Tsin-Wah Leung

To evaluate the impact of intimate partner violence on the quality of life in Obstetric/Gynecological (OBGYN) patients. A total of 1614 OBGYN patients were classified into four groups (Group 1: requesting termination of pregnancy, n=300; Group 2: infertility patients, n=500; Group 3: other general gynecological patients, n=300; Group 4: obstetric patients, n=514) were successfully interviewed in the absence of their male partners, using a structured questionnaire modified from the Abuse Assessment Screen Questionnaire. Those who reported ever having been abused, together with an equal number of non-abused women as controls, were asked to complete the World Health Organization Quality of Life Measure - Abbreviated version (Hong Kong) Questionnaire. The overall lifetime prevalence of intimate partner violence was 7.2%, with the lifetime prevalence being 12.7%, 1.8%, 4.7%, and 10.9% respectively in Groups 1-4. The mean quality of life domain scores among the abused victims were significantly lower in the physical health domain, social relationship domain, environment domain and psychological health domain. The baseline quality of life of the victims of intimate partner violence is significantly impaired compared with the non-abused controls.

(1) To determine and compare the prevalence of domestic violence among abortion-seeking patients with other general gynecology patients; (2) to see if a follow-up interview 6 weeks after abortion can improve the abuse disclosure rate; (3) to see if the abused victims accept direct referral to their gynecologists/social workers for help. This is a prospective questionnaire survey in a university teaching hospital on patients seeking abortion and an approximately equal number of other general gynecology patients. Participants were interviewed by a designated project nurse in a private setting, using a structured questionnaire (Modified Abuse Assessment Screen Questionnaire) to assess the past and recent history of abuse. The interview was repeated 6 weeks after the abortion for the abortion-seeking group. Five hundred and one participants were interviewed, including 245 seeking abortion (TOP group) and 256 other general gynecology patients (non-TOP group). The lifetime prevalence of abuse in the TOP group (27.3%) was significantly higher than the non-TOP group (8.2%) (P<0.001). Repeating the interview 6 weeks after the abortion did not increase the disclosure rate. Most abused victims were unwilling to disclose their information of abuse to their gynecologists or social workers at the time of interview. Domestic violence is a significant problem among the gynecology patients, particularly those seeking abortion. A single interview prior to abortion is adequately effective for screening. However, the most effective and acceptable way of helping these victims needs to be explored further.

The expressions of c-erbB-2, epidermal growth factor receptor (EGFR) and pan-ras in normal cervical glands (n=45), glandular dysplasia/adenocarcinoma in situ (GIN/ACIS) (n=32) and invasive cervical adenocarcinoma (n=78) were determined and correlated with clinical prognosis. The expressions of c-erbB-2, EGFR and pan-ras in GIN/ACIS lesions and invasive tumours were significantly higher than in normal glands (p<0.001), whereas there was no significant difference between expressions in GIN/ACIS lesions and invasive tumours, except for EGFR (p=0.016). Significantly more normal glands adjacent to adenocarcinoma showed moderate/strong expressions for EGFR than c-erbB-2 (p=0.007) whereas significantly more GIN/ACIS lesions showed moderate/strong expressions for c-erbB-2 than EGFR (p=0.008). No correlation was found between moderate/strong expressions for c-erbB-2, EGFR or pan-ras and stage at presentation (p=0.384, 0.056, 0.842 respectively) or with survival (p=0.58, 0.19, 0.26 respectively). In conclusion, EGFR is more important in inducing dysplastic change/malignant transformation whereas c-erbB-2 plays a more significant role in tumour progression and invasion. However, neither c-erbB-2, EGFR nor pan-ras carried any prognostic significance on patient survival.

To investigate the potential role of somatic mitochondrial DNA (mtDNA) mutations in tumorigenesis, the occurrence of mutations in mtDNA of ovarian carcinomas was studied. We sequenced the D-loop region of mtDNA of 15 primary ovarian carcinomas and their matched normal controls. Somatic mtDNA mutations were detected in 20% (3 of 15) tumor samples carrying single or multiple changes. Complete sequence analysis of the mtDNA genomes of another 10 pairs of primary ovarian carcinomas and control tissues revealed somatic mtDNA mutations in 60% (6 of 10) of tumor samples. Most of these mutations were homoplasmic, and most were T-->C or G-->A transitions, but one represented a differential length within a run of identical C residues. A region of mtDNA sequence including the 16S and 12S rRNA genes, the D-loop and the cytochrome b gene, may represent the zone of preferred mtDNA mutation in ovarian cancer. The high incidence of mtDNA mutations found in ovarian carcinomas and other human cancers suggests that genetic instability of mtDNA might play a significant role in tumorigenesis.