The clinical role of tumor markers to detect the extent of tumor invasion and recurrence in cervical cancer has been debated. To evaluate the chncal significance of SCC, CEA and TPA as tumor markers in cervical, we studied 744 patients weith cervieal cancer from June 1990 to Mey 1994. The cut-off val ues of SCC, CEA and TPA were 1.5 ng/ml, 4.5 ng/mi and 110 U/I respectively. Followings were the results. 1. The serum concentration and positive rates of SCC before therapy(567 cases) were 3,0+/-7.0ng/ml(40.4%) for stage I,8.7+/-13.9 ng/ml(71.6%) for stage II, 10.8+/-14.7 ng/ml(85.7%) for stage III, 23.9+/-24.3 ng/ml(94.7%) for stage IV, and 13.4+/-19.1 ng/ml(75.0%) for recurrent cancer. It was increased with advancing clinical stage(p<0.01). 2. The seum levels and positive rate of CEA before therapy(627cases) were 3.4+/-4.3 ng/ml (18%) for stage I, 7.1+/-12.3 ng/ml(37.2%) for stage II, 8.4+/-9.6 ng/ml(57.9%) for stage III, 15.4+/-22.2 ng/ml(52.6%) for stage IV, and 10.3+/-16.2 ng/ml(46.4%) for recurrent cancer. It was increased with advancing clinical stage from stage Ito stage III(p<0.01). 3. The serum concentration and positiceive rate of TFA before therapy(301cases) were 51.7+/-53.8 U/l(9.5%) for stage I, 105.3+/-108.8 U/l(32.3%) for stage II, 186.3%+/-159.8 U/l(50%) for stage III, 191.3+/-l06.2 U/I(63.6%) for stage IV, and 135.4+/-117.0 U/l(46.4%) for recurrent cancer. It was increased with advencing clinical stage(p<0.01). 4. In 64 patients{24.2%) with lymph node invasion of 265 patients treated by operation, the mean serum levels of SCC, CEA and TPA were higher than lymph node negative group(p<0.05). 5. The serum levels of SCCand CKA after therepy were 82.8% in sensitivity. 94.3% in specificity, 67.9% in positive predictive value, 97.4% in negative predictive value.
Humans ; Lymph Nodes ; Recurrence ; Sensitivity and Specificity ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

No abstract available.
Dystocia* ; Female ; Pregnancy ; Shoulder*

OBJECTIVE: To evaluate the perinatal prognosis of fetuses with a single umbilical artery. METHODS: From 1992 to 1998, nineteen cases with single umbilical artery(SUA) was observed in 8,704 deliveries at Chonnam University Hospital. RESULTS: Out of nineteen fetuses, thirteen fetuses with single umbilical artery were detected by antenatal ultrasonographic examination and six fetuses were detected after birth. The male to female ratio was 0.9: 1. Congenital malformations were observed in 8 babies(42.1%) and included leg deformity, esophageal atresia, imperforated anus, ventriculomegaly, meningocele, hydronephrosis, ventricular septal defect, joint contracture, cleft lip and palate, toe anomaly, imperforated anus, kyphosis, no urethra and testis, clubfoot, patent ductus arteriosus and rnild mitral regurgitation. Among 10 cases of karyotyping analysis three cases were diagnosed as trisomy 18. Fourteen fetuses(77.8%) showed growth restriction at delivery. Antenatal obstetric complications were hydramnios(n = 3), oligohydramnios(n =2), and severe preeclampsia(n = 3). CONCLUSION: Careful ultrasonographic evaluation for the identification of a SUA is necessary because of its frequent association with congenital anomaly, growth restriction and cytogenetic abnormality.
Anal Canal ; Chromosome Aberrations ; Cleft Lip ; Clubfoot ; Congenital Abnormalities ; Contracture ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Female ; Fetus ; Heart Septal Defects, Ventricular ; Humans ; Hydronephrosis ; Jeollanam-do ; Joints ; Karyotyping ; Kyphosis ; Leg ; Male ; Meningocele ; Mitral Valve Insufficiency ; Palate ; Parturition ; Prognosis* ; Single Umbilical Artery* ; Testis ; Toes ; Trisomy ; Urethra

