A case report of ovarian sex cord-stromal tumor, unclassified type / 부인종양

Unclassified type occupies about 5 to 10 percent of all ovarian sex cord stromal tumors. Diagnosis is very difficult and subjective because tumors show insufficient differentiation to ovarian or testicular line or display insufficient findings to diagnose as a gynandroblastoma in spite of divergent differentiation. To our knowledge sixty-two cases have been reported in the pathology literatures as yet. The behavior of this group of tumors has not been adequately studied but is similar to granulose cell tumors or Sertoli-Leydig cell tumors. We present a case of unclassified sex cord-stromal tumor which has been experienced in our hospital with brief review of the literature.

One Case of Viable Cervical Pregnancy in Anterior Lip of the Cervix Treated by Systemic Methotrexate Treatment after Intra-amniotic Potassium Chloride Injection / 대한산부인과학회지

The cervical pregnancy is a rare condition representing less than 1% of ectopic gestations. But, it is potentially life-threatening condition because of profuse hemorrhage and requires hysterectomy in some cases. With ultrasound, diagnosis can be made earlier and conservative management is attempted in order to preserve the reproductive potential. Most cervical pregnancies are implanted within the cervical canal below the internal os of the cervix. However, we experienced one case of a unique viable cervical pregnancy in anterior lip of the cervix and treated successfully by local injection of potassium chloride into gestational sac and systemic methotrexate treatment.

A Case of Fetal Supraventricular Tachycardia with Fetal Ascites Treated by Antiarrhythmic Agent / 대한산부인과학회잡지

We experienced a case of fetal supraventricular tachycardia (SVT) with fetal ascites diagnosed at 29 weeks of gestation in 29 year-old primigravida woman. Transplacental fetal therapy with maternal oral antiarrhythmic agent (verapamil, diltiazem) resulted in restoration of normal fetal sinus rhythm and disappearance of fetal ascites. At birth, the infant did not show any cardiac arrhythmia and hydropic appearance.

A Case of Aplastic Anemia in Pregnancy / 대한산부인과학회잡지

Pregnancy complicated by aplastic anemia is uncommon condition with the significant morbidity and mortality rates. the main complication to mother is hemorrhage due to thrombocytopenia and sepsis due to leukopenia and mortality rate in pregnancy complicated by aplastic anemia is more than 20%. But it remain controversy whether pregnancy play a pathogenic role in the development of the disease. We experienced a patient with severe aplastic anemia in pregnancy who was treated with supportive transfusion of red blood cells and platelets and so we present it here with brief review of literature.

Comparison study of VTH and LAVH for the indications other than uterine prolapse / 대한산부인과학회잡지

OBJECTIVE: To compare the advantages and disadvantages between total vaginal hysterectomy (VTH) and laparoscopically assisted vaginal hysterectomy (LAVH) including the indications and safety. METHODS: We reviewed the medical records of patients who underwent VTH from July 1998 to December 1999 and those who underwent LAVH from January 2000 to April 2002. We evaluated age, parity, previous abdominal operations, indications for hysterectomy, combined operations, operation time, bleeding amount, hemoglobin change, weight of uterus, and postoperative complications. RESULTS: 1. Age was not a notable factor but parity was significantly lower in LAVH group. 2. In VTH group, 48% of patients had previous operations compared with 46% in LAVH group. 3. The most common indication for hysterectomy of both group was uterine myoma. 4. The weight of hysterectomized specimen was 256 g in VTH group and 237 g in LAVH group. 5. In VTH group, 38% received concurrent surgical procedures of which colporrhaphy was the most common (14 cases). In LAVH group, 72.5% received concurrent surgical procedures of which salpingoo- phorectomy was most common. 6. The operation time showed a notable difference; 78.6 min. in VTH group and 105.4 min. in LAVH. 7. There was no significant difference in bleeding amount and hemoglobin change. 8. Postoperative complication was higher in VTH group (14%) than LAVH group (7.5%). However all the patients recovered with conservative treatment and close observation. CONCLUSION: Both VTH and LAVH had the following advantages compared with abdominal hysterectomy: less pain, shorter hospital stay, cosmetic advantages, lower prevalence. In this study we found out that in VTH, the procedure could be done safely even if the uterus was big or with previous abdominal operations. Limited operation field and the fact that we couldn't check the abdominal cavity were some disadvantages. In comparison, LAVH offered a view of the abdominal cavity which make easy adnexal operation but because of expensive operative tools, cost was a problem. In order to satisfy the patient and lower the cost, appropriate study on the indications and training on procedures will be necessary.

