The effectiveness of ethylene glycol as cryoprotectant in mouse embryo freezing with slow freezing method / 대한산부인과학회지

OBJECTIVE: We intended to know how the cryoprotectant ethylene glycol (EG) would affect the outcome of the embryo development when used in slow freezing method. And to know if there is any difference in the outcome of frozen-thawed embryos according to freezing methods and the timing. METHODS: We used 5-6 weeks old ICR female mice and T6 containing 0.4% BSA for basic culture media. The embryos at the developmental stages of 1-cell, 8-cell and blastocyst were cryopreserved respectively by slow freezing method using EG, propylene glycol (PROH), and glycerol as a cryoprotectant. We also compared the results of slow freezing and vitrification methods with the same cryoprotectant, EG. And finally, we evaluated the quality of blastocysts by counting the cell numbers in each group. RESULTS: The post-thaw embryo development were better in EG group when they were frozen at 1-cell and blastocyst stage (P<0.05). Although there were no differences in the recovery rate, the survival rate in vitrification group was significantly higher (P<0.05). Post-thaw embryo development to morula and blastocyst were better in vitrification group when frozen at 1-cell embryo (P<0.05), not at 8-cell and blastocyst group. The cell counts of blastocyst derived from 1-cell stage frozen EG group were significantly increased than that of PROH-glycerol groups (P<0.05), however, there was no difference between the two freezing methods. CONCLUSION: These results suggest that EG may be advantageous comparing with the conventional cryoprotectants, PROH and glycerol in slow freezing method for mouse embryo cryopreservation. In terms of freezing method, vitrification is better than slow freezing.

Profile of vaginal human papillomavirus infection in hysterectomized women / 부인종양

OBJECTIVE: To examine HPV infection of vagina in the absence of cervical tissue and, thus, to determine whether the cervix, and especially the cervical transformation zone, is required for HPV infection. METHODS: We analyzed the result of pap smears that were interpreted with the Bethesda system, and the result of HPV tests of 376 hysterectomized women and 605 non-hysterectomized women who had visited in Korea medical health care center from August 2004 to December 2005. HPV test was performed with the commercially available Hybrid Capture II assay. We estimated the prevalence of vaginal HPV infection in hysterectomised and non-hysterectomized women. The variables selected for analysis were age, time of hysterectomy, self reported reasons for hysterectomy, parity and so on. RESULTS: Prevalence of vaginal HPV infection in hysterectomized women was 12.5% and non-hysterectomized women was 11.7%, showed no difference (p=0.72). The mean viral load of hysterectomized group was 79.1 and that of non-hysterctomized group was 173.9, which show no statistical difference between group (p=0.28). The cause of operation, age, duration since the operation, age group-specific duration since operation showed no difference in prevalence of HPV infection. Menopause state also did not show difference in HPV infection (p=0.67). CONCLUSION: On the basis of the present study's data, we suggest that the cervix, particularly the cervical transformation zone, may not be needed for HPV infection in vagina.

Comparison of cyclooxygenase-2 and p53 expression in normal endometrium, endometrial hyperplasia and endometrial cancer / 부인종양

OBJECTIVE: The purpose of this study is to compare the expression rate of cyclooxygenase-2 (COX-2), p53 in endometrial hyperplasia, endometrial cancer and normal endometrium and to correlate COX-2 with the clinicopathological factors and p53 in endometrial cancer. METHODS: Immunohistochemical stain of COX-2, p53 was performed on samples from a series of 19 cases of normal proliferative endometrium, 20 cases of complex endometrial hyperplasia and 19 cases of endometrial cancer. And then we analyzed the expression of COX-2 correlated the findings with clinicopathological factors and p53. Expression of COX-2 was scored according to the proportion of positive-staining cells: negative, no staining; 1+, 50. For p53 overexpression, when there were at least 10% of tumor cells stained, it was considered as positive. RESULTS: Overexpression of COX-2 (> or =2+) was seen in 5 (26.3%) of the endometrial cancers, 6 (30%) of the complex endometrial hyperplasia, and 4 (21.1%) of the normal endometria. The expression rates of COX-2 in endometrial cancer, hyperplasia and normal endometrium were not different statistically significant (p=0.93). COX-2 was not correlated with clinicopathological factors but correlated with p53 significantly (p=0.021). CONCLUSION: In this study, the immunohistochemical analysis showed no difference statistically in COX-2 expression between endometrial cancer and hyperplasia compared to normal endometria. COX-2 was significantly correlated with p53. This finding may represent that tumor suppressor p53 upregulates COX-2 expression.

