Congenital epulis, a kind of hamartoma, is a very rare tumor, which appears in front of maxillary alveolar ridge in most cases, and accompanies no malformations. As the tumor protrudes from the oral cavity, it may lead to respiratory difficulties and feeding problems. Therefore it is important for pregnant women to receive comprehensive prenatal counseling with accurate diagnosis of the fetal oral tumor. We report a rare case of prenatal detection of oral tumor with a brief review of literatures, which was confirmed to be a congenital epulis or granular cell tumor after birth.
Alveolar Process ; Counseling ; Female ; Gingival Neoplasms ; Granular Cell Tumor ; Hamartoma ; Humans ; Mouth ; Parturition ; Pregnant Women ; Ultrasonography, Prenatal

Placenta surface cyst classified subamniotic hematoma, subchorionic hematoma and subchorionic cyst by histological finding. These cysts did not affect the obstetrical outcome according to the previous report. However, we experienced that the subamniotic cyst compressed the umbilical cord to result in fetal deceleration. We report this case with brief review of literature.
Deceleration ; Hematoma ; Placenta ; Prenatal Diagnosis ; Umbilical Cord

OBJECTIVE: To evaluate the effects of simvastatin on the proliferation and apoptosis of human endometrial cells from women with endometriosis. METHODS: Endometrial tissues were obtained from four women with endometriosis. The endometrial stromal cells isolated from tissue were cultured with 0, 2 and 10 micrometer simvastatin treatments for 48 hours. The proliferation of endometrial stromal cells was inhibited with 2 and 10 micrometer simvastatin treatments compared to control. The effect of simvastatin on the sub-G1 phase of cell cycle was determined by flow cytometry. The expression of apoptosis related molecule (Bcl-2, Bax and caspase-3) was examined in control and simvastatin treatments using western blot. RESULTS: The sub-G1 phase was higher in 10 micrometer simvastatin than in control and 2 micrometer simvastatin (P<0.05). This result showed that simvastatin could induce apoptosis of stromal cells. The expression of Bcl-2 was increased in simvastatin treatments slightly (P<0.05) and the expression of Bax was not different between control and experimental groups. The activation of caspase-3 was significantly higher in 10 micrometer simvastatin treated group than control and 2 micrometer simvastatin treated groups (P<0.05). CONCLUSION: Simvastatin induces apoptosis of endometrial stromal cells and inhibits their proliferation. It was considered that simvastatin could potentially be a therapeutic agent for the treatment of endometriosis.
Apoptosis ; Caspase 3 ; Cell Cycle ; Endometriosis ; Female ; Flow Cytometry ; Humans ; Simvastatin ; Stromal Cells

OBJECTIVE: Postmenopausal osteoporosis is a common skeletal disease with serious consequences due to fracture, leading to increased morbidity and mortality. This study was carried out to evaluate the changes of national osteoporosis markets during the last 5 years and to estimate the trends of national osteoporosis market in the future. METHODS: The use of the medications for osteoporosis treatment was evaluated in terms of sales of drugs for osteoporosis treatment. The sales audit of drugs for osteoporosis treatment from Intercontinental Marketing Services (IMS) were used to analyse the sales of specific drugs. RESULTS: The total national osteoporosis market has been increased progressively and markedly during the last 5 years and was valued at 167.4 billion Korean won (KRW) in 2008. The use of hormone therapy was decreased markedly by 40% after reporting of WHI results and the reduction of hormone therapy has been continuing during the recent 5 years. The market size of the non-hormonal osteoporosis drugs has been grown by 73% during the last 5 years and was valued at 134.5 billion KRW in 2008. This non-hormonal drug market was dominated by bisphosphonates. which account for over 80% of total sales. The use of bisphosphonates and active vitamin D metabolites has been increasing but raloxifene and calcitonin, decreasing. CONCLUSION: The survery of recent national osteoporosis market using IMS sales audit showed that the use of drugs for osteoporosis treatment has been markedlly increasing during last 5 years from 2004 to 2008. This has been attributed to non-horomonal pharmacological drugs, especially bisphosphonate.
Calcitonin ; Commerce ; Diphosphonates ; Female ; Humans ; Korea ; Marketing ; Osteoporosis ; Osteoporosis, Postmenopausal ; Raloxifene Hydrochloride ; Vitamin D

