Effectiveness of sacrospinous colpopexy in vault prolapse patients / 대한산부인과학회지

OBJECTIVE: To evaluate the effectiveness of sacrospinous colpopexy in vault prolapse patients. METHODS: It is the retrospective study including 10 vault prolapse patients who received sacrospinous colpopexy at St. Paul Hospital, the Catholic University from July 1999 to April 2004. RESULTS: The 10 patients receiving sacrospinous colpopexy had the average age of 58.9 years, and the parity of 3.4. They were moderately overweighted with average BMI of 24.5. The average period from hysterectomy to diagnosis of vault prolapse was 11.1 years. Hypertension was noted on most of patients (70.0%). The average operation time was 68.5 minutes and postoperative hemoglobin decrement was 2.4 on average. During 2-month period of postoperative follow-up, there were no significant complications noted except one case of wound infection associated with diabetes and one case of transfusion due to anemia. After sacrospinous colpopexy, protruding mass out of vagina was resolved on 100% and urologic and other complications were improved over 50% of cases. CONCLUSION: Considering that several underlying medical conditions such as hypertension, obesity are associated with vault prolapse patients, sacrospinous colpopexy in case of vault prolapse is an excellent operative approach with low complication and recurrence rates.

A Case of Parovarian Serous Cystadenocarcinoma of Borderline Malignancy / 대한산부인과학회잡지

Although parovarian cysts constitute 10-20% of all adnexal masses, malignant parovarian tumors are extremely rare. Due to the rarity of this lesion, there are controversies concerning the origin, clinical behavior, and prognosis of these tumors. Currently, it is suggested that these paovarian tumors should be treated similarly to their ovarian counterparts. We experienced one case of parovarian serous cystadenocarcinoma of borderline malignancy, and report this with a brief review of the literatures.

A Clinicopathologic Study of Immature Teratoma of the Ovary / 대한산부인과학회잡지

OBJECTIVE: In this retrospective study, we analyzed the clinical and pathological characteristics of immature teratoma of the ovary. METHODS: Between 1990 and 2003, 26 patients with immature teratoma of the ovary treated in the Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea were identified, and reviewed retrospectively for patient profiles, International Federation of Gynecologists and Obstetricians (FIGO) disease stage, mode of therapy, and length of survival. RESULTS: The mean and median age at diagnosis was 27.0 and 25.5 years (range 11-58 years), respectively. Tumors were 73.1% (19/26) stage I, 3.8% (1/26) stage II, 19.2% (5/26) stage III, and 3.8% (1/26) stage IV. Eighteen patients (69.2%) had pathologic grade 2 or 3. Twenty of 26 patients underwent the conservative surgery including unilateral salpingo-oophorectomy, unilateral oophorectomy or cystectomy, and other patients were performed the total abdominal hysterectomy with bilateral salpingo-oophorectomy. All except five patients received adjuvant combination chemotherapy. Second look operation following combination chemotherapy was done in nine cases. Two patients who had grade III tumors died. Follow-up was available for all the patients, with a mean duration of 43.9 months. No recurrence was observed during this period. CONCLUSION: Immature teratoma of the ovary is a potentially curable disease in today's practice. Low stage and low grade tumors have an excellent prognosis and conservative surgery and preservation of fertility is warranted in those cases.

Clinical Course of The Patient who Had the Gynecologic Operation Using Minilaparotomy / 대한산부인과학회잡지

OBJECTIVE: To evaluate the clinical course of the patient who had the gynecologic operation using minolaparotomy. METHODS: We reviewed the chart of the patient who had the gynecologic operation using minilaparotomy in department of obstetrics and gynecology of St. Mary's hospital during Jan. 2000 Sept. 2002. RESULTS: Postopertive diagnosis is myoma (154 cases), adenomyosis (41 cases), ovary cyst (89 cases) and so on. We had performed hysterectomy (225 cases), myomectomy (86 cases), cystectomy or adenexectomy (85 cases) for these patient. There is no significant difference in clinical course between two total hysterecomized groups, one who had the operation history and the other who had not the operation history. CONCLUSION: In gynecological operations, minilaparotomy is the useful methods in any kind of the indication of operation, and show good clinical course.

The Changes of Cell Cycle Regulatory Proteins Expression by AdCMVp53 in Cervical Cancer Cell Lines / 대한산부인과학회잡지

OBJECTIVE: In this study, we investigated the cell growth inhibition, regulation of cell cycle and induction of apoptosis through recombinant p53 adenoviral vector delivery into cervical cancer cell line SiHa, to explore the possibility of p53 gene therapy. METHODS: We infected SiHa with AdCMVp53 at 50 MOI. After 48 hours, the regulation of cell cycle and apoptosis were investigated with FACS. The gene expression profiling associated with cell cycle was also investigated with cell cycle DNA membrane chip. RESULTS: SiHa cells were arrested in the G1 phase by AdCMVp53 and showed cell growth inhibition via apoptosis. The gene expression profiles involved in cell cycle including cyclin-dependent kinase inhibitor 1C (p57, Kip2), RAD9 (S.pombe) homolog, and MAD2 (mitoticarrest deficient, yeast, homolog)-like 2 were up-regulated by more than three-fold, as compared to control group. In contrast, 6 genes such as retinoblastoma-like 2 (p130), and cyclin H were down-regulated by more than three-fold. Several genes known as being differentially up- or down-regulated compared to control were confirmed by RT-PCR and Western blotting assays. CONCLUSION: The adenoviral p53 gene delivery into cervical cancer cell line, suggesting the possibility of p53 gene therapy in cervical neoplasia make the cell growth inhibition and changes of cell cycle-associated gene expression.