A case of krukenberg tumor / 대한산부인과학회지

Metastatic tumor to ovary are uncommon, but there is a situation in which a metastatic adenocarcinoma to ovary appears as a large mass and resembles a primary tumor: a Krukenberg tumor of ovary which has a signet ring histologic pattern and usually is metastatic principally from a gastrointestinal tract cancer. We have an experience of one case of metastatic Krukenberg tumor from stomach and report the case with brief review of literature.

A Clinicopathologic Study of Ovarian Granulosa Cell Tumor / 대한산부인과학회잡지

OBJECTIVE: The goal of this clinical study was to evaluate clinical and pathological findings, surgical procedures, and postoperative treatment in women with ovarian granulosa cell tumor. METHODS: A clinical study was made on 28 cases of ovarian granulosa cell tumor that were treated at the department of Obstetrics and Gynecology in Korea University Hospital between January 1978 and December 2002. Data for 28 women with granulosa cell tumor were collected retrospectively. Follow-up data were collected from the hospital records or telephone survey. Fisher's exact test and Kaplan-Meier survival analysis were applied, as appropriate. RESULTS: The mean age of patients was 49 years (range, 28 to 71 years). The most common present symptom was vaginal bleeding (11/28, 39.3%). 82.6% of patients were with FIGO stage I, 3.6% with stage II, 7.1% with stage III, and none with stage IV. Follow-up time was 62 months (5-128 months). The five year disease free survival rate was 90.4% and 10 year disease free survival rate was 86.5%. Significant prognostic factors were FIGO stage and the rupture of tumor. CONCLUSION: Even though granulosa cell tumor usually has good prognosis, it is a tumor of unquestionable malignant potential and has a tendency for late relapse. Long term follow-up is recommended. Multicenter prospective randomized studies are needed to identify the more rational treatment strategies of these rare malignant tumors.

The effectiveness and limitations of the Risk of Malignancy Index in evaluation of adnexal masses / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate the effectiveness and limitations of the Risk of Malignancy Index (RMI) for discriminating malignant from benign adnexal masses. METHODS: This study was based on 382 women who have visited Korea University Hospital for surgical exploration of adnexal masses between July 2000 and December 2003. RMI was based on menopausal status, serum CA 125 levels, and ultrasound feature. A cutoff level of 200 was chosen as the threshold for discriminating malignant from benign adnexal masses. This setup was evaluated by sensitivity, specificity, positive predictive (PPV) and negative predictive values (NPV) with respect to the ability to distinguish malignant from benign adnexal masses. RESULTS: The sensitivity was 57.1%, specificity 93.3%, PPV 74.7% and NPV 86.3%. If stage I disease is considered "benign", the sensitivity was 95.1%, specificity 89.3%, PPV 52.7%, and NPV 99.3%. The statistical significance of RMI over other factors was proven. However, it had limitations of high false negative rate (68.4%) in stage 1 ovarian malignancy including borderline malignancy. Moreover, its relationship with RMI1, RMI2, and RMI3 had no statistical significance. CONCLUSION: RMI is a simple, easily applicable method for the primary evaluation of patients with adnexal masses and an effective method to selectively refer to an oncological unit for further management due to its relatively high specificity observed from this study. However this method has significant limitations in stage I ovarian malignancy including borderline malignancy. Other methods should be evaluated to increase the diagnostic accuracy.