OBJECTIVE: The purpose of this study was to examine in vitro development of early preimplantation mouse embryos in various kind of serum-free conditioned media (SF-VCM) manufactured from DMEM cultured with Vero Cells. METHODS: A total of 846 two-cell mouse embryos were cultured in different kind of SF-VCM. SF-VCMs were divided into SF-VCM-10, -30 and -50 by media volume using DMEM #1 media, and divided into SF-VCM #1, #2 and #3 by controlled concentration of glucose and pyruvate (manufactured by DMEM #1: mixed three volume of DMEM-G (DMEM with glutamine without glucose and pyruvate) and one volume of DMEM-GGP (DMEM with glutamine, glucose, pyruvate), #2: mixed same volume of DMEM-G and DMEM-GGP and #3: mixed one volume of DMEM-G and three volume of DMEM-GGP, respectively). Experimental groups were mainly added 10% SSS, and 20% hFF was added to only Control group co-cultured with Vero cells. Development of embryos was observed every 24 hours. Results between different groups were analyzed using Chi-square test, and considered statistically significant when P-value was less than 0.05. RESULTS: In vitro developmental rate by each cleavage stages of mouse embryos cultured in SF-VCMs with a various volumes were significantly (P<0.05) higher in SF-VCM-30 (morula< or =: 97.2%, Blastocyst (BL)< or =: 97.2%, Hatching BL< or =: 82.2%) than other groups. In the rate of development on in vitro co-culture vs. a various SF-VCMs manufactured by DMEM controlled concentration of glucose and pyruvate, Group I (SF-VCM #1) was higher than other groups in each cleavage stages (morula< or =: 98.1%, Blastocyst (BL)< or =: 97.1%, hatching BL< or =: 81.7%, respectively). Moreover, specially, in the developmental rate into the hatching blastocyst < or = after 96 hours in vitro culture, Group I (81.7%) was significantly higher than control group (67.6%, P<0.05). CONCLUSION: SF-VCM #1 manufactured by volume of 30 mL DMEM #1 media cultured in vitro for 48 hours in 250 mL flask was the most effective on in vitro developmental rate of mouse preimplantation embryos. Therefore, it is expected that SF-VCM #1 has application to human IVF-ET.
Animals ; Blastocyst ; Coculture Techniques ; Culture Media, Conditioned ; Embryonic Structures ; Fertilization in Vitro ; Glucose ; Glutamine ; Humans ; Mice ; Pyruvic Acid ; Vero Cells

OBJECTIVE: The purpose of this study is to evaluate other anomalies associated with the fetal renal dysgenesis and prognosis. METHODS: Level II sonography were reviewed in the pregnant women who had been diagnosed with fetal renal dysgenesis antenatally from March 1998 to February 2005. Diagnosis was comfirmed by the autopsy or the postnatal studies including sonographic and radiologic evaluation. RESULTS: Thirty fetuses had a fetal renal dysgenesis. There were 2 cases of polycystic kidney, 4 cases of bilateral renal agenesis, 4 cases of unilateral renal agenesis, 3 cases of bilateral multicystic dysplastic kidney and 17 cases of unilateral multicystic dysplastic kidney. The common associated anomalies were congenital heart disease (7 cases), single umbilical artery (5 cases), imperforate anus (2 cases) and tracheo-esophageal fistula (2 cases). Hypospadia and scoliosis with hemivertebra were also noted. CONCLUSION: The most common anomaly associated with renal dysgenesis was congenital heart diseases. If fetal renal dysgenesis is detected antenatally, fetal echocardiography should be performed.
Anus, Imperforate ; Autopsy ; Congenital Abnormalities ; Echocardiography ; Female ; Fetus ; Fistula ; Heart Diseases ; Humans ; Hypospadias ; Kidney ; Kidney Diseases ; Male ; Multicystic Dysplastic Kidney ; Polycystic Kidney Diseases ; Pregnant Women ; Prognosis ; Scoliosis ; Single Umbilical Artery

OBJECTIVE: The aim of our study was to make a practical comparative evaluation of the first and second trimesters in order to determine the period during which a higher yield of fetal nucleated red blood cells (FNRBCs) can be obtained. METHODS: NRBCs were isolated from maternal blood during the first and second trimesters of pregnancy using double Percoll gradients with different osmolarities. Magnetic activated cell sorting was performed with Kleihauer-Betke stain. We isolated fetal NRBCs from 10 mL of samples of maternal blood and determined fetal sex and fetal aneuploidy by fluorescence in situ hybridization (FISH). RESULTS: The average number of NRBCs was 9.85 in samples obtained during the first trimester and 14.88 in samples obtained during the second trimester (P=0.07). The average number of NRBCs with Y chromosome signals was 5.73 in the first trimester and 8.22 in second trimester (P=0.56). However, the percentage of NRBCs with Y chromosome signals in the first trimester (70.6%) was significantly higher than in the second trimester (59.8%) (P=0.049). We diagnosed the blood samples from 7 pregnant women having fetal aneuploidy using this method and the number of NRBCs was 18.4. CONCLUSION: The method using Percoll osmolarity and a double density gradient system may be a very useful method for separation of NRBCs in the first trimester of pregnancy and also in the second trimester.
Aneuploidy ; Centrifugation, Density Gradient ; Erythrocytes ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Magnetics ; Magnets ; Osmolar Concentration ; Povidone ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnant Women ; Prenatal Diagnosis ; Silicon Dioxide ; Y Chromosome

