Intrawound Vancomycin Powder Application for Preventing Surgical Site Infection Following Cranioplasty

Objective@#: Surgical site infection is the most detrimental complication following cranioplasty. In other surgical fields, intrawound vancomycin powder application has been introduced to prevent surgical site infection and is widely used based on results in multiple studies. This study evaluated the effect of intrawound vancomycin powder in cranioplasty compared with the conventional method without topical antibiotics. @*Methods@#: This retrospective study included 580 patients with skull defects who underwent cranioplasty between August 1, 1998 and December 31, 2021. The conventional method was used in 475 (81.9%; conventional group) and vancomycin powder (1 g) was applied on the dura mater and bone flap in 105 patients (18.1%; vancomycin powder group). Surgical site infection was defined as infection of the incision, organ, or space that occurred after cranioplasty. Surgical site infection within 1-year surveillance period was compared between the conventional and vancomycin powder groups with logistic regression analysis. Penalized likelihood estimation method was used in logistic regression to deal with zero events. All local and systemic adverse events associated with topical vancomycin application were also evaluated. @*Results@#: Surgical site infection occurred in 31 patients (5.3%) and all were observed in the conventional group. The median time between cranioplasty and detection of surgical site infection was 13 days (range, 4–333). Staphylococci were the most common organisms and identified in 25 (80.6%) of 31 cases with surgical site infections. The surgical site infection rate in the vancomycin powder group (0/105, 0.0%) was significantly lower than that in the conventional group (31/475, 6.5%; crude odds ratio [OR], 0.067; 95% confidence interval [CI], 0.006–0.762; adjusted OR, 0.068; 95% CI, 0.006–0.731; p=0.026). No adverse events associated with intrawound vancomycin powder were observed during the follow-up. @*Conclusion@#: Intrawound vancomycin powder effectively prevented surgical site infections following cranioplasty without local or systemic adverse events. Our results suggest that intrawound vancomycin powder is an effective and safe strategy for patients undergoing cranioplasty.

The expression of clusterin, bax, p53, Ki-67, and apoptotic index in epithelial ovarian tumors / 대한산부인과학회지

OBJECTIVE: The purpose of this study was (1) to evaluate the expressions of clusterin, bax, Ki-67, p53, and apoptotic index in epithelial ovarian tumors, borderline and malignant ovarian tumors, (2) to find out the correlation between their expressions and clinicopathological parameters, and (3) to evaluate the effect on the patient's survival according to their expressions. METHODS: The histological and clinical findings of 22 cases of ovarian cystadenomas, 44 cases of borderline tumors and 96 cases of carcinomas were evaluated. Expressions of clusterin, bax, Ki-67, p53, and apoptotic index were studied on paraffin-embedded tissue sections by immunohistochemical methods. RESULTS: The expressions of clusterin, p53, and Ki-67 were higher in ovarian carcinomas than borderline tumors. The overexpression of p53, and Ki-67 were frequent in high stage, poorly differentiated and bilateral ovarian carcinomas. The overexpressions of clusterin, bax, p53, and Ki-67 showed a statistically significant correlation with histologic type. Apoptotic index was higher in bax overexpression group, but there was no correlation with overexpression of clusterin or p53. Ki-67 was higher in p53 overexpression group, but there was no correlation with overexpression of clusterin or p53. There was no statistically significant correlation with each other between the overexpressions of clusterin, bax, p53, and Ki-67. The overexpressions of clusterin, Ki-67, p53 was associated with overall patient's survival in borderline significance. CONCLUSION: The overexpression of p53, and Ki-67 were frequent in poorly differentiated ovarian carcinomas. So the overexpression of p53, and Ki-67 can be used as prognostic factor. The overexpression of clusterin was more in epithelial ovarian carcinomas than in borderline tumors but showed no significant correlation with the overall patient's survival. Further studies are required to clarify the possibility of using clusterin for target therapy in epithelial ovarian carcinomas.

