Ho Suk Saw

The ratio of estrogen receptor α to estrogen receptor β in adipose tissue is associated with leptin production and obesity

Abstract The loss of estrogen associated with menopause is suspected to play an important regulatory role in changes of fat metabolism and obesity. To evaluate the relationship between obesity and the ratio of estrogen receptor subtypes (ERα/ERβ) in adipose tissues in pre- and postmenopausal women, we measured the anthropometric indices of 31 premenopausal women and 12 postmenopausal women. Serum samples, subcutaneous and omental adipose tissues were also obtained from study participants. Serum leptin, adiponectin, IL-6, and TNF-α levels were measured using ELISA methods. Real-time RT-PCR analysis was performed to detect and to compare mRNA levels of leptin and estrogen receptor subtypes (ERα and ERβ) from adipose tissues. The ratio of abdominal subcutaneous to omental adipose tissue for the ER subtypes (Sc–Om ratio of the ER subtypes), i.e., subcutaneous ERα/ERβ over omental ERα/ERβ, showed significant correlations with anthropometric indices including BMI ( r xa0=xa00.801, p r xa0=xa00.696, p r xa0=xa00.735, p r xa0=xa00.753, p

Interferon-γ (IFN-γ): A possible prognostic marker for clearance of high-risk human papillomavirus (HPV)

OBJECTIVESnThe goal of this study was to identify cytokines that may predict high-risk HPV clearance or persistence in untreated patients with mild dysplasia or less of the uterine cervix.nnnMETHODSnA prospective analysis was performed on 57 patients who harbored high-risk HPV with histologically verified mild dysplasia or less between May 2005 and March 2006. All patients underwent follow-up evaluation at 12 months. Real-time PCR was used to quantify interferon-gamma (IFN-gamma), interleukin-10 (IL-10), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) transcripts. Hybrid Capture II testing was used to detect HPV DNA.nnnRESULTSnAmong the 57 patients that were untreated with mild dysplasia, or less, 46 (80.7%) had no detectable HPV after 12 months of follow-up. Univariate analysis showed that a negative HPV test, of untreated mild dysplasia or less, occurred in 93.3% (28/30) of patients who were IFN-gamma-positive and in 66.7% (18/27) of patients who were IFN-gamma-negative (P=0.0109). Other factors such as age, lesion grade in the colposcopic biopsy, IL-10, IL-6, TNF-alpha, day of menstrual cycle, smoking, and use of oral contraceptives were not significantly associated with high-risk HPV negative or positive results after 12-months of follow-up in patients with untreated mild dysplasia or less. The multivariate logistic regression analysis showed that only IFN-gamma-positive results were significantly associated with clearance of high-risk HPV after 12 months of follow-up (OR: 8.26; 95% CI: 1.24-54.94).nnnCONCLUSIONSnThese results suggest that intralesional IFN-gamma may be a prognostic marker for clearance of high-risk HPV.

Role of Estrogen Receptor-α and -β) in Regulating Leptin Expression in 3T3-L1 Adipocytes

We investigated the effects of the estrogen receptor‐α (ERα) and ‐β (ERβ) in the regulation of leptin, resistin, and adiponectin expression in 3T3‐L1 adipocytes. Mature adipocytes were exposed to estradiol (E2), ERα agonist (PPT (4,4′,4″‐(4‐propyl‐[1H]‐pyrazole‐1,3,5‐triyl)trisphenol)), ERβ agonist (DPN (2,3‐bis(4‐Hydroxyphenyl)‐propionitrile)), E2 with ERα antagonist (MPP (1,3‐Bis(4‐hydroxyphenyl)‐4‐methyl‐5‐[4‐(2‐piperidinylethoxy)phenol]‐1H‐pyrazole dihydrochloride)), and E2 with ERβ antagonist (R, R‐THC ((R, R)‐5,11‐diethyl‐5,6,11,12‐tetrahydro‐2,8‐chrysenediol)) at different concentrations. To clarify the expression and regulation of adipokines by ER subtypes, total RNA was extracted from cells and measured using quantitative PCR. Western blot analysis was performed to evaluate the protein expression of adipokines, ERα, and ERβ. The leptin expression was significantly increased in the cells treated with high concentrations (10−5 and 10−6 mol/l) of the PPT (P < 0.01, P < 0.05). By contrast, the leptin expression decreased in a dose‐dependent manner in the MPP‐treated groups (P < 0.05). High concentrations (10−5 mol/l) of R, R‐THC with E2 (10−7 mol/l) caused a significant increase of the leptin expression (P < 0.01). The leptin mRNA levels were positively correlated with the ERα mRNA levels (r = 0.584, P < 0.01) and negatively correlated with the ERβ mRNA levels (r = −0.236, P = 0.03) in the adipocytes. The ratio of the ERα to ERβ mRNA levels in the adipocytes was significantly associated with leptin mRNA levels (r = 0.454, P < 0.01). ERα induced leptin expression and ERβ inhibited its expression in 3T3‐L1 adipocytes. The ratio of the ERα‐to‐ERβ expression in 3T3‐L1 adipocytes may be an important potential regulatory factor in leptin expression.

