• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1489-1492
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• 2016

Background: Although there are no biomarkers that are routinely used in endometrial cancer (EC) management, many studies have found that serum human epididymis protein 4 (HE4) is superior to cancer antigen 125 (CA125) in the detection of EC. The correlation of HE4 with two prognostic factors for EC, primary tumor diameter (PTD) and depth of myometrial invasion (DMI) may be useful in identifying EC patients at high risk of lymphatic dissemination. Objective: To evaluate the correlation of serum HE4 with PTD and DMI in patients with EC. Materials and Methods: A cross-sectional study was conducted on 70 EC patients who were scheduled for elective surgery at Rajavithi Hospital between 1st September 2013 and 30th May 2014. Preoperative serum levels of HE4 and CA125 were investigated, and then gross measurement of PTD was taken and postoperative pathologic slides were reviewed for DMI including histologic types, grading and staging. Results: Preoperative serum HE4 levels were strongly correlated with PTD (r=0.65, p<0.001) and moderately correlated with DMI (r=0.46, p<0.001). Moreover, serum HE4 levels were significantly elevated in EC patients with PTD >2 cm (p<0.001) and DMI > 50% (p=0.004). The performance of serum HE4 in identifying EC patients at low risk and high risk of lymph node metastasis was significantly better than that of CA125 (AUC 0.88 vs. 0.65, p=0.003). At an optimal cut-off value of 70 pM/L, serum HE4 had a sensitivity of 83.3% and a specificity of 80.0%. Conclusions: In EC patients, preoperative serum HE4 is significantly correlated with PTD and DMI. Serum HE4 levels could be useful in identifying endometrial cancer patients at high risk of lymphatic spread who would benefit from systemic lymphadenectomy at the cut-off value of 70 pM/L.

• The Korean Journal of Physiology and Pharmacology
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• 제20권5호
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• pp.547-556
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• 2016

Myometrial relaxation of mouse via expression of two-pore domain acid sensitive (TASK) channels was studied. In our previous report, we suggested that two-pore domain acid-sensing $K^+$ channels (TASK-2) might be one of the candidates for the regulation of uterine circular smooth muscles in mice. In this study, we tried to show the mechanisms of relaxation via TASK-2 channels in marine myometrium. Isometric contraction measurements and patch clamp technique were used to verify TASK conductance in murine myometrium. Western blot and immunehistochemical study under confocal microscopy were used to investigate molecular identity of TASK channel. In this study, we showed that TEA and 4-AP insensitive non-inactivating outward $K^+$ current (NIOK) may be responsible for the quiescence of murine pregnant longitudinal myometrium. The characteristics of NIOK coincided with two-pore domain acid-sensing $K^+$ channels (TASK-2). NIOK in the presence of $K^+$ channel blockers was inhibited further by TASK inhibitors such as quinidine, bupivacaine, lidocaine, and extracellular acidosis. Furthermore, oxytocin and estrogen inhibited NIOK in pregnant myometrium. When compared to non-pregnant myometrium, pregnant myometrium showed stronger inhibition of NIOK by quinidine and increased immunohistochemical expression of TASK-2. Finally, TASK-2 inhibitors induced strong myometrial contraction even in the presence of L-methionine, a known inhibitor of stretch-activated channels in the longitudinal myometrium of mouse. Activation of TASK-2 channels seems to play an essential role for relaxing uterus during pregnancy and it might be one of the alternatives for preventing preterm delivery.

• The Korean Journal of Physiology and Pharmacology
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• 제18권6호
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• pp.503-508
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• 2014

Spontaneous myometrial contraction (SMC) in pregnant uterus is greatly related with gestational age and growing in frequency and amplitude toward the end of gestation to initiate labor. But, an accurate mechanism has not been elucidated. In human and rat uterus, all TRPCs except TRPC2 are expressed in pregnant myometrium and among them, TRPC4 are predominant throughout gestation, suggesting a possible role in regulation of SMC. Therefore, we investigated whether the TRP channel may be involved SMC evoked by mechanical stretch in pregnant myometrial strips of rat using isometric tension measurement and patch-clamp technique. In the present results, hypoosmotic cell swelling activated a potent outward rectifying current in G protein-dependent manner in rat pregnant myocyte. The current was significantly potentiated by $1{\mu}M$ lanthanides (a potent TRPC4/5 stimulator) and suppressed by $10{\mu}M$ 2-APB (TRPC4-7 inhibitor). In addition, in isometric tension experiment, SMC which was evoked by passive stretch was greatly potentiated by lanthanide ($1{\mu}M$) and suppressed by 2-APB ($10{\mu}M$), suggesting a possible involvement of TRPC4/5 channel in regulation of SMC in pregnant myometrium. These results provide a possible cellular mechanism for regulation of SMC during pregnancy and provide basic information for developing a new agent for treatment of premature labor.

• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5331-5335
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• 2015

Purpose: The aim of this study was to compare the tumor-free and overall survival rates between patients with low-risk endometrial cancer who underwent surgical staging and those who did not undergo surgical staging. Materials and Methods: Data, including demographic characteristics, grade of the tumor, myometrial invasion, cervical involvement, peritoneal washing, lymph node involvement, lymphovascular space invasion, postoperative complication, adjuvant treatment, cancer recurrence, and tumor-free and overall survival rates, for patients with low-risk endometrioid endometrial cancer who were treated surgically with and without pelvic and paraaortic lymph node dissection (LND) were analyzed retrospectively. The patients diagnosed with endometrioid endometrial cancer including the following criteria were considered low-risk: 1) a grade 1 (G1) or grade 2 (G2) endometrioid histology; 2) myometrial invasion of <50% upon magnetic resonance imaging (MRI); 3) no stromal glandular or stromal invasion upon MRI; and 4) no evidence of intra-abdominal metastasis. Then the patients at low-risk were divided into two groups; group 1 (n=117): patients treated surgically with pelvic and paraaortic LND and group 2 (n=170): patients treated surgically without pelvic and paraaortic LND. Results: There was no statistical significance when the groups were compared in terms of lymphovascular space invasion, cervical involvement, positive cytology, and recurrence, whereas the administration of an adjuvant therapy was higher in group 2 (p<0.005). The number of patients with positive pelvic nodes and the number of metastatic pelvic nodes were significantly higher in the group with positive LVI than in the group without LVI (p<0.005). No statistically significant differences were detected between the groups in terms of tumor-free survival (p=0.981) and overall survival (p=0.166). Conclusions: Total hysterectomy with bilateral salpingo-oophorectomy and stage-adapted postoperative adjuvant therapy without pelvic and/or paraaortic lymphadenectomy may be safe and efficient treatments for low-risk endometrial cancer.

• 한국가축번식학회지
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• 제22권1호
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• pp.61-66
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• 1998

In vitro contractile response of the uterus in the pregnant rat to oxytocin increases with advancing gestation. This increase coincides with an increase in uterine oxytocin receptor number. However, in vitro the change in uterine contractile response of the pregnant uterus to oxytocin with advancing gestation is not clear. The purpose of the present study was to find out that the uterine response in vitro to oxytocin changes as delivery a, pp.oaches. Secondly, to determine if the incubation of uterine tissue in vitro altered the uterine oxytocin receptor number and affinity and thus explain the ambiguity between the in vitro and in vitro results. The studies were performed on rats at days 15, 20 and 21 or pregnancy. In vitro the uterine contractile response to oxytocin was sgreater (P<0.05) at day 21 compared to days 15 and 20 (Emax : 724.8　88.9, 130.0　81.5 and 133.4　53.4, respectively). This correlated with a significant increase (P<0.05) in uterine oxytocin receptor number at day 21 (days 21, 15 and 20 : 540　89, 53　24, 89　35 fmoles/mg protein, respectively). However, the kids at days 15, 20 and 21 did not differ (P>0.05). Finally no difference (P>0.05) in oxytocin receptor number or affinity was detected between incubated and non-incubated tissue. The results of these studies suggest that either pre-oxytocin or post-oxytocin receptor factors are important in determining the uterine myometrial responsiveness to oxytocin.

• Radiation Oncology Journal
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• 제11권2호
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• pp.347-354
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• 1993

This is a retrospective analysis of 67 patients with histologically proven invasive carcinoma of uterine cervix treated with surgery followed by adjuvant radiotherapy at Inje University Seoul Paik Hospital between october 1983 and september 1991, Postoperative radiotherapy was carried out in patients with high risks of locoregional recurrence such as positive pelvic lymph node (38 pts), large tumor size more than 3 cm (22 pts), cervical stromal invasion more than 2/3 (46 pts), parametrial involvement (9 pts), positive resection margin (14 pts), endo/myometrial extension (10 pts), and angiolymphatic invasion (13 pts). Stage I A, I B, and IIA were 2 $(3\%),$ 39 $(58.2\%),\;and\;26\;(38.8\%),$ respectively. Median follow-up period was 48 months with ranges from 13 to 115 months. All 67 patients were treated externally with standard pelvic field with radiation dose ranging from 4080 to 6120 cGy in 4~6 weeks period of time. Of these, 45 patients received intracavitary radiotherapy. The overall survival rate and disease free survival rate at 5-year were $88.0\%\;and\;82.1\%,$ respectively. The survival rates by stage were $87.1\%$ in IB and $88.4\%$ in IIA. Local control rate was $80.6\%(58\;pts).$ The treatment failure was noted in 12 of 67 patients $(17.9\%):$ locoregional failure in $7(10.4\%),$ distant metastasis in 3 $(4.5\%),$ and locoregional and distant metastasis in $2(3\%),$ The univariate analysis of prognostic factors disclosed endo/myometrial extension as a significant factor of survival and recurrence $(70.0\%\;vs\;91.1\%\;P<0.05\;&\;30.0\%\;vs\;15.8\%,\;respectively).$ The complication of postoperative radiothrapy was not significant and all patient were well tolerated. In conclusion, postoperative radiotherapy in patients with high risks of locoreginal recurrence is relatively well tolerated and it gives significantly improved survival rate especially in patients with positive lymph nodes, bulky tumor size $(\geqq3\;cm),$ parametrial involvement, cervical stromal invasion more than 2/3, positive resection margin and angiolymphatic invasion.

