: Epithelioid sarcoma is an uncommon mesenchymal malignancy which represents less than 1% of all sarcomas. Rarer still are reports of this tumor initially presenting in the vulva. We report a case of vulvar proximal-type epithelioid sarcoma. : A 52-year-old had a 5-month history of slowly growing papule on the right labia majora. Excision of the mass revealed a tumor composed of large polygonal cells with abundant eosinophilic cytoplasm. An immunohistochemistry panel revealed cytokeratin AE1/AE3 positivity only. She underwent radical vulvectomy with bilateral groin node dissection. The specimen revealed a cream tan, firm, fairly defined mass at the right vulva. Microscopic examination showed a sheet-like growth pattern of large pleomorphic epithelioid cells with large vesicular nuclei and prominent nucleoli. The tumor showed loss of INI1 nuclear expression and absence of CD34 staining. EMA was positive. The case was signed out as proximal-type epithelioid sarcoma of the right vulva. Two months post-operatively, the patient was given concurrent chemotherapy with 5 cycles of cisplatin 40 mg/m2 and 6600 centigray vulvar intensity-modulated radiotherapy. She had no evidence of disease for five months until repeat workup showed tumor recurrence in the perineum. She was subsequently given 6 cycles of gemcitabine 900 mg/m2 and gemcitabine 900 mg/m2 with docetaxel 100 mg/m2. Two months after, repeat workup showed persistent progressive disease in the vulva. She was subsequently given 4 cycles of doxorubicin 60 mg/m2 and is for repeat workup. The immunohistomorphologic features of this tumor, in addition to its unusual location, present a diagnostic challenge. Clues to the diagnosis include an initial presentation as a soft tissue mass and microscopic features showing the presence of epithelioid to spindle cytomorphology with an infiltrative growth pattern. Immunohistochemistry studies revealing the loss of INI1 nuclear expression and expression of epithelial markers would ultimately establish the diagnosis of this rare clinical entity.
epithelioid sarcoma ; vulvar neoplasms ; female urogenital diseases

Population analyses and demographic data have clearly documented the rapid growth of the aging population in recent years. Although the population over 65 currently accounts for approximately 13.2% of the total population in Korea, it is estimated that this number will reach at least 40% by 2060. Aging is associated with a general decline in almost every physiological function of biological systems, including the lower urinary tract. Aging is also known to put individuals at a high risk for urinary tract infections. Geriatric hospitals in Korea have undergone a large expansion in terms of the number of beds and institutions. Many elderly patients in geriatric hospitals suffer from various genitourinary disorders. In particular, voiding dysfunction and urinary tract infections are prevalent comorbidities of other chronic geriatric diseases in patients in geriatric hospitals. Careful monitoring and management can help to reduce those genitourinary problems in elderly patients in geriatric hospitals.
Aged* ; Aging ; Comorbidity ; Female Urogenital Diseases ; Humans ; Korea ; Male Urogenital Diseases ; Urinary Tract ; Urinary Tract Infections

Introduction. Recurrent pregnancy loss is a devastating reproductive problem that affects 5% of couples trying to conceive. Majority of the cases are due to cytogenetic errors. This study determines the prevalence of chromosomal structural abnormalities in Filipino couples who presented with 2 or more pregnancy losses. Methods. Results from chromosomal analysis of couples referred for 2 or more miscarriages done at the Institute of Human Genetics-National Institutes of Health-University of the Philippines, Manila on peripheral blood samples from 1991 to 2010 were restrospectively reviewed. Results. There were 356 couples with a history of 2 or more miscarriages sent for chromosomal analysis from 1991-2010 included in this study. Among these 356 couples, 17 couples (4.8%) were found to be carriers of different chromosomal abnormalies. From a total of 18 cases, there were 13(3.6%) translocations, 1(0.3%) insertion, 2(0.6%) with marker chromosomes, 1(0.3%) pericentric inversion and 1(0.3%) deletion. Conclusion. The overall frequency of chromosomal structural abnormalities among patients with RPL in this study is 4.8% with translocations being the most common type detected. The results of this study are similar to that of previous large-scale studies which have demostrated that parental chromosomal abnormalities are associated with RPL.
Male ; Female ; RECURRENCE ; PREGNANCY ; CHROMOSOME ABERRATIONS ; ABORTION, SPONTANEOUS ; FEMALE UROGENITAL DISEASES AND PREGNANCY COMPLICATIONS ; PREGNANCY COMPLICATIONS ;

Human ; Female ; Adult ; Female urogenital diseases ; radiography ; tomography scanners ; signs and symptoms ; diagnostic imaging

Congenital absence of the uterine cervix and vagina in the presence of a functional endometrium is an extremely rare congenital anomaly. Women born with this anomaly present with collection of blood in the uterine cavity or hematometra, disabling pelvic pain and progressively worsening endometriosis. Presented is a case of a 16 year-old girl with severe pelvic endometriosis and hematometra complicated by cervicovaginal agenesis. She was managed by total abdominal hysterectomy with bilateral salpingectomy, left oophorocystectomyandadhesiolysis. Surgical management of congenital cervicovaginal agenesis remains controversial. The decision to do a conservative surgical procedure or a hysterectomy depends on the clinical profile of the patient, the expertise of the surgeon, the extent of the malformation and its association with other mullerian anomalies.

