OBJECTIVES: To investigate the number of leiomyoma patients-exposed to bisphenol A (BPA) and to observe whether the serum concentration of BPA is related to leiomyoma growth. METHODS: A total of 158 patients were recruited for this study. Leiomyoma patients were divided into three groups, mild (n = 48), moderate (n = 32) and severe (n = 28), according to the size of leiomyomas. The control (n = 30) group was defined as having no leiomyomas. Transvaginal ultrasonography was used to identify and measure the leiomyomas. Serum BPA concentrations were measured by enzyme-linked immunosorbent assay. RESULTS: BPA was detected in 87.0% out of a total of 158 samples, and in 86.0% out of 108 leiomyoma patients. In detail, the detection rates of serum BPA were 88.0% in the control group, 77.2% in the mild group, 90.0% in the moderate group and 96.0% in the severe group. The mean BPA concentration in the control group was 0.558 +/- 0.097 ng/mL, the leiomyoma groups, the mean BPA concentrations were 0.274 +/- 0.063 ng/mL (mild), 0.346 +/- 0.064 ng/mL (moderate) and 0.647 +/- 0.039 ng/mL (severe) (P = 0.0003). Values represent the mean +/- standard error. CONCLUSION: The detection rates of serum BPA in the control and leiomyoma groups were 88.0% and 86.0%, respectively. However, there was no significant difference in the serum BPA concentrations between the control and leiomyoma groups. To verify the effect of BPA on leiomyoma growth, a close and sequential monitoring is recommended for people who are at risk for uterine leiomyoma.
Endocrine Disruptors ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Leiomyoma* ; Ultrasonography ; Uterus

PURPOSE: To date, the benefits of central neck node dissection (CND) in patients with differentiated thyroid carcinoma (DTC) have not been clearly demonstrated and must be considered against the potential risks of the procedure. However, recent papers suggest that lymph node metastasis exerts a significant influence on survival and is associated with a higher risk of recurrence. The purpose of our study was to assess the recurrent laryngeal nerve and parathyroid risks of CND following total thyroidectomy in patients with DTC and to compare the results with those obtained in patients who underwent total thyroidectomy only. METHODS: We retrospectively analysed 143 consecutive patients with DTC (116 with papillary, 24 with follicular, and 3 with Hurthle cell carcinoma) operated on by a single experienced endocrine surgeon from January 1989 to January 1999. There were 61 total thyroidectomies with CND (Group 1) and 82 total thyroidectomies only (Group 2). Group 1 patients displayed evidence of macroscopic lymph node invasion during surgery. The definitions of the two main complications in the thyroid surgery were as follows: transient and permanent recurrent laryngeal nerve palsy (persisting hoarseness over six months after thyroidecomy), transient and permanent hypoparathyroidism (non-recovery of normal parathyroid function and calcemia below 8.0 mg/dl over six momths after thyroidectomy). RESULTS: There was no difference observed in the demographic data between the two groups. Three cases (4.9%) of transient hypocalcemia were detected in Group 1 and two cases (2.4%) in Group 2. Five cases (8.2%) of transient nerve palsy were presented in Group 1 and one case (1.2%) in Group 2. However, there was no significant statistical difference between the two groups (p=0.051). None of the patients demonstrated permanent nerve palsy. CONCLUSION: Following total thyroidectomy for DTC, CND does not increase the morbidity of parathyroid gland and recurrent laryngeal nerve. Therefore, in order to decrease the incidence of regional recurrence and avoid the risk of reoperation in the central neck area, we recommend cervical neck node dissection from the central neck compartment concomitant with total thyroidectomy when overt lymph nodes are palpated.
Hoarseness ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Incidence ; Lymph Node Excision* ; Lymph Nodes* ; Neck* ; Neoplasm Metastasis ; Paralysis ; Parathyroid Glands ; Recurrence ; Recurrent Laryngeal Nerve ; Reoperation ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Vocal Cord Paralysis

We report here on a case of a recurrent left anterior neck infection and focal left suppurative thyroiditis that were associated with a congenital pyriform sinus fistula (PSF) in an 18-year-old male. Acute suppurative thyroidits is a very rare clinical condition and it is usually caused by infection that's derived from infected perithyroidal tissue or a congenital internal fistula. The PSF can lead to recurrent episodes of neck inflammation and abscess, and it is the most common cause of acute suppurative thyroiditis in young man. In this current case, the CT scan showed an air-containing tract of a PSF from the left pyriform sinus to the left thyroid gland and the perithyroidal soft tissue. The CT scan also showed a neck inflammatory infiltration or abscess along the course of the sinus tract. The focal low density of the thyroid parenchyma was seen and this was suggestive of suppurative thyroiditis. Barium esophagography demonstrated the fistulous tract in the PSF. We performed laryngoscopy, and the internal opening of the pyriform sinus fistula was successfully cauterized with AgNO3 and the post procedure course was fair. When an air-containing tract and a recurrent inflammatory infiltration or abscess are present at the left anterior neck with including the thyroid and perithyroidal soft tissue, a PSF should be strongly suspected.
Abscess ; Adolescent ; Barium ; Fistula* ; Humans ; Inflammation ; Laryngoscopy ; Male ; Neck ; Pyriform Sinus* ; Soft Tissue Infections* ; Thyroid Gland* ; Thyroiditis ; Thyroiditis, Suppurative ; Tomography, X-Ray Computed

