Cardiac metastasis from known cervical cancer is rare. Even through a routine check-up, this type of metastasis can present as pulmonary emboli. Suspicion of this diagnosis in an oncology patient with complicating pulmonary emboli but no evidence of deep vein thrombosis is important, especially in cervical cancer patients with extensive pelvic lymph node metastasis and vascular invasion of a primary tumor. Early recognition may aid in improving the prognosis. We present a case of intracardiac metastasis arising from a squamous carcinoma of the cervix in a patient with pulmonary tumor emboli and review other cases from the literature.

ObjectivesDespite the possibility of early detection of cervical cancer, participation in screening programmes among young Koreans is low. We sought to identify associations between risk factors and participation in screening for cervical cancer among young Koreans.DesignNationwide cross-sectional study.SettingRepublic of Korea.Participants3734.Main outcome measuresThe Korea National Health and Nutrition Examination Survey (KNHANES V: 2010–2012) was used to evaluate factors associated with attendance for cervical cancer screening among women aged 15–39. After excluding those who were previously diagnosed with cervical cancer and those with incomplete responses to questionnaires, a total of 3734 subjects were eligible. Multi-dimensional covariates as potential predictors of cervical cancer screening were adjusted in multiple logistic regression analysis.ResultsThe participation rate for cervical cancer screening was 46% among women aged 40 or younger. The logistic analyses showed that age, education, total household income, smoking and job status among women aged 15–39 were associated with participation in cervical cancer screening (p<0.05). After age stratification, the associated factors differed by age groups. Moreover, a dose–response between participation in cervical cancer screening and high total household income in the 30–39 age group was seen.ConclusionsPredictive factors differed among young women (aged 15–29 vs 30–39). Thus, age-specific tailored interventions and policies are needed to increase the participation rate in screening for cervical cancer.

We compared results using unidirectional barbed sutures and conventional sutures for vaginal cuff closure during total laparoscopic hysterectomy (TLH).The electronic medical records and surgical videos of 170 patients who underwent TLH between January 2013 and March 2015 at Uijeong-bu St. Mary's Hospital of Catholic University of Korea were reviewed. Vaginal cuffs were closed using the 2-layer continuous running technique with unidirectional barbed sutures (V-Loc; Covidien, Mansfield, MA) in 64 patients and with polycolic acid Vicryl; Ethicon, Somerville, NJ sutures in 106 patients. Procedure time, clinical characteristics, and postoperative complications were compared between the 2 study groups. There were no differences in clinical characteristics (age, body mass index, and demographic data) between groups. The mean suturing time was significantly reduced in the barbed group (7.2 vs 12.2 minutes; P < 0.001), although the mean number of stitches was greater than in the Vicryl group (14.1 vs 12.3, P < 0.001). Perioperative complications, including episodes of vaginal bleeding, vaginal cuff cellulitis, and postoperative fever, did not differ between groups. There were no instances of vaginal cuff dehiscence in either group. Unidirectional barbed sutures can be used safely to reduce procedure time and surgical difficulty relative to conventional sutures in laparoscopic vaginal cuff closure.