Endometrial mullerian adenosarcoma after toremifene treatment in breast cancer patients: a case report / 부인종양

Toremifene is an anti-estrogen which has been shown to be effective in the treatment of breast cancer, and is thought to be a less uterotrophic agent than tamoxifen. The risk assessment concerning endometrial cancer has been inconclusive because of its rare use up to the mid-1990s. We report a case of an adenosarcoma, which is a very rare type of uterine malignancy, after toremifene treatment for 5 years in a breast cancer patient. After 1 year of toremifene use, the patient had a benign Mullerian adenofibroma. After an additional 4 years of toremifene treatment, the endometrial polypoid lesion was transformed into a Mullerian adenosarcoma. Although toremifene is a promising anti-estrogenic agent in the treatment of breast cancer patients, clinicians should not neglect the possibility of a uterine malignancy.

The immunohistochemical study on Ki-67 Expression in epithelial ovarian carcinomas / 대한산부인과학회지

OBJECTIVE: The study was to evaluate the biological significance of Ki-67 expression in common epithelial ovarian carcinomas. We investigated the correlation between Ki-67 expression and clinicopathological parameters. METHODS: One hundred patients with epithelial ovarian carcinomas stage I-IV treated at Department of Obstertrics and Gynecology, Korea University Hospital from January 1994 to December 2004 were used as study group. We determined expression of Ki-67 by immunohistochemistry using MIB-1 monoclonal antibody reactivity. RESULTS: Ki-67 overexpression was higher in high stage (III-IV) than low stage (I-II) (P<0.013). Ki-67 overexpression was higher in serous cystadenocarcinoma (76.3%) than mucinous cystadenocarcinoma (53.6%), endometrioid carcinoma (54.5%) and clear cell carcinoma (58.3%) but it was not statistically significant (P<0.191). Ki-67 expression was higher in high grade but it was not statistically significant (P<0.096). Ki-67 overexpression was not correlated with serum CA-125 level (P<0.172). Overall survival revealed significant survival difference between patients whose tumor showed Ki-67 overexpressions compared with remaining patients. CONCLUSIONS: Ki-67 overexpressions was a poor prognostic indicator in epithelial ovarian carcinomas.

Expressions of cyclooxygenase-2 and P-glycoprotein in epithelial ovarian carcinomas / 대한산부인과학회지

OBJECTIVES: The purpose of this study was to evaluate expression of cyclooxygenase-2 (COX-2) and P-glycoprotein (P-gp) in ovarian epithelial carcinomas, to find out the correlations between their expression and clinicopathological parameters, and to evaluate the response to treatment and clinical outcome according to their expression. METHODS: Immunohistochemical studies of COX-2 and P-gp were carried out in 64 cases that were treated with ovarian epithelial carcinomas at Department of Obstetrics and Gynecology, Korea University Hospital, Korea University from 1996 to 2005. RESULTS: COX-2 over-expression was detected in 20 (31.2%) cases and was significantly higher in non-responder than responder to chemotherapy (56.2% versus 22.9%, respectively; P=0.012). The patients of COX-2 overexpression showed shorter overall survival (P<0.001). Over-expression of P-gp was detected in 15 (23.4%) cases was significantly higher in non-responder than responder to chemotherapy (56.2% versus 12.5%, respectively; P<0.001). The patients of P-gp overexpression showed shorter overall survival (P= 0.042). CONCLUSION: COX-2 and P-gp overexpression could provide additional information to identify ovarian carcinoma patients with poor chance of response to chemotherapy.

Risk factors of High Grade Lesions in Glandular Cell Abnormalities on Cervical Cytology / 대한산부인과학회지

OBJECTIVE: To identify the risk factors that may predict high grade lesions in glandular cell abnormalities on cervical cytology. METHODS: This study was performed from January 2002 to December 2005 and included 87 cases of glandular cell abnormalities on Pap smear. Among them, 65 (74.7%) cases were atypical glandular cells (AGC) and 22 (25.3%) cases were AGC, favor neoplastic. The histologic diagnoses were classified as low grade lesions [normal, cervical intraepithelial neoplasia (CIN) I, and simple hyperplasia without atypia] and high grade lesions [CIN II/III, adenocarcinoma in situ (AIS), and invasive cancer]. RESULTS: Fifty-three (60.9%) cases had negative biopsies or cervicitis. Twenty-five cases had cervical lesions including one CIN I, ten CIN II/III, two AIS, twelve invasive cancers. There were 7 endometrial lesions: 5 adenocarcinomas and 2 malignant mixed mullerian tumors. Two patients had one tubal cancer and one CIN II with simple hyperplasia without atypia. High-risk human papillomavirus (HPV) positive and AGC, favor neoplastic cases were significantly associated with high grade lesions (OR 15.4, CI 2.2-109.7; OR 7.0, CI 1.1-42.8). In the cervix, only high-risk HPV positive were significantly associated with high grade lesions (OR 64.6, CI 4.5-930.8). In the endometrium, age, menopausal status, and cytologic classification were significantly associated with low grade lesions or high grade lesions (p<0.05). CONCLUSION: High-risk HPV DNA detection was strongly associated with high grade lesions in women with glandular cell abnormalites on their Pap smear. These results suggest that HPV testing may be useful as a triage of the management in women with glandular cell abnormalities.

