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Biomedical subjects

C H Song

Publications and source records attributed to C H Song.

At least 55 records · Page 3Linked to original sources

Expression of epidermal growth factor receptor in carcinoma of the cervix.

Increased expression of the epidermal growth factor receptor (EGFR) gene has been shown in a large number of tumors, generally indicating a more aggressive biological behavior of cancers than those with low or normal expression. The role of EGFR in the tumorigenesis of the uterine cervix has been poorly understood and controversial. In order to explore the relationship between EGFR status and cervical carcinoma, tissues were analyzed from 40 patients, each of whom had invasive cervical carcinoma prior to treatment, 20 patients with cervical intraepithelial neoplasia (CIN) and 10 control cases who underwent hysterectomy due to benign gynecological disease at Yonsei University College of Medicine. We measured EGFR with an enzyme-linked immunosorbent assay which was a sandwich type using a mouse monoclonal capture antibody and a rabbit antiserum as detector. Patients with invasive cervical cancer were found to have significantly higher median EGFR expression than either the patients with CIN (P = 0.002) or the control (P = 0.001), respectively. However, there was no significant difference in EGFR status between CIN and the control groups. Overexpression of EGFR was found in 29 of 40 (72.5%) invasive cervical cancers and in 5 of 20 (25%) CIN patients. In invasive cervical cancer, no significant difference in EGFR levels was noted when stratified according to age, menopausal status, histological cell type, or clinical stage. With regard to tumor size, lesions of 4 cm and larger had significantly higher receptor levels than those lesions under 4 cm (P = 0.003). Even though quantitative EGFR status did not correlate with other prognostic parameters except tumor size, our results were consistent with the concept that EGFR may play an important role in malignant transformation and tumorigenesis in cervical cancer.

Adult↗

Effect of 13-cis-retinoic acid with neoadjuvant chemotherapy in patients with squamous cervical carcinoma.

Retinoids are strong inhibitors of epithelial cancer promotion and progression in experimental carcinogenesis. Recently, therapeutic trials of retinoids have demonstrated activities in cervical cancer and precancerous lesion of cervix. Our purpose was to determine whether additional administration of 13-cis-retinoic acid would improve the treatment effect of neoadjuvant chemotherapy in patients with squamous cell carcinoma of the cervix. From January 1994 through January 1995, 40 patients with invasive cervical cancer were enrolled in this prospective study and randomized into the two groups. Group 1 had neoadjuvant chemotherapy alone and group 2 had neoadjuvant chemotherapy plus 13-cis-retinoic acid (RA) at a dosage of 1 mg/kg/day for 1 month. Patients in group 1 and group 2 were similar with respect to age, parity, clinical stage, and histological subtype. Therapeutic responses were compared using Fisher's exact test, Mann-Whitney test, and Wilcoxon signed-rank test. RA increased the complete response rate of neoadjuvant chemotherapy from 0% in group 1 to 5% in group 2. However, a difference of overall clinical response rate between the two groups was not evident. The drug toxicities in group 1 and group 2 included anemia in 30.0% and 23.7%, leukopenia in 6.7% and 15.2%, and hepatotoxicity in 6.7% and 6.8%, respectively. More frequent incidence of mucocutaneous side effects was seen in group 2 than group 1, but these side effects were mild and reversible. The clinical response rate achieved in this trial indicates that the combination of 13-cis-retinoic acid and neoadjuvant chemotherapy, at least when used on the schedule reported herein, is not superior to treatment of neoadjuvant chemotherapy alone for patients with squamous cell carcinoma of the cervix. However, a single patient achieved a complete response on this therapy, and the impact of such a treatment on survival needs to be explored.

Adult↗

Chorionic villus sampling: clinical experience of the initial 750 cases.

OBJECTIVE: To assess the factors that might influence the success rate, safety and reliability of chorionic villus sampling (CVS) and to evaluate the relationship between CVS and other congenital anomalies. DESIGN: Analysis of the outcome of 750 cases of CVS (730 cases with transcervical and 20 cases with transabdominal). SETTING: The outpatient prenatal genetic clinic of a university tertiary care center. SUBJECT: Seven hundred and fifty pregnant women that underwent CVS for prenatal genetic diagnosis from 7 to 12 weeks of gestation. RESULTS: Advanced maternal age was the most common indication for CVS (32.8%). The overall sampling success rate was 98.0% (735/750), representing 93.9% at 7 to 8 weeks, 98.1% at 9 to 10 weeks, and 98.3% at 11 to 12 weeks of gestation. The majority of cases (93.1%) required one or two aspirations. Cytogenetic analysis routinely included direct overnight and long-term culture methods which revealed 16 abnormalities (2.2%). Of 735 cases in which CVS was successful, 700 advanced to normal offspring, 17 had therapeutic termination, and 18 resulted in spontaneous abortions; there was an overall fetal loss rate of 2.4% (18/750). CONCLUSION: CVS in early pregnancy is a relatively safe and reliable method of prenatal genetic diagnosis capable of replacing genetic amniocentesis. However, it must be done by experienced personnel. No congenital anomalies were found to be related to CVS in this series.

