Mature cystic teratomas (MCTs) are benign ovarian tumors known to undergo malignant transformation in 1%–2% of cases. Most of these cases lead to squamous cell carcinomas (SCC), and the prognosis is often poor, particularly in advanced-stage disease. A 50-yearold postmenopausal woman presented with a large pelvic mass. The patient initially underwent suboptimal primary surgery and was later diagnosed with stage IIIA SCC arising from MCT. Following the first cycle of chemotherapy with carboplatin and paclitaxel, a computed tomography scan showed a rapidly growing large mass in the pelvic cavity after 4 weeks of primary surgery, leading to a second debulking surgery. However, the patient underwent only one cycle of chemotherapy after secondary debulking surgery because of her poor performance status. Subsequently, after 4 months of secondary debulking surgery, the patient developed rapidly progressive disease, leading to her death approximately after 8 months of diagnosis. While an appropriate multimodal treatment strategy has yet to be established, optimal cytoreductive surgery and adjuvant chemotherapy should be considered for treatment of advanced-stage diseases to improve survival outcomes.

An indirect inguinal hernia containing the fallopian tube alone is extremely rare in reproductive-aged women without any genital tract anomalies. Despite this rarity, early diagnosis and adequate management is important to prevent strangulation and recurrence. We present a case of an indirect inguinal hernia containing only the fallopian tube in the hernia sac, which was successfully reduced by using a laparoscopic total extraperitoneal approach and repaired with a polypropylene mesh.
Early Diagnosis ; Fallopian Tubes* ; Female ; Hernia* ; Hernia, Inguinal* ; Herniorrhaphy* ; Humans ; Laparoscopy ; Polypropylenes ; Recurrence

OBJECTIVES: To investigate the occurrence of glaucoma and association with the serum estradiol (E2) level in postmenopausal women. METHODS: We evaluated the serum E2 level, female reproductive factors and glaucoma related risk factors including intraocular pressure and optical coherence tomography (OCT) findings in 30 postmenopausal women who visited Obstetrics and Gynecology outpatient clinic. Patients who showed abnormal findings on the glaucoma screening test were classified to the glaucoma suspect group (group-G), and underwent a glaucoma confirmatory test. Serum E2 level, female reproductive and other menopausal health-related factors such as lipid profiles and bone mineral densities were analyzed in the group-G and non glaucomatous group (group-N). RESULTS: Eight out of thirty participants (26.7%) were classified to the group-G. One of them was diagnosed as having glaucoma that required treatment, and the other two were found to have early glaucomatous changes. Compared to the group-G, the group-N had a higher level of serum E2 (19.40 +/- 4.79 vs. 13.95 +/- 4.55 pg/mL) The difference, however, was not statistically significant (P = 0.525). The proportion of glaucoma suspect patients in the groups with a higher serum E2 level (> or = 20 pg/mL) and a lower serum E2 level (< 20 pg/mL) was similar (25.0 and 27.3%, P = 0.645). Multiple logistic regression analysis showed that no female reproductive factors were associated with the risk of glaucoma. CONCLUSION: Comprehensive glaucoma screening using an OCT in postmenopausal women could detect more glaucoma patients than prevalence in the similar age group. Statistical significance was not found in the association between serum E2 level and the risk of glaucoma.
Ambulatory Care Facilities ; Bone Density ; Estradiol ; Female ; Glaucoma ; Gynecology ; Humans ; Intraocular Pressure ; Logistic Models ; Mass Screening ; Obstetrics ; Postmenopause ; Prevalence ; Risk Factors ; Tomography, Optical Coherence

BACKGROUND: Treatment for chronic hepatitis B aims to suppress virus replication and virus sequestration in hepatocytes. Covalently closed circular (ccc) DNA is the template for transcription of viral genes and is responsible for viral persistence. However, limited data are available for quantification of hepatitis B surface antigen (HBsAg) in Korea. METHODS: We evaluated the Elecsys HBsAg II quant assay (Roche Diagnostics, USA) for within-run, between-run, and between-day precisions, linearity, carryover, and clinical specificity. In total, 156 serum samples were evaluated for correlation between HBsAg and hepatitis B virus (HBV) DNA. Serial samples were obtained from 10 patients at 0, 12, 24, 48, 72, and 96 weeks during follow-up. RESULTS: The assay detected HBsAg in a linear range of 0.5-48,696 IU/mL. Within-run, between-run, and between-day CVs were 2.9-4.1%, 0-1.5%, and 1.5-4.9%, respectively. Cross-reactivity between potentially interfering substances was absent, and the carryover rate was 0.00002%. The correlation of measurements between the Elecsys assay and HBV DNA PCR was weak (r=0.438, P=0.002). For predicting virologic response, cutoff values of 10,275 IU/mL and 3,846 IU/mL at 12 and 24 weeks after treatment initiation showed positive predictive values of 77.1% and 85% and negative predictive values of 84.6% and 50%, respectively. CONCLUSIONS: The Elecsys HBsAg II quant assay showed good performance for precision, linearity, carryover rate, and specificity. HBsAg level at baseline, 12 weeks, and 24 weeks after treatment initiation can predict virologic response, and the assay can be used for HBsAg quantification in clinical practice.

