A 35 year old woman, gravid 5, multiparous, was admitted to our department at 6 weeks and 5 days of gestation after being diagnosed with cervical pregnancy. Before the evacuation, the uterine arteries were embolized using angiographic techniques. As a result, dilatation and curettage were performed with minimal hemorrhage. We report one case of cervical pregnancy managed, successfully with preoperative uterine artery embolization and evacuation.
Adult ; Dilatation and Curettage ; Female ; Hemorrhage ; Humans ; Pregnancy* ; Uterine Artery Embolization* ; Uterine Artery*

No abstract available.
Teratoma*

No Abstract Available.
Arthroplasty* ; Knee*

OBJECTIVES: Leptin is a 16-kD protein encoded by the ob/ob gene and represent the amount of body fat. In pregnancy, it is thought to act in intrauterine fetal growth and energy metabolism. In this study, we investigated the effect of gestational age, fetal sex, maternal body mass index (BMI), and fetal weight estimated by ultrasound on amniotic fluid and maternal serum leptin levels at mid-trimester, respectively. METHODS: Amniotic fluid and maternal blood sampling were collected from women who was performed for genetic amniocentesis at mid-trimester (n = 26). Leptin concentrations were measured by a specific radioimmunoassay (RIA) employing human recombinant leptin. Mean gestational age was 18.19+/-1.77 weeks. Mean maternal BMI was 23.83 +/-5.12kg/m2. Male fetus was 10, and female 16. Mean fetal weight estimated by ultrasound was 254.42+/-83.80gm. RESULTS: Mean maternal leptin level( 12.49+/-4.46 ng/mL) was significantly higher than mean amniotic leptin level(5.06+/-3.20 ng/mL)( p = 0.0001) at mid-trimester. But there was no significant correlationship between maternal and amniotic leptin levels( p = 0.1376). Maternal leptin concentrations at mid-trimester were correlated positively with maternal BMI(y = 2.24 + 0.43 x, R2 = 0.494, p = 0.0103). In contrast, leptin levels in amniotic fluid did not correlate with maternal leptin levels, gestational age, fetal sex, maternal BMI, and fetal weight estimated by ultrasound respectively. CONCLUSION: Maternal leptin level was higher than amniotic leptin level and could represent maternal fat mass. It was suggested that amniotic leptin level was not associated with several factors such as maternal, fetal, and amniotic factors.
Adipose Tissue ; Amniocentesis ; Amniotic Fluid* ; Body Mass Index ; Energy Metabolism ; Female ; Fetal Development ; Fetal Weight* ; Fetus ; Gestational Age* ; Humans ; Leptin* ; Male ; Pregnancy ; Radioimmunoassay ; Ultrasonography*

Malignant germ cell tumors of the ovary are uncommon neoplasms. Although 20-25% of all ovarian tumors are derived from germ cells, only about 3% of germ cell tumors are malignant. Mixed germ cell tumors contain at least two malignant germ cell elements. These lesions should be managed with combination chemotherapy, preferably BEP. Recently we experienced a case of mixed germ cell tumor with 6 components of germ cell and sarcomatous change in a 11 year old girl. Preoperative CA-125, B-hCG, aFP, LDH, a-1-antitrypsin were elevated and the final pathologic report was mixed germ cell tumor composed of endodermal sinus tumor, embryonal carcinoma, mature and immature teratoma, choriocarcinoma, dysgerminoma and sarcomatous change, Postoperative chemotherapy with 6 courses of BEP regimen was performed and all tumor markers became normal after 4 courses of chemotherapy. What we interested in this case was several components of germ cells and sarcomatous change and the sarcomatous change might be derived from the mature cystic teratoma component, so we present this case with a brief review of the literatures here.
Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pregnancy ; Teratoma ; Biomarkers, Tumor

PURPOSE: In order to evaluate microstructural changes after shock wave exposure, gross, light microscopic and transmission electron microscopic findings were analyzed with rabbit gallgladders. MATERIALS AND METHODS: A preliminary study(2 rabbits) was performed to determine the dosage intensity of shock waves needed to inflict damage, using a EDAP LT 01 piezoelectric extracorporeal shock wave Iothotriptor. The gallbladders of three different groups of rabbits were given shock waves of various intensity. A storage value of 100, 50, 25 at rate of 20/sec under 80% power were given to group I (4 rabbits), group II( 4 rabbits), and group III(3 tabits), respectively. The rabbits were sacrified 6--12 hours later. RESULTS: The observed pathologic changes in the transmission electron microscopy were vaculization of cytoplasm and swelling of epithelial cells with dilatation and structural alteration of intracellular organelles, especially endoplasmic reticulum. Cell membrane rupture and necrosis were observed at the markedly affected area. The structural changes of intracellular organelles were minimally found at a storage value of 25. However, above pathologeic changes with dilatation and structural alterations of endoplasmic reticulums were more profund at value of 100. CONCLUSION: Early histologic changes induced by shock waves are dose dependent and the findings of cellular damage caused by ESWL might be explained as above.
Cell Membrane ; Cytoplasm ; Dilatation ; Endoplasmic Reticulum ; Epithelial Cells ; Gallbladder* ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rabbits ; Rupture ; Shock*

