Objective: To investigate the expression of endogenous hypoxia-related markers identified as being involved in vulvar squamous cell carcinoma (VSCC). Methods: We performed immunohistochemical staining of hypoxia-inducible factor-$1{\alpha}$ (HIF-$1{\alpha}$), glucose transporter-1 (GLUT-1), carbonic anhydrase 9 (CA-9) and vascular endothelial growth factor (VEGF), on tissue sections of 25 VSCC patients, 10 vulvar intraepithelial neoplasia (VIN) patients and 12 healthy controls. Results: HIF-$1{\alpha}$ expression was found in all sections, with no significant difference between controls, VIN and VSCC sections (all P<0.05). Glut-1 expression was found in 25% of control, 90% of VIN and 100% of VSCC sections. A significant difference between control and VIN or VSCC was observed (all P<0.05), while no difference was found between VIN and VSCC sections (P>0.05). CA-9 expression was negative in control sections, but it was found in 30% of VIN sections and 52% of VSCC sections with strong staining. Similarly, CA-9 expression also showed obvious differences between controls and VIN or VSCC sections (all P<0.05). However, there was no significant difference between VIN and VSCC (P>0.05). There were only 25% of control sections with weak VEGF expression, while strong staining was found in about 60% of VIN sections and 25% of VSCC sections (all P<0.05). In addition, a difference was also found between VIN and VSCC sections (P<0.05). Conclusion: Expression of endogenous hypoxia markers (HIF-$1{\alpha}$, GLUT-1, CA-9 and VEGF) might be involved in the malignant progression of VSCC.
Background: This study aimed to develop a prognostic model in patients with early-stage cervical squamous cell carcinoma based on clinicopathological features, including invasive margin characteristics. Materials and Methods: Clinicopathological features and outcomes of 190 patients with FIGO stage IB-IIA cervical squamous cell carcinoma treated by surgery were collected and analyzed for factors associated with tumor recurrence. In addition to well-recognized pathological risk factors, the pathological characteristics of invasive margin (type of invasive pattern and degree of stromal desmoplasia and peritumoral inflammatory reaction) were also included in the analysis. Multiple scoring models were made by matching different clinicopathological variables and/or different weighting of the score for each variable. The model with the best performance in the prediction of recurrence and decreased survival was selected. Results: The model with the best performance was composed of a combined score of invasive pattern, lymphovascular space invasion (LVSI), and degree of inflammatory reaction and stromal desmoplasia (total score =10). Compared to those with score ${\leq}8$, the patients with score 9-10 had a significantly higher recurrence rate in the overall group (p<0.001) and the subgroup without adjuvant therapy (p<0.001), while the significance was marginal in the subgroup with adjuvant therapy (p=0.069). In addition, the patients with score 9-10 had a higher rate of tumor recurrence at distant sites (p=0.007). The disease-free survival was significantly lower in the patients with score 9-10 than those with score ${\leq}8$ among the overall patients (p<0.001), in the subgroup without adjuvant therapy (p<0.001), and the subgroup with adjuvant therapy (p=0.047). Conclusions: In this study, a prognostic model based on a combination of pathological characteristics of invasive margin and LVSI proved to be predictive of tumor recurrence and decreased disease-free survival in patients with early-stage cervical squamous cell carcinoma.
Background: Previous reports have shown that human epidermal receptor (HER)-3 overexpression may be associated with poor prognosis in patients with breast cancer, but results have been conflicting. In this study, we sought to investigate the prognostic significance of HER-3 immunohistochemical expression in patients with metastatic breast cancer. Methods: We retrospectively analyzed HER-3 immunohistochemical expression profiles in 45 paraffin-embedded specimens from patients who had been treated between 1996 and 2006 in the Department of Oncology of the Uludag University School of Medicine, Bursa, Turkey. Membranous or cytoplasmic dominant expression patterns of HER-3 were analyzed using the Rajkumar score and a cytoplasmic 4-point scoring system, respectively. Progression-free survival (PFS) and overall survival (OS) served as the main outcome measures. Results: The median PFS in the study participants was 9 months (interquartile range: 4.5-13 months), whereas the median OS was 20 months (interquartile range: 7.5-28 months). Categorization of the patient population according to HER-3 positive immunohistochemical expression did not reveal any statistically significant difference in terms of both PFS (p=0.70) and OS (p=0.81). The results of multivariable Cox regression analysis indicated that tumor size was the only independent predictor of PFS, whereas estrogen and progesterone receptor status was independently associated with OS. Conclusions: HER-3 immunohistochemical expression did not correlate with outcomes in Turkish patients with metastatic breast cancer. Although our results suggest that HER-3 expression in cancer specimens is not of prognostic significance, further prospective studies are warranted to confirm these results.
