Hajime Kasamatsu

Factors affecting the volume of umbilical cord blood collections

Objective. Our purpose was to find factors that may help increase the number of the HSC ( CD34+) collected from umbilical cord blood for transplantation.

A case of malignant lymphoma of the ovary manifesting like an advanced ovarian cancer

BACKGROUND In recent years, true primary ovarian lymphoma has been considered to carry a favorable prognosis, although most studies of supposedly primary ovarian lymphoma have reported a poor outcome. CASE A 47-year-old woman presented with signs and symptoms suggestive of an advanced ovarian cancer. Ultrasonography and magnetic resonance imaging revealed bilateral abdominal tumors, each measuring 10 cm in diameter, thickened omentum, and a large amount of ascitic fluid, but no enlarged lymph nodes. The diagnosis of malignant lymphoma was established from the biopsy specimen after exploratory laparotomy. Six years following chemotherapy, the patient is alive and disease free without additional surgery. CONCLUSION The prognosis of ovarian lymphoma was evaluated according to clinical stage, modality of onset, histologic type, and phenotype. It remains controversial whether this case can be considered truly primary ovarian lymphoma and not merely a localized initial manifestation of a generalized disease. But if this case of advanced ovarian lymphoma were not primary, it could still be managed successfully with chemotherapy appropriate for the specific histology.

Laparoscopic-Assisted Removal of a Large Urachal Cyst

A 48-year-old woman was seen because of an abdominal tumor. Laparoscopy was performed for diagnosis and treatment. A large cystic mass was hanging from the anterior abdominal wall and was removed with laparoscopic assistance. Histologic examination revealed a urachal cyst. (J Am Assoc Gynecol Laparosc 8(1):159-160, 2001)

Laparoscopic surgery with intraoperative autologous blood transfusion in patients with heavy hemoperitoneum due to ectopic pregnancy.

Patients with ectopic pregnancy complicated by heavy hemoperitoneum generally undergo immediate laparotomy, and homologous blood transfusion is sometimes started before the operation. Two women underwent laparoscopic surgery for heavy hemoperitoneum (2600 and 1900 ml) due to ectopic pregnancy. The aspirated blood was reinfused during operation through a leukocyte-reduction filter after lavage with an autologous blood-salvage transfusion apparatus.

Laparoscopic-Assisted Surgery for Benign Ovarian Cyst in a Young Girl

A 7-year-old girl was admitted to our hospital because of sudden lower abdominal pain and vomiting. Emergency laparoscopy and cystectomy were performed, with a diagnosis of torsion of an ovarian cyst. All manipulations were possible through a 2-cm incision in the abdominal wall.

Moyamoya disease presenting as cerebral infarction after cesarean.

BACKGROUND Moyamoya disease with pregnancy is rare and might present with cerebral hemorrhage. CASE A 22-year-old primigravida suddenly developed muscular weakness in the right arm and facial discomfort 3 days after cesarean. Computed tomography and cerebrovascular angiography found cerebral infarction attributable to moyamoya disease. Bilateral anastomosis of superficial temporal and middle cerebral arteries was done. CONCLUSION Moyamoya disease with pregnancy might present as cerebral infarction after cesarean.

Bilateral tubal pregnancy after puerperal tubal ligation

Ectopic pregnancy is one complication of tubal sterilization. A 39-year-old multiparous woman underwent puerperal transcutaneous tubal ligation in the infraumbilical region after delivery of her fourth child. Tubal pregnancy occurred in the right and left salpinx, respectively, at different times, with laparoscopic surgery performed after each one.