Incidence, Disability, and Mortality in Patients With Guillain-Barré Syndrome in Korea:A Nationwide Population-Based Study

Background@#and Purpose This study aimed to identify the epidemiological features of Guillain-Barré syndrome (GBS) in the Korean population. @*Methods@#Patients with GBS were defined as those who were hospitalized with a primary diagnostic code of G61.0 on the Korean Classification of Disease in a department of neurology, rehabilitation medicine, or pediatrics. We evaluated the incidence and prevalence of GBS as well as physical disability, mortality, and cause of death in patients with GBS from 2002 to 2018 in the Korean population using the Korean National Health Insurance Service database. @*Results@#We identified 11,146 patients with GBS. The ratio of males to females was 1.48. The age-adjusted incidence rate per 100,000 persons increased steadily from 0.84 in 2002 to 1.68 in 2018, as did the age-adjusted prevalence rate per 100,000 persons, from 0.77 to 15.62. The incidence and prevalence of GBS increased with age, peaking at 70–79 years. Among 10,114 patients without physical disability at the time of GBS being diagnosed, 502 (5.0%) patients had moderate disability and 526 (5.2%) had severe disability by the end of the study period.A total of 1,221 (11.0%) patients with GBS died during the mean follow-up period of 17 years (2002–2019). There were 144 (1.3%) in-hospital deaths. @*Conclusions@#This was the first nationwide epidemiological study of patients with GBS covering the entire population including patients of all ages in the Republic of Korea. We have revealed the seasonality of admissions, disability, and long-term mortality rates in patients with GBS.

Validation of the Korean version of Center for Epidemiologic Studies Depression Scale-Revised(K-CESD-R) / 정신신체의학

OBJECTIVES: The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). METHODS: Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. RESULTS: The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. CONCLUSIONS: These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study / 예방의학회지

OBJECTIVES: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. METHODS: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. RESULTS: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). CONCLUSIONS: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

Correlation between postpartum depression and premenstrual dysphoric disorder: Single center study

OBJECTIVE: To describe the prevalence and correlates of the postpartum depression and premenstrual dysphoric disorder. METHODS: One hundred sixty six women were assessed around 10th to 14th days after delivery in Gangneung Asan Hospital, Korea, from September 2011 to March 2012. We checked their risk factors for postpartum depressive disorders using the Beck Depression Inventory and the Edinburgh Postnatal Depression Scale. Premenstrual dysphoric disorder was evaluated retrospectively and was defined as having more than 5 of the following 10 symptoms: breast tenderness, bloating, headache, peripheral edema (hand and foot), depressive symptoms, anger, irritability, anxiety, oversensitivity, and exaggerated mood swings. RESULTS: The prevalence rate of postpartum depression using the Edinburgh Postnatal Depression Scale > or =10 and Beck Depression Inventory > or =10 was 13.9% (23/166). We found statistical differences (P<0.01) between the postpartum depression group and the postpartum non-depression group in smoking history, past history of psychiatric problems, and level of marital satisfaction. The prevalence rate of premenstrual syndrome (PMS) was 9% (15/166) and among 23 women in the postpartum depression group, eight were determined to have premenstrual dysphoric disorder, yielding a prevalence rate of 34.8% (8/23). Among 143 women in the postpartum non-depression group, seven were determined to have PMS, yielding a prevalence rate of 4.9% (7/143). A correlation between postpartum depression and PMS was thus found (P<0.01). CONCLUSION: PMS appears to be associated with postpartum depression. This means that a hormone-related etiology appears to be one risk factor for postpartum depression.

Low Systolic Blood Pressure and Mortality From All Causes and Vascular Diseases Among Older Middle-aged Men: Korean Veterans Health Study / 예방의학회지

OBJECTIVES: Recently, low systolic blood pressure (SBP) was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men. METHODS: From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR) were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004. RESULTS: Among the participants aged 60 and older, the lowest SBP (<90 mmHg) category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1) and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4) compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8) and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2) also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older. CONCLUSIONS: Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older.

