• Title/Summary/Keyword: Korean Medicine Obstetrics and Gynecology

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Prognostic Factors Influencing the Result of Postoperative Radiotherapy in Endometrial Carcinoma (자궁내막암의 수술 후 방사선치료 결과에 영향을 미치는 예후인자)

  • Ki Yong-Kan;Kwon Byung-Hyun;Kim Won-Taek;Nam Ji-Ho;Yun Man-Su;Lee Hyung-Sik;Kim Dong-Won
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.110-115
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    • 2006
  • Purpose: This study was performed to determine the prognostic factors influencing relapse pattern, overall and disease-free survival in patients treated with postoperative radiotherapy for endometrial carcinoma. Materials and Methods: The records of 54 patients with endometrial adenocarcinoma treated postoperative radiotherapy at Pusan National University Hospital between April 1992 and May 2003 were reviewed retrospectively. Median age of the patients was 55 (range $35{\sim}76$). The distribution by surgical FIGO stages were 63.0% for 0Stage I, 14.8% for Stage II, 22.2% for Stage III. All patients received postoperative external radiotherapy up to $41.4{\sim}54Gy$ (median: 50.4 Gy). Additional Intravaginal brachytherapy was app led to 20 patients (37.0% of all). Median follow-up time was 35 months ($5{\sim}115$ months). Significant factors of this study: histologic grade, Iymphovascular space invasion and myometrial invasion depth were scored (GLM score) and analyzed. Survival analysis was peformed using Kaplan-Meier method. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. Results: 5-year overall and disease-free survival rates were 87.7% and 871%, respectively. Prognostic factors related with overall and disease-free survival were histologic grade, Iymphovascular space invasion and myometrial invasion according to the univariate analysis. According to the multivariate analysis, Iymphovascular space invasion was associated with decreased disease-free survival. GLM score was a meaningful factor affecting overall and disease-free survival (p=0.0090, p=0.0073, respectively) and distant recurrence (p=0.0132), which was the sum of points of histologic grade, Iymphovascular space Invasion and myometrial invasion. Total failure rate was 11% with 6 patients. Relapse sites were 2 para-aortic Iymph nodes, 2 lungs, a supraclavicular Iymph node and a vagina. Conclusion: The prognosos in patients with endometrial carcinoma treated by postoperative radiotherapy was closely related with surgical histopathology. If further explorations confirm the system of prognostic factors in endometrial carcinoma, it will help us to predict the progression pattern and to manage.

Purification and Characterization of an Antimicrobial Substance from Bacillus subtilis HH28 Antagonistic to Bacillus cereus (Bacillus cereus를 억제하는 Bacillus subtilis HH28의 항균물질 정제와 특성규명)

  • Cha, Hyun A;Chung, Dawn;Hong, Sung Wook;Chung, Kun Sub
    • Microbiology and Biotechnology Letters
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    • v.42 no.4
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    • pp.393-401
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    • 2014
  • A bacterium producing antimicrobial substance was isolated from cheonggukjang. The bacterium was identified as a strain of Bacillus subtilis by 16S rDNA sequencing and designated as Bacillus subtilis HH28. The antimicrobial substance produced from Bacillus subtilis HH28 was purified by 0-80% ammonium sulfate precipitation, DEAE-sepharose FF column chromatography, and Sephacryl S-200 HR gel chromatography. The molecular weight of the purified antimicrobial substance was estimated to be approximately 3,500 Da using Tricine sodium dodecyl sulfate-polyacrylamide gel electrophoresis and direct detection analysis. Antimicrobial substance from B. subtilis HH28 not only inhibited B. cereus, but also Listeria monocytogenes and Vibrio parahaemolyticus. The purified antimicrobial substance was stable at $40-80^{\circ}C$, and between pH 2 and 8. Antimicrobial activity of the purified substance was completely destroyed by treatment of protease, proteinase K, and pronase E, indicating that it is proteinaceous.

