PURPOSE: In patients with endometrial carcinoma, preoperative knowledge of myometrial tumor extension has important prognostic and therapeutic implications. The purpose of th is study was to assess the usefulness of meg netic resonance (MR) imaging in preoperative evaluation of myometrial invasion of early stage endometrial ca rcinoma. MATERIALS AND METHODS: MR imaging findings of 31 consecutive patients with histologicallproved endometrial carcinoma, were prospectively analyzed and compared with pathologic results. Uyometrial invasion was classified into three groups; absence of myometrial invasion, superficial and deep invasion in accordance with clinical stage IA, lB, IC respectively. RESULTS: MR imaging had an accuracy of 74.2%, a sensitivity of 85.7%, and a specificity of 70.8% in stage IA (n=7); 67.7%, 46.2%, 83.3% in stage lB (n=l 3); 93.5%, 81.8%, 100% in stage IC (n=11) respectively. Overall accuracy was 79.9%. Nine of ten incorrect cases were underestimated, and one was overestimated. Degree of invasiveness was underestimated in cases with adenomyosis, small tumor showing focal wall thickening, and faint junctional zone in postmenopausal women. CONCLUSION: The results of this study show that MR imaging can be used to distinguish superficial and deep penetration of myometrium in endometrial carcinome.
Adenomyosis ; Animals ; Endometrial Neoplasms* ; Female ; Humans ; Magnetic Resonance Imaging* ; Mice ; Myometrium ; Prospective Studies ; Sensitivity and Specificity

PURPOSE: This study was conducted to investigate the epidemic pyrogenic reactions that occurred hospital-widely in 51 patients on 30-31 Mar. 1995 at a tertiary, educational, and acute care hospital. METHODS: The remained intravenous (IV) drugs and IV fluids that were infused to patients (N=51) who developed pyrogenic reactions were cultured and tested pyrogenic matter. Pyrogenic test was done by Limulus Amebocyte Lysate (PyrotellRMA,USA). RESULTS: IV normal saline 50 cc bottles (AAXSAT and AAX5AV) those were collected being used from case patients, and new bottles stocked in the drug storage were positive to pyrogenic test. Used normal saline collected from case patients were cultured coagulase-negative Staphylococus. Moreover the company, manufacturer of these fluids reported the positive pyrogenic test on these IV fluids (AAXSAT and AAX5AV). CONCLUSION: This epidemic was a pyrogenic reaction for infused the intrinsic contaminated fluid with pyrogen. We could prevent not the additional pyrogenic reactions in study hospital but national wide epidemics to apply the rapid and well-designed epidemic investigation and infection control.
Bacteremia ; Cross Infection ; Drug Storage ; Horseshoe Crabs ; Humans ; Infection Control

BACKGROUND: This study was conducted to investigate whether the preoperative nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) was a risk factor for surgical site infections and nosocomial infections in open heart surgery patients. METHODS: From June 10, 2002 to October 30, 2002, data were collected by prospective surveillance carried out by infection control nurses. Nasal swabs were taken from patients (N= 106) on the day before surgery. The swabs were incubated in staphylococcal broth for 24 hours, and then it was incubated on mannitol salt agar for 24 hours. Muller-Hinton agar supplemented with oxacillin (6 microgram/mL) was used to identify MRSA. RESULTS: Among the study patients (N=106), four(4/106, 3.8%) were identified as MRSA carriers and nine (9/103 , 8.7%) developed nosocomial infections, including three patients (3/103 , 2.9%) who had postoperative mediastinitis Preoperative nasal carriage of MRSA was not associated with nosocomial infections nor surgical site infections (P>0.05). However, the length of hospital stay prior to nasal swab or surgery was found to be associated with MRSA carriage (OR=1.108, 95%CI: 1.026-1.197) or nosocomial infections (OR=1.087, 95%CI: 1.017-1.161). Additionally, the patients with nosocomial infections were more likely than those without to stay in the hospital for a longer period after surgery (P<0.00l). CONCLUSION: Preoperative nasal carriage of MRSA by the patient was not identified as a risk factor for surgical site infection and nosocomial infections in open heart surgery.
Agar ; Cross Infection* ; Humans ; Infection Control ; Length of Stay ; Mannitol ; Mediastinitis ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Prospective Studies ; Risk Factors ; Thoracic Surgery*

