No abstract available.
Fertilization in Vitro* ; Fertilization*

Dermoid cysts of the posterior fossa are benign, mostly midline, congenital brain neopasm, usually located above or behind the vermis or adjacent meninges2)18)20), Dermoid lesions are slow growing and may become quite large before producing signs and symptoms12). We have recently experienced a case of dermoid which arised in cerebellar hemisphere. A 32-year old woman who had a history of chronic headache at morining was visited in our department and she was also complained of a egg-sized plapable mass which was growing nature, non-tender, soft, and movable on the right occipital area. On admission, there were no specific localizing and lateralizing neurological abnormalities. Unenhanced CT scan shows hypodense mass in the left cerebellar hemisphere and cystic mass at the right occipital scalp(Fig. 1. A). T1-weighted MR image shows hypointense mass in the left cerebellar hemisphere(Fig. 2. A). The Carotid angiography shows non-specific findings. Paramedian suboccipital approach was performed and mass was removed from the lleft cerebellar hemisphere. The cystic scalp mass was removed totally from the left cerebellar hemisphere. The cystic scalp mass was removed totally from the right occipital area. Diagnosis of dermoid cyst was confirmed pathologically by the specimens obtained from two different sites, left cerebellar hemisphere and right occipital ccalp.
Adult ; Angiography ; Brain ; Dermoid Cyst* ; Diagnosis ; Female ; Headache Disorders ; Humans ; Scalp ; Tomography, X-Ray Computed

No abstract available.
Capsaicin* ; Eosinophils* ; Humans

OBJECTIVE: The clinical value of preoperative serum squamous cell carcinoma antigen(SCC) in relation to clinical stage, tumor volume, disease extent and prognosis has already reported in many papers. The aim of this study is to analyse the relationship between preoperative SCC level and pelvic lymph node metastasis. Matrials and METHODS: From March 1995 to December 1998, 157 patients who examined pretreatment SCC levels before undergoing radical hysterectomy for squamous cell carcinoma of uterine cervix were included. The effect of pelvic lymph node status on the SCC level was examined by comparing 125 cases with cancer limited uterus or upper vagina and 32 cases with cancer confined to the uterus (including upper vagina) and pelvic lymph node using multivariate analysis. RESULTS: 90% of patients without pelvic lymph node metastasis showed SCC levels of 2.9ng/ml or below. 60.7% of patients with serum SCC level more than 2.9ng/ml exhibited pelvic lymph node metastasis. The marker values exceeding 2.9ng/ml increased risk of nodal metastasis 5 times compared with serum level 2.9ng/ml or below. Multivariate analysis confirmed that the pelvic lymph node metastasis had a large impact on the marker level than did tumor size or depth of stromal infilteration. CONCLUSION: SCC levels greater than 2.9ng/ml can be considered a high risk zone for nodal metastasis
Carcinoma, Squamous Cell* ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis* ; Prognosis ; Tumor Burden ; Uterine Cervical Neoplasms* ; Uterus ; Vagina

OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

To evaluate the efficacy and diagnostic and prognostic significance of two tumor markers (SCCA, CA 125) in patient with squamous cell carcinoma of uterine cervix, the authors studied 215 patients with squamous cell carcinoma in situ and invasive carcinoma from September 1993 to November 1996. Both tumor markers were measured coincidently in 215 patients preopera-tively and in 70 cases of benign gynecologic disease for control group. Serum SCCA level of 2.5 ng/ml and CA 125 level of 35.0 U/ml were determined as cut-off levels. The results were as follows: 1. The pretreatment positive rate of SCCA in patient group were 35.8 %(77/215) and 5.7 %(4/70) in control group. 2. The mean values and positive rates of SCCA according to clinical stage were 1.44+/-3.59 ng/ml(8.7 %) for stage 0, 3.81+/-10.22 ng/ml(23 %) for stage I, 8.54+/-15.23 ng/ml(51.3 %) for stage II, 35.54+/-38.34 ng/ml(70.0 %) for stage III, 22.49+/-36.06 ng/ml(75.0 %) for stage IV, 40.33+/-58.66 ng/ml(66.7 %) for recurrent cancer, respectively. The mean SCCA value and positive rate were significantly increased stepwise by clinical stage from stage I to stage III (P<0.05). 3. The pretreatment positive rate of CA 125 in patient group were 21.9 %(47/215) and 17.1 %(12/70) in contrl group. 4. In pre-invasive and invasive groups, the mean value and positive rate of SCCA were 1.44+/-3.59 ng/ml(8.7 %), 9.05+/-25.26 ng/ml(43.2 %), respectively, and it was statistically significant between two groups (P<0.05). The mean values and positive rate of CA 125 were 24.36+/-16.14 U/ml(10.9 %), 35.15+/-59.52 U/ml(24.9 %), respectively, it was not statistically significant (P>0.05). 5. The result of preoperative serum levels of SCCA can be characterized by 35.8 % sensitivity, 94.3 % specificity, 95.1 % positive predictive value, 32.4 % negative predictive value, 49.5 % diagnostic efficiency, and with 21.9 %, 82.8 %, 79.7 %, 25.7 %, 36.8 % respectively for CA 125. Between these two tumor markers, the result of SCCA was more valuable than the other in sensitivity, positive predictive value, negative predictive value and diagnostic efficiency. The results indicate that measurement of SCCA and/or CA 125, have little efficacy in the early detection of squamous cell carcinoma considering it's low rate of positivity in preinvasive and early stage of invasive squamous cell carcinoma. However, in patients with advanced stage invasive carcinoma, measurement of serum SCCA is useful in prediction of prognosis and in early detection of recurrence, and concomitant measurements of SCCA and CA 125 may be more useful in determining prognosis, therapeutic response, and early detection of recurrence than measurement of SCCA alone.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Genital Diseases, Female ; Humans ; Prognosis ; Recurrence ; Sensitivity and Specificity ; Biomarkers, Tumor*

