OBJECTIVE: Although a great deal of knowledge accumulated with regard to the causes and epidemiologic features of cervical cancer, primary prevention has not been particularly effective to date. Most efforts with regards of control of cervical cancer have been directed toward secondary prevention with cytologic smears in a screening program. The purpose of this study was to know the cervical smear histories in the women with neoplasia of uterine cervix at present. MATERIALS AND METHOD: Between June, 1993 and October, 1996, seventy women with invasive cervical carcinoma and eighty-seven women with cervical intraepithelial neoplasia(CIN) were interviewed about cervical smear histories to assess the frequencies of past smear at the Soonchunhyang University Hospital. RESULTS: The results were follows: 1. The mean age of the women with invasive cervical cancer and CIN were 55+/-9 and 42+/-11, respectively. 2. Of the 70 cases of cervical cancer, 61%(43/70) has not been screened, compared with 43%(37/87) in cases of CIN. 3. The mean ages at first smear in the cases of previous smear were 42+/-6 of 27 cancers, 37+/-7 of 50 CINs. The gap between the age at the first smear and the age at diagnosis were about 6 years in cases of cervical cancers, about 5 years in cases of CIN. 4. The most common symptom in cervical cancers was vaginal bleeding or postcoital bleeding(57%). Although 13%(9/70) were discovered during screening without symptom in the women with cervical cancers, 58%(52/87) were diagnosed incidently during screening in CIN. 5. Pap smear numbers before diagnosis were strongly associated with age and stage. Among women diagnosed with invasive cancer under the age of 49, 75% had at least one cervical smear. But, all women with cervical cancer over age of 65 have not been screened. Unscreened rates of stage I, II, III, and IV were 34%, 78%, 85% and 83% respectively. 6. Among 38 cases who had undergone radiation therapy, 82%(31/38) had not been screen in contrast to 38%(12/32) in the women who had undergone radical surgery. 7. Among women with previous smears in the cervical cancer, 20%(14/70) have been screened within 1year. CONCLUSION: It is likely to diagnosis cervical cancer who had normal papanicolau smear in recent. So papanicolau smear is examined carefully and other adjunctive test is help to diagnosis cervical cancer exactly, for example cervicography, HPV testing.
Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Diagnosis* ; Female ; Humans ; Mass Screening ; Primary Prevention ; Secondary Prevention ; Uterine Cervical Neoplasms* ; Uterine Hemorrhage ; Vaginal Smears

Benign metastasizing leiomyoma usually occurs in women and is associated with a past hysterectomy in 80% of the cases, which is a rare entity. The patient was a 39-year-old woman who complained of cough and sputum. She underwent hysterectomy beacuse of benign leiomyoma ten years age. Chest X-ray showed nodular lesion in the left lung field. Chest CT showed a 3cm sized round well defined mass at left hilum with mild indentation of segmental bronchi of left upper lobe and a small tiny nodule in right lower lung field. Nodular lesion of left upper lobe was resected by thoracotomy.Pathological evaluation showed benign spindle-like cells having nuclei without cytotic atypia similar to those of benign leiomyoma. Immunohistochemical stainings for desmin and smooth muscle actin were positive. Therefore these nodules are considered as benign metastasizing leiomyoma from a uterine leiomyoma. We report this case with the review of literature.
Actins ; Adult ; Bronchi ; Cough ; Desmin ; Female ; Humans ; Hysterectomy ; Leiomyoma* ; Lung* ; Muscle, Smooth ; Sputum ; Thorax ; Tomography, X-Ray Computed

Nodular pulmonary amyloidosis is one of the rare manifestation of amyloid disease. It is known to be caused by anyloid L fibrils in the majority of case. We experienced an unusual case of a forty-one year-old woman who was presented with multiple nodular lesion on the chest X-ray. CT-guided core needle bilpsy, performed on the lesion, showed apple green birefringes, when stained Congo red and examined under polarized light. Ultrastructurally, there are randomly oriented, forming densed networks, and consists of fine, 7.5 to 10nm diameter, rigid, non-branching filaments of various lengths in electron-microscopic finding. We report a case of primary diffuse nodular pulmonary amyloidosis only localized in the lung, which was confirmed by CT guided core needle biopsy.
Amyloid ; Amyloidosis* ; Biopsy, Large-Core Needle ; Congo Red ; Female ; Humans ; Lung* ; Needles ; Thorax

