Massive ovarian deema is a tate conditian. It is a benign enlargement of the ovary caused by accumulation of fluid, which is thought to result from intermittent partial toraion of the ovarian pedicle. Histologically, the ovaries were characterized by diffuse edema of medulla and inner cortex. Two cases of massive ovanan edema are reported with brief review of the literatures.
Edema* ; Female ; Ovary

Pure, nongestational ovarian choriocarcinomas is extremely rare. Most ovarian choriocarcinoma are combined with other malignant germ cell tumors or can arise as a metastaais from a primnry gestational choriocarcinoma. We experienced a case of primary ovarian choriocarcinoma that probably was associated with a past history of the mixture of germ cell tumor and present it with a review of literature.
Choriocarcinoma* ; Female ; Neoplasms, Germ Cell and Embryonal ; Pregnancy

A case of 42-year-oldI kidney transplant patient who developed invasive carcinama of the cervix after immunoauppresawe therepy is reported and the literature related to this diease is revuewed. The iatmgenic immunosuppresaionn renal transplantation recipients has been associated with increased incidence of malignancy in these patients. In particular, immunosuppressed women are al greater risk of developing cervical intraepithelial neoplasia and buman papillomavirus type 16 or 18 infection. So, all such individuals are required to receive periodic gynecologic examination before renal transplantation and at regular intervals thereafter so that the development of CIN may be diagnosed at an early Stage and treated effestively.
Allografts* ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Female ; Humans ; Incidence ; Kidney ; Kidney Transplantation

Malignant germ cell tumore occur in children and young women in reproductive age, of all the germ cell maligaanci orily pure dysgerminiomas had a high cure rate prior to 1970. This was due to the exquisite wdioseneitivity of these tumors. Multiple agent chemotherapy has dramatieally improved the pr nosis af patients with malignant ovarian germ cell tumors. The purpose of this study is to report the experience at Aaan Medical Center, department of Obstetrics and Gynecology, in 16 patients withmalignant ovarian germ cell tumors treated between July, l989 and June, l994. We analyzed the effect of age, histolagic subtype, FIGO stage, surgical pmcedurse and regimens of chemotherapy, on the prognosis of thwe tumors. The results obtained were as follows: 1. In histologic subtypes, dysgenninoma(38.0%), endodermal sinus tumor(25.0%), squamous cell carcinoma arising in mature cystic teratoma(19.0%), mixed cell tumor(6.0%), immature teratoma(6.0%), malignant ectodermal tumor in mature cystic teratoma(6.0%), were counted in order. 2. No site predilection was identifed. 3. Main initial symptoms were abdominal distension(31.0%), abdominal pain(31.0%), abdominal mass palpation(25.0%), amenorrhea(6.0%) in order. 4. Multiple tumor markers were considered to be useful in diagnosis and follow up of malignant germ cell tumors of ovary. 5. The mean age of malignant ovarian germ cell tumors was 29.5 years, and 11 cases(69.3%) of tumors under the age of 30.0 years. 6. The survival rate seemed to be decreased with advancing FIGO stage.
Carcinoma, Squamous Cell ; Child ; Diagnosis ; Drug Therapy ; Ectoderm ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Prognosis ; Survival Rate ; Biomarkers, Tumor

