The incidence in women less than 35 years of age is increasing despite an overall decrease in newly diagnosed invasive cervieal cancer among all age groups. However the influence of young age on prognosis remains controversial. So 163 patients of invasive cervical cancer in women aged 35 or less treated from Jan. 1, 1984 to Dec. 31. 1993 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea, were studied retrospectively. We obtained the following results; The 5-year survival rates by clinical stage were 88.7Y% in stage I b, 71.5% in stage IIa, 31.2% in stage IIb and O% in stage III or above. The lymph node metastasis rates by stage in RAH group, were 21.3% in stage I b and 31.8% in stage IIa. The lymph nodc metastasis rates by lesion size in RAH group, were 19.2% in 2cm below, 20.7% in 2-4cm and 40.0% in 4cm above. The 5-year survival rates in RAH group were 74,9% in lymph node positive group and 89.0% in lymph node negative group. The recurrenee rates by clinieal stage were 0% in stage Ia, 20.6% in stage I b, 22.2% in stage IIa, 50.0% in stage Ilb and 90.9% in stage III or above.
Busan ; Female ; Gynecology ; Humans ; Incidence ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Obstetrics ; Prognosis ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

OBJECTIVE: The purpose of this study was to investigate clinical charactoristics of adenocarcinoma of the uterine cervix. STUDY METHODS: This study is a retrospective analysis of 103 patients with adenocarcinoma of cervix treated at the Kosin Medical center forom 1984 to 1993. RESULTS: The distribution by stage of disease included FIGO stage I, 51(49.6%); stage II, 32(31%); Stage III, 17(16.5%);Stage IV, 3(2.9%). The 2-year survival results for patients with stage I was 93.5%; stage II was 72.4%;stage III was 46.2% and stage IV was none survived. And 4 year survival results,'83.3/o, 591% and 33.3/o in stage I, II and III, reqxetively. The 4-year survivel rate varied significantly according to tumor size and lymph nade metastasis status-below 2cm 84.2%, 2cm~4cm 75%, above 4cm 0%: (stage I);negative node 91.3%, positive node 40% (stage I). The results of resurrent rate according to clinical stage was 11.8%, 25.8%, 84.6% and 100 % in stage I, ll, III and lV, respectively. CONCLUSION: Treatment strategies should be based on the stage of disease, tumor size, lymph node metastasis status and recurrent.
Adenocarcinoma* ; Cervix Uteri* ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies

OBJECTIVE: Recently p16 gene has been found as a new factor for cervical carcinogenesis. The purpose of this study is to investigate the p16 protein alteration in invasive cervical cancers, and to find the correlation with the p53 protein overexpression, HPV infection and the clinicopathologic prognostic parameters, as well as to predict the prognosis by examining the influences of the p16 gene, p53 gene, HPV to the survival rate. MATERIAL & METHODS: We examined 29 invasive cervical cancer patients who visited and operated in Obstetrics & Gynecology department of Kosin University Gospel Hospital from Jan. 1994 to Dec. 1995. We investigated clinicopathologic parameters and p16 protein alteration, p53 protein overexpression, HPV 16, 18 infection in these patients. p16 protein and p53 protein were examined by immunohistochemistry method and HPV was done by PCR method. The survival rate was examined by Kaplan-Meier method. RESULTS: The rate of p16 protein alteration, p53 protein overexpression, HPV infection were respectively 31% (9/29), 72.4% (21/29), 80.6% (26/29), and all of these factors had no statistical correlations with the clinicopathologic parameters (p>0.05).Among the 21 positive cases for p53 protein overexpression, p16 protein alteration was positive in 6 (28.6%), negative in 15 (71.4%) cases and among the 8 negative cases for p53 overexpression, p16 showed positive in 3 (37.5%), negative in 5 (62.5%). Finally among the 26 positive cases of HPV infection, p16 alteration was positive in 9 (34.6%) and negative in 17 (65.4%) and all of the 3 HPV infection negative cases showed no p16 alteration. The p16 alteration had no significant correlation with the p53 overexpression and HPV infection.The total 5 years survival rate in 29 cases of invasive cervical cancer patients was 86.2%. In the negative group of p16 protein alteration the survival rate was 80% and the positive group was all alive. In the positive groups of p53 protein overexpression and HPV infection the survival rate were 80.9% and 84.6% respectively and the negative groups were all alive. And these factors had no significant correlation with the survival rates. CONCLUSION: This results indicate that p16 protein alteration had no correlation with clinicopathologic prognostic parameters and survival rates in invasive cervical cancer. In addition p16 protein alteration had no correlation with p53 protein overexpression and HPV infection respectively.
Carcinogenesis ; Genes, p16 ; Genes, p53 ; Gynecology ; Human papillomavirus 16 ; Humans ; Immunohistochemistry ; Obstetrics ; Polymerase Chain Reaction ; Prognosis ; Survival Rate ; Uterine Cervical Neoplasms*

