Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

OBJECTIVE: The presence of the various cytokines in human peritoneal fluid has been evaluated incompletely. Changes in cytokine lefels may be related to activation of peritoneal macrophage and T-lymphocyte, development of endometriosis, and infertility. This study assesses peritoneal fluid levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-alpha) in infertile women with endometriosis and normal women without endometriosis. Design : Prospective and case-control study in university hospital. MATERIALS AND METHODS: Cytokine levels in peritoneal fluid obtained during laparotomy or laparoscopy from 21 patients in infertile patients in infertile patients with endometriosis and 24 controls undergoing laparotomy or laparoscopy with no evidence of pelvic endometriosis were determined by enzymelinked immunosorbent assay. RESULTS: The mean levels of interleukin-6 in infertile patients with endometriosis and controls were 72.7+/-23.7 pg/ml and 18.5+/-9.7 pg/ml respectively (p=0.02). Similarly, the mean levels of interleukin-8 in infertile patients with endometriosis was significantly higher than that of controls (445.0+/-89.6, vs 45.1+/-48.4, p=0.04). The mean concentration of interleukin-10 in infertile patients with endometriosis was significantly lower than that of controls (1.09+/-0.04 vs 2.19+/-0.03, p=0.03). The level of tumor necrosis factor-alpha was not significantly different between the two study groups. CONCLUSIONS: Increased IL-6 and IL-8 and decreased IL-10 levels in the peritoneal fluid may be related to pathogenesis in the endometriosis and infertility, suggesting that partially contribute to the disturbed immune regulation observed in infertili women with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Cytokines ; Endometriosis* ; Female ; Humans ; Infertility ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Laparoscopy ; Laparotomy ; Macrophages, Peritoneal ; Prospective Studies ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal* ; Ultrasonics*

The Sertoil-Leydig cell tumor (SLCT) is gonadal tumor of sex-cord type, similar to that seen in the various phase of testicular development in the male. It is the most common type of all virilizing ovarian tumors and account for less than 0.5% of all ovarian tumors. A 26-year-old woman had an ovarian SLCT associated with an elevated level of serum AFP. The tumor had a heterologous element of intestinal-type mucinous epithelium, retiform and intermediately differentiated tubules of the Sertoli cell, and AFP-producing Leydig cells. After surgery, the serum AFP level of the patient fell to the normal range. We experienced a case of AFP producing SLCT, so we present it with a brief review of literature.
Adult ; alpha-Fetoproteins* ; Epithelium ; Female ; Gonads ; Humans ; Leydig Cells ; Male ; Mucins ; Ovarian Neoplasms ; Reference Values ; Sertoli-Leydig Cell Tumor*

OBJECTIVE: To determine the value of sonographic nuchal translucency measurement for the detection of chromosomal abnormalities in high risk pregnancies. METHOD: The feasibility of nuchal translucency was tested in a prospective study of 1260 pregnancies at 10- 13 weeks' gestation. RESULTS: The nuchal translucency of 3 mm or greater was identified in 41 fetuses (3.2%), 19 of whom proved subsequently by either amniocentesis or postnatal follow-up have chromosomal abnormalities. The sensitivity of nuchal translucency for chromosomal abnormalities was 82.6% (19 of 23 cases), the positive predictive value of nuchal translucency for chromosomal abnormalities detection was 46.3% (19 of 41 cases). CONCLUSION: The observed sensitivity, false-positive rate and predictive value suggest that sonographic nuchal translucency should be undertaken at 10 to 13 weeks of gestation.
Amniocentesis ; Chromosome Aberrations* ; Female ; Fetus ; Follow-Up Studies ; Humans ; Nuchal Translucency Measurement* ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy, High-Risk* ; Prospective Studies ; Ultrasonography

OBJECTIVE: A large body of evidence suggests that cyclooxygenase-2(COX-2) is important in tumorigenesis of gastrointestinal cancer. The purpose of this study was to determine whether COX-2 was also expressed in cervical intraepithelial neoplasia(CIN) and invasive cervical carcinoma. METHODS: We studied the expression of COX-2 in normal cervix(n=6), CIN I(n=4), CIN II(n=2), CIN III(n=15), microinvasive carcinoma(n=5) and invasive carcinoma(n=7) by immunohistochemistry. RESULTS: We observed strong COX-2 expression in 16.7% of the normal cervix, 0% of the CIN I and II, 80.0% of CIN III, 60.0% of microinvasive carcinoma and 71.4% of invasive carcinoma. The intensity of immunostaining was stronger in the CIN III and invasive cancer than the normal cervix and CIN I lesions(p<0.01). CONCLUSION: These results suggest that COX-2 may have a role in carcinogenesis of CIN and may be a target for the prevention or treatment of CIN and invasive cervical cancer.
Carcinogenesis ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Cyclooxygenase 2 ; Female ; Gastrointestinal Neoplasms ; Immunohistochemistry ; Prostaglandin-Endoperoxide Synthases* ; Uterine Cervical Neoplasms*

