Desmoplastic Fibroma of the Skull

Desmoplastic fibromas are rare intraosseous bone tumors. They are benign but locally aggressive and frequently found in the long bones and mandible. We report radiographic and histopathologic finding of a case desmoplastic fibroma involving right temporal skull bone. A 53-year-old woman presented at our hospital complaining of continuous right side headaches for a year. Simple skull X-ray film showed 3 x 2.5 cm lytic lesion with mild sclerotic margin on right temporal area. A large craniectomy 1cm lateral to margin was fashioned. The resected mass showed encapsulated mass colored white gray. Histologic diagnosis was compatible with that of a the desmoplastic fibroma. There was no evidence of recurrence during the 15months of follow-up period.

Dorsal Short-Segment Fixation for Unstable Thoracolumbar Junction Fractures

OBJECTIVE: This study is to evaluate the efficacy of dorsal short-segment fixation in unstable thoracolumbar junction fractures. METHODS: The cases of 20 patients who underwent dorsal short-segment fixation were reviewed retrospectively. Clinical outcomes were analysed using Sonntag's pain level, work status, and neurological scale according to the modified Frankel classification. Radiological outcomes were analysed using Mumford's anterior body compression(%), canal compromise ratio, and Cobb's kyphotic angle. RESULTS: At the latest clinical follow-up (average=14.6 months), there were 19 (95.0%) in group I and 1 patient (5.0%) in II in pain level35). The postoperative work status were 17 (85.0%) in group I, 2 patients (10.0%) in II, and 1 patient (5.0%) in V. Surgery brought to improve the neurologic status. In success group (19 cases, 95%), the average canal compromise ratio was reduced from 0.57 (+/-0.07) to 0.05 (+/-0.08) (P<0.05), the average anterior body compression (%) was reduced from 41% (+/-17) to 18% (+/-14) (P<0.05), and the average preoperative kyphotic angle was 20.0 degrees (+/-9.0), and corrected to 5.7 degrees (+/-7.1) postoperatively, and progressed to 7.8 degrees (+/-6.2) at the latest follow-up. There was a case of implantation failure in an elderly osteoporotic patient. CONCLUSION: Although there are limitations in the patient number and follow-up period, the present study favors dorsal short-segment fixation for selective cases in unstable thoracolumbar junction fractures.

Total laparoscopic hysterectomy by intracorporeal suture and ligature in the three-port method / 대한산부인과학회지

OBJECTIVE: To optimize a technique and evaluate the outcomes of total laparoscopic hysterectomy (TLH) performed by conventional intracorporeal suture and ligature under the 3-port method. METHODS: Eighty six patients had TLH at our hospital between July 1998 and June 2000 due to gynecologic benignancies. Operation procedures, the type and number of suture and ligature and the operation time were analyzed through reviewing of their medical records and operation video tapes. RESULTS: Overall operation time was 93.2 +/- 25.3 (mean +/- SD) minutes. The mean lapsed time was 19.8 +/- 8.5 minutes for securing and dividing the round ligaments, infundibulopelivic or ovarian ligaments, 21.39.3 minutes for securing and dividing the uterine vessels, cardinal and uterosacral ligaments, 18.7 +/- 6.2 minutes for vaginal vault support and closure, 12.1 +/- 6.4 minutes for peritoneal approximation and final inspection. Overall number of suture ligature was 26.8 +/- 2.9. The mean number of suture ligature was 5.5 +/- 1.7 for securing and dividing the round ligaments and infundibulopelivic or ovarian ligaments, 4.2 +/- 1.2 for securing and dividing the uterine vessels, cardinal and uterosacral ligaments, 5.2 +/- 0.9 for vaginal vault support and closure, 12.0 +/- 1.8 for peritoneal closure and final laparoscopic inspection. The uterine weight was 205 +/- 100.3 (range: 50.0-530.0) g. No conversion to laparotomy and major operative complications were occurred except for a case of postoperative transient voiding difficulty and a case of postoperative transfusion. CONCLUSION: TLH with the 3-port method can be performed safely and reasonably in the technical aspect and operation time by using conventional intracorporeal suture and ligature. Operation techniques could be optimized more especially in the procedure of vaginal and peritoneal closure to get the shorter operation time.

