Neurological manifestation of pre-eclampsia is not so rare. But isolated abducens nerve palsy in pre-eclampsia is very rare. We report a case of severe pre-eclampsia with isolated abducens nerve palsy.
Abducens Nerve Diseases* ; Abducens Nerve* ; Neurologic Manifestations ; Pre-Eclampsia*

OBJECTIVE: Pelvic actinomycosis is a rare disease, which make chronic granulomatous suppurative pelvic abscess caused by an anaerobic Gram positive organism Actinomyces israelii usually associated with intra-uterine devices, and difficult to diagnose exactly before operation. Pelvic actinomycosis is frequently confused with gynecologic malignancy, leading to misdiagnosis and overtreatment. We experienced 8 cases of pelvic actinomycosis and provide the advice for treatment of pelvic actinomycosis METHODS: We reviewed retrospectively the medical chart of 8 cases which have visited to Department of Obstetrics and Gynecology, College of Medicine, Anam Hospital, Korea University for pelvic actinomycosis from January 1999 to January 2007. RESULTS: The mean age of patients was 45.2 years old. Main symptoms were abdominal pain, vaginal bleeding, vaginal discharge, dysmenorrhea and fever with chilling. All cases have used the intrauterine devices for 5-20 years. 3 cases were diagnosed preoperatively by endometrial biopsy, punch biopsy, or empirically, and the others suspected to tuboovarian abscess or malignancy, and then their diagnoses were conformed by operation. 5 cases were treated by operation following antibiotics therapy, and 2 cases by antibiotics without operation, and 1 case by antibiotics therapy following operation. All cases were completely cured. CONCLUSION: In the treatment of pelvic actinomycosis, most important point is making the diagnosis before operation for decreasing complication such as bowel, bladder, and other pelvic organ injury. Inevitably, if the diagnosis was established by operation, postoperative high-dose antibiotic therapy was needed for several months.
Abdominal Pain ; Abscess ; Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Biopsy ; Diagnosis ; Diagnostic Errors ; Dysmenorrhea ; Female ; Fever ; Gynecology ; Humans ; Intrauterine Devices ; Korea ; Obstetrics ; Rare Diseases ; Retrospective Studies ; Urinary Bladder ; Uterine Hemorrhage ; Vaginal Discharge

OBJECTIVE: The purpose of this study was to evaluate the impact of vaginal hysterectomy on total vaginal length (TVL). METHODS: Retrospective analysis of 155 medical records of patients underwent vaginal hysterectomy by one surgeon with benign uterine pathology in the absence of prolapse between January 2004 and February 2007. After hysterectomy, uterosacral vaginal vault resuspension (anchoring to vaginal vault about 1.0~1.5 cm proximal at the ligament) was performed for prevention of vault prolapse. Patients' characteristics and TVL before and after surgery were evaluated. RESULTS: Preoperative mean TVL was 7.32+/-0.84cm. At two months after the surgery, mean TVL was 7.42+/-0.77 cm. The change of vaginal length was statistical significance (P=0.045). Eighty-one patients were reevaluated at five to twelve months after surgery, mean TVL was longer than the preoperative results (7.3+/-0.82 cm vs 7.48+/-0.78 cm, P=0.011). We evaluated 30 patients who were followed at least 12 months after the surgery, the length was longer than the preoperative results, also (7.17+/-0.81 cm vs 7.46+/-0.66 cm, P=0.006). CONCLUSION: Although that appears to be statistically significant elongation of the total vaginal length after vaginal hysterectomy, the impact is unlikely to be clinically significant.
Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Medical Records ; Pathology ; Prolapse ; Retrospective Studies

OBJECTIVE: This study was designated to determine the effect of cord blood cell transplantation in ischemic injury model. METHODS: In this study, we administered human umbilical cord blood (hUCB)-derived CD34(+) cells into the lateral ventricle or directly into the striatum and assessed cell migration in mice with cryoinjury and behavioral recovery in rats with transient middle cerebral artery occlusion (MCAo). CD34(+) cells were isolated by magnetic cell sorting using CD34-microbeads and labeled with CM-Dil. RESULTS: When CD34(+) cells were injected into mice brain with cryoinjury, cells were migrated into a injury site after one week of injection. Similarly, injected CD34(+) cells were migrated into the periphery of infarcted area in rats with transient MCAo. When spontaneous activity was measured using a modified neurological severity score (mNSS), it was found that functional recovery was significantly higher when CD34(+) human umbilical cord blood cell (hUCBC) was transplanted 24 hours after stroke compared with phosphate buffered saline (PBS)-injected or CD34(-) transplanted, stroked animals (P<0.05). Although only small portion of transplanted cells were differentiated into neural lineages, CD34(+) hUCBC transplantation increased Brdu incorporation and recruitment of doublecortin (DCX) (+) cells in ischemic boundary zone. CONCLUSION: These results suggest that hUCBC transplantation may be an effective treatment for brain injuries, such as stroke, or neurodegenerative disorders by promoting endogenous repair process of the brain.
Animals ; Brain ; Brain Injuries ; Bromodeoxyuridine ; Cell Movement ; Cell Transplantation ; Fetal Blood ; Humans ; Infarction, Middle Cerebral Artery* ; Lateral Ventricles ; Mice ; Middle Cerebral Artery* ; Neurodegenerative Diseases ; Rats* ; Stroke ; Transplants

