The maintenance ability and Ca²⁺ availability of skeletal muscle are enhanced by sildenafil

Sildenafil relaxes vascular smooth muscle cells and is used to treat pulmonary artery hypertension as well as erectile dysfunction. However, the effectiveness of sildenafil on skeletal muscle and the benefit of its clinical use have been controversial, and most studies focus primarily on tissues and organs from disease models without cellular examination. Here, the effects of sildenafil on skeletal muscle at the cellular level were examined using mouse primary skeletal myoblasts (the proliferative form of skeletal muscle stem cells) and myotubes, along with single-cell Ca2+ imaging experiments and cellular and biochemical studies. The proliferation of skeletal myoblasts was enhanced by sildenafil in a dose-independent manner. In skeletal myotubes, sildenafil enhanced the activity of ryanodine receptor 1, an internal Ca2+ channel, and Ca2+ movement that promotes skeletal muscle contraction, possibly due to an increase in the resting cytosolic Ca2+ level and a unique microscopic shape in the myotube membranes. Therefore, these results suggest that the maintenance ability of skeletal muscle mass and the contractility of skeletal muscle could be improved by sildenafil by enhancing the proliferation of skeletal myoblasts and increasing the Ca2+ availability of skeletal myotubes, respectively.

Patient Satisfaction, Vaginal Bleeding, Sexual Function following Laparoscopic Supracervical Hysterectomy

PURPOSE: This study was done to evaluate postoperative patient satisfaction, vaginal bleeding, and sexual function in women after laparoscopic supracervical hysterectomy (LSH). METHODS: A retrospective study was conducted using a questionnaire mailed to 131 women who underwent LSH between 2008 and 2011at the Department of Obstetrics &Gynecology, D University Hospital in Chungnam province. Indication for LSH was uterine myoma. The questionnaire contained questions on overall postoperative satisfaction, influence on quality of life of vaginal bleeding, and sexual satisfaction following surgery. Data were collected from March to July 2013 and 109 (83.2%) patients returned the questionnaire. RESULTS: Most women reported being very satisfied (90.8%) or satisfied (7.3%), but 2 women (1.8%) were not satisfied with LSH. Four patients (3.4%) reported experiencing vaginal bleeding but with no negative influence on quality of life. Of sexually active women, 82 patients (90.1%) reported improvements in sexual function, 8 patients (8.8%) reported "no change", and one patient (1.1%) reported a deterioration. CONCLUSION: Results of this study indicate that LSH is associated with a high degree of patient satisfaction, no negative influence on quality of life from vaginal bleeding, and improvement in sexual function to a minimum 2 years after the procedure.

Comparative study of laparoscopic assisted vaginal hysterectomy and laparoscopic supracervical hysterectomy / 대한산부인과학회지

OBJECTIVE: To compare the clinical results between laparoscopic assisted vaginal hysterectomy (LAVH) and laparoscopic supracervical hysterectomy (LSH) in women with uterine leiomyoma. METHODS: One hundred four women underwent laparoscopic hysterectomy for the treatment of uterine leiomyoma between July 2008 and December 2009. A total of 60 women decided to undergo complete hysterectomy with removal of uterine cervix (LAVH group) and 44 women wished to preserve the uterine cervix (LSH group). Outcome measures including patient's characteristics, operating time, blood loss, rate of complications, were assessed and compared between groups. RESULTS: The women in the LAVH group were significantly older as compared with the LSH group, 45.16+/-0.84 years versus 42.41+/-0.62 years respectively. There were no significant differences in patient's characteristics (body mass index, parity, prior surgery) between the two groups. The mean operating time was 64.07+/-2.37 min. for LAVH group and 69.76+/-2.01 min. for LSH group; the mean hemoglobin change was 1.62+/-0.13 g/dL for LAVH group, 1.83+/-0.14 g/dL for LSH group, no significant differences were noted between two groups respect to the mean operating time and the mean hemoglobin change. There is no post-operative complications in both LAVH and LSH group. CONCLUSION: Based on our results, in women with uterine leiomyoma, LAVH and LSH seem to be the preferred hysterectomy techniques. The mean age was younger in LSH group, but did not appear to offer any significant benefits over LAVH. LAVH proved to be a valid alternative to LSH, and appropriate method for laparoscopic hysterectomy.

