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A case of extratubal secondary trophoblastic implants after laparoscopic treatment of ectopic pregnancy.

Korean Journal of Obstetrics and Gynecology.2008;51(5):584-587.

Persistent ectopic pregnancy (PEP) is defined as persisting pregnancy after conservative surgical treatment of ectopic pregnancy. PEP usually occurs in the original implantation site after incomplete removal of the trophoblast, but rarely may occur in other sites within the abdominal cavity, i.e., extratubal secondary trophoblastic implantation (ESTI). A 35-year old patient visited our clinic 40 days after laparoscopic surgery for ectopic pregnancy. She was diagnosed with hemoperitoneum and had then undergone a laparotomy procedure. Her operative findings revealed secondary implantation of the trophoblast in her greater omentum, which presented acute bleeding from the ruptured implanted trophoblast. In order to prevent the occurrence of ESTI, management must include minimizing any possible remnant trophoblast during the operative procedure, close and regular follow up of postoperative hCG, and consideration of postoperative prophylactic methotrexate. The patient must be well informed about all possible complications after treatment of ectopic pregnancy.
Abdominal Cavity ; Female ; Follow-Up Studies ; Hemoperitoneum ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Methotrexate ; Oligopeptides ; Omentum ; Pregnancy ; Pregnancy, Ectopic ; Surgical Procedures, Operative ; Trophoblasts

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A case of liposarcoma within a leiomyoma.

Soo Ah KIM ; Hyuk JUNG

Korean Journal of Obstetrics and Gynecology.2008;51(5):579-583.

Liposarcoma is the most common soft tissue sarcoma and tends to occur in the retroperitoneum and deep soft tissue of the trunk and extremities. Liposarcoma of the uterus is a rare neoplasm. Liposarcoma has a peak incidence between the fifth and seventh decades. Liposarcoma of the uterus typically presents in postmenopausal women. Liposarcomas are divided into five main types: well-differentiated, myxoid, round cell, pleomorphic, and de-differentiated. The mainstay of treatment is complete surgical resection. Histological grade is the most important factor affecting survival rates for patients with liposarcomas and adjuvant chemotherapy or radiation therapy can be helpful. Liposarcoma of the uterus is a rare neoplasm and we report a case of liposarcoma arising in a uterine leiomyoma.
Chemotherapy, Adjuvant ; Extremities ; Female ; Humans ; Incidence ; Leiomyoma ; Liposarcoma ; Sarcoma ; Survival Rate ; Uterus

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Two cases of paratubal cysts manifesting as huge pelvic masses in young women.

Eun Ae SHIN ; Eun Ji KANG ; Eun Mi CHANG ; Young Ju CHA ; Si Won JEON ; Soo Yoon LEE ; Sa Ra LEE ; Woong JU ; Seung Cheol KIM

Korean Journal of Obstetrics and Gynecology.2008;51(5):574-578.

Paratubal cysts come from paraovarium of the broad ligament between the fallopian tube and ovary. Overall, these cysts constitute 10% of all adnexal masses and are commonly incidental findings upon surgical exploration for other reasons. They more commonly occur in women between 30 and 40 years of age. We report two cases of rapidly growing, huge paratubal cysts in young women, which are presented with brief review of literature.
Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Incidental Findings ; Ovary ; Parovarian Cyst

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Third trimester listeriosis in twin pregnant woman with multiple organ dysfunction syndrome and combined endocarditis: A case report.

Eun Jung SOH ; Tae Gyu AHN ; Ae Rah HAN ; Hyang Ah LEE ; Jong Yun HWANG ; Hye Sung WON ; Dong Heon LEE ; Jun Sik CHO

Korean Journal of Obstetrics and Gynecology.2008;51(5):568-573.

Human listeriosis is a relatively rare but serious disease with mortality rate 20~40%. Listeria monocytogenes affects patients with decreased cell mediated immunity such as the elderly, transplant recipients, cancer patients, renal failure, diabetes, HIV, pregnant women and unborn child, neonate. We experienced a case of listeriosis in twin pregnant woman at 35th weeks without preterm labor. The pregnant woman present sepsis with fever at first time. Sepsis progress to MODS (multiple organ dysfunction syndrome) and combined endocarditis. We reported it with brief of literatures.
Aged ; Child ; Endocarditis ; Female ; Fever ; HIV ; Humans ; Immunity, Cellular ; Infant, Newborn ; Listeria ; Listeria monocytogenes ; Listeriosis ; Multiple Organ Failure ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Third ; Pregnancy, Twin ; Pregnant Women ; Renal Insufficiency ; Sepsis

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Comparison of the efficacy of additional vaginal dressing disinfectants for reduction of wound-related complications in laparoscopic hysterectomy.

Yeong Min LEE ; Shin Young KIM ; Min Hyung JUNG ; Bo Yon LEE ; Chu Yeop HUH

Korean Journal of Obstetrics and Gynecology.2008;51(5):563-567.

