관상동맥 스텐트 시술 후의 재협착에 관한 연구

김윤철,이정우,김보영,강정아,임대승,이민수,김정희,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

Coronary stent implacement is known as an effective treatment in the intimal dissection after percutaneous transluminal coronary angioplasty and the prevention of restenosis. However, In-stent restenosis still remains a major concern in clinical stenting. The stents were placed in 103 patients from July 1996 to March 1999 and performed follow-up coronary angiograms in 59(57.3%) patients. To identify the clinical, angiographic and procedurerelated variables 'which predict late restenosis within the stented artery, 59 patients(58.3±9.9, M:F= 41:18) were studied. The clinical characteristics of the patients were stable angina in 23(39.0%), unstable angina in 14(23.7%), acute myocardial infarction in 21(35.6%) and old myocardial infarction in 1(1.7%). Coronary stenting was performed in 1 patient(1.7%) for primary lesion, 50 patients(84.7%) for suboptimal results after PTCA, 6 patients(10.2%) for bail-out procedure, and 2 patients(3.4%) for restenotic lesions. All patients were treated with aspirin and ticlopidinc. The follow-up angiograms were obtained at 7±4 months. The overall in-stent restenosis rate was 27.1%. The coronary angiographic findings were 32 single vessel(54.2%), 19 two vessel(32.2%) and 8 three vessel disease(13.6%). The angiographic morphological characteristics were type A in 33(55.9%), type B in 14(23.7%), type C in 12(20. 3%) cases. Variables of 16 patients with restenosis were compared with those of 43 patients without restenosis. Previously known predictors for in-stent restenosis were multiple stenting, stenting for restenotic lesions, residual stenosis after stenting, stenting for total occlusion lesions, reference diameter, balloon to vessel ratio, acute gain and minimal luminal diameter after procedure, design and characteristics of stents, ostial lesion of aorta, high pressure method for stenting, lesion length, diabetes mellitus, size of artheroma, saphenous vein grafts, ulcerlating lesions and calcified lesions. In this study, Reference diameter before stenting(2.43±0.54mm vs. 2.88±0.65mm, p=0.016) and balloon-to-artery ratio(1.28±0.26 vs. 1.11±0.18, p=0.006) were predictors for in-stent restenosis. 1) The overall in-stent restenosis rate was 27.1%. 2) In the analysis of predictors for in-stent restenosis, there was no significant differences in clinical, angiographic factors between group with restenosis and without restenosis. But, Only reference diameter before stenting and balloon-toartery ratio were predictors of late in-stent restenosis. In conclusion, stenting is effective revascularisation method for selected patients with ischemic heart disease, and to minimize in-stent restenosis rate, stent implanting is achieved in a large vessel on the basis of an artery-to-stnet ration of 1:1, if possible.

안면중앙부 골절 진단시 전산화단층사진과 Waters 방사선사진의 진단능 비교

전인성,최순철 大韓口腔顎顔面 放射線學會 1997 Imaging Science in Dentistry Vol.27 No.1

This study was intended to compare the diagnostic ability between Waters' radiograph and CT in the diagnosis of midfacial fracture. The study group included 44 patients(male:32, female:12, age range:16-74 years old) with facial injury who underwent surgery. Waters' radiograph and both axial and coronal scanning were performed before surgery. Three oral radiologists and three non-oral radiologist interpreted 44 Waters' radiographs and 88 CT in three ways; 1) interpretation using Waters' radiograph only, 2) interpretation using CT only, 3) interpretation using Waters' radiograph and CT. The interpretation sites were confined to the walls of maxillary sinus; anterior, posterior, medial, lateral and superior wall. ROC curves were made with the findings during surgery as a gold standard except the posterior wall, where the joint evaluation of Waters' radiograph and CT by other three oral radiologists was used. ROC areas were compared according to the interpreting methods, the interpretation sites, and groups (R group ; oral radiologist group, N group ; non-oral radiologist group). The obtained results were as followed: 1. The diagnostic ability of CT only and Waters' radiograph and CT was higher than Waters' radiograph only in both groups(P<0.05). But there was no difference between CT only and Waters' radiograph and CT. 2. Generally, the diagnostic ability for the lateral antral wall was the highest and that for the posterior antral wall was the lowest in both groups(P<0.05). 3. In R group, for the anterior antral wall the diagnostic ability using CT only was increased but for the medial, lateral and superior antral walls the diagnostic ability was increased in only using Waters' radiograph and CT. 4. In N group, for the anterior and medial walls the diagnostic ability using CT only was increased. But for the posterior, lateral and superior antral walls there were no difference among three interpreting methods. 5. The diagnostic ability of R group was higher than N group in all interpreting methods.