A clinical study on gestational trophoblastic disease / 부인종양

OBJECTIVE: To evaluate the clinical characteristics and the outcome of the management for gestational trophoblastic disease (GTD) patients diagnosed at our hospital and to report the current situation of GTD in Korea. METHODS: Between January, 1991, and December, 2000, One hundred and eleven women were diagnosed as GTD and managed in our hospital. Patients were classified according to clinical diagnosis and their medical records were investigated. RESULTS: Cases of benign, malignant nonmetastatic, malignant metastatic low risk and malignant metastatic high risk GTDs were 62, 36, 2 and 11 respectively. The mean age (year), gravidity and parity (number) of GTD patients were 33.3+/-9.9 (range: 19-54), 3.2+/-3.0 (range: 0-16) and 1.7+/-1.8 (range: 0-7) overall. About 75% of GTD patients were women in their 20s and 30s, and 85% occurred in patients with parity of 3 or less. The most common prior gestational event was abortion (37.1%) for molar pregnancy and molar pregnancy (61.2%) for persistent gestational trophoblastic tumor (PGTT). The progression rate of molar pregnancies to PGTT was 38.0%. MTX (16.3%) was mainly used as a single agent, and EMACO (28.6%) or MAC (22.4%) were primarily used for multidrug chemotherapy for the treatment of PGTT. In the treatment of PGTT, overall remission rate was 95.9% (n=47/49). CONCLUSION: The trends for GTD in Korea revealed significant changes, not only a decrease in the incidence of GTD, but also an improvement in the outcome of the management. There is a necessity of further community-based surveys for GTD.

A Case of Diagnosis and Management of Unruptured Rudimentary Horn Pregnancy with the Use of Laparoscopy / 대한산부인과학회잡지

The incidence of pregnancy in a rudimentary uterine horn is very rare. We experienced a case of unruptured rudimentary uterine horn pregnancy in the first trimester. The patient was diagnosed by laparoscopy and removed by laparoscopic resection of the pregnant rudimentary uterine horn. We report our case with brief review of literatures.

Laparoscopic versus Laparotomic Management of Adnexal Tumor before Week 18 of Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To evaluate the safety and benefit of laparoscopic surgery compared with laparotomy for the management of adnexal tumor during pregnancy. METHODS: We reviewed 54 cases of adnexal tumor during pregnancy which were managed surgically at Chonbuk National University Hospital between January 1996 and July 2002. Laparoscopy was performed in 17 patients. The remaining 37 patients had laparotomy. The medical records were reviewed retrospectively to confirm variable factors, such as gestational age, operating time, surgical methods, pathologic results, and pregnancy outcomes and complications. RESULTS: Mean gestational age at surgery was significantly different between two groups (85.2 vs 103.0 days). Operating time was not significantly different between two groups. Hospital stay (4.6 vs 7.0 days) was significantly shorter in the laparoscopy group than laparotomy group. No operative or postoperative maternal complications occured in the pregnant women who had laparoscopic surgery. Five preterm deliveries and one intrauterine fetal death occured in the laparotomy group. CONCLUSION: Comparing with laparotomy, laparoscopic surgery allows a shorter hospital stay, a reduced rate of postoperative complications and a maternal and fetal morbidity compared. Laparoscopic surgery appears to be safe and effective during pregnancy.

The Effect of a Priming Dose of Atracurium on the Onset Time in Rapid Sequence Tracheal Intubation / 대한마취과학회지

BACKGROUND: Depolarizing muscle relaxant, frequently used for rapid sequence endotracheal intubation in clinical field, has serious complication that occur intermittently, such as, hyperkalemia, increased intraoccular pressure and sudden cardiac arrest, especially in infants and adolescents. So the priming principle, i.e., the administration of a subparalyzing dose of a nondepolarizing muscle relaxant (priming dose) prior to the intubating dose, was developed for rapid sequence endotracheal intubation with nondepolarizing muscle relaxant. However, the priming dose sometimes causes complications, such as, swallowing difficulty or pulmonary aspiration, and this can cause patient discomfort or fatal complications. In this study we examined proper atracurium priming dose and evaluated possible complications of priming doses. METHODS: One hundred patients, scheduled for elective surgery were randomly allocated into five groups according to the priming dose used (group 1; 0, group 2; 0.03, group 3; 0.06, group 4; 0.09, group 5; 0.12 mg/kg). Patients received a midazolam and fentanyl injection, the base line TOF ratio was measured, and an intubating dose was given. We also examined changes in vital sign for 20 minutes after injection and noted the time when the twitch height became zero (onset time). RESULTS: In group 1, the onset time was 107 +/- 22.9 sec, and in groups 4 and 5, the onset times were 85.0 +/- 15.6 and 69.9 +/- 19.3 sec, respectively. But, in group 5, some patients showed tachycardia and swallowing difficulty. CONCLUSIONS: The optimal priming dose of atracurium was determined as 0.09 mg/kg, in most cases, however patients sensitivity to the atracurium should be considered.

