No abstract available.
Humans

PURPOSE: Colposcopic response of preoperative uterine cervix carcinomas to intra-arterial cisplatin infusion chemotherapy was analyzed to evaluate the efficacy of this therapy after selective pelvic arteriography. MATERIALS AND METHODS: Nine patients of stage 1/11 cervical carcinomas were treated twice with intra-arterial cisplatin chemotherapy of a 3-week interval, with every week follow-up of colposcopy and histology until the radical hysterectomy and pelvic lymphadenectomy on the 6th week. Cisplatin of 50mg/m~ was slowly infused via autoinjector for 10 minutes with the catheter tip placed in both internal iliac arteries around uterine artery branching. RESULTS: Colposcopic regression rate of tumor size was as follows:more than 2/3 decrease of original size in 2 patients, 2/3-1/2 in 2 patients, less than 1/2 in 4 patients, but in one patient minimal increase in tumor size was recognized. Colposcopic and postoperative microscopic pathology revealed degeneration and necrosis of the tumor cells and/or adjacent lymph nodes and fibrosis of surrounding tissues. All patients have been doing well until postoperative 25 months without recurrence or significant complications. CONCLUSION: Preoperative intra-arterial cisplatin chemotherapy after selective internal iliac rteriography is helpful to decrease tumor size and improve histologic response and prognosis in stage I and II cervical carcinomas.
Angiography* ; Catheters ; Cervix Uteri* ; Cisplatin* ; Colposcopy ; Drug Therapy* ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Hysterectomy ; Iliac Artery ; Lymph Node Excision ; Lymph Nodes ; Necrosis ; Pathology ; Prognosis ; Recurrence ; Uterine Artery

Cervicography is used commonly in cervical cancer screening with a Pap smear. Many reports shows that the combination of these two methods is more accurate and helpful in cervical cancer screening. OBJECTIVE: The purpose of this investigation was to evaluate the efficacy of conjoined methods in cervical cancer screening and to evaluate any difference between health care center and out-patient treatment. METHODS: Pap smear and cervicogram data were obtained for 699 patients who visited the Department of Obstetrics and Gynecology, Chungnam National University Hospital from January 1997 to December 1997. Of these patients, 551 patients visited the health care center and 148 were out-patients. We exmined all pertinent information, including biopsy results, for patients with detected abnormalities. A total of 62 patients received a biopsy. RESULTS: 1. Results for Papanicolaou smear were: sensitivity, 81.8%, specificity, 98.0%, positive predictive value, 83.7%, negative predictive value, 98.8%, false negative rate, 18.2%, and false positive rate, 2.0%. 2. Results for cervicography were: sensitivity, 86.4%, specificity, 97.8%, positive predictive value, 73.1%, negative predictive value, 99,1%, false negative rate, 13.6%, and false positive rate, 2.2%. 3. Results for the conjoined method were: sensitivity, 97.7%, specificity, 97.2%, positive predictive value, 70.5%, negative predictive value, 99.8%, false negative rate, 2,3%, and false positive rate, 2.8%. 4. When cervicography and Papanicolaou smear were used conjointly The sensitivity, specificity, negative predictive value, false negative rate, and false positive rate were statistically significant for Papanicolaou smear (P<0.05). 5. There was no statistical significance difference between cervicography and the conjoined method. 6. Compared with out-patients, Health care center patients showed increased diagnostic error and failure to follow-up. CONCLUSION: When cervicography and Papanicolaou smear were used conjointly, cervical cancer detection rates were increased.
Biopsy ; Chungcheongnam-do ; Delivery of Health Care ; Diagnostic Errors ; Follow-Up Studies ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Outpatients ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