Primary Cardiac Sarcoma in Pregnancy: A Case Report

Primary cardiac sarcoma is a rare disease in adults. It is also associated with poor prognoses, due to diagnostic delay, therapeutic difficulty, and high metastatic potential. The coincidence of pregnancy and a primary cardiac intimal sarcoma is extremely rare. We report a pregnant woman at 27(+5) weeks gestation who was admitted to the hospital with acute-onset dyspnea. A mass was found on the left atrium by transthoracic echocardiography. Subsequently, the intracardiac mass was removed, and mitral valve replacement and modified DeVega tricuspid annuloplasty were performed. The patient was diagnosed with a undifferentiated sarcoma, and gave birth to a 1,230 g living baby boy by Caesarean section from preterm contraction at 29(+5) weeks gestation. The patient then received systemic chemotherapy. However, 10 months after the initial clinical onset, the patient suddenly died. Surgery is the standard treatment for cardiac tumors, and their removal should always be attempted, even in pregnant women. Although the overall survival rates of the patients are rather poor, palliative cardiac surgery allows the prolonging of pregnancy, until an acceptable fetal viability level is reached.

Clinicopathologic characteristics and prognostic factors of adenocarcinoma of the uterine cervix: a study of 80 cases / 부인종양

OBJECTIVE: The purpose of this study was to evaluate the clinicopathologic findings, treatment, and prognostic factors of adenocarcinoma of the uterine cervix. METHODS: This study retrospectively reviewed 80 patients with histologically proven stage I, II, and III cervical adenocarcinoma, at the Department of Obstetrics and Gynecology of Korea University Anam, Guro, and Ansan Hospitals, between January 1990 and December 2005, for clinical profiles and survival. Survival was analyzed according to the Kaplan-Meier method. Univariate analysis of prognostic factors was performed with the test of log rank. Cox regression model was used in multivariate analysis of prognostic factors. RESULTS: The mean age at the time of diagnosis was 48.5 years (range: 28-81 years) and the most common presenting symptom was uterine bleeding (51.3%). Fifty-eight patients (72.5%) presented with stage I, nineteen (23.7%) with stage II, and three (3.8%) with stage III. Surgery was the main treatment for stage I and IIa and radiation therapy for stage IIb or more. The 5-year survival rates for stages I, II, and III were 85.0%, 63.8%, and 0.0%, respectively. Univariate analysis showed that stage, lymph node metastasis, and lymph-vascular space invasion were significant prognostic factors (p or =50) were significant independent predictors for poor survival (OR 37.352, CI 3.167-440.579; OR 9.823, CI 1.808-53.354, respectively). CONCLUSION: The results suggest that FIGO stage and age are significant independent prognostic factors for patients with adenocarcinoma of the uterine cervix.

A case of malignant peripheral nerve sheath tumor of pelvic cavity / 대한산부인과학회지

A 75-year-old female presented with a 1-month history of low abd pain. A 15 x 13 cm solid mass was noted in pelvic cavity by imaging study. The patient underwent an exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymph node dissection and omentectomy. Immunohistochemistry aided in the final diagnosis of a malignant peripheral nerve sheath tumor. The patient had several poor prognosis factor and relapsed into tumor and died 5 month after surgery. An extremely rare case of malignant peripheral nerve sheath tumor of pelvic cavity is reported with a brief review of the literature.

