Endometrial adenocarcinoma in a 13-year-old girl

Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature.

A case of 17 alpha-hydroxylase deficiency / 대한생식의학회지

17alpha-hydroxylase and 17,20-lyase are enzymes encoded by the CYP17A1 gene and are required for the synthesis of sex steroids and cortisol. In 17alpha-hydroxylase deficiency, there are low blood levels of estrogens, androgens, and cortisol, and resultant compensatory increases in adrenocorticotrophic hormone that stimulate the production of 11-deoxycorticosterone and corticosterone. In turn, the excessive levels of mineralocorticoids lead to volume expansion and hypertension. Females with 17alpha-hydroxylase deficiency are characterized by primary amenorrhea and delayed puberty, with accompanying hypertension. Affected males usually have female external genitalia, a blind vagina, and intra-abdominal testes. The treatment of this disorder is centered on glucocorticoid and sex steroid replacement. In patients with 17alpha-hydroxylase deficiency who are being raised as females, estrogen should be supplemented, while genetically female patients with a uterus should also receive progesterone supplementation. Here, we report a case of a 21-year-old female with 17alpha-hydroxylase deficiency who had received inadequate treatment for a prolonged period of time. We also include a brief review of the recent literature on this disorder.

Arteriovenous malformation in uterine cervix during pregnancy

As the development of Doppler ultrasonography, many cases of uterine arteriovenous malformation (AVM) have beed diagnosed. But there is no case of cervical AVM in pregnant uterus. We present a 33-year-old pregnant woman who was diagnosed with AVM of the uterine cervix during the midtrimester. Color Doppler sonography and magnetic resonance image were used for diagnosis. We performed Cesarean section because of the risk of massive bleeding from the cervical AVM at 34 weeks' gestation. This is the first case of cervical AVM during pregnancy with a successful outcome and an uneventful postpartum course.

The Effects of Taste Preferences on Nutrients Intake and the Degree of Dental Caries in Preschool Children / 대한지역사회영양학회지

The purpose of this study was to investigate the effects of preschool children's taste preferences on their intake of nutrients and the degree of dental caries. The subjects were 126 preschool children (boys 62 and girls 64) in Daegu area. Their taste preferences and food intake were investigated and their teeth were also examined. The energy intake of boys (1550 kcal) were significantly higher than that of girls (1441 kcal). Daily dietary intakes of nutrients-except niacin and vitamin C-were higher than those of RDA. Vitamin B1 intake of the group preferring a salty taste was significantly lower than that of the other group (p < 0.05). Vitamin B2 intake of the group preferring a salty taste was significantly higher than that of the other group (p < 0.05). Vitamin C intake of the group preferring a hot taste was significantly higher than that of the other group (p < 0.05). The group with a preference for sweet had more experiences of dental caries and more decayed teeth than the other group, but which is not significant. The experiences of dental caries were negatively correlated with protein intake (p < 0.01). The decayed teeth were negatively correlated with energy and protein intakes (p < 0.01). Our data suggested that taste preferences are associated with vitamins intake and the degree of dental caries in preschool children. It means the sweet preference increased the experiences of the dental caries.

Primary Cutaneous Meningioma on the Scalp of an Infant: A Case Report

During childhood, meningioma is an uncommon tumor, and in infants, extracranial meningioma is very rare. We report a case of primary cutaneous menigioma occurring on the scalp of a ten-month-old girl.

CT Findings in Differential Diagnosis of Pelvic Inflammatory Bowel Mass and Tuboovarian Abscess

PURPOSE: To evaluate the CT findings which may help differentiate pelvic inflammatory bowel mass(IBM) fromtubo-ovarian abscess(TOA). MATERIALS AND METHODS: Twenty-five patients with histologically confirmed TOA(n=14),periappendiceal abscess(n=9), an abscess caused by diverticulitis(n=1), and by ulcerative colitis(n=1) wereevaluated. For TOA, age distribution ranged only from the 3rd to the 5th decade, but for IBM, the range was the 2nd to 8th decade with highest frequency during the 3rd-4th decade. CT findings were retrospectively analysed forbilaterality, internal septa, anterior displacement of the mesosalpinx, and perirectal and mesenteric fat. RESULTS: Mesenteric fat infiltration was detected in all 11 cases of pelvic IBM, but in only two of 14 TOA cases(p<0.05).Anterior displacement of the mesosalpinx was observed in two of 11 pelvic IBM cases and in nine of 14 TOAcases(P<0.05). There were no significant difference in bilaterality, internal septa, or perirectal fatinfiltration. CONCLUSION: Mesenteric fat infiltration was the most reliable finding in differentiating pelvic IBMform TOA. Anterior displacement of the mesosalpinx, and age distribution were also helpful in differentiating thetwo disease groups.