Risk Factors for Depression of Patients with Tuberculosis in Tuberculosis Specialty Hospital (결핵전문병원에 입원한 결핵환자의 우울증위험인자)

  • Wang, Jung-Hyun;Park, Chul-Soo;Kim, Bong-Jo;Lee, Cheol-Soon;Cha, Boseok;Lee, So-Jin;Lee, Dongyun;Seo, Ji-Yeong;Ahn, InYoung;Baek, Jong Chul;Kang, Hyung Seok;Moon, Sung Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.2
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    • pp.114-120
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    • 2015
  • Objectives : This study aimed to investigate the risk factors of depression for patients with tuberculosis(TB). Methods : A total of 57 patients with TB were recruited. All participants completed the Becks Depression Inventory-II for evaluating depressive symptoms. The risk factor for depression was analyzed by binary logistic regression analysis. Nomogram was performed for probability of depression. Results : Low body mass index(BMI, OR 0.801, 95% CI 0.65, 0.98), interruption of treatment for TB(OR 5.908, 95% CI 1.19, 29.41), past history of depression(OR 24.653, 95% CI 1.99, 308.44) were associated with increased risk for depression. The calibration curve for predicting probability of survival showed a good agreement between the nomogram and actual observation(Original C-index=0.789, bias corrected C-index=0.754). Conclusions : The result of the present study indicate that low BMI, interruption of treatment for TB, and past history of depression were risk factors for depression in patients with TB. The psychiatric intervention may be needed to prevent depression if the patients with TB have risk factor during treatment for TB.

Significance of Toxoplasma Antibody Titers by Indirect Latex Agglutination Tests in Pregnant Women and Pelvic Tumor Patients (임산부 및 골반장기 종양환자에서의 Toxoplasma Latex 응집항체치의 의의)

  • Choe, Won-Yeong;Choe, Hyeong-Rak;Na, Jong-Gu
    • Parasites, Hosts and Diseases
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    • v.23 no.2
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    • pp.300-304
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    • 1985
  • A total of 377 pregnant women, 43 pelvic tumor patients and 80 of multiphysic health center persons as controls were examined by indirect latex agglutination test in order to evaluate Toxoplasma antibody titers at Kang-Nam St. Mary's Hospital in Seoul. Throughout this survey, 1 : 32 or more titers of diluted sera were regarded as positive. 1. The 377 samples of test sera in pregnant women showed negatives in 319 cases (84.6%), 1 : 2 in 44 cases (11.7%), 1:4 in 9 cases (2.4%), 1:8 in 2 cases (0.5%), 1:16 in 1 case (0.3%) and 1 : 32 in 2 cases (0.5%) respectively. 2. The 43 samples of test sera in pelvic tumor patients showed negatives in 29 cases (67.4%), 1:2 in 8 cases(18.6%), 1:4 in 1 case(2.3%), 1:16 in 2 cases (4.7%), 1:32 in 1 case(2.3%) and 1 : 128 in 2 cases (4.7%). 3. The 80 samples of test sera in multiphysic health center persons as controls negatives in 56 cases (70.0%), 1.2 in 19 cases (23.8%), 1:4 in 3 cases (3.8%), 1:8 in 1 case (1.3%) and 1 : 128 in 1 case (1.3%). 4. Among total 420 study cases, 5 cases (1.2%) showed Positives, and they were 2 cases (0.5%) of pregnant women and 3 cases (7.0%) of pelvic tumor patients. 5. One case (1.3%) out of 80 control sera showed positive result.

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Effect of Hypoxia-induced XIAP Expression on Apoptosis of Trophoblast Cells in Placenta (Hypoxia에 의한 X-linked Inhibitor of Apoptosis 발현이 태반 내 영양막세포의 세포자멸사에 미치는 영향)

  • Lee, Jong-Sung;Jeon, Su-Yeon;Choi, Jong-Ho;Lee, Yoo-Jin;Cha, Dong-Hyun;Kim, Gi-Jin
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.217-229
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    • 2010
  • Objective: Apoptosis plays an important role for the maintenance of the normal pregnancy. Expression of X-linked inhibitor of apoptosis (XIAP) is able to effectively prevent apoptosis and controls trophoblast cells death throughout placental development, but it is still unknown in the function of XIAP in trophoblast cells exposed to hypoxic condition, which is one of the factors causing preeclampsia. Therefore, we conducted to compare XIAP expression in normal and pre-eclamptic placenta tissues and analyzed the function of XIAP in HTR-8/SVneo trophoblast cell line exposed to hypoxic condition. Methods: The expression of XIAP was analyzed in placental tissues from the following groups of patients (none underwent labor): 1) term normal placenta (n=15); 2) term with pre-eclamptic placeneta (n=15); and 3) pre-term with pre-eclamptic placenta (n=11) using semi-quantitative RT-PCR, immunohistochemistry, and Western blot. In order to evaluate the function of XIAP in HTR-8/SVneo trophoblast cells under hypoxic condition, HIF-$1{\alpha}$ plasmids, and hypoxic condtion were transfected and treated into HTR-8/SVneo trophoblast cells for 24 hours, respectively. Results: We observed that XIAP are expressed in the syncytiotrophoblasts and syncytial knot of placental villi. The expression of XIAP was significantly decreased in preeclamptic placenta tissues than in normal placenta tissues without labor (p<0.05). Furthermore, we confirmed the XIAP expression in HTR-8/SVneo trophbolast cells exposed to hypoxia was translocated from cytoplasm into nucleus and decreased XIAP by hypoxic condition induced apoptosis in HTR-8/SVneo trophoblast cells through up-regulation of pro-apoptotic proteins. Conclusion: These results suggest that the expression of XIAP is involved in placental development as well as decreased expression of XIAP by hypoxia is associated with pre-eclampsia through inducing trophoblast cells apoptosis.

