Effect of Surgical Therapy on the Courses of Human Papillomavirus Infection in Cervical Intraepithelial Neoplasia / 대한산부인과학회잡지

OBJECTIVE: To investigate whether human papillomavirus (HPV) associated with cervical intraepithelial neoplasia was successfully eliminated after surgical therapy such as large loop excision of transformation zone (LLETZ) or type I extended hysterectomy. METHODS: Seventy four cervical intraepithelial neoplasia (CIN) patients with HPV infection who were admitted for LLETZ or type I extended hysterectomy were recruited into this prospective study. HPV infection was confirmed by HPV DNA genotyping using HPV DNA Chip (Biomedlab, Seoul, Korea) before and after surgical therapy. RESULTS: According to the assay used (HPV DNA Chip(R)) at the postoperative visit, 82.5% of treated patients were completely free from HPV infection. And there was no statistical difference between LLETZ and type I extended hysterectomy (p=0.452). However, there was persistent infection in 17.5% of treated patients after final surgical therapy. CONCLUSION: Although the HPV infection associated with CIN was effectively eliminated after LLETZ and type I extended hysterectomy, there was persistent infection in 17.5% of treated patients. Therefore, the careful followed-up examination of HPV infection should be taken in these patients.

Imaging Diagnosis of Fetal Abdominal Solid Tumor / 대한산부인과학회잡지

OBJECTIVE: Ultrasonography is screening modality of choice and plays an important role in prenatal diagnosis of various diseases and neoplasm of fetus. Recently, Magnetic Resonance Imaging was used as a diagnosis tool to fetal disease. We would like to evaluate efficacy of ultrasonography and magnetic resonance imaging for the diagnosis of fetal abdominal solid tumor. METHODS: Among 2,055 cases of abnormal ultrasonography findings detected by prenatal ultrasonography from January 1996 and June 2002, a comparison between the diagnosis made by prenatal ultrasonography, fetal magnetic resonance imaging (MRI), postnatal radiological studies and histopathologic studies was made in four cases with fetal abdominal solid tumor. RESULTS: The first case was diagnosed as adrenal tumor or hepatic tumor by US, hemangioedothelioma of liver by fetal MRI, and confirmed as hemangioendothelioma postnatally. The second case showed concordance with mesoblastic nephroma among the diagnosis made by US, fetal MRI, and postnatal histopathologic studies. The third case was diagnosed as extrathoracic pulmonary sequestration by US and MRI, and the same diagnosis was made by postnatal histopathologic studies. The fourth case was suspected as kidney tumor by US and was diagnosed as adrenal as adrenal neuroblastoma postoperatively. CONCLUSION: Fetal solid tumor is not a common disorder, but the location, size and orgin of tumor plays important role in the prognosis of neonatal period; additional workup by fetal MRI would improve the diagnosis of such tumors.

Comparison of Burch Colposuspension, Pubovaginal Sling Operation and Tension-Free Vaginal Tape for Surgical Treatment of Stress Urinary Incontinence In Women / 대한산부인과학회잡지

OBJECTIVE: The object of this study was to compare the cure rate and confirm the clinical efficacy of three most frequent surgical procedures for stress urinary incontinence (Burch colposuspension, pubovaginal sling operation, tension-free vaginal tape). MATERIALS AND METHODS: We collected datas from the records of ninety-one patients who were diagnosed as stress urinary incontinence from Jan. 1999 to May 2001. Burch colposuspension was performed by department of gynecology, Severance hospital in thirty-three patients, pubovaginal sling operation was performed by department of urology in twenty-eight patients, and tension-free vaginal tape was performed by department of urology in thirty-one patients. We investigated the characteristics of patients, preoperative urodynamic study results, cure rates and complication rates for the result, and compared them by x2-test. RESULTS: There were statistically no significant differences between the cure rate of each operation after 3, 6 month of operation but after 12 months of follow up, the cure rate of pubovaginal sling operation was significantly higher than that of Burch operation and tension-free vaginal tape. CONCLUSION: The cure rate of pubovaginal sling operation was significantly higher after 12 months of follow up after surgery. There was no significant difference between cure rates of Burch operation and tension- free vaginal tape. We propose randomized prospective study with larger population in the future.

A Case of Persistent Cloaca with Hydrocolpos / 대한산부인과학회잡지

Persistent cloaca is a very rare congenital anomaly with a single common perineal opening for the genital, urinary and gastrointestinal tracts, which arises from defects in the embryonal process of descent of urorectal septum or fusion to cloacal membrane. Anomalies associated with persistent cloaca are found in the upper urinary tract, gastrointestinal tract, cardiovascular system, central nervous system and respiratory system, which are not easily detected through ultrasound during pregnancy. It has been reported that if those anomalies are diagnosed early, they can be corrected surgically. We present a case of persistent cloaca with hydrocolpos confirmed by autopsy after emergency cesarean section which was initially presented as a huge abdominal cystic mass and bilateral hydronephrosis by ultrasound at 34 weeks of gestation.