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Biomedical subjects

S B Kang

Publications and source records attributed to S B Kang.

At least 19 recordsLinked to original sources
PubMed2005

Assessing clinical performance of gynecology residents: sonographic evaluation of adnexal masses based on morphological scoring systems.

OBJECTIVE: To assess the performance of inexperienced gynecology residents in the evaluation of adnexal masses using sonographic scoring systems. METHODS: From April 2003 to October 2004, transvaginal sonography was performed preoperatively by junior gynecology residents on 1-month shifts on 123 patients suspected of having adnexal masses. A total of 137 adnexal masses were found and evaluated using two different morphological scoring systems (those of DePriest and Lerner). The diagnostic performance of the sonographic scoring systems was assessed using the McNemar test and receiver-operating characteristics (ROC) curve analysis was used for lesion characterization. The diagnostic accuracy when the results of both scoring systems satisfied malignancy cut-off values was also investigated. RESULTS: Histopathological analysis revealed that, of the 137 lesions, 109 were benign, 23 were malignant and five were borderline. Best clinical cut-off levels were > or = 5 on the DePriest and > or = 3 on the Lerner scores. Both systems achieved good performance for characterizing malignancy. No significant difference was found in terms of the accuracy of the two systems as determined by mean areas under the ROC curves (0.816 and 0.783, P = 0.562). The combined approach using both scoring systems resulted in higher specificity (77.1%, P < 0.05) and positive predictive value without a significant decrease in sensitivity (82.1%) compared with either system alone. Of the 43 histologically confirmed false-positive cases, mature cystic teratoma was most common, with 13/22 (59%) cases being misinterpreted as malignancies. CONCLUSION: Junior residents, inexperienced at sonography, performed fairly in terms of evaluating adnexal masses with the help of morphological scoring systems.

Adnexal Diseases↗
PubMed2003

Miliary tuberculosis and acute respiratory distress syndrome.

OBJECTIVE: Miliary tuberculosis is a life-threatening disease caused by the haematogenous spread of Mycobacterium tuberculosis. We evaluated the clinical manifestations of 34 patients with miliary tuberculosis. DESIGN: A retrospective case review. RESULTS: The diagnosis of miliary tuberculosis was based on the identification of miliary nodules on chest radiography and one of the three following criteria: 1) acid-fast bacilli smear and/or culture positive in clinical specimens (22/34), 2) histopathological identification of TB granuloma (6/34), and 3) radiological and clinical improvement after anti-tuberculosis treatment (6/34). The median age (+/-SD) of the patients was 42.7 +/- 21.6 years, with two peaks, in the age group 20-30 and in those over 60. There were 16 underlying diseases in 14 patients, of which liver cirrhosis was the most common. The drug sensitivity pattern was available for 17 isolates of M. tuberculosis: 14 were sensitive, while the other three were resistant to at least one anti-tuberculosis drug. Eight patients developed acute respiratory distress syndrome (ARDS), five of whom died during intensive care. Platelet count, serum albumin and liver enzyme level at the time of admission were significant factors both for ARDS development and for survival. CONCLUSION: ARDS caused by miliary TB is associated with a high fatality rate; scope remains for improvement in its management.

Adolescent↗
PubMed2001

Polymorphism of TP53 codon 72 and the risk of cervical cancer among Korean women.