OBJECTIVES: Apathy Evaluation Scale (AES) is one of the most frequently used scales to evaluate apathy. The purpose of this study was to evaluate the reliability and validity of the Korean version of the AES (K-AES) and to apply the K-AES in examining the characteristics of apathy in the Korean patients with schizophrenia. METHODS: 129 healthy people and 29 patients with schizophrenia have been evaluated using the K-AES, Physical Anhedonia Scale (PAS), Social Anhedonia Scale (SAS), and the Beck's Depression Inventory (BDI). Split-half reliability and internal consistency were evaluated and factor analysis and correlation analysis was conducted. Between-group comparison was conducted using independent sample t-tests. RESULTS: K-AES showed good reliability and validity. Factor analysis confirmed 3 factors, which represented interest and drive, initiative, self-awareness and self-assessment. Patients with schizophrenia showed significantly higher K-AES and BDI scores than the healthy group. K-AES scores in patients with schizophrenia were significantly correlated with the PAS score, but did not correlate with SAS and BDI scores. CONCLUSION: This study demonstrates the reliability and validity of the K-AES. Our findings also suggest that the K-AES may be a reliable instrument in assessing apathy as a negative symptom in patients with schizophrenia.
Anhedonia ; Apathy* ; Depression ; Factor Analysis, Statistical ; Humans ; Reproducibility of Results* ; Schizophrenia* ; Self-Assessment ; Weights and Measures

Intra-abdominal lymphangiomas are a rare entity. We report a case of cystic lymphangioma arising from the mesoappendix of a 21-year-old female patient. Barium enema examination revealed a pliable submucosal lesion at the cecal base, without contrast filling in the appendiceal lumen. US and CT demonstrated a multiseptated cystic mass in the pericecal and periappendiceal areas.
Barium ; Enema ; Female ; Humans ; Lymphangioma ; Lymphangioma, Cystic* ; Young Adult

OBJECTIVE: Patients with bipolar disorder have attention deficit during even euthymic status. Bipolar disorder patients showed more childhood attention deficit and other ADHD like feature. Alpha 7 nicotinic receptor (CHRNA7) gene has been known to play roles in attention and sensory gating, and association between CHRNA7 gene and bipolar disorder has been reported. Therefore, we investigated a possible association between childhood attention deficit of bipolar disorder and CHRNA7 gene polymorphisms. METHODS: We included 122 patients with bipolar disorder (89 subjects of bipolar disorder type I, 33 subjects of bipolar disorder type II). Childhood attention deficit was measured by Wender Utah Rating Scale (WURS). Factor analysis was done for WURS to extract inattention factor from childhood ADHD like feature. Three factors were extracted: Impulsivity, Inattention, and Mood instability. All subjects were ethnically Korean. Genotyping was done for three intronic Single Nucleotide Polymorphism (SNPs) of CHRNA7 gene: rs2337506 (A/G), rs6494223 (C/T), and rs12916879 (A/G). Analysis of association was done by UNPHASED version 3.1.4, a free software for genetic statistics. RESULTS: Genetic association tests found no association between factor score of inattention and any SNP or combination of SNPs of CHRNA7. Positive association between WURS total score and SNP rs6494223 (p=0.043), factor score of impulsivity and SNP rs2337506 (p=0.038) as well as SNP rs6494223 (p=0.043) was revealed. These positive associations were survived after 1,000 permutation tests. Combination of SNPs association tests performed for total WURS and factor scores could not find any significant association. CONCLUSION: We could not find association between CHRNA7 gene and childhood attention deficit in bipolar disorder. However, we found CHRNA7 gene involved in childhood impulsivity of bipolar disorder, another ADHD like feature. Further studies with larger sample and denser polymorphisms are necessary to clarify genetic role of CHRNA7 in attention and impulsivity of bipolar disorder.
Bipolar Disorder ; Humans ; Introns ; Polymorphism, Single Nucleotide ; Receptors, Nicotinic ; Sensory Gating ; Utah

PURPOSE: To study the CT patterns of left lobar atrophy, including pathologic and hemodynamic features, incases of primary biliary disease. MATERIALS AND METHODS: CT findings of left hepatic lobar and segmental atrophyin 26 patients with histologically or radiologically-proven underlying bile-duct disease were reviewed. Seventeen cases were oriental cholangiohepatitis (OCH) with left intrahepatic stones and nine were cholangiocarcinomainvolving the hilar or left hepatic bile duct. The distribution and appearance of atrophy and adjacent lobarhypertrophy were studied. CT scans were examined for the presence of stenosis or obstruction of the left portalvein, and the enhancing pattern of lobar atrophy was analysed. In patients who had undergone left lobectomy, themechanism of lobar atrophy was correlated with radiographic and pathologic features. RESULTS: All patients showedbile duct dilatation localized to atrophic left hepatic segments. In cholangiocarcinoma, the distribution ofatrophy was characteristically lobar, in contrast to segmental distribution in OCH. Compensatory hypertrophy wasmore common in OCH and particularly involved the caudate lobe. Organic and functional occlusion of the left portalvein was a cause of atrophy, even in OCH. Periportal fibrosis and inflammation were the main pathological featureof atrophy. On spiral CT scan, delayed enhancement of atrophic liver parenchyma was the characteristic feature. CONCLUSION: Lobar or segmental left hepatic lobe atrophy is seen in bile duct disease caused by OCH orcholangiocarcinoma. This finding suggests that the disease process is advanced, and that there is obstruction ornarrowing of the left portal vein, associated with periportal fibrosis and inflammation.
Atrophy* ; Bile Duct Diseases ; Bile Ducts ; Biliary Tract Diseases* ; Biliary Tract* ; Cholangiocarcinoma ; Cholangitis ; Constriction, Pathologic ; Dilatation ; Fibrosis ; Hemodynamics ; Humans ; Hypertrophy ; Inflammation ; Liver ; Portal Vein ; Tomography, Spiral Computed ; Tomography, X-Ray Computed