were not statistically different. The proportion of patients with decreased renal function was lower in the PN group than in the RN group (PN=0% vs. RN=11.5%). The postoperative change in serum creatinine and the GFR 1 year after nephrectomy was higher in the RN group than in the PN group (PN=0.2±0.2, 12.1±9.1 vs. RN=0.3±0.5, 18.1±12.5), but there was no statistical difference., Conclusions: There were no statistically significant differences in prognosis or renal function between patients treated with PN and those treated with RN for pT1b RCC. PN may be a useful treatment modality for patients with pT1b RCC.

Objective: Cervical neoplasia is attributed to a persistent human papillomavirus (HPV) infection. We performed a hospital-based, case-control study to evaluate the associations of HPV genotypes and other cofactors with cervical intraepithelial neoplasia (CIN)., Methods: A total of 158 women were enrolled after we received their informed consent, and the control group (the non-CIN group; n = 80) was selected from women at St Paul's Health Promotion Center. The CIN group (n = 78) was enrolled from the outpatient clinics at Kangnam St Mary's Hospital. Cervical intraepithelial neoplasia was confirmed with colposcopic-guided biopsy or loop electrosurgical excision procedure-conization. A structured questionnaire, Papanicolaou test, and HPV testing were completed. We compared each risk factor using chi2 tests and simple logistic regression analysis between the CIN and non-CIN groups. Finally, odds ratios (ORs) were calculated again by multiple logistic regression analysis., Results: The most frequent HPV types in CIN were HPV-16, HPV-58, HPV-31/-33, and HPV-35/-56. The OR of the A9 group (HPV-16, HPV-31, HPV-33, HPV-35, HPV-52, HPV-58) was 22.7 (95% confidence interval [CI], 8.3-62.5), that of the A6 group (HPV-53, HPV-56, HPV-66) was 2.9 (95% CI, 1.1-7.5), and that of the A7 group (HPV-18, HPV-39, HPV-45, HPV-59, HPV-68) was 1.5. Sexual debut before 20 years old had significantly higher OR than did a sexual debut after 30 years (OR, 32.9; 95% CI, 2.8-364.7). The OR for CIN in single women versus married women was 6.2 (95% CI, 2.5-15.2). Compared with parous women (parity >3), nonparous women had a higher OR (95% CI, 1.4-16.7). On the multiple logistic regression analysis including the sexual debut age, the marital status, parity, cytology, and the HPV groups, the A9 group had a significant OR for CIN (6.1; 95% CI, 1.6-23.6)., Conclusions: The risk of CIN was higher for women infected with the HPV-A9 group after multiple logistic regression analysis. The other clinical risk factors were not significant factors of CIN.

Aim: To determine whether clinical outcomes show a benefit from extended hysterectomy in patients with early endometrial cancer., Methods: We reviewed the medical records of 101 patients who had endometrial cancer with clinical stage I disease. All the patients were surgically staged, and two types of hysterectomy, simple hysterectomy (SH) or extended hysterectomy (EH), were performed by surgeon's preference. The postoperative pathology findings, recurrence rate and disease-free survivals (DFS) between the two groups were compared., Results: Sixty-six patients and thirty-five patients underwent SH and EH, respectively. At subsequent surgical staging, seven patients (10.6%) in the SH and four (11.4%) in EH group were upgraded to stage II or III disease. The surgical and pathological features were not different between the groups. Though the recurrence rate was lower in the EH group (9.09% for SH vs 2.86% for EH), it showed no statistical significance (P = 0.241). The 5-year DFS (88.2% for SH vs 96.0% for EH) showed no statistically significant difference between the groups either (P = 0.242)., Conclusion: Compared to SH, EH did not have any prognostic benefit in clinical stage I endometrial cancer. Until the therapeutic role of the EH is determined by further studies using a larger sample size, SH remains the treatment of choice in patients with early endometrial cancer, and surgeons should not perform extended operation without definite evidence of the disease.