Successful management of maternal factor VII deficiency in a cesarean section

Factor VII (FVII) deficiency is an infrequent hereditary bleeding disorder that can make excessive bleeding in surgical interventions, such as a postpartum hemorrhage in a cesarean section. Although a recombinant form of activated FVII has been applied for bleeding control in FVII-deficient patients, its applications in the field of obstetrics are still limited, especially in Korea. Replacement of blood products is still preferred as first-line therapy, with antifibrinolytic agents used as adjunctive therapy. We report herein the case of a successful cesarean section in an 18-year-old woman with FVII deficiency.

Agent Orange Exposure and Prevalence of Self-reported Diseases in Korean Vietnam Veterans / 예방의학회지

OBJECTIVES: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. METHODS: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. RESULTS: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR, 1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR, 1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. CONCLUSIONS: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.

Serum 2,3,7,8-Tetrachlorodibenzo-p-dioxin Levels and Their Association With Age, Body Mass Index, Smoking, Military Record-based Variables, and Estimated Exposure to Agent Orange in Korean Vietnam Veterans / 예방의학회지

OBJECTIVES: The aim of this study was to examine the levels of serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and evaluate their association with age, body mass index, smoking, military record-based variables, and estimated exposure to Agent Orange in Korean Vietnam veterans. METHODS: Serum levels of TCDD were analyzed in 102 Vietnam veterans. Information on age, body mass index, and smoking status were obtained from a self-reported questionnaire. The perceived exposure was assessed by a 6-item questionnaire. Two proximity-based exposures were constructed by division/brigade level and battalion/company level unit information using the Stellman exposure opportunity index model. RESULTS: The mean and median of serum TCDD levels was 1.2 parts per trillion (ppt) and 0.9 ppt, respectively. Only 2 Vietnam veterans had elevated levels of TCDD (>10 ppt). The levels of TCDD did not tend to increase with the likelihood of exposure to Agent Orange, as estimated from either proximity-based exposure or perceived self-reported exposure. The serum TCDD levels were not significantly different according to military unit, year of first deployment, duration of deployment, military rank, age, body mass index, and smoking status. CONCLUSIONS: The average serum TCDD levels in the Korean Vietnam veterans were lower than those reported for other occupationally or environmentally exposed groups and US Vietnam veterans, and their use as an objective marker of Agent Orange exposure may have some limitations. The unit of deployment, duration of deployment, year of first deployment, military rank, perceived self-reported exposure, and proximity-based exposure to Agent Orange were not associated with TCDD levels in Korean Vietnam veterans. Age, body mass index and smoking also were not associated with TCDD levels.

Cancer Incidence in Korean Vietnam Veterans During 1992-2003: The Korean Veterans Health Study / 예방의학회지

OBJECTIVES: The aim of this study was to investigate the association between Vietnam experience including exposure to military herbicides and cancer incidence in Korean Vietnam War veterans. METHODS: The cancer cases of 185 265 Vietnam veterans from January 1, 1992 to December 31, 2003 were confirmed from the Korea National Cancer Incidence Database. The age-adjusted incidence and standardized incidence ratios (SIRs) were calculated using the male population during 1992 to 2003 as a standard population. RESULTS: The age-adjusted overall cancer incidence per 100 000 person-years was 455.3 in Vietnam veterans. The overall cancer incidence was slightly yet significantly lower in veterans (SIR, 0.97; 95% confidence interval, 0.95 to 0.99) than in the general population. The overall cancer incidence in enlisted soldiers was not lower (SIR, 1.00), whereas that in officers was significantly lower (SIR, 0.87) than in the general population. The incidences of prostate cancer and T-cell lymphoma in all veterans, and lung cancer and bladder cancer in enlisted soldiers, and colon cancer and kidney cancer in non-commissioned officers, and colon cancer, kidney cancer, and prostate cancer in officers, were higher than in the general population. The SIR for overall cancer among Vietnam veterans rose from 0.92 for 1992-1997 to 0.99 for 1998-2003. CONCLUSIONS: The overall cancer incidence in Vietnam veterans was not higher than in the general male population. Vietnam veterans and military rank subcohorts experienced a higher incidence of several cancers, including prostate cancer, T-cell lymphoma, lung cancer, bladder cancer, kidney cancer, and colon cancer than the general population. The SIR for overall cancer increased over time in Vietnam veterans.