A Survey for Understanding of Breastfeeding among Mothers with Chronic Hepatitis B Infection (만성 B형 간염 산모들의 모유수유에 대한 인식조사)

  • Lee, Kwang-Hee;Kim, Jong-Hyun;Kang, Jin Han;Hur, Jae Kyun;Koh, Dae Kyun;Park, Sook Kyung;Kim, Youngtaek;Seo, Kyung
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.191-198
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    • 2009
  • Purpose : Breastfeeding should be recommended for infants born to mothers with chronic hepatitis B Infection after postexposure prophylaxis. However, high proportion of these mothers are reluctant to engage in breastfeeding in Korea. This survey was taken to identify the cause of that reluctance. Method : Questionnaires were given to mothers with chronic hepatitis B infection who were registered at the 'Hepatitis B Perinatal Transmission Prevention Program' operated by Korea Center for Disease Control and Prevention. They visited a community health center for blood sample collection and signed a consent paper. The questionnaires were sent to the mothers. Result : Among 839 mailed questionnaires, 114 were returned marked 'address unknown'. The overall reply rate was 17% (n=125). Among responders, 52% (n=62) were breastfeeding and 48% (n=60) were formula-feeding. The most influential factor for breastfeeding was the mother's own decision (75%) and the obstetrician's recommendation (17%). For formulafeeding mothers, their decisions were influenced by obstetricians (57%), and by their own thinking (28%). The relationship between breastfeeding and perinatal prophylaxis failure was recognized as 45% 'related' and 50% 'not-related'. A total of 91% of breastfeeding mothers replied that they will breast-feed again. Among formula-feeding mothers, 78% answered that they will breast-feed if they were known that 'there is no direct relationship between breastfeeding and perinatal prophylaxis failure'. Conclusion : Despite the fact that there is no direct relationship between breastfeeding and perinatal prophylaxis failure, many were reluctant to breast-feed. Healthcare professionals have influence over the mothers for decision making. It will be necessary to educate healthcare personnel so that they can make a conceptual change as well as to promote the fact to the general public.

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Early and Late Bowel Complication Following Irradiation of Cancer of the Uterine Cervix (자궁경부암의 고선량 치료후의 장관 합병증)

  • Kim Myung Se;Kim Kyung Ae;Kim Sung Kyu;Shin Sei One;Lee Sung Ho;Chang Jae Chun
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.59-70
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    • 1989
  • Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still $44\%$ of patient will develop recurrent cancer. This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen Which is $5500\~1000 CGy$ higher than Other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was $46\%$, but only 1 patient $(1\%)$ had operative treatment because of incomplete obstruction of small bowel. Most symptoms appeared within 12 months and most common complaints were frequent bowel movement. Barium enema and sigmoidoscopy were performed for persistent symptomatic patients. Only one patient had abnormal finding in barium enema which showed inefficiency of this method for detecting bowel complication. Patient's age, total tumor dose, total TDF, rectal dose were not significant risk factors for complication, but boost dose, previous history of operation had some relationship with complication risk. Even though dose of point A and rectum is $500\~1,000cGy$ higher than other institution, such a low rate of severe complications may suggest that fear of complications should not be overestimated than cure rate and the possibility of more aggressive treatment for better local control should not be underestimated.

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Megakaryocyte Colony Formation of Fetal Liver Cells (태아 간세포의 거핵구 집락형성)