OBJECTIVE: To evaluate the frequency and obstetric consequences of women with uterine anomalies and correlation between obstetric consequence and congenital uterine anomalies. Materials and METHODS: A retrospective study was made on 65 patients with uterine anomalies in order to evaluate the obstetric consequence at department of obstetrics and gynecology, Soonchunhyang University Hospital from January 1994 to June 1997. The diagnosis of uterine anomalies was made with hysterosalpingogram or ultrasonogram, or at the time of cesarean section. The uterine anomalies were classified according to the classification of Buttram and Gibbons and compared the pregnancy outcome for each classification. The obstetric consequences were divided into preterm delivery, premature rupture of membranes, intrauterine growth restriction, and abnormal presentation of fetus. Statistical analysis was carried out using chi-square test, the significance was defined as P< 0.05. RESULTS: 1. The incidence of uterine anomalies accounted for 1.04% (65/6,250 deliveries). 2. The most common uterine anomalies were class III (Uterine didelphys, 47.7%). 3. We noted preterm birth rate (16.9%), premature rupture of membranes rate (20%), intrauterine growth restriction rate (9.2%) in 65 patients. 4. The rate of breech presentation was 41.5% and the mean birth weight was 2,747 gram. 5. When uterine anormalies were present, the incidence of obstetric consequences was significantly increased. CONCLUSION: We concluded that congenital uterine anomalies were closely related to obstetric consequences, such as preterm, breech presentation, intrauterine growth retardation.
Birth Weight ; Breech Presentation ; Cesarean Section ; Classification ; Diagnosis ; Female ; Fetal Growth Retardation ; Fetus ; Gynecology ; Humans ; Hylobates ; Incidence ; Membranes ; Obstetrics ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Retrospective Studies ; Rupture ; Ultrasonography

OBJECTIVE: To determne whether abnormal results of doble saeening tests for Down syndrome with MSAFP and free B-hCG are associated with adverse pregnancy outcome. METHODS: Between October 1994 and September 1997, 205 among 1731 who were screened had increased risk for Down screening program of CIS biointernational, Fetuses with Chromosomal abnormality or congenital anomalies and less than 35 years of maternal age were excluded from this study. Down syndrome screening test was performed between 14-22 weeks of gestation. RESULTS: Of 1731 women, 205 (13.4%) had increased Down syndrome risk. The pregnancy outcome of women with increased Down syndrome risk were compared with those of women without such risk There were no significant difference in the incidence of preterm labor (6[2.9%] vs 112[7.3%)), premature rupture of the membranes (2[0.9%] vs 56[3.6%]), pregnancy induced hypertension (2[0.9%] vs 36[2.3%]), abruptio placentae (0[0%] vs 2[0.1%]), low birth weight (2[0.9%] vs 21[1.3%]), oligohydramnios (4[1.9%] vs 10[0.6%]), intrauterine fetal death (0[0%] vs 2[0.1%]). CONCLUSION: False positive results of Down syndrome screening test in the 2nd trimester do not appear to be associated with adverse pregnancy outcome. But there are statistically significant increases of adverse pregnancy outcome in wemen with elevation of MSAFP or elevation of free B-hCG.
Abruptio Placentae ; Chromosome Aberrations ; Down Syndrome ; Female ; Fetal Death ; Fetus ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Mass Screening* ; Maternal Age ; Membranes ; Obstetric Labor, Premature ; Oligohydramnios ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

