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Expression of Osteopontin in Eutopic and Ectopic Endometrial Tissues in Endometriosis (자궁내막증 환자의 정상위치 및 이소성 자궁내막에서의 Osteopontin의 발현)

  • Koo, Yun-Hee;Kim, Chung-Hoon;Kim, Ji-Sun;Lee, Young-Jin;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.3
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    • pp.149-157
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    • 2007
  • Objective: This study was performed to compare the expression of osteopontin (OPN) mRNA and protein in the eutopic and ectopic endometrial tissues in women with endometriosis and endometrial tissues in women without endometriosis. Methods: A total of 32 women with histologically confirmed endometriosis were recruited for study group. For controls, 34 women undergoing operative treatment for cervical intraepithelial neoplasia (CIN) or benign gynecologic condition other than endometriosis were recruited. At the time of laparoscopy or laparotomy, a biopsy specimen was taken from the endometrial cavity and peritoneal endometrial implant or endometrioma whenever appropriate. We employed real time quantitative RT-PCR to quantify OPN mRNA expression of these tissues and performed western blot analysis to measure the quantity of OPN. Results: The expression of OPN mRNA was significantly higher in both eutopic and ectopic endometrial tissues of women with endometriosis than in endometrial tissues of controls during both proliferative and secretory phase. In the eutopic endometrial tissue of women with endometriosis, OPN mRNA expression significantly increased during the secretory phase compared to the proliferative phase in women with endometriosis as well as controls. However, in the ectopic endometrial tissue, OPN mRNA expression significantly decreased during the secretory phase compared to the proliferative phase. The expression of OPN protein was significantly higher in women with endometriosis than in controls. Conclusion: This study shows the marked expression of OPN mRNA and protein in eutopic and ectopic endometrial tissues in women with endometriosis may be associated with the adhesion and invasion of endometrial explants.

Comparison of Gene Expression Profile in Eutopic Endometria with or without Endometriosis: A Microarray Study (자궁내막증 환자와 대조군에서의 자궁내막 유전자 발현의 차이: Microarray를 이용한 연구)

  • Chung, Min-Ji;Chung, Eun-Jung;Lee, Shin-Je;Kim, Moon-Kyu;Chun, Sang-Sik;Lee, Taek-Hoo
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.1
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    • pp.19-31
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    • 2007
  • Objective: Pathogenesis of the endometriosis is very complex and the etiology is still unclear. Our hypothesis is that there may be some difference in gene expression patterns between eutopic endometriums with or without endometriosis. In this study, we analyzed the difference of gene expression profile with cDNA microarray. Methods: Endometrial tissues were gathered from patients with endometriosis or other benign gynecologic diseases. cDNA microarray technique was applied to screen the different gene expression profiles from early and late secretory phase endometria of those two groups. Each three mRNA samples isolated from early and late secretory phase of endometrial tissues of control were pooled and used as master controls and labeled with Cy3-dUTP. Then the differences of gene expression pattern were screened by comparing eutopic endometria with endometriosis, which were labeled with Cy5-dUTP. Fluorescent labeled probes were hybridized on a microarray of 4,800 human genes. Results: Twelve genes were consistently over-expressed in the endometrium of endometriosis such as ATP synthase H transporting F1 (ATP5B), eukaryotic translation elongation factor 1, isocitrate dehydrogenase 1 (NADP+), mitochondrial ribosomal protein L3, ATP synthase H+ transporting (ATP5C1) and TNF alpha factor. Eleven genes were consistently down-regulated in the endometriosis samples. Many extracellular matrix protein genes (decorin, lumican, EGF-containing fibulin-like extracellular matrix protein 1, fibulin 5, and matrix Gla protein) and protease/protease inhibitors (serine proteinase inhibitor, matrix metalloproteinase 2, tissue inhibitor of metalloproteinase 1), and insulin like growth factor II associated protein were included. Expression patterns of selected eight genes from the cDNA microarray were confirmed by quantitative RT-PCR or real time RT-PCR. Conclusion: The result of this analysis supports the hypothesis that the endometrium from patients with endometriosis has distinct gene expression profile from control endometrium without endometriosis.