Correlations between umbilical and maternal serum adiponectin levels and neonatal birthweight / 대한산부인과학회지

OBJECTIVE: Adiponectin is an adipocyte-derived hormone with profound insulin sensitizing, anti-inflammatory, and antiatherogenic effects. Apart from its obvious potential as a mediator of adult metabolic syndrome, in pregnancy, adiponectin could have a significant role in regulating energy homeostasis. However, correlations between umbilical cord and maternal serum adiponectin levels and neonatal birthweights are far from understood. The purpose of the present study was to clarify correlations between umbilical cord and maternal serum adiponectin levels and neonatal birthweights. METHODS: The study included 30 healthy mothers who had given birth to healthy neonates. Adiponectin levels in maternal serum and umbilical cord serum were determined by ELISA and analysed. RESULTS: The ranges of adiponectin levels for umbilical cord and maternal serum were 7.12-24.93 microgram/mL and 1.76-8.20 microgram/mL, respectively. Umbilical cord adiponectin levels (14.82+/-3.66 microgram/mL) were significantly higher than maternal serum levels (4.73+/-1.87)(p<0.001). Umbilical cord adiponectin levels were correlated positively with neonatal birthweights (r=0.459, p=0.011). No significant differences in adiponectin levels were found between female and male neonates. In addition, there was no correlation between umbilical cord adiponectin levels and maternal serum adiponectin levels, maternal body mass index, umbilical leptin, or insulin levels. CONCLUSION: The levels of adiponectin were higher in umbilical cord than in maternal serum. The adiponectin levels in umbilical cord were found to correlate positively with neonatal birthweights. Therefore, adiponectin may be involved in fetal energy metabolism in pregnancy.

Usefulness of an Unconjugated Estriol for prediction of Gestational Diabetes Mellitus / 대한산부인과학회지

OBJECTIVE: Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders complicating pregnancy. It is associated with adverse outcomes of pregnancy including obstetrical complications such as increased rate of cesarean section, preeclampsia, and birth trauma, and perinatal morbidities, such as macrosomia, hypoglycemia, hypocalcemia, and hyperbilirubinemia. Therefore, screening for gestational diabetes mellitus and early diagnosis of this condition allows intervention to be carried out, thereby, the reduction of the untoward effects mentioned above can be minimized. But selective screening based on clinical or historic risk factors has been reported ineffective to identify the women with GDM. BACKGROUND: Circulating sex hormones have a role in the development of insulin resistance associated with certain physiological states including hyperandrogenism and polycystic ovary syndrome. Throughout pregnancy, normal human pregnancy is a hyperestrogenic state of major proportions. To evaluate the clinical correlation between Gestational diabetes mellitus and unconjugated estriol, we used it to screening protocol using three biochemical markers for unconjugated estriol levels. METHODS: In our retrospective between January 2002 and December 2003 at Korea university medical center, 137 women were screened for three biochemical tests and 50 gm Glucose challenge test at second trimester of pregnancy. The 50 gm GCT positive (n=56) women were performed 100 gm oral glucose tolerance test and by NDDG diagnosic criteria, women were diagnosed as Gestational diabetes mellitus (n=42). RESULTS: With logistic regression analysis, the significant risk factors were family history of DM (odd ration 16.59 95% CI 2.66-103.52), previous macrosomia birth (odd ratio 9.02 95% CI 1.98-41.6), maternal BMI (odd ratio 1.29 95% CI 1.09-1.49), parity (odd ratio 0.31 95% CI 0.11-0.83), glucosuria (odd ratio 0.68 95% CI 0.26-1.76) and among three biochemical test, estriol (odd ratio 1.60 95% CI 0.49-5.27), AFP (odd ratio 1.35 95% CI 0.35-5.28), hCG (odd ratio 0.59 95% CI 0.27-1.28). CONCLUSION: The screening test of GDM would be preferable and intensified management approach needed for patients with obesity, previous macrosomia birth. In three biochemical test, estriol and AFP levels were elevated in GDM but these odd ratio were not statistically significant.

