Fundus Autofluorescence, Fluorescein Angiography and Spectral Domain Optical Coherence Tomography Findings of Retinal Astrocytic Hamartomas in Tuberous Sclerosis

PURPOSE: To analyze the structural and morphological characteristics of retinal astrocytic hamartomas in tuberous sclerosis patients using fundus autofluorescence, fluorescein angiography and spectral-domain optical coherence tomography. CASE SUMMARY: Fundus examination, fundus autofluorescence, fluorescein angiography and spectral-domain optical coherence tomography were performed in three patients with tuberous sclerosis and the morphological and structural characteristics of retinal astrocytic hamartomas were analyzed. In the fundus autofluorescence, type 1 retinal astrocytic hamartoma showed hypofluorescence and type 3 showed central hyperfluorescence and surrounding hypofluorescence. Spectral domain optical coherence tomography showed dome-shaped hyper-reflectivity within the nerve fiber layer and focal adhesion of the vitreous cortex in the type 1 retinal astrocytic hamartoma. No abnormalities were observed in the outer retinal layer and retinal pigment epithelium. In the type 3 retinal astrocytic hamartoma, optical coherence tomography showed disorganization of retinal tissue and posterior shadowing. Intratumoral cavitation and moth-eaten appearance caused by intratumoral calcification were observed and the vitreous cortex adhered to the top of the tumor and showed traction. Retinal arterial sheathing was observed in all cases and hyper- reflectivity of the arterial wall was noted on optical coherence tomography. CONCLUSIONS: Fundus autofluorescence, fluorescein angiography and spectral-domain optical coherence tomography are helpful for the classification and diagnosis of retinal astrocytic hamartomas found in tuberous sclerosis patients as well as for differentiation from other lesions.

Expression and localization of Rdd proteins in Xenopus embryo / 대한해부학회지

The previous study has shown that repeated D domain-like (Rdd) proteins, a group of novel secretory proteins consisting of repeated domains of a cysteine-rich sequence, are involved in the process of blood vessel formation in Xenopus embryo. We performed further experiments to examine the localization of Rdd proteins in embryogenesis. Detection of tagged Rdd proteins expressed in blastomeres showed that Rdd proteins formed a high molecular weight complex and existed in the extracellular space. A rabbit antibody against the Rdd synthetic peptide identified a single band of 28 kD in embryonic tissue extract. By whole-mount immunostaining analysis, signal was detected in the regions of inter-somites, vitelline veins, and branchial arches at the tailbud stage. Staining of Rdd was remarkably reduced in the embryos injected with vascular endothelial growth factor Morpholino. We suggest that Rdd proteins interact with a molecule(s) associated with vascular precursor cells.

Comparison of Efficacy between MonoPrep(R) and Papanicolaou Smear for Cervical Cancer Screening / 대한산부인과학회잡지

OBJECTIVE: To compare the specimen adequacy and cytologic diagnostic results of MonoPrep(R), a type of liquid based preparation, with the conventional Pap smear. METHODS: In randomly selected 156 patients who visited the department of Obstetrics and Gynecology, Ajou University Hospital for cervical biopsy, conventional Pap smear and matched MonoPrep(R) were performed. Statistical analysis was performed with chi-square test. RESULTS: There were more "Unsatisfactory" and "Satisfactory but limited by (SBLB)" results in the conventional Pap smear group, even though no statistical significance could be found between the two groups. ASC/LSIL ratio was significantly decreased in the MonoPrep(R) group, showing 0.4 with MonoPrep(R) and 1.9 with conventional Pap smear demonstrating a 78.4% decrease (P<0.001). In detecting abnormal cervical lesions, conventional pap smear showed a sensitivity of 87.7%, positive predictability of 82.3%, false negativity of 10.3%, while MonoPrep(R) showed a sensitivity of 94.8% (P=0.04), positive predictability of 97.4% (P<0.001), and false negativity of 2.6% (P=0.016). CONCLUSION: MonoPrep(R) is more effective for the detection of cervical lesions with higher sensitivity and lower false negativity compared to conventional pap smear.

