Rare mullerian anomalies without any present classification were sometimes reported. A 30-year-old nulligravid woman was referred to our hospital with 2-year history of primary infertility. Laparoscopic examination revealed a relatively intact uterine fundus with both patent fallopian tubes. Hysteroscopic exam confirmed the presence of double vagina and cervix, as well as complete uterine septum with opening at the lower segment. Hysteroscopic septotomy was successfully performed through the right-sided cervix. A variant of complete septate uterus with double cervix that communicated at the isthmic portion could be successfully treated by hysteroscopic operation.
Adult ; Cervix Uteri ; Fallopian Tubes ; Female ; Humans ; Infertility ; Uterus ; Vagina

Lipomatous variant of angiomyofibroblastoma is a rare tumor of the vulva. Most of cases are usually premenopausal and present with a slowly growing mass without pain. A 46-year-old woman presented with a swelling of the left labium major. The lesion was thought to be a Batholin's gland cyst or a lipoma preoperatively and a local excision was performed. The tumor was well demarcated and rubbery. On microscopic examination, the alternating hypercellular and edematous hypocellular component with abundant vessels was noted. A large amount of adipose tissue was scattered in the lesion. Stromal cells were positive for vimentin, estrogen receptor, and progesterone receptor and negative for desmin antibody immunostaining. The local excision was enough for complete treatment. No recurrence was noted for 7 months after surgery.
Adipose Tissue ; Desmin ; Estrogens ; Female ; Humans ; Lipoma ; Middle Aged ; Receptors, Progesterone ; Recurrence ; Stromal Cells ; Vimentin ; Vulva

Primary malignant melanoma arising from the ovarian mature cystic teratoma is extremely rare, with only 31 cases have been described in the literature. It is one of the rarest forms of malignant transformation of ovarian mature cystic teratoma and usually develops unilaterally after menopause. Recently, we experienced a case of primary malignant melanoma arising from ovarian mature cystic teratoma in 71-year-old woman. The diagnosis was confirmed by positive immunohistochemical results of S-100 protein and HMB 45. Here we report the rare case with review of literature.
Aged ; Female ; Humans ; Melanoma ; Menopause ; S100 Proteins ; Teratoma

Basal cell carcinoma (BCC) is the most common human malignant neoplasm, accounting for 75% of all non-melanoma skin cancer. The incidence of BCC is strongly correlated with sun exposure as well as older age. Therefore, the vast majority of BCCs is observed in elderly patients on the sun-exposed skin of the head and neck with a frequency of more than 80%. BCC is very rare on sun-protected skin such as the perianal and genital regions and other etiologic factors must be considered in these cases. Although the pathogenesis of vulvar BCC is unclear, early diagnosis is very important. Because BCC in these areas sometimes seems innocuous, it is recommended that a biopsy of all suspect lesions be performed. We report a woman with BCC of the vulva treated with wide local resection and reviews the literatures on this subject.
Accounting ; Aged ; Biopsy ; Carcinoma, Basal Cell ; Early Diagnosis ; Female ; Head ; Humans ; Incidence ; Neck ; Skin ; Skin Neoplasms ; Solar System ; Vulva

Conjoined twins are very rare and the mortality rate of the fetus is extremely high. Early prenatal diagnosis is crucial, as it provides the opportunity for the mother and father to help in recognizing the conjunction of the twins and to help medical team in defining the prognosis of conjoined twins. We present a case of thoraco-omphalopagus conjoined twins diagnosed by two-dimensional and three-dimensional transabdominal sonography at 14(+2) weeks of gestation.
Fathers ; Fetus ; Humans ; Mothers ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Twins, Conjoined

The incidence of acute leukemia in pregnancy is as low as 1 in 75,000 pregnancies. There is no established guideline for the treatment of leukemia during midtrimester pregnancy. But nowadays, consensus is not to delay the leukemia treatment with chemotherapy even in pregnancy. Many authors reported successful outcomes of mothers and newborns. Because of the leukemia itself and side effects of the chemotherapy, anemia, thrombocytopenia and neutropenia are commonly encountered in women treated with chemotherapy. With chemotherapy in utero just before the delivery, the newborn could be neutopenic. We report one case of midtrimester pregnant woman who took chemotherapy for leukemia and suffered from neutropenic fever and preterm labor. The newborn was neutropenic. However, both the mother and the baby were successfully recovered from neutropenia.
Anemia ; Consensus ; Female ; Fever ; Humans ; Incidence ; Infant, Newborn ; Leukemia ; Mothers ; Neutropenia ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second ; Pregnant Women ; Thrombocytopenia