Purpose: Although the prognosis of patients with pT1a stage renal cell carcinoma (RCC) is generally good, some of these patients show distant metastasis. In this study, we intended to identify the perioperative and pathologic prognostic factors for patients with pT1a stage RCC., Materials and Methods: A total of 93 patients who were diagnosed with pT1aN0M0 RCC between January 1995 and December 2004 were included. All the patients underwent radical (n=63, 67.7%) or partial (n=30, 32.3%) nephrectomy by a single surgeon. Preoperative data [age, sex, body mass index (BMI), and the presence of symptoms], follow-up duration, surgical methods, and pathological parameters (tumor size, tumor location, histologic type, Fuhrman's nuclear grade and the presence of microvascular invasion, hemorrhage, necrosis, calcification, and a cystic component in the tumor) were retrospectively analyzed to identify which of these were prognostic factors for pT1a RCC., Results: The patients' mean age was 55.0+/-11.4 years and the mean follow-up duration was 63.6+/-31.1 months. The 5-year cancer-specific survival rate and the 5-year recurrence- free survival rate were 100% and 88.1%, respectively. Nine patients (9.7%) showed distant metastasis, but local recurrence was not shown. Fuhrman's nuclear grade (p=0.040, OR=5.147), microvascular invasion (p=0.011, OR=13.500), and tumor necrosis (p<0.001, OR=26.000) had a significant impact on distant metastasis in the univariate analysis. The multivariate analysis subsequently showed that microvascular invasion (p=0.033, OR=17.947) and tumor necrosis (p=0.002, OR=15.922) were independent prognostic factors., Conclusions: Microvascular invasion and tumor necrosis are the prognostic factors for patients with pT1a RCC.

Ovarian borderline tumor (BOT) with noninvasive implants traditionally is considered to be non-aggressive. Recurrences are delayed and transformations to high-grade carcinoma are rarely documented. We report on a patient with BOT with early recurrence and high-grade carcinoma transformation in a short interval after complete laparoscopic staging. A 27-year-old unmarried woman presented with a 26 cm in size ruptured left ovarian mass. Laparoscopic left salpingo-oophorectomy with right ovarian biopsies, multiple peritoneal biopsies, omental biopsy and washing cytology were performed. FIGO Stage I ovarian serous borderline tumor with microinvasion was confirmed. About ten months later, a 15 cm in size left BOT recurred and was resected by laparoscopic cystectomy including staging surgery. Seven months after the second surgery, we found a pelvic mass by sonogram and elevated CA125. A third diagnostic laparoscopy revealed invasive serous carcinoma with multiple peritoneal implants. In spite of radical surgery and adjuvant chemotherapy, the patient died of a progressive metastatic liver tumor. A case of early recurrence with malignant transformation of BOT is presented together with a brief review.

Preterm birth (PTB), defined as birth before 37 weeks of gestation, is the leading cause of perinatal morbidity and mortality. PTB is a major cause of long-term health problems in neonates, including respiratory distress syndrome, chronic lung disease (bronchopulmonary dysplasia), infection, intraventricular hemorrhage, and severe neurologic deficit. In the absence of reliable clinical predictors of PTB, obstetric care providers should focus their attention on the 2 best and most widely accepted methods of identifying women at high risk of PTB in both nullipara and multipara: fetal fibronectin and cervical length measurements.

We developed nomograms to predict disease recurrence in patients with Ta, T1 transitional cell carcinoma of the bladder. Thirty-eight training hospitals participated in this retrospective multicenter study. Between 1998 and 2002, a total of 1,587 patients with newly diagnosed non-muscle invasive bladder cancer were enrolled in this study. Patients with prior histories of bladder cancer, non-transitional cell carcinoma, or a follow-up duration of less than 12 months were excluded. With univariate and multivariate logistic regression analyses, we constructed nomograms to predict disease recurrence, and internal validation was performed using statistical techniques. Three-year and five-year recurrence-free rates were 64.3% and 55.3%, respectively. Multivariate analysis revealed that age (hazard ratio [HR]=1.437, p<0.001), tumor size (HR=1.328, p=0.001), multiplicity (HR=1.505, p<0.001), tumor grade (HR=1.347, p=0.007), concomitant carcinoma in situ (HR=1.611, p=0.007), and intravesical therapy (HR=0.681, p<0.001) were independent predictors for disease recurrence. Based on these prognostic factors, nomograms for the prediction of disease recurrence were developed. These nomograms can be used to predict the probability of disease recurrence in patients with newly diagnosed Ta, T1 transitional cell carcinoma of the bladder. They may be useful for patient counseling, clinical trial design, and patient follow-up planning.

