The Differences in Second Trimester Quad Test Markers in Patients with Severe Preeclampsia Depending on the Disease Onset Time and the Presence of Fetal Growth Restriction / 대한주산의학회잡지

OBJECTIVE: To compare the differences in the second trimester Quad test markers in patients who subsequently developed preeclampsia depending on the disease onset time and the presence of fetal growth restriction (FGR). METHODS: A retrospective study was carried out on 66 women with severe preeclampsia and 345 controls who were delivered at Dong-A University hospital and Ilsin Christian Hospital from January 2006 to December 2008. Severe preeclampsia patients were grouped according to with (n=30) or without (n=36) FGR. Severe preeclampsia patients were also grouped according to early onset (n=16) or late onset (n=50) The levels of the second trimester human chorionic gonadotropin (hCG), inhibin-A, unconjugated estriol (uE3), alpha-fetoprotein (AFP) were compared in each group. RESULTS: In the pregnancies that subsequently developed severe preeclampsia, the second trimester hCG, inhibin-A and AFP were significantly higher than the controls. We found that levels of hCG, inhibin-A in severe preeclampsia complicated by FGR were significantly higher than those without FGR. We also found that levels of AFP and inhibin-A in early onset severe preeclampsia were significantly higher than late onset severe preeclampsia. CONCLUSION: The levels of second trimester Quad test markers in patients that subsequently developed severe preeclampsia were different according to with or without FGR and onset time.

Declining concentrations of dehydroepiandrosterone sulfate and free testosterone with advancing age / 대한산부인과학회지

OBJECTIVE: To investigate the relationship between serum dehydroepiandrosterone sulfate (DHEAS) or free testosterone (FT) levels and aging. METHODS:One hundred and thirty one women without androgen excess symptoms such as oligomenorrhea or amenorrhea or hirsutism were recruited for measuring serum DHEAS, FT levels by radioimmunoassay. A P-value <0.05 was considered to be significant statistically. RESULTS: The levels of DHEAS were 211.39+/-33.01 microg/dL (twenties, n=10), 127.99+/-11.79 microg/dL (thirties, n=31), 94.30+/-7.49 microg/dL (forties, n=57) and 71.79+/-5.71 microg/dL (over fifties, n=33) respectively (mean+/-SE, P<0.001). The levels of FT were 3.98+/-0.94 pg/ml (twenties, n=10), 3.37+/-0.47 pg/mL (thirties, n=31), 2.68+/-0.30 pg/mL (forties, n=57) and 1.97+/-0.28 pg/mL (fifties, n=33) respectively (mean+/-SE, P=0.030). Mean value declining of DHEAS (r=-0.48865, P<0.0001) was bigger than those of FT (r=-0.29334, P<0.0007). CONCLUSION: Both DHEAS and FT levels decline with age and DHEAS decreases more steeply than FT.

Declining concentrations of dehydroepiandrosterone sulfate and free testosterone with advancing age / 대한산부인과학회지

OBJECTIVE: To investigate the relationship between serum dehydroepiandrosterone sulfate (DHEAS) or free testosterone (FT) levels and aging. METHODS:One hundred and thirty one women without androgen excess symptoms such as oligomenorrhea or amenorrhea or hirsutism were recruited for measuring serum DHEAS, FT levels by radioimmunoassay. A P-value <0.05 was considered to be significant statistically. RESULTS: The levels of DHEAS were 211.39+/-33.01 microg/dL (twenties, n=10), 127.99+/-11.79 microg/dL (thirties, n=31), 94.30+/-7.49 microg/dL (forties, n=57) and 71.79+/-5.71 microg/dL (over fifties, n=33) respectively (mean+/-SE, P<0.001). The levels of FT were 3.98+/-0.94 pg/ml (twenties, n=10), 3.37+/-0.47 pg/mL (thirties, n=31), 2.68+/-0.30 pg/mL (forties, n=57) and 1.97+/-0.28 pg/mL (fifties, n=33) respectively (mean+/-SE, P=0.030). Mean value declining of DHEAS (r=-0.48865, P<0.0001) was bigger than those of FT (r=-0.29334, P<0.0007). CONCLUSION: Both DHEAS and FT levels decline with age and DHEAS decreases more steeply than FT.

A case of successfully resected retroperitoneal hemangiopericytoma / 대한산부인과학회지

Hemangiopericytoma is a rare mesenchymal neoplasm, accounting for about 1% of vascular tumor. Hemangiopericytoma is known to be derived from the vascular pericyte and occurs most commonly lower extremities, pelvis and retroperitoneum. Surgical radical excision is the treatment of choice. Because of malignant features of hemangiopericytoma, long term and close follow-up is important. We report a case of successfully resected retroperitoneal hemangiopericytoma.

