North Korea Must be Global Scale Cohort, Not a Galapagos in the Medical Research Field.

Objective: This study aimed to compare the research trend regarding gynecologic malignancies in North Korean medical journal and South Korean medical journal. Methods: Articles published in the journal of "Pediatrics, Obstetrics, and Gynecology" in North Korea and "Obstetrics & Gynecology Science" in South Korea from 2006 to 2016 were analyzed by using frequency analysis. Studies on gynecologic malignancies were classified by international classification of disease (ICD-10). Results: Out of 3361 reviewed articles, 116 articles published in North Korean journal and 519 articles published in South Korean medical journal were classified as gynecologic oncology. We found a distinct difference between North and South Korean medical journals regarding research trends on gynecologic oncology. The proportions of gestational trophoblastic disease, cervical cancer, and anogenital warts were higher in North Korean medical journal, but proportions of ovarian cancer, fallopian tube cancer, peritoneal cancer, corpus uterine cancer, and vulvar cancer were higher in South Korean medical journal. Conclusion: This study enforced an analysis of research trends on gynecologic malignancies in North Korean and South Korea medical journals, and a distinct difference was observed in this regard. In the future, grand scale cohort study in the genetic identical two Korean population is needed for research of environmental effect on gynecologic cancer.

Single-port laparoscopic salpingectomy for surgical treatment of tubal pregnancy: comparison with multi-port laparoscopic salpingectomy.

BACKGROUND: This study investigates the safety and feasibility of transumbilical single-port laparoscopic salpingectomy (SPLS) using conventional laparoscopic instruments compared to conventional multi-port laparoscopic salpingectomy (MPLS) for surgical treatment of tubal pregnancy. MATERIAL AND METHODS: We conducted a retrospective analysis of 63 patients with tubal pregnancy who underwent SPLS and 71 patients who underwent conventional MPLS between January 2008 and December 2010. All patients in the SPLS group had a drainage tube placed through the umbilicus, and, in the MPLS group, through a 5-mm trocar site in one side of the lower abdomen. RESULTS: No significance difference was discovered between the groups with regard to adjusted hemoglobin values (SPLS, 1.9 ± 1.0 g/dL versus MPLS, 1.7 ± 1.0 g/dL, P = 0.335). Additionally, there was also no significant difference in clinical characteristics, intraoperative findings, or operative outcomes. CONCLUSIONS: Our study demonstrated that transumbilical SPLS using conventional laparoscopic instruments has operative outcomes comparable to MPLS for the surgical treatment of tubal pregnancy. Transumbilical SPLS may therefore be offered as a feasible alternative to MPLS.

Pure nongestational choriocarcinoma of the ovary: a case report.

Pure ovarian choriocarcinoma can be gestational or nongestational in origin. Nongestational choriocarcinoma of the ovary is extremely rare, and its diagnosis is very difficult during the reproductive years. We present a case of a 33-year-old woman diagnosed with pure nongestational ovarian choriocarcinoma. Following surgery, multiple courses of a chemotherapy regimen of etoposide, methotrexate, and actinomycin-D (EMA) were effective.

Single-port laparoscopic cornual resection for a spontaneous cornual ectopic pregnancy following ipsilateral salpingectomy.

OBJECTIVE: To describe the single-port laparoscopic management of a spontaneous cornual ectopic pregnancy following ipsilateral salpingectomy. DESIGN: Case report and technique description. SETTING: University hospital. PATIENT(S): A 28-year-old woman with a spontaneous cornual pregnancy of 5 weeks' gestation following previous ipsilateral salpingectomy. INTERVENTION(S): Single-port laparoscopic cornual resection (surgeon, Y.-W.K.). MAIN OUTCOME MEASURE(S): Serum ß-hCG levels. RESULT(S): Complete resolution of cornual pregnancy. CONCLUSION(S): We performed a successful single-port laparoscopic cornual resection for a spontaneous cornual ectopic pregnancy following ipsilateral salpingectomy.

Brain metastasis from uterine cervical cancer.

Uterine cervical cancer usually spreads by local extension and through the rich lymphatic network to the retroperitoneal lymph nodes. However, brain metastasis from primary cervical cancer is extremely rare. They are usually seen late in the clinical course and have poor prognosis. We present a 48-year-old woman with squamous cell carcinoma of the cervix who developed multiple brain metastases after 30-month treatment of the primary disease. The patient received whole brain radiation therapy and steroids, and she is alive without any neurologic symptoms and signs at the 6-month follow-up after treatment of the recurrence.

