The study of the reproductive outcome after myomectomy in infertile patients with uterine myoma / 대한산부인과학회지

OBJECTIVE: The purpose of this study is to evaluate the reproductive outcome after myomectomy in infertile patients with uterine myoma. METHODS: During the period from January 1993 to December 2002, 55 infertile women with uterine myoma underwent abdominal myomectomy at Department of Obstetrics and Gynecology. RESULTS: Pregnancy occurred in 32 women and pregnancy rate was 58.2%. Parity, the number, type, and location of myoma, the opening of endometrial cavity during operation and the presence of endometriosis were not significantly different between the pregnant and nonpregnant group. But the mean age and duration of infertility were significantly low in pregnant group. The 24-month cumulative probability of conception was 84.4% and the spontaneous abortion rate after myomectomy was 28.1%. CONCLUSION: Our results suggest a benefit of myomectomy in infertile patients. Factors affecting the pregnancy rate after surgery in these patients are the age of the patient and the duration of infertility. Therefore, it is important that we should explain these factors to patients carefully before surgery.

Comparison of cyclooxygenase-2 and p53 expression in normal endometrium, endometrial hyperplasia and endometrial cancer / 부인종양

OBJECTIVE: The purpose of this study is to compare the expression rate of cyclooxygenase-2 (COX-2), p53 in endometrial hyperplasia, endometrial cancer and normal endometrium and to correlate COX-2 with the clinicopathological factors and p53 in endometrial cancer. METHODS: Immunohistochemical stain of COX-2, p53 was performed on samples from a series of 19 cases of normal proliferative endometrium, 20 cases of complex endometrial hyperplasia and 19 cases of endometrial cancer. And then we analyzed the expression of COX-2 correlated the findings with clinicopathological factors and p53. Expression of COX-2 was scored according to the proportion of positive-staining cells: negative, no staining; 1+, 50. For p53 overexpression, when there were at least 10% of tumor cells stained, it was considered as positive. RESULTS: Overexpression of COX-2 (> or =2+) was seen in 5 (26.3%) of the endometrial cancers, 6 (30%) of the complex endometrial hyperplasia, and 4 (21.1%) of the normal endometria. The expression rates of COX-2 in endometrial cancer, hyperplasia and normal endometrium were not different statistically significant (p=0.93). COX-2 was not correlated with clinicopathological factors but correlated with p53 significantly (p=0.021). CONCLUSION: In this study, the immunohistochemical analysis showed no difference statistically in COX-2 expression between endometrial cancer and hyperplasia compared to normal endometria. COX-2 was significantly correlated with p53. This finding may represent that tumor suppressor p53 upregulates COX-2 expression.

A case of diffuse large B-cell lymphoma of the uterus and ovary / 부인종양

Malignant lymphoma of uterus and ovary is a very rare disease. Under the impression of ovarian malignancy, subtotal abdominal hysterectomy with bilateral salpingo-ophorectomy was done due to severe pelvic adhesion. Histopathologic and immunohistochemical study demonstrated the tumor to be diffuse large B-cell lymphoma of the ovary with involvement of the uterus. So, we have experienced a case of malignant lymphoma of the uterus and ovary in Department of Obstetrics and Gynecology and Pathology, College of Medicine Korea University and discribed our case with a brief review of literature.

Correlations between umbilical and maternal serum adiponectin levels and neonatal birthweight / 대한산부인과학회지

OBJECTIVE: Adiponectin is an adipocyte-derived hormone with profound insulin sensitizing, anti-inflammatory, and antiatherogenic effects. Apart from its obvious potential as a mediator of adult metabolic syndrome, in pregnancy, adiponectin could have a significant role in regulating energy homeostasis. However, correlations between umbilical cord and maternal serum adiponectin levels and neonatal birthweights are far from understood. The purpose of the present study was to clarify correlations between umbilical cord and maternal serum adiponectin levels and neonatal birthweights. METHODS: The study included 30 healthy mothers who had given birth to healthy neonates. Adiponectin levels in maternal serum and umbilical cord serum were determined by ELISA and analysed. RESULTS: The ranges of adiponectin levels for umbilical cord and maternal serum were 7.12-24.93 microgram/mL and 1.76-8.20 microgram/mL, respectively. Umbilical cord adiponectin levels (14.82+/-3.66 microgram/mL) were significantly higher than maternal serum levels (4.73+/-1.87)(p<0.001). Umbilical cord adiponectin levels were correlated positively with neonatal birthweights (r=0.459, p=0.011). No significant differences in adiponectin levels were found between female and male neonates. In addition, there was no correlation between umbilical cord adiponectin levels and maternal serum adiponectin levels, maternal body mass index, umbilical leptin, or insulin levels. CONCLUSION: The levels of adiponectin were higher in umbilical cord than in maternal serum. The adiponectin levels in umbilical cord were found to correlate positively with neonatal birthweights. Therefore, adiponectin may be involved in fetal energy metabolism in pregnancy.

A case of Krukenberg tumor of ovary metastases from ductal type breast carcinoma / 대한산부인과학회잡지

Krukenberg tumor of the primary breast carcinoma is rare and this is almost invasive lobular carcinoma. They are usually bilateral and frequent in premenopausal women. Diagnosis of symptomatic Krukenberg tumor is reported to be 1 or 2 year after the diagnosis of primary neoplasm. But sometimes it is discovered prior to the detection of the primary breast carcinoma. Unexpected ovarian micrometastasis was recognized after oophorectomy of normally appearing ovaries in breast cancer patients. Existence of Krukenberg tumor means advanced primary disease and possible metastasis to other organs, and have a poorer prognosis. We report a case of Krukenberg tumors occurred 3 years after the diagnosis of primary ductal type breast carcinoma.