Junsik Park

Expression of ezrin in vagina cells of postmenopausal rats after dietary administration of omega-3 Fatty Acid formula.

Objectives To see the effect of dietary administration of omega 3-fatty acid formula on the vaginal cells of postmenopausal rats. Methods Three-week-old female Wistar/ST rats were raised after one week of adjustment period. The rats were then divided into three groups, for three different kinds of diet; general diet, 1% omega-3 fatty acid diet, and 2% omega-3 fatty acid diet. After eight weeks of having assigned diet, after the oophorectomy, with the same diet previously they had Immunohistochemistry, Immunofluorescence, and Western Blot about ezrin, merlin were done. Results In immunohistochemistry, estrogen injection group revealed thicker and well differentiated features. In Immunofluorescence, Omega-3 fatty acid composition in diet did not effect expression of ezrin and merlin in rat vagina in estrogen injection group, their vaginal epithelium showed full layers (from basal to apical layer). In Western Blot analysis, Omega-3 fatty acid composition in diet did not affect expression of ezrin and merlin in rat vagina estrogen presented significant impact on expression of ezrin and merlin. Conclusion Although omega-3 fatty acid composition changed in diet, vaginal epithelial morphology unchanged. Estrogen did effect on vagina cell, but omega-3 fatty acid did not effect on ezrin and merlin in vagina.

Gynecologic complication of chronic graft-versus-host disease: Vaginal obstruction

Allogenic peripheral blood stem cell transplantation (Allo-PBSCT) is being used to treat hematological malignancies with increasing frequency. Graft-versus-host disease (GvHD) is a complex complication of PBSCT. A 43-year-old woman came to the gynecology clinic for amenorrhea. She had been diagnosed with acute myeloid leukemia 2 years earlier and treated with induction and consolidation chemotherapy. After developing complete remission, she underwent Allo-PBSCT. When she started chemotherapy, her menstrual cycle completely disappeared. Fourteen months after menopausal hormone replacement therapy, it was discovered that her upper vaginal canal was completely obstructed. The lower vagina had an atrophic appearance. We report a rare case of partial vaginal obstruction as a complication of chronic GvHD and review the literature. We expect that this case report provides an opportunity to remind clinician of the gynecologic complications of GvHD.

Sclerosing Stromal Tumor in an Elderly Postmenopausal Woman

Sclerosing stromal tumor (SST) of the ovary is a rare tumor derived from the sex cord stroma. This tumor was first described by Chalvaridjian and Scully in 1973. SST of the ovary is prevalence of 1.5% to 6% of ovarian stromal tumors. Patients are most commonly diagnosed in their 20s and 30s. There have been reports of SST postmenopausal women aged 65-, 67-, and 71 in the Republic of Korea; however, no report of this disease has been reported in women older than 80. In this study, we would like to report an 80-year-old postmenopausal woman who did not previously complain of any symptoms, and was finally diagnosed with SST. She was involved in a traffic accident, and huge pelvic mass was found during the evaluation of intra-abdominal hemorrhage. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed ; a final pathologic diagnosis reported SST.

Endosalpingiosis in Postmenopausal Elderly Women

In gynecology, endosalpingiosis is a benign condition in which the fallopian tube-like epithelium is found outside the fallopian tube. The thirty-four point five percent of endosalpingiosis cases have concurrent endometriosis and 40% of the endosalpingiosis group are in postmenopausal states. In contrast with endometriosis, there are no significant links between infertility, chronic pelvic pain and endosalpingiosis. The symptoms of endosalpingiosis are not yet settled. Endosalpingiosis is almost always an incidental finding; it is commonly found through microscopic examinations, and is then confirmed by pathologists for excision and biopsy. Therefore, the clinical differential diagnosis of an intramural mass is more important for clinicians when discussing further surgery with the patients. We report case of woman who has endosalpingiosis and is presented with vaginal bleeding. We first suspect the disease during physical examination. Under the impression of pelvic mass, laboratory tests and radiological images of contrast enhanced chest computer tomography are taken. Images show multisepted cystic masses in left adnexa. To rule out the pelvic mass, we executed exploratory laparotomy. Pathologic results show endosalpingiosis near the ovary section. But the endosalpingiosis, is not generally considered a pathology, and thus, no treatment is necessary.

