A Case Report of Arteriovenous Malformation of the Uterus complicated with Hydatidiform Mole / 대한산부인과학회잡지

Uterine arteriovenous malformation(AVM) is a rare cause of massive uterine bleeding. Although uterine AVM is a rare cause of menorrhagia or postmenopausal bleeding, it is important to consider in the assessment of a patient with abnormal uterine bleeding because accurate diagnosis can allow appropriate treatment to be planned and avoid hysterectomy in women who wish to retain their reproductive capacity. Curettage may precipitate life-threatening hemorrhage and is therefore contraindicated when uterine AVM is suspected. These lesinons may be congenital or acquired. Acquired lesions are believed to follow trauma or may arise after choriocarcinoma or other gynecologic malignancies. Until rescently, this condition was difficult to diagnose and management almost always required hysterectomy. Doppler flow ultrasound and pelvic angiography are important for diagnosis and assessment. Transcatheter embolization has replaced hysterectomy as the treatment of choice in woman who wish to retain their fertility. We have experienced one case of uterine AVM complicated by partial hydatidiform mole, which is presented with a brief review of the literature.

Two Cases of Primary Transitional Cell Carcinoma of Ovary / 대한부인종양콜포스코피학회잡지

Primary transitional cell carcinoma of ovary has been recently recognized as a separate subtype of epithelial cancer. It is unusual tumor and in which definite urothelial features are present, but no benign Brenner component is identified. These tumor are more aggressive and tend to present at a higher stage than malignant Brenner tumors, but they appear to respond better to chemotherapy than other type of ovarian epithelial cancer. We have experienced two cases of ptimary transitioaal cell carcinoma of ovary. So we report these cases with a brief review of literature.

Clinical study of the use of silicone ring pessary in management of pelvic organ prolapse / 대한산부인과학회잡지

OBJECTIVE: To evaluate the safety and efficacy of the silicone ring pessary in the management of pelvic organ prolapse. METHODS: This study was evaluated for the clinical analysis of 58 pelvic organ prolapse patients who visited our hospital and weared silicone ring pessary from January 1997, to December 1998. RESULTS: Among 58 patients, failure rate was 13.7%(8/58) and complication rate was 50%(29/58). Main causes of failure were vaginal ulcer(4 cases) and recurrent falling out of pessary(3 cases). Most common problems were recurrent falling out of pessary(10 cases) and vaginal erosion with or without ulcer(9 cases), vaginitis(6 cases). There was no significant difference of failure rates and complication rates between hysterectomized patients and the non-hysterectomized patients. CONCLUSION: In management of pelvic organ prolapse which unsuitable for operation, pessary is noninvasive, simple and effective alternative method.

A Clinical Study of Unruptured Ectopic Pregnancies with the Treatment of Systemic or Local Methotrexate Injecton / 대한산부인과학회잡지

OBJECTIVE: To evaluate safety and efficacy of systemic or local methotrexate(MTX) injection to patients with unruptured ectopic pregnancy METHODS: From October 1995 to October 1999, 35 unruptured ectopic pregnancies were eligible for the conservative management. 25 tubal pregnancies, 4 cervical pregnancies, 4 pregnancies of previous cesarean section scar, and 2 cornual pregnancies diagnosed by ultrasonography & serumbeta-hCG were evaluated. Patients were treated with one of following three protocols : (1) A single-dose of 50mg/m2 of intramuscullar(IM) MTX(7 cases) (2) Two to four doses of 1.0mg/kg of IM MTX with citrovorum rescue(20 cases) (3) Transvaginal ultrasonogram-guided intra-amniotic instillation of 50mg methotrexate (8 cases) The mean age of these patients was 30.8 yrs (range 24-42) and gestational age at diagnosis ranged from 22-75 days (mean 47). Initial level of serumbeta-hCG ranged from 166.4-55363.8 mIU/mL (mean 9069.2). Patients were monitored with serumbeta-hCG titers three times per week ,and then weekly until the serumbeta-hCG level was less then 10 mIU/mL. RESULT: 31 of 35 patients (88.6%) were successfully treated and remaining 4 patients failed conservative therapy and so required surgery. Mean duration of resolution was 38.5 days (range 11-105). Side effect rate was 45.7% but severity of symptoms were so mild that no treatment was needed in most cases. CONCLUSION: Nonsurgical conservative management of MTX appears to be effective and safe treatment modality for some selected unruptured ectopic pregnancy. But further comparative studies and long-term follow-up are needed to evaluate reproductive outcome and reduce side effects of MTX.

A Case of Pulmonary Embolism after Cesarean Delivery / 대한주산의학회잡지

No abstract available.

