OBJECTIVE: The purpose of this study is to evaluate the validity of sentinel lymph node detection and the possibility of clinical application in treatment of vulvar cancer patients. PATIENTS AND METHODS: From March 2001 to January 2002, four patients with vulvar cancer were eligible for this study. All the patients were preoperative technetium-99 m colloid albumin and intraoperative isosulfan blue dye injection intradermally at the junction of tumor mass and normal skin. Superficial lymphatic channels and groin lymph node dissections were made to detect sentinel lymph node and then complete inguinofemoral lymph nodes dissection was performed. All the sentinel lymph nodes were sent to pathologic department for frozen biopsy. RESULTS: Ten sentinel lymph nodes were identified in one-hundred and ten groin lymph nodes. All the ten sentinel lymph nodes showed benign. There was no case that non-sentinel lymph nodes were positive in the presence of negative sentinel lymph nodes by frozen biopsy (negative predictive value was 100%). CONCLUSION: Sentinel lymph nodes detection by combination use of technetium-99 m colloid albumin and isosulfan blue dye injection was simple and accurate in our preliminary study. To reduce postoperative morbidity, lymphedema and to minimize extensive inguinofemoral lymph nodes dissection, sentinel lymph node frozen biopsy may be a reasonable alternatives and a suitable method for limited control of vulvar cancer. This preliminary study showed the possibility of clinical application of sentinel lymph node detection in vulvar cancer surgery.
Biopsy ; Colloids ; Groin ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Lymphedema ; Skin ; Vulvar Neoplasms*

OBJECTIVE: Epithelial ovarian cancer is the most common cause of death due to gynecologic malignancies in adults, but is rare in children and adolescents. This is a report of series of such patients under 20 years of age documenting their presentation, histologic type, stage of disease, treatment, and outcome. METHODS: We collected data on 21 patients with epithelial ovarian cancer under 20 years of age between January 1990 and December 2005. Patient records and pathology were reviewed. RESULTS: Epithelial ovarian cancer under 20 years of age was 2.2% in overall ovarian cancer. Epithelial ovarian cancer was 42.0% among 50 patients under 20 years of age and the most common histologic type was germ cell tumors (54%). The median age at the time of diagnosis was 17.6 years (range, 13-20 years), and the median follow-up was 87 months (range, 4-175 months). There were seventeen (81.0%) mucinous tumors, four (19.0%) serous tumors. About thirty-eight percent were low malignant potential or borderline tumors. About Eighty-five percent (18 patients) of tumors were stage I disease and about fourteen percent (3 patients) were stage III disease at the time of diagnosis. Surgical treatment included conservative surgery in 18 patients (85.7%), total abdominal hysterectomy and bilateral salpingo- oophorectomy in 3 patients (14.3%). CONCLUSION: Epithelial ovarian cancers are rare in patients in children and adolescents. The majority of ovarian cancers in this age group are mucinous tumors, stage I at diagnosis and borderline ovarian tumor. Conservative management is feasible to achieve preservation of fertility.
Adolescent ; Adult ; Cause of Death ; Child ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Mucins ; Neoplasms, Germ Cell and Embryonal ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Ovariectomy

Cervical cancer and its precursors are caused principally, if not exclusively, by HPV infection and HPV DNA is found in more than 90% of cervical cancers. Cervical cytology is limited by its false negativity and this may be supplimented by other adjunctive test such as HPV test. It is therefore important to explore the use of HPV DNA detection as a primary or supplementary screening method and to determine whether HPV typing can be used as a predictor of a lesion's clinical behavior. Cervical cytology and Hybrid Capture test for HPV detection were performed in 450 asymtomatic wornen visited Health Care Center in Kangnam St. Mary's Hospital,and none of whom was believed to have current cervical disease. The Papanicolaou cytology results were classified by The Bethesda System : 333(74.%) women were classified to within normal limit, 19(4.2%) benign reactive change, 38(8.4%) ASCUS, 59(13%) low grade SIL, and only one woman high grade SIL. Twenty five of 450(5.6%) women showed HPV infection by Hybid Capture test. Among 98 wornen with abnormal Papanicolaou cytology, 16(16.3%) women showed HPV DNA positivity. (continue)
Delivery of Health Care ; DNA* ; Female ; Humans* ; Mass Screening* ; Papilloma* ; Uterine Cervical Neoplasms

