Ovarian cancer has the highest mortality rate among gynecologic malignancies in developed countries. Most women present with advanced disease and require a combination of surgery and chemotherapy. One patient presented with recurrent ovarian cancer was initially treated with taxol and platinum-based compounds. Although response to these agents occurred, tumor progression was evident by elevated CA 125 levels and CT findings after a period of 4 months. This patient was then treated with topotecan and exhibited a response and stopped therapy. Topotecan exhibited activity in this patient with ovarian cancer resistent to both platinum and paclitaxel. We report a case of advanced ovarian cancer which was treated with topotecan after taxol-cisplatin treatment failed.
Developed Countries ; Drug Therapy ; Female ; Humans ; Mortality ; Ovarian Neoplasms* ; Paclitaxel ; Platinum ; Topotecan*

BACKGROUND: In recent years, lymphocyte subset analysis in peripheral blood is widely performed using erythrocytes-lysed whole blood and two color immunofluorescence/flow cytometry method. Use of fresh blood drawn within 6 hours of staining is recommended, and some patients have to revisit the hospital for blood collection. We tested whether 24 hours-refrigerated/stored whose blood can be used for lymphocyte subset analysis. METHODS: Twenty consecutive blood samples from patients (including nine HIV positive patients) collected in EDTA-vacutainer were tested: 1) on the day of sampling using fresh blood kept at room temperature for up to 6 hours until staining (as recommended by the manufacturer) and 2) on the following day using the same tube of blood refrigerated for 24 hours after the first staining. Two colon immunofluorescenc staining was done using Simultest(TM) IMK-Lymphocyte kit (Beckon Dickinson, U.S.A.) and flow cytometric analysis was performed using FACScan and SimulSET(TM) software (Becton Dickinson, U.S.A.). Results of alive kinds of Lymphocyte subsets (CD3+, CDl9+, CD3+CD4+CD3+CD8+, CD3-CDl6+ and/or CD56+) on day 1 and day 2 were compared by pained-t test and Wilcoxon signed rank test. RESULTS: There was no significant change of values for all of the lymphocyte subsets except CD3+CD8+suppressor/cytotoxic (S/C) T cells. There was a slight but statistically significant change in S/C T cells (39.9%-->41.8%: 1.9%, p=0.008) after 24 hours of refrigeration, and this change was observed mainly in HIV-positive patient group. However, there was no significant change in the absolute count of helper/inducer T cells or CD4/CD8 ratio, and the change of S/C T cells in these patients was not considered to be of clinical significance. CONCLUSIONS: The difference in the values of lymphocyte subsets between fresh blood and 24 hours-refrigerated blood was negligible and it is concluded that 24 hours-stored blood samples can be used for lymphocyte subset analysis for clinical purposes.
Colon ; HIV ; Humans ; Lymphocyte Subsets* ; Lymphocytes* ; Refrigeration ; T-Lymphocytes

OBJECTIVES: The most often perfomed major operation in gynecology is hysterectomy.Our purpose was to compare the indications, charateristics and outcomes of patients undergoing total abdominal hysterectomy and total vaginal hysterectomy and to help to establish guidelines to determine the route of hysterectomy. METHOD: The hospital charts of 400 women who underwent elective inpatient hysterectomy at Kyung-Hee University hospital from January 1994 to January 1999, were abstracted retrospectively. Data were collected regarding patients, age, parity, preoperative indications, the route of hysterectomy, uterine weight, operative and postoperative complications and the length of stay. The operative indications were benign uterine disease except from uterine prolapse. Bisection or combined morcellation were used in most cases to obtain reduction in uterine size. RESULT: Patients in whom the vaginal route was successful included 18% of those with uterine weights exceeding 280gm. There was statistically significant difference for uterine weight, operative time, bleeding amount, the length of stay in two camparative group. 4% of vaginal hysterectomy and 7% of total abdominal hysterectomy has documented operative complications. CONCLUSIONS: Vaginal hysterectomy is safe operation with few intraoperative and postoperative complications without notable blood loss. Vaginal hysterectomy allow one to shorten the operating time and allows early postoperative discharge of some patients from hospital. Skilled performance of vaginal hysterectomy is worth greater attention and should be used more often in gynecological study.
Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Inpatients ; Length of Stay ; Operative Time ; Parity ; Postoperative Complications ; Retrospective Studies ; Statistics as Topic* ; Uterine Diseases ; Uterine Prolapse ; Weights and Measures

No abstract available.

