Leiomyomas are the most common mesenchymal tumors of the vulva, which have an extremely low incidence. Although these tumors are known a low grade tumor, they have to be removed immediately to prevent further growing and sarcomatous change in the future. We experienced a case of leiomyoma of the vulva, and reported it with a brief review of literatures.
Incidence ; Leiomyoma* ; Vulva*

OBJECTIVE: To evaluate whether lipopolysaccharide (LPS) modulates the expression of cyclooxy- genase-2 (COX-2) and also whether COX-2 is involved in the LPS induced matrix metalloproteinase-2 (MMP-2) and MMP-9 activation in human trophoblastic (TL) cell line. METHODS: We used the TL (trophoblast-like) cells and evaluated the effect of LPS on expression of COX-2 mRNA and protein and on activities of MMP-2 and MMP-9. Also, we pretreated cell line with LPS and NS398, a COX-2 inhibitor, and compared MMPs activities with LPS only group. In the present study, COX-2 was analyzed by RT-PCR and western blot analysis and gelatin zymography was done for the evaluation of gelatinase activities of MMP-2 and MMP-9. RESULTS: The mRNA and protein expressions of COX-2 were increased by LPS in time- and dose-dependant fashions. COX-2 mRNA expression began to rise from 1 hour of LPS treatment and was increased steadily thereafter. COX-2 protein expression was detected from 1 hour of LPS treatment, but maximally increased by the 3 hours of treatment. LPS also increased MMP-2 and MMP-9 activities in time and dose dependant fashions. Especially, active form of MMP-9 was observed in the high concentration of LPS (>50 microgram/ml). When adding COX-2 inhibitor (NS398) to LPS pretreated cell line, the MMPs activities increased in two or three fold compared to LPS only group. CONCLUSION: Our results suggested that LPS induces expression COX-2 and up-regulates activities of MMP-2 and MMP-9 in trophoblastic cell, but COX-2 although involved in LPS mediated MMP-2 and MMP-9 activation, may act through a different pathway than the commonly known prostaglandin metabolites mediated one.
Blotting, Western ; Cell Line* ; Gelatin ; Gelatinases ; Humans* ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; RNA, Messenger ; Trophoblasts*

No abstract available.
Hypertension, Pulmonary*

OBJECTIVE: The purpose of this study was to evaluate female victims of sexual assault and assess the similarities and differences between them. METHODS: Case files and photographs of 59 women examined at Holy Family hospital for sexual assault during Jan 1, 1991 to Dec 31 2001 were reviewed. RESULTS: The mean age of the patients was 17.12 (+/-11.50). 45 (76.3%) of assailants were strangers to the victims. 35 (59.3%) had genital injuries and 8 (13.6%) needed surgical treatments. No victim was pregnant and 17 (28.8%) was reported to police. CONCLUSION: Sympathetic concern in the treatment of women who come forward to report the experience of sexual assaults will result in more reporting of rape. The victims need to be educated at home, at school, and by their primary care providers to avoid situations in which they could make themselves vulnerable to sexual assault, and they should be taught the importance of immediately reporting their assault and seeking medical care.
Female* ; Humans ; Police ; Primary Health Care ; Rape

OBJECTIVE: Although a common clinical problem, no uniform definition for fear of childbirth has been settled. The purpose of this study was to identify the association of serotonin in labor. METHODS: A prospective study of serotonin and review of the medical records from the department of obstetrics and gynecology, Catholic University of Korea Holy Family Hospital from January 2004 to May confirmed 30 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. Blood sampling of serotonin was done during labor according to cervix dilatation. Sample collection series on patients latent phase (before labor begins S1), active phase (cervix dilatation 3-5 cm S2), second stage (cervix dilatation full S3), third stage (at delivery of placenta within 24 hours S4), cord artery blood (S5) could be administered. Patient were divided into two groups. From this group 17 patients (G1) who were initial serotonin normal concentration (1.5-7.5 ng/mL), and 13 patients (G2) who were initial serotonin high concentration. RESULTS: The concentration of serotonin of G1 were S1-5.8 +/- 0.8 ng/mL, S2-7.2 +/- 2.5 ng/mL, S3-8.5 +/- 3.7 ng/mL, S4-6.5 +/- 1.5 ng/mL, S5-4.9 +/- 1.2 ng/mL. The serotonin concentration of G2 were S1-10.1 +/- 2.7 ng/ mL, S2-11.2 +/- 5.2 ng/mL, S3-10.3 +/- 3.9 ng/mL, S4-11.8 +/- 8.6 ng/mL, S5-5.0 +/- 1.0 ng/mL. CONCLUSION: The association of serotonin in labor was studied that the change of serotonin concentration was determined according to initial serotonin concentration. This difference of initial serotonin concentration will be studied about genetic polymorphism and factor by molecular biology.
Arteries ; Cervix Uteri ; Diagnosis ; Dilatation ; Female ; Gynecology ; Humans ; Korea ; Medical Records ; Molecular Biology ; Obstetrics ; Parturition ; Placenta ; Polymorphism, Genetic ; Pregnancy ; Prospective Studies ; Serotonin*