Thin basement membrane nephropathy (TBMN) is characterized by persistent hematuria, mild proteinuria, normal renal function and family history of hematuria. Many studies report that TBMN commonly occurs together with other glomerular diseases such as minimal change nephrotic syndrome, membranous nephropathy, IgA nephropathy and focal segmental glomerulosclerosis. Especially, the case of TBMN with minimal change nephrotic syndrome has been rare. We report a case of adult minimal change nephrotic syndrome with TBMN in a 44-year-old female with general edema and microscopic hematuria. On renal biopsy, electron microscopic examination demonstrated diffuse thinning of glomerular basement membrane with the thickness less than 250nm and diffuse foot process effacement. Treatment with corticosteroid resulted in complete remission of proteinuria.
Adult ; Basement Membrane ; Biopsy ; Edema ; Electrons ; Female ; Foot ; Glomerular Basement Membrane ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Hematuria ; Humans ; Nephrosis, Lipoid ; Proteinuria

OBJECTIVE: The aim of this study was to know the clinicopathological characteristics that help to make a decision about diagnosis and treatment of ovarian masses in Korean women. METHODS: Women who were undergone operations and histopathologically confirmed as ovarian masses at Inje University Busan Paik Hospital and Donrae Paik Hospital from January of 1997 to June of 2009 were enrolled in this study. Distribution according to histopathological types and ages were analyzed. RESULTS: Of the 2875 cases, there were 1078 cases (37.5%) of non neoplastic masses and 1797 cases (62.5%) of neoplastic masses. In the neoplatic masses, there were 1286 cases (44.7%) of benign tumors, 140 cases (4.9%) of borderline tumors and 371 cases (12.9%) of malignant tumors. Endometriomas were most common tumors (644 cases, 59.7%) among non-neoplastic masses. Mature cystic teratomas were the most common tumors (598 cases, 46.5%) among benign tumors. Mucinous cystadenomas were the most common types (105 cases, 75.0%) among borderline tumors. Epithelial ovarian cancers were the most common types (267 cases, 72.0%) among malignant tumors. As the result of age distribution, mature cystic teratomas were the most common types of the women of the first and second decade, endometriomas were the most common types of the women of the third and fourth decade, and benign epithelial tumors were the most common types of the women of fifth and after sixth decade. CONCLUSION: Taken as a whole, neoplastic ovarian masses were more common than non-neoplastic masses, but most common ovarian mass was endometrioma which is non-neoplastic mass.
Age Distribution ; Cystadenoma, Mucinous ; Endometriosis ; Female ; Humans ; Ovarian Neoplasms ; Teratoma

BACKGROUND: Hepatitis C virus (HCV) core antigen (Ag) levels are known to be well correlating with HCV RNA levels, and may be used as an alternative marker of HCV replication for monitoring the response to HCV treatment. However, the low sensitivity of HCV core Ag assay has been an obstacle for clinical use. In this study, recently developed ARCHITECT HCV Ag assay (Abbott Laboratories, USA) was evaluated for analytical performance and clinical usefulness. METHODS: A total of 109 sera from HCV infected patients including various genotypes of HCV (1b, 2, 2a/2c, 2b, and 3a) and 20 sera from healthy donors were used for evaluating the sensitivity, precision, and linearity of the HCV core Ag assay. The cross reactivity with HIV, hepatitis B virus and myeloma proteins (N=5, each) and correlation with HCV RNA PCR assay were also evaluated. RESULTS: The sensitivity of the HCV core Ag assay was 97.2% (106/109) and there were no false positive results and cross reactivity. The within-run, between-run and between-day CVs were 3.0%, 2.5% and 3.0%, respectively. The levels of HCV core antigen showed a good correlation with those of HCV RNA quantification (r=0.940). The HCV Ag assay showed an excellent linearity in the range from 0.63 to 17,114 fmol/L (r=0.999). CONCLUSIONS: The ARCHITECT HCV Ag assay was good in sensitivity, precision, and linearity and its results well correlated with HCV RNA levels. This assay could be used as a good marker of viral replication for monitoring the therapy response in chronically HCV infected patients.
Chemiluminescent Measurements/*methods ; Cross Reactions ; Genotype ; Hepacivirus/genetics/*immunology ; Hepatitis Antigens/*blood ; Humans ; Polymerase Chain Reaction/*methods ; RNA, Viral/blood ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Viral Core Proteins/*blood

