The ectopic ovary is a rarely reported gynecologic entity. A variety of synonymous terms have been used to describe this condition, such as supernumerary ovary, accessory ovary, and ovarian implant syndrome. The etiology of ectopic ovary is poorly understood. The ectopic ovaries may occur in two ways. First, in the embryonic theories, they are believed to result from abnormal separation of a small portion of the developing and migrating ovarian primordium. Second, the accessory ovary can occur from acquired conditions such as inflammation and operations. In this report, we describe a case of the ectopic ovary with a mature cystic teratoma autoamputated into the cul-de-sac and subsequently diagnosed by laparoscopy.
Female ; Inflammation ; Laparoscopy ; Ovary ; Teratoma

Iatrogenic endometriosis and leiomyoma are rare complication of laparoscopic subtotal hysterectomy. I experienced a case of pelvic endometriosis and leiomyoma concurrently arising after laparoscopic subtotal hysterectomy 2 years ago. The patient was a 43-year-old woman, and her chief complaint was palpable mass with pelvic pain in pelvis. Contrast-enhanced computed tomography image showed multiple well enhanced masses. She underwent laparoscopic surgery which revealed pelvic endometriosis and leiomyomas. The solid masses in cul-de-sac and on the surface of rectum were revealed endometriosis. The solid masses on the surface of anterior abdominal wall and descending colon were revealed leiomyoma. Implantation of viable endometrial and leiomyoma tissues could occur during uterine morcellation at time of laparoscopic subtotal hysterectomy in some patients. Vigorous irrigation and meticulous inspection should be performed.
Abdominal Wall ; Adult ; Colon, Descending ; Endometriosis ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Leiomyoma ; Myoma ; Pelvic Pain ; Pelvis ; Rectum

Sclerosing stromal tumor (SST) of the ovary is a rare, benign tumor. The most common clinical symptom is menstrual irregularity. Diagnosis of SST is often made by postoperative pathologic examination. The important differential diagnoses are other sex cord stromal tumors including fibroma, thecoma and etc. We present four cases of SST of the ovary during 10 years with a brief review of the literature.
Diagnosis, Differential ; Female ; Fibroma ; Ovary ; Sex Cord-Gonadal Stromal Tumors ; Thecoma

About 20~30% of benign or malignant tumors of ovarian origin arise from embryonic cells, and only 3% represent malignancy. But under age of 20, 70% of ovarian tumors arise from embryonic cells, and over 1/3 of them are malignant tumors. Over all the ovarian tumors arising from embryonic cells, immature teratoma is germ cell tumor, components include immature tissues and cells derived from ectoderm, mesoderm, and endomermal origins. Most of the immature tissues are from neuroectodermal origins. The immature teratoma of the ovary is a rare tumor, representing less than 1% of all ovarian neoplasm. These tumors typically present in young age woman (mean age 10~20 years) with pelvic and abdominal pain. Nowadays newly developed combination chemotherapeutic agents such as bleomycin, etoposide, cisplatin give us great survival and disease free prognosis than before. We have experienced two cases of immature teratoma so we report them with a brief review of concerned literatures.
Abdominal Pain ; Bleomycin ; Cisplatin ; Ectoderm ; Etoposide ; Female ; Humans ; Mesoderm ; Neoplasms, Germ Cell and Embryonal ; Neural Plate ; Ovarian Neoplasms ; Ovary ; Prognosis ; Teratoma

OBJECTIVE: To compare the clinical results between laparoscopic assisted vaginal hysterectomy (LAVH) and laparoscopic supracervical hysterectomy (LSH) in women with uterine leiomyoma. METHODS: One hundred four women underwent laparoscopic hysterectomy for the treatment of uterine leiomyoma between July 2008 and December 2009. A total of 60 women decided to undergo complete hysterectomy with removal of uterine cervix (LAVH group) and 44 women wished to preserve the uterine cervix (LSH group). Outcome measures including patient's characteristics, operating time, blood loss, rate of complications, were assessed and compared between groups. RESULTS: The women in the LAVH group were significantly older as compared with the LSH group, 45.16+/-0.84 years versus 42.41+/-0.62 years respectively. There were no significant differences in patient's characteristics (body mass index, parity, prior surgery) between the two groups. The mean operating time was 64.07+/-2.37 min. for LAVH group and 69.76+/-2.01 min. for LSH group; the mean hemoglobin change was 1.62+/-0.13 g/dL for LAVH group, 1.83+/-0.14 g/dL for LSH group, no significant differences were noted between two groups respect to the mean operating time and the mean hemoglobin change. There is no post-operative complications in both LAVH and LSH group. CONCLUSION: Based on our results, in women with uterine leiomyoma, LAVH and LSH seem to be the preferred hysterectomy techniques. The mean age was younger in LSH group, but did not appear to offer any significant benefits over LAVH. LAVH proved to be a valid alternative to LSH, and appropriate method for laparoscopic hysterectomy.
Cervix Uteri ; Female ; Hemoglobins ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Leiomyoma ; Outcome Assessment (Health Care) ; Parity