OBJECTIVE: To assess molecular markers of amniotic fluid derived stem cells (AFSCs) in aspects of increased neurological deficit in Down syndrome. METHODS: Amniotic fluid samples through amniocentesis for prenatal diagnosis from four mid trimester pregnancies; by routine chromosomal analysis, two of them were trisomy 21 (Down syndrome) and others were normal, were selected after informed consent. Cells from two-stage culture protocol were assayed; morphology through phase contrast microscopy, chromosomal analysis, reverse transcriptase-polymerase chain reaction and Western blot analysis. RESULTS: AFSCs were highly proliferative in subcultures and most of them were mononuclear, fibroblast-like, fusiform cells. There were also a few ovoid cells. The chromosomal analysis of amniotic fluid stem cells was identical to that of amniotic fluid cells. Two of four samples were 47,XX,+21, others were 46,XX. Of the proteins related to Down syndrome, the expression of S100beta were increased in AFSCs of Down syndrome, COL6A1 (Collagen IV, alpha 1) was down-regulated in them and insulin like growth factor binding protein-1 was expressed in all AFSCs. Stem cell markers were expressed heterogeneously. Oct4 (POU5F1), nanog, and SOX2 (sex determining region Y) were expressed in both groups. But c-Kit was not expressed in AFSCs of Down syndrome. The neural cell marker, neuron specific enolase was detected in both groups. Other neural cell markers, microtubule associated protein 2, glial fibrillary acidic protein were undetectable in ASFCs of Down syndrome. Bcl-2 gene family proteins related with apoptosis were assayed. The expression of Bcl-XL was increased in Down syndrome more than in normal pregnancy. Bcl-2 and BID were expressed in all AFSCs and Bax was down-regulated in Down syndrome. CONCLUSION: AFSCs are an excellent choice for many future tissue engineering strategies and cell based therapies. Analysis of molecular features of AFSCs from normal and Down syndrome will provide the basis of further experimental study.
Amniocentesis ; Amniotic Fluid ; Apoptosis ; Blotting, Western ; Down Syndrome ; Female ; Genes, bcl-2 ; Glial Fibrillary Acidic Protein ; Humans ; Informed Consent ; Insulin ; Microscopy, Phase-Contrast ; Microtubule-Associated Proteins ; Phosphopyruvate Hydratase ; Pregnancy ; Prenatal Diagnosis ; Proteins ; Stem Cells ; Tissue Engineering ; Trisomy

OBJECTIVE: Many clinical trials have proven the close relationship between the loss of human mitochondrial DNA and aging process. The purpose of this study was to evaluate the different types of mitochondrial DNA deletion and its frequency in luteinized granulosa cells in different aged groups of women undergoing in vitro fertilization (IVF). METHODS: The ovum pick up was done in 51 women who participated in Konyang University IVF program, and mitochondrial DNAs extracted from luteinized granulosa cells, were screened to search for different types of deletion and its frequency. The deleted mitochondrial DNA were analyzed by polymerase chain reaction method. DNA sequencing was performed to reveal exact deletion point. RESULTS: Three different types of deletions (4,977 bp, 7,150 bp, and 5,777 bp) were confirmed. To find the difference between the aged groups, we have divided women into groups younger than 32 years, between 32 to 37 years, and older than 37 years. The deletion of 4,977 bp was 60.9% (14/23) in younger than 32 years, 46.2% (6/13) in 32 to 37 years, 46.7% (7/15) in older than 37 years. There was no statistical significance between aged groups and the incidence of the deletion. The deletion of 7150 bp was 34.8% (8/23), in younger than 32 years, 30.8% (4/13) in 32 to 37 years, 40% (6/15) in older than 37 years. We investigated relationship between the frequency of deletion and the aging, but there was no statistical significance. In case of 5,777 bp, the deletion was 43.5% (10/23) in younger than 32 years, 30.8% (4/13) in 32 to 37 years, 53.3% (8/15) in older than 37 years. It showed no statistical significance as well as other types. CONCLUSION: In this study we have found three different types of deletion of mitochondrial DNA obtained from luteinized granulosa cells in women with infertility. There were no significant differnces of each type of deletion in 3 different aged groups of infantile women. The limitation of this study is that the analyze were done qualitatively. If we could provide the quantitative analyze it could be applied clinically.
Aged ; Aging ; DNA, Mitochondrial ; Female ; Fertilization in Vitro ; Granulosa Cells ; Humans ; Incidence ; Infertility ; Lutein ; Ovary ; Ovum ; Polymerase Chain Reaction ; Sequence Analysis, DNA