Clinical Analysis of Pulmonary Hamartoma: 37 Cases (폐과오종 37예에 대한 임상 고찰)

  • Choi, Si-Young;Yoon, Jeong-Seob;Wang, Young-Pil;Park, Jae-Kil;Park, Chan-Beom;Sa, Young-Jo;Jeon, Hyun-Woo;Kang, Chul-Ung;Kim, Yong-Hwan
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.564-568
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    • 2007
  • Background: Pulmonary hamartomas are the most common form of pulmonary benign tumors, and they occur in approximately $2{\sim}5%$ of all pulmonary neoplasm. However, only a few reports have been published on the clinical characteristics of pulmonary hamartoma in Korea. Material and Method: The charts, X-rays and pathological specimens of 37 pulmonary hamartoma patients who were diagnosed by a pathological examination from January of 2000 to May of 2005 at the Catholic Medical Center were retrospectively reviewed. Result: The peak incidence of the tumor occurred in the seventh decade of life (32.4%), There were 23 men (62.6%) and 14 women (37.8%), with mean age of 55.6 years. Twenty-six patients (70.3%) were asymptomatic and 11 patients (29.7%) had symptoms. A total of 29 tumors (78.4%) were parenchymal, and 8 (21.6%) were endobronchial. Twenty cases (54.1%) were in the right lung and 17 cases (45.9%) were in the left lung. The right lower lobe was most commonly involved. Thirty-two (86.5%) hamartomas were diagnosed by surgical resection, 4 cases (10.8%) were diagnosed by bronchoscopic biopsy and 1 case (2.7%) was diagnosed by a fine needle aspiration biopsy. Thirty-four hamartomas (91.9%) were managed by surgical resection without complication. No recurrence or malignant changes were seen during the follow up period. Conclusion: Pulmonary hamartomas are most common in males during their fifth to seventh decade and they more commonly involve the right lung. No recurrence or malignant changes were seen during the follow up period.

Diagnostic Performance of Combined Single Photon Emission Computed Tomographic Scintimammography and Ultrasonography Based on Computer-Aided Diagnosis for Breast Cancer (유방 SPECT 및 초음파 컴퓨터진단시스템 결합의 유방암 진단성능)

  • Hwang, Kyung-Hoon;Lee, Jun-Gu;Kim, Jong-Hyo;Lee, Hyung-Ji;Om, Kyong-Sik;Lee, Byeong-Il;Choi, Duck-Joo;Choe, Won-Sick
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.201-208
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    • 2007
  • Purpose: We investigated whether the diagnostic performance of SPECT scintimammography (SMM) can be improved by adding computer-aided diagnosis (CAD) of ultrasonography (US). Materials and methods: We reviewed breast SPECT SMM images and corresponding US images from 40 patients with breast masses (21 malignant and 19 benign tumors). The quantitative data of SPECT SMM were obtained as the uptake ratio of lesion to contralateral normal breast. The morphologic features of the breast lesions on US were extracted and quantitated using the automated CAD software program. The diagnostic performance of SPECT SMM and CAD of US alone was determined using receiver operating characteristic (ROC) curve analysis. The best discriminating parameter (D-value) combining SPECT SMM and the CAD of US was created. The sensitivity, specificity and accuracy of combined two diagnostic modalities were compared to those of a single one. Results: Both SPECT SMM and CAD of US showed a relatively good diagnostic performance (area under curve = 0.846 and 0.831, respectively). Combining the results of SPECT SMM and CAD of US resulted in improved diagnostic performance (area under curve =0.860), but there was no statistical differerence in sensitivity, specificity and accuracy between the combined method and a single modality. Conclusion: It seems that combining the results of SPECT SMM and CAD of breast US do not significantly improve the diagnostic performance for diagnosis of breast cancer, compared with that of SPECT SMM alone. However, SPECT SMM and CAD of US may complement each other in differential diagnosis of breast cancer.