OBJECTIVE: It has recently been suggested that white women who are homozygous for the allele of the gene for wild-type p53 protein (TP53) that encodes arginine at position 72 are more susceptible to human papillomavirus-associated cervical carcinoma than are women who are heterozygous for this polymorphism and women who are homozygous for the allele that encodes proline at that position. This study was undertaken to analyze whether the TP53 codon 72 single-nucleotide polymorphism might be correlated with the risk of cervical cancer among Korean women. STUDY DESIGN: Peripheral blood samples from patients with invasive cervical carcinoma yielding a positive result for human papillomavirus 16 (n = 100), patients with cervical intraepithelial neoplasia grade III (n = 134), and healthy control subjects (n = 100) were examined. The presence and genotype of human papillomavirus in cancerous cervical tissues were determined by E6, E7-based nested polymerase chain reaction. Germline genomic deoxyribonucleic acid was extracted from peripheral blood leukocytes and examined by polymerase chain reaction amplification of the specific allele assay as described by Storey et al. Deoxyribonucleic acid samples from patients whose TP53 sequences had been determined by direct sequencing were used as positive control preparations. RESULTS: The respective proportions of individuals who are homozygous for the arginine allele, homozygous for the proline allele, and heterozygous for the 2 alleles were 40%, 12%, and 48% among women with invasive cervical carcinoma, 52%, 9%, and 39% among women with cervical intraepithelial neoplasia grade III, and 52%, 11%, and 37% among the control group. No significant differences in the frequency of codon 72 alleles were found among the 3 groups (chi(2) = 4.414; P =.353; degrees of freedom = 4). CONCLUSION: This finding suggests that the risk of cervical cancer may not be increased for Korean women with the allele of TP53 encoding arginine at codon 72.

Antibodies, Viral↗
PubMed2000

Decreased expression of mac25 mRNA in uterine leiomyomata compared with adjacent myometrium.

PROBLEM: The pathogenesis of uterine leiomyomata is still unclear. Recently it has been suggested that mac25 plays a tumor-suppressive role in various tumors. The aims of this study were to evaluate a possible involvement of mac25 in the growth of leiomyoma and in the mechanism of a gonadotropin-releasing hormone agonist (GnRHa) inducing shrinkage of leiomyoma. METHODS OF STUDY: Mac25 mRNA transcript was measured by Northern blot in total RNA extracted from the paired specimens of leiomyoma and adjacent myometrium from untreated patients (n = 25) and from leiomyoma specimens from GnRHa-pretreated patients (n = 10). RESULTS: Mac25 mRNA expression was significantly lower in large leiomyoma (more than 150 cm3 in volume) than in adjacent myometrium and small leiomyoma (less than 120 cm3 in volume) from untreated patients. There was no difference in this expression between the proliferative and secretory phases of the menstrual cycle. Leiomyoma from GnRHa-pretreated patients had mac25 gene expression levels similar to myometrium and small leiomyoma from untreated patients. CONCLUSIONS: Mac25 may be involved in the growth of uterine leiomyoma and the action of GnRHa may, in part, be mediated by mac25.

Adult↗
PubMed1999

Primary endodermal sinus tumor of the omentum.

Endodermal sinus tumor (EST) is a rare neoplasm which usually arises in the testis or ovary. But extragonadal EST is well recognized and may arise in a wide array of sites such as the mediastinum, vagina, and brain. We report a case of primary EST of the omentum and to our knowledge it is the first case of omental EST in the literature. A 45-year-old woman with a history of abdominal distension was treated with total abdominal hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy, followed by four cycles of BEP (bleomycin, etoposide, cisplatin) combination chemotherapy. Microscopically, the tumor exhibited typical patterns of EST and stained for alpha-fetoprotein and cytokeratin. She has remained free of disease for 10 months of follow-up. According to previous studies, debulking surgery and BEP chemotherapy were used as primary therapy with good results. The subject of extragonadal EST is reviewed, and the possible histogenesis of this tumor at such a rare site is discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Establishment and characterization of 12 uterine cervical-carcinoma cell lines: common sequence variation in the E7 gene of HPV-16-positive cell lines.