OBJECTIVE: We performed immunohistochemistry for the evaluation of follicle stimulating hormone receptor (FSHR), luteinizing hormone receptor (LHR) expression in the ovarian tumors and examined the blood level of the gonadotropins in ovarian cancer patients to investigate ovarian carcinogenesis process related to gonadotropins. METHODS: Between January 2002 and July 2003, 25 patients with ovarian tumors were treated in the Hallym University Sacred Heart Hospital. 25 ovarian tumors including 7 borderline tumors, 1 sex cord stromal tumor, 1 germ cell tumor, and 16 carcinomas were examined for FSHR, LHR expression by immunohistochemistry. Serum gonadotropins were collected from 13 cases of 25 ovarian tumors who were not taking hormones at the time of blood collection. RESULTS: Followings are results summarized. 1. Mean FSH levels were lower among cases compared with controls. LH levels were lower among cases than controls, but the difference was not statistically significant. 2. The steady decline of FSHR, LHR expression from borderline tumor (86%, 100%) to carcinoma (56%, 43%) is observed. 3. Patients showing significant gonadotropins receptors expression showed lower serum FSH and LH levels when compared with patients with no detectable gonadotropins receptors. CONCLUSION: The presence of FSHR, LHR in ovarian tumors provide additional evidence supporting the relation of gonadotropins and ovarian carcinogenesis. But, this study did not support the hypothesis that pituitary goandotropins increase the risk of ovarian cancer. The decline of receptor expression from borderline tumors to carcinoma suggests that FSH, LH may be needed in early ovarian cancer development. If further studies of gonadal peptides and gonadotropins are done, we can suggest the cut-off value of gonadotropins on ovarian carcinogenesis.
Carcinogenesis ; Gonadotropins* ; Gonads ; Heart ; Humans ; Immunohistochemistry ; Neoplasms, Germ Cell and Embryonal ; Ovarian Neoplasms* ; Peptides ; Receptors, FSH ; Receptors, Gonadotropin ; Receptors, LH ; Sex Cord-Gonadal Stromal Tumors

OBJECTIVE: The purpose of this retrospective study is to evaluate the efficacy of Loop Electrosurgical Excision Procedure (LEEP) in the diagnosis and in the treatment of CIS (carcinoma in situ). METHODS: Between Jan. 1999 and Apr. 2000, 94 patients with CIS were treated in the Hallym University Sacred Heart Hospital. Three procedures were performed: cytology, punch biopsy and LEEP (loop electrosurgical excision procedure). And the results of cervical cytology, punch biopsy, phathologic diagnosis of LEEP specimens were evaluated in comparison with the pathologic diagnosis of hysterectomy specimens. RESULTS: Followings are results summarized. 1. The concordance rate of LEEP histology with punch biopsy was 60% (53 cases). In comparison to punch biopsy, the higher LEEP histologic rate was 22% (19 cases), and lower LEEP histologic rate was 18% (16 cases), respectively. 2. 67 patients were diagnosed CIS and among them 58 patients underwent hysterectomy. In histologic comparison between LEEP and hysterectomy, there were on 1 (1.7%) patient who had more advanced diagnosis after operation. 3. 67 patients were diagnosed CIS and among them 58 patients underwent hysterectomy. The residual lesion was identified in 19 of 58 patients (33%). CONCLUSION: LEEP was useful diagnostic tool in CIS. But, in therapeutic efficacy, simple LEEP seems to be incomplete. Therefore, when we use LEEP for CIS as therapeutic tool, additional procedure, such as wide excision or endocervical deep resection may be asked. And careful follow up asked in therapeutic LEEP.
Biopsy ; Cervix Uteri* ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Humans ; Hysterectomy ; Retrospective Studies

Actinomycosis is a chronic, progressive, suppurative disease which appears to be difficult to establish a correct preoperative diagnosis. Most of pelvic actinomycosis in women are related to a long time intrauterine device(IUD) inserted state. The causative agent is a branching, gram-positive anaerobic or microaerobic organism, not fungi. Ascending infection of the upper genital tract by actinomycosis may be clinically inapparent. We experienced a case of clinically inapparent tuboovarian actinomycosis in a 47-year-old women with IUD, discovered pathologically after laparotomy.
Actinomycosis* ; Diagnosis ; Female ; Fungi ; Humans ; Intrauterine Devices* ; Laparotomy ; Middle Aged

Ovarian transitional cell carcinoma (TCC) resembles transitional cell carcinoma of the bladder. As a very rare type of tumor, it accounts for less than 2% of the total incidence of ovarian cancer. Though more aggressive than malignant Brenner tumor, it shows more favorable prognosis because of better response to the chemotherapy than other epithelial ovarian carcinomas. We experienced a case of ovarian TCC in a menopausal woman with a chief complaint of palpable pelvic mass, who underwent staging operation and platinum based (carboplatin-cyclophosphamide) chemotherapeutic treatment, and herein report the case with a brief review of related literatures.
Brenner Tumor ; Carcinoma, Transitional Cell* ; Drug Therapy ; Female ; Humans ; Incidence ; Ovarian Neoplasms ; Ovary* ; Platinum ; Prognosis ; Urinary Bladder