DMBA 유도 햄스터 협낭암 발생과정에서 방사선 조사가 증식세포핵항원(PCNA)의 발현과 apoptosis 유발에 미치는 영향

전인성,허민석,최항문,이삼선,최순철 대한구강악안면방사선학회 2000 Imaging Science in Dentistry Vol.30 No.3

Purpose : This study was carried out to investigate the effect of irradiation on the expression of proliferating cell nuclear antigen (PCNA) and apoptosis induction during the carcinogenesis in hamster buccal pouch. Materials and methods : Three months old Syrian golden hamsters were divided into control and 2 experimental groups, Hamsters in control group were left untreated on buccal pouchs. Twenty four hamsters were treated with 0.5% DMBA tri-weekly on the right buccal pouch. Forty eight hamsters were treated with 0.5% DMBA tri-weekly and irradiated with the dose of 5 Gy and 10 Gy at 6,9, 12, 15 weeks after DMBA application. Resected buccal pouches were sectioned and examined for potential expression pattern of PCNA and apoptosis. Results : The PCNA index was increased with the stages of buccal pouch epithelium carcinogenesis except the hyperplasia stage in control group (p< 0.05). The irradiation did not effect on the PCNA index in the dysplasia and the carcinoma in situ stage, but in the hyperplasia stage, the PCNA index was increased with 10 Gy radiation and decreased in the carcinoma stage (p< 0.05). The apoptotic index was significantly decreased from the carcinoma in situ stage and the lowest in the carcinoma stage, The apoptotic index was significantly decreased in the hyperplasia and dysplasia stage with the 5 Gy irradiation and significantly increased only in the carcinoma stage with the 10 Gy irradiation (p< 0.05). Conclusion : The PCNA and apoptotic index were varied according to the irradiation period and dosage in each carcinogenesis stage. (Korean J Oral Maxillofac Radiol 2000; 30: 207-216)

한국 일 도시지역 청소년의 우울 증상 유병률과 관련요인에 대한 연구

조성진,전홍진,김무진,김장규,김선욱,류인균,조맹제 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.4