The Effects of Preventive PEEP on Perioperative Pulmonary Functions in Patients Receiving Gastrectomy with a Kent Retractor / 대한마취과학회지

BACKGROUND: Postoperative pulmonary complications (PPCs) following upper abdominal surgery are common, and are associated with prolonged hospital stay even for cardiopulmonary healthy patients. The development of atelectasis and the unequal distribution of perfusion-ventilation during anesthesia and surgery, and perhaps the reappearance of these disturbances after surgery, are the main hypotheses used to explain postoperative hypoxemia and pulmonary complications. Atelectasis may be increased by using a Kent retractor, which retracts the abdominal wall and compresses the lung. This study evaluated the effect of preventive intraoperative positive end-expiratory pressure (PEEP) on perioperative oxygenation and complications in patients who receive gastrectomy with a Kent retractor. METHODS: Thirty eight cardiopulmonary healthy patients were randomly allocated to receive 0 (control), 5 or 10 cmH2O of PEEP during surgery. Arterial blood was obtained to evaluate arterial oxygenation and the unequal distribution of perfusion-ventilation by analyzing arterial oxygen tension and alveolar-arterial oxygen tension differences ((A-a)Do2) during the perioperative period. Pulmonary function and complications were also evaluated. RESULTS: Intraoperative arterial oxygenation improved for all patients receiving 5 or 10 cm H2O PEEP. In the control group, there was statistically significant decrease in PaO2 and increase in (A-a)Do2 after Kent retractor was applied, but the others did not show this effect (P<0.05). No differences in postoperative oxygenation, the incidence of pulmonary complications or pulmonary function were observed between the three groups. CONCLUSIONS: The application of PEEP was effective at improving oxygenation, and at preventing atelectasis and an unequal distribution of perfusion-ventilation during gastrectomy with a Kent retractor. However, the effects of PEEP did not extend beyond surgery.

A Study on the Translocation of Human Chromosome / 대한주산의학회잡지

OBJECTIVE: The aim of this study was to evaluate the relation between the chromosomal translocation and the outcome of pregnancy. METHODS: Between 1989 and 2001, 26 translocation carriers have been detected in our center and Jin Obstetrics and Gynecology Clinic. The subjects consisted of 26 couples that included 14 reciprocal translocation carriers and 12 Robertsonian translocation carriers. The balanced translocation carriers were analyzed retrospectively. RESULTS: The most frequent indication for parental chromosomal examination was repeated abortions or fetal death(57.7%). In contrast to couples with reciprocal translocations, a high excess of female over male carriers was found in the group of Robertsonian translocations. The rates of miscarriages (68.0%) in prior pregnancies were significantly higher than the birth rates of morphologically normal newborns(16.0%). Prenatal chromosomal examination in subsequent pregnancies revealed that 24.0% of the fetuses showed normal karyotypes, 56.0% of the fetuses showed balanced translocations and 20.0% of the fetuses showed a chromosomal imbalance. The unbalanced karyotypes consisted of three trisomies, one partial trisomy and one duplication. There was no case of partial monosomy in this study. CONCLUSIONS: The risk of unbalanced chromosome abnormalities was greater in our study than the empirically known risk. Prenatal examination is always indicated in carriers of any type of translocation.

A case of heterotopic pregnancy in a natural cycle: ultrasound diagnosis / 대한산부인과학회잡지

Heterotopic pregnancy in a natural cycle is rare case. This case occurs by one out of 30,000 cases of pregnancies. It is quite difficult to diagnose a heterotopic pregnancy clinically. But, recently, the availability of high-resolution sonography has improved the preoperative diagnosis rate. We present a case of spontaneous heterotopic pregnancy which was diagnosed pre-operatively by transvaginal ultrasound.

A case of the surgical treatment for deep vein thrombosis in the leg caused by huge uterine adenomyosis / 대한산부인과학회잡지

Uterine adenomyosis is a common benign pelvic tumor in women. One of the complications that may be infrequently associated with the huge pelvic mass is venous stasis of the lower extremities and may develop thrombophlebitis secondary to pelvic compression. Intravascular thrombosis in the deep vein of the legs is a serious illness that sometimes cause death due to acute pulmonary thromboembolism. Deep vein thrombosis (DVT) has been reported to be closely related to pregnancy, surgical procedure, long term bedrest, obesity, and oral contraceptives. However, there is few report about deep vein thrombosis caused by huge uterine adenomyosisWe report a case of deep vein thrombosis caused by huge adenomyosis was treated by hysterectomy, thrombectomy, and thrombolysis with a brief review of the literature.

