Comparative study of an aprepitant regimen with an ondansetron regimen, for efficacy in gynecological cancer patients with chemotherapy / 대한산부인과학회지

OBJECTIVE: We compared the impact of chemotherapy-induced nausea and vomiting (CINV) on patients of an aprepitant regimen with an ondansetron regimen, for antiemetic efficacy after highly emetogenic chemotherapy (HEC). METHODS: The study was performed prospective on 61 patients who is diagnosed initially the gynecological cancer during chemotherapy at Gospel hospital of Kosin university between March 2007 and October 2007. The study was divided according to an aprepitant/ondansetron regimen. The efficacy of controlling acute (during the 24 hours after chemotherapy) /delayed (day 2 days thought 5) nausea, vomiting and adverse effects were compared. Statistical analysis was performed using the chi-square test. RESULTS: The efficacy of controlling nausea with an aprepitant regimen and an ondansetron regimen was 86.7%, 83.9% in acute periods (Pvalue= 0.742) and 99%, 83.9% in delayed periods (P-value=0.083), respectively. The efficacy of controlling vomiting with an aprepitant regimen and an ondansetron regimen was 93.3%, 90.3% in acute periods (P-value=0.809) and 96.7%, 83.9% in delayed periods (Pvalue= 0.034), respectively. The efficacy of controlling delayed vomiting with an aprepitant regimen reported significantly. The common adverse effects in both groups were not significantly. CONCLUSION: The regimen including aprepitant was superior in preventing CINV as compared with a regimen in which both ondansetron and dexamethasone were given delayed periods in patients receiving chemotherapy

Comparative study of an aprepitant regimen with an ondansetron regimen, for efficacy in gynecological cancer patients with chemotherapy / 대한산부인과학회지

OBJECTIVE: We compared the impact of chemotherapy-induced nausea and vomiting (CINV) on patients of an aprepitant regimen with an ondansetron regimen, for antiemetic efficacy after highly emetogenic chemotherapy (HEC). METHODS: The study was performed prospective on 61 patients who is diagnosed initially the gynecological cancer during chemotherapy at Gospel hospital of Kosin university between March 2007 and October 2007. The study was divided according to an aprepitant/ondansetron regimen. The efficacy of controlling acute (during the 24 hours after chemotherapy) /delayed (day 2 days thought 5) nausea, vomiting and adverse effects were compared. Statistical analysis was performed using the chi-square test. RESULTS: The efficacy of controlling nausea with an aprepitant regimen and an ondansetron regimen was 86.7%, 83.9% in acute periods (Pvalue= 0.742) and 99%, 83.9% in delayed periods (P-value=0.083), respectively. The efficacy of controlling vomiting with an aprepitant regimen and an ondansetron regimen was 93.3%, 90.3% in acute periods (P-value=0.809) and 96.7%, 83.9% in delayed periods (Pvalue= 0.034), respectively. The efficacy of controlling delayed vomiting with an aprepitant regimen reported significantly. The common adverse effects in both groups were not significantly. CONCLUSION: The regimen including aprepitant was superior in preventing CINV as compared with a regimen in which both ondansetron and dexamethasone were given delayed periods in patients receiving chemotherapy

A case of down's syndrome in twins of unlike sex / 대한주산의학회잡지

Down syndrome is a chromosome related desease that shows mental retardation, growth retardation and many other signs such as defects in the face, hands and skin. Down syndrome is very uncommon in dizygotic twins, especially in twins with different sex. This twin's chromosomal analysis shows both twins with trisomy 21, but the parents' chromosomal analysis is normal. A 30 year old infertile woman who became pregnant via ICSI(intracytoplasmic sperm injection) has shown dizygotic twins with different sex to have Down syndrome and therefore it is being reported along with simple documents.