Background: To investigate the effect of pectinase-treated Panax ginseng (GINST) in cellular and male subfertility animal models. Methods: Hydrogen peroxide ($H_2O_2$)-induced mouse spermatocyte GC-2spd cells were used as an in vitro model. Cell viability was measured using MTT assay. For the in vivo study, GINST (200 mg/kg) mixed with a regular pellet diet was administered orally for 4 mo, and the changes in the mRNA and protein expression level of antioxidative and spermatogenic genes in young and aged control rats were compared using real-time reverse transcription polymerase chain reaction and western blotting. Results: GINST treatment ($50{\mu}g/mL$, $100{\mu}g/mL$, and $200{\mu}g/mL$) significantly (p < 0.05) inhibited the $H_2O_2$-induced ($200{\mu}M$) cytotoxicity in GC-2spd cells. Furthermore, GINST ($50{\mu}g/mL$ and $100{\mu}g/mL$) significantly (p < 0.05) ameliorated the $H_2O_2$-induced decrease in the expression level of antioxidant enzymes (peroxiredoxin 3 and 4, glutathione S-transferase m5, and glutathione peroxidase 4), spermatogenesis-related protein such as inhibin-${\alpha}$, and specific sex hormone receptors (androgen receptor, luteinizing hormone receptor, and follicle-stimulating hormone receptor) in GC-2spd cells. Similarly, the altered expression level of the above mentioned genes and of spermatogenesis-related nectin-2 and cAMP response element-binding protein in aged rat testes was ameliorated with GINST (200 mg/kg) treatment. Taken together, GINST attenuated $H_2O_2$-induced oxidative stress in GC-2 cells and modulated the expression of antioxidant-related genes and of spermatogenic-related proteins and sex hormone receptors in aged rats. Conclusion: GINST may be a potential natural agent for the protection against or treatment of oxidative stress-induced male subfertility and aging-induced male subfertility.
Objectives Obesity and climacteric symptom are affected by various cultural, social and psychological factors. This study is performed to recognize the relationship between obesity, climacteric symptom, and other social and psychological factors such as self-esteem, depression, eating attitude, stress response and social readjustment rating. Methods SRRS(social readjustment rating scale), SES(self-esteem scale), SRI(stress response inventory), BDI(Beck depression inventory), KEAT-26 (Korean Eating Attitude Test-26) and Kuperman index were given to 43 peri-menopausal women aged 45-55 and BMI ${\geq}23$. They were given written consent and this study is performed under the permission of institutional review board of Kyung Hee East-west Neo Medical Center. And height, body weight, waist circumference were measured. These variables were treated by correlation and regression analysis for finding effect factors of climacteric symptom. Result BMI and WC were not related to climacteric symptom. There were significant correlation between KEAT-26(r=0.4388, p=0.004), SES (r=-0.4748, p=0.001), SRI(r=0.6941, p<0.001), BDI(r=0.6354, p<0.001) and Kuperman index. In multiple regression, SRI was find to be a prediction factor of Kuperman index.(Kuperman index=19.033+0.7SRI($R^2$=0.490)). Conclusion Climacteric symptom is related to self-esteem, eating attitude, depression and stress response. And the most important prediction factor of climacteric symptom is stress response. So managing of stress response may be essential to treating climacteric syndrome. And it is necessary to study about climacteric symptom with many other effective factors of various peri-menopausal subjects.
Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.
본 연구자는 Zinc Selenium autometallography ($ZnSe^{AMG}$) (Danscher et al., 1997) 염색법을 중심으로 중추신경계통 내 zinc ($Zn^{2+}$)의 분포와 이들을 함유하고 있는 신경종말, 소위 ZEN(zinc-enriched) terminals의 미세구조에 관하여 보고한 바 있다. 이번 연구에서는 다른 몇 가지, 즉 Neo-Timm staining (Danscher, 1982), TSQ fluorescence staining (Frederickson et al.,1987), Zinc transporter-3 Immunohistochemistry ($ZnT3^{IHC}$) (Palmiter et at., 1997) 염색법으로 흰쥐 해마복합체에 분포하는 $Zn^{2+}$를 염색한 후 이들의 염색패턴에서 차이점을 밝히고자 하였다. $ZnSe^{AMG}$ 염색법은 $Zn^{2+}$에 대한 특이성은 다소 떨어지나 광학 및 전자현미경하에서 관찰이 가능하며, 반영구적인 표본으로 보관이 가능하다는 장점이 있었고, TSQ는 $Zn^{2+}$에 대한 특이성이 매우 높을 뿐 아니라 그 염색법이 매우 간단하다는 장점이 있는 반면 형광물질의 안정성과 표본보관이 용이하지 않다는 단점이 있다. 그 외 Neo-Timm 염색법은 TSQ형광염색법과 유사한 염색 패턴을 보였으며, $ZnT3^{IHC}$염색법은 오히려 $ZnSe^{AMG}$에 가까운 염색의 결과를 보였다. 본 연구의 결과는 중추신경계통 내 $Zn^{2+}$에 관한 형태학적 연구에서 기초자료로 활용될 수 있을 것이다.