OBJECTIVE: The purpose of this study was to estimate the effect of age on the risk of in-hospital surgical morbidity in patients with pelvic organ prolapse (POP). METHODS: Of the women aged 40 years and older who underwent surgical correction of POP at this institution from March 1999 to February 2006, 322 had medical records that could be analyzed. These patients were grouped according to decade of age and assessed according to a set of characteristics and postsurgical complications. RESULTS: There were 35 patients between 40 to 49 years of age, 97 between 50 to 59 years, 123 between 60 and 69 years, 64 between 70 to 79 years and 3 patients were 80 years or older. There were no differences between age groups regarding the following variables: stage, delivery history, BMI, previous surgical history, underlying medical disease, duration of hospital stay, operation time, type of operation and anesthesia, difference of preoperative and postoperative hemoglobin level. There were differences only for parity. Also, between each age group, no statistical differences were noted in postoperative complications. CONCLUSION: The risk of in-hospital surgical morbidity in patients with POP was not related to the age of the patients.
Anesthesia ; Female ; Humans ; Length of Stay ; Medical Records ; Parity ; Pelvic Organ Prolapse* ; Postoperative Complications

OBJECTIVE: To report 18 months follow up results of radiofrequency myolysis and analysis the factors which effect the success rate of myolysis. METHODS: 153 patients who took radiofrequency myolysis between October 2004.~June 2006 in this hospital were enrolled this retrospective study. Except 14 patients which had incomplete data, total 139 patient's charts were reviewed. Sonographic evaluations were checked after a week, 1 month, 3 months, 6 months, 12 months, and 18 months after myolysis. Questions about complications like vaginal bleeding, abdominal pain, feber and vaginal discharge were asked to patients in every visits. Volume of the myoma were checked via 3D ultrasonography. RESULTS: Reduction rate of the volume of myoma after 18 months were 73% and reoperation rate were 4.3%. Improvement rates of patients symptom were 87% (menorrhagea 95%, dysmenorrheal 75%, pelvic pain 60%) The patients who had myomas sized over 100 ml before treatments showed statistically higher rate of reoperation, and decreased rate of satisfaction. Reoperation rate and reduction rate of myoma showed no difference through pathologic diagnosis. The patients who had initial symptoms showed higher rate of satisfaction after myolysis. Total satisfaction rate were 62%, and no serious complications like bowel injury, bladder injury, sepsis and peritonitis were not reported. CONCLUSION: Satisfaction rate after radiofrequency myolysis was increased in symptomatic leiomyoma especially smaller than 6.5 cm in diameter.
Abdominal Pain ; Diagnosis ; Follow-Up Studies* ; Humans ; Leiomyoma ; Myoma ; Pelvic Pain ; Peritonitis ; Reoperation ; Retrospective Studies ; Sepsis ; Ultrasonography ; Urinary Bladder ; Uterine Hemorrhage ; Vaginal Discharge

OBJECTIVE: Embryo transfer is a critical step in assisted reproduction. However, the different aspects of the procedure were not fully estimated. The aim of this study is to evaluate the impact of each aspect in the procedure to success of pregnancy. METHODS: Medical records of 525 fresh IVF/ICSI cycles were reviewed retrospectively. All embryo transfers were performed under ultrasonography guidance and after removal of cervical mucus. Assessed primary variables are difficulty of procedure (easy, moderate, and difficult), presence of blood in the catheter, types of catheter (soft or hard) and physician factor, and confounding variables are age of patient, total number of oocytes, number of transferred embryos, the highest grade of embryo, endometrial thickness. Measured outcomes were clinical pregnancy (visible fetal heart beat by ultrasonography) and live-birth rate. Univariate analysis and multivariate analysis by logistic regression test were used. RESULTS: Among the variables of embryo transfer procedure, the difficulty of procedure was the only significant factor influencing both clinical pregnancy (OR: 0.402, 95% CI: 0.205-0.789, easy vs. moderately difficult) and live birth rate (OR: 0.380, 95% CI: 0.178-0.841, easy vs. moderately difficult). The difference between moderately difficult and very difficult procedure was not significant. Presence of blood was significant for live-birth rate (OR: 0.512, 95% CI: 0.267-0.980). Types of catheter and physician factor were not significant factors. CONCLUSION: The difficulty of the transfer procedure and presence of blood in catheter are significant factors influencing ART outcome.
Catheters ; Cervix Mucus ; Confounding Factors (Epidemiology) ; Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro ; Fetal Heart ; Humans ; Live Birth ; Logistic Models ; Medical Records ; Multivariate Analysis* ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Reproduction ; Retrospective Studies ; Ultrasonography