Immunohistochemical Study of Bcl-2 Oncoprotein Expression in Childhood Non-Hodgkin's Lymphoma

PURPOSE: The aim of the present study was to assess the clinicopatholgical significance of Bcl-2 oncoprotein expression in childhood non-Hodgkin's lymphoma (NHL). METHODS: We have assessed 16 cases of childhood NHL during last 6 years from 1990 to 1995. Bcl-2 oncoprotein expression has been semiquantitatively analyzed in paraffin sections from 16 cases of childhood NHL with 39 control cases of adult NHL. The expression of Bcl-2 oncoprotein was correlated with histologic grade, immunophenotype, proliferative activity as measured by immunostain of Ki-67 antigen, clinical stage, and survival rate (event free survival rate, EFS). RESULTS: 1) Bcl-2 oncoprotein expression significantly decreased according to increase of histological grade (P0.05). 5) EFS of patients was significantly correlated with Bcl-2 oncoprotein expression, that is, reduced EFS was demonstrated in the patients with low Bcl-2 oncoprotein expression (P<0.05). CONCLUSIONS: Thus Bcl-2 oncoprotein, as demonstrated immunohistochemically in routinely paraffin embedded tissue, can be restrictively used in prediction of prognosis and grade of childhood NHL, in aggrement with the role of Bcl-2 oncoprotein in blocking of apoptosis and indirect contribution to increase of cellular proliferative activity of NHL.

Ultrasonographic and pathologic study of ovarian tumors

This is a retrospective study of 161 ovarian neoplasms, all of which were surgically removed and had preoperative sonographic examinations. They were evaluated respect to age, tumor size and its echogenicity. The results were as follows: 1. Of all 161 tumors, physiologic lesions were 67 cases (41.6%), germ cell tumors were 28 cases (17.4%) and serous tumors were 19 cases (11.8%). 2. Of all 161 tumors, right ovarian lesions were 82 cases (50.9%), left were 59 cases (36.7%), and bilateral lesions were 20 cases(12.4%). 3. The most characteristic findings of tumors were as follows: 1) Physiologic tumors were 2-9cm sized (88.1%), anechoice-5% echogenic (79.1%), and developed during 4th & 5th decades (91.0%). 2) Inflammatory tumors were 2-9cm sized (94.1%), 50%-totally echogenic (76.5%), and during 4th & 5th decades (94.1%). 3) Serous tumors were 2-9cm sized (60.3%), anechoic-5% echogenic (89.5%), and during 3rd & 4th decades (84.2%). 4) Mucinous tumors were 5-19 cm sized (77.8%), anechoic-5% echogenic (77.8%), during 2nd-8th decades with diffuse distribution. 5) Endometrioid tumors were 5-14cm sized (100.0%), variable echogenic, and during 3rd & 4th decades (90.9%). 6) Germ cell tumors were 5-14cm sized (75.0%), variable echogenic, during 3rd & 4th decades (82.1%). 7) Parovarian cysts were 2-14cm sized (90.0%), anechoic-5% echogenic (100.0%), with diffuse age distribution. 4. The malignant and borderline malignant tumors were 9 caseswith more than 10cm sized (77.8%), and developed during older than 4th decade (100.0%). Anechoic 3 cases, 1-5% echogenic 2 cases, and totally echogenic 4 cases were found.

Clinical Study to the Problem of Intestinal Gas for Intravenous Urography / 대한비뇨기과학회지

Intravenous urography is very important in the detection of pathological conditions of the urinary tract, but the presence of intestinal gas shadows may be very confusing in the interpretation of urograms. There is considerable difference of opinion regarding the desirability of preparing patients for excretory urography. we obtained clinical impression and statistical results that intestinal gas was increased with prolonged duration after last diarrhea, also with sleeping after last diarrhea. So we attempted one new method of preparation in which employed 30cc, of castor oil for catharsis two times at night before examination and next morning 6:00 a. m. and result was compared with other methods. A total of 300 cases, for the most in-patients, consisted of 6 groups, were studied in this report. All patients had nothing by mouth after midnight until the X-rays were completed and pyelograms usually were taken in the morning. Following methods of preparation were studied. Group 1 : 60 cc. castor oil at bed time. Group 2 : 60 cc. castor oil at 4:00 a. m. Group 3 : 30 cc. castor oil at bed time and 30 cc. at 6:00 a. m. Group 4 : 60 cc. castor oil at bed time and enema in the morning. Group 5 : No cathartics and enema. Group 6 : Dulcolax 2 tablets at bed time. The X-ray films were graded as A) excellent B) good C) fair D) poor by three or more examiners. Group 3. afforded best result. We believed that result was due to prevention of intestinal fermentation by ingestion of castor oil at bed time and passage of swallowed air before X-ray examination by repeated ingestion at 6:00 a. m. A larger series of cases over a longer period of time, for more accurate statistical study, is warranted.