Human ; Female ; Adolescent ; abnormalities ; Endometriosis ; Female Urogenital Diseases and Pregnancy Complications ; Hematometra

The authors reviewed 729 Pediatric inpatients in this Hospital during 3 years period from Jan. 1978. To Dec. 1980. The results were obtained as follow: 1. The male to female ratio was 2.2:1. 2. Distrstribution of cases as follows:; Infectious and parasitic diseases 39.5%, diases of the respiratory system 23.87% and diseases of the genitourinary system 10.29%, in turn, listed respecteively in decreasing order of frequency. 3. Major leading causes of hospitalization were gastroenteritis(11.11%) and pneumonia(11.11%) of all patients, bronchitis and bronchiolitis(5.76%) and glomerulonepihritstis(5.35%) in turn, listed respectively in decreasing order of frequency. 4. The highest age group was in the 2years-6years and 6years-12years, and the patients in these age group were occupied 23.87% respectively. 5. Seasonal distribution of patients showed high incidence in fall(Sept, Oct, and Nov.). 6. The distribution of duration of hospitalization as follow: Over 8days 26.75%, in 3days 16.87%, and 24 hours-48 hours 13.58% in order of frequency. 7. The mortality rate was 4.12%. Majou leading causes of deaths were pueumonia, sepsis and drug intoxicationin order of frequency.
Bronchitis ; Cause of Death ; Female ; Hospitalization ; Humans ; Incidence ; Inpatients* ; Male ; Mortality ; Parasitic Diseases ; Respiratory System ; Seasons ; Sepsis ; Statistics as Topic* ; Urogenital System

OBJECTIVE: The purpose of this study was to evaluate if the number of normal vaginal deliveries influences lower urogenital system function and the incidence of incontinence. MATERIALS AND METHODS: The POP-Q (Pelvic Organ Prolapse Quantitation) examination was performed in 217 premenopausal women who visited our hospital for routine check up. They were asked to fill in the Bristol female lower urinary tract symptom (BFLUTS) and self-report questionnaire for fecal incontinence and constipation assessment questionnaires. Exclusion criteria included patients with a history of pelvic surgery, BMI >25, chronic lung disease, cardiovascular disease, colon disease or smoking. RESULTS: There was a significant difference between the vaginal delivery group and none vaginal delivery group in the point Aa, Ba, Ap, Bp and Tvl in POP-Q (P<0.05). The patients were classified into four groups (0, 1, 2,above 3) according to the number of vaginal deliveries, and the incidences of fecal incontinence were 4%, 29%, 32%, 26% in each group, respectively. The incidence of fecal incontinence was significantly lower (P<0.05) in those who did not deliver vaginally, while no difference was observed in the number of vaginal deliveries. The BFLUTS-IS (incontinence symptom) score was higher in the patients with higher number of vaginal deliveries (P<0.05). There were also more patients with sexual dysfunction as was shown by the BFLUTS-sex questionnaire (P<0.05) in those patients with higher number of vaginal deliveries. CONCLUSION: We observed that the number of vaginal delivery is significantly associated with the incidence of fecal and urinary incontinence, and also that it was a major cause of disorders of the pelvic floor and sexual dysfunction.
Cardiovascular Diseases ; Colon ; Constipation ; Fecal Incontinence ; Female ; Humans ; Incidence ; Lung Diseases ; Pelvic Floor ; Prolapse ; Surveys and Questionnaire ; Smoke ; Smoking ; Urinary Incontinence ; Urinary Tract ; Urogenital System*

OBJECTIVETo compare the specificity and sensitivity of two genotyping approaches for human papillomavirus (HPV).

METHODHPV DNA was amplified and detected in clinical specimens by polymerase chain reaction in a pair of universal primers MY09/11, and then genotyped with either sequencing method or liquid chip hybridization method (luminex method).

RESULTSequencing method obtained precise genotyping results in single-type HPV infection, while luminex method obtained accurate genotyping results in multiple-type HPV infection.

CONCLUSIONA combined method using both sequencing and luminex method is suitable for the genotyping of HPV-infected specimens.