Lipoprotein(a)[Lp(a)] is a LDL-like particle with a glycoprotein called apo(a) attached to its apoB through disulfide bond. Many case-control studies support the opinion that plasma Lp(a) levels were associated with coronary artery disease. This study was conducted to assess the relationship between plasma Lp(a) level and coronary artery disease in Korean population. Serum levels of Lp(a), in addition to other lipids and known clinical risk factors for coronary artery disease were determined in 92 subjects undergoing coronary angiography. Among them 30 patients had no obstruction in the coronary artery(cath-control group), while the others revealed the presence of coronary artery stenosis more than 50%(CAD group). The Lp(a) levels of the CAD group were significantly higher the those of cath-control group(31.8+/-25.0mg/dl vs 14.6+/-11.9mg/dl, p<0.005). Other lipids except triglycerides(166.9+/-70.5mg/dl vs 116.2+/-56.1mg/dl, p<0.005) were not significantly different between two groups. The patients with significant coronary artery disease of two or more vessels were found to have higher Lp(a) levels than those of one vessel disease. Lp(a) levels had no relations with other lipids, diabetes, smoking, hypertension and age. Stepwise discriminant analysis revealed that Lp(a) was the best discriminator among risk factors for coronary artery disease. These results suggested that Lp(a) level was a significant independent risk factor for coronary artery disease.
Apolipoproteins B ; Case-Control Studies ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Glycoproteins ; Humans ; Hypertension ; Lipoprotein(a)* ; Plasma ; Risk Factors* ; Smoke ; Smoking

No abstract available.
Child* ; Humans

OBJECTIVE: To compare the age of menarche, changing patterns of the menstrual characteristics in adolescent girls between 1988 and 1998. METHODS: A survey was undertaken for 1,500 highschool girls and compare with those of pervious study for 5,000 middle and highschool girls performed by same author in 1998 by means of questionnaire. RESULTS: During a decade, the mean menarcheal age decreased from 13.5+/-1.0 to 12.7+/-1.0 years(p=0.001). Gynecologic age, Body mass index were associated with age of menarche in both 1988 and 1998. The interval of menstruation was 30.6 3.5dyas in 1998 and shortened compared with 32.1+/-6.3 days in 1988(p=0.001). The duration of menstruation was lengthened in 1998 than in 1988(6.1+/-1.1 days vs 5.8+/-2.2 days, p=0.001). The incidence of irregular cycle(28.2% vs 58.2%, p=0.001), dysmenorrhea(73.9% vs 77.8%, p=0.001), and secondary amenorrhea(16.2% vs 27.2%, p= 0.001) decreased in 1998 compared with those of 1988. The incidence of agonies about menstruation was also decreased in 1998 than in 1988(26.2% vs 69.1%, p=0.001). The most common agony about menstruation in 1988 was irregular cycle(28.4%), but dysmenorrhea( 64.3%) in 1998. CONCLUSIONS: From the above results, the mean age of menarche was advanced since last decade but most of the adolescent girls still have suffered from dysmenorrhea.
Adolescent* ; Body Mass Index ; Dysmenorrhea ; Female ; Humans ; Incidence ; Menarche ; Menstruation ; Surveys and Questionnaire