We aimed to investigate whether postconization human papillomavirus (HPV) DNA testing can predict treatment failure and improve the accuracy of conventional follow-up in women with high-grade cervical intraepithelial neoplasia (CIN). Between March 2001 and October 2005, 120 patients with confirmed CIN 2 or 3 were treated with loop electrosurgical excision procedure (LEEP) and were enrolled. Six patients were lost to the follow-up. Postconization follow-up was performed at every 3-6 months during the first year and then annually. Specimens were tested for the presence of HPV, using the Hybrid Capture 2 (Digene Co, Gaithersburg, MD) and HPV DNA chip (Mygene Co, Seoul, Korea) test. Persistent HPV infection was defined as persistently (two times or more) positive HPV tests with the same HPV subtype(s) at initial diagnosis. Twenty-two (19.3%) patients showed treatment failure after conization. The only significant risk factor for redevelopment of CIN after conization was persistence of the same HPV subtype (P < 0.0001). And women with recurrent or residual CIN had higher HPV load during the 6-month follow-up postconization. In conclusion, the persistence of the same HPV subtype after LEEP conization was an important predictor of treatment failure. The follow-up protocol after conization of CIN should include both cervical cytology and HPV test, and HPV DNA chip test is needed to detect a persistent HPV infection.

Our aim was to identify novel genomic regions of interest and provide highly dynamic range information on correlation between squamous cell cervical carcinoma and its related gene expression patterns by a genome-wide array-based comparative genomic hybridization (array-CGH). We analyzed 15 cases of cervical cancer from KangNam St Mary's Hospital of the Catholic University of Korea. Microdissection assay was performed to obtain DNA samples from paraffin-embedded cervical tissues of cancer as well as of the adjacent normal tissues. The bacterial artificial chromosome (BAC) array used in this study consisted of 1440 human BACs and the space among the clones was 2.08 Mb. All the 15 cases of cervical cancer showed the differential changes of the cervical cancer-associated genetic alterations. The analysis limit of average gains and losses was 53%. A significant positive correlation was found in 8q24.3, 1p36.32, 3q27.1, 7p21.1, 11q13.1, and 3p14.2 changes through the cervical carcinogenesis. The regions of high level of gain were 1p36.33-1p36.32, 8q24.3, 16p13.3, 1p36.33, 3q27.1, and 7p21.1. And the regions of homozygous loss were 2q12.1, 22q11.21, 3p14.2, 6q24.3, 7p15.2, and 11q25. In the high level of gain regions, GSDMDC1, RECQL4, TP73, ABCF3, ALG3, HDAC9, ESRRA, and RPS6KA4 were significantly correlated with cervical cancer. The genes encoded by frequently lost clones were PTPRG, GRM7, ZDHHC3, EXOSC7, LRP1B, and NR3C2. Therefore, array-CGH analyses showed that specific genomic alterations were maintained in cervical cancer that were critical to the malignant phenotype and may give a chance to find out possible target genes present in the gained or lost clones.

The purpose of the present study was to evaluate the efficacy and safety of bipolar transurethral prostatectomy (TURP) using the Gyrus PlasmaKinetic System compared with conventional monopolar TURP. This study included 102 patients with benign prostatic hyperplasia (BPH) who underwent TURP from January 2003 to March 2005. In all, 49 consecutive patients had bipolar and 53 had monopolar TURP. All patients were assessed by preoperative and postoperative International Prostate Symptom Score (IPSS), uroflowmetry, transrectal ultrasonography, operative time, weight of resected tissue, change in serum sodium and hemoglobin, duration of catheter use, length of hospital stay, and complication rates. Significant improvement was seen postoperatively in both groups, and no difference was observed in the resection time, weight of resected tissue, change in serum sodium and hemoglobin, improvement of IPSS and peak flow rate (Qmax), or complication rates over the 12-month follow-up in both groups. There was, however, a significant difference in duration of catheter use and hospital stay. Duration of catheter use (2.28 days vs. 3.12 days) and hospital stay (3.52 days vs. 4.27 days) were shorter in the bipolar group (p = 0.012 vs. p = 0.034, respectively). Our results demonstrate that bipolar TURP using the Gyrus Plasma Kinetic System is as effective as conventional monopolar TURP with the additional advantage of reduced length of catheter use and hospital stay. Bipolar TURP is a promising new technique that may prove to be a good alternative to conventional TURP in the future.

