Sentinel lymph node biopsy combined with preoperative ultrasonography in predicting axillary lymph node metastasis in early breast cancer / 中华普通外科杂志

Objective@#To investigate the prediction of axillary lymph node metastasis in patients with early breast cancer by sentinel lymph node biopsy (SLNB) combined with preoperative ultrasound.@*Methods@#From Jun 2014 to Oct 2018, 340 patients with early breast cancer were enrolled in the 5th Department of General Surgery of Second Hospital of Lanzhou University. 113 cases were grouped into ultrasound examing, 75 patients in the SLNB, and 152 patients in the SLNB combined with preoperative ultrasound.Using the results of axillary lymph node dissection as gold standard, the 3 groups were compared.@*Results@#The sensitivity of SLNB, ultrasound and SLNB combined with ultrasound for suspicious axillary lymph node biopsy were 90.1%, 85.7%, and 96.4%, respectively. The specificity was 84.0%, 76.3%, and 100%, and the accuracy was 91.6%, 83.0%, and 97.4%, respectively. The false negative rates were 8.6%, 14.3%, and 3.6%, respectively.@*Conclusion@#Preoperative ultrasound diagnosis of axillary lymph node status combined with sentinel lymph node biopsy can significantly improve the diagnosis rate of axillary lymph node metastasis in early breast cancer.

Sentinel lymph node biopsy combined with preoperative ultrasonography in predicting axillary lymph node metastasis in early breast cancer / 中华普通外科杂志

Objective To investigate the prediction of axillary lymph node metastasis in patients with early breast cancer by sentinel lymph node biopsy (SLNB) combined with preoperative ultrasound.Methods From Jun 2014 to Oct 2018,340 patients with early breast cancer were enrolled in the 5th Department of General Surgery of Second Hospital of Lanzhou University.113 cases were grouped into ultrasound examing,75 patients in the SLNB,and 152 patients in the SLNB combined with preoperative ultrasound.Using the results of axillary lymph node dissection as gold standard,the 3 groups were compared.Results The sensitivity of SLNB,ultrasound and SLNB combined with ultrasound for suspicious axillary lymph node biopsy were 90.1％,85.7％,and 96.4％,respectively.The specificity was 84.0％,76.3％,and 100％,and the accuracy was 91.6％,83.0％,and 97.4％,respectively.The false negative rates were 8.6％,14.3％,and 3.6％,respectively.Conclusion Preoperative ultrasound diagnosis of axillary lymph node status combined with sentinel lymph node biopsy can significantly improve the diagnosis rate of axillary lymph node metastasis in early breast cancer.

MRI findings of rare intracranial germ cell tumors of the pineal region with pathologic / 中华放射学杂志

Objective To analyze the MRI features of rare intracranial germ cell tumors of the pineal region compared with pathologic findings.Methods The MRI and pathologic data of 32 patients with rare intracranial germ cell tumors of the pineal region were reviewed retrospectively.All cases were proved by surgery and pathological examinations.Results Fourteen teratomas with malignant transformations were cyst-solidary which were mixed signals on plain MRI and the solid components showed obvious enhancement.The adiposity signals could be seen in teratomas.The level of serum or CSF AFP was high.Microscopically,many tissue components could be seen.The signal of 6 yolk sac tumors were homogeneous,and they had great enhancement after enhanced scanning.Increasing of preoperative serum AFP level could be seen in all patients.The 5 embryonal carcinomas were well-defined margin masses and heterogeneous with cystoid variation and necrosis and moderate to severe edema.The solid components showed obvious enhance.The signals of 7 mixed germ cell tumors were atypical,which depended on the components of germ cell tumors.Conclusion The MRI findings of the rare intracranial germ cell tumors of the pineal region(teratomas with malignant transformations,yolk sac tumors endodermal sinus tumor,embryonal carcinomas and mixed germ cell tumors)show some feature which are correlated with pathology.Suggestive diagnosis could be made combined with clinical data and MRI features.