A total of 12 carcinoma cell lines of the human uterine cervix were established from 5 keratinizing and 5 nonkeratinizing squamous-cell carcinomas, and 2 small-cell carcinomas. Of these, 10 lines grew as adherent cells and 2 as floating aggregates. All lines showed (i) similarity in morphology to the primary tumor from which they were derived; (ii) high viability with relatively long doubling times (48-96 hr); (iii) absence of Mycoplasma and other bacteria, apart from one Mycoplasma-contaminated line; (iv) genetic heterogeneity by DNA-fingerprinting analysis; (v) absence of p53 mutation from exon 4 through 9; and (vi) the presence of HPV DNA sequence. Among the lines, 7 were infected by HPV-16, 3 by HPV-18, 1 by HPV-31, and 1 by HPV-33; the 2 cell lines derived from small-cell carcinomas contained HPV-18. Interestingly, 6 of the 7 cell lines containing HPV-16-type DNA harbored the same alteration of E7 at nucleotide position 647 (amino acid 29, AAT --> AGT, Asn --> Ser), whereas the 3 HPV-18-positive lines did not; 3 cell lines proved to have intact E1/E2 of HPV, suggesting the presence of episomally replicating HPV DNA as well as the integrated form, whereas the other 9 lines were shown to have integrated HPV. Taken together, these cell lines would be very useful for studying the biology of uterine cervical carcinoma.

Carcinoma↗
PubMed1997

Major sequence variants in E7 gene of human papillomavirus type 16 from cervical cancerous and noncancerous lesions of Korean women.

Geographic specificity of nucleotide sequence variations in the coding and noncoding regions of HPV 16 genome has been reported. Little has been known, however, regarding whether these naturally occurring sequence variations of HPV 16 may result in marked differences in biological properties, such as oncogenic potential. This study was performed to identify sequence variants in the HPV 16 E7 gene derived from Korean women with cervical cancerous and noncancerous lesions, and to assess the association between the sequence variant and the cervical cancer. We examined E7 variants of HPV 16 in a total of 157 patients with no cervical disease (NCD, n = 87) or cervical neoplasia (cervical intraepithelial neoplasia 3, n = 21; cervical carcinoma, n = 49), using the nested polymerase chain reaction (PCR) and the PCR-directed sequencing methods with outer consensus and inner type-specific primers. Forty-two (NCD, n = 9; CIN 3, n = 6; cervical carcinoma, n = 27) of 157 cervical samples contained HPV 16 E7 DNA, but only 8 had prototype sequences. Four variants of the HPV 16 E7 gene were identified. The variant with a single nucleotide change at position 647 (A --> G, Asn --> Ser) was found in about 60% of DNA samples with HPV 16. The second most common variant, found in 16.7% of cases, had three silent mutations at positions 732 (T --> C), 789 (T --> C), and 795 (T --> G). Two other variants were detected, one in a patient with cervical cancer and the other in a patient with no cervical disease. One had a single nucleotide change at position 666 (G --> A) and the other had one silent mutation at position 796 (T --> C). The most common variant in Korea has a change of nucleotide affecting the predicted amino acid related with high antigenicity and binding to retinoblastoma protein. There was a statistically significant trend for this variant to be more frequently detected in cancerous lesions of the uterine cervix than in noncancerous lesions. These data suggest that naturally occurring sequence variants of HPV 16 E7 gene may have different oncogenic properties.

Adult↗
PubMed1997

Establishment and characterization of human ovarian carcinoma cell lines.

Five human ovarian carcinoma cell lines cultured from primary and metastatic tumors of Korean patients were characterized. These lines were isolated from two papillary serous cystadenocarcinomas, two endometrioid carcinomas, and one malignant Brenner tumor. It was shown that the growth of these cell lines was stable when cultured after at least 20 passages. Population doubling times varied from 40 to 67 hr. All lines showed high viability and were proven by DNA fingerprinting analysis to be unique. Contamination by mycoplasma or bacteria was excluded. In two lines, SNU-8 and SNU-840, an elevated level of CA125 antigen secretion could be detected, whereas CEA was undetectable in all five lines. Four different mutations in functional and highly conserved regions of the p53 gene were identified in three of our five lines (60%), namely in SNU-119, SNU-251, and SNU-563. Included were two missense mutations, one in-frame 3-base-pair deletion, and one out-of-frame 1-base-pair deletion. It is interesting to note that one of these three lines, SNU-251, presented an additional simultaneous nonsense mutation of the BRCA1 gene and missense mutation of the hMLH1 gene. In its lacking both wild-type alleles of the BRCA1 gene, SNU-251 might serve as an unusual and important in vitro model for studies related to ovarian carcinoma and the BRCA1 gene. It is thus likely that the establishment and characterization of these permanent human ovarian carcinoma cell lines in continuous cultures can provide useful tools for in vitro studies related to human ovarian carcinomas.

