The Effect of Body Mass Index on Survival in Advanced Epithelial Ovarian Cancer

Controversy remains regarding the effect of obesity on the survival of patients with ovarian cancer in Asia. This study examined the impact of obesity on the survival outcomes in advanced epithelial ovarian cancer (EOC) using Asian body mass index (BMI) criteria. The medical records of patients undergoing surgery for advanced (stage III and IV) EOC were reviewed. Statistical analyses included ANOVA, chi-square test, Kaplan-Meier survival and Cox regression analysis. Among all 236 patients, there were no differences in overall survival according to BMI except in underweight patients. In a multivariate Cox analysis, surgical optimality and underweight status were independent and significant prognostic factors for survival (HR, 2.302; 95% CI, 1.326-3.995; P=0.003 and HR, 8.622; 95% CI, 1.871-39.737; P = 0.006, respectively). In the subgroup of serous histology and optimal surgery, overweight and obese I patients showed better survival than normal weight patients (P = 0.012). We found that underweight BMI and surgical optimality are independent risk factors for the survival of patients with advanced ovarian cancer. High BMI groups (overweight, obese I and II) are not associated with the survival of advanced EOC patient. However, in the subgroup of EOC patients with serous histology and after optimal operation, overweight and obese I group patients show better survival than the normal weight group patients.

Candidates for Tumor Markers of Cervical Cancer Discovered by Proteomic Analysis

Cervical cancer is the second most common gynecological cancer among Korean women. While nationwide screening program has developed, the pathogenesis of cervical cancer is unknown. The aim of this study was to compare the protein expression profiles between cervical squamous carcinomas and normal cervical tissues in order to identify proteins that are related to the cancer. Three cervical cancer tissue samples and three normal cervical tissue samples were obtained and protein expression was compared and was identified in the samples with the use of matrix assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS). A total of 20 proteins that showed up-regulated expression in the cervical cancer tissue samples were selected and identified. Seven proteins were matched to allograft inflammatory factor 1 (AIF-1), actine-like protein 2 (ALP2), brain type fatty acid-binding protein (B-FABP), NCK adaptor protein 1 (NCK-1), islet cell autoantigen 1 (ICA69), cationic trypsinogen (PRSS1), and cyclin-dependent kinase 4 (CDK4), but the remaining 13 proteins were unidentifiable. After confirmation by RT-PCR, Western blotting and immunohistochemistry, we found that B-FABP, NCK-1, and CDK4 were related to the pathogenesis of cervical cancer. These proteins are suggested as candidates of new pathological tumor markers for cervical cancer.

Clinicopathologic characteristics of granulosa cell tumors of the ovary: a multicenter retrospective study / 부인종양

OBJECTIVE: To evaluate the clinicopathologic characteristics and prognostic factors of ovarian granulosa cell tumors. METHODS: Medical records of 113 patients presenting between January 1995 and December 2007 were retrospectively reviewed. RESULTS: One-hundred two patients had adult type disease, with a mean age of 46.2 years (range, 18 to 83 years) and a mean follow-up period of 54.7 months (range, 1 to 155 months). The distribution of FIGO stages was 86 patients at stage I, 11 at stage II, and 5 at stage III. During follow-up, ten patients recurred at a mean time of 48 months (range, 4 to 109 months). Among them, three patients died after a mean of 57 months (range, 25 to 103 months). In recurrence analysis, advanced stage (p=0.032) and presence of residual disease (p=0.012) were statistically significant, and age<40 years, premenopause and positive washing cytology were marginally significant (p<0.1). In multivariate analysis, stage was the only factor associated with recurrence; adjuvant chemotherapy and fertility-sparing surgery were not statistically significant. Among 36 patients with fertility-sparing operations, eight patients had nine pregnancies and delivered seven babies. Eleven patients had juvenile type tumors; the mean age was 20.0 years (range, 8 to 45 years) and the mean follow-up period was 69.8 months (range, 20 to 156 months). The distribution of FIGO stage was nine patients at stage I and two at stage III. There were no recurrences or deaths reported. Four patients had seven pregnancies and delivered six babies. CONCLUSION: Stage is the only factor associated with disease-free survival, and fertility-sparing surgery may be a treatment option for women with early-stage disease who want to retain fertility.