Intramural pregnancy is extremely rare and difficult to diagnose. Because of the high rate of uterine rupture in most cases, hysterectomy is often necessary. The optimal medical management for this condition is unknown. We report 2 cases of intramural pregnancy diagnosed by pelvic MRI and treated with systemic methotrexate.

We designed this study to compare the efficacy of using a three-dimension head mounted displayer (3-D HMD) and a conventional monitor in audio-visual sexual stimulation (AVSS) in differential diagnosis of psychogenic from organic erectile dysfunction (ED). Three groups of subjects such as psychogenic ED, organic ED, and healthy control received the evaluation. The change of penile tumescence in AVSS was monitored with Nocturnal Electrobioimpedance Volumetric Assessment and sexual arousal after AVSS was assessed by a simple question as being good, fair, or poor. Both the group of healthy control and psychogenic ED demonstrated a significantly higher rate of normal response in penile tumescence (P<0.05) and a significantly higher level of sexual arousal (P<0.05) if stimulated with 3-D HMD than conventional monitor. In the group of organic ED, even using 3-D HMD in AVSS could not give rise to a better response in both assessments. Therefore, we conclude that using a 3-D HMD in AVSS helps more to differentiate psychogenic from organic ED than a conventional monitor in AVSS.

Human papillomavirus (HPV) is implicated as an etiologic agent in neoplasitc lesions of the cervix. In this study, we used an HPV DNA chip to detect the type-specific sequence of HPV from cervical swabs in women with biopsy- proven neoplastic lesions of the cervix. Four hundred seventy-one patients were involved and classified into four groups based on the cytopathologic diagnosis: group I (normal, n = 290), group II (low-grade squamous intraepithelial lesions (SIL), n = 68), group III (high-grade SIL, n = 51), and group IV (invasive cervical cancer, n = 55). HPV detection rates were 17.6% (51 of 290), 73.5% (50 of 68), 92.2% (47 of 51), and 95.2% (59 of 62) in patients of group I to group IV, respectively. HPV-16 was the most frequent type (21.8%) in all specimens tested, and significantly increased the prevalence by advancing the grade of the cervical lesions (P < 0.01). The next frequent virus types were HPV-18 and HPV-58. The prevalence of multiple HPV infections was 37.3, 43.7, 27.7, and 28.8%, and no significant difference was detected between each group (P > 0.05). This suggests that the HPV DNA chip is a sensitive diagnostic tool for the detection of HPV in cervical specimens, and that it would provide more useful information on viral genotype and multiple HPV infections. Taken together, molecular biological data on HPV might be beneficial for the prevention and management of cervical neoplastic lesions.