OBJECTIVE: To detect meconium peritonitis for the fetal period is important for prenatal counseling. The aim of this study was to evaluate prenatal ultrasound finding for diagnosing meconium peritonitis and postnatal clinical course and outcomes. METHODS: The prenatal and postnatal medical records of all patients to our institutions with confirmed meconium peritonitis were reviewed, with emphasis on prenatal ultrasound findings, postnatal investigations, operative findings, outcomes of meconium peritonitis. RESULTS: Fourteen fetuses were confirmed to have meconium peritonitis at birth by operation. Eight cases were diagnosed correctly because of prenatal ultrasound showing ascites and calcification/dilated or hyperechoic bowel loops. In the other 6 cases, prenatal ultrasound showed only ascites. One patient was operated on first day of life and its intra-operative finding was malrotation of small bowel, volvulus with strangulation, perforation and jejunal atresia. Most cases were operated on 2nd or 3rd day of life. Intra-operative findings were ileal atresia and perforation in 11 cases and jejunal atresia and perforation in 3 cases. Four patients underwent ileostomy but all patients survived and prospered. CONCLUSION: All patients do not present typical prenatal ultrasound findings of meconium peritonitis. Therefore, even in pregnancies associated with isolated ascites, meconium peritonitis should be taken into consideration. Favorable outcome of intrauterine meconium peritonitis is reassuring in prenatal counselling and stems from multidisplinary team approach.
Ascites ; Counseling ; Fetus ; Humans ; Ileostomy ; Intestinal Atresia ; Intestinal Volvulus ; Meconium ; Medical Records ; Parturition ; Peritonitis ; Pregnancy ; Prenatal Diagnosis

The efficacy and immunogenicity of human papillomavirus (HPV) vaccines has proven excellent in several phase 2 and phase 3 trials involving tens of thousand women. Two versions of HPV vaccine had been developed, both target HPV 16 and HPV 18, which involve approximately 70% of cervical cancer. We have summarized the recent review of all randomized controlled trials in which vaccines against HPV were compared with placebo regarding efficacy, safety, and immunogenicity. Both vaccines have an excellent safety profile, are highly immunogenic, and have atributed complete type specific protection against persistent infection and associated lesions in fully vaccinated girls and young women. Data strongly suggest that both vaccines can have a variable level of cross protection against HPV types genetically and antigenically-closely related to vaccine types. Demonstration of cross protection against combined endpoints [cervical intraepithelial neoplasia (CIN) 2/3 and adenocarcinoma in situ] for HPV-31 has been reached for the quadrivalent vaccine. Bivalent HPV vaccine showed significant type-specific cross-protection against CIN2+ associated with HPV-31, HPV-33, and HPV-45. The bivalent vaccine is also registered for above age 26 in Australia, Israel and Korea. In our country, we have already set up the clinical guideline of both vaccines. Although these prophylactic vaccination is likely to provide important gains in the prevention of cervical cancer, we should have need to establish the new screening guideline in post-vaccination period and to make next version of vaccination-guidelines related of specific subgroups of patients who would benefit from the vaccine (women older than 26 years, boys, and men).
Adenocarcinoma ; Australia ; Cervical Intraepithelial Neoplasia ; Cross Protection ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Israel ; Korea ; Mass Screening ; Papillomavirus Vaccines ; Transcutaneous Electric Nerve Stimulation ; Uterine Cervical Neoplasms ; Vaccination ; Vaccines

Female adnexal tumors of probable Wolffian origin (FATWO) are rare. Although the histological features of the benign tumors are recognized, features of malignancy are not well defined in published work because these tumors are particularly rare. In this study, we report a 52-year-old woman with a High malignant FATWO. The frozen biopsy of the fragile uterine mass, located at the left broad ligament, revealed a malignant FATWO with high mitotic figure (up to 36/10 HPF). The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and paraaortic and pelvic lymph node dissection. Pathologic findings were consistent with malignant FATWO infiltrating to the unilateral salpinx without lymph node metastasis. The patient received three cycles of adjuvant treatment with paclitaxel and carboplatin. There was no clinical evidence of recurrence during the 12 months of follow-up; the patient is currently still being followed-up.
Adenoma ; Adnexal Diseases ; Biopsy ; Broad Ligament ; Carboplatin ; Fallopian Tubes ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Paclitaxel ; Recurrence