No abstract available.
CpG Islands* ; Methylation*

OBJECTIVE: To investigate the effect of adjuvant hormonal therapy on the endometrium and ovary of breast cancer patients. METHODS: A retrospective review was performed on the 207 patients who had taken tamoxifen or anastrozole, as adjuvant hormonal therapy after breast cancer surgery between January 2003 and December 2006. Gynecologic surveillance constituted of ultrasonographic exam of the endometrial thickness and ovarian cyst formation. The patients were classified into three groups and analyzed; premenopausal/postmenopausal women receiving tamoxifen and women receiving anastrozole. RESULTS: Mean duration of follow up was 20.6+/-6.6 months. There was no difference of mean endometrial thickness before hormonal therapy among the three groups (p=0.327). In women receiving tamoxifen, the endometrium was continuously thickened in proportion to the duration of the therapy irrespective of menopausal status while it remained unchanged in women receiving anastrozole (p<0.05). Endometrial biopsies were performed in 28 patients receiving tamoxifen. The most common histologic finding was proliferative endometrium in premenopausal women (7/21) and atrophic endometrium in postmenopausal women (6/7). There was no case of endometrial cancer in both groups. Ovarian cyst was found in 32 women and the most were developed in premenopausal women receiving tamoxifen (30/32). All of them showed benign nature on transvaginal ultrasonographic findings. CONCLUSION: Women undergoing adjuvant hormonal therapy after breast cancer surgery exhibited changes in the endometrium and ovary. However most changes were not a serious problem in this study and frequent gynecologic surveillance in these patients needs further investigation.
Biopsy ; Breast ; Breast Neoplasms ; Endometrial Neoplasms ; Endometrium ; Female ; Follow-Up Studies ; Humans ; Nitriles ; Ovarian Cysts ; Ovary ; Retrospective Studies ; Tamoxifen ; Triazoles

OBJECTIVE: To investigate the effect of adjuvant hormonal therapy on the endometrium and ovary of breast cancer patients. METHODS: A retrospective review was performed on the 207 patients who had taken tamoxifen or anastrozole, as adjuvant hormonal therapy after breast cancer surgery between January 2003 and December 2006. Gynecologic surveillance constituted of ultrasonographic exam of the endometrial thickness and ovarian cyst formation. The patients were classified into three groups and analyzed; premenopausal/postmenopausal women receiving tamoxifen and women receiving anastrozole. RESULTS: Mean duration of follow up was 20.6+/-6.6 months. There was no difference of mean endometrial thickness before hormonal therapy among the three groups (p=0.327). In women receiving tamoxifen, the endometrium was continuously thickened in proportion to the duration of the therapy irrespective of menopausal status while it remained unchanged in women receiving anastrozole (p<0.05). Endometrial biopsies were performed in 28 patients receiving tamoxifen. The most common histologic finding was proliferative endometrium in premenopausal women (7/21) and atrophic endometrium in postmenopausal women (6/7). There was no case of endometrial cancer in both groups. Ovarian cyst was found in 32 women and the most were developed in premenopausal women receiving tamoxifen (30/32). All of them showed benign nature on transvaginal ultrasonographic findings. CONCLUSION: Women undergoing adjuvant hormonal therapy after breast cancer surgery exhibited changes in the endometrium and ovary. However most changes were not a serious problem in this study and frequent gynecologic surveillance in these patients needs further investigation.
Biopsy ; Breast ; Breast Neoplasms ; Endometrial Neoplasms ; Endometrium ; Female ; Follow-Up Studies ; Humans ; Nitriles ; Ovarian Cysts ; Ovary ; Retrospective Studies ; Tamoxifen ; Triazoles

Recently, a case of cervical cancer on the mucosal surface of a pedunculated cervical leiomyoma had been reported. We experienced a similar but distinct case of microinvasive squamous cell carcinoma on the mucosal surface of a pedunculated submucous leiomyoma. A 45-year-old Korean woman underwent type I hysterectomy for heavy bleeding from pedunculated submucous leiomyoma. Histopathological examination revealed that the leiomyoma of which mucosa was covered focally by microinvasive squamous cell carcinoma. During the management of pedunculated leiomyoma protruding through cervix, caution must be taken because of, although rare instance, a possible coexisting malignancy.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Leiomyoma* ; Middle Aged ; Mucous Membrane ; Uterine Cervical Neoplasms

OBJECTIVE: Ideal cancer screening program should be not only accurate but also cost-effective. However, in Korea, the two aspect of cervix cancer screening program was not yet evaluated. Thus we conducted this study to evaluate the cost-effectiveness and accuracy of various screening methods for detecting uterine cervical neoplasia. METHODS: We used various methods (conventional Pap smear, cervicography and HPV test) to detect cervical neoplasia on 255 women who visited the Seoul National University Hospital from Dec. 1996 to Jul. 1997 and analyzed the accuracy and cost-effectiveness of each method along with various combinations of methods using Bayesian theorem. The accuracy was judged by the final histopathologic diagnosis. RESULTS: Sensitivity (SE) and specificity (SP) of each method to detect cervical intraepithelial neoplasia (CIN) 1 or above were 83.0% and 69.4% in Pap smear, 53.7% and 85.2% in cervicography, and 57.8% and 80.6% in HPV test, respectively. The combination of Pap smear with cervicography or with HPV test for detecting CIN 1 or above had same SE and SP of 89.1% and 62.0% respectively. The combination of cervicography and HPV test had SE of 78.9% and SP of 70.4%. Three methods combination showed 93.9% SE and 54.6% SP. The estimated cost per method was highest in three methods combination (117,000 won) and lowest in Pap smear alone (12,000 won). The cost for detection of one case of cervical neoplasia was highest in combination of cervicography and HPV test (241,907 won) and lowest in Pap smear alone (25,385 won). CONCLUSION: The combinations of each method showed increased SE. These combinations, however, had low SP and high cost than individual method. Cervicography or HPV test alone should not be considered as an alternative to Pap smear for cervical cancer screening because its cost-effectiveness is not significantly better than that of Pap smear.
Cervical Intraepithelial Neoplasia ; Diagnosis ; Early Detection of Cancer ; Female ; Humans ; Korea ; Mass Screening* ; Sensitivity and Specificity ; Seoul ; Uterine Cervical Neoplasms

