Woo Dae Kang

Chonnam National University, Gwangju, Gwangju, South Korea

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Publications (35)54.94 Total impact

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    ABSTRACT: The incidence, histologic distribution, and clinical manifestations of ovarian tumors in the pediatric population are distinct from those in adults. Although ovarian neoplasms in childhood and adolescence are rare, the diagnosis should be considered in young girls with abdominal pain and a palpable mass. Differential diagnosis in children and adolescents with ovarian tumors should be conducted on the basis of unique clinical manifestations, elevated serum tumor marker levels, and distinctive imaging findings. Although the clinical manifestations are nonspecific and may overlap, they may assist in diagnosis of some types of ovarian tumors. Children who present with a palpable mass or symptoms of precocious puberty have a high likelihood of malignancy. Many ovarian tumors are associated with abnormal hormonal activity and/or abnormal sexual development. Elevated levels of serum tumor markers, including α-fetoprotein, the beta subunit of human chorionic gonadotropin, and CA-125, raise concern for ovarian malignancies. However, negative tumor markers do not exclude the possibility of malignancy. Identification of imaging features at ultrasonography, computed tomography, and magnetic resonance imaging can help differentiate benign from malignant ovarian tumors and, in turn, plays a crucial role in determining treatment options. At imaging, malignant ovarian tumors usually appear predominantly solid or heterogeneous and are larger than benign tumors. Because surgery is the primary treatment for ovarian tumors, ovarian salvage with fertility preservation and use of a minimally invasive surgical technique are important in children and adolescents. ©RSNA, 2014.
    Radiographics 11/2014; 34(7):2039-2055. DOI:10.1148/rg.347130144 · 2.73 Impact Factor
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    ABSTRACT: [This corrects the article on p. 334 in vol. 57, PMID: 25105110.].
    09/2014; 57(5):424. DOI:10.5468/ogs.2014.57.5.424
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    ABSTRACT: Precipitous delivery may lead to serious maternal and neonatal complications. Uterine artery pseudoaneurysm (UAP) is one of the causes of delayed postpartum hemorrhage. Here we describe 3 cases of UAP manifesting as delayed postpartum hemorrhage after precipitous delivery. The duration of the second stage of labor in cases 1, 2, and 3 was 15, 15, and 60 min, respectively. Excessive vaginal bleeding occurred 10, 9, and 31 days after delivery, respectively. Ultrasonogram and pelvic angiography revealed the UAP in each case and uterine artery embolization was performed. UAP may be a complication of precipitous delivery. © 2014 S. Karger AG, Basel.
    Gynecologic and Obstetric Investigation 07/2014; 78(2). DOI:10.1159/000363742 · 1.25 Impact Factor
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    ABSTRACT: Serous borderline tumors of the ovary are fairly common, making up between 4% and 14% of ovarian epithelial tumors. While to our knowledge serous borderline tumor of the fallopian tube occurs rarely with only ten previously reported cases in literature. We report the case of the serous borderline tumor of the fallopian tumor in a 25-year-old woman and review the literature.
    07/2014; 57(4):334-337. DOI:10.5468/ogs.2014.57.4.334
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    ABSTRACT: The Foley catheter balloon may affect cervical ripening through changes in biochemical mediators by immunoassay and immunohistochemistry, when it is used for pre-induction cervical ripening. The aim of the study was to evaluate the changes in the biochemical mediators from the extra-amniotic space and immunohistochemistry in ripened cervical tissue after the insertion of a Foley catheter balloon (FCB) for pre-induction cervical ripening. A total of 18 pregnant women with a Bishop's score < 6, who were undergoing labour induction, were evaluated in this prospective study. The FCB was irrigated with 10 ml of phosphate buffered saline and the irrigant was collected 0, 2, 4 and 8 h after placement of the FCB or until spontaneous expulsion of the FCB occurred. Irrigant specimens were also collected from 10 spontaneous labouring (SL) women in the active phase of labour. The levels of interleukin (IL)-6, IL-8, matrix metalloproteinase (MMP)-8 and NO were measured. Cervical specimens were obtained from 12 women, including four undergoing induction; four SL and four non-pregnant (NP) women. Immunohistochemical staining was performed to localise hyaluronic acid synthase (HAS)-1, IL-6, IL-8, MMP-8, endothelial nitric oxide synthase (eNOS) and inducible NOS (iNOS). Results showed that the levels of IL-6, IL-8, and MMP-8 significantly increased over time in FCB group (p < 0.01). In the immunohistochemical analysis of cervical tissues, immunoreactivity of HAS-1 in the after FCB group was stronger than any of the other groups. The protein expressions of IL-6, IL-8, MMP-8, eNOS and iNOS were more prominent in the after FCB and SL groups than in the NP and the before FCB groups. iNOS was only observed in the after FCB and SL groups. It was concluded that FCB may affect cervical ripening through changes in biochemical mediators by immunoassay and immunohistochemistry, when it is used for pre-induction cervical ripening.
