Ovarian cancer is the seventh most common cancer in the world and the fifth most common cause of death from cancer; it is responsible for over half of all deaths related to gynecological cancers. The presence of lymphatic metastasis is an important prognostic factor in ovarian cancer. Nodal metastases to the pelvic and the para-aortic lymph nodes are common, particularly in an advanced of the disease (stages III-IV). The finding of distant nodal metastasis, especially subclavian lymph node metastasis, from ovarian carcinoma is very uncommon. 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) or FDG-PET/computed tomography (CT) provides an improved imaging for detecting metastatic lymph nodes in patients with ovarian cancer. Immunohistochemically, ovarian carcinoma cells are positive for estrogen receptor, progesterone receptor, cancer antigen 125, Wilms' tumor 1 protein, and p53; they are negative for thyroid transcription factor (TTF-1) and caudal-related homeobox 2 (CDX-2). This report describes a Korean woman diagnosed with ovarian cancer with subclavian lymph node metastasis revealed by FDG PET/CT and verified by an immunohistochemical staining. Differentiating between the primary ovarian lesion and the metastatic lesion will allow the initiation of an appropriate treatment and help predict the prognosis.
Cause of Death ; Estrogens ; Female ; Genes, Homeobox ; Humans ; Immunohistochemistry* ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Positron-Emission Tomography and Computed Tomography ; Prognosis ; Receptors, Progesterone ; Thyroid Gland ; Transcription Factors ; Wilms Tumor

Steroid cell tumors account for less than 0.1% of all ovarian tumors. There are three steroid cell tumor subtypes: steroid cell tumor not otherwise specified (NOS), stromal luteoma and Leydig cell tumor. Steroid cell tumor, NOS, is the most common type and has malignant potential. This report describes a case of an ovarian steroid cell tumor, NOS. A 35-year-old woman visited hospital with the complaint of metrorrhagia. Physical examination revealed increased pubic hair. Transvaginal ultrasound indentified a 4.9 x 3.4 cm, well-circumscribed and solid left ovarian tumor. After laparoscopic left oophorectomy, the tumor was revealed as an ovarian steroid cell tumor, NOS. During the laparoscopic surgery, tumor ruptured. Complete surgical staging was performed and no evidence of metastasis was found. Gonadotropin releasing hormone agonist was administered monthly for 6 months. The patient has had no evidence of recurrence for 43 months.
Adult ; Female ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Hair ; Humans ; Laparoscopy ; Leydig Cell Tumor ; Luteoma ; Metrorrhagia ; Neoplasm Metastasis ; Ovarian Neoplasms ; Ovariectomy ; Ovary ; Physical Examination ; Recurrence ; Sex Cord-Gonadal Stromal Tumors ; Steroids ; Ultrasonography

Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy.
Abdomen ; Abdominal Wall* ; Carboplatin ; Diagnosis ; Drug Therapy ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Ovum ; Paclitaxel ; Positron-Emission Tomography ; Postmenopause ; Prognosis ; Recurrence

In gynecology, endosalpingiosis is a benign condition in which the fallopian tube-like epithelium is found outside the fallopian tube. The thirty-four point five percent of endosalpingiosis cases have concurrent endometriosis and 40% of the endosalpingiosis group are in postmenopausal states. In contrast with endometriosis, there are no significant links between infertility, chronic pelvic pain and endosalpingiosis. The symptoms of endosalpingiosis are not yet settled. Endosalpingiosis is almost always an incidental finding; it is commonly found through microscopic examinations, and is then confirmed by pathologists for excision and biopsy. Therefore, the clinical differential diagnosis of an intramural mass is more important for clinicians when discussing further surgery with the patients. We report case of woman who has endosalpingiosis and is presented with vaginal bleeding. We first suspect the disease during physical examination. Under the impression of pelvic mass, laboratory tests and radiological images of contrast enhanced chest computer tomography are taken. Images show multisepted cystic masses in left adnexa. To rule out the pelvic mass, we executed exploratory laparotomy. Pathologic results show endosalpingiosis near the ovary section. But the endosalpingiosis, is not generally considered a pathology, and thus, no treatment is necessary.
Aged* ; Biopsy ; Diagnosis, Differential ; Endometriosis ; Epithelium ; Fallopian Tube Diseases ; Fallopian Tubes ; Female ; Gynecology ; Humans ; Incidental Findings ; Infertility ; Laparotomy ; Menopause ; Ovary ; Pathology ; Pelvic Pain ; Physical Examination ; Thorax ; Uterine Hemorrhage