The Effect of Hydramnios on the Outcomes of Pregnancies Complicated with Gestational Diabetes Mellitus / 대한산부인과학회잡지

OBJECTIVE: To determine whether hydramnios occurring in pregnant women complicated with gestational diabetes mellitus (GDM) affects maternal and neonatal outcomes. METHODS: We evaluated 277 pregnant women with singleton pregnancies and GDM diagnosed by the National Diabetes Data Group (NDDG) criteria. The study group was consisted of 23 pregnant women diagnosed as hydramnios (Amniotic fluid index; AFI>24 cm) by ultrasonography, and the control group was consisted of 254 pregnant women with normal AFI (10-24 cm). Retrospective review of maternal and neonatal outcomes in these women was performed. Student t-test, chi-square test, Fisher's exact test, and logistic regression analysis were used for statistics. RESULTS: There were no significant differences in the maternal age and parity between the two groups. The frequency of preterm labor was higher in the study group compared to the control group (4.3% vs. 34.8%, p<0.001). The frequencies of cesarean delivery due to cephalopelvic disproportion or failure to progress, preeclampsia, and placental abruption were not significantly different between the two groups. The study group showed significantly shorter gestational age (38.2+/-1.4 weeks vs. 36.7+/-2.5 weeks, p<0.05) and heavier neonatal birth weight at delivery (3,405.0+/-595.2 gm vs. 3,701.3+/-757.9 gm, p=0.026). The frequencies of preterm birth (5.1% vs. 39.1%, p<0.001), macrosomia (13.0% vs. 34.8%, p<0.001), admission to neonatal intensive care unit (7.1% vs. 34.8%, p=0.050), neonatal respiratory complications (3.9% vs. 21.7%, p<0.001), and hyperbilirubinemia (11.0% vs. 47.8%, p<0.001) were higher in the study group even after logistic regression analysis for controlling gestational age. CONCLUSION: Hydramnios occurring in pregnant women with GDM may be associated with increased risk of preterm birth and neonatal respiratory complications, but not associated with adverse maternal outcomes, except preterm labor.

Twin Pregnancies: In Vitro Fertilization vs. Spontaneously Conceived / 대한산부인과학회잡지

OBJECTIVE: To compare the obstetrical and perinatal outcomes of twin pregnancies after IVF-ET with those of twin pregnancies conceived spontaneously. METHODS: Two hundred and six cases of IVF-ET twin pregnancies (IVF group) were compared with 229 spontaneously conceived or ovulation induced twin pregnancies (spontaneously conceived group) for obstetrical and perinatal outcomes. All were delivered between July 1994 and February 2002 at Ajou University Hospital. Their clinical records were reviwed. RESULTS: The mean maternal age of IVF group and spontaneously conceived group was 30.7+/-3.7 years, 28.4+/-4.0 years and primiparous women were 86.9%, 58.5% (p=0.000). In IVF group and spontaneously conceived group, mean gestational age was 35.0+/-1.7 weeks, 35.5+/-2.1 weeks (P=0.000), mean birth weight 2311.4+/-411.7 gm, 2324.3+/-447.1 gm (P=0.015), and frequency of birth weight less than 2500 gm 70.6%, 60.3% (p=0.001). In both groups, the frequencies for preterm labor, preeclampsia, intrauterine growth restriction, and birth weight discordancy were 42.2%, 32.3% (p=0.032), 8.3%, 18.3% (p=0.002), 5.3%, 8.7% (p=0.052%), 7.8%, 10.9% (p=0.262), respectively. On the comparison of the chorionicity, monochorion- diamnion was 2.0%, 36.3% (p=0.000) and dichorion-diamnion was 98.0%, 62.8% (p=0.000). And there was no significant difference in congenital anomaly, Apgar scores, frequency and duration of neonatal intensive care unit admission. CONCLUSION: In IVF-ET twin group compared with spontaneously conceived group, there was higher incidence of preterm labor, and low birth weight.