Shiuh-Young Chang

Laparoscopic Treatment of Isolated Tubal Torsion in a Premenarchal Girl

Tubal torsion in a premenarchal girl was diagnosed by pelvic ultrasonography and laparoscopy. A laparoscopic approach was used to resect the twisted tube. To our knowledge, this is the first reported case of laparoscopically managed torsion of a fallopian tube occurring in the absence of torsion of the ovary in a patient of this age group. Video-assisted minimally invasive surgery appears to be suitable for treatment of tubal torsion in children; hospitalization is short, cosmetic results are excellent, and return to normal activity is rapid. (J Am Assoc Gynecol Laparosc 6(2):209-211, 1999)

The expression of DAZL1 in the ovary of the human female fetus

OBJECTIVE To determine whether DAZL1 is expressed in human fetal ovarian tissue. DESIGN The presence of DAZL1 expression was determined by reverse transcriptase polymerase chain reaction (RT-PCR). SETTING Academic tertiary care medical center and research unit of university. PATIENT(S) Five female abortuses between the 19th and 22nd week of gestational age. INTERVENTION(S) Fetal ovarian tissues were collected immediately after the cessation of the heart beat. MAIN OUTCOME MEASURE(S) The product of RT-PCR. RESULT(S) DAZL1 expression was detected in all five samples. CONCLUSION(S) DAZL1 is not only expressed in human testes but also in ovaries. It may play a role in germ cell survival and gonad development in both sexes.

Two Different Timings of Intrauterine Insemination for Non-Male Infertility

AbstractPurpose: Our purpose was to assess the simplicity andconvenience of treatment scheduled not on weekends, bycomparing two different timings of intrauterine insemination(IUI) protocol. Methods: A prospective observational study of two differentprotocols of intrauterine insemination was designed. Twohundred and ten infertile couples with normal spermiogramswere included in this study. Fifty-eight couples were treatedwith IUI 26 to 28 h after human chorionic gonadotropin(hCG) injection plus timed intercourse within a 12- to18-hr period and 147 couples had IUI 36 to 38 hr after hCGinjection and timed intercourse within a 12- to 18-hourperiod. Pregnancy rates were compared with two differentprotocols of IUI. Results: The mean age, duration, and causes of infertilityand the cycle characteristics following follicular stimulationwere similar between the two groups. The cyclecharacteristics of follicular stimulation in the two treatment groupswere not different. There also were no significant differencesbetween the groups in the type of sperm concentration, spermmotility, and the percentage of sperm with normalmorphology per insemination. The number of follicles greater than17 mm per patient was not significantly different betweenthe two groups. The pregnancy rate per cycle also wassimilar between the two groups in men with lower motilesperm numbers (<40 × 106)(23.6% vs. 23.4%) and in menwith higher sperm numbers (≥40 × 106)(25% vs. 24.4%). Conclusions: The different timing but similar efficacy ofthese two IUI protocols provides a practical choice toclinicians. The availability of both protocols may avoidunnecessary scheduling of clinical and laboratory work on weekendsand holidays in women participating in controlled ovarianhyperstimulation and IUI programs for treatment ofnon-male infertility.

Ectrodactyly ectodermal dysplasia-clefting syndrome with hematocolpometra presenting as acute urinary retention

Reported is a case of ectrodactyly ectodermal dysplasia-clefting syndrome with imperforated hymen. This patient presented to the emergency room complaining of abdominal pain and an inability to void over the preceding 32h. Physical examination revealed the patient’s limb abnormalities consisting of ectrodactly of the hands and feet, hyperkeratotic skin, dysodontiasis, a cleft lip and cleft palate, both of which had been repaired. Catheterization of the patient’s bladder yielded 800ml of clear urine; pelvic ultrasound demonstrated a markedly dilated vagina and uterus. Under general anesthesia, the girl underwent a hymenotomy using a CO2 laser and cruciate incision. Approximately 1100ml of chocolate-colored blood was drained from the vagina and uterus. The patient was discharged later on the same day as surgery after smoothly voiding urine. Four weeks following discharge she had a normal menstrual period and also normal micturition. Clinical examination 1year after the operation showed an asymptomatic female, with normal micturition and normal monthly menses. Ectrodactyly ectodermal dysplasia-clefting syndrome was first described in 1970 by Rüdiger et al. (1). Clinical manifestations of the syndrome included ectrodactyly, features of ectodermal dysplasia, and a cleft lip and/or palate. We present the case of a girl with ectrodactyly ectodermal dysplasia-clefting syndrome who presented with acute urinary retention secondary to hematocolpometra. A MEDLINE search of the literature published between 1966 and 2001 using key words such as ‘ectrodactyly ectodermal dysplasia-clefting syndrome’, ‘hematocolpometra’, and ‘acute urinary retention’ identified no similar case.