The effect of pomegranate on postmenopausal syndrome in ovariectomized rats / 대한산부인과학회지

OBJECTIVE: To determine whether or not pomegranate extract can affect postmenopausal syndrome in ovariectomized rats. METHODS: Seventy-nine female Sprague-Dawley rats were used: A, no intervention; B, sham operation and distilled water; C, ovariectomy and distilled water; D, ovariectomy and 10% dilute pomegranate; E, ovariectomy and 20% pomegranate; and F, ovariectomy and 40% pomegranate. The study samples were obtained 4 weeks later. The following parameters were investigated for analyses: the thickness of urogenital epithelium, tail skin temperature, serum levels of sex hormones, lipid profile, homocysteine, and thiobarbituric acid reactive substances. RESULTS: 20% pomegranate had a transient thickening effect of bladder epithelial layer. There was an intermittent lowering effect of tail skin temperature of pomegranate extract, however, it was not consistent. There were lowering effect in serum homocysteine and elevating effect in serum high density lipoprotein-cholesterol. Pomegranate did not reverse post-ovariectomy reduced sex hormone levels. CONCLUSION: Pomegranate extract showed a tendency to reverse ovariectomy-related urothelial changes. Also pomegranate had a serum homocysteine-lowering effect.

Clinical Implication of 2nd Trimester Glycosuria / 대한주산의학회잡지

OBJECTIVE: To analyze the incidence of gestational diabetes mellitus (GDM) and its clinical implication of glycosuria identified in 2nd trimester pregnancy. METHODS: This study included pregnant women who had undertaken the 50 g oral glucose tolerance test (50 g OGTT) between 24 and 28 weeks gestation and delivered at term (N=704). Blood and urine sample were collected and analyzed for glucose level, one hour after 50 g OGTT. We applied women to 100 g OGTT if their blood glucose level after 50 g OGTT were more than 140 mg/dL. We compared blood glucose level, rate of GDM, birth weight and number of macrosomia at different urine glucose levels. Urine glucose level were measured by urine dipstick test and grouped to trace, 1+, 2+, 3+, and 4+, which were corresponding to 100, 250, 500, 1,000, 2,000 mg/dL. RESULTS: Women with glycosuria after 50 g OGTT were 258/704 (36.6%). Mean blood glucose levels were 117+/-23 mg/dL, 128+/-20 mg/dL, 135+/-23 mg/dL, 132+/-17 mg/dL, 139+/-25 mg/dL, 153+/-45 mg/dL, mean birth weight 3.29+/-0.40 kg, 3.25+/-0.40 kg, 3.27+/-0.41 kg, 3.34+/-0.35 kg, 3.28+/-0.41 kg, 3.33+/-0.40 kg, and numbers of macrosomia (> or =4.0 kg) 20 (4.5%), 3 (4.8%), 1 (1.8%), 2 (4.2%), 3 (6.7%), 0 (0%) at glycosuria level of negative, trace, 1+, 2+, 3+ and 4+ respectively. Glycosuria level was correlated significantly with blood glucose level (P=0.000), but not with birth weight and macrosomia (P=0.838, 0.881). The rate of GDM was 7/55 (12.7%), 2/48 (4.7%), 7/45 (15.6%), 8/48 (16.7%) in glycosuria level of 1+, 2+, 3+, 4+ and their relationship was statistically significant (P=0.000, AUC=0.734, 95%CI 0.638-0.830). In the cut off value of glycosuria 1+ or greater, sensitivity and positive predictive value were 72.7 and 12.2%. CONCLUSION: Glycosuria correlates well with blood glucose level and GDM prevalence but not with birth weight.