OBJECTIVE: To evaluate the inhibition of Clusterin gene expression via shRNA decreases proliferation and metastasis and increases chemosensitivity to paclitaxel in xenografted PEOH cells. METHODS: 1 x 10(6) paclitaxel resistant cell lines transduced with Clusterin shRNA in lentiviral inoculated subcutaneously into the flank region of 6 to 8 week-old female nude mice. Parental cells transduced with LacZ was used as a control. Tumor growth was measured twice every week and calculated by using the formula: length x width x depth x 0.5236. The mice were sacrificed and examined for Clusterin expression on tumor cells and counted the metastasis sites. RESULTS: shRNA for Cluaterin works in vivo and it is the in accord with the in vitro results. Although shRNA for Clusterin group showed decreased tumor growth and proliferation it has not statistical significance. But transfection of Clusterin shRNA on PEOH significantly increased paclitaxel-sensitivity (P<0.05). CONCLUSION: shRNA targeting of the Clusterin gene decreased the ovarian cancer cell's paclitaxel resistance.
Animals ; Cell Line ; Clusterin* ; Female ; Gene Expression* ; Heterografts* ; Humans ; Mice ; Mice, Nude ; Neoplasm Metastasis ; Ovarian Neoplasms ; Paclitaxel* ; Parents ; RNA, Small Interfering* ; Transfection

OBJECTIVE: To provide clinical information for the best diagnosis and treatment of primary malignant cervical lymphoma based on the information obtained from these cases. METHODS: Between 1989 and 2006, six women with primary malignant cervical lymphoma were diagnosed and treated at our institution. Data were obtained from their medical records and were retrospectively analyzed. RESULTS: The mean patient age at the time of diagnosis was 63 (range 19-74). The chief complaint was vaginal bleeding in five women and the voiding difficulty for one woman. five of six patient had the cervical lesions (erosion and tumoral mass), while the other was non specific cervical findings. The Papanicolaou test was performed on three women, one of whom was HSIL. All six patients were confirmed with cervical lymphoma through the pathologic diagnosis. Surgical treatment (radical hysterectomy with bilateral salpingo- oophorectomy, pelvic lymph node dissection, and para-aortic lymph node dissection) was performed in one case, simple hysterectomy with complementary chemotherapy in two, and chemotherapy in one. Two patients refused treatment. Among four patients treated, one experienced recurrence in an ovary and the others have remained in remission. CONCLUSION: Primary malignant cervical lymphoma is a rare malignancy. Physicians can miss early detection of this disease because of its 'silent' symptoms and very low incidence. The accumulated data regarding this tumor can make it easy to detect at an early stage, thereby allowing it to be successfully treated. Further studies should be conducted to obtain further information regarding the cervical lymphoma.
Cervix Uteri ; Diagnosis ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Lymphoma* ; Medical Records ; Ovariectomy ; Ovary ; Papanicolaou Test ; Recurrence ; Retrospective Studies ; Uterine Hemorrhage

OBJECTIVE: The aim of this study is to determine the efficacy and toxicity of docetaxel in patients with recurrent or persistent epithelial ovarian cancer, previously treated with paclitaxel and platinum combination chemotherapy. METHODS: Forty patients with recurrent or persistent epithelial ovarian cancer, had been treated with docetaxel combination chemotherapy at Asan Medical Center from May 1989 to December 2006. They received docetaxel (75 mg/m2) only or docetaxel (75 mg/m2) and platinum (carboplatin AUC5 or cisplatin 75 mg/m2) on day 1. The administration was repeated every 3 or 4 weeks. The response of patients was evaluated with CA-125 response criteria and RECIST criteria. The toxicities were defined according to the NCI common toxicity criteria. RESULTS: Twenty patients had been evaluated by RECIST criteria and twenty patients had been evaluated by CA-125 response criteria. The overall response rate was 35% (14/40). Eleven patients were belonged to complete response (CR), and three patients were belonged to partial response (PR). The mean response duration (RD) was 11.29 months (4 to 20.7 months) and the mean time to progression (TTP) was 6.91 months (1 to 23 months). The response rate in the platinum-sensitive patients was 38.7% but in the platinum-resistant patients was 22.2%. The platinum-sensitive patients showed more favorable response rate, but that was not significant statistically. Heavily treated group, more than three prior regimens were used, had poor outcome. The common toxicities were alopecia and gastrointestinal toxicities (anorexia and nausea). Bone marrow suppression was the most serious drug toxicity, however, it was tolerable. CONCLUSION: The docetaxel is a considerable 2nd line chemotherapy with acceptable efficacy and toxicity in patients with recurrent or persistent epithelial ovarian cancer previously treated with paclitaxel and platinum combination chemotherapy.
Alopecia ; Bone Marrow ; Chungcheongnam-do ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Ovarian Neoplasms* ; Paclitaxel ; Platinum