Antigens, Neoplasm↗
PubMed1997

Establishment and characterization of cell lines derived from uterine malignant mixed Müllerian tumor.

OBJECTIVE: We report the establishment and characterization of three new cell lines derived from uterine malignant mixed müllerian tumor (MMMT). METHODS: Three uterine MMMT cell lines from primary tumors of Korean patients were cultured and the involved cell morphology, growth properties, DNA profiles, immunohistochemical properties, tumor-associated antigen secretion, and genetic alterations of related oncogenes and tumor suppressor genes were studied as well. RESULTS: Three MMMT cell lines were successfully established including one homologous tumor SNU-539 and two heterologous tumors SNU-685 and SNU-1077. All lines showed substrate adherence and high viability and were proven by DNA fingerprinting analysis to be unique. Contamination by mycoplasma and bacteria was excluded. SNU-539 and SNU-1077 cells stained positively for both epithelial and mesenchymal antigens, while SNU-685 cells only stained positively for mesenchymal antigens. The level of secretion of tumor-associated antigens, CA125 and CEA, was shown to be undetectable in all three lines. One missense mutation from AAC to GAC at codon 239 of exon 7 in the p53 gene was identified in SNU-539. CONCLUSIONS: These newly established and characterized permanent uterine MMMT cell lines might be regarded as valuable resources for a multitude of in vitro investigations, which should be used for clarifying the obscure histogenetic origin and understanding the biological behavior of this aggressive tumor.

Aged↗
PubMed1997

Radiological findings in serous surface papillary carcinoma of the ovary. Case reports.

Serous surface papillary carcinoma (SSPC) is a malignant tumor originating from the surface epithelium of the ovary, and is characterized by macroscopic normal ovaries accompanied by diffuse peritoneal dissemination. Therefore diagnosis of SSPC cannot usually be made preoperatively. We report on two cases of SSPC in which US, CT, and MR demonstrated nodularities along the surface of the normal-sized ovaries, adjacent organs and pelvic peritoneum in addition to findings of peritoneal seeding. These imaging findings may suggest the correct preoperative diagnosis of SSPC.

Cystadenocarcinoma, Papillary↗
PubMed1997

Risk factors associated with uterine cervical cancer in Korea: a case-control study with special reference to sexual behavior.

OBJECTIVE: A hospital-based case-control study was conducted to identify characteristics of women at high risk of developing cervical cancer with special reference to sexual behavior in Korea. METHODS: Histologically confirmed cases of invasive cervical cancer were selected from the Department of Gynecology, Seoul National University Hospital between September 1992 to May 1995 (n = 203). Women with normal pap smear tests and women free of past history of any malignancies were regarded as controls (n = 827). Information on risk factors were collected by both a self-administered questionnaire and a direct interview. RESULTS: Uterine cervical cancer risk was higher in women with a less educated spouse (Ptrend = 0.0003), women with a family history of cervical cancer (adjusted odds ratio [OR] = 2.20., 95% confidence interval [CI] 1.21-4.01), women of shorter height (Ptrend = 0.02), women with early age at first full term pregnancy (Ptrend = 0.0005), and women who have had multiple full term pregnancies (Ptrend = 0.006) by the multiple linear logistic analysis. Particularly noteworthy was a significant decreasing trend in the adjusted OR with the age at first sexual intercourse increasing (Ptrend = 0.002) after adjusting the number of sexual partners. The husband's indecent sexual history showed a borderline significance (Ptrend = 0.07). CONCLUSIONS: This study confirmed that the risk factors of cervical cancer in Korea are similar with those found in other countries.