The Effect of Pomegranate on Depression, Anxiety, and Food Intake in Ovariectomized Rats / 대한폐경학회지

OBJECTIVES: To determine whether or not pomegranate extract can affect depression, anxiety, and food intake in ovariectomized rats. METHODS: Seventy-nine female Sprague-Dawley rats were divided into six groups: A, no operation and no drug intake; B, sham operation and distilled water; C, ovariectomy and distilled water; D, ovariectomy and 10% dilute pomegranate extract; E, ovariectomy and 20% dilute pomegranate extract; and F, ovariectomy and 40% dilute pomegranate extract. Beginning 2 days after surgery, drugs were administrated for 4 weeks. After that, the rats were subjected to the elevated plus maze (EPM) test and forced swim test (FST). RESULTS: The 10% pomegranate extract had a lower % closed arm entry frequency in the EPM test. A pomegranate dose-dependent decrease in the duration of immobility duration in FST was shown. Pomegranate did not reverse ovariectomy-related hyperphagia and weight gain. CONCLUSION: Pomegranate extract improved depression and anxiety in a postmenopausal model with ovariectomized rats.

Prenatally Detected Congenital Perineal Mass Using 3D Ultrasound which was Diagnosed as Lipoblastoma Combined with Anorectal Malformation: Case Report

We report a case of prenatally diagnosed congenital perineal mass which was combined with anorectal malformation. The mass was successfully treated with posterior sagittal anorectoplasty postnatally. On ultrasound examination at a gestational age of 23 weeks the fetal perineal mass were found on the right side. Any other defects were not visible on ultrasonography during whole gestation. Amniocentesis was performed to evaluate the fetal karyotyping and acetylcholinesterase which were also normal. As the fetus grew up, the mass size was slowly increased more and more. At birth, a female neonate had a perineal mass on the right side as expected. During operation, the anal sphincteric displacement was found near the mass and reconstructed through posterior sagittal incision. This is the first reported case of prenatally diagnosed congenital perineal mass, after birth which was diagnosed as lipoblastoma and even combined with anorectal malformation. This case shows that it can be of clinical importance to be aware of this rare fetal perineal mass in prenatal diagnosis and counseling.

The Effect of Pomegranate on Postmenopausal Syndrome: A Randomized, Double-blind, Placebo-controlled Trial / 대한폐경학회지

OBJECTIVES: To investigate the safety and effect of pomegranate extract on postmenopausal syndrome. METHODS: One hundred twelve women participated in a randomized, double-blind, placebo-controlled trial conducted in a tertiary university hospital in Korea. Women were treated with pomegranate extract or placebo for 12 weeks. The primary end point was menopausal symptoms, which were evaluated based on the Kupperman Index. The secondary end point was the serum estradiol (E2, pg/ml) level. Statistical analysis was performed. RESULTS: Menopausal symptoms as the Kupperman Index were significantly improved in the pomegranate group compared to placebo during the 12 weeks of intervention (P < 0.0001). Melancholia did not differ between the two groups. There was also no difference in serum E2 levels. There were no differences between the two groups in age, body weight, height, systolic and diastolic blood pressures, serum white and red blood cell counts, and fasting blood glucose, hemoglobin, aspartic transaminase, alanine transaminase, total cholesterol, triglycerides, high- and low-density lipoprotein-cholesterol, creatinine, and E2 levels. The side effects of pomegranate extract were negligible. CONCLUSION: Pomegranate extract is safe and effective in the treatment of menopausal symptoms. Further studies on whether or not the beneficial effect of pomegranate extract is due to the estrogen component are needed.