    Journal of Obstetrics and Gynaecology 11/2013; 33(8):830-8. DOI:10.3109/01443615.2013.831043 · 0.60 Impact Factor
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    ABSTRACT: To evaluate the value of apparent diffusion coefficient (ADC) histogram analysis for predicting tumor recurrence in patients with uterine cervical cancer treated with chemoradiation therapy (CRT). Our institutional review board approved this retrospective study and waived informed consent from each patient. Forty-two patients (mean age, 56 ± 14 years) with biopsy-proven uterine cervical squamous cell carcinoma who underwent both pre-treatment pelvic magnetic resonance imaging with a 3.0 T magnetic resonance scanner and concurrent CRT were included. All patients were followed-up for more than 6 months (mean, 36.4 ± 11.9 months; range 9.0-52.8 months) after completion of CRT. Baseline ADC parameters (mean ADC, 25th percentile, 50th percentile, and 75th percentile ADC values) of tumors were calculated and compared between the recurrence and no recurrence groups. In the recurrence group, the mean ADC and 75th percentile ADC values of tumors were significantly higher than those of the no recurrence group (p = 0.043 and p = 0.008, respectively). In multivariate analysis, the 75th percentile ADC value of tumors was a significant predictor for tumor recurrence (p = 0.009; hazard ratio, 1.319). When the cut-off value of the 75th percentile ADC (0.936 × 10(-3) mm(2)/sec) was used, the overall recurrence free survival rate above the cut-off value was significantly lower than that below the cut-off value (51.9% vs. 91.7%, p = 0.003, log-rank test). Pre-CRT ADC histogram analysis may serve as a biomarker for predicting tumor recurrence in patients with uterine cervical cancer treated with CRT.
    Korean journal of radiology: official journal of the Korean Radiological Society 07/2013; 14(4):616-25. DOI:10.3348/kjr.2013.14.4.616 · 1.81 Impact Factor
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    Woo Dae Kang, Ho Sun Choi, Seok Mo Kim
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    ABSTRACT: OBJECTIVES: This study was conducted to determine whether vaccination with the quadrivalent human papillomavirus (HPV) vaccine after loop electrosurgical excision procedure (LEEP) for high-grade cervical intraepithelial neoplasia (CIN2-3) is effective in preventing recurrence of CIN2-3. METHODS: Between August 2007 and July 2010, 737 patients aged 20-45 years who were diagnosed with CIN2-3 were treated by LEEP and followed. Three hundred and sixty patients were vaccinated with the quadrivalent HPV vaccine after LEEP (vaccination group), and 377 patients were followed without vaccination (non-vaccination group). Vaccination group was received the first dose at 1 week after LEEP and the remaining two doses two and six months later. Post-LEEP follow-up was performed at 3, 6, 9, 12, 18, and 24 months during the first 2 years and yearly thereafter. RESULTS: Irrespective of causal HPV type, 36 (4.9%) patients developed recurrence. In vaccination group (360 patients), 9 patients (2.5%) developed recurrence, whereas 27 patients (7.2%) in non-vaccination group (377 patients) developed recurrence. In patients infected with HPV of 16 and/or 18 type, 5 patients (2.5%) in vaccination group (197 patients) and 18 patients (8.5%) in non-vaccination group (211 patients) developed recurrent disease related to vaccine HPV types (HPV 16 or 18 types) after LEEP (P < 0.01). Multivariate analysis showed that no vaccination after LEEP was an independent risk factor for recurrent CIN2-3 (HR = 2.840; 95% confidence interval, 1.335-6.042; P < 0.01). CONCLUSIONS: Vaccination with the quadrivalent HPV vaccine after treatment may be considered in preventing recurrence of CIN2-3.
