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

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*

Reconstruction of soft tissue dejects on the lower leg and foot remains a difficult challenge for surgeons. If the deject was large and complicated by bone defects, an excellent result could be obtained with free tissue transfer. In case of no bony problem, no major infection and relatively small defect, a local flap is more Convenient and economic than free tissue transfer because of its simple, one-stage and reliable operation. The vascularization of the subcutaneous tissue reveals the predominance of the vascular network in this layer with regard to the dermal or fascial plane. The dermal vascular network at the donor site is sufficient to let the skin survive without its underlying subcutaneous vascular support. Distally based adipofascial flaps, nourished by the lower perforator originating from the major vessel as link pattern were. used successfully for reconstruction of the bone and/or tendon exposure of the lower leg and foot in 10 patients. Between February 1992 and December 1995, ten cases underwent this procedure to reconstruct soft tissue defect on the lower leg and foot. The average age of the patients was 50.6 years (range 5 - 73years). Follow-up was from 10 months to 38 months (mean 21 months). The average time of the operation was about 2 hours 18 minutes. The length to width ratio of adipofascial flap was 2.4 - 5.0 : 1 (mean 3.4 : 1). The advantages of this method are easy dissection, short operation, preservation of the major vascular pericles of the lower limb, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar, and versatility (it is supple and can adapt to every surface, and it can be grafted on the deep or the superficial side). In conclusion, this technique is an useful and alternative method for reconstruction of soft tissue defects on the lower leg and foot in selected cases.
Cicatrix ; Extremities ; Follow-Up Studies ; Foot* ; Humans ; Leg* ; Linear Energy Transfer ; Lower Extremity ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants

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

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

No abstract available.
Pregnancy Rate* ; Pregnancy*

The purpose of this study was to determine the frequency of chromosomal or genetic causes of primary amenorrhea, and was made to assess the etiology of disorders in those patients whose chromosome appeared normal. Sixty eight patients with primary amenorrhea were evaluated clinically and cytogenetically, which were refered to our Cytogenetic Laboratory in Department of Obstetrics and Gynecology, Pusan National University Hospital, from Aug. 1988 to Dec. 1996. The results were as follows. l. Out of 68 cases with primary amenorrhea, 40 cases (58.9%) had the normal chromosome constitutions and 28 cases (41.1%) had the abnormal chromosome constitutions including 46, XY. 2. Turner's syndrome was found in 25 cases (36.7%), consisting of 11 cases (16.1%) of 45, X, 3 cases (4.3%) of 46, X, i (Xq), 1 case (1.5%) of 46, X, inv (X), 1 case (1.5%) of 46, X, del (Xq), 1 case (1.5%) of 46, X, del (Xp), 1 case (1.5%) of 46, X, tel (Xq), 1 case (1.5%) of 45, X/46, XX, 1 case (1.5%) of 45, X/46, XY, 1 case (1.5%) of 45, X/47, XXX, 2 cases (2.9%) of 45, X/46, X, del (Xq), I case (1.5%) of 45, X/46, X, del (Xq), 1 case (1.5%) of 45, X/46, X, r (X). 3. 3 cases (4.3%) had the 46, XY chromosome constitution consisting of 2 cases (2.9%) of testicular feminization syndrome and 1 case (1.5%) of pure gonadal dysgenesis. 4. Among 40 patients whose chromosome are normal, the etiologies of amenorrhea were assumed to be caused by 11 cases (27.5%) of hypogonadotropic hypogonadism (idiopathic), 10 cases (25.0%) of congenital absence of vagina, 5 cases (12.5%) of pure gonadal dysgenesis in order of frequency.
Amenorrhea* ; Androgen-Insensitivity Syndrome ; Busan ; Constitution and Bylaws ; Cytogenetics* ; Female ; Gonadal Dysgenesis ; Gynecology ; Humans ; Hypogonadism ; Male ; Obstetrics ; Turner Syndrome ; Vagina