Adult↗

Pulmonary damage by Vibrio vulnificus cytolysin.

Vibrio vulnificus is an estuarine bacterium that causes septicemia and serious wound infection. Cytolysin produced by V. vulnificus has been incriminated as one of the important virulence determinants of bacterial infection. Cytolysin (8 hemolytic units) given intravenously to mice via their tail veins caused severe hemoconcentration and lethality. Cytolysin treatment greatly increased pulmonary wet weight and vascular permeability as measured by (125)I-labeled albumin leakage without affecting those factors of other organs significantly. Blood neutrophils were markedly decreased in number after cytolysin injection, with a concomitant increase in the level of pulmonary myeloperoxidase activity, indicating that cytolysin-induced neutropenia might be due to pulmonary sequestration of neutrophils. By microscopic examination, severe perivascular edema and neutrophil infiltration were evident in lung tissues. These results suggest that increased vascular permeability and neutrophil sequestration in the lungs are important factors in lethal activity by cytolysin.

Animals↗

The clinical implications of early diastolic notch in third trimester Doppler waveform analysis of the uterine artery.

To evaluate the clinical utility of third trimester Doppler waveform analysis of the uterine artery in predicting complicated pregnancies and fetal well-being, we compared adverse pregnancy outcomes in 2321 women with the presence of an elevated systolic-diastolic ratio (greater than 2.6) with the persistence of an early diastolic notch and with the combination of an elevated systolic-diastolic ratio and an early diastolic notch. The positive predictive values are 47.5%, 82.9%, and 92.6%, respectively. From these data we can conclude that determination of the presence or absence of an early diastolic notch is more valuable in predicting the perinatal outcome than is the presence of an elevated systolic-diastolic ratio alone. We also suggest that an assessment of the uterine artery systolic-diastolic ratio combined with the evaluation for persistent early diastolic notch would be a clinically useful test for fetal well-being.

Apgar Score↗

Bone mineral density in premenopausal anovulatory women.

To examine the impact of amenorrhea on bone mineral density in women of reproductive age, we performed a cross sectional study in 190 amenorrheic women, comprising 113 premature ovarian failure, 27 primary hypothalamic amenorrhea, 38 hyperprolactinemia and 12 Sheehan's syndrome. Measurement of bone mineral density was carried out using dual photon absorptiometry at four sites: femur neck, ward's triangle, trochanter and spine (L2-4) and we compared the result with that of 163 normal-cycle control women with age matched. Bone mineral densities was significantly low in patients with primary hypothalamic amenorrhea and premature ovarian failure at all four sites. In those with hyperprolactinemia a decrease in bone mineral density was noted at femur neck and spine while those with Sheehan's syndrome is associated with decreased bone density at femur neck, ward's triangle and trochanter. The degree of bone loss and the affected sites seems differ depending on the type of amenorrhea. In patients with primary hypothalamic amenorrhea, significant bone loss was already noted at all four sites by age 20. The decrement in bone density continued rapidly during the early twenties up to age 25 and then slowed after age 25. In those with premature ovarian failure with secondary amenorrhea there were no decrease in bone mineral density within the first year after onset of amenorrhea, however, in the subsequent 2 years, the reduction in BMD was rapid and thereafter the reduction slowed remarkably. The BMD in this study positively correlated with the body mass index and negatively with the phosphorus intake.

Absorptiometry, Photon↗

Rapid chromosome analysis and prenatal diagnosis using fluid from the cystic hygroma, hydrothorax and isolated ascites: new source for chromosome analysis.

OBJECTIVE: To determine whether abnormally collected fetal body fluid could be used as alternative cell sources for cytogenetic assessment. METHOD: Using modified lymphocyte culture, the abnormal fetal body fluids obtained from the five fetal anomaly cases (3 cystic hygromas, 1 hydrothorax, and 1 isolated ascites) were analyzed in order to determine their karyotypes. RESULTS: Two cases showed 45, X and 46, XX/45, X and the other three showed a normal karyotype. CONCLUSION: The cytogenetic analysis from body fluid aspiration yields a rapid and accurate result within 96 hours. This method could be helpful when cordocentesis or placental biopsy is not feasible or when time requirement for amniotic fluid cell culture is burdensome to patient management.

