Hae-Hyeog Lee

Absence of dysplasia in the excised cervix by a loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

OBJECTIVEnAbsence of dysplasia in the excised specimen following loop electrosurgical excision procedure (LEEP) for treatment of cervical intraepithelial neoplasia (CIN) 2/3 is an occasional finding of uncertain clinical significance. We evaluated several factors including age, liquid-based Pap (LBP) test, human papillomavirus (HPV) load before treatment, and HPV typing as predictors for absence of dysplasia. Absence of dysplasia in LEEP specimens was analyzed in terms of factors for recurrent disease after LEEP conizationnnnMETHODSnIn total, 192 women (mean age, 39.3+/-8.4 years; range, 24 to 70 years) with biopsy-proven CIN 2/3 were treated by LEEP conization. Age, LBP test, histological grade, HPV load, and HPV DNA typing were evaluated as possible predictors of the absence of residual dysplasia or recurrent disease.nnnRESULTSnOf the LEEP specimens, 34 (17.7%) showed no dysplasia in preoperative biopsies from patients with proven CIN 2/3. Low HPV load (<100 relative light units [RLU]) was significantly related to the absence of dysplasia in LEEP specimens, using logistic regression. Margin involvement and high HPV load (>/=400 RLU) were significant factors for recurrence.nnnCONCLUSIONnAbsence of dysplasia in LEEP specimens occurred in 17.7% of our specimens. Prediction of the absence of dysplasia in LEEP specimens was associated with low HPV load. Residual/recurrent disease after LEEP was associated with a positive resection margin and high viral load, and was not associated with absence of dysplasia in LEEP specimens. Even if there is no dysplasia in conization specimens, close follow-up for residual/recurrent disease is needed.

Laparoscopic resection of the rudimentary horn of a unicornuate uterus diagnosed by three-dimensional computed tomography

A 16-year-old woman was admitted to the emergency room due to severe lower abdominal pain. She had no surgical or obstetric history. Menarche had occurred 2 years ago. She suffered from dysmenorrhea and pelvic cyclic pain during menstruation. The three-dimensional computed tomography combined with ultrasonography revealed a rudimentary horn of unicornuate uterus. We performed a laparoscopic removal of this uterine anomaly without any complication in the post-operative period. Laparoscopy resulted in anatomical and reproductive outcome equivalent to those offered by a laparotomic approach, and minimally invasive surgery had additional advantages such as, better cosmetic results and postoperative period, which are important for very young patients. n xa0 n Key words:xa0Uterus, laparoscopy, Imaging three-dimensional, tomography x-ray computed.

Endometriosis-induced hemoperitoneum in the colonic serosa

Endometriosis is an inflammatory disease. The etiology of endometriosis is exactly unknown.xa0A 42-year-old virgin experienced a sudden increase in pain that began one day prior to examination. She had been suffering from dysmenorrhea and menorrhagia. The patient had abdominal guarding with severe rebound tenderness. On computed tomography, both ovaries were normal, and sigmoid colon was seen in the peripheral portion of the pelvic hematoma. Pathologic findings revealed endometriosis in the colonic serosa cyst. Our data provide a new diagnostic key for hemoperitoneum caused by endometriosis in the colonic serosa. n n xa0 n n Key words:xa0Hemoperitoneum, endometriosis, colon.