A case of metastatic ovarian carcinoma originated from small cell lung carcinoma / 대한산부인과학회지

Approximately 5% to 22% of malignant tumors involving the ovary are metastases, and the carcinomas of the gastrointestinal tract are responsible for 81% to 88% of these cases. A lung cancer, one of the most common malignancies and well known to metastasize widely, rarely metastasize to the ovary. There has been no report on small cell lung cancer metastasized to the ovary in Korea. Recently, we experienced a case of metastatic ovarian cancer originated from small cell lung cancer in 46-year-old Korean woman with which is confirmed with the immunohistochemistry. Herein we report the case with brief review of literature.

Endometrial Stromal Sarcomas: A Retrospective Analysis of 28 Patients, Single Center Experience for 20 Years / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of this study was to evaluate the behavior of endometrial stromal sarcomas (ESSs) in relation to their clinical and pathogenic features, and to determine the optimal treatment strategy. MATERIALS AND METHODS: A retrospective analysis was performed involving 28 patients with histologic-proven ESSs treated at our institution between 1987 and 2006. RESULTS: The median follow-up was 54.7+/-63.1 months and the 5-year survival rate was 82.0%. Twenty-two (81.5%) and 5 patients (18.5%) had low- and high-grade disease, respectively. Univariate analysis revealed that the histologic grades, based on mitotic count, were associated with longer survival (p=0.004). However, among those patients with low-grade tumors, 5/20 patients (25%) had a recurrence and 2/21 patients (9.5%) had distant metastasis during the follow-up period. With the exception of 2 patients, 26 patients with ESSs underwent hysterectomy as primary treatment. Adjuvant treatment after surgery was administered to 14/26 patients (53.8%). Hormone therapy with progesterone, chemotherapy, and/or radiotherapy did not influence overall survival. However, the postoperative adjuvant therapy group, regardless of the treatment modality, was associated with relatively increased overall survival when compared to the surgery only group (p=0.054). CONCLUSION: The preoperative differential diagnosis of ESSs from other benign gynecologic diseases is often difficult. We recommend adjuvant therapy be administered after hysterectomy in patients with ESS to prevent recurrence or distant metastasis.

Expression of the p16(INK4a) and Ki-67 in relation to the grade of cervical intraepithelial neoplasia and high-risk human papillomavirus infection / 부인종양

OBJECTIVE: The purposes of this study were to evaluate the expression of p16(INK4a) (referred as to p16) and Ki-67 in cervical intraepithelial neoplasia (CIN), and the correlation between high-risk human papillomavirus (HPV) infection and the above biomarkers. METHODS: We analyzed 31 patients who were diagnosed with CIN at Kwandong University Myongji Hospital from October 2006 to September 2007. CIN specimens (CIN1, 12; CIN2, 6; CIN3, 13) were obtained by colposcopy-directed biopsy (CDB) or loop electrical excision procedure (LEEP). The expressions of p16 and Ki-67 were evaluated by immunohistochemical methods with antibodies to p16 and Ki67. The immunohistochemical staining results were classified into four grades: 0, 1, 2 and 3. HPV genotyping or Hybrid Capture-II test was used to detect high-risk HPV. RESULTS: The expression of p16 (p<0.001) and Ki-67 (p=0.003) were positively associated with CIN grade. p16 expressions increased significantly with high-risk HPV infection (p=0.014), especially HPV type 16 and 58. Ki-67 expression was not related with high-risk HPV. There was positive correlation between the expression of the p16 and Ki-67 (p=0.007). CONCLUSION: CIN grade were positively related to the expression of p16 and Ki-67. p16 expressions of high-risk HPV specimens significantly increased more than Ki-67. Therefore, in the diagnosis of CIN and high-risk HPV infection, p16 can be a useful biomarker.

A Case of Intramural Pregnancy / 대한산부인과학회잡지

Intramural pregnancy is among the rarest forms of ectopic pregnancy. Since it has been first reported by Doederlein in 1913, 37 cases were reported in worldwide literatures. The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament. Because of the difficult early diagnosis of intramural pregnancy, most cases were found after the onset of complications such as uterine rupture, shock and hemoperitoneum. Early detection of intramural pregnancy with the use of transvaginal ultrasonogram is important, and MRI is a useful, noninvasive imaging modality. We report a case of successful conservative chemotherapy for a intramural pregnancy with brief review of literatures.

Rapid Prenatal Diagnosis of Trisomy 21 by Real-Time Quantitative Polymerase Chain Reaction / 대한산부인과학회잡지