    Gynecologic Oncology 04/2013; 130(2). DOI:10.1016/j.ygyno.2013.04.050 · 3.69 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the prognostic value of serum CA-125 in advanced epithelial ovarian cancer with complete remission after primary adjuvant chemotherapy. We reviewed the records of 120 patients with advanced epithelial ovarian cancer who underwent primary surgery followed by adjuvant therapy at our institution between January 1998 and December 2005. The median progression free survival was 21.6 months and 12.5 months in patients with nadir CA-125 levels ≤10 U/mL and 10 to 35 U/mL, respectively. Median overall survival in the same respective order was 130.2 months and 35.3 months. The level of serum CA-125 after the first cycle of adjuvant chemotherapy was most significantly higher in the recurrent group compared with the non-recurrent group. The optimal cut point of CA-125 on the receiver operating characteristic curve was 35 U/mL. Median progression free survival was 64.6 months and 12.8 months in patients with nadir CA-125 levels ≤35 U/mL and >35 U/mL, respectively, after first cycle of adjuvant chemotherapy. Serum CA-125 level after the first cycle of adjuvant chemotherapy is a strong independent prognostic factor for advanced epithelial ovarian cancer with complete response.
    01/2013; 56(1):29-35. DOI:10.5468/OGS.2013.56.1.29
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    ABSTRACT: The study was undertaken to compare the clinical and quality-of-life (QoL) outcomes of the inside-out transobturator vaginal tape (TVT-O)-only procedures and TVT-O procedures with concomitant transvaginal gynaecological surgery for the treatment of stress urinary incontinence (SUI). A review of charts from January 2006 to March 2010 identified 305 patients with urodynamic stress incontinence for whom we performed the TVT-O. Of the initial 305 patients, 272 (89.2%) were re-examined for complications 1 month, 4 months, 1 year and 2-4 years postoperatively (122 TVT-O only; 150 TVT-O + other transvaginal gynaecological surgery). They were also evaluated with the Urogenital Distress Inventory Questionnaire (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) 1-4 years after the procedure. The median follow-up was 37.3 months. The success rate was 89.3% in the TVT-O-only group vs 93.3% in the TVT-O with concomitant gynaecological surgery group (p =0.729). The QoL score was quite good for 91.8% of the TVT-O-only patients and for 96.7% of the TVT-O with concomitant gynaecologic surgery patients (p =0.405). In conclusion, gynaecological operations performed concomitantly with the TVT-O procedure do not affect the clinical and QoL outcomes of the TVT-O procedure.
    Journal of Obstetrics and Gynaecology 04/2012; 32(3):280-4. DOI:10.3109/01443615.2011.654290 · 0.60 Impact Factor
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    ABSTRACT: To assess the clinical outcomes of total mesh repair with the Prolift technique as treatment of advanced pelvic organ prolapse in elderly patients who desire uterine preservation. Case control series study (Canadian Task Force classification II-2). Medical school-affiliated hospital. Sixty-eight patients over the age of 70 years with advanced pelvic organ prolapse, Pelvic Organ Prolapse Quantification stage III (n = 59) or IV (n = 9), underwent a total Prolift procedure and were followed up for a minimum of 2 years. Transvaginal pelvic floor repairs were performed with a total Prolift system. The concurrent pelvic surgery included midurethral sling operation with a TVT-O, if indicated. The assessment included intraoperative and postoperative complications, Urogenital Distress Inventory scores, and Incontinence Impact Questionnaire scores. Objective and subjective data were available for 68 patients. The anatomic success rate was 97.1% after 2 years. Complications included bladder perforation in 1 patient (1.5%), de novo stress urinary incontinence in 20 patients (29.4%), dyspareunia in 4 patients (22.2%), and vaginal erosion in 1 patient (1.5%). The Pelvic Organ Prolapse Quantification stages, Urogenital Distress Inventory scores, and Incontinence Impact Questionnaire scores all improved significantly after surgery. The total Prolift procedure is an alternative surgical option that uses a minimally invasive transvaginal approach to surgically treat elderly patients with advanced pelvic organ prolapse.