Peritoneal trophoblastic implant can occur after treatment of ectopic pregnancy. Similarly, after termination of intrauterine pregnancy, trophoblastic implants are rare but can be a complication of perforation during dilatation and curettage. We report an extremely rare case of trophoblastic implant on the myometrium, ovarian surface, and peritoneal wall 4 months after uncomplicated dilatation and curettage. To the best of our knowledge, this is the first case of peritoneal trophoblastic implant following dilatation and curettage without uterine perforation. Knowledge of this case is useful for the management of patients with persistent low-level elevation of serum human chorionic gonadotropin after termination of pregnancy.
Animals ; Chorionic Gonadotropin* ; Dilatation and Curettage ; Female ; Humans* ; Mice ; Myometrium ; Pregnancy* ; Pregnancy, Ectopic ; Trophoblasts* ; Uterine Perforation

OBJECTIVE: Arsenic trioxide (As2O3) is known to have potent anti-vascular activity and significantly suppress solid tumor growth. The present study was conducted to investigate the vascular shutdown effects of a novel arsenic compound, tetraasrsenic oxide (As4O6), in comparison with As2O3 using cervical cancer animal model. METHODS: Mice tumor challenge model was used C57BL/6 mice transplanted with TC-1 cells. After the growth of tumors was reached up 200~250 mm3, mice were divided into 3 groups randomly for control and treatment of either As2O3 or As4O6. As2O3 and As4O6 was treated by i.p. injection. The tumor size was caliperated in twice for weeks and anti-vascular effect were assessed by Evans blue extraction assay and Hoechst 33342 staining. In tumor tissue, histopathological feaure was obserevd by hematoxylin and eosin (H&E) staining. RESULTS: In mice treated with either As2O3 and As4O6 (i.p.), both of As2O3 and As4O6 was significantly suppressed the tumor growth compared with control group. Moreover, effect of As4O6 is more pronounced. These tumor growth inhibition is led to the massive necrosis and vacular shutdown in tumor tissue. CONCLUSION: This study suggests that As4O6 may have potential anticancer activity via vascular shutdown in C57BL/6 mice transplanted with TC-1 cells.
Animals ; Arsenic ; Arsenicals ; Benzimidazoles ; Eosine Yellowish-(YS) ; Evans Blue ; Hematoxylin ; Mice ; Models, Animal ; Necrosis ; Oxides ; Transplants ; Uterine Cervical Neoplasms

OBJECTIVES: After Women's Health Initiative (WHI) study had been published, the use of hormone therapy (HT) have been decreasing even though it is the most effective therapy for menopausal symptom. The survey was conducted to investigate Korean menopausal women's perception of HT and behavior when they are treated by HT. METHODS: During 4 weeks from September 2009 to October 2009, total 600 women aged 45~64 participated in the survey by face to face interview. Out of answering women, women who have visited clinic/hospital at least 1 time to treat their menopausal symptom during last 1 year were included. One hundred fifty women for each age group, 45~49, 50~54, 55~59 and 60~64, were recruited in consecutive order. RESULTS: Eighty percent women who have visited clinic/hospital to treat menopausal symptom, visited obstetrics and gynecology. Only 16% of these women were current user, and other 84% of these women had no experience of HT (53%) or stopped therapy (31%). Among current user, only 9% of women have used HT more than 5 years. Eighty percent of current user had used HT less than 2 years. Most distressing menopausal symptom is 'hot flush' regardless HT experience. When doctor recommend HT, 72% of patients accept HT in overall. Among women who had no experience of HT, the most common reason of not to take HT was concern of side effects (51%). And 67% of women who had concern of side effects worried about cancer incidence. CONCLUSION: Many women with menopausal symptom do not take HT even though it is the most effective therapy. Most of women who take HT stop treatment within 1 year. Most common reason of not to take HT is concern about side effect, increasing incidence of cancer related to HT. Therefore, HT should be considered to short-term relief of menopausal symptoms and at the minimal dose, if possible.
Aged ; Female ; Gynecology ; Humans ; Incidence ; Menopause ; Obstetrics ; Women's Health