A study of support-therapeutic effect and reducing side effect for high-dose vitamin C use of gynecological cancer patients with chemotherapy / 부인종양

OBJECTIVE: The high-dose vitamin C is useful in the cancer. Consequently its use should have become how many help even from gynecological cancer patient who is in chemotherapy. METHODS: The study was performed prospective on 57 patients who is diagnosed initially the gynecological cancer during chemotherapy at Gospel Hospital of Kosin University between January 2005 and October 2006. The study was divided to its use 29 (cervix cancer: 17, ovarian cancer 12) and no high-dose vitamin C use 28 (cervix cancer: 11, ovarian cancer 17). The cervix cancer was treated by FP chemotherapy for all stage and the ovarian cancer was treated by CC chemotherapy for stage 1, CT or PT chemotherapy for advanced stage for 6 times respectively regarding a treatment in tumor marker change aspect and the side effect researched GOG classifications. RESULTS: It evaluated the nausea and vomiting significantly in ovarian cancer (p<0.05). It evaluated for liver enzyme, Hb, WBC, platelet serum creatinine, sensory, motor nervous system and tumor marker with the high-dose vitamin C group does not have the difference from the control group statistically. CONCLUSION: The high-dose vitamin C is a possibility of reducing nausea and vomiting in the ovarian cancer chemotherapy without other side effect. The regarding a tumor marker change it was not significantly but when it analyzed a recurrence a survival rate with more patient and follow up in long period, its use of should have become how many help in gynecological cancer treatment.

Expression of telomerase RNA and caspase-3 in cervical intraepithelial lesions and invasive carcinoma / 부인종양

OBJECTIVE: Telomerase is an RNA-dependent DNA polymerase that synthesizes TTAGGG telomeric DNA. It has been detected in a variety of human malignancies, suggesting that it's activity may play a role in the tumorigenic process. Also, maintenance of telomerase activity is associated with increased resistance to apoptosis. Caspase-3 activation has been found to be essential components of the apoptotic pathway. METHODS: To determine whether telomerase is involved in carcinogenesis of uterine cervix and to analyze the relationship between telomerase RNA and caspase-3 expression according to cervical cancer stage, we performed in situ hybridization for telomerase RNA and immunohistochemistry for caspase-3. The materials were 10 normal cervical tissues, 12 low grade intraepithelial lesions (LSIL), 20 high grade intraepithelial lesions (HSIL), 17 microinvasive carcinomas, 19 invasive carcinomas. RESULTS: Telomerase RNA was weakly expressed in a few basal cells of normal squamous epithelium in uterine cervix. But, high expression rate was noted in squamous intraepithelial lesions and invasive carcinoma groups. Expression of telomerase RNA was demonstrated 5 (41.6%) of LSIL, 7 (35.0%) of HSIL, 6 (35.2%) of microinvasive carcinoma, and 11 (57.8%) of invasive carcinoma. Expression of caspase-3 was demonstrated 0% of LSIL, 13 (65.0%) of HSIL, 13 (76.4%) of microinvasive carcinoma, and 7 (36.8%) of invasive carcinoma. Relationship between telomerase RNA and caspase-3 expression according to stage was not seen. Telomerase RNA and caspase-3 expression showed weakly inverse correlation in invasive carcinoma group. Telomerase RNA and caspase-3 expression was not correlated with clinico-pathologic factors, including stage, tumor differentiation, invasion depth, and lymph node metastasis (p>0.05). But, weak correlation between telomerase RNA expression and tumor size was noted (p=0.05). CONCLUSION: These data indicate telomerase might be involved in carcinogenesis of uterine cervix. Distinct relationship between telomerase RNA and caspase-3 was not seen according to stage. Expression of telomerase RNA and caspase-3 had no correlation with clinico-pathologic factors.

Ovarian carcinoma initially presenting as enlargement of axillary lymph node / 부인종양

Ovarian carcinoma is usually asymptomatic in early stage and over 70% of it initially diagnose advanced stage due to diffuse intraabdominal disease. Presenting symptoms and signs often relate to the degree of intraabdominal spread. The most common presenting symptoms and sign include abdominal pain, distension and palpable pelvic mass. The enlarged finding of isolated, distant lymph node without intraabdominal symptom and sign is vary rare. We experienced a patient who initially diagnosed enlarged axillary lymph node from ovarian carcinoma. We report this case with a brief review of literature.