OBJECTIVE: To study the relationship between serum human papillomavirus (HPV) deoxyribonucleic acid (DNA) and clinicopathologic prognostic factors and the clinical usefulness of serum HPV 16 DNA in cervical cancer patients. METHODS: All the patients were treated at our institution, from January, 2002 to February, 2007. DNA extracted from serum of 17 patients with HPV 16 infected carcinoma in situ and 65 patients with HPV 16 infected squamous cell carcinoma of the uterine cervix (stage IA-IIIB) were examined for HPV 16 DNA using polymerase chain reaction with types 16 specific E6 primer. Clinicopathological parameters were obtained from medical records, and the relationship between the discrete variables and serum HPV 16 DNA status were evaluated. RESULTS: HPV 16 DNA was not detected in serum from all patients with carcinoma in situ. However, among the 65 patients with HPV 16 infected squamous cell carcinoma of the uterine cervix, we detected 17 HPV 16 DNA positive samples (26.2%) in serum. Positive HPV 16 DNA in serum was correlated with age (P=0.0071), serum squamous cell carcinoma (SCC) antigen (P=0.0034), tumor size (P=0.0029), clinical stage (P<0.0001), deep stromal invasion (P=0.0048), resection margin positivity (P=0.0008), and pelvic lymph nodal metastasis (P=0.0040). CONCLUSION: The serum HPV 16 DNA in patients with cervical cancer was correlated with poor prognostic factors that need adjuvant treatment.
Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri ; DNA ; Female ; Human papillomavirus 16 ; Humans ; Medical Records ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

BACKGROUND: The frequencies and distributions of unexpected antibodies have been reported using two different criteria, based on either number of persons tested or number of tests performed. But there has been no study that compared the results of analyses based on these two different criteria using the same data set. METHODS: Unexpected antibody tests performed in a University Hospital during recent 6 yr (January 2002-December 2007) were retrospectively analyzed: 76,985 tests (59,503 persons) for screening and 875 tests (749 persons) for identification. Data were analyzed using two different criteria, based on 'persons tested' and 'tests performed'. Antibodies had been screened and identified using LISS/Coombs gel cards with DiaMed-ID system (DiaMed AG, Switzerland). RESULTS: Frequencies of unexpected antibodies based on 'persons tested' and 'tests performed' were 1.32% and 1.34%, respectively (P=0.88). For frequently detected as well as rarely detected antibodies, there were no significant differences in the frequencies based on two different criteria. However, for rarely detected antibodies (anti-Xg(a) and Anti-E & D), the frequencies based on 'tests performed' were higher than those based on 'persons tested', affecting a change in the order of frequencies of antibodies detected. CONCLUSIONS: As there were no significant differences in the frequencies of unexpected antibodies calculated using two different criteria, both criteria can be used together for the patient population in our hospital. However, two criteria should be compared to validate the results for other populations.
Blood Group Antigens/*immunology ; Data Interpretation, Statistical ; Humans ; Isoantibodies/blood/*immunology ; Retrospective Studies

OBJECTIVE: To evaluate correlation of sites of positive margin and residual tumor and to establish management after conization. METHODS: Of 599 cold-knife conizations [15 (2.6%) with cervical intraepithelial neoplasia (CIN) I, 37 (6.1%) with CIN II, 450 (75.1%) with CIN III, 97 (16.2%) with microinvasion] performed at our institution from January, 1993 to June, 2006, 144 patients (24.0%) had positive margins and 113 patients were included in the retrospective study excluding 31 cases that were not followed more than 12 months. Correlation of conization pathology and residual tumor according to sites of positive margin were evaluated. RESULTS: The prevalence rates of positive margins were 6.7% (1/15) in CIN I, 21.6% (8/37) in CIN II, 21.1% (95/450) in CIN III, and 41.2% (40/97) in microinvasion. The prevalence rate of positive margin increased with severity of conization pathology (P=0.0001). Of 113 patients followed more than 12 months, 27.4% (31/113) had residual tumor [0.0% (0/1) in CIN I, 12.5% (1/8) in CIN II, 18.9% (14/74) in CIN III, and 53.3% (16/30) in microinvasion]. The prevalence rate of residual tumor increased with severity of conization pathology (P=0.0028). Residual tumor was more common in patients in whom both endocervical and exocervical margins or in whom only the endocervical margin were involved than in those in whom only exocervical margin was involved [87.5% (7/8) or 35.3% (24/68) versus 0% (0/37), respectively]. CONCLUSIONS: Expectant management is reasonable for patients with positive margin after conization. However, careful follow-up of these patients is essential, particularly in endocervical involvement.
Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Conization ; Female ; Follow-Up Studies ; Humans ; Neoplasm, Residual ; Prevalence ; Retrospective Studies