Background: In this study we examined the use of a new-human papillomavirus (HPV) detection method, the HPV oligonucleotide microarray system (Biomedlab Co., Korea), which we compared with the well-established HPV DNA detection system (Hybrid Capture II; HC-II, Digene Co.). This new method prompted us to develop a new HPV genotyping technique, using the oligonucleotide microarray, to detect the generic and type-specific sequence of HPV types. In particular, we undertook the evaluation of the clinical efficacy of the HPV oligonucleotide microarray for detecting HPV in cervical neoplastic lesions., Methods: One hundred forty patients were involved and classified into three groups according to their histopathologic diagnoses: Group I (nonspecific chronic cervicitis; n = 61), Group II (low-grade squamous intraepithelial lesion (SIL); koilocytosis, and mild dysplasia; n = 39), and Group III (high-grade SIL; moderate, severe dysplasia and in situ carcinoma; n = 40). Cytological diagnoses were based on the Bethesda System and cervical samples were analyzed by the two methods. The HPV oligonucleotide microarray detected 15 types of high-risk HPV (HPV-16/-18/-31/-33/-35/-39/-45/-51/-52/-56/-58/-59/-66/-68/-69) and 7 types of low-risk HPV (HPV-6/-11/-34/-40/-42/-43/-44)., Results: In 105 of the 140 cervical samples (75%), HPV DNAs were examined using the HC-II method. HPV detection rates using the HPV microarray agreed with those of HC-II. One HC-II-positive, but HPV microarray-negative, case occurred in the low-grade SIL (Group II) and was later confirmed negative for HPV. The other HPV microarray-positive but HC-II-negative case was found to be HPV-18 by PCR. Low-risk types of HPV were detected in 3 of 39 low-grade SIL cases (Group II) using the HPV microarray. HPV-16 was the most frequent type (32.1%) in all specimens tested, and was significantly more frequent in low-grade or high-grade intraepithelial lesions (Groups II or III) than in normal controls (Group I) (P < 0.05). HPV-58 was the second most common type (17.5%) in Group III. The HPV microarray was found to have advantages in terms of identifying the HPV genotypes and cases of multiple HPV infection. Double HPV infections were detected in 12 cases and triple HPV infections in 7 cases. Two cases were positive for four types of HPV (HPV-16/18/33/35, HPV-16/18/58/68). The sensitivity of HPV testing (HC-II; 94.9%, HPV microarray; 93.7%) for identifying patients with squamous intraepithelial lesion was significantly better than the sensitivity of cytology (77.1%, P < 0.05). On using multiple logistic regression analysis to estimate the relative risk of SIL versus HPV type, HPV-16-positive cases were found to have a 7.5-fold risk of SIL (95% CI = 3.28-16.51; P < 0.01). HPV-33 and HPV-58 were found to be significantly related to high-grade SILs (P < 0.01)., Conclusions: Our results suggest that the HPV oligonucleotide microarray is highly comparable to HC-II for detecting HPV in cervical specimens. The HPV oligonucleotide microarray provides useful information on viral genotype and multiple HPV infections in HPV-related cervical lesions. Genetic information on HPV in cervical specimens might be a particular benefit of the new procedure in the management of cervical neoplastic lesions

Purpose: Growth regulation of cancer cells very frequently involves tumor suppressor gene p53, Rb and cell cycle regulator, however the molecular biologic mechanisms of growth regulation in ovarian carcinoma cells are not fully defined. To assess the mechanism of growth suppression, we treated IFN-gama in ovarian carcinoma cells., Materials and Methods: Growth suppression by treatment of IFN-gama was determined by cell proliferation assay in ovarian carcinoma cell lines. Apoptosis was determined by DNA fragmentation assay and electron microscopy. Molecular mechanism of the apoptosis in ovarian carcinoma cell by IFN-gama was further analyzed by the western blot., Results: We found that IFN-gama had remarkable growth- suppressive effects in PA-1 and A2774 ovarian carcinoma cells in a time-dependent manner. Apoptosis was observed in PA-1 and A2774 cell following treatment of IFN- gama by DNA fragmentation assay and EM. The expression of IRF-1 protein from A2774 and PA-1 cell extracts was elevated by increasing the concentration of IFN-gama. IFN-gama caused an increased expression of the important apoptosis-related gene, ICE (interleukin-1beta-converting enzyme) protein in A2774 and PA-1., Conclusion: The coordinate induction of IRF-1 and ICE by IFN-gama in ovarian carcinoma cells suggests a functional relationship between these proteins in programmed cell death. The significance of this study is the molecular biologic background of IFN-gama considered as an alternative treatment trial of ovarian cancers.