In consecutive 56 patients with cervical carcinoma, we retrospectively analyzed the accuracy of magnetic resonance imaging (MRI) in regard of determining the depth of stromal invasion and reviewed the pitfalls in MRI interpretation. All patients underwent hysterectomy and were categorized into 3 groups: (1) no stromal invasion, (2) invasion to inner 2/3 of stromal thickness, (3) invasion to outer 1/3 of stromal thickness. In each group, MR image was analyzed for the size of the tumor mass and the ratio of spared stromal thickness to normal stromal full thickness (invasion ratio). Most tumor masses were not detected in the group of no stromal invasion. The degree of the depth of stromal invasion increased with the tumor size, and invasion ratio decreased as stromal invasion deepened. Overall accuracy for stromal invasion on MRI was 69.6%,and positive predictive value (PPV) for no stromal invasion was relatively lower than those of the other two groups. MRI is a promising modality to evaluate stromal invasion of cervical carcinoma by measuring the tumor size and invasion ratio, if MRI is performed prior to biopsy in axial scan perpendicular to the endocervical long axis.
Biopsy ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Pathology, Surgical* ; Retrospective Studies

No abstract available.
Dysgerminoma* ; Female ; Ovary*

Squamous cell carcinoma of the ovary is rare and usually arise from preexisting cystic teratomas, endometriosis or Brenner tumors which undergo carcinomatous degeneration in their epithelial elements. Some of squamous cell carcinoma of the ovary is known to be associated with cervical neoplasm, but the pathogenesis is still unknown. Recently we experienced one case of ovarian squamous cell carcinoma in patients with microinvasive squamous cell carcinoma of uterine cervix. We report this case with possible pathogenesis and brief review of literatures.
Brenner Tumor ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Endometriosis ; Female ; Humans ; Ovary ; Teratoma ; Uterine Cervical Neoplasms

OBJECTIVES: This non-randomized retrospective study was to investigate the clinical characteristics and to evaluate the actual 5-year survival rate of the patients with invasive cancer of the cervix. METHODS: 489 evaluable patients with invasive cancer of the cervix were treated at Korea Cancer Center Hospital from January to December 1992. In this retrospective study, we studied the clinico-pathologic characteristics(age, FIGO stage, histologic type, nodal metastasis) and treatment modalities by the review of medical records. Especially, the survival was confirmed by the support of the police and government office. RESULTS: The most common subsets of patients were found in the group of FIGO stage IIb(32.5%) and age between 51 and 60(33%). Surgery was the main treatment in stage Ib/IIa(65%) and radiation in stage IIb or more(97%). Nodal metastasis were surgically identified in 6% of stage Ib, 29% of stage IIa and 36% of stage IIb. Overall actual 5-year survival rate was 72.2%; stage Ia(100%), Ib(94%), IIa(82%), IIb(63%), IIIa(36%), IIIb(47%), and IV(0%). The five-year survival rate according to LN status in surgically confirmed FIGO stage Ib-II patients were 91.9% in negative patients and 73.1% in positive patients respectively. Five-year survival rate was significantly different according to stage(P < 0.02) and nodal metastasis(p < 0.01). However, age and histologic type did not show any significant differences in survival. CONCLUSION: Overall actual five-year survival rate of 489 evaluable patients with invasive cancer of the cervix who were treated at Korea Cancer Center Hospital from January to December 1992 was 72.2%. Five-year survival rate was different according to stage and nodal metastasis.
Humans ; Korea ; Medical Records ; Neoplasm Metastasis ; Police ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