A Case of Immature Teratoma of the Ovary with Gliomatosis Peritonei / 대한산부인과학회잡지

Immature teratoma is composed of varying quantities of immature differentiating among anyone or all three germ layer. The pure immature teratoma accounts for fewer than 1% of all ovarian cancer, but it is the second most common germ cell malignancy. About 50% of pure immature teratomas of the ovary occur in women between the ages of 10 and 20 years, and they rarely occur in postmenopausal women. The most frequent site of dissemination is the peritoneum, and much less commonly, the retroperitoneal lymph node. Among the tumors with embryonal elements, those containing neural tissues demonstrate most clearly the importance of the ability to mature. Gliomatosis peritonei is the most dramatic demonstration of the significance of maturation, because most patients with these tumors have survived, even with this disseminated disease. The purpose of this paper is to report on a immature ovarian teratoma with predominantly mature glial tissues in peritoneum which we have experienced in this hospital recently with brief review of the literature.

Comparison of Intravaginal Misoprostol and Cervical Laminaria Tent Insertion in Endometrial Curettage due to Abnormal Uterine Bleeding / 대한산부인과학회잡지

OBJECTIVE: To compare cervical dilatation efficacy and safety of intravaginal misoprostol with that of cervical laminaria tent insertion in endometrial curettage due to abnormal uterine bleeding METHOD: Patients requesting endometrial curettage due to abnormal uterine bleeding were randomized into two group. In group I (n=53), 100 g tablet of misoprostol was placed in the posterior vaginal fornix at midnight. In Group II (n=54), laminaria tent number 5 was inserted in cervical canal at midnight. Endometrial curettage was performed on the next morning. The degrees of cervical dilatation were measured by Hegar dilator just before endometrial curettage. Both groups were compared about cervical dilatation efficacy and side effect. RESULT: The degrees of cervical dilatation were 8.8+/-1.1 mm in group I and 9.3+/-1.9 mm in group II. There was no significant statistical difference. (P=0.134) The mean intervals from the use of misoprostol or laminaria to endometrial curettage were 704+/-140 minutes in group I and 829+/-156 in group II. In group I, mild fever (less than 38 degrees) was observed in four women and one complained mild abdominal pain. In group II, five women revealed mild fever and fifty women complained abdominal discomfort. All didn't need any medication or special therapy. CONCLUSION: Intravaginal misoprostol was appeared as efficacious as laminaria tent in cervical dilatatory effect before endometrial curettage in abnormal uterine bleeding patients. It was considered more convenient, safer and more cost effective method compared than cervical laminaria tent in cervical preparation before endometrial curettage.

A Case of Edward Syndrome / 대한산부인과학회잡지

Trisomy 18, called Edward syndrome, occurs in about 3500-8000 births. It is much more common at conception, with about 95% of cases resulting in spontaneous abortion or stillbirth. Postnatal survival is poor, with the majority of patients dying in early infancy. Characteristic findings include cardiac malformations, mental retardation, growth retardation, a prominent occiput, micrognathia, clenched hands, and rocker-bottom feet, omphalocele. The prenatal sonographic findings of our case include delayed growth, omphalocele, wrist joint fixation, choroid plexus cyst, hydramnios and postnatal gross findings include growth retardation, omphalocele, wirst joint fixation, absence of radius, syndactyly, focal absence of phalanges and flexion deformities of fingers and toes. We report a case of prenatally diagnosed Edward syndrome, which is confirmed by chromosome analysis, with brief review of related literatures.

A Case of Congenital Unilateral Renal Agenesis / 대한주산의학회잡지

No abstract available.