The definition and management of microinvasive cervical cancer varies from time to time depending on the organization involved and is a persistent focus of controversy. The purpose of defining microinvasion is to identify a group of patients who are not at risk of lymph node metastases or recurrence and who therefore may be treated with less than radical therapy. Microinvasive cervical cancer with Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Recurrence ; Uterine Cervical Neoplasms

Uterine artery ligation or embolization is a minimally invasive alternative for treatment of symptomatic leiomyoma. However, the experience with pregnancy management and outcome after ablating uterine blood flow is still unknown. We have recently experienced a case of a woman who had two successful spontaneous intrauterine pregnancies after laparoscopic uterine artery ligation to treat uterine myoma for dysmenorrhea and menometrorrhagia.
Dysmenorrhea ; Female ; Humans ; Leiomyoma* ; Ligation* ; Myoma ; Pregnancy* ; Uterine Artery*

OBJECTIVE: This study was designed to evaluate the patterns of menstruation including menorrhagia using menstrual index, to find out correlations between patient's own judgement and actual patterns of menstruation in Korean women, and to develop the menstrual diary using menstrual index as a screening of menstrual disorders. METHODS: Seventy-seven women teachers of elementary school undergoing routine health screening test were asked to complete a pictorial blood loss assessment chart and a set of interview sheets regarding menstrual history and their subjective judgement on their amount of menstruation. Spearman correlation test was used to assess the correlation between menstrual index which was obtained from pictorial chart and serum hemoglobin concentration. RESULTS: The mean menstrual intervals were 29.8 days (SD+/-5.1), the mean menstrual duration was 5.6 days (SD+/-1.3), the mean value of menstrual index was 170.3 (SD+/-89.2) which varied from 12 to 411, the mean serum hemoglobin concentration was 12.3 g/dL. Significant correlation was found between the serum hemoglobin concentration and the menstrual index (r=-0.29, p=0.01). Seventeen of 20 women who had anemia (serum hemoglobin concentration below 12.0 g/dL) and 25 of 26 women who had menorrhagia (menstrual index above 200) considered her menstruation as 'normal'. CONCLUSION: Many women who have anemia due to menorrhagia are not aware of the serious consequences of menorrhagia. Writing a 'menstrual diary' using menstrual index would be easier and more practical method in predicting menorrhagia.
Anemia ; Female ; Humans ; Mass Screening ; Menorrhagia ; Menstruation ; Writing

Clear cell carcinoma of the endometrium is a relatively rare malignancy that is considered to be one of the most aggressive types of endometrial carcinoma. It is an infrequent variant sharing a common Mullerian origin, accounting for 1 to 5 percent of all endometrial cancers. Histologically, these tumors consists of hobnail cells which have translucent or slightly eosinophilic cytoplasm and protrude to lumen of gland. These tumors occur predominantly in postmenopausal women and carry a relatively unfavorable prognosis comparing with other histologic types of endometrial cancer. We experienced a case of clear cell carcinoma of endometrium in a 81-year old women and this case is presented with a brief review of the literaturs.
Aged, 80 and over ; Cytoplasm ; Endometrial Neoplasms* ; Endometrium ; Eosinophils ; Female ; Humans ; Prognosis

CA-125 is an antigenic determinant expressed by more than 80% epithelial ovarian cancer. Although developed for use in the diagnosis and monitoring of epithelial ovarian cancer, elevations of CA-125 concentrations can also be associated with some normal physiologic conditions, various other malignancies and benign conditions. Adnexal cysts are frequently encountered during the reproductive years. 10 to 35% of benign cystic adnexal masses may be an endometrioma. Because endometriomas are not likely to resolve spontaneously, and may enlarge or rupture during period of observation, a test to detect an endometrioma would assist in the evaluation and management of adnexal cysts. Serum CA-125 concentration is seldom >100 U/ml in endometriosis. We reported a patient with endometrioma presenting with a very high CA-125 concentration, which may confuse diagnosis with ovarian cancer.
Diagnosis ; Endometriosis* ; Female ; Humans ; Ovarian Neoplasms ; Rupture

