Congenital ovarian anomaly manifesting as extra tissue connection between the two ovaries: A case report.

BACKGROUND: Ovarian anomalies except for uni- or bilateral streak gonads are rare. We present a rare case of an ovarian anomaly in which both ovaries were connected by extra tissue. CASE SUMMARY: A 32-year-old, primipara with a twin pregnancy at 36 weeks of gestation was admitted to the hospital with severe preeclampsia. She underwent emergency cesarean section owing to persistent headache, blurred vision, and general edema. Following a peritoneal incision, a thin rectangular-shaped tissue was seen in front of the uterus. After delivery, the extra tissue was removed; no other anomalies were reported in either the ovaries or uterus. Pathology results of the removed tissue disclosed a well-vascularized loose stromal tissue with few follicles and scattered luteinized cells. In this case, to prevent pelvic adhesion or intestinal obstruction resulting from volvulus, strangulation, and torsion, the extra tissue was removed. CONCLUSION: We report a case of a rare ovarian anomaly where both ovaries were connected by extra tissue. If the extra tissue extends to the abdominal cavity, it should be removed to prevent pelvic adhesion or abdominal complications including intestinal volvulus, strangulation, and torsion.

Corrective surgery using a gridiron incision for abdominal pain caused by a folded ovary in the third trimester of pregnancy.

INTRODUCTION: Sonography and magnetic resonance imaging (MRI) may be helpful to obtain an accurate diagnosis of acute abdominal pain in pregnancy. Adnexal torsion presenting in the first or second trimester can be confirmed and treated through laparoscopic surgery; however laparoscopic surgery in the third trimester can be difficult owing to the large uterus, and a gridiron incision can be useful. CASE REPORT/CASE PRESENTATION: An 18-year-old gravida 1, para 0 (G1P0) woman at 30 + 4 weeks of gestation presented with sudden-onset cyclic pain in the right lower quadrant. Abdominal ultrasonography showed a normal appendix, and MRI showed a normal appendix and normal ovaries. The patient's prominent tender point was marked and compared with the MR images, which confirmed the mark as the position of the right ovary. Laparotomy was performed through a gridiron incision, and a folded right ovary was identified. The ovary was unfolded, and TachoSil® and Surgicel® were used to maintain the unfolded position. The patient's pain resolved, and her postoperative course was uneventful. She delivered a healthy, 2540-g male baby at 35 weeks' gestation. DISCUSSION/CONCLUSIONS: A gridiron incision was useful to treat a folded ovary in the third trimester and to evaluate the adnexa and minimize uterine manipulation.

Extracts of Magnoliae flos inhibit inducible nitric oxide synthase via ERK in human respiratory epithelial cells.

Nitric oxide (NO) is a marker of pulmonary inflammation. In asthma, the levels of exhaled NO are elevated and the source of this increased NO is inducible nitric oxide synthase (iNOS) within airway epithelial cells. Epimagnolin and fargesin are compounds isolated from the ethanol extract of Magnoliae flos, the seed of the Magnolia plant and are used to treat nasal congestion, headache and sinusitis in Asian countries. This study investigated whether epimagnolin and fargesin inhibit extracellular signal-regulated kinase (ERK) activation and decrease iNOS expression and NO production in stimulated human respiratory epithelial cells. An immortal Type II alveolar cell line of human origin (A549) was stimulated by cytomix (CM), composed of IL-1beta, TNF-alpha and IFN-gamma, with or without concurrent exposure to M. flos extract (epimagnolin or fargesin). CM-induced levels of NO production, iNOS expression and ERK activation were evaluated. A549 cells stimulated with CM showed increases in iNOS mRNA and protein expression, and NO synthesis. However, treatment with epimagnolin or fargesin decreased levels of iNOS mRNA and protein expression, and NO synthesis. CM stimulated a rapid increase in the activity of ERK, whereas epimagnolin and fargesin inhibited ERK phosphorylation. Epimagnolin and fargesin inhibit iNOS expression and decrease production of NO via ERK pathway in cytokine-stimulated human respiratory epithelial cells.