OBJECTIVES: To compare the efficacy of additional vaginal dressing disinfectants for reduction of wound-related complications in laparoscopic hysterectomy. METHODS: From September 2006 to June 2007, 226 of 243 patients underwent laparoscopic hysterectomy were enrolled. The patients were classified into three groups (no additional disinfectant (n=76), povidone-iodine (n=68), and chlorhexidine (n=82) for disinfectants) and the short term postoperative complications related with wound morbidity were recorded by 2 months out-patient follow up. RESULTS: The mean age of all patients was 46.6+/-7.6 years old, and the mean BMI (body mass index) was 24.2+/-3.4, mean operation time was, 137.2+/-48.0 minutes, and the mean estimated blood loss was 451.8+/-240.2 ml. There was no significant difference among three groups in their mean age, mean BMI, frequency of vaginal culture (+) before surgery, frequency of wound/stump infection after surgery, frequency of wound disruption, and frequency of fever. The significant difference was shown in mean operation time and mean estimated blood loss but those did not affect frequency of vaginal culture (+) before surgery, frequency of wound/stump infection after surgery, frequency of wound disruption, and frequency of fever. CONCLUSIONS: We conclude that the kind of disinfectant for additional vaginal dressing for laparoscopic hysterectomy does not matter deeply in causing short term wound-related complications after the surgery.
Bandages ; Chlorhexidine ; Disinfectants ; Fever ; Humans ; Hysterectomy ; Outpatients ; Postoperative Complications ; Povidone-Iodine

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The expression of p57(kip2) in normal ovaries and ovarian tumors.

Mi Jin AHN ; Ji Yeon KIM ; Sung Ki LEE ; Kyung Jin KIM ; Byung Woo JANG ; Sung Eun HUR ; Nam Hee KIM ; Ki Hyun KIL ; Bum Kyeong KIM ; Sung Tae KIM

Korean Journal of Obstetrics and Gynecology.2008;51(5):555-562.

OBJECTIVES: The purpose of this study is to investigate the expression of CDK (Cyclin dependent kinase) inhibitor, p57(kip2) in human ovarian corpus luteum, benign and malignant ovarian tumors. METHODS: 46 women undergoing laparoscopic surgery or laparotomy for ovarian tumors were enrolled. Total 46 formalin-fixed, paraffin-embedded sections of corpus luteum, benign and malignant ovarian tumors were stained by immunohistochemistry for expression of p57(kip2). RESULTS: p57(kip2) was stained in theca cell of growing follicle but not induced in human corpus luteum. There was the expression of p57(kip2) in mature teratoma, immature teratoma and endometrioma but not in epithelial ovarian tumors. CONCLUSIONS: These results showed that p57(kip2) expression may be not important in luteinization of the ovary and seemed not to play a role in development of epithelial ovarian tumors. However, it may involve pathogenesis of mature teratoma, immature teratoma and endometrioma.
Corpus Luteum ; Endometriosis ; Female ; Humans ; Immunohistochemistry ; Laparoscopy ; Laparotomy ; Lutein ; Luteinization ; Ovary ; Teratoma ; Theca Cells

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Vascular endothelial cell growth factor (VEGF) polymorphisms and haplotypes in Korean women with advanced endometriosis.

Soo Yoon LEE ; Eun Mi CHANG ; Eun Ae SHIN ; Sung Eun HUR ; Ji Young LEE ; Hye Sung MOON ; Hye Won CHUNG

Korean Journal of Obstetrics and Gynecology.2008;51(5):544-554.

OBJECTIVE: Endometriosis is the presence of normal endometrial mucosa (glands and stroma) abnormally implanted on the outside of uterus. The pathophysiology of endometriosis is not clear yet, but Sampson's theory of the transplantation of endometrial tissue onto the pelvic peritoneum via retrograde menstruation is most widely accepted. Vascular endothelial cell growth factor (VEGF) is involved in the pathophysiology of endometriosis via its angiogenetic property. This study was designed to investigate whether single nucleotide polymorphism and its haplotype and diplotype of VEGF genes are associated with the risk of advanced endometriosis or not. METHODS: This study investigated 260 patients of endometriosis; they underwent operation, and were diagnosed with endometriosis stage III, IV histopathologically. And control group of 199 women underwent surgery with benign ovarian cyst. The single nucleotide polymorphisms of VEGF gene were -2578C>A, 405G>C, 936C>T. They were analyzed by polymerase chain reaction and restriction fragment length polymorphism, and haplotype and diplotype analysis were done. RESULTS: The result of this study showed no association among -2578C/A, 405G>C, 936C>T single nucleotide polymorphisms and severe endometriosis. Haplotype and diplotype of -2578C>A, 405G>C, 936C>T in the VEGF gene were shown to have no association with endometriosis. We found no association between VEGF genetic polymorphism and risk of endometriosis. And haplotype and diplotype analysis also revealed no statistically significant value between VEGF polymorphism and endometriosis. CONCLUSIONS: So, the results of this study suggest polymorphism of VEGF gene may not be associated with risk of endometriosis in Korean women.
Endometriosis ; Endothelial Cells ; Female ; Haplotypes ; Humans ; Menstruation Disturbances ; Mucous Membrane ; Ovarian Cysts ; Peritoneum ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Transplants ; Uterus ; Vascular Endothelial Growth Factor A

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Expression of leptin receptors and the antiapoptotic effect of leptin on epithelial ovarian cancer cell lines.

