46,X,inv(Y)/45,X mosaicism is a extremely rare sex chromosomal disorder. We experienced an unusual mosaic Turner syndrome case in a 29-years old Korean woman with a phenotypic female, primary amenorrhea and immature secondary sexual characteristics. Cytogenetic analysis including GTG banding revealed 46,X,inv(Y)(q11.2q12?)[15]/45,X[35] mosaicism, and X/Y chromosome Fluorescence in situ hybridization (FISH) analysis result was ish (SRY-,DYZ3-)[16]/ ish der(Y)del(Y)(q12)inv(Y)(p11.3q12)(SRY sp, DYZ3-)[4] and its meaning was coexistence of microdeletion and inversion of Y chromosome. To our knowledge, this karyotype may be a very rare variant of Turner syndrome, and we report this case with brief review of related literature.
Adult ; Amenorrhea ; Chromosome Disorders ; Cytogenetic Analysis ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Karyotype* ; Mosaicism ; Turner Syndrome* ; Y Chromosome*

Abdominal pregnancy is a rare form of ectopic pregnancy, which has been classified as early and advanced abdominal pregnancies. In case of early abdominal pregnancy, we may miss the diagnosis because the symptoms and clinical characteristics are non-specific. However, recently, the early diagnosis is made because of the development of quantitative beta-hCG measurement, transvaginal ultrasonography and the development of laparoscopy. Omental pregnancy is a very rare form of abdominal pregnancy, which is hard to detect early. When ruptured, it accompanies with massive hemorrhage. So, early diagnosis and treatment is essential to prevent high morbidity, mortality and serious complications. Definite diagnosis is made by cytopathologic examination of tissue specimen after surgery. We have experienced a case of ruptured early omental pregnancy and reviewed it briefly.
Diagnosis ; Early Diagnosis ; Female ; Hemorrhage ; Laparoscopy ; Mortality ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic ; Ultrasonography

BACKGROUND AND OBJECT: Cheiro-oral syndrome (COS) is characterized by a sensory disturbance in the unilateral hand and ipsilateral mouth corner. It is usually due to a lesion in the parietal cortex, thatamocortical projections, thalamus, or rarely brain stem. However, the syndrome is relatively unknown and rarely mentioned in most neurological textbooks. We presented ten cases of COS with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible site. METHODS AND RESULTS: We studied 10 patients with stroke who showed restricted sensory disturbance on the one hand and ispilateral mouth. The study forms consisted of clinical manifestaion, neurological examination, electrophysiological, and neuroradiologic studies. Computed tomography and/or magnetic resonance imaging identified lesion in the thalamus in 5, brain stem in 3, and corona radiata in 1 patient. But, the anatomical responsible site for one case was not founded. Infarction had occurred in nine cases and hemorrhage in one. Seven of the 10 patients showed sensory disturbances restricted to the perioral area, hands, fingers when they were first examined; the remaining patients complained more diffuse sensory disturbances at first, but it had become restricted to perioral and fingers, usually within 2-3 weeks. The durations of symptom varied from 5 days to more than 15 months and these symptoms were improved within 2-3 weeks to 4 months in treated patients. CONCLUSION: When the symptoms and signs of the COS were presented, especially if a history of migraine is lacking, neuroradiological methods such as CT or MRI should be undertaken to localize and diffentiate the nature of lesion.
Brain Stem ; Fingers ; Hand ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Migraine Disorders ; Mouth ; Neurologic Examination ; Rabeprazole ; Stroke ; Thalamus

Ovarian pregnancy is comparatively rare form of ectopic pregnancy. Although earlier diagnosis is now possible due to the availability of quantitative beta-hCG measurement and the development of transvaginal ultrasonograghy, it is mostly difficult to diagnosis before surgery, and frequently misdiagnosed as a ruptured corpus luteum accompanied with massive hemoperitoneum. Definite diagnosis is made only by cytopathologic examination of tissue specimen. The treatment of ovarian pregnancy has been operative management including oophorectomy, salpingo-oophorectomy and ovarian wedge resection. But recently conservative management using laparoscopic technique has become the preferred treatment. We have experienced a case of primary ovarian pregnancy and reviewed it briefly.
Corpus Luteum ; Diagnosis ; Female ; Hemoperitoneum ; Ovariectomy ; Pregnancy ; Pregnancy, Ectopic*