A case of fetal intracranial hemorrhage diagnosed by antenatal ultrasonographic examination / 대한주산의학회잡지

Fetal intracranial hemorrhage is quite rare. Antenatal fetal intracranial hemorrhage may occur spontaneously, or in association with various maternal or fetal conditions. Currently, antenatal fetal intracranial hemorrhage may be diagnosed by imaging techniques including ultrasonography and less frequently, magnetic resonance imaging (MRI). We report a case of spontaneous fetal intracranial hemorrhage that was diagnosed antenatally in the third trimester with a brief review of literatures.

The change of lipid peroxidation and superoxide dismutase activity in placenta by the birth to placental weight ratio at birth / 대한산부인과학회지

OBJECTIVE: The object of this study is to determine whether there is any association between birth to placenta weight ratio and oxidative stress. 34 pregnant women (who gave birth after 36 weeks of pregnancy by cesarean section without labor) were divided into three groups according to their birth to placenta weight ratio. The degree of lipid peroxidation in the placenta and the activity of superoxide dismutase which removes peroxide products were compared in three groups METHODS: In the 34 women who gave birth through cesarean section before labor, we classified the patients to three groups ; the first group (n=13) women whose birth to placenta weight ratio was equal to or above 5.0. The second group (n=14) whose ratio was between 4.3 and 5.0. The third group (n=7) whose ratio was less than 4.3. We measured malondialdehyde (MDA) as a indicative marker of lipid peroxidation through a Thibarbituric Acid (TBA) method, and the activity of superoxide dismutase (SOD) as a antioxidant defense system through a Bioxytech SOD-525 kit (OxisResearch, USA). Data were analyzed statistically using ANOVA test (SPSS for Windows 10.0) and students's t-test. RESULTS: In a group consisting of preeclampsia and FGR, the birth to placenta weight ratio had no significant difference. The mean MDA concentration of group 1 was 7.38+/-6.6 nmole/mg protein, which was significantly lower than both mean of group 2 (17.39+/-12.54 nmole/ mg protein) and group 3 (19.89+/-8.69 nmole/mg protein), There were no significant differences between group 2 and 3. The MDA/SOD ratio of group 1 was 1.01+/-0.97, which was significantly lower than those of group 2 and 3, which were 2.79+/-2.92 and 3.29+/-2.18, respectively. However, there were no significant differences between group 2 and 3. CONCLUSIONS: It is possible to assume that oxidative stress participates in the mechanism of decreased birth to placental weight ratio. Th decreased ratio is probably due to excessive lipid peroxides in placenta. To evaluate the association of birth to placental weight ratio with oxidative stress.

Abdominal wall endometriosis in the absence of previous surgery: A case report / 대한산부인과학회지

Endometriosis is a common gynecological entity and characterized by the presence of endometrial glands and stroma outside the normal location in the uterine cavity. Endometriosis has been reported mostly in the pelvic cavity but anywhere in the body such as umbilicus, appendix, bladder, cervix, pleural cavity, lung, rectum, vagina, vulva and round ligaments. The abdominal wall is one of the most common sites of extrapelvic endometriosis and usually develops in association with a prior surgical scar. However, endometriosis involving the scarless abdomen is rare. We experienced an unusual presentation of a woman with abdominal wall endometriosis in the absence of previous surgery associated with recurrent pneumothorax in menstrual cycle. We report this case with brief review of the literature.

A Case of Large Cystic Myxoid Leiomyoma in Uterine Round Ligament / 대한산부인과학회지

Uterine leiomyomas are the most common benign uterine tumor. They may be subserosal, intramural, or submucosal in location within the uterus or located in the cervix, in the broad ligament, or on a pedicle. But leiomyoma of the round ligament of the uterus is a rare condition occurring predominantly in premenopausal middle-age women, which is usually single and unilateral. In 50% of patients, they are associated with similar lesion of the uterus. Recently we have experienced a case of large cystic myxoid leiomyoma of the round ligament of the uterus misdiagnosed as an ovarian tumor in 32 year-old multiparous woman. We report this case with a brief review of literatures.