Specific types of HPV are currently implicated as etiologic agents of precuraors and cancerous lesions of the uterine cervix. This study used the data gained from one hundred twenty five wmen who underwent cnnrrent. Papanicoiaou smear, colposcopic diagnosis, and cervicovaginal lavage for HPV BNA test at Dysplasia Clinic in Kangnam St. Mary's Hospital. 38 patients had low-grade squemous intraepithelial lesiona (LGSILs) and 34 had high grade squamoua intrepithelial lesions (HGGILs), 24 invasive cervical cancers, and 29 normal control. Comlposcopic feeturee were prpectiively recorded by Reids colposcopic index and t,hen correlated with histapathologic diagnoeis. Using the colposcopic index, 86.4% was eorrelated with histapathologic findings. DNAs extracted from the cervicovaginal lavages were analyzed by polymerase chain reaction (PCR) using the HPV L1 consensus primers. HPV DNA was detected in 79 of 125 women (63.2%). Prevalences of HPV DNA in the patients with LGSIL (71.1%), HGSIL, (76.5%i) and cervix caneer (75.0%) showed no difference in statistics. Low-risk oncogenic viruses.(HPV-6/11) were present in 13.2% of patients with LGSIL, but none was detect,ed in thoee with HCSIL and cervix cancer. Intermediate-riak oncogenic viruses (HPV-31/33/35) were deterted in 5.3% of patients with LGSIL 8.8% in HGSIL, and none in cervix cancer. Prevalence of high-rsk onccgenie type HPV 16/18 was higher in HGSIL (41.2%) and invnsive cervical cancer (45.8%) than those of LGSII (15.8%) and cnntrols (3.5 %) (P = 0.0001). These data indicate that colposcnpic scoring has adjunctive diagnostic rale in predict,ing his-tology. And, HPV DNAs were found in similar incidence in the various histologic grades of cervical neoplasia. HPV-6/11 were detec only in LGSIL and HPV 31/33/35 in LGSIL and HGSIL, but not in invasive canser. HPV-16/18 were the predominant viruses which were detected in HGSIL, and invasive aervi 1 cancer. In canch.isizn, a combination of HPV testing and colposcopic scoring would provide sensitive screening methade for cervial cencer and pr nceraus lesions. And HFV typing might have prognmtic value in the management of patients with HPV related cervical neoplastic lesions.
Cervix Uteri ; Colposcopy* ; Consensus ; Diagnosis* ; DNA ; Female ; Humans* ; Incidence ; Mass Screening ; Oncogenic Viruses ; Polymerase Chain Reaction ; Prevalence ; Respiratory Sounds ; Therapeutic Irrigation ; Uterine Cervical Neoplasms

The widespread uae of colposcopy in the evaluation of abnormal cervical cytology has been accompanied by a trend toward decreased utilization of Papanicolaou smears and cone biopsy. But its accuracy is dependent on the criteria determining its limitations and the observer's experience. This study was performed to evaluate the diagnostic accuracy of Papanicolaau smear and eolposcopic finding and to campare these findinga with thase af colposcopically directed biopsy, conization and hysteretomy and to determine the value of endocervical curettage. Nine hundred twenty six patients were evaluated from Jan. 1, 1986 to Dec. 31, 1993 at the cancer detectinn center of the department of obstetrics and gynecology, Yonsei University, College of Medicine. Three major classes were involved in this study ; 662 cases with within normal limit Papanicolaou amears with cervical examination grossly suspicious for cancer, 187 cases with squamous intraepithelial lesion or greater, and 72 caees with reactiue or reparative change. The patients with inveaive rnalignancies of the cervix visihle to the naked eye were not included in this study. The majority of patients(75%) were 31 to 50 years of her age. The colposcopic examination wee deemed unsatisfactory in 45 cases in whom the upper limit, of the transformation zone could not be visualized. There were 881 cases each with a satisfactory colposcopie examination. We obtained the following results. In the satisfactory group with within normal limit Pap smears which had clinical impression of gross suspicion for cancer, 54 of 662 cases(8%) were diagnosed as more than cervical intraepithelial neoplasia I and 36(5.5%) were diagnosed as more than cervical intraepithelial neoplasia II with the histology of colposcopically directed biopsy. The analysis of the diagnostic values of Pap smears for cervical cancer screening showed that the sensitivity was 80.0%, the specificity was 93.8%, the false negative rate was 80.0%, the false positive rate was 15.2%, the negative predicitive value was 92.1%, and the positive predicitive value was 83.6%. In the satisfactory group with within normal limit Pap smears which had clinical impression of gross suspicion for cancer, 54 of 662 cases(8%) were diagnosed as more than CIN I and 36(5.5%) were diagnosed as more than CIN III with the histolgy of colposcopically directed biopsy. The accuracy of colposcopic impression when compared to histology of the colposcopically directed biopsy in the satisfactory group was 89.8% (within 1histologic degree) and 82.7% (precise agreement). Histologic comparision of colposcopically directed biopsy and final surgical specimen showed accuracy of 87.2% (within 1 histologic degree) and 66.5% (precise agreement). The accuracy of endocervical curettage with colposcopically directed biopsy when compared with final surgical specimen in unsatisfactory group was 82.2% (with 1 histologic degree) and 57.7% (precise agreement). In conclusion, satisfactory colposcopic evaluation in conjuction with Pap smear offers accurate method for cervical cancer detection. But endocervical curettage with colposcopically directed biopsy appears to be of less value in unsatisfactory group. Therefore futher evaluation is need.
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Colposcopy* ; Conization ; Curettage ; Female ; Gynecology ; Humans ; Mass Screening ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