OBJECTIVE: Trisomy 21 (Down syndrome) is the most common chromosomal anomaly which occurs 1 out of 700-1000 birth. Current techniques such as amniocentesis, chorionic villi sampling (CVS), require lengthy laboratory culture procedures and high costs. This study was undertaken to establish a rapid prenatal diagnosis of trisomy 21 using real-time quantitative polymerase chain reaction of fetal DNA from amniotic fluid. METHODS: Real-time quantitative PCR was performed with DNA template obtained from 14 normal serum, 10 normal amniotic fluid samples, 14 Down syndrome serum, and 7 Down syndrome amniotic fluid samples. Primers for D21S167 and S100B of chromosome 21 were used. Primers that direct amplification of 165-bp fragment of the IGFI (Insulin-like growth factor-1) gene on chromosome 12 are included to generate an internal standard for quantitation. RESULTS: The relative levels of D21S167 and S100B were 2.6 and 2.4 times higher in the serum of Down syndrome patients compared to the control group. The difference between these two groups was statistically significant (P-value: 0.0012 and 0.0016). The relative levels of D21S167 and S100B were 2.1 and 2.7 times higher in the amniotic fluid of Down syndrome fetuses compared to control group. The difference between these two groups was statistically significant (P-value 0.0379 respectively). CONCLUSION: Prenatal diagnosis of trisomy 21 by real-time quantitative PCR-associated STR (small tandem repeats) analysis of D21S167 and S100B is useful, accurate and rapid diagnostic method and also can be employed in diagnosis of trisomy 13, 18. Furthermore, it may also be useful for prenatal diagnosis with fetal DNA from maternal blood and for preimplantation genetic diagnosis.

Clinical Usefulness of Fluorescence in Situ Hybridization (FISH) in the Diagnosis of Genetic disease / 대한산부인과학회잡지

INTRODUCTION: The traditional cytogenetic analysis requires relatively long cell culture time, intensive labour and trained personnel. But, in clinical situations, rapid diagnosis of genetic disease is very important for urgent decision for future management. So we need more rapid and precise diagnostic tools for clinical genetic counselling. The fluorescence in situ hybridization (FISH) has been studied for detecting chromosomal aneuploidies because this method can get rapid and precise results of cytogenetic studies. OBJECTIVE: To evaluate the clinical utility of fluorescence in situ hybridization technique as a diagnostic tool of chromosomal anomaly. METHODS: Peripheral blood or gonadal tissue were obtained from the patients (n=63) clinically suspicious of genetic disease. Chorionic villi (n=6), amniotic fluid (n=9), and fetal cord blood (n=2) were obtained from 15 pregnancies undergoing fetal karyotyping at 9 to 30 weeks of gestation for prenatal genetic counselling. Karyotyping was performed by both traditional cytogenetics and FISH, using commercially available kits. After the procedures, the results of FISH were compared with the results of traditional cytogenetic studies. RESULTS: In a blind series of 17 samples all, including trisomy 21 (1 case), trisomy 18 (1 case), monosomyX (1 case), 47,XYY (1 case), and 47,XXY (1 case), were correctly identified. FISH results were correspondent with conventional karyotyping results in 7 patients with intersex except one case of suspicious of mosaicism. In nine children of Turner syndrome, the results of two methods were correspondent too. There was a fluorescent signal defect in band 15 q11-q13 in one of chromosome 15 in 18 children of 29 patients, clinically suspicious of Prader-Willi syndrome, with FISH method and only four patients were diagnosed as Prader-Willi syndrome with G-banding microscope. It was impossible to identify the defect in chromosome 15 q11-q13 in 10 (34%) children by both methods. Two children of 11 patients, clinically suspicious of Angelman syndrome, were diagnosed as Angelman syndrome with both method respectively. And four children were diagnosed as Angelman syndrome only with FISH method. In 5 cases, we cannot detect the defect in chromosome 15 q11-q13 with both methods. In four cases of Williams syndrome, the results of both methods were as follows; 1 case (25%): diagnosed as Williams syndrome by both methods; 2 cases (50%): diagnosed

The clinical significance of ASCUS and AGUS in Pap smear / 대한부인종양콜포스코피학회잡지

OBJECTIVE: This study was undertaken to evaluate the clinical significance of ASCUS and AGUS in routine Papanicolaou smears. METHOD: A review of retrospective medical records was conducted on 267 women whose Papanicolaou smears yielded diagnoses of either ASCUS or AGUS from March, 1998 to December, 2000 at Youngdong Severance Hospital. RESULT: The incidences of ASCUS and AGUS on PAP smears are 1.3%(258 cases) and 0.1%(23 cases). Of these, 89 cases with ASCUS and 9 cases with AGUS had subsequent cervical biopsies. The biopsy cases with ASCUS showed 68(74.4%) cervicitis, 2(2.2%) hyperkeratosis, 1(1.1%) condyloma, 9(9.9%) CIN 1, 5(5.5%) CIN 2, 1(1.1%) CIN 3, 2(2.2%) microinvasive squamous cell carcinoma and 1(1.1%) adenocarcinoma. Those with AGUS showed 6(6.6%) cervicitis, 1(1.1%) CIN 2, 1(1.1%) CIN 3, 1(1.1%) endometrial cancer. Women under 35 year-old(P=0.012) or who had coital history in younger periods(before 20 years old, P=0.014) had much higher frequency of high grade lesion. The overall incidence of HSIL was higher in the group with ASCUS favoring SIL than in the group with unqualified ASCUS. (P=0.042) The group with AGUS also had much higher frequency of high grade lesion than the group with ASCUS. (P=0.043) CONCLUSION: Immediate colposopic evaluation should be performed for AGUS and ASCUS favoring SIL. Regarding ASCUS, high risk patients who are under 35 years old or who have early coital history(< 20 yrears old) also should undergo colposcopic examination. With the exception of the aboves, we propose HPV screening and HPV DNA testing for intermediate screening test.

Peripheral neuropathies in patients with pneumoconiosis: electrodiagnostic study and approach to its etiologies

No abstract available.