The Correlation of Serum Level of Tumor Marker CA125 and CA19-9 and Severity of Endometriosis / 대한산부인과학회지

OBJECTIVE: The purpose of this study is to evaluate the clinical usefulness of serum level of CA125 and CA19-9 to assess the severity of endometriosis. METHODS: The study was conducted on 80 patients with histologically diagnosed endometriosis and 20 patients in control group. Preoperative serum CA125 and CA19-9 levels were measured by immunoradiometric assay and the severity of disease was staged according to the revised American Fertility Society (1985) classification system. RESULTS: Both serum level of CA125 and CA19-9 in endometriosis patient (81.7+/-120.44 U/mL, 47.1+/-80.74 U/mL, Mean+/-SD) were higher than control group (10.8+/-6.48 U/mL, 11.7+/-8.82 U/mL, Mean+/-SD)(p=0.001, p=0.054). The serum CA125 level increased significantly according to stages (p=0.051), but serum CA19-9 level showed an increasing trend (p>0.05). With the cutoff value of CA125 with 35 U/mL and CA19-9 with 37 U/mL, overall positive rate for CA125, CA19-9, and CA125 combined with CA19-9 was 45.1%, 33.8%, and 52.5%. There was no difference between the positive rate with CA125 combined with CA19-9 (52.5%) and that with CA125 alone (45.1%)(p>0.05). With the cutoff value of CA125 with 15 U/mL and CA19-9 with 9 U/mL, overall positive rate for CA125, CA19-9, and CA125 combined with CA19-9 was 82.5%, 76.3%, and 92.5%, the positive rate with CA125 combined with CA19-9 (92.5%) was higher than that with CA125 alone (82.5%)(p=0.056). CONCLUSION: Because the positive rate with combined serum CA125 and CA19-9 level is not higher than that with serum CA125 alone for the severity assessment of endometriosis, it is recommended to use serum CA125 level alone.

Clinical Evaluation on 160 Cases of Laparoscopically Assisted Vaginal Hysterectomy (LAVH) / 대한산부인과학회지

OBJECTIVE: To report our clinical outcome on 160 cases of laparoscopically assisted vaginal hysterectomy (LAVH) and to evaluate the efficacy and safety of LAVH. METHODS: From May, 1998 to April 2004, 160 patients were performed LAVH at the Department of Obstetrics and Gynecology, Dankook University Hospital. We retrospectively analyzed the results with regard to age, parity, height, weight, previous operation history, preoperative indication, combined operation, operation time, uterine weight, change of hemoglobin, hospitalization, convert to total abdominal hysterectomy (TAH), and complication. RESULTS: The mean age was 44.63 +/- 6.79 years, The mean parity was 2.34 +/- 1.18. The common previous operations were tubal ligation (54%) and appendectomy (17%). The common preoperative indications were myoma (75%) and adenomyosis (10%). The most common combined operation was unilateral salpingoophorectomy (39%). The mean operation time was 97.81 +/- 29.90 minutes, and the mean uterine weight was 215.59 +/- 89.97 g. The mean hemoglobin change was 2.08 +/- 1.34 g/dL, and the mean hospitalization was 4.45 +/- 0.71 days. The complications were bladder injury (1 case), rectum injury (1 case), subcutaneous hematoma (2 cases), hemoperitoneum (1 case). CONCLUSION: LAVH is effective and safe alternative to TAH in many cases of gynecologic surgery. LAVH has been possible to replace TAH with improvement of surgical skill and laparoscopic instruments.

A Case of Poland Syndrome Diagnosed by Prenatal Ultrasonography / 대한산부인과학회지

Poland syndrome is a rare congenital disorder. It is characterized by unilateral chest wall hypoplasia, ipsilateral arm and hand abnormalities, and a variety of associated anomalies. It is suggested that the deformity has a sporadic and nongenetic nature. The main pathogenetic mechanism is the interruption of embryological blood supply to the subclavian artery with hypoplasia at the end of the 6th week of gestation. Most frequently involved muscle is the sternocostal portion of the pectoralis major muscle, with hypoplasia of breast and nipple, rib anomalies and unilateral brachysyndactyly. We experienced an unusual case of Poland syndrome which was detected by prenatally ultrasonographic evaluation at 36 gestational weeks. So, we report this case with a brief review of the literature.

Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy (LAVH) and Total Laparoscopic Hysterectomy (TLH) / 대한산부인과학회지

OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH), and to realize the merits and demerits of both operations, so we know which pelviscopic hysterectomy operation is better method at the present time. METHODS: 30 of LAVH cases and 30 of TLH cases were performed from 12 December 2002 to 25 February 2004 at department of OB and GY, Dankook University Hospital. We analyzed the results with regard to patient's characteristics, indication of hysterectomy, size of uterus, operation time, blood loss, duration of hospitalization and complications. RESULTS: LAVH operations, and TLH operations were performed by same operator respectively. There were no significant differences in patient's characteristics (age, height, weight) between the two groups. The main preoperative indication was myoma uteri in both groups, followed by CINIII in LAVH groups and adenomyosis in TLH groups. The majority of uterine size on operation field was adult fist size in both groups. The mean operation time was 86.3 +/- 19.5 min for LAVH group and 153.3 +/- 44.4 min for TLH group, the operation time is significantly longer in TLH group (P-value0.05). The duration of hospitalization was not significantly different between the two groups (6.1 +/- 0.4 days for LAVH, 6.2 +/- 0.8 days for TLH, P-value>0.05). There is no complication in LAVH group, 3 complications in TLH group. CONCLUSION: LAVH has no significant differences in patient's characteristics, indication of operation, size of uterus, blood loss and duration of hospitalization, compared with TLH, but it has the merits of short operation time and less complication. In this study we consider that LAVH operation method stands at advantage over TLH.

A Case of the Uterus Didelphys with Unilateral Obstructed Hemivagina / 대한산부인과학회잡지

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly due to M llerian duct malformation. The most common clinical presentation is pelvic pain and dysmenorrhea shortly after menarche, in associated with the finding of a vaginal or pelvic mass. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patient. The simple and adequate treatment of the condition is incision of the obstructed vaginal septum providing adequate drainage of the retained blood. We report a case of uterus didelphys with obstructed hemivagina with brief review of the literature.

Prophylactic Antiemetic Efficacy of Ondansetron in Gynecologic Pelviscopic Patients / 대한마취과학회지

BACKGROUND: The safety and efficacy of ondansetron were evaluated for the prophylaxis of postoperative nausea and vomiting (PONV) after pelviscopic gynecologic procedure. We compared the effects of three doses of intravenous ondansetron, 1 mg, 4 mg, and 8 mg. METHODS: Eighty women were randomly allocated to one of 4 groups receiving 1 mg (group 1, n = 20), 4 mg (group 2, n = 20), 8 mg (group 3, n = 20) or normal saline (group 4, n = 20) at the end of pelviscopic operation. PONV were measured using a 4 point scale (0: none, 1: mild, 2: moderate, 3: severe) 1 hr, 2 hr, 6 hr, 12 hr, 24 hr after the operation and other side effects were checked. RESULTS: Over the 24 hr study period, group 2 and 3 showed a significant lower incidence of nausea (15%, 10%) and vomiting (5%, 5%) than in group 1 (nausea: 25%, vomiting: 5%) or group 4 (nausea: 40%, vomiting: 30%). Complete response rates of each group were 80%, 90%, 90% and 50% during first 2 hrs and 50%, 80%, 75% and 30% after 2 hrs after operation. Adverse events were minor, and ondansetron treated patients had profiles similar to those of the placebo. CONCLUSIONS: We concluded that ondansetron at 4 mg or 8 mg is a safe and effective prophylactic antiemetic for women requiring gynecologic pelviscopic surgery under general anesthesia.

Clinical Significance of Serum CA 125, CA 19-9 as Tumor Markers in Benign Ovarian Tumors / 대한산부인과학회잡지

OBJECTIVE: This study was designed to determine the clinical significance of serum CA 125 and CA 19-9 levels in preoperative differential diagnosis of benign ovarian tumors. METHODS: 104 patients who visited the department of Obstetrics and Gynecology of Dankook University Hospital from February 1999 to December 2001, and who were diagnosed as adnexal mass and underwent surgery, and free of other medical diseases, were enrolled as subjects. An analysis of preoperative serum CA 125, CA 19-9 levels of patients was performed in correlation with the postoperative histologic diagnoses. The histologic diagnoses were grouped as mature cystic teratoma, endometrioma, mucinous cystadenoma, serous cystadenoma, benign cystic tumor group, adnexal inflammatory disease group. Study group was defined as endometrioma, adnexal inflammatory disease in CA 125, and mature cystic teratoma, endometrioma in CA 19-9, and the others were defined as control group. Statistical analysis with Chi square test was done on the number of cases who showed CA 125 or CA 19-9 increment over cut off value between study group and control group. Study group was compared with control group in the mean value of serum tumor marker level and the mean value of elevated serum tumor marker level over cut off value. RESULTS: The number of cases who showed serum CA 125 increment over cut off value (35 U/ml) was significantly higher in endometrioma and adnexal inflammatory disease group (p<0.05), and the number of cases who showed serum CA 19-9 increment over cut off value (37 U/ml) was significantly higher in endometrioma and mature cystic teratoma group (p<0.05). The mean value of serum tumor marker level and the mean value of elevated serum tumor marker level over cut off value in those groups showed no significant difference in comparison with those of the other groups. CONCLUSION: In this study, increment of CA 19-9 in endometrioma and CA 125 and CA 19-9 in mature cystic teratoma showed statistically significant higher frequency than other groups. We concluded that checking the preoperative serum level of CA 125 and CA 19-9, combined with transvaginal ultrasonography, may be helpful in differential diagnosis of benign ovarian tumors and in discriminating benign ovarian tumors from malignant ovarian tumors, if any other condition that may cause serum level elevation of CA 125 and CA 19-9 is excluded.