Adult↗

Loop diathermy and cold-knife conization in patients with cervical intraepithelial neoplasia: a comparative study.

One hundred and sixty-eight cases of cervical conization were performed for cervical intraepithelial neoplasia (CIN) in a 32-month study. The indications for conization were unsatisfactory colposcopic finding, abnormal epithelium that extended into the endocervical canal, a microinvasive cervical cancer, and significant discrepancy among cytology, colposcopy, and/or punch biopsy histology. In the early period of the study, conization was done by the cold-knife method (N = 107), whereas loop diathermy was used in the latter part of the study (N = 61). Both groups were similar in terms of age, indications for conization, and size of cervical cone specimens. Loop diathermy conization was done in a significantly shorter time (5.7 +/- 1.8 minute vs 15.2 +/- 6.1 minute)(P < 0.05) than cold-knife conization. However, the difference in the postoperative complications between loop diathermy(3.0%) and cold-knife conization(4.7%) was not significant. The incidence rate of residual CIN III lesions in the subsequent hysterectomy specimens, found by histological documentation on these specimens was 25.0 and 26.1 percent after loop diathermy and cold-knife conization respectively. These results suggest that loop diathermy is much easier to perform and a more time-conserving treatment modality than cold-knife conization in the management of patients with cervical intraepithelial neoplasia.

Adult↗

Successful replacement of allergen-specific immunotherapy by allergen-mixture therapy.

BACKGROUND: Some clinicians utilize allergen-specific immunotherapy (specific therapy), employing only the extracts of allergens that produce positive skin tests. Others use allergen-mixture immunotherapy (mixture therapy), employing premixed extracts containing both skin reactive and non-reactive (irrelevant) allergens. OBJECTIVE: The purpose of this study was to compare the efficacy of these two approaches and to identify sensitization to irrelevant allergens included in mixture therapy. METHOD: A total of 20 adults with allergic rhinitis/asthma who were switched from successful specific therapy (average duration of 6.1 years) to mixture therapy (2.0 years) were evaluated with symptom-medication scores, skin test results, and local/systemic reactions at three time points: before specific therapy, before, and 2 years after mixture therapy. RESULTS: Symptom-medication scores for all patients improved at the end of specific therapy and remained improved during mixture therapy (12.3 versus 12.0 with P = .75). The sums of positive skin tests at three points were not different (7.8 versus 8.3 versus 9.8 with P > .4 at all points). Reaction rates did not differ either. Skin sensitization to irrelevant allergens occurred in five patients during mixture therapy. These patients, however, also experienced spontaneous conversions from negative to positive reactions to the allergens not included in the therapy, indicating that sensitization may be partly due to a spontaneous increase in skin reactivity. CONCLUSION: These findings suggest that allergen-mixture immunotherapy is as efficacious as allergen-specific therapy and may be associated with skin sensitization in some patients. There was no evidence of increased adverse clinical reaction.

Adult↗

Antibodies in patients with inflammatory bowel disease and the apparent influence of medications.

Patients with inflammatory bowel disease (IBD) are known to have increased antibodies to several food and bacterial antigens. To assess selected isotype contributions in greater detail, we examined the concentrations of IgA, IgG, IgE, and IgG4 antibodies to five selected antigens, two of bacterial and three of food origin. Thirty patients with IBD and thirty matched healthy controls were studied. Most antibodies were increased in IBD patients compared to controls. Statistically significant increases were more frequent in Crohn's disease (CD) than in ulcerative colitis (UC). An unexpected finding was that IBD patients treated with sulfasalazine had statistically higher levels of most IgA antibodies than healthy controls, while steroid treated patients had lower levels. These findings suggest differing effects on the immune systems of IBD patients by each of these commonly used drugs.

Adult↗

Pulsatile gonadotrophin-releasing hormone therapy in patients with pituitary tumours treated by surgery and irradiation.