A case of ipsilateral ruptured cornual pregnancy after salpingectomy for tubal pregnancy: 2-port pelviscopic cornual resection using a multichannel port / 대한산부인과내시경학회지

Cornual pregnancy is a rare type of ectopic pregnancy. Its incidence is 2-4% of all tubal pregnancy. Cornual pregnancy is relatively rare in the woman who has the history of ipsilateral salpingectomy. The standard treatment of cornual pregnancy was cornual resection or hysterectomy through laparotomy. Recently, pelviscopic cornual resection has been performed with the advance of technique and instruments. We performed 2-port pelviscopy using a multichannel port in the case of ipsilateral ruptured cornual pregnancy after salpingectomy for tubal pregnancy. This method was relative safe and easy and offers the advantages in reduced surgical morbidity, less bleeding and less operation time. Therefore, we present a case of ipsilateral cornual pregnancy after salpingectomy that surgically treated under 2-port pelviscopy with a brief review of literature.

Mortality Patterns among Korean Vietnam Veterans / 대한산업의학회지

OBJECTIVES: A total of 320,000 Korean soldiers in three combat units and four supporting units participated in the Vietnam War. The aim of this study was to investigate the association between Vietnam experience and mortality by comparing mortalities in Korean Vietnam War veterans to the general population. METHODS: The deaths of 185,760 Vietnam veterans from January 1, 1992 to December 31, 2005 were confirmed by matching the veterans' information to death records from the National Statistical Office. Crude death rate, age adjusted rate and Standardized mortality ratios (SMRs) were calculated 95% confidence. Age was standardized to the total male population during 1992-2005 with the age of 36 to 83 years old. RESULTS: The age adjusted death rate per 100,000 was 868.1 among veterans and 1226.5 among the general population. Mortality of all causes was significantly lower among veterans (SMR=0.83, 95% CI: 0.82-0.84). Mortalities from neoplasms (SMR=0.87), circulatory diseases (SMR=0.79), and external causes of deaths (SMR=0.92) were significantly lower among veterans. Mortalities from several external causes of deaths including Intentional self-harm (X60-X84), assault and accidental poisoning, angina pectoris, chronic ischemic heart diseases, prostate cancer, and malignant neoplasms of hematopoietic system including multiple myeloma, non-Hodgkin's lymphoma, and leukemia were not different between veterans and the general population. CONCLUSIONS: Mortality among Vietnam veterans was lower than that among the general population. It would be explained mainly by healthy veteran effect.

The predictive factors for injury severity and pregnancy outcomes after traffic accidents during pregnancy / 대한산부인과학회지

OBJECTIVE: To estimate the predictive factors associated with traffic injury severity and pregnancy outcomes in traffic accidents during pregnancy. METHODS: We performed a retrospective case review study to assess 109 pregnant women who were injured by traffic accidents and were admitted to Gangneung Asan Hospital and KyungHee University Hospital from September 1996 to January 2009. The clinical data of maternal age, parity, gestational age, symptoms of the patients that happened after accidents, accident location, seat position in vehicle, maternal injury severity which was quantified with injury severity score (ISS), pregnancy outcomes, and subchorionic hematoma were reviewed with the medical records or the telephone interviews. Adverse pregnant outcomes included abortion, preterm delivery and fetal death in uterus. Multiple logistic regression analysis was performed to evaluate the predictive factors for injury severity and pregnancy outcomes after traffic accidents. RESULTS: Pedestrian injury and first trimester were significantly associated with severity of maternal injury. Multivariate analysis revealed that abdominal pain was independently predictive factor for the severity of maternal injury. The second trimester, pedestrian injury, right front seat of vehicle, severity of maternal injury and subchorionic hematoma were significantly associated with adverse pregnancy outcomes. Multivariate analysis revealed that severity of maternal injury and subchorionic hematoma were independently predictive factors for adverse pregnancy outcomes. CONCLUSION: According to predictive factors for pregnancy outcomes, the severity of maternal injury estimated with ISS score and subchorionic hematoma seems to be helpful indicators in the management of traffic accident injuries during pregnancy.