• Radiation Oncology Journal
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• 제24권2호
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• pp.110-115
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• 2006

목적: 수술 후 보조적으로 방사선치료를 받은 자궁내막암 환자의 전체생존율, 무병생존율, 재발 부위 등을 분석하여 이와 관련된 예후인자를 알아보고자 하였다. 대상 및 방법: 1992년 4월부터 2003년 5월까지 부산대학교병원에서 수술 후 방사선치료를 받은 자궁내막암 환자 중 조직유형이 선암인 환자 54명을 대상으로 후향적 분석하였다. 전체 환자의 중앙 나이는 55세(35-76세)였고, 병기 분포는 FIGO 병기 I군이 34명(63.0%), 병기 II군이 8명(14.8%), 병기 III군이 12명(22.2%)이었다. 모든 환자는 수술 및 외부 방사선조사($41.4{\sim}54.0Gy$, 중앙값 50.4 Gy)를 받았고, 20명(전체 환자의 37.0%)의 환자에서 추가로 질내 근접치료($15.0{\sim}24.0Gy$, 중앙값 15.0 Gy)를 받았다. 전체추적기간은 $5{\sim}115$개월로 중앙추적기간은 35개월이었다. 분석 결과 유의 인자로 나타난 조직 분화도(histologic grade), 림프-혈관 침범(Iymphovascular space invasion), 그리고 자궁근 침범 정도(myometrial invasion depth)를 점수화(GLM 점수)하여 생존분석을 시행하였다. 생존분석은 Ka-plan-Meter 법을, 단변량 및 다변량 통계분석은 각각 log-rank 검정과 Cox 회귀분석을 사용했다. 결과: 전체 자궁내막암 환자의 5년 생존율은 87.7%였고, 5년 무병생존율은 87.1%였다. 단변량 통계분석에서는 조직분화도, 림프-혈관 침범, 그리고 자궁근 침범 정도가 전체생존율 및 무병생존율과 관련 있는 인자였고, 다변량 통계분석에서는 림프-혈관 침범이 무병생존율과 관련 있는 인자였다(p=0.0158). GLM 점수는 전체생존율 및 무병생존율과 의미 있는 관계를 나타냈고(각각 p=0.0090, p=0.0073), 원격재발에도 유의한 예후인자로 나타났다 (p=0.0132). 전체 환자 중 6명(11%)의 환자에서 재발을 보였고, 재발 부위는 대동맥 림프절 2명, 폐 2명, 쇄골상부 림프절 1명, 질 1명이었다. 결론: 수술 및 수술 후 방사선치료를 받은 자궁내막암 환자의 예후는 수술 후의 병리 소견과 밀접한 관계를 가지고 있다. 더 많은 연구를 통해 자궁내막암 환자의 예후인자를 체계화한다면, 병의 진행양상을 예견하고 대처하는데 도움이 될 것이다.

• The Korean Journal of Pain
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• 제11권1호
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• pp.113-115
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• 1998

Dysmenorrhea(cyclic pain associated with menses) is a frequent disorder, with as many as 50% of young women experiencing the symptom, and up to 10% being unable to function normally for some time each month. The most recent theory of the cause of the pain of dysmenorrhea incriminates uterine ischemia and sensitization of uterine pain fibers resulting from excessive myometrial contractility after prostaglandin stimulation. We administered stellate ganglion block for the treatment of dysmenorrhea and had good results in two cases. From our experience, we recommend the stellate ganglion block may be an effective treatment for a dysmenorrhea.

• 대한수의학회지
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• 제43권4호
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• pp.551-554
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• 2003

Nitric oxide synthase (NOS) has been reported in uterus. We examined the expression of the NOS isoforms, constitutive endothelial (eNOS) and inducible NOS (iNOS), in bovine uterus by immunohistochemistry. eNOS immunoreactivity was localized predominantly to the endothelial cells that line uterine microvessels and to endometrial glandular epithelial cells, but was barely detectable in endometrial stromal cells. iNOS immunostaining was detected in glandular epithelial and stromal cells in the endometrium and in the endothelial cells of myometrial blood vessels. These findings suggest that both eNOS and iNOS may play important roles in the physiology of the uterus, possibly by generating NO.

• Journal of Yeungnam Medical Science
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• 제25권2호
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• pp.124-127
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• 2008

Leiomyomas are common in the myometrial layer of the uterus, though they are rarely found in other reproductive organs. Leiomyomas are benign, hormone-sensitive smooth muscle tumors. They develop during the reproductive years and regress after menopause. Preoperative diagnosis is difficult to make. We present a case of a 54-year-old woman with a vaginal wall tumor. The management in this case included surgical excision. Histologic examination definitively confirmed the diagnosis of a vaginal leiomyoma. We report the details of this case along with a brief review of the literature.