Adult↗
PubMed1996

Clinical utility of calculated creatinine clearance as a guide to chemotherapy in patients with gynecologic malignancies.

OBJECTIVE: To examine the relationship between calculated and measured creatinine clearance, and also to evaluate the clinical utility of calculated creatinine clearance before administration of chemotherapy in patients with gynecologic malignancies. METHODS: In 38 patients with gynecologic malignancies, a total-69 paired creatinine clearance measured by 24-hour urinary creatinine clearance and calculated were compared. RESULTS: The significant correlation (r = 0.597, p < 0.0001) was observed between creatinine clearances determined by both methods. There were 26 (37.7%) 24-hour urine collections. The correlation between two methods improved when these inaccurate samples were excluded (r = 0.876, p < 0.0001). In addition, if a creatinine clearance of 50 ml/min is set as a threshold for dose modification, only 2.9% of the patients would have received reduced doses inappropriately, by using the calculated creatinine clearance alone. CONCLUSION: These results suggest that in patients with gynecologic malignancies, a calculated creatinine clearance prior to chemotherapy is sufficient for evaluation of renal function and measured creatinine clearance would be determined only when calculated creatinine clearance is below the threshold for dose modification.

Adult↗
PubMed1995

Factors associated with improving success rates with gamete intrafallopian transfer under thin-needle spinal anesthesia.

PURPOSE: In order to reduce the risk of major anesthetic complications associated with laparoscopic gamete intrafallopian transfer procedures, we have exclusively used thin-needle spinal anesthesia over the years 1991 - 1994. This paper will review complication rates in order to further establish the safety profile of GIFT under thin-needle anesthesia and report the changes in our GIFT protocol from 1991 to 1994 which have been associated with a statistical improvement in the implantation rate from 11% to 23% (P = 0.01) and an increase in delivery rates from 29% to 42% per transfer procedure. METHODS: Sixty-eight laparoscopic GIFT procedures were done in women with at least one patent oviduct and failure to respond to less invasive treatment. Clinical variables were analyzed to determine if similar patient populations had been treated over the study period. RESULTS: The improved delivery rates and implantation rates could not be explained by patient selection. No major perioperative complications occurred. Minor perioperative complications and difficulties included one patient requiring general anesthesia, one patient developing a spinal headache which could be managed conservatively at home, and one patient requiring a minilaparotomy to complete the GIFT procedure. The more serious complications occurred as a result of the superovulation and multiple oocyte transfer rather than the surgical or anesthetic technique. These included two patients with severe ovarian hyperstimulation requiring hospitalization, and five delivered triplet pregnancies. Factors associated with improving success rates included improvements in semen and equipment preparation as well as an increase in the number of sperm transferred from 200,000 to 500,000. CONCLUSIONS: GIFT can be performed with relative safety under thin needle spinal anesthesia with high implantation and delivery rates if care is made to optimize sperm and equipment preparation. GIFT under thin-needle spinal anesthesia may be an attractive alternative for treatment of longstanding nontubal infertility in couples willing to take the risk of ovarian hyperstimulation and multiple pregnancy.

Adult↗
PubMed1995

Randomized trial of epirubicin and cisplatin chemotherapy followed by pelvic radiation in locally advanced cervical cancer. Cervical Cancer Study Group of the Asian Oceanian Clinical Oncology Association.

