Promoter hypermethylation and loss of heterozygosity of FHIT genes in squamous cell carcinoma of uterine cervix / 부인종양

OBJECTIVE: This study was to investigate the status of hypermethylation and loss of heterozygosity (LOH) in chromosome 3p tumor-suppressor gene for cervical carcinoma. METHODS: We examined the promoter methylation status of the chromosome 3p gene, fragile histidine triad (FHIT), in 37 samples of cervical squamous cell carcinoma and corresponding noncancerous tissues using a methylation-specific polymerase chain reaction. We also analyzed the 37 paired samples for LOH at two loci on chromosome 3p. RESULTS: Promoter hypermethylation in FHIT was detected in 24% of tumors, whereas no hypermethylation was detected in the corresponding noncancerous tissues. LOH in the regions of FHIT was observed in 10% of informative cases. There were no correlations between LOH and promoter hypermethylation for the gene. FHIT hypermethylation was associated with small tumors and, when adjusted for tumor size, correlated significantly with more frequent lymph node metastasis. CONCLUSION: Promoter hypermethylation and LOH of FHIT gene may play a role in cervical carcinogenesis. In addition, hypermethylation of FHIT may be associated with the status (aggressiveness) of cervical carcinoma.

A Comparison of Oral Misoprostol and Vaginal Dinoprostone Pessary in Induction of Labor at Term / 대한주산의학회잡지

OBJECTIVE: The aim of this study was to compare the efficacy and safety of oral prostaglandin (PG) E1, misoprostol, and vaginal PGE2, dinoprostone pessary, in the induction of labor at term. METHODS: From March 2004 to March 2006, we retrospectively analyzed 175 women who underwent labor induction at term with an unfavorable cervix (the Bishop score=4). Women in the misoprostol group (n=72) received 100 microgram oral misoprostol and the second dose could be repeated every 6 hours if the Bishop score remained at 4 or less. Women in the dinoprostone group (n=103) received 10 mg vaginal dinoprostone pessary. Intravenous oxytocin, if necessary, was administrated 6 hours after the last dose of oral misoprostol or removal of the dinoprostone pessary. RESULTS: Mode of delivery and indications for cesarean delivery were similar in the two groups. The interval from PG administration to active phase of labor (median [range], 9.6 [3.0~37.2] hr vs. 12.0 [1.8~41.7] hr, p<0.05) and vaginal delivery (median [range], 12.7 [3.2~38.4] hr vs. 15.5 [3.3~ 37.1] hr, p<0.05) were shorter in the misoprostol group than the dinoprostone group. However, delivery within 12 hours and within 24 hours after PG administration was similar in the two groups. Uterine hyperstimulation syndrome occurred in 5 (6.9%) women in the misoprostol group and in none in the dinoprostone group (p<0.05). The neonatal outcome was not different between the two groups. CONCLUSION: Overall, oral misoprostol is as effective as vaginal dinoprostone pessary for induction of labor at term, but it is associated with shorter labor induction time and higher risk of uterine hyperstimulation syndrome.

Clinical outcome of preterm premature rupture of membranes in singleton versus twin pregnancy / 대한산부인과학회지

OBJECTIVE: To compare the latency period and perinatal outcome of singleton and twin pregnancies complicated by preterm premature rupture of the membranes (PPROM). METHODS: From January 1996 to December 2005, the medical records of women with singleton (n=345) and twin pregnancies (n=73) complicated by PPROM (24-34 weeks of gestation) were reviewed. Pregnancy and neonatal outcomes including the latency period, neonatal morbidity, and mortality were compared between the singleton and twin groups. RESULTS: No differences were noted with respect to gestational age at the time of membrane rupture and use of tocolytics, steroid and prophylactic antibiotics between the two groups. The latency period was significantly shorter in twins (median [range]; 4.0 [0-50] day vs. 1.0 [0-25] days, p<0.001), and significantly more twins were born within 48 hours and within 7 days after rupture of the membranes (within 48 hours, 33.0%vs. 65.8%, p<0.001; within 7 days, 67.5%vs. 87.7%, p<0.001). The latency period was longer when PPROM occurred before 30 weeks of gestation than after 30 weeks of gestation in both groups (median [range]; singleton, 11.5 [0-50] days vs. 3.0 [0-33] days, p<0.001; twin, 3.0 [0-25] days vs. 0 [0-6] day, p<0.001). Although gestational age at delivery was similar in singleton and twin groups, more twin infants had low birth weight, low Apgar score and neonatal morbidities. CONCLUSION: Twin pregnancy with PPROM, compared to singleton pregnancy with PPROM, had shorter latency period and worse perinatal outcome.

Clinical outcomes of first trimester discordant twins / 대한산부인과학회지

OBJECTIVE: To compare the clinical outcomes of first trimester discordant twins with second or third trimester discordant twins and concordant twins. METHODS: Pregnancy outcomes of twin pregnancies delivered from October 1994 to February 2006 were analyzed retrospectively. Subjects were categorized into following three groups: 1) group 1, first trimester discordant twins defined as intertwin CRL difference > or =5 days at 10-14 weeks of gestation (n=32), 2) group 2, second or third trimester discordant twins defined as intertwin AC difference >20 mm at 20-28 weeks of gestation or intertwin fetal weight difference >25% beyond 29 weeks of gestation (n=42), 3) group 3, concordant twins with no discordancy throughout the whole gestation (n=723). Perinatal complications analyzed for were congenital anomaly, fetal growth restriction (FGR), fetal death in utero (FDIU). RESULTS: The three groups were similar with respect to maternal characteristics and chorionicity. Overall, the group 2 had higher perinatal complications compared to the group 3. Congenital anomaly was more common in the group 1 than the group 2 (21.9% vs. 11.9%, p<0.001). However, FGR rate was higher in the group 2 than the group 1 (32.3% vs. 71.8%, p<0.01). Congenital anomaly, FGR and FDIU were more common in the group 1 compared to the group 3 (21.9% vs. 3.5%, p<0.001, 32.3% vs. 9.1%, p<0.01, 6.3% vs. 1.0%, p<0.05, respectively). CONCLUSIONS: First trimester discordant twins have an increased risk of congenital anomaly, FGR and FDIU, and therefore, they should be regarded as a high-risk pregnancy likewise second or third trimester discordant twins.