Objectives: Banhahoobak-tang has been used to treat plum-pit qi, chest and hypochondriac distension, moist or greasy tongue coat, and wiry slow or wiry slippery pulse. It might be used to control coughing and vomiting. We observed that Banhahoobak-tang extract (BHTe) had anti-psychological stress effect. The objective of this study was to determine the effect of BHTe on restoring the transcriptional regulation of genes related to psychological stress. Methods: After giving psychological stress to mice, BHTe was orally administered at 100 mg/kg/day for five days. After extracting whole brain tissue from the mice, the gene expression changes were determined by microarray. Transcription factor binding site (TFBS) analysis showed up- and down-regulated genes related to psychological stress were protected by BHTe and segregated according to the structure of TFBS. We performed text based Pubmed search to select significant target genes involved in psychological stress affected by BHTe. Results: 1. Serum corticosterone level was decreased in the BHTe administered group, although the psychological stress was increased. 2. The BHTe administered group had no significant change in noradrenaline content in brain tissue, but the psychological stress group had decreased level. 3. The BHTe administered group had increased time of staying at open-arm than the psychological stress group. 4. Microarray revealed that TANK and RARA genes were up-regulated genes while AES, CDC42, FOS, NCL, and PVR were down-regulated genes by psychological stress but restored by BHTe.
The present study investigated neuroprotective effects Rehmanniae Radix on PC12 cells and hippocampal neural cells. PC12 cells were damage by $H_2O_2$ and nitric oxide and organotypic hippocampal slice cultures were damaged by oxygen-glucose deprivation. Then methanol extract of Rehmanniae Radix was treated with 0.5, 5, and $50\;{\mu}g/ml$ in culture media. Effects of Rehmanniae Radix were evaluated with cell viability assay, PI-staining, and TUNEL-labeling. Treatment of Rehmanniae Radix ($with\;5\;and\;50\;{\mu}g/ml$) produced significant increase of cell viability of PC12 cells damaged by $H_2O_2$ and by SNP-induced nitric oxide. Treatment of Rehmanniae Radix produced significant decrease of PI-uptake % in CA1 ($with\;5\;and\;50\;{\mu}g/ml$) and DG ($with\;50\;{\mu}g/ml$) regions of organotypic hippocampal slice cultures damaged by oxygen-glucose deprivation. Moreover, treatment of Rehmanniae Radix produced significant decrease of TUNEL- positive cells in CA1 ($with\;5\;and\;50\;{\mu}g/ml$) and DG ($with\;50\;{\mu}g/ml$) regions of organotypic hippocampal slice cultures damaged by oxygen-glucose deprivation. These results suggest that methanol extract of Rehmanniae Radix has neuroprotective effects on PC12 cells damaged by oxidative stress and on organotypic hippocampal slice cultures damaged by oxygen-glucose deprivation.
This study was conducted to explore the depression, anxiety, spouse support, and the difference of these variables according to the general characteristics and disease related characteristics in married women who had received gynecologic cancer treatment. The subjects consisted of 62 patients with cervical cancer, 18 patients with ovarian cancer, and 7 patients with endometrial cancer who were admitted to the department of obstetrics and gynecology, 3 education hospital in Seoul from January, 1996 to August, 1999. The data were collected from March 25 to July 25, 2000 by using a mailed questionnaire. The results were as follows : 1. The mean score of depression was 35.1 with the range from 20 to 76. The mean score of the anxiety was 38.6 with the range from 24 to 58. The mean score of the spouse support was 33.8 with the range from 12 to 48. 2. The score of depression was significantly different by the general characteristics: woman's education level(p=.040), economic level(p=.002), and the satisfactory level on married life(p=.009). The score of spouse support was significantly different by the general characteristics: woman's education level(p=.009), spouse's education level(p=.001), spouse's religion (p=.004), economic level(p=.008), and the satisfactory level on married life(p=.000). The scores of depression, anxiety, and spouse support were not significantly different by the disease related characteristics. 3. The score of depression had a positive correlation with anxiety(r=.731), and a negative correlation with spouse support(r=-.425). 4. The main influencing factors on the depression were economic level$(13.4\%)$ and satisfactory level on married life$(4.4\%)$. The main influencing factors on the spouse support were satisfactory level on married life$(23.6\%)$ and spouse's education level$(9.2\%)$. Based upon the above findings, the depression, anxiety, and spouse support of women who had received gynecologic cancer treatment were higher than healthy married women. The score of depression and anxiety had a negative correlation with spouse support. The factors influencing spouse support were satisfactory level on married life and spouse's education level. Therefore it is recommended that nursing intervention for women who had received gynecologic cancer treatment would be focused to improve spouse support for alleviating depression and anxiety level.
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