OBJECTIVE: Intrafascial vaginal hystrectomy(IVH) is an intrafascial cylindriform enucleation of the cervix and supracervical amputation of the uterus through vagina, leaving the highly vascularized extrafascial cervical tissue and corresponding nerves intact. The supracervical amputation of the uterus through vagina and intrafascial cylindriform enucleation of cervix enable to perform an minimal invasive surgery and organ-preserving surgery. Pelvic floor support is maintained and sexual sensation is preserved. Physical stress to the patient is minimalized. Our purpose is to evaluate the outcomes of IVH. METHOD: 21 patients were performed IVH from January 1996 to July 1998. RESULT: The mean age was 43.4+7.2 years and the mean parity was 2.6+0.8. The mean operation time was 116.1+21.4 minutes and the mean postoperative hemoglobin change was 2.0+1.6gm/dL. The mean postoperative hopitalization time was 8.2 + 2.7days. CONCLUSION: The IVH is an operation technique for the patients who are sexually active and want to remain their uterus.
Amputation ; Cervix Uteri ; Female ; Humans ; Parity ; Pelvic Floor ; Sensation ; Uterus ; Vagina

It is well known that histologic grade and tumor stage are important prognostic factors, and that the monoclonal antibody to proliferating cell nuclear antigen(PCNA) can recognize S-phase cells. The PCNA index of 53 transitional cell carcinomas(TCCs) of the urinary bladder was studied to evaluate its prognostic validity. The PCNA indices of TCCs ranged from 38 to 92, whih were quite different from that of normal transitional epithelium(9.4). The PCNA indices were significantly higher in tumors of the higher histologic grade and/or tumor stage(correlation coefficient 0.64 and 0.43; P=0.00). The PCNA index was particularly valuable in discriminating the superficial TCCs from the deeply invasive TCCs(67.1+/-15.46 and 79.9+/-9.70; P=0.000). Among TCCs of the same tumor stage, the histologic grade affected the PCNA index. However, TCCs of the same histologic grade revealed similar PCNA indices regardless of tumor stage. These results indicate that the PCNA index is an objective and reliable prognostic factor in TCCs, which is superior to the conventional histologic grade.

The prognosis of malignant ovarian tumor is poorer than that of borderline malignant ovarian tumor, Therefore an accurate diagnosis and estimation of the biologic behavior of the tumor are necessary for proper management of the patient. The histologic investigation of the tumor may provide information on the estimation of the malignant potential of tumor cells, but it may be a questionable method because of the subjective determination of tumor grade. Quantification of proliferative activity of tumor cells may play a role as an objective method to provide an estimation of the malignant potential of tumor cells. An evaluation of histologic findings was done on 84 cases of ovarian mucinous and serous tumors that were surgically resected and diagnosed during the period from January 1981 through July 1992. The proliferating cell nuclear antigen (PCN A) labelling index estimated from the immunohistochemical stain for PCN A and the Sphase fraction and porliferative index obtained from flow cytometric DN A analysis were assessed each other with histologic findings. The results are as follows: The presence of aneuploidy in malignant tumors was statistically significant as compared with benign tumors. The borderline malignant tumors showed no significant difference between the number of diploidy and aneuploidy. The PCNA labelling index, S-phase fraction and proliferative index tended to increase as the histologic grade of tumors went up. They were higher in malignant tumors than in others. The PCN A labelling index, S-phase fraction and proliferative index were higher in tumors with aneuploidy than in those with diploidy. In contrast to borderline malignant tumors, the PCNA labelling index in malignant tumors revealed a significant relation with the mitotic index. The S-phase fraction and proliferative index showed, in malignant tumors, a close correlation with the architectural grade and nucleolar grade, but not in borderline malignant tumors. Considering these results, the presence of aneuploidy, PCNA label.

Malignant tumors of the breast which contain stromal osteoclast-like, multinucleated giant cells are a rare entity of yet unknown clinical significance. These benign multinucleated giant cells are known to occur mostly in areas of prominent angiogenesis and in close association with tumor cells. Supplementary immunohistochemical and electronmicroscopic examinations indicate that the multinucleated giant cells are of histiocytic origin. We report on a case of infiltrating ductal carcinoma with stromal osteoclast-like multinucleated giant cells occurring in the right breast of a 37 year-old woman. Grossly, the tumor was characterized by a well-circumscribed dark brown, solid firm mass. Microscopically, multinucleated giant cells were found in the stroma intermingled with malignant tumor cells. The stroma showed only a small amount of mononuclear cell infiltration and a moderate degree of vascular proliferation. Immunohistochemical stains revealed the tumor cells to be positive for carcinoembryonic antigen, epithelial membrane antigen and cytokeratin while the multinucleated giant cells were positive for vimentin, CD68 and negative for all other stains tested. Ultrastructurally the multinucleated giant cells differed from tumor cells by having abundant cytoplasmic organelles such as rough endoplasmic reticulum, lysosomes, ribosomes, and vesicles but lacking desmosomes or other types of intercellular junctions. Other characteristic features of multinucleated giant cells included, indented nuclei and prominent cytoplasmic process.
Female ; Humans