  • Kwon, Byung O;Ju, Hye Young;Kim, Chun Soo;Jeon, Dong Seok;Kim, Jong In;Kim, Heung Sik
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.247-255
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    • 2002
  • Purpose : This study was undertaken to obtain basic data about the megakaryocyte colony formation of fetal liver cells by using immunocytochemical staining and ex vivo culture with growth factors. Methods : The mononuclear cells were isolated from fetal liver and bone marrow with idiopathic thrombocytopenic purpura(ITP) and pancytopenia. These mononuclear cells were cultured in $MegaCult^{TM}-C$(Stem Cell Tech, Canada) media in the presence of growth factors and CFU-Megakaryocyte( CFU-Mk) colonies were counted on day 12. The expansion of CD34+ and CD41+ cell was analyzed by flow cytometry after 5 days incubation using flask culture. Results : The numbers of CFU-Mk colonies of mononuclear cells obtained from fetal liver in the 11th week gestational age were more than those in the 19th week specimens; growth factors could not enhance the colony expansion in all cases. Total numbers of CFU-Mk colony of fetal liver cells were higher than bone marrow from ITP or pancytopenia groups. The numbers of pure or large CFU-Mk colonies of fetal liver cells were also higher than bone marrow specimens. The rate of CD34+ cell expression of fetal liver was increased after flask culture and the enhancement effect of epression was seen only in cases which added thrombopoietin. The rate of CD41+ cell expression of fetal liver was increased after incubation, but the enhancement effect of growth factors was unclear. Conclusion : This study revealed good results about the megakaryocyte colony assay of fetal liver mononuclear cells using $MegaCult^{TM}-C$ media. This study suggests that the fetal liver could be a good source of megakaryocytic progenitor cells for clinical application in hematopoietic stem cell transplantation.

Medicolegal Problems in Pediatric Area (소아과 영역에서 의료분쟁)

  • Kwon, Soo Jeong;Jang, Ji Young;Kim, Nam Su;Yum, Myung Kul;Seol, In Joon;Jung, Ku Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.813-819
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    • 2005
  • Purpose : Medicolegal problems start when the patient asserts the mistake of doctor and doctor does not accept it. The purpose of this study is to assess the actual condition of medicolegal problems and to provide solutions of medicolegal problems in the pediatric field. Methods : There is not official statistical data about medicolegal problems in our country. We gathered data of legal insurance program of Korean Medical Association(KMA) and court cases and other fragmentary data. Results : Between 1981 and 1995, of total 2,338 cases reported to legal problem insurance program of KMA, most common ones were 748 cases of obstetrics and gynecology. Pediatric case was ranked at the 5th, 74 cases(3.1%). According to analysis of 41 medicolegal cases' after 1990, maltreatment of patient had the highest incidence of 14 cases, injection and medication were related to 12 cases, misdiagnosis was 9 cases, patient management were related to 4 cases, and others were 2 cases. The trial result of the medicolegal cases was that 31 cases were compensated, and 8 cases were defeated, and 2 cases were still in the process. Conclusion : The aspect of medical legal problem has the tendency of radicalism and systematization. This brings an economic destitution in the patient and gives damage to a doctor. In order to reduce medicolegal problem, doctor should offer a duty of explanation and efforts to his best to satisfy patient and endeavor to make an intimate doctor-patient relationship.

A Study of Altered IL-6 and TNF-α Expression in Peritoneal Fluid of Patients with Endometriosis (자궁내막증 환자의 복강 액내 IL-6와 TNF-α의 변화 양상에 관한 연구)

  • Kang, Jeong-Bae;Lee, Young-Kyeong
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.1
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    • pp.45-52
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    • 2006
  • Objective: Our purpose was to investigate the relationship between the levels of IL-6 and tumor necrosis factor-${\alpha}$ in the peritoneal fluid of women with and without endometriosis and infertile women. Methods: This study is prospective and case-control study in University hospital, enrolled thirty-four women with laparoscopic findings of minimal to severe endometriosis, and thirty-seven women with no visual evidence of pelvic endometriosis and with benign gynecologic disease. IL-6 and tumor necrosis factor-${\alpha}$ levels in peritoneal fluid were determined using commercial ELISA. IL-6 and tumor necrosis factor-${\alpha}$ concentrations were compared among women with and without endometriosis, and with infertile and fertile women, and then also compared according the revised American Fertility Society classification. Results: IL-6 and tumor necrosis factor-${\alpha}$ concentrations were higher than in the peritoneal fluid of women with endometriosis than in matched normal controls. Cyclic variations in IL-6 concentrations were seen in peritoneal fluid from patients with endometriosis: the concentrations in the secretory phase were significantly higher than those in the proliferative phase. The concentrations were higher than among of infertile women than in fertile women. A significant correlation between IL-6 and tumor necrosis factor-${\alpha}$ concentrations and endometriosis stage III and IV was noted. Conclusion: Increased levels of IL-6 and tumor necrosis factor-${\alpha}$ in patients with endometriosis in the peritoneal fluid may be relate to the pathogenesis of endometriosis suggesting that partially contribute to the disturbed immune regulation observed in patients with endometriosis.