Improved Specificity of $^{18}F-FDG$ PET/CT for Lymph Node Staging of Non-Small Cell Lung Cancer Considering Calcified Lymph Node as Benign (비소세포 폐암에서 석회화 림프절을 양성으로 보았을 때 $^{18}F-FDG$ PET/CT의 특이도 향상)

  • Kwon, Seong-Young;Seo, Young-Soon;Min, Jung-Joon;Song, Ho-Chun;Na, Kook-Joo;Choi, Chan;Kim, Young-Chul;Kim, Yun-Hyun;Bom, Hee-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.16-21
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    • 2007
  • Purpose: We evaluated the diagnostic value of $^{18}F-FDG$ PET/CT (PET/CT) in lymph node staging of non-small cell lung cancer (NSCLC) considering calcification and histologic types as well as FDG uptake. Materials and Methods: Fifty-three patients (38 men, 15 women; mean age, 62 years) with NSCLC underwent surgical resection (tumor resection and lymph node dissection) after PET/CT. After surgery, we compared PET/CT results with the biopsy results, and analyzed lymph node metastases, based on histologic types. PET diagnosis of lymph node metastasis was determined by maximum SUV (maxSUV) > 3.0, and PET/CT diagnosis was determined by maxSUV > 3.0 without lymph node calcification. Results: By PET diagnosis, the sensitivity, specificity, and accuracy of overall lymph node staging were 45% (13 of 29), 91% (228 of 252), and 86% (241 of 281). Specificity was 91% in both squamous cell carcinoma and adenocarcinoma, while sensitivity was 71% in squamous cell carcinoma and 36% in adenocarcinoma. When we excluded calcified lymph node with maxSUV > 3.0 from metastasis by PET/CT diagnosis, specificity improved to 98% in squamous cell carcinoma and 97% in adenocarcinoma. The degree of improvement was not dependent on histologic types. Conclusion: PET/CT improved specificity of lymph node staging by reducing false positive lymph node regardless of histologic types of NSCLC.

Comparative Study on Acoustic Characteristics of Vocal Fold Paralysis and Benign Mucosal Disorders of Vocal Fold (성대마비와 양성 성대점막질환의 음향학적 특성비교)

  • Kong, Il-Seung;Cho, Young-Ju;Lee, Myung-Hee;Kim, Jong-Seung;Yang, Yun-Su;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.122-128
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    • 2007
  • This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

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CLINICAL STUDY OF AMELOBLASTOMA ON THE JAW (악골에 발생한 법랑아세포종의 임상적 연구)

  • Kim, Hyun-Syeob;Ryu, Jae-Young;Yu, Min-Gi;Seo, Il-Young;Shet, Uttom Kumar;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Choi, Hong-Ran;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.535-542
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    • 2007
  • Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jaw. It is localized in the mandible(80%) and in the maxilla(20%). In every case, the selection of the surgical treatment must consider some fundamental elements, including the age and general state of health the clinicopathological variant, and the localization and extent of the tumor. This study was invested the clinicopathological findings of 23 patients with ameloblastoma which had been diagnosed by biopsy during the period of 1987 to 2005 at Chonnam National University Hospital. And it contained the statistical analysis according to the treatment methods and the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, histologic findings, treatment methods. The results obtained are were follows. The age of patient ranged from 10 to 91 years(means, 35.9 years) at biopsy. Thirteen(57%) of the 23 subjects were males, and 10(43%) were females. Twenty(87%) of the 23 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 20(87%) patients. Radiographically, 11(48%) of the 23 tumors were unilocular with a well-demarcated border and 12(52%) were multilocular. The most common histologic pattern was plexiform and acanthomatous rather then follicular. Conservative treatment was performed 7 cases(30%), radical treatment 11 cases(48%), and combined treatment 5 cases(22%). Follow-up period ranged from 2.1 years to 22 years(mean 5.1 years). Based on the above results, surgical excision after marsupialization was found to be useful as a preliminary treatment of the large cystic ameloblastoma in children and adolescents. On the contrary, the lesion with a soap bubble appearance, the one with ineffective marsupialization was subjected to extensive excision of the tumor with a wide margin of normal bone.

