The value of serum CA 125 in tubo-ovarian abscess / 대한산부인과학회지

OBJECTIVE: The aim of this study is to measure the serum levels of CA 125, ESR and CRP in patients with tubo-ovarian abscess (TOA) before and after treatment of abscess and to assess the usefulness of CA 125 in the diagnosis, prediction of the outcome of TOA treatment and clinical follow-up of patient's condition. METHODS: This retrospective study included 65 patients with TOA. Serum CA 125, ESR, CRP and WBC counts were measured. The treatment was done conservatively with antibiotics. The patients were divided into two groups: those with successful results into group 1 (29 cases) and those with unsuccessful results into group 2 (36 cases). If treatment was considered to be unsuccessful, surgical intervention was additionally performed. RESULTS: The serum levels of CA 125, ESR and abscess size on admission in group 2 were significantly higher than in group 1. ESR, abscess size and CA 125 in order were valuable predictive factors affecting the success of medical treatment. And the new cutoff value was 36.5 mm/h, 4.2 cm and 68.3 U/ml, respectively. The sensitivity rate of CA 125, ESR levels was significantly higher in group 2 than in group 1. Although CRP was decreased significantly 10 days after treatment, the serum CA 125 was not decreased significantly. And it took 51.5 days for CA 125 to be normalized after the initiation of treatment. CONCLUSIONS: The serum CA125, ESR levels and abscess sizes are predictive factors affecting the success of medical treatment of abscess treatment. And CA 125 and ESR are useful for diagnosing severity of disease. But serum CA 125 level is an inappropriate marker for monitoring short-term efficacy of treatment.

Prenatal ultrasonographic diagnosis of Fetus in Fetu at 2nd trimester: A case report / 대한산부인과학회지

Fetus in fetu is an very rare condition in which a vertebrate fetus is incorporated within its twin. Although a number of cases were reported at 3rd trimester of gestation or postnatally, the authors present a retroperitoneal fetus in fetu with 9 x 7 x 6 cm sized cystic mass that was diagnosed at 2nd trimester using ultrasonography and confirmed on a computed tomography scan after birth. The mass was successfully excised postnatally and consistent with a fetus in fetu by pathological confirmation. Solid mass was surrounded by a fluid-containing sac and showed highly ordered organogenesis around an axial vertebral column.

Tissue viability of human placental explants in normoxic and hypoxic culture / 대한산부인과학회지

OBJECTIVE: In vitro study systems for research of placental hypoxia are needed, among which human placental villous explant culture technique under experimentally variable condition is commonly used. So we performed this study to assess the viability of placental villous explant in normoxic and hypoxic culture that can provide validity for that system. METHOD: Placental villous explant tissues obtained from 9 cases of normal term pregnancies were incubated in normoxic (20% O2) and hypoxic (2~5% O2) condition for 72 hours. The viability of tissue was evaluated morphologically by microscopic examination and biochemically by LDH assay at variable time interval (0, 6, 12, 24, 48, 72 hours). The apoptosis of the tissue was assessed by TUNEL assay. RESULT: By light microscope, all of H&E stained placental explant tissue sections in normoxic and hypoxic culture showed intact villous integrities without definitive syncytial sloughing and fibrinoid necrosis as time elapsed. Tissue viability of LDH assay during 6, 24, 48, 72 hours of placental villous explants showed over all 52.3~67.6% and didn't show statistically significant difference between normoxic and hypoxic culture. Tissue viability in both groups maintained 61.2~67.6% for the first 24 hours and eventually decreased with time. TUNEL assay showed over all negative findings in normoxic and hypoxic culture at different time periods. CONCLUSION: In vitro human placental explant culture system can be a useful and feasible technique for research of placental hypoxia which is related to development of obstetrical complications such as preeclampsia, intrauterine fetal growth restriction and preterm labor and so on. But our in vitro placental explant system needs some modification in culture condition and technique for maximizing viability of the tissue.

Sudden rapid growth of an aggressive angiomyxoma after taking pomegranate seeds oil / 부인종양

Aggressive angiomyxoma (AA) is a rare soft tissue tumor of undetermined etiology that occurs mainly in the female vulva and perineum. It has been demonstrated to increase in size under the estrogenic stimulation and shown to respond to treatment with a GnRH agonist. A 47-year-old woman was presented with a large vulvar mass. The mass had grown slowly before she took pomegranate seeds oil on a regular basis for a year, which is known to contain natural estrogen for a year. The almond-sized mass enlarged into a fetal head-sized one in a year. Our case is implying that external administration of estrogenic substance may be a contributory factor to the sudden accelerated growth of AA. Although the past medical history in this case relies on an unverified observation by the patient alone, the unique clinical course and impressive gross appearance of AA may help clinicians with diagnosis in practice.