INTRODUCTIONThe purpose of this case series was to determine the sonographic features of neonatal ovarian torsion.

MATERIALS AND METHODSSeven surgically proven cases of neonatal ovarian cysts were included in this retrospective study. The patients were divided into 2 groups, torsion and non-torsion. These 7 patients were evaluated for the clinical presentation, sonographic features, surgical and pathological findings. The findings on follow-up sonography after surgery were also noted.

RESULTSThe sonographic appearance was variable. Of the 4 cases with torsion, 2 lesions had internal echoes with 'fi sh-net appearance'. The other 2 lesions were predominantly cystic on the sonography with internal echoes and echogenic nodule. A calcific focus was present in 1 of these echogenic nodules. One of the cysts had fluid-fluid level. In the non-torsion group, only 1 lesion had mixed echogenic appearance. The other 2 lesions were cystic with low level internal echoes in 1 of the cysts. The surgical procedure performed in the torsion group was salpingo-oophorectomy in 2 patients and oophorectomy in 1 patient. In 1 patient, cystectomy was attempted without success. In the non-torsion group, only cystectomy was performed with preservation of normal ovaries, which was confirmed on follow-up sonography.

CONCLUSIONThe sonographic features of cysts with 'fish-net appearance', fluid-debris level and cysts with echogenic nodule favour torsion. The former sign has so far not been described as a sonographic predictor for neonatal ovarian torsion.

Female ; Humans ; Infant, Newborn ; Ovarian Cysts ; diagnostic imaging ; pathology ; surgery ; Ovary ; diagnostic imaging ; pathology ; Postoperative Period ; Retrospective Studies ; Torsion Abnormality ; diagnostic imaging ; pathology ; surgery ; Ultrasonography, Doppler ; instrumentation

OBJECTIVE: To assess the feasibility of laparoscopic cytoreduction in patients with localized recurrent epithelial ovarian cancer (EOC) by comparing its outcomes to those of laparotomy. METHODS: We performed retrospective analysis in 79 EOC patients who had a localized single recurrent site, as demonstrated by computed tomography (CT) scan, magnetic resonance imaging, or positron emission tomography/CT scan; had no ascites; were disease-free for 12 or more months prior; and who had undergone secondary cytoreduction (laparoscopy in 31 patients, laparotomy in 48 patients) at Samsung Medical Center between 2002 and 2013. By reviewing the electronic medical records, we investigated the patients' baseline characteristics, surgical characteristics, and surgical outcomes. RESULTS: There were no statistically significant differences between laparoscopy and laparotomy patients in terms of age, body mass index, cancer antigen 125 level, tumor type, initial stage, grade, recurrence site, type of procedures used in the secondary cytoreduction, adjuvant chemotherapy, and disease-free interval from the previous treatment. With regards to surgical outcomes, reduced operating time, shorter hospital stay, and less estimated blood loss were achieved in the laparoscopy group. Complete debulking was achieved in all cases in the laparoscopy group. CONCLUSION: The laparoscopic approach is feasible without compromising morbidity and survival in selected groups of patients with recurrent EOC. The laparoscopic approach can be a possible treatment option for recurrent EOC.
Adolescent ; Adult ; Aged ; Cytoreduction Surgical Procedures/*methods ; Feasibility Studies ; Female ; Humans ; Laparoscopy/methods ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Recurrence, Local/diagnostic imaging/*surgery ; Neoplasms, Glandular and Epithelial/diagnostic imaging/*surgery ; Ovarian Neoplasms/diagnostic imaging/*surgery ; Ovary/diagnostic imaging/surgery ; Positron-Emission Tomography ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo observe the clinical effect of traditional Chinese medicine Bushen Houxue (BSHX) method combined with ultrasound-guided follicle aspiration (MFA) in treating refractory polycystic ovary syndrome (PCOS).

METHODSForty-four patients with PCOS were randomly assigned to two groups by randomizing digital table, 20 in the observation group and 24 in the control group. MFA was performed on both groups, and the decoction of BSHX, which consisted of dodder seed 20 g, prepared rehmannia root 10 g, mulberry mistletoe 20 g, epimedium 15 g, psoralea fruit 10 g, solomonseal rhizome 10 g, honeylocust thorn 15 g, peach kernel 10 g, pleione bulbocodioides 10 g, red sage root 20 g, and licorice root 6 g, was given to the observation group one dose every day for 14 days every menstrual cycle. Changes of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) were determined before and after MFA. The impacts on quantity of HMG used, number of sinus follicle, mature follicle, incidence of ovarian hyperstimulating syndrome (OHSS), luteinized unrupture follicular syndrome (LUFS) and pregnance rate were also observed.

RESULTSMFA had been performed for 42 cycles in the observation group and 56 cycles in the control group. Levels of T, LH and LH/FSH ratio markedly reduced after aspiration, showing significant difference as compared with those of before treatment in both groups (P < 0.01), and difference of LH/FSH between groups was of statistical significance (P <0.01). In the observation group, 18 patients (90.0%) had their sinus follicle decreased to < 10 after MFA, while in the control group, it reached to <10 in 22 patients (91.70%), all were different to those before treatment (P <0.01). In the observation group, the quantity of HMG used for promoting ovulation was (585.0 +/- 195.0) IU, number of mature follicle at the day of HCG injection was 1.1 +/- 0.3, while in the control group, the corresponding data were (1470.0 +/- 532.5) IU and 3.1 +/- 1.4, all with significant difference between groups (P <0.01). None of OHSS and 1 case of LUFS occurred in the former group, while 1 mild OHSS and 2 LUFS in the latter. After ovulation promoting therapy and in the 3-month secutive follow-up period, pregnancy was found in 8 out of the 18 patients in the observation group (one twins and 7 single), with the pregnancy rate of 44.4%; while in the control group, 7 in 22 (2 twins and 5 single) was found, the pregnancy rate being 31.8%.

CONCLUSIONBSHX method combined with MFA is a safe and effective treatment for refractory PCOS, with few trauma. The combined usage of Chinese herbal medicine could significantly reduce dosage of HMG used for promoting follicle and the production of multiple mature follicles, thus to avoid the risk of OHSS.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follicle Stimulating Hormone ; metabolism ; Humans ; Luteinizing Hormone ; metabolism ; Oocyte Retrieval ; Polycystic Ovary Syndrome ; diagnostic imaging ; drug therapy ; metabolism ; surgery ; Ultrasonography ; Young Adult