One Case of Viable Cervical Pregnancy in Anterior Lip of the Cervix Treated by Systemic Methotrexate Treatment after Intra-amniotic Potassium Chloride Injection / 대한산부인과학회지

The cervical pregnancy is a rare condition representing less than 1% of ectopic gestations. But, it is potentially life-threatening condition because of profuse hemorrhage and requires hysterectomy in some cases. With ultrasound, diagnosis can be made earlier and conservative management is attempted in order to preserve the reproductive potential. Most cervical pregnancies are implanted within the cervical canal below the internal os of the cervix. However, we experienced one case of a unique viable cervical pregnancy in anterior lip of the cervix and treated successfully by local injection of potassium chloride into gestational sac and systemic methotrexate treatment.

Comparison study of VTH and LAVH for the indications other than uterine prolapse / 대한산부인과학회잡지

OBJECTIVE: To compare the advantages and disadvantages between total vaginal hysterectomy (VTH) and laparoscopically assisted vaginal hysterectomy (LAVH) including the indications and safety. METHODS: We reviewed the medical records of patients who underwent VTH from July 1998 to December 1999 and those who underwent LAVH from January 2000 to April 2002. We evaluated age, parity, previous abdominal operations, indications for hysterectomy, combined operations, operation time, bleeding amount, hemoglobin change, weight of uterus, and postoperative complications. RESULTS: 1. Age was not a notable factor but parity was significantly lower in LAVH group. 2. In VTH group, 48% of patients had previous operations compared with 46% in LAVH group. 3. The most common indication for hysterectomy of both group was uterine myoma. 4. The weight of hysterectomized specimen was 256 g in VTH group and 237 g in LAVH group. 5. In VTH group, 38% received concurrent surgical procedures of which colporrhaphy was the most common (14 cases). In LAVH group, 72.5% received concurrent surgical procedures of which salpingoo- phorectomy was most common. 6. The operation time showed a notable difference; 78.6 min. in VTH group and 105.4 min. in LAVH. 7. There was no significant difference in bleeding amount and hemoglobin change. 8. Postoperative complication was higher in VTH group (14%) than LAVH group (7.5%). However all the patients recovered with conservative treatment and close observation. CONCLUSION: Both VTH and LAVH had the following advantages compared with abdominal hysterectomy: less pain, shorter hospital stay, cosmetic advantages, lower prevalence. In this study we found out that in VTH, the procedure could be done safely even if the uterus was big or with previous abdominal operations. Limited operation field and the fact that we couldn't check the abdominal cavity were some disadvantages. In comparison, LAVH offered a view of the abdominal cavity which make easy adnexal operation but because of expensive operative tools, cost was a problem. In order to satisfy the patient and lower the cost, appropriate study on the indications and training on procedures will be necessary.

A Case of Immature Teratoma of the Ovary with Gliomatosis Peritonei / 대한산부인과학회잡지

Immature teratoma is composed of varying quantities of immature differentiating among anyone or all three germ layer. The pure immature teratoma accounts for fewer than 1% of all ovarian cancer, but it is the second most common germ cell malignancy. About 50% of pure immature teratomas of the ovary occur in women between the ages of 10 and 20 years, and they rarely occur in postmenopausal women. The most frequent site of dissemination is the peritoneum, and much less commonly, the retroperitoneal lymph node. Among the tumors with embryonal elements, those containing neural tissues demonstrate most clearly the importance of the ability to mature. Gliomatosis peritonei is the most dramatic demonstration of the significance of maturation, because most patients with these tumors have survived, even with this disseminated disease. The purpose of this paper is to report on a immature ovarian teratoma with predominantly mature glial tissues in peritoneum which we have experienced in this hospital recently with brief review of the literature.