A Case of Huge Benign Tumor of the Ovary / 대한산부인과학회지

Recently a huge benign tumor of the ovary (greater than 25 pounds) is rare because of early detection and operation. Although infrequently seen, many serious problems associated with the removal of such tumors have been described, including cardiovascular and respiratory complications. For successful management and good prognosis, it certainly requires slow decompression. We have experienced one case of huge benign tumor of the ovary, and report this case with brief review of literatures.

A Case of Peritoneal Desmoplastic Small Round Cell Tumor which involved both ovaries / 대한산부인과학회지

Peritoneal desmoplastic small round cell tumor is a very rare malignant neoplasm and has specific clinical features; It is predominant in children and young males and has a well-demarcated large intra-abdominal tumor, which has not been associated with a primary visceral organ, with diffusely scattered multiple small tumors and rarely involves ovaries. It is a very aggressive and fast growing tumor along the peritoneal surfaces of the abdomen and pelvis. It has a typical histologic features and a specific immunohistochemical staining pattern. There is no definite treatment. It responses to surgery and chemotherapy at early period of therapy but relapses soon and rapidly progresses and then causes the death. We have experienced a peritoneal desmoplastic small round cell tumor which involved both ovaries, so we report this case with a brief review of literature.

A Case of Non-Hodgkin Lymphoma during Pregnancy / 대한산부인과학회지

The occurrence of Non-Hodgkin's lymphoma (NHL) during pregnancy is very rare and this malignancy is most commonly associated with aggressive histology and dissemination. Treatment in pregnant women with low-grade lymphoma may be delayed until after delivery but women with an aggressive lymphoma must have a immediate initiation of standard chemotherapy whether to have a therapeutic abortion or not. A-32-year-old woman with NHL stage IIb complicating pregnancy is presented. The diagnosis was made aggressive lymphoma. The baby weighting 1,830 gm was delivered by normal spontaneous vaginal delivery. Following delivery, the patient received combination chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone regimen but magnetic resonance imaging undertaken during follow-up showed leptomeningeal involvement, indicating poor prognosis. She wanted discharge ten months later from disseminated disease. We experienced a case of rapid growing Non-Hodgkin's lymphoma developed on anterior mediastineum that diagnosed during pregnancy and treated following delivery. We report this case with a brief review of literature.

A case of paraovarian tumor of boderline malignance / 대한산부인과학회지

Paraovarian cysts arise in the mesosalpinx, between the ovarian hilum and the fallopian tube. Clinical significance of paraovarian tumors is considerably less frequent than ovarian tumors, and malignant paraovarian lesions are exceedingly rare. Paraovarian carcinomas or borderline malignancy mostly occur in young women. Abdominal enlargement and pelvic pain are the usual complaints. Usually they have a capsule, are unilateral and are connected to the broad ligament. Little is known about the biological behavior of the paraovarian borderline malignancies, since these lesions are so rare. The appropriate therapy for this unusual lesion have not been fully defined. We had experienced a case of papillary serous adenocarcinoma of borderline malignancy and report this case with a brief review of literature.

A Case of Adenoid cystic Carcinoma in the Uterine Cervix / 대한산부인과학회지

Adenoid cystic carcinoma is an uncommon adenocarcinoma type which affects mainly the salivary gland and respiratory system. In the female reproductive tract it occurs more commonly in Bartholin's gland and than in uterine cervix. Almost patients are postmenopausal women. The main presenting complaint is vaginal spotting having an abnormal pap smear. It has been diagnostically confused with adenoid basal carcinoma which has a somewhat different clinical course and pathology. The treatment should be individualized to the patients by local recurrence or distant metastasis. It shows relatively unfavorable survival. Recently we experienced a case of adenoid cystic carcinoma arising in the cervix after menopause, so we report this case with a brief review of literature.