A Clinical Study of Uterine Sarcoma / 대한산부인과학회잡지

OBJECTIVE: Uterine sarcomas are rare and characterized by rapid clinical progression and poor prognosis. The manegement of uterine sarcoma has been challenged. The purpose of this study was to investigate the clinicopathologic findings and outcome of patients with uterine sarcoma METHODS: From Sep. 1990 to July. 1999, 8 patients with histologically proven uterine sarcoma at department of obstetrics and gynecology of Chonbuk University Hospital were evaluated for their clinical profiles and survival retrospectively RESULTS: The age of patients with uterine sarcoma ranged 31 to 60, and the mean age was 46 years. The most common pathologic type of uterine sarcoma was leiomyosarcoma. The common presenting symptom were irregular uterine bleeding, hypermenorrhea and lower abdominal palpable mass. The patients with uterine sarcoma were treated by surgery, post-operative radiotherapy and adjuvant chemotherapy. The mean follow up duration was 34.1 months. The 2 year survival rate was 50%. Distant metastasis were reveled at two patients, and the sites are lung and brain. CONCLUSIONS: Uterine sarcomas are aggressive tumor with a poor prognosis. The Major treatment is surgery and the effect of chemotherapy and radiotherapy were undetermined.

Clinical Efficacy of High-risk HPV DNA Test Using Hybrid Capture System in Cervical Epithelial Cells / 대한부인종양콜포스코피학회잡지

Human papillomavirus(HPV) has implicated in the development of cervical cancer. Several studies has suggested a strong correlation between HPV 16, 18 and cervical intraepithelial neoplasia(CIN). For detecting and typing HPV DNA in cervical tissues, recently the chemiluminescent molecular hybridization assay method has been widely used. This study was performed to determine the usefulness of hybrid capture assay for detecting high-risk HPV in cervical epithelial cells, and to compare the correlation among cervical cytology, biopsy finding and HPV infection, and to determine whether the addition of the hybrid capture assay to cytologic test would improve the ability to identify significant lesions. This study included 267 patients who visited the colposcopic clinic of the department of obstetrics and gynecology, Chonbuk University Hospital from May, 1997 to October 199S. Pap smears hybrid capture assays, and colposcopically directed biopsy were performed concurrently on al1 women. The results obtained were as follow; l. Using hybrid capture assay, the detection rate of high-risk HPV of all patients was 37.1%(99/267). There was no statistical significance in the detection rate of HPV between the age groups. 2. The false negative rate of Pap Smear was 53.3% and showed significant discrepancies between the cytologic and histologic diagnosis. 3. According to the cytologic diagnosis, the detection rates of high-risk HPV were 7.1% in normal, 25.3% in ASCUS or LSIL, and 61.6% in HSIL. In each cytologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 4. According to the histologic diagnosis, the detection rates of high-risk HPV were 0.1% in normal, 11.1% in CIN I, and 72.7% in CIN II or CIN III. In each histologic group, the patients who had positive results for high-risk HPV showed higher incidence rate of high grade lesions than those with negative results(P<0.05). 5. According to the comparison of histologic diagnosis between positive and negative results of high-risk HPV test due to each cytology, there was no statistical significance in the incidence rate of cervical neoplasia, Above results suggest that high-risk HPV test using hybrid capture assay may be a useful method in supplement the pitfalls of cervical cytology. This test might also have prognostic value in the management of patients with CIN.

Various Perforationg Artery Pedicled Flaps

The recent development of microsurgical tissue transfer has enabled any defect in any area to be reconstructed with free flaps. However, the need for a more functional and thinner flap has been raised due to bullkiness of the flap and donorsite morbidity. For better functional and aesthetic results, various perforator flaps excluding muscles or adjacent subcutaneous tissue have been recently reported. We report 44 cases of perforating artery pedicled flaps from April 1995 to August 1998, including 21 cases of anterolateral thigh flap, 12 cases of gluteal artery perforator flap, 4 cases of posterior interosseous flap, and 7 cases of paraumbilical perforator flap for various soft tissue defects. Even though marginal necrosis of flap occurred in 9 cases, complete healing without significant problem was possible. The advantages of perforator flaps are as follows: 1. It is possible to obtain a relatively thin fasciocutaneous flap, but still with sufficient volume 2. Donor site morbidity was reduced without damage of main artery. 3. In spite of diverse vascular pattern of the perforator, the location of perforating arteries can be Detected with relative ease and mapped preoperatively with an ultrasound Doppler. The need of meticulous and tedious dissection could be a sole disadvantage of these flaps. This report describes the clinical experience with a perforator-based flap, anticpating applications of many other types of perforator flap in the future.