OBJECTIVE: This study aims to survey the change of comsumption of hormone therapy (HT) before and after publication of Women's Health Initiative Study(WHI) result in Korea from 2000 to 2009. METHODS: Data from Intercontinental Marketing Services were used to analyze and ten years of hormone consumption from 2000 to 2009 was expressed in terms of hormone sales amount (Korean won, KRW, 1 dollar=1,100 won). Total hormone consisted of Estrogen (ET), Estrogen/Progestogen (EPT), and Tibolone. To identify changes in total hormone consumption, the cumulative growth rate was based on the sales in 2002. RESULTS: After publication of WHI result in 2002, HT consumption had been continuously decreased by 39% from 51.1 billion (bn) KRW in 2002 to 31.4 bn KRW in 2006. From 2007 to 2009, HT consumption has been slightly increased to 3.56 bn KRW. The decreased consumption of HT is mainly due to decrease of ET/EPT comsumption by 49%. Tibolone consumption was decreased by 25% during next 2years after WHI publication, but thereafter gradually increased over pre-WHI publication level in 2009. The proportion of consumption of low dosage regimen was markedly increased from 3.5% in 2002 to 41.8% in 2009. CONCLUSION: The total hormone consumption was markedly decreased after WHI. Low dosage regimen consumption was increased, comprising 3.5~41.8% of total EPT consumption. Tibolone consumption was transiently decreased during 2 years after WHI publication, but thereafter increased gradually and reached over the level of pre-WHI publication in 2009. We expect that low-dosage regimen of HT and tibolone will be more widely used. An individual-based treatment approach is essential in assessing the appropriateness of initiating hormone replacement therapy.
Commerce ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Korea ; Marketing ; Menopause ; Norpregnenes ; Publications ; Women's Health

OBJECTIVE: The aim of this study is to comparing the prevalence and correlationships between human papillomavirus (HPV) and Chlamydia trachomatis (CT) infection in cervical samples among women with abnormal cervical cytology. METHODS: This study was included three hundred seventy four patients with a abnormal liquid-based cytology in Dankook University hospital. All of them underwent HPV DNA test and CT analysis with polymerase chain reaction. All patients also went through colposcopic directed cervical biopsies or Loop Electrosurgical Excision Procedure, conization. The histo-pathologic results were classified as normal, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and carcinoma in situ (CIS). RESULTS: Abnormal liquid-based cytology patients were pathologically proven to have CIN. Among 374 patients, the number of within normal limits (chronic cervicitis) and koilocytosis was 186 cases (49.7%), CIN 1, 64 cases (17.1%), CIN 2, 16 cases (4.3%) CIN 3, 55 cases (14.7%), and CIS, 53 cases (14.2%). HPV DNA positive patients were 235 cases and HPV DNA negative patients were 139 cases. The impact of CT infection seems not to interfere with the development or even the progression of CIN. Thirty one patients had positive infection of CT (8.3%) and 343 patients were negative infection of CT (91.7%). Both HPV and CT positive infected patients were 25 cases (6.7%) in abnormal cytologic women. The correlation between HPV and CT DNA positive among women with abnormal cytology was statistically significant. (P=0.022) CONCLUSION: This study suggests that CT infection is associated with HPV infection, but the clinical significance of the association between CT and HPV infection remains to be elucidated.
Biopsy ; Carcinoma in Situ ; Cervical Intraepithelial Neoplasia ; Chlamydia ; Chlamydia trachomatis ; Conization ; DNA ; Female ; Human Papillomavirus DNA Tests ; Humans ; Polymerase Chain Reaction ; Prevalence

