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Intramural pregnancy is extremely rare and difficult to diagnose. Because of the high rate of uterine rupture in most cases, hysterectomy is often necessary. The optimal medical management for this condition is unknown. We report 2 cases of intramural pregnancy diagnosed by pelvic MRI and treated with systemic methotrexate.

Objective: To investigate whether multiparameter flow cytometric analysis of solid tumor specimens, including gynecologic tumors, which were stained triply with phycoerythrin (PE), fluorescein isothiocyanate (FITC) and propidium iodide (PI), can be performed simultaneously without interference from normal diploid cell populations and spectral overlap on a standard flow cytometer. Methods: MCF-7 breast cancer cell lines and heterogeneous cell populations mixed with MCF-7 cells and human peripheral blood lymphocytes (PBL) were fixed with 1% paraformaldehyde and permeabilized with 100% methanol. Cytokeratin and several proliferation-associated cellular antigens (proliferating cell nuclear antigen (PCNA), p53, c-erbB/2 and c-myc) were labeled with PE and FITC, which was followed by DNA staining using PI. These labeled cells were measured on a standard FACScan flow cytometer equipped with a 488 nm single laser. Results: The coefficient of variation (CV) of the G 0 G 1 peak of MCF-7 cells was 4.3 and the cell cycle phase fractions of G 0 G 1 , S and G 2 M were 44.9, 45.9 and 9.2%, respectively. Fluorescein isothiocyanate, PE and PI fluorescences were detected without interference. The MCF-7 cells expressed cytokeratin, PCNA, p53, c-erbB/2 and c-myc antigen. In the heterogeneous population of MCF-7 cells mixed with PBL, two cellular populations were clearly separated into diploid PBL and aneuploid MCF-7 cells without interference. The CV of G 0 G 1 peak of PBL was 2.3 and the G 0 G 1 , S and G 2 M phase fractions were 85.5, 2.7 and 11.8%, respectively. The DNA index of MCF-7 cells was 1.7, which indicated that the MCF-7 cell line was composed of tumor cells with aneuploid DNA. The CV of the G 0 G 1 peak of the MCF-7 cells was 4.2, and the cell cycle phase fractions were 47.5% for G 0 G 1 , 42.3% for S, and 10.2% for G 2 M. The MCF-7 cells expressed cytokeratin, but the PBL did not. Conclusions: Multiparameter flow cytometer analysis was useful to determine DNA ploidy status, phase fraction of the cell cycle and expression of cellular antigens and selective cytokeratin expression allowed epithelial originated tumor cells to be differentiated from normal stromal cells. This analysis could be performed without interference of spectral overlaps of fluorochromes using software-based algorithmic compensation of spectral overlaps. Thus, this method offers new possibilities for multiparameter flow cytometric analysis and its use should be extended to future studies of the diagnosis, treatment and prediction of prognosis of the neoplasm.

Tuberculous peritonitis in pregnancy is one of the least common forms of extrapulmonary tuberculosis in pregnancy. The case is described herein of a 23-year-old primigravida woman with primary tuberculous peritonitis in pregnancy at 24 weeks' gestation. Excisional biopsy taken from the peritoneum during laparotomy resulted in the histopathologic diagnosis of tuberculous peritonitis. The patient made a good physical recovery after being placed on antituberculous chemotherapy and gave birth to a healthy male neonate of 2.5 kg at 37 weeks' gestation by vaginal delivery.

Objective: To evaluate the usefulness of power spectral analysis on fetal heart rate variability as a new diagnostic method of fetal distress. Study design: Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into three groups: normal fetus group (36); presumed distress group (26); and acidemic distress group (14). In order to perform linear analysis on the raw data of the fetal heart rate, after resampling, we performed Fourier transformation and investigated power distributions among very low frequency (VLF), low frequency (LF), high frequency (HF) bands, and autonomic balance (LF/HF). Results: The results of the spectral analysis showed that in normal fetus group, the difference in the distribution of power spectrums of VLF, LF and HF was significantly higher than in presumed distress group and acidemic distress group. In fetal distress, the LF and VLF value (≤0.0023, ≥0.0437) were good predictors (sensitivity 97.5%, 75.0% and specificity 86.1%, 94.4%). The LF value (≤0.0013) was a good predictor in fetal acidemia (sensitivity 97.5% and specificity 86.1%). C onclusions: A computerized spectral analysis of fetal heart rate variation is a good predictor of fetal distress, which is made automatically and objectively.

To evaluate the influence of non-insulin-dependent diabetes mellitus (NIDDM) on bone mineral density (BMD), we measured BMD in 185 female patients with NIDDM using dual energy X-ray absorptiometry (DEXA). BMD was measured in lumbar vertebrae (L2-4). BMD is slightly higher in the diabetic patients compared with control subjects and bone loss related to menopause starts before the onset of menopause. The BMD of postmenopausal women showed a definite decrease with aging and there was abrupt bone loss after 55 years of age (p < 0.05). In relation to the duration of diabetes, the decrease of BMD for 15 years was 10.0%. BMD was negatively correlated with age, years since menopause (YSM), and disease duration (r = -0.584, r = -0.470, r = -0.186). These results suggest that age, YSM, and the duration of disease appear to be the risk factors for decreased BMD in the diabetic patients.

Congenital diaphragmatic hernia (CDH) is often associated with major anomalies and chromosomal abnormalities. Chromosomal abnormalities are usually detected in 9.5% to 34% of fetuses with CDH prenatally diagnosed and the defect has also been reported in association with multiple syndromes such as Pallister-Killian syndrome, Fryns syndrome, Di George syndrome and Apert syndrome. Among the chromosomal abnormalities associated with CDH, trisomy 21, 18, and 13 are most common. Association with complex chromosomal aberrations such as mosaicism has also been reported. However, CDH presented in a fetus with Y-autosome translocation is extremely rare. Herein, we reported a case of fetus with 46,XY/46,X,-Y, +der(Y)t(Y;1)(q12;q12) mosaicism who presented with CDH diagnosed by ultrasonography at 19 weeks' gestation.