Intracranial Migration of Intravitreal Silicone Oil: A Case Report

A 51-year-old woman with a history of diabetes mellitus for 20 years developed traction retinal detachment in the left eye. The detachment was treated using intravitreal SiO as an endotamponade agent. However, the intraocular pressure of the affected eye increased up to 49 mmHg on postoperative day 2, decreased to 30 mmHg 7 days later, and reached normalized pressure 18 days after intraocular tamponade. After 9 months following retinal surgery, the patient had to undergo a second surgery for vitreous hemorrhaging of the contralateral eye. In route to the operating room, the patient suddenly presented dizziness; her blood pressure was 200/100 mmHg. Pre-contrast CT scan showed a high-density nodular lesion in the optic chiasm and the left optic nerve that resembled a small subarachnoid hemorrhage in the suprasellar cistern (Fig. 1). From a brain CT angiography, a tiny aneurysm was found in the distal internal carotid artery at the inferior aspect to the left ophthalmic artery origin. The patient underwent a transfemoral carotid angiography; an aneurysm was confirmed. A brain MRI, including the orbits, revealed a foreign substance extending to the left side of the optic chiasm, along the left intraorbital and intracranial optic nerve (Fig. 2a–c). The substance had an intermediate signal intensity with a prominent chemical shift artifact in T2-WI and a low signal intensity in T1and T2-fat saturation images, identical to the properties presented by SiO in a phantom study. We performed CT and MR imaging on SiO and PFCL phantoms. SiO shows a high attenuation in CT scans and a high signal intensity with a prominent chemical shift artifact in T1-WI, an intermediate signal intensity in T2-WI with prominent chemical shift artifact, and a low signal intensity in fat-saturated MR images. PFCL shows a high attenuation Introduction

Fetal thrombotic vasculopathy accompanied by fetal growth restriction

Abstract Fetal thrombotic vasculopathy, a rare condition, is defined as thrombosis in the fetal circulation of placenta causing fibrotic villi and its detection before delivery is difficult. Thrombosis in fetal placenta involves various problems such as uteroplacental insufficiency, central nervous system injury and even perinatal death. Here, we report a case of fetal arterial thrombosis predisposed to neonatal neurologic impairment. This case emphasizes an importance of placental biopsy, especially when the neonate seems to have problems. We recommend that pathological examination of placenta be performed not only when abnormal gross findings of placenta, but also when fetal abnormalities are observed.

Preliminary testing for endometriosis and gene polymorphisms

Sir Cherrie Evans and Peter Johnson provide important feedback on the implementation of recommended changes to the Helping Mothers Survive Bleeding After Birth training program in their letter to the editor. The changes that we have suggested (full day training session instead of half day training session, translation of the teaching materials into the local language, and validation of facilitators by means of knowledge and skills testing) (1) have been implemented in the latest version of the Helping Mothers Survive Bleeding After Birth training program. To ensure good quality training it is important that training programs continue being monitored and evaluated. This will provide evidence-based feedback on the perception of the training by its trainees and facilitators and on the effect that it has on their knowledge and skills. This is especially important for a training program such as Helping Mothers Survive Bleeding After Birth that is going to be rolled out worldwide. The settings in which the training program will take place will differ from setting to setting. Therefore structured feedback will provide important information to facilitate adjustment of the training program (when needed), thereby ensuring maximum training effect and enhancing implementation. We are looking forward to seeing the results of the study of Cherrie Evans and Peter Johnson in Uganda, which will provide feedback on the training program as it is currently practiced.