Peutz-Jeghers syndrome with multiple genital tract tumors and breast cancer: A case report with a review of literatures

We report here on the multiple genital tract neoplasms in a 41-yr-old Korean woman with Peutz-Jeghers Syndrome (PJS). The patient presented with lower abdominal pain. Her previous medical history was PJS and breast cancer. Pelvic ultrasound showed a multilocular cyst at the right adnexal region, diagnosed as bilateral ovarian mucinous borderline tumors. An ovarian sex cord tumor with annular tubules was incidentally diagnosed together with a minimal deviation adenocarcinoma of the uterine cervix and mucinous metaplasia of both the Fallopian tubal mucosa and the endometrium. Although the cases of multiple genital tract tumors with PJS has rarely been reported, the present case appears to be the first in Korea in which the PJS syndrome was complicated by multiple genital tract tumors and infiltrating carcinoma of the breast. The clinical significance of the multiple genital tract tumors and breast cancer associated with PJS is reviewed.

The expression of epidermal growth factor receptor, vascular endothelial growth factor, matrix metalloproteinase-2, and cyclooxygenase-2 in relation to human papilloma viral load and persistence of human papillomavirus after conization with negative margins

The aim of this study was to investigate the correlations between human papillomavirus (HPV) load and vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), matrix metalloproteinase-2 (MMP-2), and cyclooxygenase-2 (COX-2), and to identify biomarkers that may predict high-risk HPV clearance or persistence after conization with negative margins. The following samples were analyzed: 77 paraffin-embedded specimens from patients with cervical intraepithelial neoplasia (CIN), including 27 CIN 2 conization specimens and 50 CIN 3 conization specimens. Immunohistochemical analysis was performed with antibodies to VEGF, EGFR, MMP-2, and COX-2. Hybrid capture II testing was used to detect HPV DNA. VEGF expression was significantly associated with HPV load (ρ = 0.27186, P= 0.0191), while COX-2 expression was significantly and inversely associated with HPV load (ρ =−0.34309, P= 0.0028). In univariate analysis, HPV load (P= 0.0112) and VEGF expression (P= 0.0274) were significantly associated with high-risk HPV clearance or persistence after conization with negative margins. In multiple regression analysis, high viral load (relative light unit/positive control > 500) and positive VEGF expression were significantly associated with high-risk HPV persistence after conization with negative margins (odds ratio [OR]: 9.915, CI: 1.891–51.994; OR: 6.661, CI: 1.208–36.722, respectively). In conclusion, VEGF expression is related to HPV load, while COX-2 expression is inversely related to HPV load, and immunohistochemical analysis of VEGF expression and HPV viral load are a significant and an independent prognostic indicator of high-risk HPV persistence after conization with negative margins.

Laparoscopic Management of Early Omental Pregnancy Detected by Magnetic Resonance Imaging

Omental pregnancy is a very rare form of abdominal pregnancy, and can be life threatening in cases of rupture, which may lead to massive hemorrhage. A 28-year-old woman in the ninth week of amenorrhea had severe abdominal pain, and showed unstable vital signs caused by intraperitoneal hemorrhage. Emergency laparoscopy revealed large amounts of blood and blood clots in abdominal cavity, and active bleeding was observed from the right ovary. Uterus, left ovary, and bilateral fallopian tubes were grossly free. However, serum beta-human chorionic gonadotropin level increased after the operation, and histopathologic results did not show evidence of pregnancy in either right ovary or endometrium. Abdominal magnetic resonance imaging was performed and revealed a well-defined cystic mass at the lateral side of the ascending colon, suggested to be the focus of ectopic pregnancy. The patient was approached laparoscopically and consequently underwent partial omentectomy.

Laparoscopic management of primary omental pregnancy.

Abdominal pregnancy is a rare and serious type of extrauterine pregnancy that is estimated to be approximately 1% to 4% of all ectopic pregnancies with omental pregnancy is the least common. An incidental case of a primary omental pregnancy was treated by laparoscopic partial omentectomy. The aim of this presentation is to keep in mind that pregnancy can exist in unusual locations, so a thorough inspection of the abdominal cavity is imperative.

Finger-assisted stretching technique for cesarean section

To compare the perioperative outcomes of two cesarean section methods, the finger‐assisted stretching technique (FAST), based on a modified Joel‐Cohen method, with the traditional technique.