Clinical Guidelines for Methotrexate in Conservative Treatment for Ectopic Pregnancy / 대한산부인과학회지

OBJECTIVE: To provide more useful guidelines for methotrexate (MTX) treatment in ectopic pregnancy, including patient selection, therapeutic dose, and reproductive outcome. METHODS: Retrospectively, records of 54 patients treated for ectopic pregnancy with systemic MTX were reviewed. MTX was administered 1.0 mg/kg intramuscularly, alternatively with leucovorin 0.1 mg/kg intramuscularly for up to four daily doses of each drug. Samples for beta-hCG detection were obtained on days +3, +7 after beginning of the therapy and then weekly until values were undetectable. RESULTS: 50 patients (92.6%) were treated successfully. 4 patients (7.4%) for whom MTX therapy failed, were treated surgically. The endometrial thickness significantly increased in the failed group, compared to the successful group (14.3+/-4.0 mm vs 7.0+/-2.8 mm, P=0.0001). The serum hemoglobin levels significantly changed in the failed group, compared to the successful group (2.1+/-0.9 g/dL vs 1.0+/-0.8 g/dL, P=0.044). Patients were divided into increasing group and decreasing group according to beta-hCG levels on day 0, that were higher or lower than day -2 level. The resolution time of beta-hCG between increasing group and decreasing group was significantly different (27.6+/-14.0 days vs 17.7+/-8.6 days, p=0.016). In 8 patients (15.1%), an immediate rise of beta-hCG was recorded on day 3 after MTX treatment, but on day 7, a rapid decrease was recorded. Women were treated with significantly different therapeutic dose of MTX according to initial level of serum beta-hCG (p=0.021). There were mild complications (12%). MTX treatment preserved the fallopian tube and thus preserved fertility (70%). CONCLUSION: Systemic MTX use with the dose according to initial level of serum beta-hCG is a safe and highly effective treatment in clinically stable ectopic pregnancy.

The Quantitative Analysis of Mitochondrial DNA Copy Number in Premature Ovarian Failure Patients Using the Real-time Polymerase Chain Reaction / 대한산부인과학회잡지

OBJECTIVE: To design a screening method which identifies women with a potential of progression to the premature ovarian failure (POF) in near future, particularly among young women who have high FSH level but no symptoms and signs of POF. METHODS: Peripheral venous blood samples were collected from 30 patients with POF (age range, 19- 39 years) and from 30 controls with normal serum FSH level who had delivered two or more naturally conceived babies (age range, 32-39 years). mtDNA/28S rRNA ratio was determined by real-time quantitative PCR. Comparative threshold cycle (CT) method was adopted for the relative quantitation between two groups and the effectiveness of the method was evaluated. RESULTS: A significant decrease in mtDNA/28S rRNA ratio was found in the POF group (0.58 0.38) when compared with the control group (1.15 0.67) (P<0.01). In both control and POF groups, there was positive correlation between mtDNA and mtDNA/28S rRNA ratio (r=0.774, P<0.001; r=0.556, P=0.001, respectively) and negative correlation between 28S rRNA and mtDNA/28S rRNA ratio (r=-0.677, P<0.001; r=-0.627, P=0.001, respectively), which indicated the suitability of the method. CONCLUSION: This study showed a significant decrease in mtDNA copy number in the peripheral venous blood of POF patients. The comparative CT method was found to be an effective and efficient alternative for the screening purposes. With this basis, further studies on the early diagnostic and/or screening method for the POF might be enriched.

A Clinicopathologic Characteristics and Survival Analysis of Ovarian Tumors / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to identify the clinicopathologic characteristics, treatments and overall 5-year survival and to analyze the prognostic factors affecting the survival in patient with ovarian tumors. METHODS: We reviewed retrospectively the outcome of 116 patients with ovarian cancer and 64 patients with borderline malignant ovarian tumor, who had been treated at Department of Obstetrics and Gynecology, Korea University Anam Hospital from Jan. 1991 to Dec. 2001. Univariate and multivariate analysis for survival were conducted to test the prognostic significance of several clinicopathologic factors. RESULTS: The mean age of the patients with borderline malignant ovarian tumor was 39.9 years old, and nulliparity was most common (42.2%). Mucinous tumor was the most common histologic subtype (68.8%). The FIGO stage distribution of borderline malignancy were 89.1%, 1.6%, 9.3% for stage I, II, and III, respectively. The overall 5-year survival rate of patients with borderline malignancy was 98.4%. The mean age of the patients with ovarian cancer was 50.1 years old. The incidence of ovarian cancer according to histologic type were 74.1%, 12.9%, 11.2%, 0.9%, 0.9%, in epithelial ovarian cancer, Sex-cord stromal tumor, malignant germ cell tumor, metastatic carcinoma of the ovary, and small cell carcinoma, respectively. The FIGO stage distribution of ovarian cancer were 40.5%, 12.1%, 42.2%, 5.2% for stage I, II, III, and IV, respectively. The overall 5-year survival rate of patients with ovarian cancer was 60.9%. In multivariate analysis, FIGO stage was identified as a significant independent prognostic factor in this study. CONCLUSION: In this study, patients with borderline malignancy of the ovary have good prognosis and the overall 5-year survival rate was 98.4%. Otherwise, the overall survival rate of patients with ovarian cancer was 60.9% and the stage was most important prognostic factor.

