An Unusual Relapse of Acute Lymphoblastic Leukemia in the Uterine Corpus / 대한산부인과학회잡지

The relapse of leukemia is usually classified as hematologic relapse and extramedullary relapse. The most common sites of clinical extramedullary relapse are the central nervous systems (CNS) and gonads. However, the relapse in the uterus is very rare. We experienced a very unusual case of uterine relapse of acute lymphoblastic leukemia (ALL) after about a 6-year remission period. This female patient returned to our hospital with a two-month history of amenorrhea. Pelvic radiology confirmed an about 7 cm sized ill-defined ovoid mass in the uterus. There was no evidence of ALL relapse in the peripheral blood or CNS. The uterine biopsy showed diffused homogenous infiltration of numerous small round cells in uterine corpus, suggesting ALL relapse. The bone marrow study revealed 100% cellularity, most of which were lymphoblasts. Our patient received the bone marrow transplantation (BMT) and achieved the second complete remission (CR). Therefore, we here report our case with a brief review of literature.

Flow Cytometric Detection of Apoptosis and p53 Protein in OVCAR-3 and SKOV-3 Ovarian Cancer Cell Lines / 대한산부인과학회잡지

OBJECTIVE: Taxol (paclitaxel)-induced apoptosis was studied to understand their biological mechanism correlated with the expression of p53 in the SKOV-3 and OVCAR-3 ovarian cancer cell lines. MATERIALS AND METHODS: The SKOV-3 and OVCAR-3 cell lines were cultured in RPMI 1640 medium without taxol (control group) and with taxol for 24 h and 48 h (experimental group). After harvest, the cells were stained with annexin V-FITC (fluorescein isothiocyanate) and anti-cytokeratin antibodies (clone CAM5.2 and clone MNF116). They were washed and stained with p53 antibody. After then the secondary antibodies, i.e., FITC- or phycoerythrin (PE)-conjugated goat anti-mouse (GAM) immunoglobulin G (GAM IgG-FITC or GAM IgG-PE) were added in the cells and they were incubated in the dark. DNA of these cells were stained sequentially with propidium iodide (PI). Standard FACScan equipped with a 488 nm single laser was used for the analysis of these cells. RESULTS: Both of SKOV-3 and OVCAR-3 cell lines were arrested in the G2M phase after treatment of taxol, suggesting that these cells would eventually enter into the stage of cell death. Fractions of negative cytokeratin and positive annexin V and amount of sub-G0G1 fraction indicative of apototic fractions were lower in the SKOV-3 cell line compared with that in OVCAR-3 cell line, probably as a result of lower sensitivity of SKOV-3 cell line to the taxol. p53 expression were not detected in SKOV-3 cell line. On the basis of observed findings in SKOV-3 cell line and findings of high expressions of p53 regardless of taxol treatment, no increases in their expressions according to culturing time, and gradual increases in sub-G0G1 fractions and in fractions of negative cytokeratin and positive annexin V indicative of apoptosis in OVCAR-3 cell line, we concluded that the expression of p53 would not be associated with cell cycle changes and the arrest in the G2M pahse but associated with the appearance of apotosis. CONCLUSION: Our results suggest that flow cytometric detection of the apoptotic fractions would be an effective, fast, and accurate method for the chemosensitivity test in tumor cells before the administration of anti-cancer drugs in gynecologic cancer patients.

A Clinical Study on 1594 Cases of Operative and Diagnostic Laparoscopy / 대한산부인과학회잡지

OBJECTIVE: Laparoscopic surgery provides patients with the benefits of shortened hospital stay and faster return to normal activity. The objective is to evaluate the efficacy of laparoscopic surgery in gynecologic patients. METHODS: From January, 1999 to December, 2002, total 1594 patients were performed laparoscopic surgery at Uijongbu St. Mary's Hospital. We reviewed the medical record and analyzed these cases about age, parity, diagnosis, name of operation, operation time, duration of hospitalization and side effect. RESULTS: The results of this study summarized as follows: 1. The mean age of patients was 34.0 years old and the great incidence occurred in 26-30 years old group (24.7%). 2. The average parity of patients was 1.05. 3. The common indications were ovarian cyst (34.4%), myoma uteri (19.1%), infertility (9.5%), ectopic pregnancy (15.0%), etc. In diagnostic pelviscopy, the most common indication was infertility (50.6%), and ovarian cyst (38.3%) was the most common indication in operative pelviscopy. 4. The major types of operative pelviscopy were cystectomy, LAVH, TLH, salpingectomy, adnexectomy, electrocauterization. 5. The mean duration of hospitalization was 3.72 days. 6. The major complication of surgery were intestinal injury, postoperative paralytic ileus, bleeding at resection site, but they were controlled without difficulty. CONCLUSION: Pelviscopic surgery is useful and recommended for the treatment of gynecologic disease, because this is safe and has many advantages.

A case of Necrotizing Fascitis after Cesarean Section / 대한산부인과학회잡지

The necrotizing fascitis, that develops after a Cesarean section, is acknowledged as a rare complication due to the development of antibiotics. Having a very high mortality rate, the only way to prevent the septic shock and the impairment of the cardiopulomary function is the use of adequate antibiotics, the infusion of IV fluids, a radical section of the necrotized fascia and a through cleansing. We have an experience in treating a primipara who had a necrotic fascitis after Cesarean section, and therefore, report this case with the review of articles enclosed.

A case of Neuroblastoma Diagnosed by Prenatal Ultrasonography / 대한산부인과학회잡지

We report a case that a neuroblastoma in a fetus was recognized before birth and its growth could be observed. The diagnosis was made by ultrasonography. The suprarenal mass initially showed pure cystic features on ultrasound. Surgical exploration revealed an adrenal cystic tumor and histology showed a neuroblastoma in situ. Forty-five infants with prenatally detected neuroblastoma were found in the English literature; about one-half of them were cystic neuroblastomas and most had a favorable outcome.