OBJECTIVE: To evaluate the prevalence and genotype of high risk HPV infection with oligonucleotide microarray based DNA chip in cervical cancer. METHODS: The presence of HPV and its type were tested with oligonucleotide microarray based DNA chip in 84 specimen from cervical cancer (squamous cell carcinoma; 58, adenocarcinoma; 22, adenosquamous carcinoma and small cell carcinoma; 4). RESULTS: The overall detection rate of high risk HPV infection was 84.5% (71/84). In squamous cell carcinoma and adenocarcinoma, the detection rate were 79.3% (46/58) and 100% (22/22) respectively. The distribution of HPV types in squamous cell carcinoma and adenocarcinoma was as follows; HPV 16 (60.3%, 59.1%), HPV 18 (1.7%, 27.3%). CONCLUSION: The most common type of high risk HPV detected in squamous cell carcinoma and adenocarcinoma of cervix was HPV 16 followed by HPV 18. In contrast with squamous cell carcinoma, HPV 18 was more frequently detected than HPV 16 in adenocarcinoma. HPV DNA chip seems to be effective in the detection and typing of HPV in tissues from cervical cancer.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Genotype ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Oligonucleotide Array Sequence Analysis ; Prevalence* ; Uterine Cervical Neoplasms*

Vaginal and cervical agenesis is an uncommon Mullerian anomaly. Total hysterectomy and vaginoplasty remains the classical treatment of this malformation. We present a case of reconstruction of utero-neovaginal continuity in the patient with normal functioning uterus and previously constructed neovagina by McIndoe method. She experienced two episodes of withdrawal bleeding during 2 months after surgery and fully satisfied with the results.
Hemorrhage ; Humans ; Hysterectomy ; Uterus

OBJECTIVE: Menorrhagia is defined as a complaint of heavy cyclical menstrual bleeding occurring over several consecutive cycles and approximately 30% of women suffer from it. Recently uterine balloon ablation therapy (UBT) system has been used widely as a safe and easy surgical option for this cumbersome symptom. The aims of this study were to determine the safety and the efficacy of UBT system in the management of menorrhagia, and to identify the possible factors for a successful outcome. METHODS: From August 2003 to May 2004, 77 patients with menorrhagia were enrolled. Demographic information, diary score for menorrhagia, and size of uterus were checked before treatment. All patients were treated with UBT system under IV anesthesia at day-surgery unit and followed up post-operatively. The change of diary score, and the change of hemoglobin/hematocrit were recorded. And the change of quality of life was assessed. RESULTS: Medical records of 73 patients who completed scheduled follow up were analyzed. Mean age was 43.7 years old, pre-operative mean diary score was 255.9+/-98.0 and pre-operative mean hemoglobin was 10.67+/-1.67. After the operation, the diary score significantly decreased to 53.3+/-27.5, and the hemoglobin significantly increased to 12.67+/-1.53. Multiple logistic regression analysis showed that success of treatment was influenced by the indication of UBT, patient age, uterine depth, and adequate intra-operative balloon pressure. An improvement in self-reported quality of life scores was also observed. CONCLUSION: The UBT system is a safe and effective method to treat menorrhagia and can be easily done under outpatient basis. Thus, it is a good alternative to hysterectomy or hysteroscopic endometrial ablation with a comparable success rate and minimal risk.
Anesthesia ; Endometrial Ablation Techniques ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hysterectomy ; Logistic Models ; Medical Records ; Menorrhagia* ; Outpatients ; Quality of Life ; Uterus

OBJECTIVE: The aim of this study is to compare the efficacy of the TVT and TOT which have been widely used in the surgical management of stress urinary incontinence. METHODS: The study was carried on 22 patients with stress urinary incontinence who had operation at Seoul National University Bundang Hospital from April to December 2004. Review of medical records was done and clinical characteristics were compared according to the operation procedure. RESULTS: The TVT was done on 11 patients and TOT on 11 patients. There were no significant differences in patients' age, parity, body mass index, menopausal status, and severity of incontinence. The operation time was significantly shorter in TOT than in TVT. Complication rate and hospital stay were not significantly different between TVT and TOT. The cure rate (patients' satisfaction) was 90.9% in TVT, 100% in TOT. CONCLUSION: The TVT and TOT are both effective surgical treatment for stress urinary incontinence. The TOT is simple and time saving procedure because it can be done without cystoscope.
Body Mass Index ; Cystoscopes ; Female ; Humans ; Length of Stay ; Medical Records ; Parity ; Seoul ; Suburethral Slings* ; Urinary Incontinence*

Malignant transformation of endometriosis is an infrequent complication. Clear cell carcinoma from endometriosis is very rare in the paraovarian cyst. To date no cases have been reported. We report a case of clear cell carcinoma arising from endometriosis of the paraovarian cyst with a brief review of literature.
Endometriosis ; Female