No abstract available.
Cervix Uteri* ; Conization* ; Female ; Pregnancy*

No abstract available.
Hypothyroidism* ; Megacolon* ; Pericardial Effusion* ; Pregnancy*

No abstract available.
Cystadenocarcinoma, Mucinous* ; Mucins*

OBJECTS: The purpose of this study was to evaluate the relative usefulness of the morphologic scoring system and spectral doppler ultrasonographic analysis in differentiating between benign and malignant adnexal masses. METHODS: All patients scanned between July 1995 and June 1998 with sonographically identified and pathologically confirmed adnexal masses formed the study group. The adnexal masses were scored as benign or malignant on the basis of their sonographic appearance. Specific categories included inner wall structure, wall thickness, septal structure, and echogenicity. Women whose morphologic findings were suspicious for malignancy underwent doppler sonography. A threshold pulsatility index of 1.0 and resistance index of 0.4 were used to differentiate benign from malignant lesions. The findings were correlated with the presence of malignancy. RESULTS: Two hundred fifty one patients formed the study group; 215 patients were benign and 36 patients were malignant pathologically. Using the morphologic scoring system, 31 of the 36 malignant masses were classified as suggestive of malignant tumor, and 147 of the 215 benign masses were classified as not suggestive of malignant tumor (sensitivity, 86%; specificity, 68%; positive predictive value, 31%; negative predictive value, 97%). Doppler velocimetry was performed on a total of 62 patients, 19 patients with malignant tumors and 43 patients with benign tumors. A mean PI value of 0.85 and RI value of 0.52 for malignant tumors and mean PI value of 2.00 and RI value of 0.75 for benign tumors was shown. The PI value was significantly lower (p 0.001) in malignant than that of in benign masses, but RI value was not significant (p 0.184). The sensitivity and specificity in the detection of malignancy combined with doppler velocimetry was 86% and 67%, respectively. CONCLUSION: Doppler velocimetry studies did not add substantially to the prediction of malignancy using the morphologic scoring system.
Diagnosis* ; Female ; Humans ; Rheology ; Sensitivity and Specificity ; Ultrasonography

BACKGROUND: Carcinoma of the uterine cervix is a theoretically preventable disease because its precursor lesions can be detected by cervical Papanicolau smears and appropriately treated, Although cervical cytology screening programmes have resulted in the redution of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. The focus of criticism has been the false-negative Pap smear, and the false-negative Pap smear is the major quality issue currently facing the physicians. To reduce the false-negative rate of Pap smear, it is essential to improve the accuracy of Pap smear. But false-negative rate of Pap smear has been reported variously. OBJECTIVE: This study was undertaken to evaluate accuracy of Pap smear by study false-negative and false-positive rate of Pap smear and to determine whether false-negative and false-positive rate had any correlations with clinical factors. STUDY DESIGN: The study population was comprised of 346 women, who were undertaken gynecologic operation at the Department of Obstetrics & Gynecology at Hanyang University hospital between March, 1997 and April, 1998. All patients were taken Pap smear before operation. In 93 women of these, preoperative diagnosis were cervical intraepithelial neoplasia and carcinoma in situ of uterine cervix, and in 253 women of these, preoperative diagnosis were benign disease as uterine myoma or adenomyosis, etc. All of their surgical specimen were examined. Pap smear, pathology, medical charts of all patients were reviewed retrospectively, and false-negative rate and false-positive rate were calculated. Clinical factors that associated with false-negative and false-positive rate were evaluated. Fishers exact test and Pearson chi-square test were used of statistical analysis, RESULTS: False-negative rate of Pap smear was 7.2%, false-positive rate was 4.6%, corresponding rate with histology was 88.2%. Sensitivity and specificity of PAP smear were 87.0% and 97.0% respctively. According to gross finding of uterine cervix, erosion was 46.6% in cervical intraepithelial neoplasia, 67.8% in carcinoma in situ, 66.6% in microinvasive carcinoma of uterine cervix and 55.3% of 103 erosion findings was cervical intraepithelial neoplasia, carcinoma in situ or microinvasive carcinoma. 23.1% of cervical lesion were normal gross finding. Menopause was associated with false-negative rate and previous vaginal infection history, previous cervical minor operation, delivery mode, contraception method, pelvic inflammatory disease history, vaginal bleeding at Pap smear and gross finding of cerbix were not associated. There were no clinical factors that were associated with false-positive rate. CONCLUSION: Compared with other reports, false-negative rate(7.2%) and false-positive rate(4.6%) of Pap smear was lower and corresponding rate(88.2%) was higher in Hanyand university hospital. Because of higher false-negative rate in menopausal women, it need more careful to take and interpretate Pap smear in these group.
Adenomyosis ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Contraception ; Diagnosis ; Female ; Gynecology ; Humans ; Incidence ; Leiomyoma ; Mass Screening ; Menopause ; Mortality ; Obstetrics ; Pathology ; Pelvic Inflammatory Disease ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; Uterine Hemorrhage