This clinical study was conducted to survey 300 cases of total laparoscopic hysterctomy (TLH) by the Department of Obstetrics and Gynecology of Boram Hospital in Ulsan, Korea from January, 2000 to June, 2001. TLH has been described in much of the recent literature. We analyzed 300 cases of TLH to evaluate the clinical data such as distribution of age, parity, clinical indication, previous operation history, type of surgery, operation time, weight of uterus, Hb change of post-operation first day and the complications of using this technique. The mean age of patients was 41.3. The mean parity of patients was 2.6. The clinical indications for TLH were myoma (72.3%), adenomyosis (11.3%), PID (5.3%), CIS (4%) and others (5.7%). The most previous operation was bilateral tubal ligation. Others were cesarean section, appendectomy. The most concomitant procedure with TLH was posterior colpoperineorrhaphy. Salpingo-oophorectomy and appendectomy were also carried out concomitantly. The mean operation time was 124 minutes. The mean weight of the uterus was 230 gm. The mean Hb change post-operation on the 1st day was 1.3g/dL. The complications of TLH were bleeding to need blood transfusion, ureteral injury and bladder injury. Thus this technique can be safely performed by skilled laparoscopists for properly selected patients but there is a need for prospective studies for comparision with various laparoscopic hysterctomies.
Adenomyosis ; Appendectomy ; Blood Transfusion ; Cesarean Section ; Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Korea ; Myoma ; Obstetrics ; Parity ; Pregnancy ; Sterilization, Tubal ; Ulsan ; Ureter ; Urinary Bladder ; Uterus

Intramural pregnancy implanting in the previous cesarean section scar is one of the rarest form of an ectopic pregnancy and probably the most dangerous form because of its risk of rupture and hemorrhage. Pathologically, the location of the gestational sac is completely isolated from the uterine cavity and entirely surrounded by myometrium without any contact of endometrium. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are highly desirable. We have recently experienced a case of intramural pregnancy implanting in the scar of cesarean section, treated completely with systemic methotrexate injection. So, we report this case with a brief review of the literature.
Animals ; Cesarean Section* ; Cicatrix* ; Diagnosis ; Endometrium ; Female ; Fertility ; Gestational Sac ; Hemorrhage ; Humans ; Methotrexate* ; Mice ; Myometrium* ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

OBJECTIVE: Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been limitation because of the low sensitivity and high false negative rate in the detection of preclinical or clinical disease of the cervix. This study was performed to explore the usefulness of Hybrid Capture System HPV DNA test as a diagnostic method of the cervical cancer. METHODS: Cervical cytology and Hybrid Capture System 1 (HCS1) HPV DNA test were performed in 1,023 women who visited Gynecologic Oncology Clinic in Guro Hospital, Korea University Medical Center. HPV DNA were retested by HCS1, HCS2 and Polymerase Chain Reaction(PCR), in randomly selected 200 women to compare these DNA tests. RESULTS: While the sensitivity and specificity of cervical cytology in detection of cervical lesion were 71.2% and 89.5%, those of HCS1 HPV DNA test were 63.0% and 86.9% respectively. There was significant difference in detection of cervical precancerous lesions between HCS1 and HCS2 (P<0.05), but not between HCS2 and PCR (P=0.14). And the sensitivity and specificity were improved with combining cytology and HCS1 HPV DNA test(82.2%, 86.9%~). CONCLUSION: HCS HPV DNA test may be considered as a useful adjunctive test with cervical cytology in cervical cancer screening.
Academic Medical Centers ; Cervix Uteri ; DNA ; Female ; Human Papillomavirus DNA Tests* ; Humans ; Korea ; Mass Screening* ; Mortality ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Epithelioid trophoblastic tumor (ETT) is an unusual variant of gestational trophoblastic tumor that is closely related to choriocarcinoma and placental site trophoblastic tumor (PSTT) but shows different morphologic, immunohistochemical features. ETT grows in a nodular pattern compared with the infiltrative pattern of PSTT. Histologically the tumor is characterized by uniform population of mononucleate intermediate trophoblastic cells that resemble the trophoblastic cells in the chorionic laeve, so we called them "chorionic-type intermediate trophoblast". Immunohistochemically ETT was positive for cytokeratin, epithelial membrane antigen(EMA) and staining for human placental lactogen (hPL) and human chorionic gonadotrophin (hCG) was generally patchy, focal or negative whereas PSTT contained more hPL-positive cells than hCG-positive cells. ETT can behave in a malignant fashion such as distant metastasis. We experienced a case of ETT by clinical result, pathologic finding, so we report a case with brief literature review.
Choriocarcinoma ; Chorion ; Female ; Humans ; Keratins ; Membranes ; Neoplasm Metastasis ; Placental Lactogen ; Pregnancy ; Trophoblastic Neoplasms* ; Trophoblastic Tumor, Placental Site ; Trophoblasts*

Although recently the incidence of heterotopic pregnancies are increasing because of assisted reproduction, heterotopyic pregnancies were rare with an incidence of 1 per 30,000 pregnancies. In this presentation, we describe a case of combined intrauterine and cervical pregnancy after artificial abortion. The patient was treated by local injection of methotrexate directly into gestational sac under the guidance of sonogram after systemic methotrexate treatment. The gestational products were removed by dilatation & currettage due to persistent vaginal bleeding on the next day. So we report a case with a brief review of the literatures.
Dilatation ; Gestational Sac ; Humans ; Incidence ; Methotrexate ; Pregnancy* ; Pregnancy, Heterotopic ; Reproduction ; Uterine Hemorrhage