Yong-Il Ji

Expression Patterns of Thymosin β4 and Cancer Stem Cell Marker CD133 in Ovarian Cancers

Thymosin β4 (Tβ4), a small acidic actin binding peptide, is overexpressed in a side population of cancer stem cells and CD133-positive colorectal cancer stem cells. In order to understand the relationship between Tβ4 and CD133, we studied the expression patterns of Tβ4 and CD133 in ovarian cancers. The expression patterns of Tβ4 and CD133 were studied in normal ovaries, primary ovarian cancers, metastatic ovarian cancers, primary stomach cancers, and normal stomachs by Western blot and immunohistochemistry. Expression patterns and co-localization of Tβ4 and CD133 were examined by immunofluorescence and confocal laser-scanning microscopy. Tβ4 is overexpressed in primary ovarian cancers, but not in primary stomach cancers, when compared with normal controls. However, Tβ4 levels in metastatic stomach cancers to the ovary are significantly upregulated compared with levels in normal stomachs and primary stomach cancers. These results suggest that Tβ4 levels are related to tumorigenesis in ovarian cancers and metastasis in stomach cancers. The expression of Tβ4 in normal ovaries and normal stomachs was weak, but was co-localized with CD133 expression. Tβ4 expression was also co-localized with CD133 expression in primary ovarian carcinomas, metastatic ovarian cancers from stomach cancers and primary stomach cancers. These data suggest that Tβ4 expression is strongly related to CD133 expression and is a characteristic of stem cells or cancer stem cells.

Uterine adenomyosis which developed from hypoplastic uterus in postmenopausal woman with mayer-rokitansky-kuster-hauser syndrome: a case report.

Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHS) is characterized by vaginal agenesis with variable Müllerian duct abnormalities. We report here a case of uterine adenomyosis which developed from a hypoplastic uterus in a patient with MRKHS. A 55-year-old postmenopausal woman visited a university hospital for pelvic mass. She had underwent vaginoplasty via the McIndoe procedure for MRKHS at 15 years of age. Pelvic magnetic resonance imaging showed a 5.4 × 4.8 × 4.7 cm mass suspicious for a uterine myoma. She received total abdominal hysterectomy with bilateral salpingo-oophorectomy, and neither the cervix nor endometrium was found grossly in the surgical specimen. The final histologic diagnosis was uterine adenomyosis.

Alternative surgical approaches for aggressive angiomyxoma at different sites in the pelvic cavity

Aggressive angiomyxoma, a rare soft tissue benign neoplasm, predominantly occurs in the female pelvic peritoneum and perineum region during reproductive age. It is slow growing, locally infiltrative, and has a high risk of local recurrence and the neoplastic character of blood vessels. The standard treatment is surgery. We report three unusual aggressive angiomyxoma cases. The first case was a pedunculated mass of the left labium major; the second, a left perineal mass that infiltrated into the paravesical area via the obturator foramen; and the third, a big mass in the retroperitoneal cavity, found that growing aggressive angiomyxoma looked like lava expulsion in the pelvic area. After a thorough examination and full radiologic workup, we performed surgical excision in each patient via different approaches. Histopathologic findings were consistent with diagnosis of aggressive angiomyxoma. To date, no relapse has been observed.

Laparoscopic uterine artery occlusion before cervical curettage in cervical ectopic pregnancy: Safe and effective for preventing massive bleeding

Cervical ectopic pregnancy is associated with high risk for massive bleeding conditions. Cervical ectopic pregnancy can usually be treated by methotrexate injection or surgery. We present 4 cases of cervical ectopic pregnancy that were treated successfully with different uterine-conserving methods. By comparing our experience of 4 cases managed in different ways, we found that laparoscopic uterine artery occlusion before cervical curettage is more effective method for preventing massive bleeding.

Gastrointestinal Bleeding Caused by Ileal Metastasis of a Tubal Complete Mole: A Case Report

BACKGROUND Tubal hydatidiform mole is known to be an extremely rare disease, moreover, gastrointestinal metastasis from an ectopic complete mole has never been reported. MATERIALS AND METHODS A 33-year-old woman presented with gastrointestinal bleeding. She had undergone laparoscopic left salpingectomy for a tubal complete mole a month earlier. An ileal invasion of mole was identified. The patient received nine cycles of adjuvant methotrexate chemotherapy after small bowel resection and anastomosis. She was been without recurrence 20 months after therapy. DISCUSSION Gestational trophoblastic diseases in ectopic pregnancy are rare and gastrointestinal tract metastasis is very infrequent. There have been a few case reports of choriocarcinoma presenting gastrointestinal tract metastasis. To our knowledge, this is the first report of molar pregnancy in a Fallopian tube with ileal metastasis. CONCLUSION Ectopic molar pregnancy with gastrointestinal metastasis carries a high risk of intestinal perforation and uncontrollable gastrointestinal bleeding. Despite its rarity, gastrointestinal metastasis should nevertheless be considered a possible cause for gastrointestinal bleeding in ectopic molar pregnancy patients after elimination of the more common etiologies.

Pregnancy in woman with Klippel-Trenaunay syndrome: A case report

The Klippel-Trenaunay syndrome is rare congenital disease characterized by a triad of cutaneous vascular malformations, varicose veins, and hypertrophy of bone and soft tissue. Although several cases of pregnancy in women with Klippel-Trenaunay syndrome were reported as there may be increased risk of pregnancyand/or delivery-associated complications such as varicosities, thromboembolism and hemorrhage, there is little general information regarding how to deal with pregnancy in patients with Klippel-Trenaunay syndrome and their obstetric outcome. We describe the case of a woman suffering from Klippel-Trenaunay syndrome delivering a healthy child with a brief review of concerned literature.

A CASE OF AMNIOTIC BAND SYNDROME ASSOCIATED WITH ANENCEPHALY DEMONSTRATED USING THREE- DIMENSIONAL ULTRASOUND AT EARLY PREGNANCY

양막대증후군은 파열된 양막이 태아에게 부착하여 태아 기형을 유발하는 드문 질환으로 사지, 안면-두개골, 몸통 등 태아의 다양한 이상을 초래한다. 태아에 부착된 양막을 확인하는 것으로 산전진단이 가능하며 최근 3차원, 4차원 초음파를 이용하면 산전진단에 도움이 된다는 보고들이 있다. 그러나 전형적인 사지 절단이 동반되지 않고 다발성 기형이 아닌 경우의 양막대증후군은 산전진단이 쉽지 않다. 특히 뇌없음증의 경우 일차적인 신경관결손과 양막대증후군의 감별은 다음 임신을 위해서도 매우 중요하다. 저자들은 임신 12주에 부검을 통해 양막대증후군으로 진단된 뇌없음증 태아의 양막대를 3차원 초음파 영상을 재검토를 하여 확인하였기에 문헌 고찰과 함께 보고하는 바이다.

A case of full-term delivery after septic shock during second trimester of pregnancy

The Septic shock is a major cause of maternal death during pregnancy which has a great influence on the fetal state. Septic abortion is the representative cause. However, there are many different causes or unknown causes as well. As soon as the diagnosis of septicemia, it should be treated immediately and aggressively. According to the gestational age and fetal condition such as fetal distress, the delivery time should be decided. This case is of a mother who suffered from septic shock at the 23rd week of the pregnancy. The cause of the septicemia could not be found in this case, but the patient was able to recover through early aggressive treatment. The fetus was in a favorable condition so the patient was able to give birth to the baby in full-term after recovering from sepsis.