Non-Tuberculous Mycobacterium Induced Pseudoaneurysm of the Common Carotid Artery

An 81-year-old male patient presented with complaint of a pulsating neck mass. The patient had a previous history of cervical lymphadenopathy by non-tuberculous mycobacterium infection. Rapid growth of the mass on admission and contrast enhanced computed tomography of the neck resulted in a diagnosis of non-tuberculous mycobacterium induced pseudoaneurysm. The patient underwent emergency open repair of the pseudoaneurysm. Pseudoaneurysm of the common carotid artery is regularly reported, but here we report a rare case of non-tuberculous mycobacterium induced pseudoaneurysm of the common carotid artery.

Placenta increta presenting as postabortal uterine mass and hemoperitoneum in the first trimester: A case report / 대한산부인과학회지

Placenta increta is one of lethal complications of pregnancy characterized by invasion of placenta villi into the underlying myometrium and usually presented in early postpartum period with difficult placental removal and massive bleeding. Placenta increta may complicate first and early second-trimester pregnancy loss causing profuse post-curettage hemorrhage but the lesion is rarely found and hard to diagnose. We experienced a case of hemoperitoneum caused by implanted chorionic villi on the uterine serosa regurged from uterine cavity, 6weeks after artificial abortion at gestational age of 5 weeks and 5 days.

A case of clear cell adenocarcinoma of the uterine cervix in a 6-year-old girl / 대한산부인과학회지

The clear cell adenocarcinoma of uterine cervix is very rare tumor, and only 4-9% of entire adenocarcinoma appears to be diagnosed as clear cell adenocarcinoma. Its risk factor and pathogenesis are not exactly known, but intrauterine exposure to DES (diethyl stilbestrol) and associated non-steroidal estrogen during pregnancy before 18weeks is one known risk factor, and also hormonal change or genetic cause are suggested as the risk factors. The peak age of its occurrence has bimodal pattern, which are groups before 24 years-old and after 45 years-old, and clear cell adenocarcinoma arising in latter group is not associated with intrauterine DES exposure. It is also reported that 25% of young women who has clear cell adenocarcinoma had no history of hormonal exposure. The treatment and prognosis is similar to other kinds of uterine cervical adenocarcinoma. With a short literature review, we are reporting a case of 6-year-old girl who visited our clinic because of vaginal mass naturally fallen off with a minor bleeding which was finally diagnosed as clear cell adenocarcinoma, and had no maternal history of DES exposure during pregnancy.

Analysis of HLA-G expression in preeclampsia and intrauterine growth restriction / 대한산부인과학회지

OBJECTIVE: To determine whether soluble HLA-G protein levels in plasma and/or HLA-G protein in placental tissues differ between women with gestational complications (preeclampsia and/or intrauterine growth restriction, IUGR) and women with normal pregnancies. METHODS: A sandwich enzyme-linked immunosorbent assay was used to investigate the HLA-G expression level in 11 cases of preeclampsia, 8 cases of preeclampsia with IUGR, 18 cases of IUGR, and 10 normal control subjects. RESULTS: Plasma HLA-G levels were decreased significantly in the preeclampsia group (median, 0.072 microgram/mL), the preeclampsia with IUGR group (median, 0.086 microgram/mL), and the IUGR group (median, 0.081 microgram/mL), in comparison with normal pregnant women (median, 0.360 microgram/mL) (P=0.002, P=0.049, and P=0.003, respectively). Also, Placental HLA-G levels were decreased significantly in the preeclampsia group (median, 0.016 microgram/mg), the preeclampsia with IUGR group (median, 0.015 microgram/mg), and the IUGR group (median, 0.021 microgram/mg), in comparison with normal pregnant women (median, 0.091 microgram/mg) (P<0.001, P=0.002, and P=0.001, respectively). There was a significant correlation between plasma and placental HLA-G levels (r=0.807, P<0.001). CONCLUSION: Our results indicate that the attenuated expression of placental HLA-G and reduced release of this protein into the maternal circulation in gestational complications, such as preeclampsia and IUGR may alter the maternal-fetal immune relationship, and thus could be at play in the pathophysiology of these diseases. This suggests that assessment of levels of HLA-G proteins may be useful in predicting development of preeclampsia and IUGR.