PURPOSE: Pelvic radiation is standard treatment for women with stage IIb to IVa cervical cancer, but treatment results are disappointing, particularly for women with bulky tumors. We investigated the role of primary chemotherapy followed by pelvic radiotherapy in a randomized trial. PATIENTS AND METHODS: Two hundred sixty patients with stage IIb and IVa cervical cancer received either standard pelvic radiotherapy or primary chemotherapy with cisplatin 60 mg/m2 and epirubicin 110 mg/m2 administered at 3-week intervals for three cycles, followed by pelvic radiotherapy. RESULTS: Ninety-nine patients have relapsed with a median follow-up duration of 1.3 years; in 62 patients, the first site of progressive disease was the pelvis. Patients who received primary chemotherapy had a significantly higher pelvic failure rate than those who received radiotherapy alone (P < .003). Seventy-six patients have died, and those who received primary chemotherapy had significantly inferior survival compared with those who received radiotherapy alone (P = .02). Tumor response following chemotherapy was observed in 63%. After radiotherapy, tumor response occurred in 72% of those who received combined modality treatment, compared with 92% of those who received radiotherapy alone. CONCLUSION: Primary chemotherapy with epirubicin and cisplatin, although resulting in tumor response in a significant proportion of patients, is accompanied by an inferior local control rate and survival compared with standard pelvic radiotherapy alone.

Adenocarcinoma↗
PubMed1995

Ovarian dysgerminoma: color Doppler ultrasonographic findings and comparison with CT and MR imaging findings.

We describe three cases of ovarian dysgerminoma in which color Doppler sonography demonstrated multilobulated solid ovarian masses with prominent flow signal in the fibrovascular septa. This color Doppler sonographic finding of fibrovascular septa correlated well with the computed tomographic, magnetic resonance imaging, and pathologic findings, and it may suggest the diagnosis of ovarian dysgerminoma.

Adult↗
PubMed1994

Postanesthesia nursing care for ambulatory surgery patients post-spinal anesthesia.

There has been a renewed interest in spinal anesthesia in recent years. However, its use for ambulatory surgery patients has not been as well accepted as its use for inpatients because of the high incidence of postdural puncture headache (PDPH) and uncertain patient recovery time before hospital discharge. Recently, studies indicate that the incidence of PDPH can be lowered to an acceptable level by applying improved techniques such as the use of a 27-g spinal needle or a needle with a tip designed like a pencil point, such as a Whitacre (Becton-Dickinson, Rutherford, NJ) or Sprotte (Pajunk, Geisingen, Germany) needle. Also, by using xylocaine or bupivacaine, which are short- or intermediate-acting local anesthetics, rather than tetracaine, a long-acting anesthetic, patients can be safely discharged from the hospital within 4 to 6 hours from the induction of anesthesia. These improved techniques have allowed spinal anesthesia to be a valid, even desirable, option for selected patients undergoing ambulatory surgery. When considering spinal anesthesia for ambulatory surgery patients, it is important that the postanesthesia care staff be knowledgeable, because nursing care is one of the three integral parts of total patient care that makes ambulatory surgery successful. The other two components are surgery and anesthesia management. This presentation reviews the history, indications, benefits, and complications of spinal anesthesia and recommends nursing care for patients undergoing ambulatory surgery.

Adult↗
PubMed1993

Clinical immunoscintigraphy of ovarian carcinoma using iodine-131-labeled 145-9 monoclonal antibody.

The monoclonal antibody (Mab) designated 145-9 recognizes CA125 antigen but binds to a different epitope than that recognized by OC125 antibody. This is a clinical study assessing the safety, kinetics and imaging sensitivity of Mab 145-9. Two milligrams of Mab were labeled with 111 MBq (3.0 mCi) of 131I and infused intravenously in 18 patients with ovarian carcinoma. Immunoscintigraphies were done at three, five, and seven days. There were no adverse reactions to the injection of this Mab. All immunoscintigraphies were considered positive. Immunoscintigraphy detected tumor lesions were confirmed in operative fields, in two patients with normal serum levels of CA125 and in four patients whose sonography and/or x-ray computed tomography showed negative findings. In five patients, immunoscintigraphy was repeated without any adverse reaction and revealed the progress of the carcinoma. Pharmacokinetic studies showed the steady-state volume of distribution (Vdss) to be 2772 +/- 466 ml (mean +/- s.d.), and clearance 51.3 +/- 12.7 ml/hr. In summary, immunoscintigraphies using 131I-labeled Mab 145-9 were done safely in patients with ovarian carcinoma. Preliminary results reveal a high sensitivity compared to radiological methods and tests currently in use.

Adult↗