The MRI findings of meningeal peripheral-type primitive neuroectodermal tumors / 中华放射学杂志

Objective To analyze the MRI features of Ewing sarcoma/peripheral primitive neuroectodermal tumors(pPNETs) arising from the meninges.Methods The MRI imaging of 9 patients with Ewing sarcoma/pPNET were reviewed retrospectively,and imaging features and pathological characteristics were analyzed.Results The age of most patients ranged from 10 to 20 years.Magnetic resonance revealed a spindle-like lesion with a wide base in 8 cases.The lesions showed heterogenous iso-or hypo-intense signal on T1 WI in 7 cases,heterogenous hypo-iso-intense signal on T1 WI in 2 case,and iso-or mildly hypderisointense on T2WI in all cases.The solid part of the tumor was heterogeneously enhanced after injection of gadolinium with cyst degeneration or necrosis.The dural tail sign could be seen in 3 cases.The adjacent skull erosion could be seen in 6 cases.The breakthrough of the plate of cranium and soft-tissue invasion was present in 2 cases.The right eye proptosis was present in 1 case.The distant metastasis was found in 3 cases.Pathology showed that the lesions had high cell density.Hemorrhage and necrosis could be observed.The cells were like lymphocytes and spindle cells with transparent cytoplasm.CD99 and Vimentin were expressed in all tumor cells.Conclusion The imaging findings of the meningeal pPNET are different from meningiomas,which could be useful for the diagnosis and differential diagnosis.

Effects of a safflower tea supplement on antioxidative status and bone markers in postmenopausal women

We conducted this study to examine the effects of safflower seed granular tea containing physiologically active polyphenols on antioxidative activities and bone metabolism. Forty postmenopausal women ages 49 to 64-years were recruited from Daegu and Gyeongbuk and were randomly assigned to either a safflower tea supplement (Saf-tea) group (n = 27) or a placebo group (n = 13). The Saf-tea group received 20 g of safflower seed granule tea per day containing a 13% ethanol extract of defatted safflower seeds, whereas the placebo group received a similar type of tea that lacked the ethanol extract. No significant changes in nutrient intake for either the placebo or Saf-tea groups were observed before or after the study period, except vitamin A intake increased after 6 months in the Saf-tea group. Dietary phytoestrogen intakes were similar in the Saf-tea group (60.3 mg) and placebo group (52.5 mg). Significant increases in plasma genistein and enterolactone were observed in the Saf-tea group. After 6 months of supplementation, serum levels of antioxidant vitamins such as alpha-tocopherol and ascorbic acid increased significantly, and TBARS levels decreased in the Saf-tea group compared to the placebo group. Serum osteocalcin levels were reduced (P < 0.05) in the Saf-tea group after 6 months, whereas serum osteocalcin did not change in the placebo group. Urinary deoxypyridinoline/creatinine excretion was not different between the two groups at baseline, and did not change in either group after 6 months. Bone mineral density decreased significantly in the placebo group (P < 0.01) but not in the supplemented group. It was concluded that polyphenols (72 mg/day), including serotonin derivatives, in the Saf-tea had both antioxidant and potential bone protecting effects in postmenopausal women without liver toxicity.

Comparative study of the MRI findings of lymphoplasmacyte-rich meningioma with pathological findings / 中华放射学杂志

Objective To investigate the MRI features of intracranial lymphoplasmacyte-rich meningioma and the corelation between the MRI features and pathologic findings. Methods The MRI and pathologic data of 7 patients with lymphoplasmacyte-rich meningioma were reviewed retrospectively. All cases were proved by surgery and pathological examinations. Results All lesions were solitary. The tumors crawled along meninges in 6 cases and in 5 cases the tumors did not appear as mass lesions. In 2 cases, the tumors appeared as half-moon. The boundary of all of the tumors was unclear, accompanying heavy peritumoral brain edema. The brain invasion can be seen in 7 cases. The lesions showed hypo-isointense signal on T1 WI in 7 cases, hyper-isointense signal in 5 cases and hypo-isointense in 2 cases on T2 WI.Enhancement scan demonstrated marked enhancement in 7 cases. Extensive thickening of the meninges was observed in 6 cases. Pathological results showed that the cells were abundant and diversified, with a great quantity of lymphoplasmacytes, and there were typical meningeal epithelial cells area in the surgical specimen. Conclusion The MRI findings of lymphoplasmacyte-rich meningioma show some features different from other common meningiomas, which would be helpful to the diagnosis and differential diagnosis.