The Effect of Pomegranate on Postmenopausal Syndrome: A Randomized, Double-blind, Placebo-controlled Trial / 대한폐경학회지

OBJECTIVES: To investigate the safety and effect of pomegranate extract on postmenopausal syndrome. METHODS: One hundred twelve women participated in a randomized, double-blind, placebo-controlled trial conducted in a tertiary university hospital in Korea. Women were treated with pomegranate extract or placebo for 12 weeks. The primary end point was menopausal symptoms, which were evaluated based on the Kupperman Index. The secondary end point was the serum estradiol (E2, pg/ml) level. Statistical analysis was performed. RESULTS: Menopausal symptoms as the Kupperman Index were significantly improved in the pomegranate group compared to placebo during the 12 weeks of intervention (P < 0.0001). Melancholia did not differ between the two groups. There was also no difference in serum E2 levels. There were no differences between the two groups in age, body weight, height, systolic and diastolic blood pressures, serum white and red blood cell counts, and fasting blood glucose, hemoglobin, aspartic transaminase, alanine transaminase, total cholesterol, triglycerides, high- and low-density lipoprotein-cholesterol, creatinine, and E2 levels. The side effects of pomegranate extract were negligible. CONCLUSION: Pomegranate extract is safe and effective in the treatment of menopausal symptoms. Further studies on whether or not the beneficial effect of pomegranate extract is due to the estrogen component are needed.

Expression pattern of the class I homeobox genes in ovarian carcinoma / 부인종양

OBJECTIVE: Although some sporadic reports reveal the link between the homeobox (HOX) genes and ovarian carcinoma, there is no comprehensive analysis of the expression pattern of the class I homeobox genes in ovarian carcinoma that determines the candidate genes involved in ovarian carcinogenesis. METHODS: The different patterns of expression of 36 HOX genes were analyzed, including 4 ovarian cancer cell lines and 4 normal ovarian tissues. Using a reverse transcription-polymerase chain reaction (RT-PCR) and quantification analysis, the specific gene that showed a significantly higher expression in ovarian cancer cell lines than in normal ovaries was selected, and western blot analysis was performed adding 7 ovarian cancer tissue specimens. Finally, immunohistochemical and immunocytochemical analyses were performed to compare the pattern of expression of the specific HOX gene between ovarian cancer tissue and normal ovaries. RESULTS: Among 36 genes, 11 genes had a different level of mRNA expression between the cancer cell lines and the normal ovarian tissues. Of the 11 genes, only HOXB4 had a significantly higher level of expression in ovarian cancer cell lines than in normal ovaries (p=0.029). Based on western blot, immunohistochemical, and immunocytochemical analyses, HOXB4 was expressed exclusively in the ovarian cancer cell lines or cancer tissue specimens, but not in the normal ovaries. CONCLUSION: We suggest HOXB4 may be a novel candidate gene involved in ovarian carcinogenesis.

The utility of the human papillomavirus DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia / 부인종양

OBJECTIVE: We evaluated the human papillomavirus (HPV) DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia (VAIN). METHODS: A retrospective review of the medical records of patients with a pathological diagnosis of VAIN was performed. Eligible women (N=48) were followed for cytology and HPV DNA test, and colposcopic biopsies were taken at 3- to 6-month intervals. Thirty-seven patients were followed for more than 6 months; their HPV DNA test results were compared to the cytology results for the prediction of disease prognosis. RESULTS: The degree of VAIN was more severe in patients with a high initial HPV DNA load (p=0.009). Patients with VAIN 2 and VAIN 3 were older than those with VAIN 1 (p=0.005 and 0.008, respectively). In 26 out of 37 patients (70.3%), the VAIN resolved. The other patients had persistent lesions with no progression to invasive vaginal carcinoma. The last follow-up HPV DNA load was significantly higher in the group with persistent VAIN compared to the group with resolved VAIN (p<0.0001). Negative cytology was observed in 25 out of 26 patients in the VAIN resolved group and in nine out of 11 patients in the VAIN persistent group (p=0.205). CONCLUSION: These results suggest that the HPV DNA test, especially for viral load, was more effective for the diagnosis and prediction of persistent VAIN than cytology.