Human papillomavirus (HPV) infection is known as the major cause of the development of cervical cancer. The E6 and E7 proteins of oncogenic HPV can play critical roles in immortalization and malignant transformation of cervical epithelial cells. From the previous epidemiologic data, it has been determined that long-term use of oral contraceptives may be a risk factor for cervical cancer. Investigation of the estrogenic and antiestrogenic effects on the proliferation of cervical cancer cells and the gene expression of HPV would help to explain the role of estrogen in the HPV-associated pathogenesis of cervical cancer. In this study, cervical cancer cells (HeLa, CaSki, and C33A) were cultured in vitro in the presence of 17beta-estradiol or tamoxifen to observe their regulatory growth effect and HPV E6/E7 gene expression. The estrogenic effect on the promoter activity of HPV URR was further confirmed by transient transfection assay, which was conducted in C33A cells using the HPV-18 URR-CAT reporter plasmid. The supplemental effect of estrogen receptors on URR promoter activity was also evaluated. The proliferation of HeLa and CaSki cells was stimulated by estradiol at physiologic concentration levels (

Uterine leiomyoma is a benign smooth muscle tumor of the myometrium and is the most commonly encountered neoplasm in women of reproductive age. As for most benign tumors, the pathogenesis of leiomyoma remains obscure, especially at the molecular genetic level. The purpose of this study was to perform a genome-wide allelotype analysis to identify potential sites of tumor suppressor gene inactivation. Fifty-two cases of uterine leiomyoma were subjected to allelotype analysis by using matched pairs of tumor and blood DNA. Loss of heterozygosity (LOH) was assessed at 61 microsatellite markers distributed throughout the genome and representing all 41 chromosome arms. In general, LOH was very rare except on chromosome 7q, where LOH was observed in 34% of all informative tumors. Fine-deletion mapping with 25 microsatellite markers from the 7q22 region revealed a minimal deletion unit of approximately 4 cM, bounded by the markers D7S2453 proximally and D7S496 distally, that probably harbors a novel tumor suppressor gene involved in the etiology of this tumor.

To estimate the prevalence of urinary stone disease in Koreans, and to determine the inter-relationships between urinary stone disease and various epidemiological factors, 1,521 controls and 1,177 cases with urinary stones were evaluated. Of special interest in this study were: 1) proportion of past urinary stone history among controls; 1.9% 2) the point prevalence rate of urinary stones among controls; 0.2% 3) the recurrence rate of urinary stones (the proportion of past history of urinary stone) among cases; 56.8% 4) high incidences (76.3%) in the thirties to the fifties among cases 5) the risk factors for urolithogenesis; obesity [higher than 25 of BMI (body mass index, weight/height2)], more than 10 year-experience as a production worker, past stone history, familial stone history, low physical activity (< 2,000 Kcal/day), and low intake of fruit. However, the well-known risk factors for urinary stones; over intake of meat or fish and milk or dairy products, perspiration, amount and kind of drinking water, and stress unexpectedly were not significantly different between the controls and the cases.

The present study was undertaken to investigate the role of nitric oxide (NO) in erectile physiology by correlating its action with the existence and activity of nitric oxide synthase (NOS), which produces NO. We applied Western blot analysis in both human and rat penile tissue. In the rat, reduced nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining and spectrophotometric assay were also performed, in addition to in vivo electroerection study with pharmacological manipulation. Western blot analysis identified a protein of 155 KDa identical to the neural form of NOS in the human and rat penis. The NOS blot densities in the two species were similar, and both were lower than that in the rat cerebellum. Histochemical staining localized NOS to neurons innervating the corpora cavernosa, including the pelvic plexus, the cavernosal nerves and their terminal fibers within the corporeal erectile tissue, and dorsal penile nerves. NOS activity was also found in the cerebellum, urethra, penis, and urinary bladder, in decreasing order of intensity. Intracavernous injections of NOS inhibitor (L-NOARG or L-NAME in concentrations from 10(-6) M to 10(-3) M suppressed electrostimulation-induced erection in a concentration-dependent manner. Subsequent intracavernous injection of L-Arginine (10(-2) M) partially restored the erection. The neural form of constitutive NOS in the corpora cavernosa synthesizes NO, which mediates penile erection. Determination of cavernosal NOS expression or activity may permit characterization of certain pathological conditions that cause impotence.