Interstitial heterotopic pregnancy by in vitro fertilization and embryo transfer after bilateral salpingectomy / 대한산부인과학회지

Although assisted reproductive technology is associated with higher rates of interstitial pregnancy and heterotopic pregnancy, heterotopic pregnancy after bilateral salpingectomy is still extremely rare. We report a case of heterotopic pregnancy after bilateral salpingectomy in an in vitro fertilization/embryo transfer patient, who underwent cornual resection by laparotomy due to ruptured cornual pregnancy. However, 3 days after surgery, the remaining intrauterine pregnancy miscarried, and a dilatation and curettage was performed.

Relation between HPV and cyclooxygenase 2 overexpression in cervical carcinoma in situ and carcinoma / 대한산부인과학회지

OBJECTIVE: The aim of this study was to identify the relation between HPV infection and cyclooxygenase 2 (COX-2) overexpression in cervical carcinoma in situ (CIS) and carcinoma. METHODS: Fourteen patients with CIS, 14 patients with invasive cervical carcinoma, and 14 patients with myoma as control were enrolled. Polymerase chain reaction was used to detect high risk types of HPV, and immunohistochemistry was used to detect COX-2 expression. RESULTS: The frequencies of high risk types of HPV infections in CIS or carcinoma were significantly higher than control [CIS: 11 (78.6%), carcinoma: 14 (100%), control: 1 (7.1%), P-value>0.001]. COX-2 expressions in CIS were higher than control (P=0.037), and those in carcinoma were higher than CIS (P=0.002). Three patients with CIS did not show HPV infection and showed lower COX-2 expression than the other patients with HPV infection in CIS group (P=0.013). There was strong correlation between COX-2 expression and HPV infection (P>0.001). However, in multivariate analysis, disease progression from normal to invasive carcinoma was the only independent factor to affect COX-2 overexpression. CONCLUSION: Disease progression from normal to invasive carcinoma might be more important factor to affect COX-2 overexpression than high risk types of HPV infection.

A Case of Malignant Melanoma Showing Systemic Metastases With Melanuria / 대한피부과학회지

A 31-year old woman had been diagnosed as a metastatic melanoma of unknown origin 7 month before. Multiple cutaneous nodules had developed about 2 months before. When she visited our dermatologic clinic, the number of cutaneous nodules was increased and her urine was dark-brown colored. Histopathologically, the cutaneous nodule had typical for metastatic melanoma. After cytospin of her urine, we observed melanin dusts within macrophage on Fontana-Masson stain. This is a rare case showing melanuria.

The Relationship between the Expression of Cytokeratins, Ki-67, and the Infection of Human Papillomavirus 16, 18 Type in the Carcinogenic Progression of the Uterine Cervical Epithelium / 대한산부인과학회잡지

OBJECTIVE: To evaluate the relationship between the expression of cytokeratins, Ki-67 and the infection of human papillomavirus 16, 18 type in the carcinogenic progrssion of the uterine cervical epithelium. METHODS: Investigation the expression patterns of CKs and Ki-67 monoclonal antibody, and compared them with the incidence of HPV infection in 120 patients including 30 cases of normal cervical epithelium, 30 cases of LSIL, 30 cases of HSIL and 30 cases of SCC, to possible relationship between them. RESULTS: The expression of CK 14, and Ki-67 increased as the cervical lesions progressed from normal to SILs and SCC. In contrast, CK 13 is decreased as the cervical lesions progressed from normal to SILs and SCC. Statistical analysis revealed significant corelations between the CK 14 and spinal layer, between CK 13 and basal layer, between Ki-67 and all layers. HPV was detected in 16.7% of normal cervical tissue, 50.0% of LSIL, 70.0% of HSIL, 80.0% of SCC with PCR technique. The labelling indices of Ki-67 were significantly higher in HSIL than in normal cervical tissue and LSIL. The labelling indices were also higher in groups with positive reactions to CK 14, 13, and HPV than in groups with negative reactions to them. CONCLUSION: It was postulated that examination of patterns of immunoreactivity of CK 14, 13, and Ki- 67 could be a useful and convenient tool to explain the trasition from normal cervical epithelium to SCC via LSIL and HSIL and thereby predict the differentiation potential of the studies for lesions.