Adenocarcinoma arising in mature cystic teratoma: a case report / 부인종양

Benign cystic teratoma is recognized as one of the most common tumors in women during the reproductive age and frequently is treated by pelviscopic operation. Malignant transformation of a benign cystic teratoma is a rare event, and adenocarcinoma is extremely rare, and distinguishing this malignant change from benign disease preoperatively is nearly impossible even by the use of radiological imaging or various tumor markers. Therefore, patients should be informed that if a laparoscopic cystectomy is undertaken, a prompt second staging operation should be performed if the definitive pathology reveals an unexpected malignancy. We present a case with thyroid papillary carcinoma of follicular variant arising from mature cystic teratoma removed by laparoscopic salpingo-oophorectomy followed by staging laparotomy. We briefly reviewed literatures with regard to malignant transformation of a benign cystic teratoma.

Protein expression patterns of epithelial ovarian cancers characterized by proteomic analysis / 부인종양

OBJECTIVE: The purpose of the present study is to identify the expression profiles of proteins in human epithelial ovarian cancers, as compared with those seen in normal ovarian tissues, via proteomic analysis. METHODS: Three epithelial ovarian cancer tissues and three normal ovarian tissues were intraoperatively obtained. We performed two- dimensional electrophoresis in order to separate tissue proteins by molecular weight, and then compared protein expression patterns. 21 up-regulated spots were identified by MALDI-TOF in epithelial ovarian cancers. Then, the expression of some of the up-regulated proteins was evaluated at the mRNA level via RT-PCR, in both the epithelial ovarian cancer tissues and the normal ovarian tissues. RESULTS: Proteomic analysis revealed about 200 up-regulated spots in epithelial ovarian cancer tissues, of which 21 were selected and identified by MALDI-TOF. 16 proteins were matched to MLC3nm, MACMARCKS, MYL2, S100A14, MIA, VHL, GUCA1B, RABL2A, BRMS1, IFI30, VILIP1, MAPRE1, NME5, DIO2, KLK 2, and CPA2. The up-regulation of these proteins was also evaluated at the mRNA level via RT-PCR, which revealed that MACMARCKS, S100A14, GUCA1B, RABL2A, VILIP1, MAPRE1, NME5, DIO2, and KLK2 were distinctly up-regulated in the cancer tissues. Five protein spots could not be matched, even with RT-PCR. CONCLUSION: This proteomic analysis may constitute a powerful tool for the identification and characterization of many promising candidate proteins related to epithelial ovarian cancers.

Epidemiology of Cervical Cancer

Invasive cancer of the cervix is considered a preventable disease because it has a long preinvasive state, cervical cytology screening programs are currently available, and the treatment of pre-invasive lesions is effective. Cancer of the cervix is the second most common cancer among women worldwide, with an estimated 493,000 new cases and 274,000 deaths in 2002. The highest incidence rates are observed in sub-Saharan Africa, Melanesia, Latin America and the Caribbean, South-Central Asia, and South East Asia. In Korea, cervical cancer is the fifth most common cancer among women with over 3,000 new cases every year. Age-standardized incidence rate (ASR) is 15.5 per 100,000, which is lower than those in developing countries but higher than in western countries such as Europe and North America. The patients' mean parity is 2.59, and the range of age in peak incidence is 40~49 years (29.8%), followed by 50~59 years (21.9%). As the age goes on, more advanced stage cancer is frequent. Squamous cell carcinoma is the most common cell type, and adenocarcinoma is more frequent among those under 60 years old. Operation (56.0%) is the major treatment modality under stage IIa, and concurrent chemoradiation (31.6%) is the major treatment over stage IIb. The 5year survival rate is 73.9%. It is generally thought that human papillomavirus (HPV) test and HPV vaccine might play an important role in lowering the incidence of cervical cancer, and continuous epidemiologic studies will support its usefulness and efficacy.