Endometrioid Adenocarcinoma Arising from Endometriosis of the Uterine Cervix: A Case Report

Endometrioid adenocarcinoma arising from endometriosis of the uterine cervix is rare in premenopausal woman. We describe here a patient with this condition and review the clinical and pathological features of these tumors. A 48-yr-old woman complaining of severe dysmenorrhea was referred for investigation of a pelvic mass. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Histological examination revealed an endometrioid adenocarcinoma directly adjacent to the endometriosis at the uterine cervix, with a transition observed between endometriosis and endometrioid adenocarcinoma. The patient was diagnosed as having endometrioid adenocarcinoma arising from endometriosis of the uterine cervix and underwent postoperative chemotherapy. Gynecologists and pathologists should be aware of the difficulties associated with a delay in diagnosis of endometrioid adenocarcinoma arising from endometriosis when the tumor presents as a benign looking endometrioma.

Massive Perivillous Fibrin Deposition in Placenta

Massive perivillous fibrin deposition (MFD) is a rare condition characterized by heavy accumulation of fibrin in intervillous or perivillous spaces encasing villi throughout the placenta. This condition may cause varying degrees of placental insufficiency, leading to a significantly increased risk of intrauterine growth retardation, intrauterine death, and pre-term delivery. However, the objective criteria for the diagnosis of MFD have not been clearly established. We report a case of MFD associated with intrauterine growth retardation and preterm premature rupture of membranes.

Analysis of clinical factors influencing on the operation time of classical intrafascial supracervical hysterectomy (CISH) / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to find clinical factors affecting the operation time of the classical intrafascial supracervical hysterectomy (CISH) performed on patients with uterine disease. METHODS: From January 2001 to December 2006, a total of 148 patients were reviewed and 130 patients with CISH were entered into the study. We investigated clinical factors, such as age, parity, BMI, height, weight, transverse diameter of uterus, previous operation number, operation assistant, period in sequence of operation date, pathology of uterus and operation time of surgery. The statistical assessment was used to find out the main factor determining the operation time of CISH. RESULTS: The mean operation time of CISH was 135.5 minutes and the mean transverse diameter of uterus was 7.2 cm. The main indications for CISH were uterine myoma or adenomyosis with dysmenorrhea, menorrhagia and vaginal bleeding. The operation time of CISH was affected by the transverse diameter of uterus and period which was categorized in sequence of operation date. CONCLUSION: Mainly, pre-operative ultrasonographic evaluation of uterine transverse diameter could predict the operation time of CISH.

An analysis of the risk factors for metabolic syndrome affecting stress urinary incontinence in korean middle-aged and older women / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to identify the relationship between metabolic syndrome and stress urinary incontinence. METHODS: Based form 362 case, the risk factors including the parameters of metabolic syndrome for stress urinary incontinence (SUI) were analyzed retrospectively: body mass index (BMI), hypertension, insulin resistance, triglyceride, HDL-cholesterol. RESULTS: The risk for metabolic syndrome were associated positively with SUI. Women with the risks for metabolic syndrome had 2.503 times of the odds for SUI compared without the risks for metabolic syndrome (95% CI 1.28-4.87, p<0.001). The independent risk factors for SUI were BMI (OR 3.574 ; 95% CI 0.09-0.31, p<0.001) and insulin resistance (OR 2.563 ; 95% CI 0.04-0.31, p=0.011) by multivariate analysis. CONCLUSION: Our results suggested that metabolic syndrome was the important factor of the stress urnary incontinence. And we confirmed the need for the treatment of metabolic disturbance and the prevention of metabolic syndrome aimed at correcting hormonal-metabolic disturbance in middle-aged and older women with SUI.