Two cases of malignant mesothelioma of the peritoneum and pericardium / 대한산부인과학회지

Malignant mesothelioma is a rare neoplasm and arises from the serosal lining of the pleural, peritoneal and pericardial cavities. The median survival rang from 5 to 12 months, mainly because of lack of effective treatment. The incidence is approximately one per 1,000,000 and peritoneal mesothelioma represents one fourth of all mesotheliomas. There is a relationship between mesothelioma and asbestos exposure, but non-asbestos related cases were reported. Treatments of malignant mesothelioma are cytoreductive surgery and adjuvant chemotherapy, but current treatment options are unsatisfactory. We report two cases of malignant mesothelioma of the peritoneum and pericardium treated by operation and adjuvant chemotherapy with a brief review of literature.

Two cases of malignant mesothelioma of the peritoneum and pericardium / 대한산부인과학회지

Malignant mesothelioma is a rare neoplasm and arises from the serosal lining of the pleural, peritoneal and pericardial cavities. The median survival rang from 5 to 12 months, mainly because of lack of effective treatment. The incidence is approximately one per 1,000,000 and peritoneal mesothelioma represents one fourth of all mesotheliomas. There is a relationship between mesothelioma and asbestos exposure, but non-asbestos related cases were reported. Treatments of malignant mesothelioma are cytoreductive surgery and adjuvant chemotherapy, but current treatment options are unsatisfactory. We report two cases of malignant mesothelioma of the peritoneum and pericardium treated by operation and adjuvant chemotherapy with a brief review of literature.

A case of successfully resected suburethral endometriosis with dysuria / 대한산부인과학회지

Urinary tract endometriosis is rare, especially suburethral endometriosis with symptoms of dysuria and urgency is very rare. We report a case of successful surgically treated suburethral endometriosis through the Retzius space.

Two cases of thromboembolism in clear cell ovarian adenocarcinoma / 대한산부인과학회지

High incidence of deep venous thrombosis after radical pelvic surgery is well known. Among gynecologic malignancies, ovarian cancer, especially clear cell adenocarcinoma is likely to develop thromboembolism. We report 2 cases of pulmonary thromboembolism and deep vein thrombosis in ovarian clear cell carcinoma with endometriosis and history of IVF-ET during cislatin-irinotecan chemotherapy following the surgery.

The efficacy of concurrent cisplatin and 5-flurouracil chemotherapy and radiation therapy for locally advanced cancer of the uterine cervix / 부인종양

OBJECTIVE: To evaluate the efficacy of concurrent chemoradiation (CCRT) using 5-flurouracil (5-FU) and cisplatin for locally advanced cervical cancer. METHODS: We reviewed the medical records of 57 patients with locally advanced cervical cancer (stage IIB-IVA and bulky IB2-IIA tumor) who underwent the CCRT at Dong-A University Hospital from January 1997 to June 2007. The CCRT consisted of 5-FU, cisplatin and pelvic radiation. Every three weeks, 75 mg/m(2) cisplatin was administered on the first day of each cycle and 5-FU was infused at the dose of 1,000 mg/m(2)/d from the second day to the fifth day of each cycle. Radiation was administered to the pelvis at a daily dose of 1.8 Gy for five days per week until a medium accumulated dose reached to 50.4 Gy. If necessary, the radiation field was extended to include paraaortic lymph nodes. Consolidation chemotherapy was performed using 5-FU and cisplatin. RESULTS: Fifty-seven patients were enrolled and the median follow-up duration was 53 months (range 7-120 months). The overall response rate was 91.5% (74% complete response and 17.5% partial response). The 5-year overall survival and 3-year progression free survival rates were 69.4% and 74.9%, respectively. During the follow-up period (median 23 months, range 7-60 months), fourteen patients were diagnosed as recurrent disease. CONCLUSION: CCRT with 5-FU and cisplatin which is the primary treatment for patients with locally advanced cervical cancer was effective and well tolerated.

The efficacy of MRI to diagnosis the bladder and rectal invasion in cervical cancer / 부인종양

OBJECTIVE: To evaluate the efficacy of MRI in bladder or rectal invasion of cervical cancer. METHODS: Between January 2000 and December 2005, 106 cervical cancer patients who underwent cystoscopy or sigmoidoscopy examination retrospectively compared with results of the MRI finding. A 5-point invasion score was used to determine bladder or rectal invasion in MRI (1 = no invasion, 3 = serosal invasion, 5 = definite mucosal invasion). Score of 3 or above was suspicious for both rectal and bladder invasion. RESULTS: Eighty one patients with negative for both rectal and bladder invasion in MRI were normal in cystoscopy and sigmoidoscopy. MRI identified 17 patients with suspected bladder invasion, 7 patients had confirmed bladder invasion in cystoscopy. MRI identified 11 patients with suspected rectal invasion, 1 patients had confirmed rectal invasion in sigmoidoscopy. The detection of rectal and bladder invasion by MRI had a negative predictive value of 100%. CONCLUSION: The use of a 5-point scoring system for predicting rectal or bladder invasion in MRI is accurate in detecting cervical cancer patients with no evidence of rectal or bladder invasion. The cervical cancer patients with no evidence of rectal or bladder invasion in MRI can obviate invasive cystoscopy and sigmoidoscopy.