    Journal of Minimally Invasive Gynecology 01/2012; 19(3):307-12. DOI:10.1016/j.jmig.2011.12.014 · 1.58 Impact Factor
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    ABSTRACT: Gestational trophoblastic neoplasm includes tumor spectrum of four entities: hydatidiform mole (complete and partial), invasive mole, choriocarcinoma and placental site trophoblastic tumor. The hydatidiform mole is usually benign, but it is regarded as a pre-malignant disease. The other three conditions are malignant and are termed gestational trophoblastic tumor. Although most molar pregnancies behave in a benign fashion, metastatic tumors develop after complete molar pregnancy in 4% of patients. However, even when the disease is spread to many distal organs, it is highly curable with chemotherapy in most cases. We recently encountered an unusual case of metastatic gestational trophoblastic neoplasm following complete mole, presenting as spontaneous renal and cerebral hemorrhage with a fatal course.
    01/2012; 55(10):766. DOI:10.5468/KJOG.2012.55.10.766
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    ABSTRACT: This study was undertaken to compare the complications of outside-in transobturator tape procedures (TOT) and inside-out transobturator tape procedures (TVT-O) with concomitant gynecologic surgery for the treatment of female stress urinary incontinence (SUI). A retrospective review of 206 consecutive patients who underwent either TOT or TVT-O with concomitant gynecologic operations between March 2008 and February 2011 was conducted. The incidence of perioperative complications was compared. For statistical analysis, chi-squared tests were used. There were no reports of intraoperative complications such as vaginal injury or bladder perforation. Postoperative complications were noted in 23 procedures (11.2%). These included 6 cases of urinary retention (2.9%), 2 cases of vulva hematoma (1.0%), 7 cases of urinary tract infection (3.4%), 4 cases of de novo urgency (2.9%), and 4 cases of vaginal erosion (2.9%). There were no significant differences in complication rates between the two groups. Our results suggest that inside-out and outside-in procedures are simple and safe techniques that may have a low rate of complications when used with a concomitant gynecologic operation.
    12/2011; 47(3):165-9. DOI:10.4068/cmj.2011.47.3.165
  • Woo Dae Kang, Ho Sun Choi, Seok Mo Kim
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    ABSTRACT: The aim of this study was to determine whether or not the serum human chorionic gonadotropin (hCG) level and ratio during 2 weeks after evacuation is predictive of persistent gestational trophoblastic neoplasia (GTN) in patients with complete molar pregnancies. Between January 2000 and June 2010, a total of 467 patients with complete molar pregnancies were diagnosed. Seventeen patients, who had prophylactic chemotherapy and in whom insufficient data were available, were excluded. A receiver operating characteristic curve was used to determine the most useful predictive factor for persistent GTN and multivariate logistic regression was used for analyses. Persistent GTN was diagnosed in 109 of the 450 patients (24.2%) on the basis of the 2000 FIGO criteria. The optimal cut-off point for hCG 1 and 2 weeks after evacuation was 6400 mIU/mL (sensitivity, 54.1%; specificity, 65.1%) and 2400 mIU/mL (sensitivity, 64.2%; specificity, 78.3%), respectively. The optimal cut-off point for the ratio of pre-evacuation hCG to hCG 2 weeks after evacuation was 30 (sensitivity, 63.3%; specificity, 86.5%). Based on multivariate analysis, this ratio<30 was an independent predictive factor for persistent GTN (odds ratio=6.885; 95% confidence interval, 4.006-11.832; P<0.001). The decline ratio in hCG level 2 weeks after evacuation in patients with complete molar pregnancies is the most reliable predictor of persistent GTN. Our analysis may allow clinicians to stratify risk in patients with complete molar pregnancies and to provide more accurate counseling based on the hCG levels obtained 2 weeks after evacuation.