OBJECTIVES: To examine the effect of diazoxide on hypoxia-induced soluble fms-like tyrosin kinase-1 (sFlt-1) release in JEG-3 choriocarcinoma cells. METHODS: Cells were cultured under normoxia (20% O2) or hypoxia (1% O2), and expression of sFlt-1 mRNA and protein release was determined by quantitative real-time reverse-transcriptase polymerase chain reaction (qRT-PCR) assays and enzyme-linked immunosorbent assay (ELISA). RESULTS: Tumor necrosis factor-alpha (TNF-alpha) as well as hypoxia stimulated sFlt-1 release and diazoxide inhibited both of them. The selective inhibitor of mitochondrial adenosine triphosphat (ATP)-sensitive K+ channel opener (K(ATP)) 5-hydroxydecanoate (5-HD) completely reversed the diazoxide-induced inhibition of hypoxia-stimulated sFlt-1 release. qRT-PCR and Western blot analyses showed that diazoxide up-regulated the heme oxygenase-1 (HO-1) expression. In addition, the HO-1 inducer cobalt protoporphyrin (CoPP) and the metabolic product of HO-1 bilirubin mimicked diazoxide to inhibit sFlt-1 release and reactive oxygen species (ROS) production under hypoxia, whereas the HO-1 inhibitor zinc protoporphyrin IX (ZnPP IX) antagonized the effect of diazoxide. In cells transfected with the HO-1 siRNA, diazoxide did not exert any effect on sFlt-1 release and ROS production under hypoxia. CONCLUSION: These results, taken together, strongly suggest that up-regulation of the HO-1 expression is the crucial mechanism responsible for the diazoxide-induced inhibition of the sFlt-1 release and ROS production under hypoxia.
Adenosine ; Anoxia ; Bilirubin ; Blotting, Western ; Choriocarcinoma* ; Cobalt ; Diazoxide* ; Enzyme-Linked Immunosorbent Assay ; Female ; Heme Oxygenase-1 ; Humans ; Polymerase Chain Reaction ; Pregnancy ; Reactive Oxygen Species ; RNA, Messenger ; RNA, Small Interfering ; Tumor Necrosis Factor-alpha ; Up-Regulation ; Vascular Endothelial Growth Factor Receptor-1 ; Zinc

OBJECTIVES: Borderline ovarian tumors (BOT) are premalignant lesions. Approximately 10% of all epithelial ovarian cancers are known to be hereditary with hereditary breast and ovarian cancer (HBOC) accounting for approximately 90% of cases; the remaining 10% are attributable to Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC). The aim of our study is to estimate this risk based on screening immunohistochemistry (IHC). METHODS: Thirty-four patients diagnosed with BOT were identified. Family history, clinical characteristics, and IHC data (breast cancer 1, early onset [BRCA1], breast cancer 2, early onset [BRCA2], mutS homolog 2 [MSH2], mutL homolog 1 [MLH1]) were collected for all cases from the patients' medical charts. Nuclear staining of the tumor was scored as negative and positive. RESULTS: Among 32 patients, 14 (44%) had serous type and 18 (56%) had mucinous type. The mean patient age was 44 years (range 19-86).The number of patients with weak IHC staining for MSH2 and BRCA2 was 1 (3%) and 6 (19%) respectively. The median follow up was 21.8 months. CONCLUSION: According to the results, we discovered that 3% and 19% of patients with BOT had a risk of hereditary cancer based on IHC analysis respectively. This pilot study may help clinician to counsel effectively for confirmative tests.
Breast ; Breast Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis ; Follow-Up Studies ; Humans ; Immunohistochemistry* ; Mass Screening ; Mucins ; Ovarian Neoplasms ; Pilot Projects

OBJECTIVES: To investigate awareness and experience of menopausal symptom and hormone therapy in Korean postmenopausal women. METHODS: A total of 570 postmenopausal women were accepted our survey. The women filled out the questionnaires composed of medical and surgical history, menopausal age and symptom, demand of treatment on menopausal symptom, and personal method for overcoming the symptom. Also, we make inquiries about experience of hormone therapy, concern about hormone therapy, improvement of menopausal symptom after therapy, adverse effect, and cause of cease the therapy. RESULTS: According to the survey, 80% (456/570) of the women experienced menopausal symptom. When they felt the symptom at first, 47% (213/570) of women was 46-50 years old. The most common menopausal symptom was hot flushes (141/570). A number of Korean women regarded that menopause was a natural process of ageing (69%). Eighty two % of women thought to need to have treatment on menopausal symptom. However, only half (43%) visited doctor. The most concerned disease after menopause they had answered was osteoporosis (60%) but only 22% of women were taken regular check-up of bone mineral density. The common causes were unwilling to do treatment were concern about adverse effect (51%) and indefinite fear of cancer (32%). Moreover, many women got diverse information about menopause from the mass media than professional advice. CONCLUSION: Only a minority of Korean postmenopausal women with menopausal symptoms had taken a hormone therapy. We should provide appropriate education and counsel to Korean peri-menopause women.
Bone Density ; Education ; Female ; Humans ; Mass Media ; Menopause ; Osteoporosis ; Surveys and Questionnaires