OBJECTIVE: Pulsatile administration of GnRH for induction of ovulation is effective for women with idiopathic hypogonadotrophic hypogonadism. We were interested to assess the pituitary-ovarian response to pulsatile GnRH infusion and the therapeutic effectiveness of restoring ovulation in a group of hypogonadotrophic women previously treated with surgery and irradiation to pituitary tumours. PATIENTS: The group of patients comprised 15 hypogonadotrophic women, aged 29-40 years (mean 32.4 years), who had undergone transsphenoidal adenomectomy or craniotomy and irradiation with a total of 4500-5400 cGy in 25 fractional doses divided over 5-6 weeks. The time interval from irradiation to study was 6.3 +/- 2.0 years (mean +/- SD). TREATMENT: A single bolus GnRH (100 micrograms) test and pulsatile infusion of GnRH were performed to assess the pituitary gonadotrophin reserve and induce ovulation. We tried to correlate the pituitary response with characteristics of intracranial lesions on computerized tomography findings. We undertook ovarian biopsy in one patient who failed to respond to gonadotrophin therapy and pulsatile infusion of GnRH. RESULTS: Twelve women (80%) showed evidence of ovulation in response to pulsatile GnRH treatment and five subsequently became pregnant. Four of 12 ovulators were previous non-ovulators to exogenous gonadotrophin therapy. There was no correlation between pituitary response and character of lesions based on computerized tomography findings. A patient who failed to respond to either gonadotrophin or pulsatile infusion of GnRH had premature ovarian failure on ovarian histology. CONCLUSIONS: The functional reserve capacity of pituitary gonadotrophs may remain less impaired by tumour encroachment, pituitary surgery or irradiation than had previously been thought. This holds promise for ovulation induction in hypogonadotrophic patients who had been treated with surgery and irradiation for pituitary tumours.

Adult↗

Maternal HEL immunization has no lasting effects on the immune response of offspring to immunization with hen egg-white lysozyme.

The effect of prior maternal immunization on the murine offspring response to subsequent immunization with hen egg-white lysozyme was examined. Adult female A/J mice were immunized with 100 micrograms HEL-CFA intraperitoneally 10-27 weeks before conception. The offspring of these experimental female mice were then immunized with HEL-CFA at differing ages. Suppression of the anti-HEL IgG B cell response was observed when the offspring were immunized prior to 3 weeks of age when high levels of maternal antibody were still present. Older offspring, more than 8 weeks of age, were immunized with HEL-CFA to determine if exposure to maternal immunoglobulin early in ontogeny had primed or altered the offspring response to HEL. At this age, suppressive effects of transferred maternal antibody were no longer evident. Priming was not detected in the offspring as judged by the total magnitude of the anti-HEL antibody response or the kinetics of the response when experimental and age-matched control offspring were examined. Furthermore, qualitative differences in the response as evidenced by IgG vs IgM content and fine specificity of the response (primary vs secondary antibody) were not observed. No evidence was found to suggest that exposure to polyclonal maternal anti-HEL antibody had primed the offspring for a more efficient or qualitatively different response to immunization with the protein antigen HEL. After maternal antibody levels decreased, the offspring response was similar to that of controls, suggesting that the response had not been permanently altered by the prior exposure early in ontogeny to polyclonal maternal antibody.

Animals↗

Ovarian transposition with subsequent intrauterine pregnancy.

A 28-year-old married, Korean woman was diagnosed with a right unicornuate uterus, a left hypoplastic tube, and a right ovarian necrotic corpus luteal cyst. We performed a right oophorectomy and an excision of the left hypoplastic tube and then transferred the left ovary to the right broad ligament with intact vascular pedicles. Thus the remaining left ovary and right fallopian tube were placed in proximity. The patient conceived 2 months after the operation and delivered a living male infant.

Adult↗

Growth hormone response to L-dopa and pyridostigmine in women with polycystic ovarian syndrome.

OBJECTIVE: To evaluate the GH secretion and clarify the factors influencing the GH secretion in women with polycystic ovarian syndrome (PCOS). DESIGN: Comparison of the GH response to L-dopa with or without pyridostigmine (inhibitor of acetylcholinesterase) pretreatment and insulin response to oral glucose tolerance test in patients with PCOS and matched controls. SETTING: Outpatients and healthy volunteers studied at a clinical research unit of a university hospital. PATIENTS, PARTICIPANTS: Ten women with PCOS and 9 controls with regular cycles were recruited. INTERVENTIONS: After an overnight fast, each subject underwent a GH stimulation test with L-dopa with or without pyridostigmine pretreatment. Plasma insulin and glucose levels were measured after a 75-g glucose load. MAIN OUTCOME MEASURES: Plasma GH, insulin-like growth factor I (IGF-I), insulin, and nonesterified fatty acids. RESULTS: Growth hormone responses and GH area under the response curve (AUC) to L-dopa were significantly lower in PCOS than those in controls. Pyridostigmine enhanced the GH response to L-dopa significantly in PCOS. Insulin responses and insulin AUC to oral glucose load were significantly higher in PCOS than those in controls. Plasma IGF-I levels of PCOS were significantly higher than controls. Insulin AUC had a positive correlation with plasma IGF-I levels but an inverse correlation with GH AUC in PCOS and controls. CONCLUSION: Our result indicated that decreased GH secretion of PCOS may be associated with a high somatostatin activity and a high plasma IGF-I level.