Reduction of Zygomatic Arch Fractures Via Postauricular Approach

Zygomatic arch fracture is one of the most commonly seen facial bone fractures and there have been many methods of reduction designed so far. However, for a simple fracture, the Gillies temporal approach is most commonly used because of the easy reducibility, and also because the depressed fracture can be approached without a facial incision. The Gillies temporal approach starts in the temporal area, between the temporalis muscle and deep temporal fascia. We have developed a new route which starts in the postauricular hair margin area and then reaches to the periosteum of the temporal bone. An elevator is then inserted to penetrate the periosteum and subperiosteal dissection is performed toward the zygomatic process of the temporal bone. At the origin of the zygomatic process, the route of dissection changes to the posterior aspect of the zygomatic arch using a curved palate elevator or the authors' modified Langenbeck elevator. This method of approach has been used in 6 cases of zygomatic arch fracture with good results and we report this method along with written reports.

Use of microplate on flxation of orbital rim fracture

The orbitozygomatic area occupies a key anatomic position in midface, is prone to injury, and plays a prominent role in facial aesthetics. So the facial appearance including orbital shape can be altered by complications of orbitozygomatic fractures. Most possible initial complications include blindness, hyphema, retinal detatchment, and paralysis or entrapment of extraocular muscles. Long term sequelaes include infraorbital nerve dysfunction, loss of malar projection, enophthalmos, and dystopia. Accurate anatomic reduction and rigid fixation is essential for management of orbitozygomatic fractures to minimize those late sequelaes. Conventional fixation devices to fix displaced fracture of facial bone are interosseous wire and miniplate. But interosseous wirings are unstable for primary bone healing and time consuming. Miniplates have great deal in rigid fixation but their high profile and palpability are the main complaints in many patients, especially in orbital rim area. In this article, we reviewed the 30 cases of zygomamaxilla complex fractures with orbital rim fracture fixed with microplates, and discussed the stability of microplate and superiorities in final aesthetics result. The use of microplates in these area permits enough stability of fracture segment with ease of procedures and superiorities in final results without any palpability.

The Current Trend in the Diagnosis and Management of Ectopic Pregnancy / 대한산부인과학회잡지

This retrospective study was undertaken to investigate the current clinical trend in the management of ectopic pregnancy. 562 patients of ectopic pregnancy were admitted and managed at the Department of Obstetrics and Gynecology, Chonbuk National University Hospital from Jan. 1. 1985 to Dec. 31. 1996. All cases had a reliable medical record and were divided into two groups, of which group A includes patients admitted from Jan. 1. 1985 to Dec. 31. 1990, group B from the Jan. 1. 1991 to Dec. 31. 1996. The results were obtained as follows. 1. The number of cases of ectopic pregnancy were 248 in group A and 314 in group B. 2. The age group of 20 to 29 years of age was top ranked in group A(49.6%) as well as in group B(46.8%). The age group of 30 to 39 years was 43.2% in group A and 46.6% in group B, respectively. 3. In group A, the case who experienced two deliveries was 31.9%, and nulliparous woman was 30.6%. In group B, the case who experienced two deliveries was 33.1%, nulliparous woman was 33.1%. 4. On reviewing the past medical history, ectopic pregnancy was 11.2% in group A, 10.8% in group B, respectively. Pelvic inflammatory disease was 8.1% in group A and 11.0% in group B, respectively. 5. The interval between the last menstrual period and the onset of symptoms was prevalently in 4 to 8 weeks(64.5% in group A, 61.8% in group B). The terval of 12 weeks or more was 2.0% in group A and 6.0% in group B, respectively. 6. In considering the chief complaints, low abdominal pain was 85.9% and vaginal spotting was 69.0% in group A. On the other hand, low abdominal pain was 91.4% and vaginal spotting was 76.4% in group B, meanwhile nausea and vomitting was 8.6% and dizziness was 3.5% in group A, there were 23.4% of nausea and vomitting and 9.7% of dizziness in group B,7. In relation of the diagnostic methods, the positive rate of culdocentesis in group B was lower than the rate in group A. Diagnostic laparoscopy was done in 5.6% of group A and 14% of group B. The detection rate of adnexal mass and fluid collection in the pelvic cavity was higher in group B than in group A on the ultrasonographic examination. 8. Initial hemoglobin value of 10.1mg/dl or more was 70.9% in group A and 73.2% in group B. The value of 8.0gm/dl or less was 6.4% in group A and 7.0% of group B, respectively. Initial systolic pressure of 110mmHg or more was 74.6% in group A and 66.6% in group B. The systolic pressure of 90mmHg or less was 3.6% in group A and 8.3% in group B.9. The conceptus was almost implantd in the fallopian tube. The ampullary portion was the most common site of ectopic implantation in both groups. 10. Intraabdominal hemorrhage of 500ml or less in amount was 52.4% in group A and 61.1% in group B, individually. However transfusion was not given in 55.6% of group A and in 71.0% of group B. 11. In the therapeutic modalities, laparotomy was performed in 96.8% of group A and in 82.8% of group B, respectively. The pelviscopic operation was done in 2.4% of group A and in 22.3% of group B. In conclusion, ectopic pregnancy was diagnosed increasingly prior to the onset of the hypovolemic symptoms according to developement of high-resolution ultrasonogram, diagnostic laparoscopy and beta-hCG test, therefore the use of minimally invasive techniques in the management of ectopic pregnancy was increasing.