Hyuk Min KWON ; Ji Yeon LEE ; Tae Gyu AHN ; Hyang Ah LEE ; Jong Yun HWANG ; Jun Sik CHO ; Dong Heon LEE

Korean Journal of Obstetrics and Gynecology.2008;51(5):534-543.

OBJECTIVE: The potential role of leptin as an endocrine regulator is unknown in ovarian cancer. In the present study, we investigated the expression of letpin receptors in IOSE (Immortalized ovarian surface epithelium) and ovarian cancer cell lines, and potential role of leptin on the cell growth and taxol induced apoptosis. METHODS: To check the presence of leptin receptors in 4 human epithelial ovarian cancer cell lines (SK-OV-3, R182, A2780 and CP70), RT-PCR was done. In the RT-PCR, 2 primers were used; primers for short form of leptin receptor and for long form of leptin receptor. Cancer cell lines were treated with leptin and the cell viability was measured using the cellTiter 96 Aqueous One Solution Cell Proliferation Assay Kit. The antiapoptotic effect of leptin against taxol induced apoptosis on ovarian cancer cell lines was evaluated by checking caspase 3/7 activity. RESULTS: Leptin receptors on ovarian cancer cell lines were expressed differentially according to the type of isoform. There was long form leptin receptor on CP70, but no short form receptor. All other cell line showed both short and long form receptors. Leptin increased cell viability in all cell lines in a dose-dependent manner and reduced the number of apoptotic cells in A2780. CONCLUSIONS: There were leptin receptors in IOSE and some ovarian cancer cell lines. Chronic increase in leptin concentration may enhance the growth of ovarian cancers. In part, the increased cell growth after leptin treatment seemed to be due to the antiapoptotic effect of leptin.
Apoptosis ; Cell Line ; Cell Proliferation ; Cell Survival ; Humans ; Leptin ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Paclitaxel ; Receptors, Leptin

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The expressions of vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) in the progression of invasive cervical cancer.

Sun Young YU ; Yong CHO ; Soyi LIM ; Young Han PARK ; Yong Woo LEE ; Young Hee CHOI ; Eu Sun RO

Korean Journal of Obstetrics and Gynecology.2008;51(5):527-533.

OBJECTIVE: To evaluate the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) in the progression of cervical cancer. METHODS: A total 87 specimens of uterine cervix, representing 6 normal epithelium, 11 intraepithelial neoplasm, 25 cervical carcioma in situ (CIS), 19 cervical microinvasive carcinoma and 26 cervical invasive carcinoma, were evaluated. All specimens were prepared with tissue array method which can allow evaluation many specimens in one slide. The protein expressions of VEGF and MMPs (MMP-2, MMP-9) were evaluated by immunohistochemical staining. RESULTS: The protein expressions of VEGF and MMP-2 were increased significantly with the progression of cervical cancer (p<0.05), but there was no statistically significant difference in MMP-9 expression (p>0.05). The VEGF and MMP-2 expressions revealed positive correlations with the progression of cervical cancer. CONCLUSIONS: The VEGF, MMP-2 in each or together may play a role in the progression of cervical cancer.
Carcinoma in Situ ; Cervix Uteri ; Epithelium ; Female ; Matrix Metalloproteinases ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A

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The expression of Thymosin beta4 with angiogenic factors in epithelial ovarian cancer.

Ari KIM ; Hye Won CHUNG ; Jong Il KIM ; Sun Hee CHUN ; Hye Sung MOON

Korean Journal of Obstetrics and Gynecology.2008;51(5):518-526.

OBJECTIVE: The aim of this study was to determine thymosin beta4 expression in epithelial ovarian cancer compared to normal ovarian tissue. METHODS: Normal and pathologic ovarian tissues were obtained from healthy women (n=18), and from patients with ovarian cancer (n=27). The expression of thymosin beta4 mRNA was examined by quantitative competitive polymerase chain reaction (QC PCR). Thymosin beta4 mRNA expression was examined with angiopoietic factors such as vascular endothelial growth factor, angiopoietin-1 and 2. RESULTS: The expression of thymosin beta4 mRNA in epithelial ovarian cancer was higher than that in the normal ovary (p<0.05). Thymosin beta4 mRNA expression was not correlated with ovarian cancer stages, pathologic types, preoperative CA125 levels, or metastasis to lymph nodes but was correlated with the expression vascular endothelial growth factor and angiopoietin-2 (p<0.05). CONCLUSIONS: Our results suggest that overexpression of thymosin beta4 mRNA may be a biologic marker to differentiate epithelial ovarian cancer from normal ovary and it may play a role in angiogenesis of epithelial ovarian cancer.
Angiogenesis Inducing Agents ; Angiopoietin-1 ; Angiopoietin-2 ; Biomarkers ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Ovary ; Polymerase Chain Reaction ; RNA, Messenger ; Thymosin ; Vascular Endothelial Growth Factor A

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