A Case of Vaginal Expulsion of Submucosal Fibroid after Uterine Artery Embolization / 대한산부인과학회잡지

Uterine fibroids are the most common benign tumor of the female genital organ. Menorrhagia is the most common symptom associated with uterine fibroid. Since the first suggestion that embolization of uterine arteries might have a role in the management of fibroids by Ravina et al (France) in 1995,3 uterine artery embolization for management of fibroids has been performed actively in United states, United Kindom and Japan, and excellent therapeutic results have been reported. We have performed uterine artery embolization on patients with symptomatic fibroids or adenomyosis since August 1998. There have been few case reports of expelled fibroids out of vagina after uerine artery embolization, so we present a case in which successful embolization in woman with submucosal myoma resulted in a subsequent vaginal expulsion.

A Study of Sexuality in Korean Adolescence / 대한산부인과학회잡지

OBJECTIVE: The objective of this survey is to introduce the recent adolescent sexuality, such as the level of sexual knowledge of adolescent, their actual state for the attitudes and behaviors toward sex, and in Korea in comparison with the past and to seek the answers to the improvement of the teproductive health statos of the adolescents. METHOD: The total number of 11,433 girls was drawn fiom middle and high schools girls in Seoul, Pusan, Incheon, Kwangju, Taegu, Taejeon and Ansan. Among them, the number of 82 girls was drawn fiom factory workers in Ansan. For the data collection, the survey was conducted during the period fiom Feb 15, 1994 to May 23, 1995 by using prepared questionaire. RESULT: Of those who respond to this study, 37.6% had sexual problems, which was that of acquaintance of the opposite sex(44.7%), menstruation(33.1%), and sexual maturity(13.1%). Among them, only 5.5% had a feeling of satisfaction about sex education. In regard to the attitude toward the friendly relationsbip with the oppasite sex, the approval rate respondents was 80.4%. Many respondents felt chastity and a virtue, but only 60.1% answered that pemarital chastity should be kept. For the each age group, age at sexual intercourse is revealed that among the respondents about 31.5% are experienced sexual intercourse for under 14 yearss old group, 25.3% for 15 years old, 26.3% for 16 years old, 12.6% for 17 years old, 3.3% for 18 years old, 1.0% for 19 years old. The major information source of knowledge source was school(38.4%), mass-media such as TV/radio(22.6%), book and magazine(19.9%), friends(16.2%), and parents (1.5%). CONCLUSION: In order to cope with the problems of adolescent sexuality, a drastic and strong policy measures should be taken by the government. At the same time, the public should be aware of the urgency of adolescent sexual problems. The most effective countermeasures appear to be education. Sexual education is necessary for the youth that they should bave an adequate sexual knowledge, attitudes and behaviors in their adolescent period.

A case of endometrial osseous metaplasia of a referred endometria l cancer patient / 대한부인종양콜포스코피학회잡지

Endometrial osseous metaplasia is a rare condition. The etiology and pathogenesis remain controversial. In most cases, the development of this condition is observed to be related to the history of abortion, either spontaneous or therapeutic and also, frequently associated with menstrual irregularity and endometritis. Patients usually present with secondary amenorrhea, irregular menstruation, pain, and dysmenorrhea. The authors recently experienced a case of endometrial osseous metaplasia of a referred endometrial cancer patient who had no history of abortion at all. We report this case with a brief review of the literature.

Two Cases of Primary Tubal Carcinoma / 대한부인종양콜포스코피학회잡지

Primary carcinoma of the fallopian tube is very rare, accounting for fewer than 1% of all malignant gynecologic tumors. Abnormal vaginal bleeding is the leading presenting complaint. The histology and behavior of primary tubal carcinoma are similar to ovarian cancer, thus the evaluation and treatment are also essentially the same. The correct preoperative diagnosis of tubal carcinoma is very difficult and its incidence is less than 1%. The prognosis of patients with primary tubal carcinoma has generally been regarded poor, with an overall survival rate parallels that of epithelial ovarian cancer. Recently we experienced two cases of primary tubal carcinoma, therefore we present these rare malignant neoplasm of the female genital tract with a brief review of the literature.

Two Cases of Primary Tubal Carcinoma / 대한부인종양콜포스코피학회잡지

Primary carcinoma of the fallopian tube is very rare, accounting for fewer than 1% of all malignant gynecologic tumors. Abnormal vaginal bleeding is the leading presenting complaint. The histology and behavior of primary tubal carcinoma are similar to ovarian cancer, thus the evaluation and treatment are also essentially the same. The correct preoperative diagnosis of tubal carcinoma is very difficult and its incidence is less than 1%. The prognosis of patients with primary tubal carcinoma has generally been regarded poor, with an overall survival rate parallels that of epithelial ovarian cancer. Recently we experienced two cases of primary tubal carcinoma, therefore we present these rare malignant neoplasm of the female genital tract with a brief review of the literature.