Two Cases of Myxoid Change in Decidualized Cutaneous Endometriosis in the Abdominal Scar Following Cesarean Section and immunohistochemical study / 대한산부인과학회잡지

Decidualized cutaneous endometriosis infrequently arises in the abscence of pelvic disease. It is described in which the histologic features included cytologic atypia, circumscription of endometrial epithelial cells with glandular or cystically dilated space, mononuclear cells within and around the endometrial nodules, and accompanied myxoid change. This histologic pseudomalignancy is not common and be misinterpreted as metastatic carcinoma or malignant tumors arising from soft tissue due to location of nodule and histologic feature. We have experienced two cases of myxoid change in decidualized cutaneous endometriosis in the abdominal scar following Cesarean section, which is presented with a brief review of the literature.

Histologic Diagnosis of Cervcial Precursor Lesion: Applying the Bethesda System and HPV 16, 18 Correlates / 대한산부인과학회잡지

OBJECT: To support the application of the Bethesda classification to the histologic diagnosis of cervical squamous lesions. METHODS: We evaluated the cervical biopsies and human papilloma virus (HPV) DNA status of 100 clinic patients. The 100 biopsy specimens were analyzed using criteria of the Bethesda system for low-grade squamous intraepithelial lesion(LSIL) and high-grade squamous intraepithelial lesions(HSIL) in association with analysis of HPV DNA virus type by PCR. RESULTS: By PCR amplified from paraffin embedded tissues, the 40 of 90 cases of classified as HSIL were HPV 16 or 18 positive and 1/10 cases of classified as LSIL was HPV 16 positive. CONCLUSION: This study supports the usefullness of certain histologic criteria of the Bethesda system for distinguishing squamous intraepithelial lesions into two grades.

Malignant Struma Ovarii: two cases report and literature review / 대한산부인과학회잡지

Struma ovarii consists of thyroid tissue which is derived from germ cells in a mature teratoma. Five percent of struma ovarii are malignant, and of these only five percent metastasize. The rarity of this disease has resulted in difficulty in agreeing on treatment regimens and in limited imaging and monitoring difficulties encountered in their management. We have experienced two cases of malignant struma ovarii with brief review of the literature.

Hepatocellular Carcinoma Metastatic to the Ovary: one case report and review literature / 대한산부인과학회잡지

Metastatic hepatocellular carcinoma of the ovary is an extremely rare ovarian tumors and may cause a diagnostic problem. This tumor was first described by Ooartman and Elliot in 1983. The differential diagnosis in cases of hepatocellular carcinoma metastatic to the ovary is with primary and metastatic hepatoid tumors of the ovary and diverse other tumors of the ovary composed of oxyphil cells, which may be primary or metastatic. We have experienced one case of metastatic hepatocellular carcinoma of the ovary with brief review of the literature.

A Case of Squamous Cell Carcinoma of the Ovary Arising in Mature Cystic Teratoma / 대한산부인과학회잡지

Squamous cell carcinoma of the ovary is very rare malignant tumor originating from the malignant transfomation of mature cystic teratoma, usually being reported in about 1-3% of cases. Of malignant transformation, squamous cell carcinoma is the most common type and its prognosis is poor. Because of its rarity, the clinicopathologic characteristics are not well established. We have experienced a case of squamous cell carcinoma arising in mature cystic teratoma of ovary and present it with brief review of the literature.

