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

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

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: 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

Our aim was to identify histologic changes in cervical carcinoma tumor cells due to chemotherapy,by electron microscopic examination. Cisplatin and 5-fluorouracil were used between March 1, 1994 and February 28, 1995 on a total of 16 patients. The treatment schedule consisted of 75 mg/m2 cisplatin via iv with hyperhydration on Day 1, in combination with 1000 mg/m2 5-fluorouracil via continuous iv on Day 1 to 5. The treatment was repeated every 4 weeks with a maxinum of 3 courses. Ultrastructurally, chemotherapy induced apoptosis,indicated by condensation of nucleus and cytoplasm,fragmentation of nuclei, and apoptotic bodies. Due to repeat chemotherapy, increased levels of desmosomes were noted and parts of tumor nests were replaced by mature squamous cells. Tumor nests were reduced in size, mitochondria exhibited swelling, the endoplasmic reticulum was dilated, and infiltration of inflammatory cells increased after chemotherapy. These results suggest that chemotherapy induces apoptosis and injury to the cytoplasm and nuclei of tumor cells. However, the exact selection mechanism of the biochemical pathway of cell death is not fuUy understood. Further study of the molecular biologic actions of cell death after chemotherapy is warranted.
Apoptosis ; Appointments and Schedules ; Cell Death ; Cisplatin ; Cytoplasm ; Desmosomes ; Drug Therapy* ; Endoplasmic Reticulum ; Fluorouracil ; Humans ; Mitochondrial Size

No abstract available.
Leiomyoma*

Cervicography is an adjunct method of cervical cancer screenign intended to complement papanicolaou smear. Cervicography involves obtaing and evalutionag a photographic image of the cervix.the purpose of this investigation was to evalute the efficacy of cervicography in cervicla cancer screening. Papanicolaou smear and cervigram data were obtainde for 169 patients who visited Department of Obstetrics and Gynecology, Chungnam Nationa University Hospital form September 1995 to march 1996. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen.the resunt wre as follows:1. the sensitivity and the specificity of cervicography was 78.8% and 86.3% respcetively. 2. the positive predictive value, negative predictive value, false negative rate, and false positive rate of cervicography were 71.9%, 90.15%, 13.7%, 21,2% respectively. 3. The sensitivity and the specifictiy of Papanicolaou smear was 84.6% and 92.3% respectivesly. 4. the positivie predictive value, negative predictive value, false negative rate, and false positive rate of Papanicoloau smear were 83.0%, 93.1%, 7.7%, 15.4% respecitively. 5. There was no significant difference between the sensitiviey and the specificity of cervicography and Papanicolaou smear (p=0.449, p=0.139) 6. When cervicography and Papanicolaou smear were used donjointly, the sensitivity was higher than for cervicography or Papanicolaou smear used alone (96.1% vs 78.8% p= 0.008, 96.1% vs 86.3%. p=0.047) However the specificity of the combined tests was lower than Papanicicolaou smear(80.3% vs 92.3% p=0.008). Cervicography is a useful method to detect cevical cancer. Howerver when cervigrams are used in conjuction with Papanicolaou smear, the detection rate of cervical cancer will be increased.
Chungcheongnam-do ; Complement System Proteins ; Early Detection of Cancer ; Female ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Cervicography is an adjunct method of cervical cancer screenign intended to complement papanicolaou smear. Cervicography involves obtaing and evalutionag a photographic image of the cervix.the purpose of this investigation was to evalute the efficacy of cervicography in cervicla cancer screening. Papanicolaou smear and cervigram data were obtainde for 169 patients who visited Department of Obstetrics and Gynecology, Chungnam Nationa University Hospital form September 1995 to march 1996. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen.the resunt wre as follows:1. the sensitivity and the specificity of cervicography was 78.8% and 86.3% respcetively. 2. the positive predictive value, negative predictive value, false negative rate, and false positive rate of cervicography were 71.9%, 90.15%, 13.7%, 21,2% respectively. 3. The sensitivity and the specifictiy of Papanicolaou smear was 84.6% and 92.3% respectivesly. 4. the positivie predictive value, negative predictive value, false negative rate, and false positive rate of Papanicoloau smear were 83.0%, 93.1%, 7.7%, 15.4% respecitively. 5. There was no significant difference between the sensitiviey and the specificity of cervicography and Papanicolaou smear (p=0.449, p=0.139) 6. When cervicography and Papanicolaou smear were used donjointly, the sensitivity was higher than for cervicography or Papanicolaou smear used alone (96.1% vs 78.8% p= 0.008, 96.1% vs 86.3%. p=0.047) However the specificity of the combined tests was lower than Papanicicolaou smear(80.3% vs 92.3% p=0.008). Cervicography is a useful method to detect cevical cancer. Howerver when cervigrams are used in conjuction with Papanicolaou smear, the detection rate of cervical cancer will be increased.
Chungcheongnam-do ; Complement System Proteins ; Early Detection of Cancer ; Female ; Gynecology ; Humans ; Mass Screening* ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

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