Isolated tubal torsion is a rare disease that causes acute lower abdominal pain. In most of cases, the ovary and the fallopian tube are together twisted due to an ovarian tumor, but the fallopian tube alone is rarely twisted. Tubal torsion mainly occurs in fertile women, and it rarely occurs prior to menarche and during menopause. We experienced a case where isolated tubal torsion occurred in a perimenopausal female with total abdominal hysterectomy, while the findings showed a normal ovary. We report this case with a brief review of related literature.
Abdominal Pain ; Fallopian Tubes ; Female ; Humans ; Hysterectomy ; Menarche ; Menopause ; Ovary ; Rare Diseases

Gestational trophoblastic neoplasm (GTN) is prone to pulmonary metastasis. Although most pulmonary metastatic lesions response with chemotherapy, some lesions do not resolve and persist on radiologic investigations. A 25-year-old women was referred for persistent pulmonary metastatic lesion of GTN. Here, we present a case of chemo-resistant choriocarcinoma metastatic to lung managed by video-assisted thoracoscopic surgery.
Adult ; Choriocarcinoma ; Female ; Gestational Trophoblastic Disease ; Humans ; Lung ; Neoplasm Metastasis ; Pregnancy ; Thoracic Surgery ; Thoracic Surgery, Video-Assisted

Heterologous sarcomas of the uterus are rare neoplasms. We report a rare case of heterologous uterine sarcoma composed of leiomyosarcomatous and liposarcomatous components with a brief review of literature. A 53-year-old woman had vaginal spotting. The endometrial biopsy performed at a local clinic revealed a high grade spindle cell sarcoma. Pelvis magnetic resonance imaging showed about 5.4 cm sized multiseptated T1 and T2 high signal mass in a uterine fundus without lymph node metastasis or pelvic wall involvement. Total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymph node dissection, and peritoneal washing cytology were performed. Pathologic diagnosis was made as leiomyosarcoma with liposarcomatous differentiation (lipoleiomyosarcoma). The patient received adjuvant postoperative radiotherapy (5040 cGy). Follow up images showed no evidence of disease 8 months after surgery.
Biopsy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Leiomyosarcoma ; Liposarcoma ; Lymph Node Excision ; Lymph Nodes ; Magnetic Resonance Imaging ; Metrorrhagia ; Middle Aged ; Neoplasm Metastasis ; Pelvis ; Sarcoma ; Uterus

Enteric duplication cysts are rare congenital malformation, of these, only 4% are gastric origin. It is diagnosed in 80 % of the patients before 2 years of age. Recently, prenatal diagnostic ratio gets higher through sonography and several diagnostic methods. In this paper, we describe a case of a cystic gastric duplication diagnosed prenatally with brief reviews of literature.
Humans ; Prenatal Diagnosis

OBJECTIVE: The aim of this study was to evaluate the oncologic and reproductive outcomes of patients with ovarian yolk sac tumor after bleomycin, etoposide, cisplatin (BEP) chemotherapy following surgery. METHODS: Of 145 patients with histologically confirmed malignant ovarian germ cell tumor, 43 had yolk sac tumor and received BEP chemotherapy after surgery. A retrospective analysis of these patients was performed. RESULTS: The mean age of 43 patients was 24.8 years (range, 7 to 59 years). Thirty eight patients were nulliparous. Of 179 BEP chemotherapy cycles, grade 1~2 hematologic and non-hematologic adverse events occurred in 46 cycles in 21 patients. Thirty nine patients showed complete remission, 1 patient showed partial remission, and 3 patient had progressive disease during BEP chemotherapy. After median follow-up time of 57 months (range, 3 to 153 months), 5 patients had recurrent disease and three of them died of disease. The 5-year recurrence free survival rate and overall survival rate were 86% and 94%, respectively. After chemotherapy, all but one premenarchal patients had normal menstruation. Of them 5 patients tried to conceive and 3 of them succeeded in pregnancy. CONCLUSION: BEP chemotherapy was very safe and effective in patients with ovarian yolk sac tumor. Survival outcomes are excellent and reproductive outcomes are promising after BEP chemotherapy.
Bleomycin ; Cisplatin ; Drug Therapy, Combination ; Endodermal Sinus Tumor ; Etoposide ; Female ; Follow-Up Studies ; Humans ; Menstruation ; Neoplasms, Germ Cell and Embryonal ; Pregnancy ; Recurrence ; Retrospective Studies ; Survival Rate ; Yolk Sac