Significance of HPV viral load for prediction of recurrence after treatment in patients with carcinoma in situ of cervix / 부인종양

OBJECTIVE: The purpose of this study is to verify association between HPV viral load and recurrence after conization and analyse clinicopathological characteristics in patients with carcinoma in situ of cervix. METHODS: We reviewed the chart of 154 women with carcinoma in situ who underwent conization from January 2003 to December 2005. Pap smear and high risk HPV test was performed before treatment and colposcopic examniation with biopsy was performed in necessary. After operation, repeated Pap smear and quantitative high risk HPV test (Hybrid capture II test, HC II) were performed in three month after conization for recurrence of disease. We studied the medical records of the patients, analyzed demographic characteristics and conducted the correlation between the prognostic factors of the age, parity, presence of high risk HPV infection before and after the operation, existence of invasion of resection margin after conization and remaining or recurrent lesions. RESULTS: Positive of cone margin showed significantly high recurrence rate than negative cone margin (p<0.05). And posttreatment HPV viral load was significantly higher in recurrent patients (p<0.05). But initial Pap smear, age and parity has not shown in difference. CONCLUSION: We can conclude that a clear association between positive cone margin, high HPV viral load and recurrence of disease after conization. A patient with positive resection margin after or high viral load after conization should be evaluated and treated aggressively.

Sexual behavior of Korean young women: preliminary study for the introducing of HPV prophylactic vaccine / 부인종양

OBJECTIVE: The decision of optimal age for administration of recently approved prophylactic human papillomavirus (HPV) vaccines in the world depend on the basis of the sexual behavior of each countries. The aim of the study was to survey the age-specific sexual behavior including the sexual debut time and sexual experience in the Korean young women to design the tailored HPV vaccination. METHODS: This study was conducted by the Synovate Healthcare in the 6 city of Korea e.g. Seoul, Pusan, Daegu, Incheon, Kwangju and Daejon. By a stratified sampling methods 2,400 women aged 12-29 years old were included. The measures of sexual behavior presented in this report were collected by a Computer-Assisted Self-Interviewing (ACASI), in which the respondent enters her own answers into a computer without telling them to an interviewer. RESULTS: Among women 12-29 years of age, 39 percent of women (934 persons in 2,400 women) and 33 percent of single women (724 persons in 2,190 women) have had vaginal intercourse; 8 percent of women under 19 years old single women (79 persons in 1,045) and 56 percent of single women with 20-29 years old (645 persons in 1,145). Number of sexual partner was 2.8 person and 54 percent of women had more than 2 partners. Age of the first sexual activity (sexual debut) was 21 years old. The age of partner at the sexual debut was 23.2 years old. Sexual experience before 15 years old was only 2%. About the condom, 41% did not use or rarely use. CONCLUSION: Our data demonstrate that the sexual debut time of young Korean women differ from other countries in which the prophylactic HPV vaccine had already used. We conclude that the optimal age for HPV vaccination in Korea would be determined at 15-17 years old by this situation.

Recommendation guideline of Korean Society of Gynecologic Oncology and Colposcopy for quadrivalent human papillomavirus vaccine / 부인종양

Genital HPV infection is the most common sexually transmitted infection, but the majority of infections are self-limited. However, persistent infection with high-risk types can cause cervical cancer in women, which is the most common female genital cancer in Korea. In addition, HPV infection is the cause of genital warts and is associated with other anogenital cancers. The HPV vaccine is composed of the HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein in yeast using recombinant DNA technology produces noninfectious virus-like particles (VLP) that resemble HPV virions. The quadrivalent HPV vaccine is a mixture of four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18 combined with an aluminum adjuvant. Clinical trials indicate that the vaccine has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, vaginal and vulvar cancer precursor lesions, and genital warts caused by HPV types 6, 11, 16, or 18 among females who have not already been infected with the respective HPV type. The recommended age for primary vaccination of Korean females is 15-17 years, considering sexual debut and duration of protection of the vaccine. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 18-26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.