OBJECTIVE: The purpose of this study was to investigate the treatment effects of a topical application of 5-aminolevulinic acid (5-ALA) for photodynamic therapy (PDT) to treat cervical cancer. METHODS: We first investigated the effects of 5-ALA cream according to application time. And to find the effective 5-ALA concentration and the distribution times in vivo, 20% 5-ALA cream was topically applied to the tumor of the nude mouse. We then observed the distribution of 5-ALA via fluorescence measurement with using a 532 nm diode laser. 25 nude mice were divided into Control, ALA, Laser, and PDT group. To evaluate the PDT effect at cancer lesion, we applied 20% 5-ALA cream to the tumor by the same method, and the PDT was done by using a 632 nm diode laser at the time of the peak level of fluorescence. We checked the changes of the volume of cancer for 30 days, and then biopsy was done. RESULTS: The effective post-irradiation time after topical ALA application was 9 hours. In the PDT group, 40% (4/10) of the mice showed decreased tumor size. CONCLUSION: The maximum PpIX fluorescence at 9 hours after local applicationof 5-ALA cream was checked. And PDT group did not show any statistical difference than control group in the growth of tumor size than control group. However responding cases (4/10) of PDT group showed the meaningful decrease of tumor size than control group (P<0.05).
Animals ; Biopsy ; Fluorescence ; Lasers, Semiconductor ; Mice ; Mice, Nude ; Photochemotherapy ; Protoporphyrins ; Triazenes ; Uterine Cervical Neoplasms

OBJECTIVE: To investigate the effect of alteration of social conditions towards pregnancy termination on the acceptance of genetic amniocentesis. METHODS: Retrospective review of medical records was conducted for women (<20 weeks' gestation, singleton pregnancy) who visited our outpatient department between February 1, 2009 and August 31, 2010. Acceptance of genetic amniocentesis was compared between two groups of women: one from February 1, 2009 to November 30, 2009 (2009 group) and the other from December 1, 2009 to August 31, 2010 (2010 group) after strict regulation of pregnancy termination. The acceptance rate of those who were referred to our center for genetic amniocentesis in same time period was also evaluated. RESULTS: Overall, 19 of 101 (19%) women in the 2009 group and 10 of 93 (11%) in the 2010 group, opted for invasive diagnostic methods (P=0.16). Women > 35 years in the 2010 group (5/30, 17%) were less likely to accept genetic amniocentesis than 2009 group (15/30, 50%; P=0.01). Similar results were observed in those who were indicated for genetic amniocentesis. (9/35, 26% vs 19/34, 56%; P=0.02). Acceptance rate of genetic amniocentesis was increased for those who were referred from private clinic, but without statistical significance (15/21, 71% vs 13/14, 93%; P=0.20). CONCLUSION: After strict regulation of pregnancy termination, acceptance rate of genetic amniocentesis was significantly decreased among women who had increased risk for chromosomal abnormalities or neural tube defect at our center. Whereas, there were no significant change in acceptance rate for those who were referred for amniocentesis from private clinic.
Abortion, Therapeutic ; Amniocentesis ; Chromosome Aberrations ; Female ; Humans ; Medical Records ; Neural Tube Defects ; Outpatients ; Pregnancy ; Prenatal Diagnosis ; Retrospective Studies ; Social Conditions

OBJECTIVE: The risk of macrosomia in diabetic complicated pregnancy is increased perinatal morbidity. But it is difficult to predict adverse outcomes after birth with conventional diagnostic tools of diabetes in pregnant women. We evaluated the birth-weight between diabetic and non-diabetic pregnant women based on gestational weeks to determine adverse pregnancy outcome. METHODS: We selected 166 diabetic complicated pregnant women delivered between January 2005 and December 2008 and 248 non-diabetic pregnant women at same period. We compared the birth-weight between two groups in relation to the gestational age below and over 37 weeks. Fetal anomalies, fetal death, and multifetal pregnancy were excluded in this study. And we also evaluated the incidence of baby who had birth-weight 3.8 kg or more and their neonatal outcomes between two groups. RESULTS: There were 4.9% (166/3404) of diabetic complicated pregnancies. The preterm births (birth before 37 weeks of gestation) were occurred 32.5% (54/166) and term births (birth after 37 weeks of gestation) were 67.5% (112/166). The mean birth-weight in preterm birth showed 2,492 g of gestational diabetes, 3,315 g of pregestational diabetes and 2,118 g of control group (P=0.001). The mean birth-weight and gestational age at delivery in term birth showed pregestational diabetes and gestational diabetes were heavier and shorter than those of control group (P=0.002). The incidence of 3.8 kg or more of birth-weighted baby appeared 43.5% (10/23) of pregestional diabetes, 16.8% (24/143) of gestational diabetes and 8.5% (21/248) of control group (P=0.000). The Apgar score less than 7 at minutes of neonate were more frequent in pregestational and gestational diabetes than that of control group (P=0.013). CONCLUSION: It is important to classify the type of diabetes during pregnancy and there should be needed to predict adverse pregnancy outcomes including macrosomia.
Apgar Score ; Diabetes, Gestational ; Female ; Fetal Death ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Parturition ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Premature Birth ; Term Birth