A case of small cell carcinoma of pulmonary type of ovary associated with huge mucinous cystadenocarcinoma / 대한산부인과학회지

Small cell carcinoma of ovary is extremely rare. This neoplasms compose predominantly or exclusively of small round cells with scant cytoplasm. There are two types of primary small cell carcinoma of ovary described in the literature : the hypercalcemic type and the pulmonary type. The first 11 patients with a primary ovarian small cell carcinoma of the pulmonary type were described by Eichorn et al. in 1992. The prognosis of this tumor is very poor and only limited data on the treatment of this tumor type are available. In the present case report, we describe a patient with the pulmonary type of small cell carcinoma associated with huge mucinous cystadenocarcinoma with a brief review of the concerned literatures.

Low-grade Mucinous Cystic Tumor Associated with Endo-metriosis in the Cecum

We report here on an unusual case of mucinous cystic tumor that was associated with endometriosis in the cecum. A 45-year-old woman was admitted to the hospital due to her 5 day history of right lower quadrant abdominal pain with a mild fever. A laparotomy was performed under the clinical impression of the tubo-ovarian abscess. A relatively well defined a multi-locular cystic mass (8.0x8.0x7.0 cm) filled with white-to-yellow thick mucoid material was found in the wall of the cecum. The right ovary and fallopian tube showed marked fibrous adhesion to the external surface of the cecal mass. A right hemicolectomy and salpingo-oophorectomy were performed. Histologically, the tumor was similar to those of ovarian borderline mucinous tumor, the intestinal type, and the mucinous epithelium of the tumor was merged with the endometriotic epithelium and stroma. On immunostaining, the CK20 positive mucinous epithelium was well demarcated from the CK7 endometriotic epithelium. This is the first case of low-grade mucinous cystic tumor intimately associated with intestinal endometriosis in the cecum.

An Analysis of the Metabolic Syndrome and the Clinicopathologic Prognostic Factors Affecting Survival in Patients with Uterine Endometrial Cancer / 대한산부인과학회지

OBJECTIVE: We aimed to evaluate the metabolic syndrome and the clinicopathologic prognostic factors of endometrial cancer results from 35 surgically staged patients and to find out those novel prognostic factors. METHODS: This study is based on 35 endometrial cancer patients. Difference of survival rate in the following histologic parameters and parameter of metabolic syndrome was analyzed: age, body mass index (BMI), hypertension, insulin resistance, triglyceride, HDL-cholesterol, FIGO stage, tumor grade, myometrial invasion, cervical involvement, adnexal metastasis, and lympho-vascular space invasion (LVSI). Concerning lymph node involvement, the ratio of metastatic lymph node to dissected lymph node (metastatic ratio: MR) was calculated in total pelvic lymph node. MR was divided into less than 0.5 to more than 0.5. In each group, 5-year survival rate (5YSR) was analyzed and compared. RESULTS: The overall 5YSR for all 35 patients was 78.8%. The 5YSR for insulin resistance and normal insulin tolerance were 94.1%, 33.6% (p=0.009). LVSI, adnexal metastasis and MR of pelvic lymph node were independent prognostic factors for the endometrial cancer patients. CONCLUSION: Our results suggested that there was a relationship between insulin resistance and endometrial cancer and we confirmed the need for the treatment of metabolic disturbance and the prevention of metabolic syndrome aimed at correcting hormonal-metabolic disturbance in endometrial cancer patients. The MR of pelvic lymph node is thought that one of the most important prognostic factor of the endometrial cancer.

Female adnexal tumor of probable Wolffian origin: A Case Report / 대한산부인과학회지

Female adnexal tumors of probable Wolffian origin (FATPWO) were first reported in 1973 and the disease is a rare clinical entity. They are often found in the leaves of the broad ligament, ovary and paravaginal tissue. We report a 40-year-old woman who presented with both adnexal masses filling the pelvic cavity which were hard and fixed on palpation, and the masses were radiologically diagnosed as both ovarian fibroma-thecomas on the CT scan. The left adnexal mass was surgically excised and pathologically proved to be fibroma, the left adnexal mass was excised and pathologically proved to be FATPWO.