The amplification of c-myc oncogene was evaluated in 42 cases of ovarian carcinomas to correlate with clinical parameters. Using oligonucleotide primers, sequences from the c-myc exon-3 gene and from a control gene, tissue plasminogen activator (tPA), were amplified simultaneously by polymerase chain reaction (PCR). After the products of differential PCR (d-PCR) were electrophoresed, slot blot hybridization was performed, and hybridized with P32 dATP-labeled myc and tPA oligonucleotide probes and then autoradiographed. The signal intensities of the two products were quantitated by densitometry and the ratios of two products (c-myc/tPA) were measured. The ovarian carcinomas showed significantly increased amplification of c-myc oncogene Oligonucleoti compared to normal control group (p<0.05). 15 of 42 cases (35.7%) showed various degrees of the MYC gene amplification up to 27 folds in various histologic types of ovarian carcinomas. No significant differences of the MYC gene amplification according to histologic subtypes, tumor action) grades and clinical stages of ovarian carcinomas were present.
Densitometry ; DNA Primers ; Genes, myc ; Oligonucleotide Probes ; Oncogenes* ; Polymerase Chain Reaction* ; Tissue Plasminogen Activator

Three patients(1%) with recurrent molar pregnancy were managed arnong 317 registered molar pregnancies at the department of Obstetrics and Gynecology, Hanyang University Hospital between 197S and 1991. Reeurrent molar pregnancy seemed to be oaiated with a worsening histology and an increased incidence of proliferative trophoblastic sequelae in the successive episodes of hydatidiform mole. The treatment of recurrent mole is discussed and the literature regardmg recurrent rnolar pregnancy is reviewed.
Female ; Gynecology ; Hydatidiform Mole ; Incidence ; Obstetrics ; Pregnancy ; Trophoblasts

No abstract available.
Ovarian Neoplasms*

Previous studies have shown that the cancer cell lines secrete multiple cytokines, such as macrophage colony-stimulating factor(M-CSF), granulocyte-macrophage colony stimulating factor(GM-CSF), interleukin-l(IL-1), interleukin-2(IL-2), interleukin-6(IL-6), and tumor necrosis factor-alpha(TNF-alpha). We evaluated the levels of IL-2, IL-6, and TNF-alpha in the ascites of 23 patients with ovarian cancer. These levels were then compared with cytokine concentration found in 10 patients who had benign ascites and also studied the relation between levels of cytokines and clinical parameters. Enzyme-linked immunosorbent assay(ELISA) was used to determine the levels of cytokines in ascitic fluids. The median age of the group was 56, and the median follow-up time was 24 months. The levels of IL-2 was not elevated in ascites of ovarian cancer(30.5 vs 37.2 pg/ml, p=0.083), 1 he levels of TNF-alpha in the ascites with ovarian cancer were higher when compared with ascites of benign disease and was nearly approached statistically significant(91.0+/-20.7 vs 440.2+/-117.9pg/ml, p=0.058). Significantly higher IL-6 levels were detected in patients ascites compared with ascites with benign disease(354.3+/-42.9 vs 5,605+/-1,137pg/ml, p=0.006). IL-6 and TNF-a levels in ascites did not correlate statistically with tumor volume, histologic type or with survival time. IL-6 levels did not correlated statistically with volume of ascites. IL-6 and TNF-a levels did not correlated either. Circulating platelet counts in patients with ovarian cancer were significantly higher than in patients with benign conditions (282.6+/-5 vs 388.4+/-21.2x-10(9)/l, p=0.003). Thrombocytosis(platelet counts>400x10(9)/l) occured in 35%(8/23) of the cases with ovarian cancer. IL-6 levels in ascites correlated signi-ficantly with circulating platelet counts(R=0.427, p=0.042). This study showed that the patients with ovarian cancer have elevated levels of IL-6 in ascites. IL-6 levels were not correlate with disease status in patients with ovarian cancer. However, the correlation was found between IL-6 levels and thrombocytosis. This observation suggest a role for IL-6 in the development of tumor-associated thrombocytosis. A larger study would help in evaluating the potential biological roles and use of cytokines as tumor markers in ovarian cancer.
Ascites* ; Ascitic Fluid ; Blood Platelets ; Cell Line ; Cytokines ; Follow-Up Studies ; Humans ; Interleukin-2 ; Interleukin-6 ; Macrophages ; Necrosis* ; Ovarian Neoplasms* ; Platelet Count ; Thrombocytosis ; Tumor Burden ; Biomarkers, Tumor ; Tumor Necrosis Factor-alpha

OBJECTIVE: This study was done to assess long-term survival and risk factors for recurrence after neoadjuvant chemotherapy and radical hysterectomy for locally advanced cervical cancer patients. METHODS: Between August 19S3 and May 1990, 80 cervical cancer stage IB-IIB patients with tumor diameter 4cm or more received neoadjuvant VBP chemotherapy and radical hysterectomy. After follow-up more than 10 years for these patients, survival rate and risk factors for recurrence were analyzed. RESULTS: Seventy eight of SO patients were followed for 10 years. During this period, 20,5% patients(16/78) had recurrences and all of them died of recurrence. Five and 10 year survival rates were 82%(64/78) and 79.4%(62/78), respectively. High risk factor for recurrence was pelvic lymph node invasion. However, clinical stage, initial tumor mass size, number of neoadjuvant chemotherapy, clinical response, or residual tumor size were not clinically significant risk factors for recurrence. Initial tumor size was correlated with pelvic lymph node metastasis. In recurrent patients, site of recurrence was not different according to pelvic lymph node status. For node positive patients, combination of chemotherapy and radiation seemed to be more effective in reducing recurrence compared to chemotherapy or radiation only. CONCLUSION: For locally advanced stage IB-IIB cervical cancer patients who received neoadjuvani chemotherapy and radical hysterectomy, pelvic lymph node metastasis was high risk factor for recurrence and initial tumor size was closely correlated with pelvic lymph node invasion even after neoadjuvant chemotherapy.
Drug Therapy* ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Recurrence* ; Risk Factors* ; Survival Rate ; Uterine Cervical Neoplasms*