A Clinical Study of 215 Cases of Pelviscopic Surgery in Gynecologic field / 대한산부인과학회잡지

OBJECTIVE: To evaluate the scope of pelviscopic surgery on gynecologic disease, safety or efficacy associated with the procedure. METHODS: Two hundred fifteen cases of pelviscopic surgery which were performed at Dankook University Hospital from March 1998 to February 2002. All cases were analyzed with regard to the age, parity, indications for surgery, types of the surgery, past history of surgery, operation time, hospital days, intra and postoperative complications. RESULTS: The mean age of patient was 39.2 years, the mean number of parity was 1.8. The most common clinical indication of the surgery was ovarian tumor 106 cases (50.2%), followed by myoma uteri 80 cases (37.2%), CIN III 14 cases (6.5%). The types of surgery were LAVH 93 cases (43.3%), salpingo-oophorectomy 61 cases (28.4%), oophorectomy 34 cases (15.8%). The operation time ranged 20 to 200 minutes and the mean duration of hospitalization was 4.4 days. CONCLUSION: The pelviscopy offers the advantages of reduced surgical morbidity, less bleeding, less postoperative pain, shorter hospital stays. Pelviscopic operation is safe and effective alternative to laparotomy in many cases of gynecologic surgery.

Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy (LAVH) and Total Abdominal Hysterectomy (TAH) / 대한산부인과학회잡지

OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH). METHOD: 60 of LAVH cases and 60 of TAH cases, which were performed at Dankook university hospital from April 1998 to December 2000. We analyzed the results with regard to patient's characteristics, indication of hysterectomy, weight of uterus, operation time, blood loss, hospital stay and complications. RESULTS: Total 120 of hysterectomy cases (60 LAVH, 60 TAH) were enrolled in this study. All operations, LAVH and TAH, were performed by same surgeon. There were no significant differences in patient's characteristics (age, height, weight, parity) between the two groups. The main preoperative indication was myoma uteri, followed by adenomyosis, CIN III, for both LAVH and TAH. The mean uterine weight of TAH cases was larger than LAVH (214.8+/-88.1 gm for LAVH, 377.1+/-269.0 gm for TAH, p0.05). The hospital stay of LAVH was significantly shorter than TAH (4.9+/-0.6day for LAVH, 7.5+/-1.9day for TAH, p<0.05). CONCLUSION: In the comparison of LAVH and TAH operation, we conclude that LAVH can be considered as the first choice when determining hysterectomy method, unless contraindication prevents it. LAVH has advantages of shorter hospitalization and the acceptable complication rate.