OBJECTIVE: The kinetic indices of apoptosis and cell proliferation m a histopathologic spectrum of the cervical neoplasia were evaluated to clarify the correlation between cervical neoplasm and apoplasis. Specific lesioas included cervical intraepithelial neoplasia(CIN), catcinoma in situ(CIS), and invasive carcinama. METHODS: Archival samples from normal cervical epithelium(n=7), low-grade squamous intraepithelial lesions(LGSIL, n=17), high-grade squamous intraepithelial lesions(HGSIL, n=17), invasive squamaus carcinoma(n=7) were evaluated for apoptosis and cell proliferation. Apoptotic cells were identified with terminal deoxynucleotidyl transferase-labeling of the 3'-OH end of DNA nucleosomes, and then apoptotic index(A.I sum of apoptotic bodies/ 1000 tumor cells) and total cell count(* 400 magnification) were calculated. RESULTS: In normal squamous epitheliam, Apoptotic bodies were mainly localized in ial layers, for low-grade squamous intraepithelial lesions(HGSIL) in superficial and intermediated layers, for high-pade squamous intraepithelial lesions(HGSIL) in intermediated and parabasal layers, for invasive carcinoma in full thic of squamous epithelium. Apototic indces(AI) in invasive carcinoma(mean: 6.21) were significantly higher than indices for high-grade squamous intraepithelial lesions(HGSIL, mean: 0.98) and high-grade squamous intraepithelial lesions(HGSIL, mean: 0.98) were significantly higher than indices for low-grade squamous intraepithelial lesions(LGSIL, mean: 0.12)(p<0.01), the total cell counts increased significantly as the specimens progressed toward invasive disease. (p<0.01) CONCLUSION: Apoptosis in cervical neoplasia appears to be closely related to poliferation and progression of the cervical squamous epithelial cell. This phenotype may allow identification of premalignant lesions with the potential to transform to cervical cancer.
Apoptosis* ; Cell Count ; Cell Proliferation ; DNA ; Epithelial Cells ; Epithelium ; Nucleosomes ; Phenotype ; Uterine Cervical Neoplasms

OBJECTIVE: Frozen-section evaluation of gynecologic tumors has historically been used to establish a histopatholgic diagnosis and to guide surgeons in appropriate surgical procedure. this study is to assess the clinical appropriation and accuracy of frozen-section biopsy in gynecologic tumors. METHODS: This is a retrospective quality assurance study all of frozen-section biopsy done at Chungnam National University Hospital during a three year period (1995 to 1997). There were 125 cases out of 2310 surgical specimens for gynecologic tumors, and the results were compared with final diagnoses based on fixed tissue specimens. RESULTS: Frozen section biopsy was accurate in 95.2% of all cases, in 96.3% (104/108) of ovarian tumor cases, and in 88.2% (15/17) of uterine tumor cases. Analysis of 6 inaccuracy cases revealed that most cases were sampling errors and occurred in mucinous tumor, belonging to all cases of ovarian tumors. Sensitivity, specificity, positive predictive value, and negative predictive value of frozen-section biopsy in ovarian tumors were 0.94, 1.00, 1, 00, 0.97. CONCLUSION: Frozen section biopsy is an appropriate method as a basic guideline during operations of gynecologic tumors and this method can obtains the highest accuracy when there is cooperation between experienced surgeons and reliable and careful pathologists. The accuracy of frozen section diagnosis has important implications regarding the type and extent of the primary surgery for gynecologic tumors.
Biopsy* ; Chungcheongnam-do ; Diagnosis* ; Frozen Sections* ; Mucins ; Retrospective Studies ; Selection Bias ; Sensitivity and Specificity

No abstract available.
Drug Therapy* ; Uterine Cervical Neoplasms*

No abstract available.
Female ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; Ovary*

No abstract available.
Female ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; Ovary*

OBJECTIVE: The need for early and correct prescription for bone densitometry led to the research for decision model useful for clinicians to address women to bone densitometry. there are few studies that have focused on both pre- and postmenopausal groups simultaneously in healthy pre-and postmenopausal Korean women. METHODS: The authors analyzed the easily obtained biometrical variables such as factors used at clinical decision rules for BMD testing and evaluated predictive values and robustness of a decision model for prediction of lumbar BMD in total , pre-and postmenopausal Korean women. RESULTS: After stepwise multiple regression analysis, Lumbar BMD in total population is 1.083-0.153 (status of menopause)-0.007 (age of menopause)+0.0039 (body weight) (R2=0.52). Postmenopausal women is 0.563-0.0077 (duration after menopause)+0.0054 (body weight) (R2=0.30) and premenopausal women is 0.23+0.0048 (height) (R2=0.05). Although its validity (52%) in total population was sufficiently high for the prediction of lumbar BMD in clinical settings, In postmenopausal women only 30% of the decision model can be explained by the predictors of bone demineralization which is not completely satisfactory in determining lumbar BMD and in premenopausal women 5% is the very low explanatory value which is necessary for identifying possible factors influencing BMD. CONCLUSIONS: Because of difference in underlying risk, as well as differences in the distribution of different risk factors according to menopausal status, this study present different robustness of prediction models according to menopausal status and suggest that it be need to design prediction models divided by menopausal status. More research is needed for computer-based screening aids useful to clinician which overcome some limitation of our study.
Bone Density ; Densitometry ; Female ; Humans ; Korea ; Mass Screening ; Prescriptions ; Risk Factors

No abstract available.
Leiomyoma*