Flow cytometry, a useful tool for measuring DNA content and cell differentiation as expressed by cell surface markers, is utilized to measure multiple antigens, especially surface antigen, intracellular oncoprotein, and DNA content, simultaneously. For this simultaneous detection, several methods off ixation and permeabilization have been used with limited values. In this study, 20 ng/ml of lysolecithin in 1% paraformaldehyde solution was utilized for fixation and permeabilization of cultured promyelocytic leukemic cells(HL 60). The cells were first stained with phycoerythrin (PE)-conjugated monoclonal antibody to the cell surface My 7 antigen and then were fixed and permeabilized with 20 ng/ml of lysolecithin in 1% partormaldehyde solution. After incubation, the fixed and permeabilized cells were stained with monoclonal antibody to intracellular c-myc antigen, which were followed by fluorescein isothiocyanate (FITC)-conjugated secondary antibody. The c-myc stained cells were finally stained for DNA content with 7-amino-actinomycin D(7-AAD). This procedure permits excellent staining for intracellular oncoproteins and preservation of surface antigens with relatively low cofficients of variation (CV) for the G0G1 peak of the DNA histograms and suggests that the sequential staining procedure of surface antigen, intracellular antigen, and DNA content will be extended for the study of correlations with cellular differentiation, expression of oncoproteins, and cell cycle analysis in the cells which are obtained from human malignant diseases using a 488 nm single laser flow cytometry.
Antigens, Surface* ; Cell Cycle ; Cell Differentiation ; DNA* ; Flow Cytometry* ; Fluorescein ; Humans ; Oncogene Proteins ; Phycoerythrin

OBJECTIVE: Ovarian cancer represents a relatively chemosensitive solid tumor, with responsiveness to a range of agents. Cisplatin is the mainstay of drug treatment and is one of the most active single agent. However, the overall outcome for patients remains unsatisfactory and the emergence of drug resistance is a major factor in treatment failure. Loss of DNA mismatch repair is a common finding in many types of sporadic cancer as well as in patients with hereditary nonpolyposis colon cancer. Cells that lack DNA mismatch repair are resistant to commonly used chemotherapeutic agents. Selection of cells for resistance to cisplatin, a well-recognized mutagen, could result in mutation in genes involved in DNA mismatch repair. METHODS: This study evaluated the mutation of hMLH1 and hMSH2, and its relation to the Taxol and Topotecan chemosensitivity in the clones from the ovarian cancer cell line 2008 and cisplatin-resistant cell line 2008/ C13*5.25. RESULTS: 1. Cells from 2008 and 2008/C13*5.25 expressed both hMLH1 and hMSH2 when analysed with immunoblotting. 2. Twenty two out of 100 single-cell clones from 2008 and 27 of clones from 2008/C13*5.25 expressed no hMLH1. hMSH2 was expressed in all clones. 3. There was no difference of Taxol chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1-deficient clones were more sensitive to Taxol than the hMLH1-proficient clones(P=0.049), but in 2008 cell lines hMLH1-proficient clones were more sesitive to Taxol(P=0.003). 4. There was no difference in Topotecan chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1- deficient clones were not more sensitive to Topotecan than the hMLH1-proficient clones. In the 2008 cell lines hMLH1-deficient clones were more sesitive to Topotecan(P=0.001). Overall, hMLH1-deficient clones from both 2008 and 2008/C13*5.25 cell lines were significantly more sensitive to Topotecan(P=0.001). 5. Microsatellite instability was not demonstrated in all 4 types of single-cell clones from 2008 and 2008/C13*5.25 cell lines. CONCLUSIONS: The present results indicate that there is no relation between mutation of mismatch repair gene and cisplatin resistance. But hMLH1-deficient ovarian cancer cells are more sensitive to Taxol or Topotecan in this study. The latter finding mandates the examination to assess the mutation of hMLH1 in tumor cells before treatment or at the time clinical resistance to cisplatin develops in ovarian cancer.
Cell Line* ; Cisplatin ; Clone Cells* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair* ; DNA* ; Drug Resistance ; Humans ; Immunoblotting ; Microsatellite Instability ; Ovarian Neoplasms* ; Paclitaxel* ; Topotecan* ; Treatment Failure

Primary fallopian tube carcinoma is a rare tumor, accounting for approximately 1% of all female genital tract malignancies. Its histologic appearance and clinical behavior resemble that of primary ovarian carcinoma, with a reported 5-year survival rate of about 30% to 50%. Presenting symptoms are variable, so pre-operative diagnosis of fallopain tube carcinoma is seldom made. Evaluation and treatment are also essentially the same as that of ovary cancer. Two postmenopausal women presented with pelvic mass and vaginal bleeding. One case was initially diagnosed as endometrioma, the other as endometritis but postoperatively pathologic examination of resected specimen revealed primary adenocarcinoma of the fallopian tube in debulking operation. We have experienced two cases of primary carcinoma of fallopian tube and reported with brief review of literature.
Adenocarcinoma ; Diagnosis ; Endometriosis ; Endometritis ; Fallopian Tubes* ; Female ; Humans ; Ovarian Neoplasms ; Survival Rate ; Uterine Hemorrhage