This study was undertaken at the department of Obstetrics and Gynecology, Chonnam University Medical School, to investigate the association between some of the risk factor and the incidence of intrauterine fetal growth restriction(IUGR). The studied population was selected from patients who admitted at Chonnam University Hospital during January, 1992 through May, 1997, with following criteria, Korean, singletone pregnancy with live birth and known gestational weeks with 28 or more. And then, the risk factors were analyzed in terms of maternal factor, placental factor, and fetal factor. The following results were obtained. 1) The incidence of IUGR was 6.1%. 2) The incidence of IUGR was higher at young aged mother and nullipara. 3) Only 39.1% of etiologic factors for IUGR was found to have known causes. According to the risk factors for IUGR, hypertensive disorder during pregnancy, anemia, cardiac disease, leukemia, and pulmonary tuberculosis were associated with increased incidence of IUGR. 4) The relative risk of IUGR was much higher in neonates born with congenital anomalies. 5) According to the placental causes of IUGR, placenta previa and placenta abruption showed some association with IUGR.
Anemia ; Fetal Development* ; Fetal Growth Retardation ; Gynecology ; Heart Diseases ; Humans ; Incidence ; Infant, Newborn ; Jeollanam-do ; Leukemia ; Live Birth ; Mothers ; Obstetrics ; Placenta ; Placenta Previa ; Pregnancy ; Risk Factors ; Schools, Medical ; Tuberculosis, Pulmonary

No abstract available.
Cervix Uteri* ; Female ; Lymph Nodes* ; Neoplasm Metastasis*

No abstract available.
Neural Plate* ; Neuroectodermal Tumors*

No abstract available.
Endometriosis* ; Female ; Pregnancy*

OBJECTIVE: To investigate the response of hyperplastic endometrium to Medroxyprogesterone acetate according to the histologic types such as simple typical, complex typical and atypical hyperplasia. METHODS: A total of 79 patients with histologically proved endometrial hyperplasia were enrolled into this prospective study between March 1996 and May 1998. Patients without atypia were placed on a regimen of cyclic therapy with 10mg MPA orally, each day for 14days per month for 3 months. In the cases in which hyperplasia did not regress , MPA was increased to 20mg. Patients with atypical hyperplasia received continuous MPA therapy, 20mg orally each day for 3 month. All patients were followed up for a minimum of 3 months and a maximum of 1 year(mean 7 months). RESULTS: In patients with simple typical hyperplasia, 45 patients(80.4%) had regression, 11 patients(19.6%) had persistence and none had progression. In patients with complex typical hyperplasia, 10 patients(83.3%) had regression, 2 patients(16.7%) had persistence and none had progression. But, in patients with atypical hyperplasia 5 patients(45.4%) had regression, 4 patients(36.4%) had persistence and 2(18.2%) patients had well differentiated endometrial adenocarcinoma. There was no recurrence during the follow up. CONCLUSION: This data suggest that most women with typical hyperplasia respond to progestin therapy, but there is high failure rate of response to progestin therapy and risk of endometrial cancer in patients with atypical hyperplasia. If the young patient desires to preserve her fertility, then progestin therapy may be considered as primary treatment in patients with atypical hyperplasia. But older patients in whom fertility is not an issue, hysterectomy should be selected as treatment of choice for atypical lesion.
Adenocarcinoma ; Endometrial Hyperplasia* ; Endometrial Neoplasms ; Endometrium ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hyperplasia ; Hysterectomy ; Medroxyprogesterone Acetate ; Medroxyprogesterone* ; Prospective Studies ; Recurrence

Pure ovarian choriocarcinoma of germ cell origin is exceedingly rare neoplasm, and even the presence of choriocarcinomatous elements admixed with other neoplastic germ cell elements is rare. In the most cases, the tumor is admixed with other neoplastic germ cell elemeats, and their presence is diagnostic of noagsatational choriocarcinoma, except for the remote of the tumor being a geatational choriocarcinoma metasttic to an ovarian germ cell tumor. We have experienced a case of nongestational ovarian choriocarcinoma in 10 year dld woman. So we report this case with a brief review of its literatures.
Choriocarcinoma* ; Female ; Germ Cells ; Humans ; Neoplasms, Germ Cell and Embryonal ; Pregnancy

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*