A Case of False Positive Amniotic Fluid Acetylcholinestserase in One Fetus of Twin Pregnancy conceived by Intracytoplasmic Sperm Injection and Zygote Intrafallopian Tube Transfer / 대한주산의학회잡지

Maternal serum alpha-fetoprotein(MSAFP) has been a world wide screening test for open neural the tube defect. But elevation of MSAFP is related to not only neural tube defect, but also incorrect gestational age, congenital anomalies such as congenital nephrosis, esophageal and intestinal obstruction, low birth weight, oligohydroamnios, fetal death and chromosomal anomalies. If MSAFP is elevated, gestational age, congenital anomalies such as neural tube defect, multiple pregnancy and fetal death must be evaluated by ultrasound. When the ultrasound is nondiagnostic, amniotic fluid AFP(AFAFP) levels are measured and if AFAFP is elevated, presence or absence of aetylchoineststarase(AChE) is determined to rule out the false positive of amniotic AFP. Amniotic AChE test yielded detection rate of open spina bifida of 99%, 98% for anecephaly and a false-positive rate of 0.34%. We report a case with elevated AFAFP and positive amniotic AChE result in one fetus of the twin pregnancy conceived by ICSI and ZIFT, but in which targeted ultrasound findings were normal, maintained the pregnancy to term and normal twin was delivered by elective cesarean section.

Two Cases of Surgical Intervention in Persistent Localized Choriocarcinoma / 대한산부인과학회잡지

Gestational trophoblastic tumors including choriocarcinoma bave become one of the most curable human malignancies with an overall cure rate exceeding 90%. Although systemic chemotherapy is the initial treatment for chorio- carcinoma, some patients with chemotherapy-resistant choriocarcinorna can be treated by integration of cbemotherapy, surgery and radio- therapy. We report two cases of persistent localized choriocarcinoma which was treated by surgical intervention.

Correlation between Amplification of c-myc Oncogene and Histophthologic Prognostic Factors in Endomentrial Cancer / 대한부인종양콜포스코피학회잡지

The c-myc oncogene encodes a 62,000 daltons nuclear transcriptional factor and is believed to regulate cellular proliferation. Although its mechanism of action is incompletely understood, oncogene amplification followed by increased expression and ultimately the production of large amounts of specific protein seem to play a central role in the oncogene mediated progression of certain solid tumor, including breast and uterine cervical cancer. We used an Southern blot hybridization to explore the relationship between c-myc onco-gene and prognostic factors of endometrial cancer and analysed the tissues from the 21 patients with endometrial cancer and 4 control cases. Six of 21 patients (29%) with endometrial cancer had at least two fold gene amplification and none of the four normal controls revealed amplified sequences. Three of the four poorly differentiated specimens (75%) demonstrated c-myc gene amplification, whereas only three of 17 low and moderately differentiated specimens (17.6%) showed c-myc oncogene amplification. Thus tumor grade was significantly associated with c-myc oncogene amplification (p=0.002). The other known prognostic factors including stage, histologic cell type, myometrial invasion and lymph node metastases showed no statistically significant association with c-myc oncogene amplification, although they were correlated with increased amplification rate of c-myc oncogene. A much larger number of patients must be studied to determine the prognostic significance of c-myc oncogene amplification in endometrial carcinoma, although these preliminary data suggest that it may predict biologically aggressive behavior of endometrial carcinoma.