Docetaxel and Carboplatin Combination Chemotherapy against Persistent or Recurrent Ovarian Cancer as 2nd or more line Chemotherapy / 대한산부인과학회잡지

OBJECTIVE: We evaluated the effects and toxicities of docetaxel-carboplatin combination chemotherapy against recurrent or persistent ovarian cancer who were previously heavily treated with one or more lines of chemotherapy. METHODS: Sixteen patients with a recurrent or persistent ovarian cancer, previously received first or more line chemotherapy, had been treated with docetaxel-carboplatin combination chemotherapy at Kosin Medical Center from December 2001 to May 2003. The docetaxel-carboplatin combination chemotherapy consists of docetaxel 75 mg/m2 and carboplatin 450 mg/m2 given i.v. every 3-4 weeks. The response of patients was evaluated with the tumor marker (serum CA-125) and imaging studies (ultrasonogram, CT, MRI). The toxicities were defined according to the WHO toxicity criteria. RESULTS: The overall response rate was 50% (8/16). Eight patients were evaluable for response by WHO criteria. The response rate by WHO criteria was 37.5% (3/8). In detail, complete response was 12.5%, partial response was 25%, stable disease was 37.5% and progressive disease was 25%. The serologic CA-125 response rate was 50% (8/16), in detail serologic partial response was 50%, and serologic stable disease was 31% and serologic progressive disease was 19%. The median response duration was 10 months (3 to 17 months), the median time to response was 1 month (1/2 to 2 months) and the median time to re-progression was 5 months (3 to 7 months). The most common toxicity was gastrointestinal toxicity and the bone marrow suppression was proved as a most serious side effect. CONCLUSION: The docetaxel-carboplatin chemotherapy as a 2nd or more lines regimen against heavily pre-treated recurrent or persistent ovarian cancer is considerable but was associated significant gastrointestinal and bone marrow side effects. Routine premedication is recommended.

A Case of Rapid Growing Breast Cancer Associated with Pregnancy / 대한산부인과학회잡지

Pregnancy associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the 12 months postpartum. The incidence is one of the most common carcinomas and approximately 1 in 3,000 pregnancies in the United States. Pregnant women are at a higher risk of presenting with more advanced disease than nonpregnant women since small lumps cannot be easily detected due to the natural tenderness and engorgement of the breasts during pregnancy and lactation. Average diagnosis delays of 5 to 7 months are reported. The prognosis is thought not to be significantly different from non-pregnancy associated breast cancer, except in cases where a delay in diagnosis is associated with more advanced disease. Therefore breast cancer is no evidence to implicate pregnancy or lactation in either the etiology and the progression. The strategies for therapeutic management of breast cancer associated pregnancy are mainly dependent on early diagnosis and the stage with gestational age. We experienced a patient who underwent a modified radical mastectomy and adjuvant chemotherapy due to rapid growing breast cancer in pregnant. We report this case with a brief review of literature.

One Case of Solitary Metastatic Adenocarcinoma of the Uterus in Patient with Previous Gastric Cancer Treatment / 대한산부인과학회잡지

The uterus is an unusual site for metastasis from an extrapelvic neoplasm. Metastasis of gastric cancer to the uterus is rare. We experienced a patient who underwent a gastrectomy and chemotherapy due to gastric cancer and who subsequently suffered a solitary metastatic adenocarcinoma of the uterus from the primary gastric cancer. Similar to Krukenberg tumors of the ovary, lymphatic dissemination is regarded as the route of metastasis from the stomach to the uterine. We report this case with a brief review of literature.

One Case of Solitary Metastatic Adenocarcinoma of the Uterus in Patient with Previous Gastric Cancer Treatment / 대한산부인과학회잡지

The uterus is an unusual site for metastasis from an extrapelvic neoplasm. Metastasis of gastric cancer to the uterus is rare. We experienced a patient who underwent a gastrectomy and chemotherapy due to gastric cancer and who subsequently suffered a solitary metastatic adenocarcinoma of the uterus from the primary gastric cancer. Similar to Krukenberg tumors of the ovary, lymphatic dissemination is regarded as the route of metastasis from the stomach to the uterine. We report this case with a brief review of literature.

A Case of Pelvic Actinomycosis with Intestinal Fistula / 대한산부인과학회잡지

Pelvic actionomycosis is a chronic suppurative and granulomatous disease with multiple abscess and draining sinus tracts caused by Actinomyces, a Gram-positive, non-acid-fast, anaerobic bacterium. Actinomycosis is a rare disease, especially in the female genital tract, which is confused with malignancy and other inflammatory diseases because of its infiltrative nature and its tendency to invade normal anatomic barriers. We have experienced a case of pelvic actinomycosis with intestinal fistula and report it with brief review of literatures.