OBJECTIVE: The aim of this study was to evaluate generational accumulation of murine fetal ovarian genes following prenatal exposure to 1.765-GHz microwave radiation. METHODS: A 1.765-GHz microwave generator was used. Twenty pregnant ICR mice were divided into two groups: the microwave-exposed experimental (irradiated) group, and the sham-exposed (sham) group. On the fifth day post-mating, dam mice were exposed to microwave irradiation in the insulated cage for 8 hours each day. The remaining mice were treated in the same way. Second generation mice were raised for 8 weeks then classified into four groups for examination. We removed the neonatal ovaries on the seventh day after the third delivery. We investigated the expression of six genes in the ovaries: Tnfaip 8, TNFsf 12, Cfd, CCL 11, Zfp 74, and Brd 3. Real time reverse transcription-polymerase chain reaction was performed using total RNA extracted from the removed ovaries. RESULTS: In the third-generation offspring, we detected some differences in ovarian gene expression between the first group and the fourth. Expression of CCL 11, and TNFsf 12 was decreased in the first group compared to the fourth group. Expression of Tnfaip 8, brd 3, Cfd, and Zfp 74 was higher in the first group than in the fourth group. We found differing results when we compared ovarian gene expression in mice of the second generation with those of the third. CONCLUSION: The results suggest that there is no generational accumulation of murine ovarian genes in offspring exposed to 1.765-GHz microwaves in the uterus.
Animals ; Female ; Gene Expression ; Mice ; Mice, Inbred ICR ; Microwaves ; Ovary ; RNA ; Uterus

OBJECTIVE: This study investigated the effects of the balanced incline shoes on the stabilized walking, fatigue reduction, improvement of blood circulation and prevention of foot related disease for the pregnant women. METHODS: The seven 7~9 month pregnant women and three maternities within 3 months after delivery without a history of disease performed the cycles for each of the two walking conditions: wearing balanced incline shoes and flat shoes. The differences between the two walking conditions were statistically investigated including three dimensional motion analysis, footprint pressures and blood flow. To find out any possible difference between these two kinds and among the subjects, the statistical tool was utilized with one-way layout design. RESULTS: Of 10 subjects, seven subjects showed the significantly decreased in distance of both knee with balanced incline shoes than flat shoes (P<0.05). Those with the balanced incline shoes had a walking pattern whose knee moved inward about 6 mm, compared to those with the flat regular ones. Over plantar pressure measurements for all ten, it also revealed statistically significant differences that the balanced incline shoes decreased its pressure 15% and that the pressure heavily on heel area was distributed outward along the arch (P<0.05). The blood stream velocity belonged to C (200~300 microm/sec) or D (100~200 microm/sec) for the nine before wearing the balanced incline shoes. However, it was found to be enhanced in A (>600 microm/sec) or B (400~600 microm/sec) after they put them on, indicating 1~2 part equivalent improvement. The blood stream velocity showed a incremental tendency after wearing balanced incline shoes. CONCLUSION: This result suggests that the balanced incline shoes corrected the postures, stabilized the gait pattern, decreased the excessive load on ankle plantar flexors, reduced the fatigue level and improved the blood circulation.
Animals ; Ankle ; Blood Circulation ; Fatigue ; Female ; Foot ; Gait ; Heel ; Humans ; Knee ; Posture ; Pregnant Women ; Rivers ; Shoes ; Walking