OBJECTIVE: To study the clinical characteristics of ovarian tumors accompanied with pregnancy. METHODS: A review was performed of 310 cases of ovarian tumors surgically resected during pregnancy from January 1990 to December 2001. RESULTS: The incidence of ovarian tumor in pregnancy was one in 181.5 deliveries and that of malignant neoplastic tumor was one in 6,251 deliveries. Among 310 cases undergoing ovarian surgery, tumor-like lesions were 110 cases (35.5%), benign tumors were 191 cases (61.6%), and malignant tumors were 9 cases (0.3%), respectively. One hundred and twenty cases of dermoid cyst (38.7%) occured most frequently, followed by 47 cases of corpus luteal cyst (15.2%), and 40 cases of simple cyst (12.9%). One hundred and ninety nine cases (64.2%) of ovarian tumors were greater than 6 cm in diameter and 189 cases (61%) were preoperatively diagnosed in 1st trimester, and 62 cases (20%) were detected incidentally during cesarean section. In complicated cases, the torsion of ovarian tumor was found in 48 cases (71.6%), the cases of rupture were 16 (23.9%), and misdiagnosed cases as appendicitis were 3 (4.5%). According to outcome of pregnancy, abortions were 19 cases (6.1%), vaginal deliveries were 43 cases (13.9%), and cesarean sections were 169 cases (53.5%). CONCLUSION: Although the incidence of malignant ovarian tumor is low, the overall incidence of ovarian tumor in pregnance is increasing. Because ovarian tumors complicating pregnancy are often entirely unsuspected, careful examination of all pregnant women in early pregnancy must be considered.
Appendicitis ; Cesarean Section ; Dermoid Cyst ; Female ; Humans ; Incidence ; Pregnancy* ; Pregnant Women ; Rupture

Cloacal anomalies are very rare congenital malformations with the incidence of 1/50,000-250,000 births. Hydrocolpos involves the dilatation of the vagina due to obstruction of the genital tract, leading to accumulation of secretions. Because of wide spectrum of abnormal anatomy involving urogenital and gastrointestinal systems, prenatal diagnosis is difficult. As ultrasound becomes more and more reliable, prenatal diagnosis is possible as early as in the second trimester. The presence of prenatally detected hydro (metro) colpos warrants a systematic evaluation of fetal and neonatal anatomy to rule out a large variety of possibly associated malformations or syndromes. We present a case of urogenital sinus maldevelopment which was initially presented as a fetal ascites.
Ascites ; Dilatation ; Female ; Humans ; Hydrocolpos ; Incidence ; Parturition ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Ultrasonography* ; Vagina