Clinical Analysis of Fetal Congenital Anomalies / 대한산부인과학회잡지

The term congenital anomalies here refers to structural defect (congenital malformations, deformations, disruptions and dysplasias), chromosomal abnormalities, inborn errors of metabolism and hereditary disease. The prevalence of major congenital malformation (i.e., defects either incompatible with life or severe enough to interfere with normal living) is about 2% to 3%. In the past, infection was one of the major cause of perinatal morbidity and mortality, but owing to the development of antibiotics and intensive care, congenital anomalies are becoming a major cause of perinatal morbidity and mortality. Perinatal diagnosis of congenital anomalies is becoming more important because appropriate perinatal care may minimize the effect of congenital anomalies. This report was based on the 234 cases of the congenital anomalies among 8,099 newborns delivered at Dankook University Hospital from Mar. 1st, 1995 to Feb. 28th, 2000. The analyzed results were as follows: 1. The overall incidence of the congenital anomalies was 2.9%. The incidence of congenital anomalies in male newborns (141, 60.2%) was statistically significantly higher than that of female (90, 38.5%) and ambiguous (3, 1.3%). 2. The incidence of the congenital anomalies of 21-25 year old maternal age was the lowest among each other age group. The incidence of this group was 1.6%, of less than 20 year old group was 2.7%, of over 35 year old group was 2.9%. But there was no statistically significant difference among each maternal age groups. 3. There was no statistically significant difference in the incidences of congenital anomalies between parity. 4. The incidence of low-birth weight less than 2,500 g in congenital anomalies was 9.2%, which was 5.1 times higher than that of the more than 2,500 g. 5. The incidence of vertex presentation in congenital anomalies (192, 82.1%) was very high compared to breech presentation (42, 17.9%). 6. In the method of deliveries, vaginal deliveries was 131 cases (56.0%) and cesarean section was 103 cases (44.0%). 7. The incidence of the congenital anomalies in stillbirth was 28.4%, which was 13 times higher than that of the live birth. 8. The perinatal mortality rate in congenital anomalies were 93 cases (39.7%) and stillbirths were 62 cases (28.4%). 9. When classified according to the type of congenital anomalies, the rate of the incidence was 13.3% (31 cases) in central nervous system, 9.4% (22 cases) in neck and face anomaly, 6.8% (16 cases) in cardiac anomaly, 1.3% (3 cases)in pulmonary anomaly, 5.5% (13 cases) in gastrointestinal anomaly, 13.7% (32 cases) in genitourinary anomaly, 18.4% (43 cases) in musculoskeletal anomaly, 9.0% (21 cases) in skin and soft tissue anomaly, 14.1% (33 cases) in multiple anomaly and 5.5% (13 cases) in chromosomal anomaly. The most common major congenital anomalies was hydrocephalus (14 cases, 5.9%) and polycystic kidney (14 cases, 5.9%). The rate of perinatal mortality of the congenital anomalies was 38.5%, particularly it was the highest in the CNS anomalies which were 89.7%, the next 50.0% in cardiopulmonary anomalies.

Uterine Tumor Resembling Ovarian Sex-cord Tumor in a 21-year-old Woman: Immunophenotype Consistent with True Sex-cord Differentiation / 대한산부인과학회잡지

A case of Clement and Scully's type II uterine tumor resembling ovarian sex cord tumors (UTROSCT) occurring in a 21-year-old woman is presented. Grossly, a 10 cm-sized fundic myometrial tumor, which was projecting into the endometrial cavity, was excised. Histologically, most parts of tumor showed the morphology of sex cord-like differentiation, including solid anastomosing cords or tubules, solid nests, and trabeculae arranged in a plexiform pattern. The sex cord elements were studied immunohistochemically with markers of sex cord, steroid cell differentiation (inhibin, O13, and A103), or both. The tumor cells were found to be diffusely immunoreactive for O13 (MIC2, CD99) and very focally positive for inhibin. There were also constant immunoreactivity for vimentin and hormone receptors and relatively rare positivity for desmin, actin, and cytokeratin. These findings provide strong evidence for the presence of true sex cord elements, the derivation of which seems to derive from the capacity for divergent differentiation of uterine stroma. This report demonstrates immunohistochemically true sex cord differentiation in UTROSCT.

Two Cases of Imperforate Hymen with Hematocolpometra / 대한산부인과학회잡지

Imperforate hymen is a rare congenital malformation. Two cases of imperforate hymen regarded to congenital origin, and formed hematocolpometra. In most instances definite finding is noticed after menarche as retention of menstrual flow results in abdominal pain, distension of the lower abdomen and often in acute urinary retention. Two cases of imperforate hymen associated with hematocolpora, hematometra and abdominal distension at age of 14 and 16 were treated satisfactorily by simple crucial incision of hymen, and drained of about 800 cc and 600 cc of tarry blood respectively. We present two cases of imperforate hymen with review of the literatures.

A Case Of Pelvic Actinomycosis Complicated By Tuboovarian Abscess / 대한산부인과학회잡지

Pelvic actinomycosis is a chronic suppurative and granulomatous disease with multiple abscess and draining sinus tracts caused by Actinomyces, a Gram-positive, anaerobic, non-acid-fast bacterium. Pelvic actinomycosis is a rare disease, but it is more common with intrauterine device users than others. The symptoms and signs of pelvic actinomycosis are variable, from asymptomatic to mimicking the symptoms and signs of pelvic mass or acute peritonitis, and sometimes it is difficult to discriminate pelvic malignancy from actinomycosis. Identifying the typical "sulfur granule" with hematoxylin-eosin stain and detecting the actinomycotic colony in Gram stain may suggest the diagnosis. We have experienced a case of pelvic actinomycosis complicated by right tuboovarian abscess in a 39-year-old woman using intrauterine device and report it with brief review of literatures.