The Relationship between Uterine Myoma Growth and the Endocrine Disruptor in Postmenopausal Women

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.

Transurethral Rescetion Syndrome after Transurethral Resection of Bladder Tumor in 2 Patients on Maintenance Hemodialysis / 대한신장학회지

Transurethral resection syndrome (TURS) is one of the complications of endoscopic transurethral operation with irrigation fluid. TURS comprehensively refer to several clinical symptoms and signs caused by intravascular absorbtion of irrigation fluid, hypertension, bradycardia, arrhythmia, respiratory distress, hypotension, confusion, blindness, seizure, coma, hyponatremia, and hypoosmolarity. TURS is mainly known as the complication of the transurethral resection of prostate (TURP), and rarely found in the procedures such as transurethral resection of bladder tumor (TUR-BT), hysteroscopy, cystoscopy, and arthroscopy. Only a few cases of TURS after TUR-BT have been reported. The patients on maintenance hemodialysis were restricted in the amount of water intake for volume control. They were susceptible to the absorption of irrigation fluid during TUR-BT since they had anuria. We hereby report the 2 cases maintenance hemodialysis patients who were led to TURS after TUR-BT.

A Case of Spontaneous Pneumoperitoneum Caused by Giant Bulla / 대한내과학회지

A spontaneous pneumoperitoneum is air in the peritoneal space that is detectable radiologically and can be managed successfully by observation alone or a laparotomy. A 73-year-old man was admitted for low back pain. He had a giant bulla in the left upper lung, detected radiologically 7 years earlier. On admission, he had free air in the subphrenic area bilaterally, while the previous giant bulla was not seen. Based on the physical examination, we thought that the new free air did not indicate a surgical abdomen, and performed additional examinations to rule out other disease. There was no abnormal finding linked to the free air. The free air had almost disappeared on a subsequent chest X-ray. We report a rare case of spontaneous pneumoperitoneum caused by a giant bulla, with a literature review

Endoscopic Foley Balloon Extraction of an Esophageal Foreign Body / 대한소화기내시경학회지

Esophageal foreign bodies should be retrieved as soon as possible, as they may cause complications such as bleeding, perforation, and respiratory distress. Flexible endoscopy is the preferred method, because it is effective and safe, but rigid esophagoscopy or a surgical procedure should be considered if flexible endoscopy fails. Extraction with a Foley balloon is an effective method for removing blunt foreign bodies from the esophagus. The general technique used is to insert the catheter into the esophagus through the nose or mouth, place it in the distal part of the foreign body, balloon the catheter, and remove the foreign body by pulling the catheter out. This procedure is generally performed under fluoroscopy, but a few reports have used Foley balloon extraction during endoscopy. We report a case of an elderly woman with a blunt foreign body in the upper esophagus. After failing to remove the object by endoscopy, we removed it with a Foley balloon under endoscopy.

A Case of Recurrent C1q Nephropathy Treated by Immunosuppressant Combination Therapy / 대한신장학회지

The definition of C1q nephropathy has been categorized since 1985. However, the clinical correlation and pathophysiology has not yet been fully revealed. Therefore, the treatment of C1q nephropathy has not been established. Our subject was a 23 year-old female patient with both leg edema and oliguria, who was presented with weight gain. Renal biopsy confirmed C1q nephropathy. Prednisolone and cyclosporine therapy was selected for treatment. After 2 weeks of treatment, the patient lost 8 kg of body weight and all laboratory examination results were normalized. Both leg edema and oliguria were resolved. After 21 weeks of regular follow-up, she stopped the medicine by herself. Eight weeks later, the patient came to the Emergency room because both leg edema recurred. Same regimen was administered for 3 weeks, and complete remission was achieved again.

A Case of Retroperitoneal Mass in Infancy, Fetus in Fetus / 대한산부인과학회잡지

"Fetus in fetus" is a rare pathologic feature consisting of a parasitic twin included within the body of the other twin, which most likely arises from inclusion of a monozygotic, diamniotic twin pregnancy. The exact embryogenesis of fetus in fetus is controversial. Some investigators propose that it is a highly organized teratoma. Since the condition was first described by Meckel in the late 18th centry, approximately 100 cases have been reported in the literature. Most cases present as an abdominal mass during the first year of life, with a few cases being detected prenatally by ultrasound examination. So we report one case of fetus in fetus detected by ultrasound examination prenatally.

A Case of Sirenomelia Diagnosed at 14 Gestational Weeks / 대한주산의학회잡지

Sirenomelia, characterised by a complete or incomplete fusion of the lower extremities, is a severe form of caudal defect affecting 1 in 60,000 births. Most cases of sirenomelia die within 5days after birth and are associated with abnormalities such as renal agenesis, urinary tract agenesis, single umbilical artery, etc. Thirdtrimester ultrasonographic diagnosis is usually impaired by severe oligohydramnios whereas the amount of amniotic fluid may be efficient to allow diagnosis in the late first trimester. We report of a case of sirenomelia at 14 weeks of gestation using prenatal transvaginal and transabdominal ultrasonography.