Efficacy of loop conization with right-angled triangular shaped excisor in patients with cervical intraepithelial neoplasia 3 / 부인종양

OBJECTIVE: To evaluate the therapeutic value of conization using right-angled triangular shape loop cone biopsy excisor in patients with CIN 3 who want preserve the uterus. METHODS: A retrospective review of 64 patients was performed who underwent therapeutic conization for CIN 3 by using right-angled triangular shape loop cone biopsy excisor from January 2000 to August 2005. RESULTS: The mean duration of 64 follow-up patients who had conization for therapeutic purpose was 21.5 months (range 10-68). Their mean age was 41.1 years old and mean parity was 1.7. Two of 64 patients had CIN 3 on exocervix margin. During the followed up period, only one person (1/64) had relapse of CIN 3, hence, a simple hysterectomy was done. CONCLUSION: Right-angled triangular shape loop cone biopsy excisor is more effective than U-shaped loop with low rate of margin positive and recurrent rate in conservative treatment in CIN 3 patients who want to preserve uterus or fertility.

A Case of Ovarian Mucinous Borderline tumor in Postoperatively Diagnosed Dermatomyositis accompanying Colon Cancer / 대한산부인과학회지

Dermatomyositis is rare inflammatory condition of the skin and muscles that the incidence is 5 cases per million population per year. This disease was strongly associated with malignant disease, particularly ovarian, lung, pancreatic, stomach and colorectal cancers, and non-Hodgkins lymphoma. A 56-year-old female patient had a ovarian tumor, thereafter she presented with typical skin lesions and muscle weakness. And then we found she had a colon cancer. Here we present the case with brief review of literature.

Analysis of prognostic factor and survival in patients with epithelial ovarian cancer treated with combination chemotherapy / 부인종양

OBJECTIVE: The purpose of this retrospective study is to identify and to discuss the clinical relevance of prognostic factors and survival rate in patients with epithelial ovarian cancer treated with combination chemotherapy. METHODS: A total of 98 histologically verified patients with epithelial ovarian cancer who were treated at Dong-A Medical Center between 1997 and 2002 were used for analysis. The 30 patients having borderline tumor were excluded. Kaplan-Meier survival curves were computed and tested statistically by the log rank test. A multivariable Cox proportional hazard model was applied to access the prognostic significance of the different covariates. RESULTS: The median age of the patients with epithelial ovarian cancer was 46.6 years and FIGO stage distribution was 38.2% for stage I, 5.9% for stage II, 44.1% for stage III, 11.8% for stage IV. The histopathologic type distribution were serous type (45.6%), mucinous type (36.8%), endometriod type (8.8%), clear cell type (7.4%), mixed type (1.4%). Residual tumor volume size of less than 1 cm or 1 cm was identified in 50 patients (73.5%) and more than 1 cm in 18 patients (26.5%) after primary cytoreductive surgery. The overall 5-year survival rate was 55.7%. According to univariate analysis, FIGO stage (p<0.0001), residual volume (p<0.0001), ascitic fluid volume (p=0.0001), menopause (p=0.0021), CA125 (p=0.0058), tumor size (p=0.0099), age (p=0.0113) were significant prognostic factors affecting survival. However, multivariate analysis in this study demonstrated that FIGO stage (p=0.011), residual tumor volume (p=0.026), ascitic fluid volume (p=0.031) were found to be the most significant independent prognostic factors. CONCLUSION: In this retrospective study, the overall 5-year survival rate of patients with epithelial ovarian cancer treated with combination chemotherapy was 55.7% and 5-year survival rate of stage I/II was 95.8%, stage III 28.4%, stage IV 0%. The overall survival of stage I/II were 90 months, stage III 39 months, stage IV 17 months. In multiple analysis, FIGO stage, residual volume, ascitic fluid volume were identified as three most significant independent prognostic factors.

Three cases of Twin-to-Twin Transfusion Syndrome which were managed with maternal digitalization / 대한산부인과학회잡지

Twin-to-twin transfusion syndrome (TTTS) is one of the complications showing high mortality rate in monochorionic twins with vascular communication in the placenta. Clinical manifestations of TTTS are usually characterized by polyhydramnios, circulatory overload, cardiac failure and fetal hydrops in the recipient twin and symmetrical fetal growth restriction, oligohydramnios, hypovolemia and anemia in the donor twin. TTTS occurres in 10-35% of monochorionic twins. We report three cases of TTTS with fetal hydrops in which amnioreduction was serially attempted and maternal digoxin treatment was tried for the therapeutic purpose.

The effect of granulocyte colony-stimulating factor in chemotherapy of acute myelogenous leukemia / 대한혈액학회지

No abstract available.