Percutaneous vertebroplasty at C7 for the treatment of painful metastases: A case report / 대한마취과학회지

The cervical spine is a less common site for metastatic disease than is the thoracolumbar spine. Percutaneous vertebroplasty (PVP) in the cervical spine can be performed using an anteromedial or lateral approach. A 51-year-old woman with breast cancer had been experiencing severe weight-bearing neck pain for 2 months, even after undergoing radiation therapy. Imaging studies revealed an osteolytic compression fracture in the C7 vertebra. For performing PVP at C7 using the anteromedial approach, a needle was inserted from the left side of the patient's neck. The needle was advanced to the anterior 1/3 anterior 1/3 or 1/2 of the vertebral body by hammering, and approximately 2 ml of cement was injected. Immediately after the operation, the patient could move her neck without pain. In conclusion, PVP using an anterolateral approach may be an option for treating metastatic osteolytic vertebral lesions in the cervical spine for alleviating intractable axial neck pain.

Clinical review of abnormal cervical cytology in pregnancy / 대한주산의학회잡지

PURPOSE: This study was performed to evaluate the clinical significance of abnormal cervical cytology in pregnancy and the effectiveness of cytologic and colposcopic surveillance of these women. METHODS: A retrospective analysis was conducted in pregnant women referred to the colposcopic clinic with abnormal cervical cytologic results above ASCUS between Jan. 2002 and Dec. 2007. The Initial colposcopy was performed at the end of 1st trimester. Cervical cytology and colposcopy were repeated once or twice during remaining period of pregnancy and at postpartum 6~8 weeks. Colposcopy directed cervical biopsies were taken in case of colposcopic abnormalities. Without evidence of invasion, no invasive procedure was attempted during pregnancy. Above CIN2 patients were treated postnatally. The postpartum diagnoses were compared to the worst antepartum impressions and initial cytologies. RESULTS: One hundred three pregnant women were referred to colposcopic clinic for 5 years. There was no invasive cervical cancer antenatally. After delivery, 53 patients were followed up and 17 patients above CIN2 lesions treated. Two microinvasive squamous cell carcinoma and 1 invasive adenocarcinoma were found postnatally. In 33 initial ASCUS cytologies, there were 7 CIN2,3 lesions and 3 invasive cancers. One CIN3 was found in 13 LSIL cytologies. All 7 HSIL patients had CIN3 lesions. There were 2 microinvasive cancers postnatally in 17 antenatal CIN2,3 patients. CONCLUSION: ASCUS cervical cytologic results in pregnancy have 30% possibility of CIN2,3 and cancer. LSIL results are normal in 85% and HSIL group 100% CIN3. Even though there is 12.5% risk of microinvasion in antenatal CIN2,3 lesions, noninvasive conservative management is reasonable.

Clinical Comparison of Maternal Characteristics and Pregnancy Outcomes between Gestational Diabetes and General Obstetric Population / 대한산부인과학회잡지

OBJECTIVE: To compare maternal characteristics and pregnancy outcomes in a group of women with gestational diabetes mellitus(GDM) diagnosed in our hospital with those of women without this disorder. MATERIALS AND METHOD: This is a retrospective study of 402 gestational diabetic women with singleton cephalic presenting pregnancies delivered at Ilsin Christian Hospital during the period January 1, 1997, through December 31, 1999. National Diabetes Data Group thresholds were used to diagnose gestational diabetes. Women in this group were compared with a nondiabetic control group(n=430) randomly selected and effects of confounding variables were analyzed using stratified analysis. RESULTS: Prevalence of GDM was 2.36%. Women with gestational diabetes were significantly older, heavier, of greater parity and more often had the following risk factors for GDM. Hypertension, cesarean delivery, macrosomia, and large for gestational age(LGA) rate were significantly increased. The adequate treatment group diagnosed before 32wks and received glucose control was compared with a inadequate treatment group. And there was no significant difference in maternal characteristics and pregnancy outcomes between the two groups. Within the adequate treatment group, three groups were subdivided by birth weight as SGA(small for gestational age), AGA(appropriate for gestational age) and LGA. The group with LGA had no difference in age, parity, pregnancy-induced hypertension, 2hr mean postprandial glucose level except body mass index and insulin treatment rate. After adjusting these two factors with stratified analysis, there was no general association between birth weight and glucose level(p=0.342). CONCLUSIONS: Maternal characteristics of gestational diabetes were significantly different compared with those of nondiabetic women. Pregnancy outcomes of gestational diabetic women were not improved by our conventional management and more intensified but acceptable and compliable treatment should be tried.

A Case of Primary Choriocarcinoma of The Fallopian Tube / 대한부인종양콜포스코피학회잡지

Choriocarcinoma is a relatively rare malignancy of which characteristic is rapid metastasis to the other organs. It is related to the previous gestation or originated from the teratoma. Choriocarcinoma is mostly originated from the intrauterine chorionic villi, but it is rarely originated from the utreine cervix, fallopian tube, ovary, vagina and pelvic cavity. Primary choriocarcinoma of the fallopian tube is exceedingly rare and it is originated from ectopic tubal pregnancy, tubal migration from the intrauterine pregnancy or intratubal teratoma. 9 Symptoms and signs of the choriocarcinoma originated from the ectopic pregnancy are abdominal pain, vaginal bleeding, palpable adnexal mass, positive pregnancy test and amenorrhea. Thus it is difficult to distinguish choriocarcinoma from ectopic pregnancy on the basis of symptoms before the microscopic diagnosis presented.20 Effective treatment of choriocarcinoma is chemotherapy. Additional operation is possible. B-HCG is a useful measure for the follow up. We experienced a 36-year-old multigravida Korean woman who was diagnosed as the rupture of ectopic pregnancy after left salpingectomy in our hospital and then confirmed primary choriocarcinoma of the fallopian tube without metastasis on microscopic finding. Postoperative chemotherapy was performed with methotrexate. The follow up of disease is still on going at two month intervals and she has remained healthy, We report this case with review of literatures.

Prenatal cytogenic study by midtrimester amniocentensis / 대한산부인과학회잡지

No abstract available.