The Use of Sonohysterography in Infertile Patients / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to assess the usefulness of sonohysterography in the detection of abnormalities of the uterine cavity in infertile patients, compared with other diagnostic methods, such as transvaginal sonography, hysterosalpingography and hysteroscopy. METHODS: Three intrauterine pathologies including intrauterine synechiae, endometrial polyp and submucosal myoma, that could be possible causes of infertility were diagnosed. RESULTS: Transvaginal ultrasonography and hysterosalpingography were able to detect 41.7% and 83.3% of uterine pathologies respectively comparing with sonohysterography to detect all of the uterine pathologies. CONCLUSION: Our results show that sonohysterography is easy, inexpensive, well-tolerated and non-invasive technique with high sensitivity in the detection of uterine pathologies. Therefore the use of sonohysterography for the diagnosis of intrauterine pathologies in infertile patients is highly recommended.

Patterns of Cytokine mRNA Expression of Various Endometriosis Lesions / 대한산부인과학회잡지

OBJECTIVE: The pathogenesis of endometriosis is generally accepted that retrograde menstruation and alterations in the local pelvic immune environment. This study was performed to help elucidate what kind of role various cytokines might play in the pathogenesis of endometriosis. METHOD: Concentrations of peritoneal fluid cytokines were compared in 7 women with normal pelvic finding and 23 women with endometriosis by enzyme-linked immunosorbent assay(ELISA). The patterns of cytokine mRNA expression in 8 ovarian endometrioma and 12 superficial pelvic endometriosis lesions were investigated by reverse transcription-polymerase chain reaction(RT-PCR) amplification method. RESULT: Both IL-6 and IL-10 levels in peritoneal fluid specimens with endometriosis tended to be higher than normal. However, there were no significant differences between peritoneal fluid concentrations of IFN-gamma, TNF-alpha, IL-1beta, and IL-5 of women with and without endometriosis. The levels of IL-6 and IL-10 were significantly higher in peritoneal fluid of women with severe endometriosis compared to women with mild endometriosis. IL-1beta mRNA was expressed in all of 8 deep and 12 superficial endometriosis lesions. IL-5 and IL-6 mRNA were expressed in only two black lesions respectively, however, both were not expressed in the all deep lesions. Expressions of IL-10 mRNA occurred in one red and one black lesion while this was expressed in only one of the deep lesions. TNF-alpha mRNA was expressed in one red and one black lesion of 12 superficial lesions compared with four of the deep lesions. There was the difference between kinds of increased cytokines in the peritoneal fluid and those of expressed cytokines in the endometriotic lesions of patients with endometriosis. CONCLUSION: This study supports the concept that local immunologic factors may be important in the pathogenesis and pathophysiology of endometriosis. The pattern of cytokine mRNA expression of endometriotic lesions would seem to indicate that proinflammatory cytokines such as IL-1beta and TNF-alpha are responsible for the development or progression of endometriosis.

Immunohistochemical Characterization and Plasma Level of Carcinoembryonic Antigen in Ovarian Tumors / 대한부인종양콜포스코피학회잡지

This study was performed to assess the significance of plasma level and histochemical character of carcinoembryonic antigen(CEA) in early diagnosis and prognosis of ovarian tumor. Plasma level of CEA was measured using EIA method and immunohistochemical tissue staining of CEA was done using biotin-strepto avidin complex immunoperoxidase technique. The percentage of patients with positive CEA level(above 2.5 ng/ml) was 23.1%(6/26) in malignant ovarian tumor and 15.6%(12/77) in benign ovarian tumor. Positive tissue staining of CEA was 42.3%(11/26) in malignant ovarian tumor and 19.5%(15/77) in benign ovarian tumor. In histologic typing, positive tissue staining of CEA was 18.1%(2/11) in serous cystadenocarcinoma, 85.7%(6/7) in mucinous cystadenocarcinoma, 37.5%(3/8) in other malignant ovarian tumors, 7.1%(1/15) in serous cystadenoma, 7.1%(1/14) in mucinous cystadenoma and 27.1%(13/48) in other benign ovarian tumors. Among 5 cases of malignant ovarian tumors with positive CEA level, 3 cases(60%) showed positive tissue staining of CEA, whereas among 21 cases of malignant ovarian tumors with negative CEA level, 8 cases (38.1%) showed positive tissue staining of CEA. However, among 11 cases of benign ovarian tumors with positive CEA level, 4 cases(36.4%) showed positive tissue staining of CEA, whereas among 66 cases of benign ovarian tumors with negative CEA level, 11 cases(16.7%) showed positive tissue staining of CEA. In the 3 year follow-up study of 12 cases with malignant ovarian tumor, among 3 cases with positive tissue staining of CEA, 2 cases(66.7%) survived. In 9 cases with negative tissue staining of CEA, 6 cases(66.7%) survived. In conclusion, these results suggest that the measurement of tumor CEA may be of value in the differential diagnosis of malignant and benign ovarian tumor, especially in diagnosing mucinous cystadenocarcinoma. However, due to the small amount of cases available for study, it was difficult to determine the correlation between the prognosis and tissue CEA staining of ovarian tumors.