Primary Ovarian Non-gestational Choriocarcinoma in a Young Woman / 대한산부인과학회잡지

Primary ovarian choriocarcinoma is an extremely rare germ cell neoplasm, and the prognosis is poor. Especially, the diagnosis of primary ovarian nongestational chori-ocarcinoma can be reliably established in a girl or innocent virgin. We report a case of primary ovarian, nongestational, pure choriocarcinoma in a 16-year-old woman. She died within 1 year after diagnosis in spite of the treatment with surgery and combin-ation chemotherapy.

Efficacy of Frozen Section Biopsy in the Diagnosis of Adnexal Neoplasms / 대한산부인과학회잡지

Recently, the possibility of inappropriate management of undiagnosed early cancers increased with spreading laparoscopic approach of adnexal tumors. The pathologic diagnosis of frozen section biopsy(FBx) guide the surgeon to perform the appropriate surgical procedure of adnexal tumors. This study was conducted to verify preliminarily the criteria for the laparoscopic management and determine the accuracy and efficacy of conditioned FBx according to the criteria. The inclusive criteria of FBx results in this study was designed by means of the preoperative transvaginal sonography(morphologic score >or=10) or tumor marker level of serum(CA-125 level>or=35 U/ml in postmenopause and >or=65 U/ml in postmenopause) or suspected gross findings of the malignancy during operation. On the other hand, cases which were convinced as dermoid cysts, endometriomas and advanced(>or=IIIb) ovarian cancers on the basis of gross findings were excluded in this study. Two hundred seventy-six operations of adnexal tumors were performed between January 1995 and June 1996 and 74 results of FBx were picked up in this study. The overall rate of conditioned FBx was 26.8%(74/276). The applied criterion in this study had the sensitivity of 0.97, specificity of 0.78, negative predictive value of 0.99, positive predictive value of 0.36. The accuracy of frozen sectional biopsy were 87.8% in the histopathologic diagnosis and 97.3% in the clinicopathologic diagnosis. The sensitivity, specificity, negative predictive value and positive predictive value for ovarian cancers(borderline+malignant) were 1 in all. It was thought that frozen sectional biopsy was a appropriate guide for the decision of methods during operation of adnexal tumors and that the criteria in this study could be used as a guideline for frozen section biopsy in the laparoscopic surgery of adnexal tumors.

A Case of Cavernous Hemangioma of the Cervix and Vagina / 대한부인종양콜포스코피학회잡지

Hemangioams are usually present at birth of appeat shortly thercafter, as red or purple patches varying in size and most often in the skin. Hemangiomas include the cervix in their ubiquitous distribution; the cervix itself is very vascular and many reported hemangiomas are nothing more than a conspicuous demonstration of local casculatity. The cervical hemangioma is a rare condition which usually presents as vaginal bleeding of unusual cause, Many of the capillary hemangiomas and some of the cavermous types frequently resolve spontaneously. However, some hemagiomas ulcerate and a severe hemorrhage results. We recently encountered a case of cervical hemangioma involving the vagina in a 56-year-old woman. This case os especially interesting in that the histologic type was a cavernous hemangioma with uncommon cariety n the uterine cervix.