연구 목적 : 한국의 일 도시지역에 거주하는 청소년의 우울 증상의 유병률과 관련요인을 밝힘으로써 청소년 정신건강 증진을 위한 기초 자료를 수집하기 위하여 실시되었다. 방 법 : 연구 대상은 부천시에 거주하는 중학교나 고등학교에 재학중인 청소년 71,102명 가운데에서 무작위 집락 표본 추출법에 의해 선정된 2,203명이었으며, 이들에 대해서 CES-D(the Center for Epidemiologic Studies Depression Scale)와 사회인구학적 정보에 대한 문항이 들어 있는 설문을 실시하였다. 설문은 직접 학교를 방문하여 수행하였다. 선정된 2,203명의 청소년 가운데에 CES-D문항을 완성한 학생은 1,972명으로 반응률은 89.5%였다. 결 과 : 1) CES-D의 절단점을 16점으로 하여 계산한 '가능한' 우울 증상의 유병률은 중학생의 경우에 남학생 34.6%, 여학생 44.7%였으며, 고등학생의 경우에는 남학생 43.8%, 여학생 49.6%였다. 2) CES-D의 절단점을 25점으로 하여 계산한 '명확한' 우울증 증상의 유별률은 중학생의 경우에 남학생 18.4%, 여학생 20.7%였으며, 고등학생의 경우에는 남학생 21.4%, 여학생 23.9%였다. 3)종교, 인문계와 실업계의 여부에 따라서 우울 증상의 유병률에는 유의한 차이가 없었다. 4) 성,학년, 생활수준에 대한 자신의 평가, 가족의 구조, 성적에 대한 만족도의 다섯 가지 변수에 대해 CES-D점수가 16점 이상인 우울 증상의 유무에 따라서 로지스틱 회귀 분석을 시행하였을 때 성적에 대해 불만적 하는 군에서 매우 만족하는 군에 비해서 8.850배의 상대 위험도를 보였다. 생활 수준을 중하정도라고 대답한 군은 상이라고 대답한 군에 비해서 2.007배의 상대 위험도를 보였다. 여학생은 남학생에 비해서 1.307배의 상대 위험도를 보였다. 5) 우울 증상에 있어서 남학생과 여학생의 비율은 전체 군에서 1:1.38이며 중학생의 경우에는 1:1.88, 고등학생의 경우에는 1:1.13으로 나타났다. 고등학생에 있어 남학생의 우울 증상이 증가하는 것은 학업과 입시에 대한 부담과 관련된 것으로 생각되었다. 결 론 : 한국 일 도시거주 중고등학생에서 CES-D로 측정한 우울 증상은 남학생의 34.3%, 여학생의 47.5%에서 나타날 정도로 흔하다. 특히 학업 성적에 대해 불만족 하는 군에서 높은 우울 증상의 상대 위험률을 보이며, 고등학생에서 남학생의 우울증의 유병률이 높아지는 것은 이 지역 학생들이 학업에 대한 높은 부담을 가지고 있다는 것을 알 수 있었다. 따라서 이들에 대한 특별한 관심이 요구된다. Objective : We tried to see the prevalence and correlates of symptoms of depression in an adolescent population in Korea, and collected the basal data for mental health promotion of adolescents. Method : We sampled 2,203 adolescents among 71,102 adolescents living in Puchon City in Korea by the randomized clustered sampling method. The Center for Epidemiologic Studies Depression scale(CES-D) was used to measure depressive symptoms. The measurements were conducted through visiting schools. Of the 2,203 adolescents(aged 13 to 18) who were sampled, 1,972 persons completed CES-D and sociodemographic questions. The response rate was 89.5%. Result : 1) The prevalence rate of 'probable' depressive symptoms with cutoff point 16 was 34.3% in the boys and 47.5% in the girls. 2) The prevalence rate of 'definite' depression symptoms with cutoff point 25 was 17.4% in the boys and 20.6% in the girls. 3) We could not find any meaningful difference in the average of CES-D from the districts where they live, the course of their education, and their religions. 4) We used the logistic regression analysis to find the risk factor for adolescent depression in these samples. Among the variables degree, it was most important risk factor in adolescent depression to dissatisfy with their school degrees. Compared it with fully satisfied group, the odds ratio was 8.850. The group of mid to low socioeconomic status had the odds ratio 2.007 compared with high socioeconomic status. The girls had the odds ratio 1.307 compared with the boys. 5) The male versus female ratio was 1: 1.38 in the total students and 1 : 1.88 in the middle school students, and 1 : 1.13 in the high school students. The male versus female ratio was relatively low in the high school students. It was the result of the high prevalence of depressive symptoms in the high school boys, and it was due to the large burden to their school degrees. Conclusion : The depressive symptoms checked by CES-D were very common among adolescents in Korean urban area. The prevalence of depressive symptoms was 34.3% in the boys and 47.5% in the girls. The result that male versus female ratio was relatively low in the high school adolescents, and the group that were dissatisfied with the school degrees had high risk of depressive symptoms, revealed that the students had large burden to their school degrees and so they needed special concerns.

Isolation of a novel protein phosphatase2C in rice and its response to gibberellin

Amir Hossain, Md,Ahn, Chul-Hyun,Lee, In Suk,Jeon, Jong-Seong,An, Gynheung,Park, Phun Bum Elsevier 2018 Biochemical and biophysical research communication Vol.503 No.3

