Sensitive New Assay System for Serum Wisteria floribunda Agglutinin-Reactive Ceruloplasmin That Distinguishes Ovarian Clear Cell Carcinoma from Endometrioma.

Wisteria floribunda agglutinin (WFA)-reactive ceruloplasmin (CP) is a candidate marker for ovarian clear cell carcinoma (CCC) reported in our previous paper. Herein, a new measurement system was developed to investigate its potential as a serum marker for CCC. Site-specific glycome analysis using liquid chromatography/mass spectrometry showed that WFA-CP from CCC binds to WFA via the GalNAcß1,4GlcNAc (LDN) structure. We used mutant recombinant WFA (rWFA), which has a high specificity to the LDN structure, instead of native WFA, to increase the specificity of the serum sample measurement. To improve the sensitivity, we used a surface plasmon field-enhanced fluorescence spectroscopy immunoassay system, which is approximately 100 times more sensitive than the conventional sandwich enzyme-linked immunosorbent assay system. With these two improvements, the specificity and sensitivity of the serum rWFA-CP measurement were dramatically improved, clearly distinguishing CCC from endometrioma, from which CCC originates. This rWFA-CP assay can be used clinically for the serodiagnosis of early-stage CCC, which is difficult to detect with existing serum markers.

Diffuse Non-obstructive Bowel Dilatation in utero: Report of a Case with a Unique Presentation.

Thus far, few reports have described the rare, non-obstructive type of fetal diffuse bowel dilatation. We describe such a case in the fetus of a 31-year-old Pakistani pregnant woman, gravida 3, para 2. A series of ultrasonographic examinations in the third trimester showed a "honeycomb" appearance of fetal d iffuse dilated bowel loops, a mildly enlarged stomach, and mild polyhydramnios. Magnetic resonance imaging further revealed fluid-filled dilated bowel loops extending to the colon and rectum. The male neonate was born at 36 weeks and had marked abdominal distension but did not show signs of mechanical bowel obstruction. He passed a profuse amount of liquid with meconium at 4 h of life. Thereafter, his distended abdomen and bowel dilatation subsided, and he became asymptomatic within a week of life. Taken together with previous case reports, among infants who show the "honeycomb" sign in utero, there definitely exists a subset with a favorable outcome and an unknown etiology. This case alerts physicians who are responsible for perinatal care to the fact that careful assessment is required for a newborn when the "honeycomb" sign is observed via fetal imaging. Without evidence of mechanical bowel obstruction, alternative etiologies should be sought to avoid unnecessary laparotomy.

Aggressive Angiomyxoma of the Vulva with No Recurrence on a 5-year Follow up: A Case Report.

We report a case of vulvar aggressive angiomyxoma (AA) which is a rare, slow growing and benign tumor of mesenchymal origin, but has a high risk of local recurrence. A 49-year-old Japanese female was referred to us with a large mass of the left vulva, measuring 15×9.5×9 centimeters. She underwent surgical excision of the tumor with no evidence of recurrence on a 5-year follow up. In this case, histopathological examination and immunohistochemical staining after excision revealed a diagnosis of vulvar AA with estrogen and progesterone receptors positive. Aggressive angiomyxoma of the vulva needs to be distinguished from benign myxoid tumor with a low risk of local recurrence as well as from malignant neoplasma. The first line treatment of AA is complete surgical excision with tumor free margins, it will reduce the recurrence.