BACKGROUND: To maximize the efficiency of the pathology laboratory class, it has been realized that students should be given an environment with repeated learning situations. For this purpose, this study was designed to present the significance that pathologists need in order to publish teaching materials over the Internet. METHODS: The pictures were captured as different magnified digital data from teaching glass slides. To modify the images, a graphics program was used, and these were transferred to the Microsoft PowerPoint software and developed as final teaching material. The final teaching material was then published on the Internet. This material can be browsed by searching through windows and by the indices of diagnosis. RESULTS: The comments from all users of the teaching material used in this study showed that it was user-friendly and appropriate for searching and reviewing. The users could assess information easily before and after the laboratory sessions. The quality of the images in this material was appropriate for printing. All users from our university were satisfied with the fact that all pictures were captured from their own teaching slides. Conclusions : Therefore, the teaching material used in this study is helpful for medical students studying pathology. Furthermore, this trial may induce others to develop pathology teaching materials over the Internet.
Computer-Assisted Instruction ; Diagnosis ; Education ; Glass ; Humans ; Internet* ; Learning ; Pathology* ; Students, Medical ; Teaching Materials*

Carcinoma of the fallopian tube accounts for less than 1% of all cancers of the female genital tract. The histology and behavior of fallopian tube cancer are simillar to ovarian cancer; thus evaluation and treatment are also essentially the same. Unlike ovarian cancer, fallopian tube cancer begins in a hollow viscus, and early lesions may be less likely to be associated with extensive intraperitoneal carcinoma. Two postmenopausal women presented with a pelvic mass. Pathologic examination of the resected specimens revealed primary adenocarcinoma of the fallopian tube. We have experienced two cases of fallopian tube cancer and reported with brief review of literature
Adenocarcinoma ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Humans ; Ovarian Neoplasms

No abstract available.
Biopsy, Fine-Needle* ; Fasciitis*

Collecting duct carcinoma of the kidney is an unusual variety of renal carcinoma considered to arise from the epithelium of the collecting ducts. We recently experienced an case of fine needle aspiration cytology of collecting duct carcinoma of the kidney in a 17 year-old girl. The smear revealed many cellular clusters of ordinary papillary pattern, characterized by clumping of cells with nuclear overlapping, in a slightly necrotic background. The tumor cells had abundant delicate granular cytoplasm with some having vacuolation. The nuclei were only slightly pleomorphic with somethat coarse chromatin and one or more small nucleoli. Some nuclei showed irregular nuclear membrane and nuclear groove. A few polmorphs were also present.
Adolescent ; Biopsy, Fine-Needle* ; Carcinoma, Renal Cell* ; Chromatin ; Cytoplasm ; Epithelium ; Female ; Humans ; Kidney ; Nuclear Envelope

BACKGROUND: Doxorubicin is considered to be one of the most effective drugs to treat a variety of human cancers. However, the dose-dependent cardiotoxicity of doxorubicin limits its clinical usefulness. This study aimed to evaluate the effect of probucol and verapamil on the cardiac neurotoxicity and cardiomyopathy induced by the long-term use of doxorubicin. METHODS: Sprague-Dawley male rats were grouped as the control group, the doxorubicin treated group, the doxorubicin treated with probucol group, and the doxorubicin treated with verapamil group. The rats were treated for 4, 6, 8 and 10 weeks. H&E staining and immunohistochemical staining for protein gene product 9.5, caspase-3, heat shock protein 70, and hsp 25 were performed. RESULTS: The degree of interstitial inflammatory cell infiltration was mildest in the probucol treated group. The reduction in the number of nerve fibers in the probucol treated group was less than the other treatment groups. There was a negative correlation between the treatment duration and stained nerve fibers in all the treatment groups. The number of caspase-3 positive cells was more increased in the doxorubicin group and the verapamil treated group than in the control and probucol treated group. CONCLUSION: It is suggested that probucol partly contributed to the inhibition of doxorubicin-induced cardiac neurotoxicity and cardiomyopathy, whereas the verapamil had no effect.
Animals ; Cardiomyopathies ; Caspase 3 ; Doxorubicin* ; Heart* ; HSP70 Heat-Shock Proteins ; Humans ; Male ; Myocardium* ; Nerve Fibers* ; Probucol* ; Rats* ; Rats, Sprague-Dawley ; Verapamil*

Uterine torsion is defined as the mtation of more than 45 degrees around the long axis of the uterus or a rotation which is severe enough to produce symptoms. Torsion of the human pregnant uterus is a very rare complication. The diagnosis is problematic and is often made during a cesrean section due to inhibited labor. Torsion of the human pregnant uterus can be caused by myoma or other uterine abnormalities, ovarian cysts, adhesions, abnormal fetal presentations, or fetal abnormalities ( though no cause can be found in about 20% of cases ). Uterine torsion produces symptoms of varying severity depending on the degree of rotation, and duration of the pregnancy. High mortality rates for both mother and infant have been reported. We experienced one case of the torsion of term pregnant uterus and report this case with a brief review of the concerned literature.
Axis, Cervical Vertebra ; Diagnosis ; Female ; Fetus* ; Humans ; Infant ; Mortality ; Mothers ; Myoma ; Ovarian Cysts ; Pregnancy ; Uterus*