For the clinical analysis and evaluation on the patients with gestational trophoblastic disease(GTD), a study was done retrospectively on 114 patients with GTD(60 in Hydatidiform mole, 10 in invasive mole, 44 in choriocarcinoma) treated from Jan. 1, 1985 to Dec. 31, 1994 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea. We obtained the following results ; The incidence of GTD was 1 per 73 deliveries in H. mole, 1 per 437 deliveries in invasive mole, and 1 per 99 deliveries in choriocarcinoma. The most prevalent age was 21-40 groups. Abnormal vaginal bleeding was a main symptom and sign. 30.6% of H. mole was managed by dilatation and curettage. 90.0% of invasive mole and 51.4% of choriocarcinoma were managed by surgical treatment and chemotherapy. The overall remissinon rate of choriocarcinoma was 71.4%(100.0% in stage I, 66.7% in stage II, 54.5% in stage III, 50.0% in stage IV).
Busan ; Choriocarcinoma ; Dilatation and Curettage ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Gynecology ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Incidence ; Korea ; Obstetrics ; Pregnancy ; Retrospective Studies ; Trophoblasts ; Uterine Hemorrhage

No abstract available.
Cisplatin* ; Drug Therapy* ; Ovarian Neoplasms*

No abstract available.
Cisplatin* ; Drug Therapy* ; Ovarian Neoplasms*

Malignant melanoma is usually a neoplasm of the skin and mucous membranes which is relatively rare, comprising 1% of all cancers. In women, approximately 3% of malignant melanoma are located in the genitalia with the vast majority occuring in the vulva and very rarely on the ovary, uterus, and uterine cervix. Opinions about its histogenesis, diagnostic criteria and elective treatment are controversial, because of rare manifestation. We report a case of primary malignant melanoma of uterine cervix with a brief review of the literature.
Cervix Uteri* ; Female ; Genitalia ; Humans ; Melanoma* ; Mucous Membrane ; Ovary ; Skin ; Uterus ; Vulva

We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.
Back Pain ; Bed Rest ; Blood Pressure ; Diskectomy ; Erythrocytes ; Female ; Glycosaminoglycans ; Hematoma ; Humans ; Critical Care ; Leg ; Middle Aged ; Psoas Muscles

OBJECTIVE: Although endoscopic procedures for lumbar disc diseases have improved greatly, the postoperative outcomes for high grade inferior migrated discs are not satisfactory. Because of anatomic limitations, a rigid endoscope cannot reach all lesions effectively. The purpose of this study was to determine the feasibility of endoscopic transforaminal suprapedicular approach to high grade inferior-migrated lumbar disc herniations. METHODS: Between May 2006 and March 2008, a suprapedicular approach was performed in 53 patients with high grade inferior-migrated lumbar disc herniations using a rigid endoscope and a semi-rigid flexible curved probe. One-to-four hours after surgery, the presence of remnant discs was checked with MRI. The outcomes were evaluated with the visual analogue scale (VAS) score and the Oswestry Disability Index (ODI) one week after surgery. RESULTS: The L2-3 level was involved in 2 patients and the L3-4 level was involved in 14 patients, while the L4-5 level was involved in 39 patients. There were single piece-type in 34 cases and a multiple piece-type in 19 cases. Satisfactory results were obtained in all cases. The mean preoperative VAS for leg pain was 9.32+/-0.43 points (range, 7-10 points), whereas the mean ODI was 79.82+/-4.53 points (range, 68-92 points). At the last follow-up examination, the mean postoperative VAS for leg pain was 1.78+/-0.71 points and the mean postoperative ODI improved to 15.27+/-3.82 points. CONCLUSION: A high grade inferior migrated lumbar disc is difficult to remove sufficiently by posterolateral endoscopic lumbar dscectomy using a rigid endoscope. However, a satisfactory result can be obtained by applying a transforaminal suprapedicular approach with a flexible semi-rigid curved probe.
Endoscopes ; Follow-Up Studies ; Humans ; Leg

OBJECTIVE: The purpose of this study was to evaluate the clinical outcomes of minimally invasive extraforaminal lumbar interbody fusion (ELIF) for revision surgery. METHODS: From January 2011 to December 2012, 12 patients who underwent minimally invasive ELIF through the Kambin's triangle for revision surgery were included in this study. All patients underwent the surgical procedure in the following sequence: (1) epidural anesthesia, (2) exposing the Kambin's triangle toward the lateral part of the dura (partial resection of the superior articular process), (3) bilateral cage insertion for reinforcement of stabilization and fusion, and (4) percutaneous transpedicular screwing. Clinical outcomes were assessed using the visual analogue scale (VAS), and Oswestry disability index (ODI). Imaging and clinical findings including surgical techniques, clinical outcomes, and related complications were depicted and analyzed. RESULTS: The mean age of the patients (5 men, 7 women) was 60.7+/-13.4 years, and the mean follow-up period was 27.1+/-4.9 months. The mean VAS (back and leg) score improved significantly at final follow-up. The mean ODI score decreased as follows: preoperative, 76.78+/-6.08; 3 months after the surgery, 37.74+/-6.67; and at final follow-up, 29.91+/-2.98. Two patients presented with transient nerve root irritation, but there were no cases of incidental dural tear or serious infection. No significant neurological deterioration or major complication was noted in any of the patients. CONCLUSION: Minimally invasive ELIF for revision surgery is an effective surgical option with a low complication rate.
Anesthesia, Epidural ; Follow-Up Studies ; Humans ; Male ; Reoperation ; Spine ; Tears