Menopause and hormone replacement therapy (HRT) are important issues today for women. Estrogens improve climacteric complaints and substantially reduce osteoporosis and cardiovascular disease. Rational clinical practice during the years of climacteric transition requires counselling on the risks and benefits of hormone replacement therapy and proper management of HRT users. Recently, significant findings from two clinical trials have been published in The Journal of the American Medical Association regarding postmenopausal women's use of oral conjugated equine estrogens and oral medroxyprogesterone acetate. This article reports principal results for the trial of combined estrogen and progestin in women with a uterus. The trial was stopped early based on health risks that exceeded health benefits over an average follow-up of 5.2 years. But, we advised Women who for a number of years have been on the combined estrogen/progestin therapy studied here should not panic, but discuss their individual situation with their physician. As for individual women, a decision about hormone use should take into account a woman's individual risk for specific conditions that may be harmed or benefited by hormone use. With respect to women on short-term use of combination hormone therapy for relief of menopausal symptoms, We note that although such use was not the focus of this study, it may be reasonable for women to continue use for this purpose, since the benefits are likely to outweigh the risks.
American Medical Association ; Cardiovascular Diseases ; Climacteric ; Estrogens ; Estrogens, Conjugated (USP) ; Female ; Follow-Up Studies ; Hormone Replacement Therapy ; Humans ; Insurance Benefits ; Medroxyprogesterone Acetate ; Menopause ; Osteoporosis ; Panic ; Risk Assessment ; Uterus

OBJECTIVE: The aim of this study is to evaluate the role of tumor suppressor genes, p53 and Rb gene, as well as apoptosis in the carcinogenesis of ovarian epithelial tumors. And the value of these factors as prognostic markers to tell the transformation of borderline tumors to overt carcinomas is also studied. METHOD: Thirty cases of ovarian epithelial benign and borderline tumors and invasive carcinoma were used and the expression of the p53 protein and Rb gene protein were evaluated by immunohistochemical method. The apoptosis was evaluated by TUNNEL method. RESULTS: Positive rate of p53 expression in benign, borderline and invasive tumors were 0, 28, and 94 %, respectively. And also, p53 was highly expressed in chemoresistant cases (2/3), in residual tumor (4/5) and in recurred cancer (2/2). Rb protein was partly lost in the borderline tumors, but the rate of Rb protein loss in both borderline tumors and invasive carcinomas were similar. Apoptosis were more active in overt carcinomas than in borderline and benign tumors. In borderline tumors, p53 protein was expressed as 28.6% positivity, and apoptosis was expressed as 28.6% negativity, which showed indirectly that there was apoptosis induction effect of p53. In ten cases of invasive carcinomas showing highly expressed p53, apoptosis revealed all positive reaction except 2 cases, and Rb protein revealed variously. This result supported the apoptosis imduction effect of p53, but it was difficult to find the association of expression degree between the two tumor supressor genes CONCLUSION: In conclusion, the values of p53 is a discriminating factor of malignancy from benign and the expression of p53 is related with clinical aggressivity such as recurrence and residual cancers. Apoptosis are more active in overt carcinoma than in benign & borderline tumor, and in borderline tumor the expression of p53 is related to apoptosis induction which results to carcinomatous change.
Apoptosis* ; Carcinogenesis ; Genes, Retinoblastoma* ; Genes, Tumor Suppressor ; Neoplasm, Residual ; Recurrence ; Retinoblastoma Protein

OBJECTIVE: To evaluate the impact of the cytologic smear of the endocervical canal immediately after cervical conization on the rate of residual cervical lesions. METHOD: A retrospective review of 229 patients who underwent cervical conization for high grade cervical intraepithelial neoplasia or microinvasive cancer followed by hysterectomy. Endocervical Papanicolaou smear with a cytologic brush performed immediately after cervical conization in all 229 patients. RESULTS: Fifty-four of 229 patients undergoing cervical conization followed by hysterectomy had residual lesion in the hysterectomy specimen. The prevalence rate of residual lesion according to the margin status of conization specimen as well as the results of the postconization Papanicolaou smear of the endocervical canal was compared. Forty-one of 78 patients (52.6 %) with positive margins had residual lesion compared with thirteen of 151 patients (8.6 %) with negative margins. Twenty-six of 34 patients (76.5 %) with positive postcone cytology had residual lesion compared with twenty-eight of 195 patients (14.4 %) with negative postcone cytology. CONCLUSIONS: Postcone cytologic smear of the endocervical canal as well as margin status are useful in predicting residual lesion after conization.
Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Conization* ; Female ; Humans ; Hysterectomy ; Papanicolaou Test ; Prevalence ; Retrospective Studies

No abstract available.
Pregnancy Rate* ; Pregnancy*