OBJECTIVE: To evaluate the clinicopathological characteristics and DNA flow cytometry in uterine sarcoma. METHODS: A retrospective review of twenty six patients diagnosed and treated for a uterine sarcoma in Korea university hospital from 1990 to 2000 has been performed. DNA flow cytometry was performed in eighteen patients on paraffin-embedded archival tissue from uterine sarcoma. RESULTS: Of the twenty six patients 10 cases (38.4%) were leiomyosarcoma, 7 cases (26.9%) were endometrial stromal sarcoma and 9 cases (34.6%) were malignant mixed mullerian tumor. Median survival time was 36.0 months, and 3-year survival rate were 30.8%, 55.5%, and 16.6%, respectively. Main symptoms were vaginal bleeding and abdominal distension. Using the FIGO surgical staging criteria, we found the following distribution; 7 cases (26.9%) stage I, 4 cases (15.3%) stage II, 9 cases (34.6%) stage III and 6 cases (23%) stage IV. Mean survival time were 74.7, 28.5, 27.9, and 16.6 month, respectively. Stage I and II patients had superior survival rate than Stage III and IV (p=0.0008). Fifty percent of tumors were aneuploid and in aneuploid tumors S-phase fraction rate was increased significantly (P=0.023). Patients with mitotic rate under 10 in 10 HPF had superior survival rate compaired with over 10 in 10 HPF (p=0.024). CONCLUSION: Stage and mitotic rate were suggested as most important prognostic factor in uterine sarcoma.
Aneuploidy ; DNA* ; Flow Cytometry* ; Humans ; Korea ; Leiomyosarcoma ; Retrospective Studies ; Sarcoma* ; Sarcoma, Endometrial Stromal ; Survival Rate ; Uterine Hemorrhage

BACKGROUND: Gallstone is one of the most common cause of acute abdominal pain and is increasingly managed by laparoscopic cholecystectomy. Silent gallstones are usually managed expectantly and are considered for surgery only if the characteristic biliary pain occurs. If predictors of stone-related complications such as acute cholecystitis, pancreatitis, and cholangitis can be identified, patients at high risk can be selectively referred for treatment regardless of symptoms development, while those at lower risk may be safely observed. The purpose of this study was to find out the predictors of stone-related complication or biliary pain in patients with gallbladder stones. METHODS: We collected clinical data retrospectively on patients who were diagnosed with gallstone at Asan Medical Center. Total gallstone number was classified into 1, 2~4, over 5. Diameter of the gallstones were subdivided into 20 mm. Statistical analysis was performed using SAS program (Ver 6.11). RESULTS: 918 patients (432 men and 486 women) were included in the analysis. The mean age was 54.3 years; that of men was 55 years and women was 53.8 years. Stone-related complications developed in 201 patients of acute cholecystitis, 78 patients of acute gallstone pancreatitis and 80 patients of acute cholangitis. Biliary pain was occurred in 568 patients. 658 patients were experienced cholecystectomy (158 patients open cholecystectomy and 500 patiens LLC). 377 patients were experiened ERCP, and 289 persons of that were experienced EST. Acute gallstone pancreatitis and acute cholangitis were significantly more frequent in older age and patients experiencing biliary pain. Their gallstone size was significantly smaller and the number was significantly more numerous in the univariate analysis. But, in the multiple logistic regression analysis, only age and the smallest stone size were independent risk factors. Patients who experiencing biliary pain were older and had significantly smaller and multiple gallstones in the univariate analysis. However in the multiple logistic regression analysis only age and stone number were independent variables. Acute cholecystitis was significantly more frequent in the old age group and patients with biliary pain. CONCLUSION: In the multiple logistic regression analysis, old age and small gallstones were predictors of acute gallstone pancreatitis and acute cholangitis. Old age and multiple gallstones were associated with biliary pain. Old age and biliary pain were predictors of acute cholecystitis, but the gallstone size and number were not associated in this study. We suggest that a well-designed prospective study is necessary in the future.
Abdominal Pain ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Chungcheongnam-do ; Female ; Gallbladder ; Gallstones* ; Humans ; Logistic Models ; Male ; Pancreatitis ; Retrospective Studies ; Risk Factors