Single-port laparoscopic myomectomy using a new single-port transumbilical morcellation system: initial clinical study.

STUDY OBJECTIVE: To evaluate the feasibility of single-port laparoscopic myomectomy with transumbilical morcellation and suturing. DESIGN: Continuing prospective study (Canadian Task Force classification II-3). SETTING: University hospital. PATIENTS: Fifteen patients who underwent single-port laparoscopic myomectomy between September 2008 and October 2009 to remove single or multiple uterine myomas, at least 1 in each patient measuring greater than 4 cm in diameter. INTERVENTIONS: All single-port laparoscopic myomectomy procedures were performed by a single surgeon (Dr. Y.W. Kim). Myomas were extracted transumbilically by cutting the myomas into smaller pieces with a knife or a conventional electromechanical morcellator. After making a single 1.5- to 2.0-cm umbilical incision, the single-port system, created with a wound retractor and a surgical glove, was inserted. All operations were performed using conventional rigid straight laparoscopic instruments. Laparoscopic suturing was performed in intramural myomas and some subserosal myomas. MEASUREMENTS AND MAIN RESULTS: Patient mean (SD; range) age was 38.3 (5.6; 29-49) years. The number of myomas per patient was 1.6 (1.4; 1-6). The diameter of the largest myomas was 6.1 (1.5; 4.2-9.6) cm. In 4 patients, only a knife was required for transumbilical extraction of myomas, and in 11 patients, transumbilical morcellation with an electromechanical morcellator with or without a knife was used. Transumbilical drainage tubes were inserted into the pelvic cavity in 11 of 15 patients. Operative time was 96.7 (33.8; 35-150) minutes. The decrease in postoperative hemoglobin concentration was 1.8 (1.2; 0.4-3.6) g/dL. During the operations, no patients required blood transfusion. No patients developed postoperative fever. Neither bowel injury nor urinary tract injury occurred in any patient. The postoperative hospital stay was 3.1 (0.8; 2-4) days. CONCLUSION: Single-port transumbilical morcellation using a conventional electromechanical morcellator with or without a knife is feasible. Single-port laparoscopic myomectomy is an alternative method with cosmetic advantage.

Photodynamic therapy-generated tumor cell lysates with CpG-oligodeoxynucleotide enhance immunotherapy efficacy in human papillomavirus 16 (E6/E7) immortalized tumor cells.

Immunotherapy with photodynamic therapy (PDT) offers great promise as a new alternative for cancer treatment; however, its use remains experimental. In this study, we examined the immunotherapeutic significance of human papillomavirus (HPV)-immortalized tumor cell lysates induced by PDT with CpG-oligodeoxynucleotide (ODN). PDT-cell lysates were generated by irradiating Radachlorin (5 microg/mL) preloaded TC-1 cells carrying HPV 16 E7. PDT-cell lysates plus ODN coinjection for protection against E7-expressing tumors as well as specific immune responses were evaluated with the following tests: heat shock protein 70 (HSP70) enzyme-linked immunosorbent assay, in vitro and in vivo tumor growth inhibition, interferon-gamma (IFN-gamma) and tumor necrosis factor-alpha (TNF-alpha) assay, cytotoxic T-lymphocyte assay, and fluorescence activated cell sorting (FACS) analysis. PDT-cell lysates plus ODN coinjection showed a significant suppression of tumor growth at both prophylactic and therapeutic levels, compared to PDT (or F/T)-cell lysates or ODN alone. In addition, we evaluated the level of the immune response with the coinjection. HSP70, an important regulator of inflammatory and immune response, was observed in abundance in the PDT-cell lysates. IFN-gamma production and cytotoxic T lymphocytes (CTL) responses were induced by PDT-cell lysates plus ODN injection. The coinjection resulted in PDT-cell lysate-specific antibodies (IgG1, IgG2a, IgG2b, and IgG3) and T-helper cell responses significantly higher than PDT-cell lysates alone. Moreover, IFN-gamma production and CTL responses were significantly induced in the PDT-cell lysate plus ODN immunized groups. These enhanced immune responses appeared to be mediated by CD8+ T cells only. These data suggest that PDT-cell lysates plus ODN injection may be an effective approach to induce CTL immune responses as a possible immunotherapeutic strategy for cancer therapy.