PURPOSE: Serum squamous cell (SCC) antigen levels were examined in uterine cervix cancer undergoing radiation therapy, and authors analyzed the relationship between SCC antigen levels and treatment results. MATERIALS AND METHODS: This is a retrospective study of 181 cervical carcinoma patients who received radiotherapy and examined serial serum SCC antigen from 1991 to 1997 at Soonchunhyang University Hospital. One hundred and eighteen patients underwent SCC antigen evaluation at diagnosis The relationship between the serum tumor marker level and disease free survival, recurrence pattern, and other prognostic factors were analyzed according to various statistical methods. RESULTS: The positivity rate (initial serum value above 2.5 ng/ml) was increased with FIGO stage (IB-IIA 57% to IV 91%) and more discriminative than cutoff value of 1.5 ng/ml. Five year disease free survival rates for the stage IB-IIA, IIB, III and IV were 79.2%, 68.7%, 33.4% and 0%, respectively. The 5-year disease free survival rate for patients with serum SCC antigen levels above 5.0 ng/ml was 34% versus 55~62% for patients with normal range (<1.5 ng/ml) or mildly elevated levels (1.5~5.0 ng/ml). Rising SCC antigen levels preceded the clinical detection of disease by a mean of 4.8 months (range 1~13 months). Negative linear corelation was observed between initial SCC antigen levels and relapse free survival (r=-0.226), and by multivariate analysis, initial SCC antigen level had a large impact on the relapse free survival. CONCLUSIONS: SCC antigen assay is a useful aid to predict the prognosis of squamous cell carcinoma of the uterine cervix and to detect recurrence.
Carcinoma, Squamous Cell ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Female ; Humans ; Multivariate Analysis ; Prognosis ; Radiotherapy ; Recurrence* ; Reference Values ; Retrospective Studies ; Uterine Cervical Neoplasms

No abstract available.
Anemia, Hemolytic* ; Mitral Valve*

Struma ovarii is a monodermal teratoma composed totally or in overwhelming proportion of thyroid tissue. It is uncommon and accounts for 1% to 3% of benign teratomas of ovary. Grossly, they are encapsulated neoplasms, several centimeters in diameter and have a red, shiny, and meaty surface. Microscopically, the tumor is composed of mature thyroid tissue consisting of various sizes, lined by a single layer of columnar or flattened epithelium. The clinical behavior is benign, and simple excision is adequate treatment. We had experienced two cases of struma ovarii arising in the left ovaries. So we report above cases with brief review of literatures.
Epithelium ; Female ; Ovary ; Struma Ovarii* ; Teratoma ; Thyroid Gland

A considerable body of evidence has been accumulated suggesting that invasive squamous cell carcinoma develops from cervical intraepithelial neoplasia(CIN). Most women with invasive cancer of the cervix are from lower socioeconomic groups, have begun heterosexual activity early in life, marry early, are multiparous, and have many sexual partners. Although the epidemiology of the cervical cancer is known well, the pathogenesis of the cervical cancer from CIN is subtle yet. Apoptosis, including the programmed cell death, is important event in normal cell turnover and maintenance of adult tissues. Apoptosis exerts a homeostatic function in relation to tissues dynamics, as the steady state of continuously renewing tissues achieved by a balance between cell replication and cell death. The specific labelling of nick ends of fragmented DNA was used to see the apoptotic cells from normal epithelium of the cervix to invasive cervical cancer. The apoptotic cells were found normally in the parabasal layer of the epithelium. As the grade of CIN increase, the apoptotic cell were found in superficial of the cervix and number of the apoptotic cell were increased. In the cervical cancer, the apoptotic cell were found in the cancerous tissues more than in the normal epithelium. This results suggest that the cell proliferation is more important than the inhibition of the apoptosis in the carcinogenesis of the cervical cancer.
Adult ; Apoptosis* ; Carcinogenesis* ; Carcinoma, Squamous Cell ; Cell Death ; Cell Proliferation ; Cervix Uteri ; DNA ; Epidemiology ; Epithelium ; Female ; Heterosexuality ; Humans ; Sexual Partners ; Uterine Cervical Neoplasms*

Massive eversion of the vagina is one of the most disturbing disorders confronting a woman. It is a complex disorder that always surgical, and all defects. The managements is always surgical, and all defects must be repaired concomitantly. Current surgical practice relies primarily on the strength of the endopelvic fascia and certain ligaments. Massive eversion of the vagina can be treated by a variety of transvaginal and transamdominal surgical technique. In most instances a transvaginal approach is useful. If strong cadinal and uteroscral support in not available fiocation of the vginal vault to the sacrospinous ligment is useful. In 1987, Miyazaki introduced his Miya Hook ligature carrier. With this instrume nt, introduction of the needle became safer and easier than with the Deschamp aneurysm needle. We had experienced two cases of massive eversion of vagina after the total abdominl hyst erectomy who were treated succesfully with sacrospinous ligement fixation by using Miya Hook. We report above two cases and review briefly.
Aneurysm ; Fascia ; Female ; Humans ; Hysterectomy* ; Ligaments* ; Ligation ; Needles ; Vagina*