<P><B>Abstract</B></P> <P>Protein phosphatase 2Cs (PP2Cs) have been referred to act as negative modulators of the protein kinase pathways involved in different environmental stress responses and developmental processes. In <I>Arabidopsis</I>, PP2Cs have been extensively studied and some are known to negatively regulate abscisic acid signaling. In rice, PP2Cs are scarcely characterized functionally. Here, we identified a novel PP2C from rice (OsPP2C34), which is highly inducible by gibberellin (GA) and expressed in various tissues. Subcellular localization analysis in maize protoplasts using a green fluorescence protein fusion vector localized OsPP2C34 to the cytosol. Genetic analysis of T-DNA insertional mutants revealed that plant height and internode length were significantly shorter in mutants than in corresponding wild types under GA treatment. The induction of the GA-inducibleα-amylase genes <I>RAmy3E</I> and <I>OsAmy</I> was delayed in mutant plants. The substrate of OsPP2C34 was identified by immunoblotting using anti serine/threonine antibodies. A 65 kDa protein was phosphorylated in <I>Ospp2c34-1</I> but dephosphorylated in the wild type during early germination stage. Overall, the present results indicated that OsPP2C34 is involved inα-amylase expression of GA signal transduction pathway.</P> <P><B>Highlights</B></P> <P> <UL> <LI> OsPP2C34 is highly inducible by gibberellin (GA) and expressed in various tissues. </LI> <LI> OsPP2C34 is localized to the cytosol and involved in α-amylase genes inducible by GA. </LI> <LI> OsPP2C34 has dephosphorylation activity at its serine/threonine residues. </LI> <LI> OsPP2C34 is a positive regulator of the GA-dependent signaling transduction pathway. </LI> </UL> </P>

한국인에서 혈소판 당단백 Ⅱb/Ⅲa 유전자 다형성과 관동맥 성형술 후 재 협착과의 관계

이민수,이정우,김보영,임대승,강정아,김정희,김윤철,성보영,최성준,성인환,전은석 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.2

Platelet aggregation is the final pathway of acute coronary syndrome such as acute myocardial infarction and unstable angina. Platelet glycoprotein IIb/IIIa is a membrane receptor for fibrinogen and yon Willebrand factor and it plays an important role in platelet aggregation and in the pathogenesis of acute coronary syndrome. It is known that polymorphism of the gene that encoding platelet glycoprotein IIb/IIIa(PI^A1/A2) is strongly related to acute coronary syndrome in Caucasian, but not in Koreans. We investigated relationship between platelet glycoprotein llb/Illa gene polymorphism and restenosis of coronary artery after angioplasty in Koreans. Total 371 patients(M=251. F=120) were enrolled. Angioplasty group comprised 143 patients who underwent coronary angioplasty, and in the angioplasty group, restenosis group comprised with the 65 patients who had restenotic lesion over 50% of luminal diameter in follow-up coronary angiography. Normal group comprised 153 patients who had no significant angiographic lesion and variant angina group comprised 75 patients who were positive in ergonovine test. Genomic DNA was extracted from peripheral arterial blood. To determine the frequency of P1^A1/A2 genotype, polymerase chain reaction(PCR) was done and the product was restricted with Mspl. 3%. agarrose gel electrophoresis showed restriction fragment length polymorphism. Clinical profile and risk factor were also reviewed. Among all 371 patients of study group, genotype of only one patients in restenosis group if is proven to be PI^A1/A2 heterozygote. All patients of normal study group, no restenosis group, and the other patients in restenosis group have an PI^A1 homozygote genotype. In our study, platelet glycoprotein IIb/Illa polymorphism has no relationship with restenosis of the coronary artery after angioplasty in Koreans. But the genotypic frequency of platelet glycoprotein IIb/IIIa gene polymorphism in Koreans is concordant with that of previous studies.

