Comparison of Hospital stay and Cost-effectiveness between Treatment Modalities in Ectopic Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare the hospital stay and cost-effectiveness between treatment modalities in ectopic pregnancy for proper management. METHODS: In this study, the authors studied 121 cases retrospectively who had been admitted and treated at Department of Obstetrics and Gynecology, Konyang University Hospital from February 1, 2000 to August 31, 2003. We analyzed clinical features, treatment modality, hospital stay and cost-effectiveness between each groups. One-way ANOVA test was used and p<0.05 was regarded as statistically significant. RESULTS: There was no difference in clinical features between treatment modalites. Of total 121 cases, operative procedures were done in 105 cases (explo-laparotomy in 58, laparoscopy in 43, dilatation and curettage in 4) and medical treatment in 16 cases (Multiple dose methotrexate protocol in 11, Single dose methotrexate protocol in 5). Average of length of hospital stay was 5.3 +/- 0.2 days in explo-laparotomy, 3.8 +/- 0.2 days in laparoscopy, 2.8 +/- 1.4 days in dilatation and curettage, 6.5 +/- 0.5 days in multiple dose methotrexate protocol, 2.4 +/- 0.4 days in single dose methotrexate protocol. According to treatment modality, there was significant difference in total cost and cost sharing. Total cost in explo-laparotomy (875,324 +/- 25,977 Won) was more expensive than that of laparoscopy (734,375 +/- 35,179 Won). But, cost sharing in explo-laparotomy (156,543 +/- 9,583 Won) was less expensive than laparoscopy (319,493 +/- 26,255 Won). Total cost and cost sharing in multiple dose methotrexate protocol (323,231 +/- 33,972 Won, 184,465 +/- 17,344 Won) was more expensive than that of Single methotrexate protocol (192,495 +/- 31,180 Won, 68,793 +/- 13,422 Won). CONCLUSION: Based on these results, it is very important that we should have an interest in ectopic pregnancy for early detection and proper management. Consequently, Achievement of precise decision and successful methotrexate treatment can be possible to decrease hospital stay and cost-effectiveness.

The Expression of c-Src and Csk in the Human Endometrium During the Normal Menstrual Cycle / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to investigate the transcriptional expression and translational localization of c-Src and Csk, related to signal transduction of cell growth, differentiation, death, and DNA synthesis in the human endometrium during the normal menstrual cycle. METHODS: The specimens were obtained from the hysterectomized uterus and endometrial biopsies that showed no endometrial pathology. The mRNA level of c-Src and Csk were examined by RT-PCR and the expression of these proteins were confirmed by immunohistochemistry. RESULTS: The c-Src mRNA was strongly expressed at all phases, except in late secretory phase. The Csk mRNA was highly expressed at all phases. In stromal cells and glandular cells, immunohistochemical expression of c-Src protein was moderate in proliferative phase and was strong in the secretory phase. The expression of Csk protein was strong at all phases and more intensive in glandular cell than stromal cell. CONCLUSION: It is suggested that c-Src may play an important role in the signaling of the differentiation of the human endometrium and the Csk may modulate the c-Src kinase activity.