    Gynecologic Oncology 11/2011; 124(2):250-3. DOI:10.1016/j.ygyno.2011.10.035 · 3.69 Impact Factor
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    ABSTRACT: This study was conducted to determine the prognostic significance of the human papillomavirus (HPV) genotype using the HPV DNA chip (HDC) test and the HPV viral load by the hybrid capture II assay (HC2) in FIGO stage IB-IIA cervical cancer undergoing radical hysterectomy. Between January 2001 and December 2005, 204 consecutive patients who underwent radical hysterectomy with pelvic lymphadenectomy for International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer were retrospectively reviewed. The Cox proportional hazard models adjusted for covariates were used for analyses and a receiver operating characteristic (ROC) curve was used to determine the HPV viral load in predicting disease progression. Of the 204 cases, the HDC was positive in 195 (95.6%) and the HC2 was positive in 192 (94.1%). The 5-year progression-free survival (PFS) was 78.4%. On multivariate analysis, HPV-18 positivity was an independent prognostic factor predictive for disease progression. The risk of recurrence was higher for HPV-18 positivity (hazard ratio=2.664; 95% confidence interval [CI], 1.437-4.938; P=0.003). The 5-year PFS rate for patients who were HPV-18-negative was 83.8%, which was higher than the 5-year PFS for patients who were HPV-18-positive (54.1%; P<0.001). The area under the ROC curve for the HPV viral load was 0.550 (P=0.314; 95% CI, 0.455-0.644). The HPV-18 genotype is a reliable prognostic factor of early-stage cervical cancer; however, the HPV viral load may not be helpful in predicting disease prognosis.
    Gynecologic Oncology 02/2011; 121(3):546-50. DOI:10.1016/j.ygyno.2011.01.015 · 3.69 Impact Factor
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    ABSTRACT: Alveolar soft part sarcoma (ASPS) of the uterine cervix is a rare mesenchymal malignancy that occurs in adolescents and young adults. A 52-year-old postmenopausal woman presented with profuse vaginal bleeding of one month's duration with severe anemia. The pelvic examination revealed a 3 cm mass on the posterior lip of the uterine cervix. On magnetic resonance imaging, the tumor had high signal intensity on T1- and T2-weighted images. A modified radical hysterectomy and bilateral salpingo-oophorectomy were performed. Immunohistochemical staining for TFE3 and electron microscopic examination revealed an ASPS of the uterine cervix. The better prognosis of cervical ASPS, compared to the soft counterparts, may be related to early clinical detection, small size, resectability, and demarcation of the tumor.
    European journal of gynaecological oncology 01/2011; 32(3):359-61. · 0.60 Impact Factor
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    ABSTRACT: Objective To evaluate predictive value of maternal serum white blood cells (WBCs), C-reactive protein (CRP) levels, placental interleukin-6 (IL-6), lipid peroxide, and protein carbonyl levels in preterm birth according to histologic chorioamnionitis (HCA). Methods This cohort study included 45 cases of preterm delivery with preterm labor and intact membranes (preterm labor [PTL] group; n=16) and preterm premature rupture of membranes (preterm premature rupture of membranes [PPROM] group; n=29). Blood samples at admission and placental sample at postpartum were collected. HCA was diagnosed in the presence of neutrophils infiltration into the subamnionic space. Results The incidence of HCA was significantly higher in PPROM group than PTL group. Maternal serum WBC and CRP levels at admission, and placental IL-6, lipid peroxide, and protein carbonyl levels in HCA group were significantly higher than group without HCA. Maternal serum CRP levels at admission, and placental IL-6, lipid peroxide, and protein carbonyl levels of PPROM group with HCA were significantly higher than PPROM group without HCA. Maternal serum CRP levels at admission of 7 days and more latency period (n=14) were significantly lowered than those of less than 7 days latency period (n=15). The cut-off points of CRP determined with the receiver operating characteristic curves was 0.875 mg/dL. Perinatal morbidity such as respiratory distress syndrome, intraventricular hemorrhage, pneumonia in HCA group was significantly higher than group without HCA.