OBJECTIVES: The aim of the present study is to evaluate the long term effects of estrogen-progestogen therapy (EPT) on uterine myomas volume in postmenopausal women. METHODS: We performed a retrospective analysis on postmenopausal women with asymptomatic uterine myoma during the period between April, 2008 and September, 2012. Postmenopause was defined as amenorrhea for longer than a year or serum follicle stimulating hormone levels higher than 40 IU/L. The volume of the myoma was assessed by transvaginal ultrasonography for every 6 months after administration of EPT. RESULTS: Thirty-eight women were included in the study, with 32 in the EPT group and 6 in the control group. Overall, uterine myoma volume (mean +/- standard deviation, cm3) in the EPT group was 19.5 +/- 24.6 at baseline, and those at 6 and 12 months were 24.7 +/- 35.1 and 28.5 +/- 56.4, respectively. Myoma volume did not change significantly with EPT, and these changes were not significantly different from the control group. Myoma volume changes were not significantly different in the subgroups according to the route of estrogen administrations and the method of progestogen administrations. Clinically significant volume increases during one year of EPT was noted in 28.1% (9/32), however, only one showed transient increases. CONCLUSION: Our results suggest that treating postmenopausal woman with EPT on a long-term basis does not increase the volume of uterine myomas.
Amenorrhea ; Estrogens ; Female ; Follicle Stimulating Hormone ; Humans ; Leiomyoma* ; Methods ; Myoma ; Postmenopause ; Progesterone ; Retrospective Studies ; Ultrasonography ; Uterus

The clear cell adenocarcinoma of uterine cervix is very rare tumor, and only 4-9% of entire adenocarcinoma appears to be diagnosed as clear cell adenocarcinoma. Its risk factor and pathogenesis are not exactly known, but intrauterine exposure to DES (diethyl stilbestrol) and associated non-steroidal estrogen during pregnancy before 18weeks is one known risk factor, and also hormonal change or genetic cause are suggested as the risk factors. The peak age of its occurrence has bimodal pattern, which are groups before 24 years-old and after 45 years-old, and clear cell adenocarcinoma arising in latter group is not associated with intrauterine DES exposure. It is also reported that 25% of young women who has clear cell adenocarcinoma had no history of hormonal exposure. The treatment and prognosis is similar to other kinds of uterine cervical adenocarcinoma. With a short literature review, we are reporting a case of 6-year-old girl who visited our clinic because of vaginal mass naturally fallen off with a minor bleeding which was finally diagnosed as clear cell adenocarcinoma, and had no maternal history of DES exposure during pregnancy.
Adenocarcinoma ; Adenocarcinoma, Clear Cell* ; Cervix Uteri* ; Child* ; Estrogens ; Female ; Female* ; Hemorrhage ; Humans ; Middle Aged ; Pregnancy ; Prognosis ; Risk Factors ; Young Adult

Sertoli-Leydig cell tumors are rare sex cord-stromal tumors. These tumors account for less than 0.5% of all ovarian tumors. Because these tumors appear predominantly in young women (between the age of 30 and 40) and are bilateral in less than 1% of cases, conservative removal of the tumor and adjacent fallopian tube is justifiable. Recently, we experienced a case of successful laparoscopic surgical staging in patient of Sertoli-Leydig cell tumor which was previously incompletely evaluated in local OBGY clinic. There are no solid data to suggest that usefulness and risk of laparoscopic surgical staging and adjuvant therapy with stage I disease of these tumors until now. So we present it with a brief review of literature.
Fallopian Tubes ; Female ; Humans ; Sertoli-Leydig Cell Tumor* ; Sex Cord-Gonadal Stromal Tumors

PURPOSE: The purpose of this study was to know whether ultrasonography is proper diagnostic tool for decision of treatment method or not, as compared the efficacy of US in allowing identifying fracture patterns of nasal bone with that of CT. MATERIALS AND METHODS: Fifty patients with nasal trauma were investigated prospectively by CT and US. According to CT and ultrasonographic findings, each case of nasal bone injury were rated as grade 1 (nasal injury but not fracture), grade 2 (simple fracture without displacement), grade 3 (unilateral simple fracture with displacement), grade 4 (bilateral simple fractures with displacement), and grade 5 (bilateral comminuted fractures with depression). Assessment for ultrasonographic method were defined as overestimations or underestimation according to whether the nasal fracture had been assigned a higher or lower grade at the review of the findings of CT. The correlation between the results of CT and ultrasonography were measured. RESULTS: In ultrasonographic estimation of grade of 50 cases of nasal bone injuries, there were correctly graded in 42 cases, overestimated in 5 cases, underestimated in 3 cases. In allowing accurate grading of nasal bone injury, images of nasal ultrasonography correlated closely with those of CT (r = 0.796). CONCLUSION: Nasal ultrasonography is a reliable method that allows appropriate grading of nasal bone injury and would be a useful first line imaging method in providing the detail necessary for proper management of patients with mild simple nasal bone injury.
Fractures, Comminuted ; Humans ; Nasal Bone ; Prospective Studies