Base Sequence ; DNA, Viral ; genetics ; Female ; Female Urogenital Diseases ; virology ; Genotype ; Humans ; Oligonucleotide Array Sequence Analysis ; Papillomaviridae ; genetics ; isolation & purification ; Papillomavirus Infections ; virology ; Polymerase Chain Reaction

OBJECTIVES: Diabetic autonomic neuropathy is a common complication of long standing diabetes mellitus and is well known to induce the motor dysfunction of cardiovascular system, genitourinary system and diges tive system. Although many studies have done to eval uate the diabetic autonomic neuropathy, gallbladder motor function and biliary dynamic study to evaluate the change of gallbladder function in diabetic patients is relatively rare. This study was performed to measure the gall bladder ejection fraction using Tc- 99m-DISIDA with fatty meal in order to evaluate the gallbladder motor func tion in diabetic patients and to examine the usefulness of it in analyzing diabetic autonomic neuropathy. METHODS: 51 diabetic patients(males 31, females 18, mean age 57yr(39-77yr)) and 18 control subjects(males 14, females 4, mean aged 47yr(31-70yr)) without gall stone and impaired liver function were enrolled in our study. Also the diabetic patients were categorized by age, disease duration, body weight and diabetic complications such as retinopathy, peripheral neuropathy and cardiovas cular autonomic neuropathy accompanying with or not. RESULTS: 1) Median value and interquartile range of gallbladder ejection fraction(%) were 66%(48-79%) in diabetic pa tients group and 75%(64-80%) in control subjects. There was no statistically significant difference between the two groups, but the mean value of diabetic patients was slightly lower than that of control subjects. 2) There was no significant difference between the two groups in mean value of gallbladder ejection fraction in every age group(P>0.05). 3) Median value of gallbladder ejection fraction in diabetic groups with less than 10 years of duration (both under 5 years and 5 to 10 years groups) was similar to that of control subjects. However in patients whose diabetic conditions last more than 10 years, the median range of gallbladder ejection fraction was significantly lower than that of control subjects(p<0.05). 4) Median range of gallbladder ejection fraction in obese diabetic patients group was significant lower than those of control subjects and non-obese diabetic pa tients(p<0.05). 5) Median value of gallbadder was lower in diabetic patients group with complications like retinopathy, periph eral neuropathy or cardiovascular autonomic neuropathy (p<0.05) in comparison with those of control subjects and diabetic patients group without diabetic complication (p>0.05). Also seven diabetic patients whose gallbladder ejection fraction was reduced under 35% have had at least two diabetic complications. CONCLUSION: We observed that gallbladder ejection fraction of diabetic patients was reduced compared with that of control subjects. This is due to the reduced gallbladder muscle contractility resulting from diabetic autonomic dysfunction. These results suggest that the assessment of gallbladder ejection fraction using 99m- Tc-DISIDA would be useful to diagnose diabetic auto nomic neropathy.
Body Weight ; Cardiovascular System ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Neuropathies ; Female ; Gallbladder* ; Gallstones ; Humans ; Liver ; Meals ; Peripheral Nervous System Diseases ; Radionuclide Imaging* ; Urinary Bladder ; Urogenital System

Herlyn-Werner-Wunderlich syndrome (HWWS) is a very rare congenital anomaly of the urogenital tract involving Mullerian ducts and Wolffian ducts, and is characterized by the triad of uterine didelphys, unilateral obstructed hemivagina and ipsilateral renal agenesis. Generally it is diagnosed at puberty after menarche due to recurrent pelvic pain or abdominal mass. We report 2 cases of female newborns whose fetal ultrasonography (USG) showed unilateral renal agenesis and were diagnosed with HWWS by postnatal evaluation. Both cases were female newborns who were born at term by vaginal delivery. They had no perinatal problems except suspicious findings of unilateral renal agenesis from fetal USG. Abdominal ultrasonography and pelvic MRI were performed after birth, and they were diagnosed with HWWS. The potential complications of this syndrome such as pyosalpinx, pelvic adhesions and increased risk of abortion or infertility can occur, but without complication, the prognosis is very good with simple surgical treatment. If renal agenesis is detected in a fetus or a newborn, possible anomalies of urogenital tract such as HWWS should be considered; and postnatal evaluation should be performed, as a simple surgical treatment before menarche can prevent unnecessary complications of disease.
Congenital Abnormalities ; Female ; Fetus ; Humans ; Infant, Newborn ; Infertility ; Kidney ; Kidney Diseases ; Menarche ; Mullerian Ducts ; Parturition ; Pelvic Pain ; Prognosis ; Puberty ; Ultrasonography, Prenatal ; Urogenital Abnormalities ; Wolffian Ducts