A Case of Primary Peritoneal Carcinoma / 대한부인종양콜포스코피학회잡지

Primary papillary serous carcinomas (PPC) of the peritoneum are very rare and classically present with widespread intraperitoneal dissemination, superficial invasion, and minimal ovarian stromal involvement. Because of clinically and histologically similar to advanced stage epithelial ovarian carcinoma the treatment has been a similar fashion-cytoreductive surgery followed by systemic chemotherapy. Histologic differentiation between papillary mesotheliomas, primary ovarian tumors, borderline tumors of the ovary with peritoneal deposits and primary peritoneal carcinoma may be difficult. The prognosis is very poor and the median lifespan 4 months. We experienced a case of primary peritoneal carcinoma and reported with the brief review of the literature.

An Immunohistochemical Study of p53 and RB Protein Expression in Normal Cervical Tissue, Cervical Intraepithelial Neoplasia and Invasive Cervical Carcinoma / 대한산부인과학회잡지

Carcinoma of the uterine cervix is the most common malignant tumor in Korean women. It is well known that carcinogenesis is a multi-step event involoving the inactivation of tumor supressor genes, such as p53 gene and RB gene. The inactivation of the normal functions of the tumor-suppressor proteins pRB and p53 are important steps in human cervical carcinogenesis, either by mutation or from complex formation with the HPV E6 and E7 oncoproteins. The pRB protein regulates early cell cyle progression by controlling transit through the G1 phase of the cell cyle. The p53 tumor suppressor gene product also plays a role in cell cycle control by the transcriptional regulation of cyclin-CDK inhibitor. Cervical carcinoma is an excellent model for studying the stepwise progression of cell transformation because this is reflected morphologically by the increasing dysplasia of the squamous cells before it becomes and invasive squamous cell carcinoma. The aim of this study was to examine the expression of pRB and compared that with overexpression of p53 in a series of cervical lesions including normal tissuess, dysplasias, carcinoma in situ and carcinomas by immunohistochemical staining with monoclonal antibody to elucidate the role of these tumor suppressor genes. The result were as follows: 1. In normal cervical mucosa and CIN I , a few positively stained cells for pRB were seen in basal and parabasal layer. 2. An abnormality of pRB, loss of expression was seen in 23.8% of CIN III and in 10.8% of invasive carcinoma. 3. Overexpression of p53 was demonstrated in 14.3% of CIN III and in 59.5% of invasive carcinoma. 4. The immunoreactivity of p53 was significantly increased (p<0.05) in stage II, III than stage I , whereas downregulation of pRB and tumor stage was not correlated. 5. The immunoreactivity of p53 was significantly increased (p<0.05) in squamous cell carcinoma than in adenocarcinoma, adenosquamous carcinoma and CIN III. These result suggest that an alteration of pRB is more frequently implicated in CIN III than invasive carcinoma, whereas overexpression of p53 may be involevd in late progression of uterine cervical carcinoma.

A Clinical Study on the Effect and Toxicity of rhGM-CSF / 대한부인종양콜포스코피학회잡지

Dosage reinforcement of chemotherapeutic agent is thought to be a solution in treating many malignancies, including ovarian cancer and cervical cancer. The remission rate after administration of chemotherapeutic agents has a positive correlation with dosage and in cases where limitations were put on dosage, improved survival rate was achieved with dose-intensive therapy facilitated by autologous bone marrow transplantation(BMT) or the use of cytokines such as G-CSF. Our objectives are to evaluate therapeutic efficacy and toxicity of GM-CSF and to elucidate the effect of premedication which was administered to minimize the toxicity of the GM-CSF. Total number of patients entered into this study was fifty two and they are consisted of thirty seven patients of the uterine cervix, fourteen patients of ovarian cancer and one endometrial cancer patient. The increase in neutrophil count and WBC count was found to be statistically valid, but the changes in the number of platelets, hemoglobin, neutrophil and monocytes were not shown to be meaningful when statistics are brought in. Administration of GM-CSF resulted in mild toxicities such as myalgia, fever, skin reaction and neuropathy. But, one patient had grade 3 myalgia. Premedication brought about meaningful reductions in the toxicities of GM-CSF and can be used safely to reduce the toxicities.

A fruitful case of pregnancy by simplified GIFT procedure with tuboplasty / 대한산부인과학회잡지

No abstract available.

Four cases of unruptured rudimentary horn pregnancy / 대한산부인과학회잡지

No abstract available.

A case of sex cord tumor with annular tubules / 대한산부인과학회잡지

No abstract available.