Adolescent↗

Gonadoblastoma and dysgerminoma associated with 46,XY pure gonadal dysgenesis--a case report.

Gonadoblastoma and dysgerminoma developed in a 24-year-old phenotypic female patient with 46,XY pure gonadal dysgenesis. This patient presented with primary amenorrhea. Clinical characteristics showed a typical stigmata of gonadal dysgenesis: primary amenorrhea, sexual infantilism, a small uterus and bilateral streak gonads. A 46,XY karyotype was made by lymphocyte culture. The patient was counseled to undergo a prophylactic bilateral gonadectomy, but she refused. Three years and three months after the initial diagnosis she felt a growing pelvic mass. Bilateral gonadectomy and total hysterectomy were performed. Histological examination revealed gonadoblastoma and dysgerminoma on both gonads. After surgery the patient received radiation therapy and also was started on hormone replacement therapy. Two years and two months after treatment by surgery the patient is well and free of recurrence.

Adult↗

Estrogen and progesterone receptor assay in carcinoma of the cervix with monoclonal antibodies.

The normal cervix has been shown to contain estrogen and progesterone receptors (ER and PR), but there have been controversial reports on the presence of these receptors in cervical carcinoma. Thus to explore the relationships between the steroid receptor status and cervical carcinoma, tissues of 34 patients with invasive cervical carcinoma prior to treatment and 30 cases of control who underwent hysterectomy due to benign gynecologic diseases at Yonsei Medical Center were analyzed for ER and PR using immunocytochemical assay with monoclonal antibodies and the results were compared with those of conventional steroid binding assay. ER and PR were positive in 65 and 71% of all tumors, respectively, and 59% of the cases were positive for both receptors simultaneously. No significant difference in receptor levels was noted when stratified according to menopausal status or clinical stage. With regard to tumor size, lesions greater than 3 cm had significantly lower receptor positivity when compared with the control. For the histological cell types, a statistically significant higher mean ER level was noted in adenocarcinoma compared to squamous cells. Even though the potential therapeutic significance of these findings is not yet known, they are consistent with the concept that steroid receptors can be used as a guide to endocrine therapy with respect to other prognostic parameters. However, the small number of advanced-stage carcinomas and the absence of data regarding survival rate in this study preclude any definite conclusions.

Adult↗

The embryonically active gene, unkempt, of Drosophila encodes a Cys3His finger protein.

The unkempt gene of Drosophila encodes a set of embryonic RNAs, which are abundant during early stages of embryogenesis and are present ubiquitously in most somatic tissues from the syncytial embryo through stage 15 of embryogenesis. Expression of unkempt RNAs becomes restricted predominantly to the central nervous system in stages 16 and early 17. Analysis of cDNAs from this locus reveals the presence of five Cys3His fingers in the protein product. Isolation and analysis of mutations affecting the unkempt gene, including complete deletions of this gene, indicate that there is no zygotic requirement for unkempt during embryogenesis, presumably due to the contribution of maternally supplied RNA, although the gene is essential during post-embryonic development.

Amino Acid Sequence↗

Evidence for idiotypic sharing between conventional and naturally activated B cells.

In the primary immune response to hen egg-white lysozyme (HEL), approximately 50% of the primary anti-HEL antibody-forming cells (AFC) express IdXE, an idiotype absent from the secondary response. Spontaneous IgM enzyme-linked immunosorbent assay (ELISA)-AFC in spleen cells from naive A/J mice were analyzed for the occurrence of IdXE by use of two affinity-purified rabbit antisera, R213 and R8, each raised against a different primary IdXE+, anti-HEL mAb. Two ELISA-AFC assay methods were used: direct coating of immunoplates with R213 or development of IgM-producing ELISA-AFC with biotinylated R8. From ages 7 days until 6 months, 10-20% of spontaneous IgM AFC were found to be IdXE+. IdXE+ anti-HEL IgG1 monoclonal antibodies, 2F4 or 3C11 (100 micrograms/ml), completely inhibited binding of biotinylated R8 (0.5 micrograms/ml) to spontaneous IgM-AFC while IdXE-, anti-HEL IgG1, 5E11 and 2C7, showed no significant inhibition. Greater than 90% of IdXE+ spontaneous IgM-AFC were not HEL specific. We conclude that a dominant set of idiotopes found in a conventional antigen-driven immune response can also play a major role in the spontaneously activated B cell repertoire. Our data argue against a bifurcation of the immune system into a compartment of idiotypic network-related cells and an independent set of non-network cells subject to antigenic stimulation.

Aging↗