[Successful Multidisciplinary Treatment of Metastatic Ovarian Cancer after Perforative Peritonitis of the Rectum Due to Disseminated Ovarian Cancer].

A72 -year-old woman who complained of abdominal pain and distention visited the emergency clinic of our hospital in April 2014. Computed tomography(CT)showed an omental mass and a pelvic mass with massive ascites. The fluid was removed by abdominal aspiration, and the patient showed perforative peritonitis next day. An emergency operation was performed. The surgical operation showed that the rectum was perforated due to stenosis covered by the ovarian cancer metastases. Aleft colectomy combined with a transverse colostomy was performed. After 4 weeks of rest, 6 courses of tri- weekly TC chemotherapy were administered, and the CA125 level decreased from 140 U/mL to 11.8 U/mL. She underwent a complete cytoreductive surgery in February 2015. She was histologically diagnosed with Grade 2b serous adenocarcinoma. After these 2 surgical operations, she underwent a splenectomy to remove a single metastasis in February 2016 and consecutive chemotherapy. For ovarian cancer, if dissemination occurs, rectal perforation can be a treatment target with a gastrointestinal surgeon's help.

Adiponectin concentration in umbilical cord serum is positively associated with the weight ratio of fetus to placenta.

CONTEXT: Adiponectin (APN) concentration in umbilical cord serum is higher than that in adult serum. Except for the positive association between birth weight and cord APN concentration, little is known about the pathophysiological function of APN in fetal development. OBJECTIVE: The objective of this study was to evaluate the relationship of cord serum APN and IGF-I concentrations with the development of the fetoplacental unit. DESIGN AND METHODS: Umbilical cord serum APN and IGF-I concentrations were measured in term singleton deliveries (n = 94). The association of cord APN and IGF-I concentrations was evaluated in relation to fetal weight, placental weight, and fetoplacental (F/P) weight ratio. RESULTS: Mean concentrations and sd of APN and IGF-I were 36.1 +/- 14.0 microg/ml and 58.6 +/- 27.0 ng/ml, respectively. Cord APN concentration was positively associated with F/P weight ratio (r = 0.375, P < 0.001) as well as fetal weight (r = 0.389, P < 0.001) but not placental weight. Cord IGF-I concentration was positively associated with fetal weight (r = 0.405, P < 0.001) and placental weight (r = 0.400, P < 0.001) but not F/P weight ratio. In multiregression analysis, only APN concentration resulted in a significant determinant of F/P weight ratio among variables (beta = 0.376, P < 0.001). CONCLUSIONS: In cord hyperadiponectinemia, fetuses tend to be disproportionately larger for their placental weight and vice versa in cord hypoadiponectinemia. APN is shown to be the first biomarker positively associated with F/P weight ratio.