Multiple cytokine analysis in gastroschisis: Association with adverse outcomes including fetal brain damage.

OBJECTIVES: To investigate the distribution of multiple cytokines in gastroschisis and reveal its association with clinical outcomes, including gastrointestinal disorders and fetal brain damage caused by chronic inflammation in gastroschisis. METHODS: We obtained amniotic fluid and arterial cord blood from 10 patients with gastroschisis, and evaluated the profile of 40 cytokines via multiplex immunoassay. The possible relationship of the cytokines with the time taken to attain full enteral nutrition and cord S100B, a surrogate marker of brain damage, was estimated. Associations among the relevant cytokines were also assessed. RESULTS: Although clinical characteristics in our cohort had no relevance, several cytokines in cord blood, especially IL-2, IL-8, CCL1, CCL7, CXCL1, CXCL2, and CXCL6, were clearly elevated in patients who took a longer time to attain full enteral nutrition, whereas only IL-16 in cord blood was significantly related to cord S100B and strongly correlation with cord S100B levels. Moreover, our data indicated that IL-16 was considerably less correlated with the other cytokines associated with adverse outcomes. CONCLUSIONS: We investigated the cytokine characteristics of both amniotic fluid and cord blood in gastroschisis, and found that certain cytokines could affect the adverse outcomes, including fetal brain damage. These findings provide important information that could further clarify the pathophysiology of gastroschisis and propose a novel clinical implication of gastroschisis that could be used to predict adverse outcomes, especially neurodevelopmental disorders.

A pitfall in diagnosing fetal abdominal lymphangioma: A report of two cases.

Typical ultrasound findings of fetal abdominal lymphangioma include thick-walled, multiseptated anechoic masses. Although a majority of cases can be suspected promptly by ultrasound examination, the two cases presented herein did not meet the standard criteria and were misleading. Both cases involved unilocular cysts without clear septations, but in retrospect were atypical findings of fetal abdominal lymphangioma. A few reports of misleading cases have been described previously; however, the precise characteristics have not been reported in detail. Therefore, in this case report, we focused predominantly upon the difficulties encountered in the prenatal diagnosis of abdominal lymphangioma based on ultrasound morphology alone.

Two cases of primary ovarian neuroblastoma arising from mature cystic teratomas.

•Primary ovarian neuroblastomas are extremely rare and have poor prognoses.•This report provides results of the same combination therapy in two cases, which indicated its efficacy for ovarian neuroblastoma.

Endometrioid endometrial carcinoma indirectly caused by pituitary prolactinoma: a case report.

We present the case of a 44-year-old nulliparous woman who experienced irregular menstrual cycles for about 10 years and developed both pituitary prolactinoma and endometrioid endometrial carcinoma. In premenopausal women, hyperprolactinemia causes hypogonadism by inhibiting secretion of gonadotropin-releasing hormone and thus suppressing luteinizing hormone levels, which can cause menstrual disorders ranging from amenorrhea, oligomenorrhea and chronic anovulatory cycle to short luteal phase of the menstrual cycle. A chronic anovulatory menstrual cycle is the most common cause of long-term exposure of the endometrium to endogenous estrogen without adequate opposition from progestins, which can lead to endometrioid endometrial carcinoma. In this case, pituitary prolactinoma may have caused the chronic anovulatory cycle and indirectly led to the endometrioid endometrial carcinoma. In patients for whom the cause of irregular menstruation and chronic anovulatory cycle is suspected to be hyperprolactinemia, explorations of both the hypophysis and endometrium are essential.