OBJECTIVE: To determine the expression of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF) and intercellular adhesion molecule (ICAM-1) in placenta from pregnancies complicated by severe preeclampsia and normal pregnancies. METHODS: Placental tissues were obtained from 10 normotensive pregnancies (control group) and 20 severe preeclamptic pregnancies (preeclamptic group). Immunohistochemical staining of placental tissue was used to determine tissue expression of VEGF, PDGF and ICAM-1. The intensity of staining was evaluated by scoring as 0, 1, 2 and 3. RESULTS: Immunolocalization of VEGF and PDGF was significantly observed in the syncytotrophoblast with less intense staining in intravillous stromal cells and intravillous endothelial cells of fetal vessels in preeclamptic group. There were no differences in immunolocalization of staining in control group. Intensity of VEGF and PDGF immunostaining in syncytotrophoblast was significantly increased in preeclamptic group. However, immunolocalization and the intensity of ICAM-1 staining were not significantly different in both groups. CONCLUSION: The expression of VEGF and PDGF in the syncytotrophoblast was significantly up-regulated in severe preeclamptic placenta. These up-regulation of VEGF and PDGF might reflect that placental ischemia and hypoxic state in severe preeclampsia induce VEGF and PDGF in the syncytotrophoblasts of placenta. However the unchanged pattern of ICAM-1 expression in severe preeclampsia suggests that ICAM-1 is unlikely to be a factor by which the adverse pregnancy outcome arises in severe preeclampsia.
Endothelial Cells ; Female ; Intercellular Adhesion Molecule-1 ; Ischemia ; Placenta* ; Platelet-Derived Growth Factor* ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Stromal Cells ; Up-Regulation ; Vascular Endothelial Growth Factor A*

A clinical and statistical observation was made on out-patients and in-patients admitted to the Department of Urology, Seoul National University Hospital for the past 24 years from 1954 to 1977. The observations were summarized as follows. 1. During the period, the total number of out-patients was 63,438 and that of in-patients, 6,028. 2. In the out-patients, lower urinary tract infections such as urethritis and prostatitis were the most common diseases regardless of the time period. 3. In the in-patient, the frequency of the disease has been changed with the lapse of time in the order of the occurrence. The interesting changes of the disease order related to the time period were noted as follows. 1954-1960 : genitourinary tuberculosis, urolithiasis, tumor, injury and congenital anomaly. 1961-1970 : urolitiasis, tumor, genitourinary tuberculosis, injury, infection and congenital anomaly. 1971-1977 : tumor. urolithiasis, genitourinary tuberculosis, congenital anomaly, injury and infection. 4. In 1977, 10 major diseases were tumor, ureteral stone, infertility, renal tuberculosis, B. P. H. hypospadias, varicocele, renal stone, scrotal injury and renal tumor 5. Major operations were performed on 4,122 cases during the period. Nephrectomy and ureterolithotomy were the most common operations. Recently, total cystectomy with ileal loop diversion, transurethral procedure and vasovasostomy, which require more skillful techniques, are increasing in number.
Cystectomy ; Female ; Humans ; Hypospadias ; Infertility ; Male ; Nephrectomy ; Outpatients ; Prostatitis ; Seoul* ; Tuberculosis ; Tuberculosis, Renal ; Ureter ; Urethritis ; Urinary Tract Infections ; Urolithiasis ; Urology* ; Varicocele ; Vasovasostomy

BACKGROUND: The basic treatment of malignant tumors is surgery, radiotherapy, chemotherapy. Even though, the object of these treatments is to kill cancer cells, they have limitations. So, in future studies of treatment of cancer, we should look into increasing human immune response using gene therapy in order to induce damage to tumor cells. OBJECTIVE: The cell growth inhibitory effect of cervical cancer cells was investigated by direct transfection using liposome(pRcCMVp53/lipofectin). and by indirect transfection using Adenovirus(AdCMVp53). METHODS: The cervical cancer cell lines we used in this study were HPV16 positive, having inhibitory gene, wild p53 gene, CaSki, SiHa, HPV18 positive HeLa, HeLaS3 and HPV negative C33A, HT3, LacZ gene was used as the marker gene for the transfection efficacy. Direct transfection was done by using lipofectin (pRcCMVp53/lipofectin) and indirect transfection was done by using virus, AdCMVp53. The effect of tumor cell growth inhibition was measured by cell counting assay. RESULT: Inhibition of growth of cervical cancer cells in cell counts of direct transfection was CaSki(88.5%), SiHa(59.1%), HeLa(86.0%), HeLaS3(78.0%), C33A(91.3%) and HT3(74.0%). Inhibition of growth of cervical cancer cells in cell counts of indirect transfection was CaSki(97.4%), SiHa(91.6%), HeLa(95.8%), HeLaS3(99.7%), C33A(97.3%) and HT3(87.4%). CONCLUSION: The inhibition of cell growth of cervical cancer cells by direct and indirect transfection was significantly reduced, and showed little differences depending on the type of cells. These results will have a great meaning in treating cervical cancer patients using gene therapy by direct or indirect transfection
Adenoviridae* ; Cell Count ; Cell Line ; Drug Therapy ; Genes, p53 ; Genetic Therapy* ; Humans ; Lac Operon ; Plasmids* ; Radiotherapy ; Transfection ; Uterine Cervical Neoplasms*