BACKGROUND: The presence of cardiac metastasis from cervical cancer is very rare. Due to the rarity of this condition, clinical characteristics of the patients with cardiac metastasis from cervical carcinoma is not well known. This study is to investigate the clinical profiles and outcomes of patients with cardiac metastasis from the carcinoma of the uterine cervix. MATERIALS AND METHODS: From Jan. 1990 to May 1999, 4 patients with cardiac metastasis from cervical cancer during the course of the disease were registered in Korea Cancer Center Hospital. The clinical characteristics of these patients were reviewed retrospectively. RESULTS: Mean age of patients was 49 years, and median interval from initial diagnosis to recurrence was 27 months. Histologically, all 4 cases were squamous cell type carcinoma. The stage distribution is two patients with FIGO stage II, one with stage I and one with stage III. Clinical symptoms of patients were dyspnea and facial edema in 2 patients, facial edema in one patients, and dyspneas only in one patient. All patients were confirmed histologically by pericardiocentesis. Synchronous metastatic lesions were supraclavicular lymph node, lung parenchyme and paraaortic, mediastinal lymph node. Following pericardiocentesis or pericardiodesis, all patients were improved clinically and survived for mean interval of 5.3 months. CONCLUSIONS: The patients with pericardial metastasis from cervical carcinoma showed a short survival time, but could be managed by pericardiocentesis or pericardiodesis with improvement of clinical symptoms.
Cervix Uteri ; Diagnosis ; Dyspnea ; Edema ; Female ; Humans ; Korea ; Lung ; Lymph Nodes ; Neoplasm Metastasis* ; Pericardiocentesis ; Recurrence ; Retrospective Studies ; Uterine Cervical Neoplasms*

A clinicopathologic study was per formed on 14 cases of malignant nondysgerminomatous ovari an germ cell tumors(NDOGCT) treated at the department of obstetrics and gynecology in Korea Cancer Center Hospital between Jan. l987 and,Jun. 1992. The results obtained were as follows ; 1. Median age of the patients was 27.5 years (range, 5 to 54) 2.Clinical symptoms presented were abdminal pain(64.3%), abdominal palpable mass(42.9%), abdominal distension(28.5%) in order of frequency. 3. Histopathologically, 7 cases(50%) were irnmature teratoma, 4 cases(28.6%) were endoder mal sinus tumor, 1 case(7.1%) was embryonal cell carcinoma, 2 cases(14.3%) were mixed germ cell tumor. 4. Bystage, 6 casse(42.9%) were in stage I, 1 case(7.1%) in stage Il, 2 cases(14.3%) in stage III, 3 cases(21.4%) in stage IV, and 2 cases(14.3%) in recurrence. 5, Serum alphafetoprotein was elevated in all patients withendodermal sinus tumor or embryonal carcinoma, and serum CA125 was elevated in about one half of the patients with nondysgerminomatous gerrn cell tumr. 6. l0 cases were managed by salpingo-oophorectomy with poatoperative chemotherapy, 3 cases by hysterectamy and salpingo-oophorectomy with postoperative chemotherapy. 7. Durations of follow up ranged 5 to 66 months, in that period, 5 cases were died, 4 cases were alive with disease and 4 casee wero no evidence of disease. 1 case was loat follow up after operation. All 5 patients were alive who had been treated with REP regirnen. In conelusion, prognosis of malignant NDOGCT is still poor in spite of adjuvant chemotherapy following surgery, and study ineluding appropriate chemotherapeutic regimen may be needed.
Carcinoma, Embryonal ; Chemotherapy, Adjuvant ; Drug Therapy ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Korea ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Phytolacca dodecandra ; Prognosis ; Recurrence ; Teratoma

OBJECTIVE: Pulmonary metastasis from carcinoma of the uterine cervix is relatively rare, and their clinical outcomes are not still remain unknown. This study is to evaluate survival and prognostic factors in recurrent cervical cancer patients showing lung metastasis. METHODS: From Jan. 1993 to Dec. 1996, 53 recurrent cervical cancer patients showing lung metastasis, registered in Korea Cancer Center Hospital, were retrospectively evaluated with respect to their clinical characteristics, response rate to salvage therapy, survival and prognostic factors. RESULTS: Median age of patients at recurrence was 58 years, and median interval of initial diagnosis to recurrence was 17 months. The most common histologic type was squamous cell carcinoma(82%), followed by adenocarcinoma(6%), adenosquamous(6%), and others(6%). Response rate to salvage therapy was 47%(complete response rate 23.5%, partial response rate 23.5%), and median survival was 10 months(range 1-39). 3 year survival rate was 18%. Age, initial stage, initial tumor size, interval of recurrence and type of chemotherapeutic regimen were not significant prognostic factors, but squamous cell carcinoma antigen(SCC) level at recurrence and response to salvage therapy was significant(p=0.0087, p=0.0104). CONCLUSION: Survival of recurrent cervical cancer patients with lung metastasis was poor despite salvage therapy. Those patients who showed low SCC level at recurrence and good response to salvage therapy had favorable outcomes.
Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Female ; Humans ; Korea ; Lung* ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Survival Rate ; Uterine Cervical Neoplasms*