Cystic Fibrous Dysplasia in the Kong Bone (낭종성 섬유성 이형성증)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo;Lee, An-Hi;Park, Jeong-Mi;Chung, Yang-Guk;Choi, Kwang-Cheon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.22-30
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    • 2007
  • Purpose: We describe clinical, radiographic, MRI and pathologic findings as well as final outcome after simple curettage and bone graft of cystic fibrous dysplasia (FD) in the long bone, which has been rarely documented in the literature. Materials and Methods: Clinical records, radiographs, MRI and histologic slides of 11 patients with cystic FD in the long bone were retrospectively analyzed. Results: Six patients complained pain for several months, 4 patients presented pain after trivial injury event, and 1 patient suffered pathologic fracture. The mode of involvement was monostotic in 10 patients and polyostotic in l patient. The femur was affected in 7 patients, the humerus in 3, and the radius in 1. Radiography showed prominent, expansive lysis associated with ground-glass density of FD. MRI revealed 2 different signals of FD and cyst. Microscopic examination revealed classic findings of FD and non-specific cystic degeneration. The final outcome was satisfactory in every patient. Local recurrence was not observed. Conclusion: Cystic FD in the long bone seems not as rare as the scarcity of reported cases would indicate. MRI features provide a basis for differential diagnosis between benign cystic change and malignant transformation. Cystic FD would be an indication for surgery and simple curettage with allo-chip-bone graft is effective.

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Cervicography as a Screening Test for Cervical Cancer (자궁경부암 선별 검사에서 자궁경부 확대 촬영술의 이용)

  • Lee, Doo-Jin;Lee, Sung-Ho
    • Yeungnam University Journal of Medicine
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    • v.16 no.2
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    • pp.169-180
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    • 1999
  • Background: Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screening test of cervical cancer. Materials and Methods: Cervicography was taken from 482 women at department of obstetrics and gynecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999. Of the 482 women, 172 women were exc1uded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology (Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. Results: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chronic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05). The sensitivity and specificity of cytology were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13. 3%) (p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%) (p<0.05). Conclusion: It seems inappropriate to use cervicography as a single screening test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.

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Effects of vocal aerobic treatment on voice improvement in patients with voice disorders (성대에어로빅치료법이 음성장애환자의 음성개선에 미치는 효과)

  • Park, Jun-Hee;Yoo, Jae-Yeon;Lee, Ha-Na
    • Phonetics and Speech Sciences
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    • v.11 no.3
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    • pp.69-76
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    • 2019
  • This study aimed to investigate the effects of vocal aerobic treatment (VAT) on the improvement of voice in patients with voice disorders. Twenty patients (13 males, 7 females) were diagnosed with voice disorders on the basis of videostroboscopy and voice evaluations. Acoustic evaluation was performed with the Multidimensional voice program (MDVP) and Voice Range Profile (VRP) of Computerized Speech Lab (CSL), and aerodynamic evaluation with PAS (Phonatory Aerodynamic System). The changes in F0, Jitter, Shimmer, and NHR before and after treatment were measured by MDVP. F0 range and Energy range were measured with VRP before and after treatment, and the changes in Expiratory Volume (FVC), Phonation Time (PHOT), Mean Expiratory Airflow (MEAF), Mean Peak Air Pressure (MPAP), and Aerodynamic Efficiency (AEFF) with PAS. Videostroboscopy was performed to evaluate the regularity, symmetry, mucosal wave, and amplitude changes of both vocal cords before and after treatment. Voice therapy was performed once a week for each patient using the VAT program in a holistic voice therapy approach. The average number of treatments per patient was 6.5. In the MDVP, Jitter, Shimmer, and NHR showed statistically significant decreases (p < .001, p < .01, p < .05). VRP results showed that Hz and semitones in the frequency range improved significantly after treatment (p < .01, p < .05), as did PAS, FVC, and PHOT (p < .01, p < .001). The results for videostroboscopy, functional voice disorder, laryngopharyngeal reflux, and benign vocal fold lesions were normal. Thus, the VAT program was found to be effective in improving the acoustic and aerodynamic aspects of the voice of patients with voice disorders. In future studies, the effect of VAT on the same group of voice disorders should be studied. It is also necessary to investigate subjective voice improvement and objective voice improvement. Furthermore, it is necessary to examine the effects of VAT in professional voice users.