Surgical management of recurrent pneumothorax in the second trimester of pregnancy / 대한주산의학회잡지

Spontaneous pneumothorax in pregnancy is generally regarded as an unusual disorder, with only approximately 44 cases having been reported in the world literature. The most common cause is the rupture of a subpleural apical bulla or bleb, due to increased respiratory demand of the peripartum period. Pneumothorax should be considered in any pregnant woman with chest pain and/or dyspnea and must be confirmed radiographically. Treatment of simple pneumothorax during pregnancy is controversal. Admission and close observation of the patient is usually done with small pneumothorax. Other treatment options are needle aspiration, needle decompression (eg, intension pneumothorax), pleurodesis, tube thoracostomy, thoracotomy, and thoracoscopy. We report a recent experience of a 34 years-old pregnant woman with recurrent pneumothorax, who was treated with thoracotomy during the 28th weeks of pregnancy. She had previously been well during pregnancy and all antenatal investigations, including ultrasound scan, were normal. Cardiovascular examination did not reveal any abnormality. On chest auscultation, air entry was reduced on the left side of the chest. Chest X-ray revealed significantly expanded left lung with a large pneumothorax. After successfully treated with surgical approach, the patient had vaginal delivery of a healthy male infant, weighing 2.93 kg, safely during 39th weeks of pregnancy.

A case of bowel obstruction due to endometriosis / 대한산부인과학회지

We have experienced a case of intestinal obstruction due to endometriosis. It may involve intestinal wall and protrude into its lumen and patients with severe intestinal involvement usually require surgical resection. Clinical manifestations are not specific, making the preoperative diagnosis difficult to establish. An emergency laparotomy was performed. The pathologic examination of the resected sample revealed endometriosis of sigmoid colon. Endometriosis can involve the intestinal tract extensively, causing a variety of clinical symptoms, and can result in a spectrum of mucosal alterations.

Association of Fas, Fas-ligand gene polymorphisms with bone mineral desity and bone resposiveness to hormone therapy in postmenopausal women / 대한산부인과학회지

OBJECTIVE: To investigate the relationship between Fas gene & Fas-ligand gene polymorphisms, and bone mineral density (BMD) after hormone therapy (HT) in postmenopausal women. METHODS: Restriction fragment length polymorphisms at the Fas A670G, G1377A gene site and Fas-ligand C843T, IVS3nt169 (T/delT) gene site and BMD at the lumbar spine and proximal femur were analyzed in 229 postmenopausal women receiving sequential HT for 1 year. BMD were measured by DEXA. The subjects were divided in normal, osteopenic and osteoporotic on the basis of the T-score values according to the classification of the World Health Organization (WHO). RESULTS: After adjusting for potential confounding factors such as age, BMI, and menopause duration, A670G polymorphism was significantly associated with BMD at the lumbar spine, the femur neck and trochanter in osteopenic and osteoporotic groups, and G1377A polymorphism was significantly associated with BMD at lumbar spine and the femur neck in osteopenic group. C843T polymorphism was significantly associated with BMD at lumbar spine and ward triangle in osteoporotic group, IVS3nt169 (T/delT) was not associated with BMD. In osteoporotic group after HT in postmenopausal women, A670G polymorphism A/A, G1377A polymorphism G/G, C843T polymorphism T/T were associated with significant annual bone mineral density change, compared with other polymorphism at the same gene. CONCLUSION: These findings suggest that Fas, Fas-ligand gene polymorphisms may be an important contributor to the variation of BMD among postmenopausal women. and that a specific Fas, Fas-ligand polymorphisms are associated with significant BMD change in postmenopausal women after HT.

Early Endometrial Cancer with Multiple Bone Metastasis / 대한산부인과학회지

A 61-year old female was found to have an endometrial cancer with surgical stage Ib, grade 2. Treatment involves surgical resection followed by radiation therapy. In the middle of adjuvant radiation therapy she complained of undifined headache and tongue deviation those came from multiple skull and skeletal metastasis. Although she received the adjuvant chemo-radiation therapy but failed. Therefore we reported a case of early endometrial cancer that unusually showed multiple bone metastasis with discussion about the pretreatment evaluation for bone metastasis.