The Prevalence of Epstein-Barr Virus in Uterine Cervical Cancer: Detection by PCR and In Situ PCR Methods / 대한산부인과학회잡지

OBJECTIVE: Uterine cervical cancer is the most common malignant tumor in Korean women. Human papillomaviruses are associated in 85-90% of the cases. However, other cofactors are considered to be important in carcinogenesis. There is an evidence that the uterine cervix is the site of shedding of the Epstein-Barr viruses(EBV). Furthermore the virus has been detected in cervical intraepithelial neoplasia and invasive carcinoma of the uterine cervix. We studied to evaluate the role of EBV in cervical carcinogenesis. METHODS: Non-neoplastic cervices(12), carcinoma in situ(32), microinvasive squamous cell carcinomas(9), invasive squamous cell carcinomas(37) and adenocarcinomas and adenosquamous carcinomas(14) were studied for EBV infection. PCR and in situ PCR for EBNA-1 were done and subtyping was done using PCR for EBNA 3C. RESULTS: In non-neoplastic cervix, EBV was detected in 16.7% by PCR and found in normal epithelial cells and lymphocytes in in situ PCR. By PCR technique, EBV was detected in 65.6% of CIS, 66.3% and 51.4% of microinvasive and invasive squamous cell carcinomas, 57.1% of adenocarcinomas and adenosquamous carcinomas. EBV subtyping was done in EBV positive cases by PCR and all showed type 1. CONCLUSION: EBV was detected in higher frequency in cervical cancer than in non-neoplastic cervix. However the frequency was not correlated to the invasion depth and histologic types of cervical carcinomas. EBV was detected in tumor cells as well as normal epithelial cells and lymphocytes also. It was suggested that EBV may play a role in cervical cancers but the mechanism in carcinogenesis remains to be solved.

Lectins Binding in Squamous Cell Carcinoma of the Uterine Cervix as a Diagnostic and Prognostic Marker / 대한산부인과학회잡지

OBJECTIVE: The aim of the study was to evaluate the corelation between an expression of lectins and survival of patients with squamous cell carcinoma of uterine cervix. METHODS: The cell surface carbohydrate profile of formalin-fixed paraffin embedded tissue section of squamous cell carcinoma of the uterine cervix was evaluated using ulex europaeus agglutinin(UEA-1), peanut agglutinin(PNA), dolichos biflorus agglutinin(DBA), soybean agglutinin(SBA) and lotus tetragonobus lectin(LTL) by the avidin-biotin complex method. Fifty-one cases of squamous cell carcinoma and 10 cases of normal squamous epithelium of the uterine cervix were selected from the file which were treated during Jan. 89 to 31 Dec. 1992 in Department of Obstetrics and Gynecology, Korea University Hospital. RESULTS: UEA-1 and LTL were negative in normal cervix while positive in 76.5%, 47.1% of squamous cell carcinoma respectively, and useful markers for differential diagnosis between normal and squamous cell carcinoma. SBA and LTL were useful for differential diagnosis of keratinizing and non-keratinizing squamous cell carcinoma. UEA-1 may play an important role in lymphovascular invasion of squamous cell carcinoma of the uterine cervix. CONCLUSIONS: There was no correlation among clinical staging, patient's survival and lectins binding in squamous cell carcinoma.

A Case of Adenoid Cystic Carcinoma of Bartholin's Gland / 대한부인종양콜포스코피학회잡지

Adenoid cystic carcinoma is a rare disease of which incidence is 10-15 % of bartholins gland carcinoma. The clinical presentation is characterized by a vulval mass that existed for a prolonged period to the onset of symptoms, usually infection, pain, and burningsensation Histologically, this tumor is characterized by cribriform pattern cell growing and perineural invasion. The obtaining of clear surgical margins is the most important aspect of treatment. Here we report a case of adenoid cystic carcinoma of the Bartholins gland with a brief review of literature.