OBJECTIVE: The objective of this study is to evaluate the safety and the clinical efficacy of the laparoscopic myomectomy through analyzing several operation factors. METHODS: There were 185 cases of laparoscopic myomectomy between January 2004 and December 2008 at the department of obstetrics and gynecology in Hanyang University Guri Hospital. Retrospectively many factors of the operation were analyzed. The factors include the size, number and type of the myoma, BMI (body mass index), operation method, operation time, and complication and the prognosis of the operation. RESULTS: For the type of myomas, 115 (62.2%) cases were intramural myomas, 38 (20.5%) cases were subserosal types and 32 (17.3%) cases were mixed types. The average diameter of the biggest myoma was 6.67+/-0.16 cm (range, 2.5~15 cm) and the average number of the myoma was 2.07+/-0.15 (range, 1~15). Previous operation history and pelvic adhesion did not show correlation with the operation time. The size, type and number of myoma and the operation methods showed correlation with the operation time. According to myoma size and number, we divided the cases into two groups, low risk group (122 cases) and high risk group (63 cases). The analysis showed that post-operation hemoglobin drop (2.89+/-0.10 g/dL vs. 4.03+/-0.23 g/dL) and blood transfusion amount (2.89+/-0.10 pints vs. 4.03+/-0.23 pints) as well as the operation time (137.58+/-4.37 min vs. 193.73+/-9.88 min) showed noticeable increase in the high risk group. CONCLUSION: This statistics show that laparoscopic myomectomy is now being applied to patients with larger and more myomas. Factors affecting operation time were the weight of myomas, number of myomas, type of myomas, number of trocars and methods of resected myomas removal. Also, operation time and post-operative hemoglobin drop increased in the high risk group.
Blood Transfusion ; Gynecology ; Hemoglobins ; Humans ; Laparoscopy ; Myoma ; Obstetrics ; Prognosis ; Retrospective Studies ; Surgical Instruments

The mature cystic teratoma of the omentum is a very rare tumor. It is generally believed that autoamputation and reimplantation of an ovarian tumor is the most common etiology of omental teratoma. Abdominal pain is the main presenting symptom of these tumors. A 41-year-old woman was admitted for pelvic mass. At laparotomy, a 8.5 x 7.0 x 7.5 cm mass was found in the pelvic cavity, attached to the omentum with adhesion to bladder. The histopathologic diagnosis was mature cystic teratoma in conjunction with the cyst wall is diffusely necrotic and calcified with hairs. The absence of the left ovary suggested that the tumor underwent autoamputation and reimplantation on the omentum. We report the case with a brief review of literature.
Abdominal Pain ; Adult ; Diagnosis ; Female ; Hair ; Humans ; Laparotomy ; Omentum* ; Ovary ; Replantation ; Teratoma* ; Urinary Bladder

Granulosa cell tumors are relatively low-grade malignancies accounting for about 1 to 2% of all primary ovarian neoplasms and have an indolent growth pattern. There are two types of tumors, adult type granulosa cell tumor (AGCT) and juvenile type granulosa cell tumor (JGCT), and each tumor reveals different clinical or histopathological features. The clinical manifestations are mostly associated with estrogen produced by tumor, which are vaginal bleeding or menstrual irregularity in AGCT and precocious puberty in JGCT. Although most patients are diagnosed in early stage with favorable prognosis, some recur after several years. So, continuous follow up is required. Recently, we experienced two cases of adult type granulosa cell tumor and report with a brief review of literatures.
Adult ; Estrogens ; Female ; Follow-Up Studies ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Ovarian Neoplasms ; Ovary* ; Prognosis ; Puberty, Precocious ; Uterine Hemorrhage

BACKGROUND: Inhaled nitric oxide (NO) therapy causes selective pulmonary vasodilation in patients with pulmonary hypertension. However, attempts to discontinue inhaled NO may be complicated by abrupt life-threatening rebound pulmonary hypertension (RPH). The purpose of this study was to determine the risk factors to develop RPH and to present the adequate weaning methods. METHODS: We studied 19 consecutive children who were treated with inhaled NO because of pulmonary hypertension after surgery for congenital heart disease. We compared the dose of NO at the time of start and withdrawal, the duration of weaning and treatment, hemodynamic data, and blood gas analysis before inhaled nitric oxide withdrawal, between patients without (group I, n = 13) and with RPH (group II, n = 6). RESULTS: Compared with group I, group II patients were older in age (1204 1688 versus 546 1654 days, P < 0.05), had a lower NO concentration just before withdrawal (3 +/- 1.6 versus 5 +/- 2.6 ppm, P <0.05), a shorter duration of NO weaning period (4 +/- 3.3 versus 15 +/- 13.4 hours, P < 0.05) and received NO therapy for a shorter duration (26 +/- 11.6 versus 57 +/- 46.0 hours, P < 0.05). CONCLUSIONS: We recommend a progressive withdrawal of inhaled nitric oxide to avoid life-threatening RPH observed in the sudden discontinuation.
Blood Gas Analysis ; Child ; Heart Defects, Congenital* ; Hemodynamics ; Humans ; Hypertension, Pulmonary* ; Nitric Oxide* ; Risk Factors ; Vasodilation ; Weaning