Histopathologic and sonographic analysis of laparoscopic removal ovarian nonendometriotic cyst: the evaluating effects on ovarian reserve.

Currently, laparoscopic cystectomy is the first-line therapy for ovarian benign cysts that are resistant to current therapies. There are different studies that point to ovarian reserve damage due to laparoscopic cystectomy. In this study, we evaluate the ovarian damage following laparoscopic cystectomy for non-endometriosis cysts using ultrasound and pathology findings. This is a prospective cohort study conducted between 7 rd month of 2011 and 10th month of 2012 in Women hospital affiliated to Tehran university of medical sciences.45 non-endometriosis cysts (17 teratoma,7 mucinous, 10 simple serous and 11 simple cysts) underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histopathologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound. AFC after cystectomy for teratoma and simple serous was significantly reduced P<0.05. By larger teratomas and more parenchyma inadvertently removed during their excision (1.64, 0.255) reduced AFC was seen and in simple serous cysts with more removed parenchyma amount (1.5) reduced AFC occurred. In our study simple cysts excision led to a loss in AFC that was not associated with any other cyst parameters. Mucinous cysts resection led to no specific ovarian reserve damage. Laparoscopic cystectomy for non-endometriosis leads to reduced ovarian reserve.

Acardiac fetus with large intestine only. A case report.

Acardiac twin syndrome is a rare complication affecting monozygotic twins, where one twin fails to develop normally and completely. In this report, we present an acardiac fetus that was seen for evaluation at 26 weeks of gestation. Initial routine ultrasound examination suggested anomalies. The first detailed ultrasound demonstrated a normal fetus with appropriate growth plus an acardiac twin with a hypoplastic lower limb with subcutaneous edema and intestine-like organ near it. The pregnancy was followed with serial ultrasonography and spontaneous delivery occurred at term. A normal infant was born, and after delivery of the placenta, at the chorionic plate of the placenta there was a sac with diminished fluid, containing some loops of the intestine. A thin cord of one vascular channel was attached to the common placenta. In our literature review, this type of acardiac fetus has not been reported previously.

The reliability and distinguishability of ultrasound diagnosis of ovarian masses.

BACKGROUND: For any radiologist, intra-observer agreement in observing and decision making in diagnosis of any disease is of great importance, and so is observing and reading ultrasound pictures of ovarian masses and distinguishing amongst their categories. AIMS: In this study, the reliability and consistency of ultrasound diagnosis of ovarian tumors have been evaluated. SETTINGS AND DESIGN: Two experienced and three less experienced radiologists assessed ultrasounds of 40 patients of Mirza Koochak Khan Hospital in Tehran, Iran, in 2005. MATERIALS AND METHODS: In this prospective observational study, the ultrasounds were performed by an expert radiologist, with a single apparatus. These ultrasounds have been evaluated separately and independently in two periods (with a 1-week interval). STATISTICAL ANALYSIS USED: Weighted kappa was used to calculate intra-observer agreement (reliability), and two statistical models were applied to assess category distinguishability (consistency). SPSS version 10, SAS version 8, and EXCEL 2003 have been used to do an appropriate statistical analysis. RESULTS: Mean of weighted kappa was 0.81, and mean of distinguishability was 0.995 for our experienced radiologists, due to their superior results. Because of weaker results obtained by the less experienced radiologists, mean of weighted kappa and mean of distinguishability were 0.65 and 0.967 respectively. Overall mean of distinguishability for benign and borderline categories was 0.969; and for malignant and borderline categories, it was 0.987. CONCLUSION: Although experienced radiologists functioned better than the less experienced radiologists, all of them showed appropriate distinguishability and intra-observer agreement in diagnosis and categorization of the ovarian masses. Distinguishing benign category from borderline was more difficult than distinguishing malignant category from borderline. In general, experienced radiologists showed better results compared to less experienced radiologists.