It has been well established that women generally have lower incidence rates of hypertension than men at similar ages and these differences may vary with age. It also has been observed in many studies that after menopause, blood pressure (BP) increases in women to levels even higher than in men. The lack of estrogens may not be suggested as the only component involved in the development of postmenopausal hypertension. Thus, in this mini-review, the possible mechanisms by which sex hormones may influence the BP are discussed. This review also examines the renal regulatory mechanisms for gender differences in BP and explores the effects of salt intake on BP (salt-sensitivity) in pre and post-menopausal women. Estrogen has been shown to stimulate nitric oxide (NO) production, thus female sex hormones have a beneficial effect on BP control. Evidences that angiotensin type 2 receptor (AT2R) is up-regulated by estrogen support the favorable effects on BPs in women than men. The kidney plays an integral role in the regulation of arterial pressure through the mechanism of pressure-natriuresis, which has been shown to be modulated by the RAS. The prevalence of salt-sensitivity increases with age and low-salt diets has shown to help reduce systolic BP (SBP) and diastolic BP. While oral hormone replacement therapy has yielded only a neutral or minimal effect on the elevation of SBP, both the transdermal route replacement and a novel progestin with anti-aldosterone activity (drospirenone) has also shown to reduce SBP.
Arterial Pressure ; Blood Pressure ; Diet, Sodium-Restricted ; Estrogens ; Female ; Gonadal Steroid Hormones ; Hormone Replacement Therapy ; Humans ; Hypertension* ; Incidence ; Kidney ; Male ; Menopause ; Nitric Oxide ; Postmenopause ; Prevalence ; Receptor, Angiotensin, Type 2 ; Sodium*

OBJECTIVES: The influence of sex steroid hormones on periodontium can be knockdown with good plaque control. The aim of the present study was to evaluate periodontal status in pre- and postmenopausal women with periodontitis following non-surgical therapy. METHODS: Total 60 female patients' periodontal status was measured by periodontal index (PRI), and oral hygiene status was measured by plaque index (PI). Both the parameters were measured at baseline i.e. before scaling and root planing and after 3 months intervals post treatment. Data were analyzed using SPSS version 21. RESULTS: The mean PRI scores in premenopausal group were 5.68 ± 0.64 and 2.53 ± 0.13, and PI scores were 1.84 ± 0.17 and 0.91 ± 0.13 respectively at baseline and 3 months. The mean PRI scores in postmenopausal group were 6.08 ± 0.46 and 2.55 ± 0.12, and PI scores were 1.86 ± 0.24 and 1.00 ± 0.24 respectively at baseline and 3 months. CONCLUSIONS: There was more desirable response to non-surgical periodontal therapy in both the groups but not significant variation in between two groups.
Dental Plaque ; Dental Scaling ; Female* ; Gonadal Steroid Hormones ; Humans ; Inflammation ; Menopause ; Oral Hygiene ; Periodontal Index ; Periodontitis* ; Periodontium ; Root Planing

OBJECTIVES: This study was coperinducted with the aim of prediction of marital satisfaction based on emotional intelligence for postmenopausal women. METHODS: This cross-sectional study was the descriptive-correlation and with a sample size of 134 people to predict marital satisfaction based on emotional intelligence for postmenopausal women was conducted in the Borujen city. The subjects were selected by convenience sampling. Data collection tools included an emotional intelligence questionnaire (Bar-on) and Enrich marital satisfaction questionnaire. RESULTS: The results of this study showed a significant positive relationship between marital satisfaction and emotional intelligence (P < 0.05, r = 0.25). Also, regression analysis showed that emotional intelligence (β = 0.31) can predict positively and significantly marital satisfaction. CONCLUSIONS: Due to the positive relationship between emotional intelligence and marital satisfaction, adequacy of emotional intelligence is improved as important structural in marital satisfaction. So it seems that can with measuring emotional intelligence in reinforced marital satisfaction during menopause, done appropriate action.
Cross-Sectional Studies ; Data Collection ; Emotional Adjustment ; Emotional Intelligence* ; Female ; Humans ; Menopause ; Personal Satisfaction ; Sample Size