Intravenous Leiomyomatosis with Intracaval Mass, Intracardiac Extension, and Pulmonary Metastasis: A Case Report / 대한산부인과학회잡지

Intravenous leiomyomatosis (IVL) with intracaval mass, cardiac extension, and pulmonary metastasis is rare and it is characterized by nodular masses of smooth muscle proliferation that may extend to variable distances. We experienced a case of the intravenous leiomyomatosis originating from the uterus and extending to the ovarian veins, the iliac veins, the inferior vena cava, the right atrium and the lung. And it was diagnosed from the various preoperative studies and operated successfully through the single-stage approach. So we report it with a brief review of the literature.

A Case of Primary Malignant Mixed M llerian Tumor of the Fallopian Tube / 대한산부인과학회잡지

Malignant mixed m llerian tumor (MMMT) of the fallopian tube is extremely rare with poor prognosis. Primary fallopian tube cancer accounts for approximately 0.3% of all female genital tract malignancies. MMMT of the fallopian tube is extremely rare, accounting for 2.4-5.2% of tubal malignancies. Its clinical behavior resemble that of primary ovarian cancer, so preoperative diagnosis of fallopain tube carcinoma is seldom made. The diagnosis is usually obtained postoperatively. Recently we have experienced a case of MMMT of the fallopian tube, so we report this case with a brief review of literature.

Expression of MAGE in Ovarian Tumor / 대한산부인과학회잡지

OBJECTIVE: Chemotherapy of ovarian cancer has a main role in the post-surgical treatment of ovarian cancer. However, relapsing patients are usually resistant to an additional chemotherapy. The development of immunotherapy is therefore needed to offer other preventive treatment modalities of ovarian cancer. MAGE encoding tumor-rejection antigens recognized by cytotoxic T lymphocytes are expressed at the mRNA level in various malignant tumors. We investigated the possibility of immunotherapy of ovarian cancer of MAGE expression. METHODS: To explore this possibility in ovarian tumors, we investigated the expression of MAGE 1-6 in 44 surgical samples of neoplastic and non-neoplastic tissues from ovaries using a MAGE 1-6 common primer by the nested reverse transcription-polymerase chain reaction (nested RT-PCR) and DNA sequencing after subcloning of PCR products. The material consisted of 5 cases of normal ovaries, 6 cases of non- neoplastic diseases (3 follicular cysts, 2 endometrioses, and 1 tuboovarian abscess), and 8 cases of benign serous, 4 cases of mucinous cystic tumor, 9 teratomas, and 4 cases of malignant serous tumor, 1 case of mucinous tumor, 2 cases of undifferentiated carcinoma, 2 borderline serous and 3 mucinous tumor. RESULTS: MAGE were expressed in 23% of benign ovarian tumors (5/21 cases). In contrast, no expression of these genes was observed in any of the 11 samples of normal and non-neoplastic ovarian tissues. All (92%) malignant tumors except one case of borderline malignant mucinous tumor showed MAGE 1-6 m RNA expression (P<0.05). The isotype of MAGE were confirmed in 5 cases for MAGE-3 (31.2%), 4 cases of MAGE-4 (25%), 2 cases of MAGE A1 (12.5%) and A 4b (12.5%), and one case of MAGE A2, 4a, combined A3 and A6, and A4 and 4b. CONCLUSION: We concluded that the expression of MAGE could be used as a target for tumor specific immunotherapy in ovarian cancer expressing MAGE.

A Case of Leiomyoma of the Vagina / 대한산부인과학회잡지

The leiomyoma of the uterus is most common benign genital tumor in women of reproductive age but occurs in the vagina rarely and may be confused with a variety of vaginal tumors. A preoperative diagnosis is seldom made. Recently we experienced a case of vaginal leiomyoma arising in the anterior vagina wall and concomitant uterine leiomyoma, so we report this case with a brief review of literature.