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This retrospective study aimed to review the prognostic factors for leiomyosarcoma (LMS) and to compare the efficacies of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH) for the management of uterine LMS. The clinical records were reviewed for 20 patients who had undergone either LAVH or TAH between 1992 and 1998 at Shin-Kong Hospital, with subsequent diagnosis of uterine LMS. Mitotic index and tumor size appeared to be the factors significantly related to survival. After comparison of the two surgical procedures, it was concluded that LAVH can be as effective as the total abdominal variant for the management of LMS.

Holoprosencephaly (HPE) is a complex human brain abnormality caused by incomplete cleavage of the prosencephalon into the right and left hemispheres, occurring between the 18 th and 28 th day of gestation. Different levels of increasing severity are defined: (1) lobar HPE, where the right and left ventricles are separated, but with some continuity across the frontal cortex; (2) semilobar HPE with a partial separation; and (3) alobar HPE, the most severe form, with a single brain ventricle and no interhemispheric fissure. Mettler [1] described the dorsal cyst of HPE as a structure that “occupies the area of the calvarium above the dorsocaudal aspect of the diencephalons” and indicated that the “walls of this cyst are always directly continuous with the most caudal parts of the walls of the telencephalon medium and its cavity communicates directly with the common ventricle of the telencephalon”. Furthermore, he added that a variable amount of the anterior wall of the dorsal cyst is “fused with the dorsal surface of the thalamus, sealing over the third ventricle”. Other authors have suggested that aqueduct stenosis or atresia results in dorsal cyst formation [2,3]. There have been many reports on the nature of dorsal cyst in HPE, but it was always noted after birth. HPE is the most common but lethal defect in the congenital cerebral abnormalities. It is a heterogeneous etiologic disease that can be caused by both a teratogenic and/or a genetic basis. Alobar or semilobar HPE is usually combined with a facial defect due to the missed embryogenesis, but early prenatal diagnosis of semilobar HPE with a dorsal cyst and no facial defect is rare. Herein, we report a case of early detection of HPE with a dorsal cyst and no facial defect in a low-risk mother, to present the distinctive features of semilobar HPE and the hypotheses involving a dorsal cyst. A 27-year-old, gravida 1, para 0, woman first visited our prenatal clinic at 9 weeks of gestation. Previous obstetric history and family history were unremarkable. An ultrasound (US) scan confirmed an intrauterine pregnancy with a fetus of crown–rump length of 2.5 cm without abnormal findings. During the second visit at 12 weeks’ gestation, a second US scan illustrated a nuchal translucency measuring 1.8 mm and a clear nasal bone structure. However, a dorsal cyst over the magnum cisterna in the transverse view (Figure A) was noted. The follow-up scans showed abnormalities of the forebrain, including partial absence of the midline echo, partial fusion of the thalami and abnormal ventricular configuration (Figures B and C), but facial structure was normal. Semilobar type of HPE with a dorsal cyst was diagnosed at that time. The other organs and systems, including cardiovascular, gastrointestinal and urinary systems, were unremarkable under the sonographic examination. Examinations for the presence of toxoplasmosis, rubella, cytomegalovirus, herpes (TORCH) were performed but without positive findings. Consequently, amniocentesis was scheduled for the next visit.

To evaluate the effect of laparoscopic ovarian cystectomy for endometrioma on the clinical outcome of IVF treatment.Patients who received IVF treatment were retrospectively classified into two groups. Group 1 included 95 patients who received IVF due to tubal occlusion. Group 2 included 127 patients who had received laparoscopic ovarian cystectomy for endometrioma(s) followed by IVF treatment. Clinical outcomes of IVF treatment were compared between two groups.More oocytes were harvested per retrieval in Group 1 than Group 2 (p0.05). The fertilization rate was higher in Group 1 than Group 2 (p0.05). Although the implantation rate was higher in Group 2 (p0.05), the clinical pregnancy rate revealed no statistically significant difference between the two groups.Women who received ovarian cystectomy for endometriomas have fewer oocytes harvested during IVF treatment. However, their chance of pregnancy was comparable to patients with tubal problems who underwent IVF treatment.

Sperm preparation has play an integral part in the success of in-vitro fertilization. The aim of this study was to compare 2 different density gradient preparations for sperm separation in respect to sperm recovery, motility, motion parameters and clinical outcome after intrauterine insemination.One-hundred and 21 women who received intrauterine insemination due to ovulation dysfunction were randomly allocated into 2 groups, using either the Percoll (Amersham, Pharmacia Biotech AB, Sweden) or the PureSperm (Nidacon, Göteborg, Sweden) density gradient method for sperm preparation. The characteristics of sperm before and after separation and the clinical outcome of intrauterine insemination were compared between the 2 groups.PureSperm and Percoll demonstrated comparable ability to recover the sperms with progressive motility. There was no difference in motion parameters and the number of sperm recovered with progressive motility between the Percoll and the PureSperm density gradient preparations. The clinical pregnancy rate was also comparable between the 2 groups, 12.5% (7/56) in the PureSperm group compared to 13.8% (9/65) in the Percoll group, (p0.05).Despite using different density composition and volume, PureSperm demonstrated clinical effect comparable to that of Percoll in preparing sperm for intrauterine insemination.

Although congenital mesoblastic nephroma (CMN) is a rare benign congenital renal tumor, it is the most common solid renal tumor in the newborn period. The most common presentation of congenital mesoblastic nephroma is polyhydramnios, and only one case with prenatal fetal hydrops has been previously reported. Prenatal diagnosis of CMN has previously been made on the basis of the findings of sonography in the third trimester, and magnetic resonance imaging (MRI)-based diagnosis has been reported recently. Here we report a case of prenatally diagnosed classical type CMN diagnosed at 22 + 3 weeks of gestation based on the findings of sonography and magnetic resonance imaging. The characteristic imaging findings in this case were fetal hydrops and polyhydramnios. To our knowledge, this is the youngest reported gestational age for prenatal diagnosis of CMN and it is the second case of CMN associated with fetal hydrops detected prenatally.

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