It hae been well established that, specifi alterations in members of the ras gene family, H-ras, K-ras and N-ras, can convert them into active oncogenes. These alterations are either point mutations occurirg in either codon 12, 13 or 61, or alternatively, a 5- to 50-fold amplification of the wfld-type gene. Activated ras oncogenes have been found in a significant proportion of all turnors, but the incidence varies considerably with the tumor type : it is frequent (20~40%) in colarectal eancer and acute myeloid leukemia, but absent or preaent rarely in breast and atomach cancer. But the role of c-K-ras point mutatio in the development of cancers in the female genital tract has not been extensively studied. Polymerase chain reaction followed by gel electrophoresis was performed respectively using wild-type normal and specific point mutation primers{GGT->GAT, GGT->AGT, GGT->TGT and GGT->GTT) to detect, point, mutation of codon 12 of c-K-ras oncogene. The c-K-ras oncogene point mutation was confirmed by Southern blot hybridization using synthetic oligonucleatide probe. 3'-end Iabelled with digoxigenin -dUTP. With this method, the frequency of point mutation on codon 12 of c-K-ras oncogene was examined the tissues in 37 casea of ovarian cancer, 7 cases of endometrial cancer, 36 cases of the gestational trophoblastic tumor, 60 cases of cervical cancer. The relationship between the presence of a c-K-ras point mutation and clinicopathological characteristics of the female genital tract cancers were also analysed. The results were as follows; 1. The incidence of four point mutations on codon 12 of c-K-ras oncogene in 37 ovarian cancers was 45.9% (17/37) and distribution were 43.2% (16/37), 2.7% (1/37) and 0% (0/37) in GGT-->GAT, GGT-->AGT, GGT-->TGT, and GGT-->GTT, respectively. According to histological type, in ovarian cancers, The point mutation of K-ras oncogene waspositive in 45 % (10/22) of serous cystadenocarcinomas. The incidence of four point mutations on codon 12 among 37 patients with ovarian cancer according to histological type was 45.5 % (10/22) with serous cystadenocarcinoma, 57.1% (4/7) of mucinous cystadenocarcinoma. Comparing the positive rate of point mutations of K-ras oncogen among 37 patients with ovarian cancer with the clinical stage, point mutation was detected in 28.5% (2/7) of patients with stage I, 40.0% (2/5) with stage II, and 52.0% (13/25) with stage III/IV. There was no statistically significant increasement of point mutations with the advance of the clinical stage of ovarian cancer. Comparing the positive rate of point mutations of K-ras oncogen among 37 patients with ovarian cancer according to the histologic grade point mutation was detected in 50.0 % (2/4) 0f patients with grade I, 451.7 % (5/12) with grade II and 47.6 % (10/21) with grade III. 2. The incidence of point mutations of K-ras oncogen among 33 patients with ovarian cancer who were performed pelvic lymph node dissection was 57.1 % (12/21) of the patients with pelvic lymph node metastases and 16.7% (2/12) of the patients without pelvic lymph node metastases. There was statistically significant difference between the positive rate of c-K-ras point mutations and the pelvic lymph nodal status(P<0.05). 3. In 7 cases of endometrial cancer, positive rate of K-ras point was 42.8 % (3/7). Point mutations were also detected in 2 cases from 4 choriocarcinomas, but, the point mutation was only detected in 1 case from 60 cervical carcinomas. From these results, we may suggest that the point mutation on codon 12 c-K-ras oncogene are considered to be one of the important genetic change in the tumor formation and progression of ovarian of c-K-ras oncogene seems to be the one stop in the multistep process of tumor formation in ovarian cancer. Furthermore, the point mutation of c-k-ras gene could occur more frequently in the patients of ovarian cancer with pelvic lymph node metastases than in those without pelvic metastases, suggesting the orle in tumor progression. And we concluded that point mutation on codon 12 is comparable frequent in uterine endometrial carcinomas and have significance as an event that contributes to progrssion of endometrial cancers and choriocarcinoma, but cervical carcinoma do not appear to have c-K-ras point mutation in general. More studies will be necessary, but the detection of c-k-ras point mutation as the possibility of biological tumor marker to predict clinical outcome may be utilized in female malignancies.
Blotting, Southern ; Breast ; Choriocarcinoma ; Codon ; Cystadenocarcinoma, Mucinous ; Cystadenocarcinoma, Serous ; Digoxigenin ; Electrophoresis ; Endometrial Neoplasms ; Female* ; Genes, ras ; Humans ; Incidence ; Leukemia, Myeloid, Acute ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes* ; Ovarian Neoplasms ; Point Mutation* ; Polymerase Chain Reaction ; Pregnancy ; Trophoblastic Neoplasms ; Biomarkers, Tumor ; Uterine Cervical Neoplasms

