Abdominal Wall Endometriosis after Cesarean Section: A Report of Two Cases / 대한산부인과학회지

Extrapelvic endometriosis remains quite rare phenomenon. The majority of extrapelvic endometriosis involve scar tissue following obstetric/gynecologic procedures. Endometriosis involving a cesarean section scar may be more common than previously recongnized. The classic symptom is a painful scar that became swollen and more tender during menstruation. The cause of surgical scar endometriosis is believed to be iatrogenic transplantation of endometrial tissue to the surgical wound. The surgical excision remains the treatment of choice for expected cures and presents the most appropriate diagnostic and therapeutic intervention. We present two cases of endometriosis appearing on the abdominal wall scar of cesarean section with a brief review of the concerned literatures.

Analysis of X Chromosome Inactivation in Women with Premature Ovarian Failure / 대한산부인과학회잡지

OBJECTIVE: Premature ovarian failure (POF) is a highly heterogenous condition, and its etiology remains unknown in approximately two-thirds of cases. POF can be caused by Turner syndrome, genetic disease, iatrogenic agents such as chemotherapy and radiotherapy, infection and autoimmune disease. X chromosome inactivation is the random process in females during early embryogenesis to achieve dosage compensation with males. But skewed X chromosome inactivation occurs in the female carriers, secondary to cell-autonomous selection against cells in which the abnormal X chromosome is active. Highly skewed X chromosome inactivation is likely to occur in POF which caused by subcytogenetic X chromosome deletion or translocation and X-linked gene mutation. The present study was performed to investigate whether highly skewed inactivation of X chromosome is observed in POF. METHODS: Eighty-six women with premature ovarian failure were studied and eighty-three normal women were enrolled as a control group. X chromosome inactivation pattern were determined by studying methylation pattern of androgen receptor gene. RESULTS: Seventy-six of the 86 POF patients were informative for X chromosome inactivation assay, 8 (10.5%) of them showed highly skewed X chromosome inactivation. In the age matched control group, 3 (4.1%) out of the 74 subjects showed highly skewed X chromosome inactivation. However, this finding is not statistically significant (p=0.2274). Among highly skewed X inactivation, one case of premature ovarian failure revealed 46,XX,del(X)(p21) by high resolution band karyotyping. Therefore highly skewed X inactivation can provide clues to evaluate the causes in POF. CONCLUSION: This study suggests that screening of skewed X chromosome inactivation for the POF will be useful to detect subcytogenetic X chromosome deletion or translocation and X-linked gene mutation associated with POF.

Expression of Angiopoietin-1 and Angiopoietin-2 mRNA in Eutopic and Ectopic Endometrium / 대한산부인과학회잡지

OBJECTIVE: To investigate the mRNA expression of Angiopoietin (Ang)-1 and Ang-2 in ectopic and eutopic endometrium from women with or without endometriosis throughout the menstrual cycle. METHODS: Total RNA was extracted and reverse transcribed into cDNA. The expression of Ang-1 and Ang-2 was examined by quantative competitive PCR (QC PCR) and each result was analyzed by Kruskal- Wallis analysis and Mann-Whitney U-test. RESULTS: The expression of Ang-1 mRNA was statistically significantly higher in endometrium of follicular phase from women with endometriosis compared to that from normal ones in the follicular phase. Endometriotic tissues expressed significantly lower Ang-2 mRNA compared to endometrium from women without endometriosis. CONCLUSION: We suggested that the expression of Ang-1 mRNA could be associated with the pathogenesis of endometriosis and might have a role as neovascularizaton and survival of ectopic endometrium.

A Case of Intracolonic Surgical Sponge misdiagnosed as Intraperitoneal Foreign Body / 대한산부인과학회잡지

Intraperitoneal foreign body is a rare but extremely troublesome condition. Such as forceps, rubber tubes, pieces of broken instruments can retained during surgery but most commonly foreign body is the surgical sponge. The retained foreign body produce intra-abdominal abscess, peritonitis, intestinal obstruction in the postoperative period or even after weeks, months or years and very uncommonly migrate into the bowel. We report a case of intracolonic surgical sponge misdiagnosed as retained intraperitoneal foreign body with brief review of literatures.

A Case of Ruptured Noncommunicating Rudimentary Uterine Horn Twin Pregnancy / 대한산부인과학회잡지

The uterus with rudimentary horn occurs as a result of a lack of development during fetal life of the middle and lower part of one of the M llerian ducts, in which there is a failure of fusion of the two ducts. Pregnancy in the rudimentary uterine horn is very rare, its incidence is reported nearly as 1 case per 100,000 normal pregnancy. We experience a case of ruptured rudimentary uterine horn twin pregnancy at 29-gestational week and report the case with brief review of literatures.

A Case of Pelvic and Abdominal Actinomycosis Associated with Wearing an Intrauterine Device / 대한산부인과학회잡지

Actinomycosis, a rare disease entity in the upper genital tract, and caused by anaerobic bacteria, Actinomyces israelii, presents some difficulties in establishing a correct preoperative diagnosis. Pelvic actinomycosis has been reported more frequently in women with intrauterine device (IUD). Actinomycosis may be confused with malignancy and other inflammatory diseases due to its infiltrative nature and tendency to invade normal anatomic barriers. So, cervicovaginal smear is recommended for all women wearing IUDs, and actinomyosis should be suspected in such patients suffering pelvic infections. We experienced a case of pelvic and abdominal actionomycosis complicated by tuboovarian abscess in a 52 year-old woman wearing IUD and report it with a brief review of related literatures.