Enlargement of bone tunnels has been noted on plain X-rays following arthroscopic ACL reconstruction. The cause of this widening is unclear, but it has been hypothesized that it may be due to either mechanical or biological cases. Ishibashi et al. reported anatomical proximal fixation resulted in the most stable reconstructed knee, with increasing instability as the level of fixation moved away from the tibial plateau. The purpose of this study is to determine if any difference exists in the amount of enlargement of the femoral tunnel following arhotoscopic ACL reconstruction with position of interference screw fixation and instability, and to know the factors which affected to the enlargement of the femoral tunnels. Total 39 patients were retrospectively reviewed for tunnel measurements radiologically at one year post-operation. (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device). The surgery was performed using an arthroscopic single and double incision technique. AP and lateral X-rays were obtained and the tunnels were measured by two independent observers using a digital caplper. The measurements were made at the widest part of the tunnel. Correction for magnification was performed by comparing the measured width of the interference screw used for fixation of the graft with its actual width. Statistical analysis was performed using a one-way analysis of variance(ANOVA) and t-test. 1. Radiographic tunnel enlargement of femoral side was average 2.42 mm (bone-patellar tendon-bone autograft : 2.36 mm, Kennedy-LAD and autograft : 2.56 mm)(p>0.05). 2. According to the position of the interference screw, the femoral tunnel enlargement were 2.25 mm in anatomical fixation, 2.40 mm in mid-tunnel fixation, 2.62 mm in mid-tunnel fixation, 2.62 mm in outer-tunnel fixation(p < 0.05). 3. The femoral enlargement according to the overall results(Clancy, 1982) were 2.39 mm in above good result group and 2.50 mm in below fair result group(p < 0.05). Tunnel enlargement group of femoral side was related to a distance between femoral articular surface and the position of interference screw. We conclude that femoral tunnel enlargement following arthoscopic bone tendon-bone ACL reconstruction is related to the mechanical effect rather than the properties of grafts and the clinical results.
Autografts ; Humans ; Knee ; Retrospective Studies ; Transplants

We review 66 patients with lower caliceal stones treated with extracorporeal shock wave lithotipsy. One of the major problems involved with extracorporeal shock wave lithotripsy is the high rate of residual stone fragments in the lower calices. We observed the influence of the presence of lower caliceal dilatation, hydronephrosis, and the size of alone on the passage of stone. Thirty-nine of the 66 patients with a lower caliceal stone and no stone fragments. The success rate was only 59 per cent. The stone was completely fragmented in 59 of 66 (89%) patients. Thirty-nine of 59 patients who had completely fragmented stones. had no residual fragments. The patients who had no lower caliceal dilatation and a relativgly small size stone (less than 1.5 x 1.0 cm). such as in group 4. had a high success rate of 70%. The patients with a large stone or the presence of caliceal dilatation. were expected to low success rate, therefore there was a need for repeated treatment with extracorporeal shock wave lithotripsy and combined treatment with percutaneous nephrostomy.
Dilatation ; Humans ; Hydronephrosis ; Lithotripsy* ; Nephrostomy, Percutaneous ; Shock*

BACKGROUND: Evaluating the segmental wall motion of left ventricle is important in patients with myocardial infarction for choosing therapeutic modality and predicting prognosis. Radionuclide Multigated Angiography(MUGA) is a reliable noninvasive method for the evaluation of left ventricular performance. Methods : MUGA scan(LV ejection fraction, phase image histogram, regional wall motion) was performed and analyzed in 45 patients with myocardial infarction(31 : acute MI, 14: old MI) and 13 normal controls. RESULTS: 1) The LVEF of acute and old MI group was significantly reduced and the SDph of acute and old MI group was significantly increased as compared with that of control group(p<0.05). 2) In acute MI group, the LVEF of group without, IV Urokinase was more reduced than that of group with IV Urokinase and the SDph of group without IV Urokinase was more increased than that of group with IV Urokinase(p<0.05). As a result of wall motion scoring, the linear correlation exists between SDPh and sum of wall motion scoring(r=0.62, p<0.01). 3) In MI group, the LVEF of anterior wall MI was more reduced than that of inferior wall MI and the SDPh of anterior wall MI was more increased than that of inferior wall MI(p<0.05). 4) In acute anterior wall MI, the reverse correlation exists between LVEF and SDPh and the linear correlation exists between sum of wall motion scoring and SDPh(r=-0.73, 0.72, p<0.01). But there are no statistical significances of correlation between them in acute inferior MI(r=-0.44, 0.42, p>0.05), in old anterior MI(r=-0.65, 0.47, p>0.05) and in old inferior MI(r=-0.47, 0.46, P>0.05). CONCLUSION: These results suggest that Phase angle(SDPh) is thought to be valuable index to evaluate left ventricular function with application of other indeces in Myocardial infarction. Left ventricular function measured by SDph in acute or anterior MI is lower than old or inferior MI.
Heart Ventricles ; Humans ; Myocardial Infarction* ; Prognosis ; Urokinase-Type Plasminogen Activator ; Ventricular Function, Left