Proliferating cell nuclear ntigen (FCNA) iis a nuclear protein that is syntheaimd in late Gl and S phases of cell cycle and is correlated with the cell proliferative stale. The recent study demonstrated that FCNA functions in 13NA replication. The present study evaluated proliferetive iindices (PI) for the assessment of tumor proliferation and for investigating prognostic significancx, in cervical tumors. lmmunohiatoehemical PCNA staining was perfurmed in formalin-fixed paraffin-embedded cervical tissues via the avidin-biotin-complex immunoperoxidase methad. Mean PI was 36.03+/-5.14% in normaI controls, as compared to 66.19+/-11.36% in cerviml intraepithelial neoplasia. and 63.19+/-10.94% in invasive cervical cancer. Our results showed no significant correlation between Pll and histological type. Among invasive cervical cancer (24 cases), PI waa 64.43+/-10.94% in squamoua cell carcinoma and 59.00+/-4.10% in adenocarcinoma. There was no eipiifiant relationship between Fl and clinical etage, and between PI and lesion size. This study auggeste that Pl may not serve as a new prognostie factor in cervical tumors.
Adenocarcinoma ; Cell Cycle ; Nuclear Proteins ; Proliferating Cell Nuclear Antigen* ; S Phase ; Uterine Cervical Neoplasms

Leiomyorrw is the mest cunmon in the uterine hunor. Smooth muscle tumors of the female genital taact arise mostly from the uterine myometrium and only rarely from the broad ligament. We experienced a cases of huge leiomyoma of the broad ligarnent with secondary cystic degeneration. In the respect of rarity, we report this case with a brief review.
Animals ; Broad Ligament* ; Female ; Humans ; Leiomyoma* ; Mice ; Myometrium ; Round Ligaments ; Smooth Muscle Tumor

This study was undertaker to define the usefuness of preoperative CA-125 assay as a diagnostic bmor marker in differentiating malignancy from benign ovarian mass. Senun CA-125 were imneasured by Microparticle Enzyme Immunoassay(MEIA) in 94 patients with ovarian mass. The results were of follows ; 1. The mean value of preopentive senun CA-125 was 18.40u/ml in benign ovarian mass and 225.99u/ml in malignant ovarian mass (P<0.001). 2. The positive rete of Ca-125 in benign ovarian mass was 10%, compared 80% in malignant ovarian mass. 3. In analysis of histolovgic type, posisitive rate of serum CA-125 in malignant serous tumor was 82%, cornpared 50% in malignant mucinoins tumor. 2. No statistically significant correlation was observed between CA-125 value and patient's age. 5. The sensitivitiy, specifieity, positive predictive value & negative predictive value were 80%, 90%, 60% & 96%, respectively in cut off value, 35u/ml, And increasing cut off value 65u/ml, sensitivity, specificity, positive predictive value & negative predictive value were 40%, 96%, 67%, 90%, resqxetively. These data suggest the preperative serum CA-125 level correlate with maignant stattis in ovarian mass. And cut off value 35u/ml was better than 65u/ml in screening for ovarian cancer.
Humans ; Mass Screening ; Ovarian Neoplasms ; Sensitivity and Specificity