Two Cases of Collodion baby in Dizygotic Twins / 대한피부과학회지

We report herein two cases of collodion baby in dizygotic twins, one boy and one girl. The babies were presented with general involvement of enclosement in a constricting parchment-like or collodion-like membrane, followed by its shedding and revealing red skin underneath. Histologically, compact dense hyperkeratosis and mild cellular infilterate in the upper dermis were seen, without parakeratosis or prominent granular layer. The babies markedly improved about 1 month later. The mild ichthyotic skin remained in the lower legs.

The Clinical Usefulness of Cervicovaginal Fetal Fibronectin as a Prediction of the Time of Induction / 대한산부인과학회잡지

OBJECTIVES: Fibronectin is a high-molecular-weight glycoprotein found in the plasma and extracellular matrix. The presence of fetal fibronectin in cervicovaginal secretion of pregnant women during the second and the third trimester has been suggested as a means of identifying women in preterm labor who be delivered prematurely. Therefore, our purpose was to determine the clinical efficacy of the presence of fetal fibronectin in cervicovaginal secretion of patient in full term as biochemical predictor of Time of Induction. METHODS: Fetal fibronectin was obtained at external os and posterior vaginal fornix in 30 women in full term who had no uterine contraction with intact membrane. The cervix was assessed by digital vaginal examination and scored with a modified Bishop score. RESULTS: There was a good correlation in delivery time after induction between the fetal fibronectin and the modified Bishop score (r=0.695,P<0.005) CONCLUSION: The presence of fetal fibronectin is better than Bishop score that is dependent on clinical experience as biochemical predictor of Time of Induction.

A Case of Leiomyoma of the Ovary in Postmenopausal Women / 대한산부인과학회잡지

Leiomyoma is one of the rarest solid tumor of the ovary. Approximately 50 cases have been published to date. However, most reported leiomyoma of the ovaries were small and rarely induced serious symptoms. We report a case of ovarian leiomyoma in 57-year-old woman which has been experienced in our haspital with brief review of literature.

Antenatal Screening for Gestational Diabetes by 50-g, 1-hour Glucose Screening Test / 대한산부인과학회잡지

OBJECTIVE: Gestational diabetes mellitus is defined as carbohydrate intolerance of variable severity first diagnosed during pregnancy. It is associated with adverse outcomes of pregnancy including obstetrical complications such as increased rate of cesarean sections, preeclampsia, and birth trauma, and perinatal morbidities, such as macrosomia, hypoglycemia, hypocalcemia, and hyperbilirubinemia. Therefore, screening for gestational diabetes mellitus and early diagnosis of this condition allows intervention to be carried out, thereby, the reduction of the untoward effects mentioned above can be minimized. METHODS: Screening for abnormal glucose metabolism was carried out in 489 pregnant women. A 50-g oral glucose load without regard to time of day or last meal, and a 1-hour plasma glucose determination with a threshold of 140mg/dl were used as a glucose screening test(GST). Patients with an abnormal GST underwent an oral glucose tolerance test(GTT). RESULTS: The overall incidence of gestational diabetes was 2.7%. The occurrence of this disorder was significantly related to the age of pregnant women, parity, or the presence of risk factors for gestational diabetes and obesity(Body Mass Index> or =26kg/m2). CONCLUSION: This study suggests that Korean pregnant women should be screened for gestational diabetes.

Dystrophic Epidermolysis Bullosa in Two Sisters / 대한주산의학회잡지

Dystrophic epidermolysis bullosa is a rare, chronic non-inflammatory bullous disease, which easily forms bullae by minor mechanical trauma or spontaneously, is inherited either in an autosomal dominant or autosomal recessive fashion. We report herein two cases which presented with bullae, erosions and ulcers on extremities, buttock, chest, abdomen and face and loss of all nail since birth in two sisters. Bulla occured bencath the basal lamina histopathologically, anchoring fibrils were almost absent on electron miaoscopy in both cases. The two sisters represented dystrophic epidermolysis bullosa considering the absence of family history inheritcd in an autosomal dominant fashion and the clinical, histological and electronmicroscopic findings.