    01/2011; 54(1). DOI:10.5468/KJOG.2011.54.1.26
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    ABSTRACT: Loop electrosurgical excisional procedure (LEEP) is a well known and effective method for the treatment of precancerous lesion of cervix. It has the advantage of being simultaneously diagnostic and therapeutic. Complications of the LEEP are usually few and mild, mainly bleeding, discomfort and infection. The vesicovaginal fistula, which occurres as a consequence of LEEP is very rare condition that has not been reported in Korea. We present a case of vesicovaginal fistula that resulted from LEEP with a brief review of the literature.
    01/2011; 54(7):390. DOI:10.5468/KJOG.2011.54.7.390
  • W. D. Kang, S. M. Kim
    Journal of Minimally Invasive Gynecology 11/2010; 17(6). DOI:10.1016/j.jmig.2010.08.421 · 1.58 Impact Factor
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    ABSTRACT: The aim of this study was to determine the factors associated with failure in patients receiving pulse dactinomycin as second-line chemotherapy for low-risk gestational trophoblastic neoplasia (GTN) according to the revised International Federation of Obstetrics and Gynecology 2000 scoring system at a single institution. Between January 1997 and June 2007, 37 patients with methotrexate-failed low-risk GTN were treated with pulse dactinomycin (1.25 mg/m intravenously every 2 weeks). All patients had low-risk GTN based on the revised International Federation of Obstetrics and Gynecology 2000 scoring system at the time of second-line chemotherapy. A logistic regression model was used to analyze the relationship between covariates and treatment failure. There were 28 (75.7%) patients who achieved primary remission with pulse dactinomycin. All 9 treatment failures achieved complete remission after receiving subsequent chemotherapy; 1 patient also underwent hysterectomy. Patients successfully treated with pulse dactinomycin required a median of 4.0 cycles (range, 2-7) to achieve a complete response. The risk of failure with pulse dactinomycin was higher for serum hCG levels 10 or higher when initiating pulse dactinomycin (odds ratio, 8.91; 95% confidence interval, 1.08-73.53) and a rising World Health Organization score of 2 or higher after first-line chemotherapy (odds ratio, 12.59; 95% confidence interval, 1.60-99.25). With respect to the previous methotrexate regimen and cause of failed methotrexate chemotherapy, there were no differences between those who were successfully treated and those who failed pulse dactinomycin. Serum hCG level and a rising World Health Organization score at the time of initiating pulse dactinomycin are important prognostic factors in patients with methotrexate-failed low-risk GTN receiving pulse actinomycin as second-line chemotherapy.
    International Journal of Gynecological Cancer 11/2010; 20(8):1424-8. DOI:10.1111/IGC.0b013e3181f5873e · 1.95 Impact Factor
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    ABSTRACT: This study was conducted to determine whether the human papillomavirus (HPV) genotype by the HPV DNA chip test (HDC) is predictive of residual or recurrent high-grade cervical intraepithelial neoplasia (CIN) 2-3 following a loop electrosurgical excision procedure (LEEP). Between January 2001-February 2007, 672 patients with CIN2-3 were treated by a LEEP and followed up with cytology, the hybrid capture II assay, and the HDC. A total of 37 (5.5%) patients developed a recurrence, and those who developed a recurrence tested positive for the same high-risk (HR) HPV genotype before and after the LEEP. The same HR-HPV genotype by the HDC during the follow-up had a sensitivity and negative predictive value of 100% for detecting residual/recurrent disease. Persistent HPV-16 and HPV-18 were significantly associated with recurrent CIN2-3 (P < .05). Persistent infection with the same HR-HPV genotype, especially HPV-16 and HPV-18, should be considered a risk factor for developing residual/recurrent CIN2-3.
    American journal of obstetrics and gynecology 07/2010; 203(1):72.e1-6. DOI:10.1016/j.ajog.2010.01.063 · 3.97 Impact Factor

Publication Stats

103 Citations
54.94 Total Impact Points

Institutions

  • 2008–2014
    • Chonnam National University
      • Department of Obstetrics and Gynecology
      Gwangju, Gwangju, South Korea
  • 2008–2013
    • Chonnam National University Hospital
      Sŏul, Seoul, South Korea