Chromosomal Aberrations in Ovarian Carcinoma Cell Line, SNU - S , Using Chromosome Painting / 대한암학회지

PURPOSE: The characterization of all recognizable chromosomal rearrangements was dis- turbed by technical limitation of conventional cytogenetic methods. Recently, the strong usefullness of generation of chromosome specific painting probes in identification of marker chromosomes has proven. This study was intended to analyze the chromosomal aberrations in human ovarian cancer cell line, SNU-8, by G-banding and multiple paintings. MATERIALS AND METHODS: Human ovarian cancer cell line, SNU-8 was cultured and harvested for cytogenetic analysis. Routine karyotyping was performed. For complete analysis of chromosomal aberrations, human chromosome-specific painting probes were constructed from somatic hybrid cells. The origins of the unidentified marker chromosomes were analyzed by fluorescent in situ hybridization (FISH) with these painting probes. RESULTS: All chromosome alterations were confirmed by the use of multiple chromosome paintings, which also demonstrated a number of additional alterations. SNU-8 had the karyotype 62-69,XXX, + der(1;10)(q10;p10),der(3;18) (q10;p10)X2,-4,+ 5,+ 7,del(9)(q21)X2,-11,-13,-15,-16,der(17;19)(q10;q10) X2, + 20,-22[cp51]. CONCLUSION: The chromosomal aberrations of SNU-8 cell line was effectively analyzed by FISH with these painting probes, and the approach methods of this study can be applied to cytogenetic analysis of chromosomal aberrations in the other cancers.

A Case of Postirradiation Uterine Papillary Serous Carcinoma / 대한산부인과학회잡지

Uterine papillary serous carcinoma is a morphologically distinct variant of endometrial carcinoma that is associated with an aggressive behavior with rapid progression and high recurrence, and poor response to salvage treatment. The most common type of malignancy developing in the uterus after radiation therapy is the malignant mixed mullerian tumor, however, the papillary serous carcinomas have rarely been reported.Here we report a case of uterine papillary serous carcinoma which had developed 7 years after radiation therapy for invasive cervical cancer.

The Effects of Sperm Motility Stimulants on the Hyperactivation, Acrosomal Reaction of Sperm and their in vitro Fertilization / 대한산부인과학회잡지

OBJECTIVES: To evaluate the effects of sperm motility stimulants on the hyperactivation (HA), acrosomal reaction (AR) and sperm penetration assay (SPA) in fresh and frozen-thawed spermatozoa from fertile men. METHODS: We treated the semen samples obtained from 20 normospermic men (fresh semens from 10 and cryopreserved ones from 10) with pentoxiphylline (PF) and 2-deoxyadenosine (2-DXA) to evaluate the change of the patterns of motility using the computerized motility analyzer. The semen samples treated with motility stimulants were incubated in the medium with calcium ionophore A23187 for the examination of the proportion of acrosome lost spermatozoa. Finally we performed SPA in both groups for the evaluation of fertilizing capacity after stimulant treatments. RESULTS: In both fresh and cryopreserved semen samples, the addition of PF and 2-DXA significantly altered the patterns of motility (ALH, VCL, HA) known to have association with sperm quality without increasing the number of sperms with progressive motility and velocity. A23187 induced AR was also augmented by the treatment with PF and 2-DZA. Although the treatment with PF did not increase the mean rates of egg penetration significantly, in selected cases in the cryopreserved semen group, the improvement of the motility pattern was impressive. CONCLUSION: PF and 2-DXA can improve the quality of sperm function in both fresh and frozen-thawed semen from normal fertile men and may increase the sperm penetration rate of zona-free hamster eggs in selected samples of the frozen-thawed semen. The results suggest that PF and 2-DXA pretreatment can be used in the clinical practice for intrauterine insemination (IUI) program with frozen-thawed sperms as well as with samples from men with abnormal semen parameters. In addition, it may be a cost- effective therapy to try IUI combined with such a pretreatment for the couples planned to enter into the ART program.