OBJECTIVE: To examine the association between prepregnancy body mass index (BMI), gestational weight gain and perinatal outcomes. METHODS: The data of women who delivered at term in our institute from January 2005 to December 2007 were analyzed retrospectively. Four categories of prepregnancy BMI and three categories of gestational weight gain were constructed and used maternal, neonatal outcomes. RESULTS: This study included 225 women with term delivered in our institute. According to prepregnancy BMI categories, lean (<18.5), normal (18.5< or =BMI<23), overweigh (23< or =BMI<25), obese (> or =25) were 35, 132, 31, 27, respectively. According to gestational weight gain categories, lean (<12 kg), normal (12~13.5 kg), overweight (>13.5 kg) were 73, 44, 108, respectively. Gestational weight gain above guidelines was common in low prepregnancy weight group, this difference was statistically significant. In women with increased prepregnancy BMI was associated with increased risk of gestational diabetes mellitus, cesarean section rate, and large for gestational age (LGA) (P<0.05). In women with overweight gain during pregnancy was associated with increased cesarean section rate and LGA (P<0.05). CONCLUSION: Increased prepregnancy BMI was associated with increased gestational diabetes mellitus, cesarean section rate, and LGA. Also excessive weight gain during pregnancy was associated with increased cesarean section rate and LGA.
Body Mass Index ; Cesarean Section ; Diabetes, Gestational ; Female ; Gestational Age ; Humans ; Overweight ; Pregnancy ; Retrospective Studies ; Weight Gain

OBJECTIVE: To develop a model based on non-invasive variables to predict the probability of subsequent maternal and/or neonatal clinical infection in women admitted to hospital for preterm labor with intact membranes. METHODS: Transvaginal ultrasound for measurement of cervical length was performed and maternal blood was collected for the determination of white blood cell (WBC) count at admission in 165 consecutive women with preterm labor (between 20.0 and 35.0 weeks). Clinical infection was defined as the presence of clinical chorioamnionitis at delivery or early onset neonatal sepsis. Receiver operating characteristic (ROC) curves and logistic regression analysis were used for statistical analyses. RESULTS: The prevalence of clinical infection was 5% (8/165). Women who developed clinical infection had a significantly lower median gestational age at admission, a lower shorter median cervical length, and a higher median WBC count as compared to those who did not develop clinical infection. Logistic regression analysis was performed and a final model was chosen, which included maternal blood WBC, cervical length, and gestational age as the best predictors of clinical infection. A risk score was calculated containing these 3 variables for each patient. The model was shown to have an adequate goodness of fit (P=0.202), and the area under the ROC curve was 0.822, indicating reasonably good discrimination. CONCLUSION: In women admitted to hospital for preterm labor with intact membranes, the risk for the subsequent maternal and/or neonatal clinical infection can be predicted non-invasively with a risk score based on cervical length at admission, maternal blood WBC, and gestational age.
Chorioamnionitis ; Discrimination (Psychology) ; Female ; Gestational Age ; Humans ; Leukocytes ; Logistic Models ; Membranes ; Obstetric Labor, Premature ; Pregnancy ; Prevalence ; ROC Curve ; Sepsis

OBJECTIVE: We investigated the usefulness of shortening of the fetal femur length (FL) and humeral length (HL) to predict Down syndrome at the middle gestation of pregnancy in Korean subjects. METHODS: This retrospective study involved 41 fetuses with Down syndrome and 328 fetuses with normal chromosome between 14+0 and 28+6 weeks of gestation. The expected FL and HL for any biparietal diameter (BPD) was calculated based on the control group data. The odds ratios for measure to expected FL and HL in comparison between normal fetuses and Down syndrome fetuses were calculated. The sensitivities of short FL and HL to predict Down syndrome were analyzed at a fixed false positive rate of 5%. RESULTS: The lengths of femur and humerus long bone for any BPD in Down syndrome group were significantly shorter than the lengths in control group (P<0.001). A low ratio of measured to expected FL and HL increased the risk of fetal Down syndrome (P<0.001). At a fixed false positive rate of 5%, the sensitivities were 21.3% (95% confidence interval [CI] 0.698~0.852, P<0.001) in FL and 29.9% (95% CI 0.773~0.914, P<0.001) in HL. CONCLUSION: Both of short FL and HL are poor marker for Down syndrome at the middle gestation of pregnancy in Korean population though the sensitivity of HL was higher than FL.
Down Syndrome ; Femur ; Fetus ; Humerus ; Odds Ratio ; Pregnancy ; Prenatal Diagnosis ; Retrospective Studies