구강 외 노출시간에 따른 흰쥐 치아 치주인대세포 활성도의 MTT 검색법을 이용한 평가

전인수,김의성,김진,이승종 대한치과보존학회 2006 Restorative Dentistry & Endodontics Vol.31 No.5

본 연구의 목적은 MTT 검색법을 이용하여 흰쥐 상악 대구치를 발거한 후 실온의 건조 상태에서의 시간 변화에 따른 쥐 치아 치근면의 치주인대 세포 활성도를 측정함과 동시에 냉동 절단법을 이용한 조직학적인 관찰 결과를 토대로 하여 MTT검색법이 유용한지를 검증하고자 하였다. 생후 4주된 암컷 Sprague-Dawley계 흰쥐 80마리를 이용하여 β-APN 전처치 후 상악 제 1 & 2 대구치를 모두 발거 하였다. 이들 치아를 즉시 혹은 10, 20, 40, 60분 동안 실온에서 건조 시킨 후 치아 자체를 MTT용액에 저장한 다음 흡광도 측정을 이용한 정량적 분석과 동시에 냉동 절단법을 이용하여 조직을 관찰하였다. MTT 검색에 의한 흡광도 값에 있어 즉시 처치군과 10분 건조군 사이에는 통계학적인 유의차가 없었다 (p>0.05). 그러나, 즉시 처치군 및 10분 건조군은 20분과 40분 및 60분 건조군과 비교시 통계학적인 유의차를 보였다 (p<0.05). 또한, 20분 건조군도 40분 및 60분 건조군 과의 군 간 비교에서 각각 통계학적인 유의차를 보였다 (p<0.05). 그러나, 40분 건조군과 60분 건조군 사이에는 통계학적인 유의차를 보이지 않았다. 조직학적 관찰에서 시간 경과에 따라 crystal의 모양과 분포 및 수에서 확연히 구별되는 특징적인 양상을 보여주었다. 즉시 및 10분 건조 군에서는 가시모양의 crystal이 전 치주인대부위 조직과 치수 내에 밀도 높게 골고루 폭넓게 퍼져 있었으나 20분 이상 건조 군에서부터는 치주인대와 치수 부위 조직 모두에서 crystal 결정체 수가 급격히 감소하는 양상을 보였다. 이번 실험의 결과를 종합적으로 분석해보면 MTT 흡광도 측정값과 냉동 절단법을 이용한 시편의 MTT 염색 관찰 소견 결과를 서로 비교 했을때 상당히 밀접한 상관 관계가 있음을 보였다. The purpose of this study was to verify the usefulness of MTT analysis as a tool of measurement of the periodontal ligament cell viability from the extracted rat molar. A total of 80 Sprague-Dawley white female rat of 4 week-old with a body weight of 100 grams were used. The maxillary left and right, first and second molars were extracted under Ketamine anesthesia. Twenty-four teeth of each group (divided as five groups depending upon the time-lapse after extraction such as immediate, 10, 20, 40 and 60 minutes) were immersed in 200 μl of MTT solution (0.5 mg/ml) and processed for optical density measurements . Another 10 teeth of each group were treated as same as above and sectioned at 10 ㎛ for microscopic examination All measurements values were divided by the value of hematoxylin-eosin staining which represented the volume of each corresponding samples. Immediate and 10 minute groups showed highest MTT values followed by 20, 40, and 60 minutes consecutively. Statistical significance (p < 0.05) existed between all groups except in immediate versus 10 minute groups and 40 versus 60 minutes. Histological findings also showed similar findings with MTT results in crystal shape and crystal numbers between the experimental groups. These data indicate that in vivo MTT analysis may be of value for evaluation of the periodontal ligament cell viability without time consuming cell culturing processes.

불명열 환자에서 진단된 중증 만성 활동성 Epstein-Barr virus 감염증

전경만,김응호,손준성,장현하,정숙인,오원섭,백경란,송재훈,고광철,정철원,고영혜 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