This is a very important differential diagnosis for postpartum hemorrhage following cesarean delivery because repeated life-threatening bleeding may induce multiple blood transfusion and require emergency surgery including hysterotomy. False or pseudoanuerysm can be acquired in association with trauma, previous surgery, trophoblastic disease, neoplasm, infection or diethylstilbestrol exposure. When a punctured or lacerated artery does not seal completely, blood may escape and dissects the adjacent tissues, and collects in perivascular areas. If this collection maintains in communication with the parent vessel, a pseudoaneurysm could result. Typically the lesion are discovered because the patients have symptoms related to delayed rupture of the pseudoaneurysms, causing hemorrhage. Radiographic techniques (angiography, ultrasound, and magnetic resonance imaging) have provided the opportunity to diagnose pseudoaneurysm, arteriovenous malformation. We report a case of postpartum hemorrhage following cesarean delivery attributed to a pseudoaneurysm of the uterine pedicle and treated with arterial embolization. Angiographic study confirmed the diagnosis and embolization of the false aneurysm was successful in controlling the hemorrhage.
Aneurysm, False* ; Arteries ; Arteriovenous Malformations ; Blood Transfusion ; Cesarean Section* ; Diagnosis ; Diagnosis, Differential ; Diethylstilbestrol ; Emergencies ; Female ; Hemorrhage ; Humans ; Hysterotomy ; Parents ; Postpartum Hemorrhage* ; Postpartum Period* ; Pregnancy ; Rupture ; Trophoblasts ; Ultrasonography ; United Nations

OBJECTIVE: The purpose of this study is to evaluate the clinical and pathological characteristics of granulosa cell tumor of the ovary. METHODS: Between 1990 and 2000, 27 patients with granulosa cell tumor of the ovary treated in the Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea were identified and reviewed retrospectively for patient profiles, International Federation of Gynecologists and Obstetricians (FIGO) disease stage, mode of therapy, and length of survival. RESULTS: The median age at diagnosis was 43.9 years (range 9-75 years). Tumors were 70.3% (19/27) stage I, 7.5% (2/27) stage II, 11.1% (3/27) stage III, and 11.1% (3/27) stage IV. There was a 15% association between granulosa cell tumor and endometrial hyperplasia. All patients underwent cytoreductive surgery, and 14 patients followed by postoperative chemotherapy. One patient received adjuvant pelvic radiotherapy and 3 patients were treated with adjuvant pelvic radiotherapy and chemotherapy. The survival rate in stage I was 100.0% after 5 years, and in stage II-IV was 62.5% after 5 years. Overall survival was 88.8% at 5 years. Mitotic index influenced the survival rate; with less 10/10 HPF the survival was 100% in 5 years, and with more or equal 10/10 HPF the longest survival was 44 months. CONCLUSION: Although most granulosa cell tumors of the ovary are slow growing, wide variation is possible, with high mitosis counts leading to a worse prognosis. However, it is difficult to predict early or late recurrences using pathologic parameters. It is therefore important that patients with theses tumors are followed up indefinitely.
Diagnosis ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Gynecology ; Humans ; Korea ; Mitosis ; Mitotic Index ; Obstetrics ; Ovary* ; Prognosis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate

OBJECTIVE: We studied to investigate whether nitric oxide (NO) and IL-1beta modulate MMP-2 and MMP-9 using TL cell line obtained from the normal term placenta. METHODS: After culturing TL cell line for 4 hours, we treated 0.1 mM of SNAP (NO donor) and 50 ng/ml of IL-1beta for 0, 1, 3, 6, and 12 hours, for investigating changes from time. We treated SNAP of 0, 0.01, 0.1, and 0.5 mM for 12 hours and IL-1beta of 0, 1, 10, and 50 ng/ml, for investigating changes from concentration. After extraction of total RNA, we performed reverse transcriptase-polymerase chain reaction (RT-PCR), gelatine zymography and Western blot analysis, for investigating expression of MMP-2 and MMP-9. RESULTS: MMP-9 was not observed in TL cell line. The expressions of MMP-2 mRNA and protein were gradually increased according to the culture time in SNAP treated group. The expressions of MMP-2 mRNA and protein were gradually increased according to the culture time in IL-1beta treated group. The expression of MMP-2 protein was not more increase in SNAP/IL-1beta-treated group than in IL-1beta treated group. The expression of MMP-2 protein was more reduced in SNAP/hemoglobin treated group than in SNAP treated group. MMP-2 protein activity was only increase in SNAP treated group. CONCLUSION: These results indicate that NO, rather than IL-1beta, upregulates the MMP-2 in TL cell line and furthermore may influence in the invasive process of trophoblasts.
Blotting, Western ; Cell Line* ; Gelatin ; Interleukin-1beta* ; Matrix Metalloproteinase 2* ; Nitric Oxide* ; Placenta ; RNA ; RNA, Messenger ; S-Nitroso-N-Acetylpenicillamine ; Trophoblasts