A clinical study of the treatment of pelvic actinomycosis / 대한산부인과학회지

OBJECTIVE: Pelvic actinomycosis is a rare disease, which make chronic granulomatous suppurative pelvic abscess caused by an anaerobic Gram positive organism Actinomyces israelii usually associated with intra-uterine devices, and difficult to diagnose exactly before operation. Pelvic actinomycosis is frequently confused with gynecologic malignancy, leading to misdiagnosis and overtreatment. We experienced 8 cases of pelvic actinomycosis and provide the advice for treatment of pelvic actinomycosis METHODS: We reviewed retrospectively the medical chart of 8 cases which have visited to Department of Obstetrics and Gynecology, College of Medicine, Anam Hospital, Korea University for pelvic actinomycosis from January 1999 to January 2007. RESULTS: The mean age of patients was 45.2 years old. Main symptoms were abdominal pain, vaginal bleeding, vaginal discharge, dysmenorrhea and fever with chilling. All cases have used the intrauterine devices for 5-20 years. 3 cases were diagnosed preoperatively by endometrial biopsy, punch biopsy, or empirically, and the others suspected to tuboovarian abscess or malignancy, and then their diagnoses were conformed by operation. 5 cases were treated by operation following antibiotics therapy, and 2 cases by antibiotics without operation, and 1 case by antibiotics therapy following operation. All cases were completely cured. CONCLUSION: In the treatment of pelvic actinomycosis, most important point is making the diagnosis before operation for decreasing complication such as bowel, bladder, and other pelvic organ injury. Inevitably, if the diagnosis was established by operation, postoperative high-dose antibiotic therapy was needed for several months.

A clinical study of borderline malignant tumors of the ovary / 부인종양

OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathological features, and to find relationship between treatment modality and prognosis of borderline ovarian tumors. METHODS: Ninety-three cases of borderline ovarian tumors that had been treated were reviewed retrospectively. RESULTS: Histologic types of this study group composed of 67 cases of mucinous borderline tumor, 23 cases of serous borderline tumor, 2 cases of mixed type, and 1 case of Brenner tumor. The mean age was 41.6 years (range 14 to 83), and 41 (44.1%) patients were nullipara. The most common chief complaint was palpable mass (39.8%) and asymptomatic cases were presented in 23 patients (24.7%). The cases of elevated serum CA125 (< or =35 IU/ml) were 25.8% in mucinous type and 61.9% in serous type. Surgical staging was completed in 57 cases and other 36 cases were incompletely staged. 45 cases were managed by conservative surgery. There were 4 cases with recurrence, and all of them were related to conservative surgery. Chemotherapy was given to 40 cases. Mean follow-up period was 27.3 months. One patient expired during follow-up, and overall 5-year survival rate was 95.2%. CONCLUSION: Borderline ovarian tumors have a good prognosis. But recurrence rate was high in conservative surgery. In conclusion, careful preoperative evaluations, complete surgical exploration and long-term follow-up after treatment are needed.

Profile of vaginal human papillomavirus infection in hysterectomized women / 부인종양

OBJECTIVE: To examine HPV infection of vagina in the absence of cervical tissue and, thus, to determine whether the cervix, and especially the cervical transformation zone, is required for HPV infection. METHODS: We analyzed the result of pap smears that were interpreted with the Bethesda system, and the result of HPV tests of 376 hysterectomized women and 605 non-hysterectomized women who had visited in Korea medical health care center from August 2004 to December 2005. HPV test was performed with the commercially available Hybrid Capture II assay. We estimated the prevalence of vaginal HPV infection in hysterectomised and non-hysterectomized women. The variables selected for analysis were age, time of hysterectomy, self reported reasons for hysterectomy, parity and so on. RESULTS: Prevalence of vaginal HPV infection in hysterectomized women was 12.5% and non-hysterectomized women was 11.7%, showed no difference (p=0.72). The mean viral load of hysterectomized group was 79.1 and that of non-hysterctomized group was 173.9, which show no statistical difference between group (p=0.28). The cause of operation, age, duration since the operation, age group-specific duration since operation showed no difference in prevalence of HPV infection. Menopause state also did not show difference in HPV infection (p=0.67). CONCLUSION: On the basis of the present study's data, we suggest that the cervix, particularly the cervical transformation zone, may not be needed for HPV infection in vagina.