최근 장기적이고 심각한 임상 증상을 유발하는 만성 활동성 EBV 감염증의 개념이 정립되면서 그 증례들이 보고되고 있다. 만성 활동성 EBV 감염증은 소아나 젊은 성인들에게서 주로 발생되며, EBV-VCA IgG, EBV-EA IgG의 수치가 높게 관찰되고, 지속적인 발열, 전신쇠약감, 광범위한 임파선비대증, 간비장비대, 범혈구감소증, 다크론성감마병증을 나타낸다. 이 질환은 환자의 임상소견, 혈액학적 소견, EBV 항체 역가 및 침범 장기의 EBV genome 검출로 확진 되며 치료로 항 바이러스 체제, 항암 치료, 골수이식술 등이 시도되고 있으나 아직 검증되어 있지 않다. 저자들은 불명열을 주소로 내원하여 중증 만성 활동성 EBV 감염증으로 진단된 증례 4례를 경험하였다. 한 례에서는 항 바이러스 제제를 추여 후 임상적, 혈액학적 호전을 보였으나 치료 20일째 발생한 세균성 복막염과 패혈증으로 사망하였고, 두 례에서 총 6회의 CHOP 항암치료와 자가조혈모세포이식을 시행 받은 후 현재까지 증상 없이 추적관찰 중이다. 지속되는 발열을 주소로 내원한 불명열 환자들에게서 EBV에 대한 검사를 시행할 경우 불명열의 원인을 규명하는데 하나의 단서를 제공할 수 있을 것으로 사료된다. Epstein-Barr virus (EBV) is one of eight human herpesvirus. Primary infection with EBV in childhood is generally asymptomatic or mild, however, often causes overt diseases such as infectious mononucleosis (IM) and lymphoproliferative disorder (LPD), the latter occursing in immunologically compromised individuals. Historically, EBV has been considered to be etiologically linked to human malignancies such as EBV genome positive Burkitt's lymphoma and nasopharyngeal carcinoma. Recently, however, another category of EBV-related disease, "chronic active EBV infection", has been made to describe persons without a clearly defined underlying disease. We report 4 cases of patients, presented with episodic fever of unknown origin (FUO), who were diagnosed as severe chronic active EBV infection. A combined application of serology for EBV and in-situ hybridization established the diagnosis of the EBV infection.

수종의 엔진 구동형 니켈-타이타늄 합금파일의 절삭각에 따른 근관성형 효과에 관한 전자현미경적 연구

전인수,금기연,박성호,윤태철 大韓齒科保存學會 2002 Restorative Dentistry & Endodontics Vol.27 No.6

The purpose of this in vitro study was to compare the effects of root canal debridement following rotary Ni-Ti instruments with positive versus negative rake angle. Seventy sound, extracted human anterior teeth & premolars were randomly divided into four groups. The used rotary instruments were Ni-Ti HERO642(Micro-Mega in France, 20 specimens), Ni-Ti ProFile(Maillefer, Ballaigues, Switzerland, 20 specimen), stainless steel engine reamer(Mani, Matutani Seisakusho Co.,Japan, 20 specimen) and negative control group(10 specimens) was only extirpated with barbed broach(Mani, Matsutani Seisakusho Co., Japan) Group 1 & 2 teeth were prepared to a #40 at the apex followed by 1 mm using crown-down technique. Group 3 teeth were instrumented from a #15 to a #40 in sequential order. After preparation and final irrigation, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. all root specimens were prepared for SEM investigation & photographed. Separate evaluations were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. the penetration depth of smear layer into dentinal tubules was also estimated in the other halves. the following results were obtained : 1. Smear layer was observed on all the prepared walls with three experimental groups except negative control group 2. Smear layer characteristics1) HERO 642 groups showed snowy & dusty appearance & were observed only few some dentinal tubuli open on the prepared walls, and the penetration depth of it into dential tubules may be 1-2 ㎛ thick. 2) ProFile groups showed shiny & burnished appearance & complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli and penetration depth of it into dentinal tubules may be 1-2㎛ thick. 3) Engine reamer groups showed obviously file's passed tracks on the prepared walls & were observed complete root canal wall covered by a homogenous smear layer with no open dintinal tubuli. The results revealed that a completely clean root canal could not be achieved regardless of positive & negative rake angle, which is in accordance with the majority of studies on root canal cleanliness In conclusion, throughout irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal walls.

남성화를 보이는 여성에서 발견된 난소의 Steroid Cell Tumor 1예

조인호,정대훈,박영미,서영진,손영실,정철회,강영미,정수전,김영남,이경복,성문수,김기태 인제대학교 2006 仁濟醫學 Vol.27 No.-

Steroid cell tumor is a rare ovarian sex cord-stromal tumor which accounts for 0.1% of all ovarian tumors. Until now, only 4 cases have been reported in domestic literatures. Steroid cell tumor often secrets testosterone and presents virilization in adult women or precocious puberty in children. Treatment is often performed by surgical removal, adjuvant chemotherapy and radiation, but completely accepted treatment was not existed. We experienced a case of steroid cell tumor, which was manifested by typical virilization in a 43-year old patient, who was previously performed hysterectomy and unilateral oophorectomy. So, we present with a brief review of the literatures.