OBJECTIVE: The purpose of this study was (1) to evaluate the expressions of clusterin, bax, Ki-67, p53, and apoptotic index in epithelial ovarian tumors, borderline and malignant ovarian tumors, (2) to find out the correlation between their expressions and clinicopathological parameters, and (3) to evaluate the effect on the patient's survival according to their expressions. METHODS: The histological and clinical findings of 22 cases of ovarian cystadenomas, 44 cases of borderline tumors and 96 cases of carcinomas were evaluated. Expressions of clusterin, bax, Ki-67, p53, and apoptotic index were studied on paraffin-embedded tissue sections by immunohistochemical methods. RESULTS: The expressions of clusterin, p53, and Ki-67 were higher in ovarian carcinomas than borderline tumors. The overexpression of p53, and Ki-67 were frequent in high stage, poorly differentiated and bilateral ovarian carcinomas. The overexpressions of clusterin, bax, p53, and Ki-67 showed a statistically significant correlation with histologic type. Apoptotic index was higher in bax overexpression group, but there was no correlation with overexpression of clusterin or p53. Ki-67 was higher in p53 overexpression group, but there was no correlation with overexpression of clusterin or p53. There was no statistically significant correlation with each other between the overexpressions of clusterin, bax, p53, and Ki-67. The overexpressions of clusterin, Ki-67, p53 was associated with overall patient's survival in borderline significance. CONCLUSION: The overexpression of p53, and Ki-67 were frequent in poorly differentiated ovarian carcinomas. So the overexpression of p53, and Ki-67 can be used as prognostic factor. The overexpression of clusterin was more in epithelial ovarian carcinomas than in borderline tumors but showed no significant correlation with the overall patient's survival. Further studies are required to clarify the possibility of using clusterin for target therapy in epithelial ovarian carcinomas.
Clusterin ; Cystadenoma

OBJECTIVE: To evaluate the maternal and neonatal outcomes of pregnancies complicated with hyperthyroidism, according to the maternal treatment and thyroid function status during pregnancy. METHODS: This retrospective study was conducted on women complicated by hyperthyroidism who delivered between January 2000 and March 2010, at Catholic University Medical Center. The baseline characteristics as well as maternal and fetal outcomes were analyzed and compared according to maternal antithyroid medication and thyroid function status. RESULTS: Among 163 pregnant women complicated with hyperthyroidism, 103 women received antithyroid medication and 109 women showed euthyroid status during pregnancy. The mean gestational age and fetal birth weight at delivery were 38.2+/-2.9 weeks and 2.99+/-0.64 kg. There was no statistical difference in maternal complications between the medication group (n=103) and the non-medication group (n=59), while neonatal thyroid dysfunction including transient hypothyroidism was significantly higher in the medication group than the non-medication group (58% vs 24.5%, P<0.0001). The incidence of admission due to hyperemesis and neonatal thyroid dysfunction were significantly higher in the thyroid dysfunction group than the euthyroid group (21.7% vs 4.6%, P=0.0146; 66.7% vs 39.4%, P=0.0223, respectively). CONCLUSION: Maternal antithyroid medication as well as thyroid dysfunction during pregnancy could indicate the careful fetal thyroid monitoring to prevent neonatal thyroid dysfunction.
Academic Medical Centers ; Birth Weight ; Female ; Gestational Age ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Thyroid Gland