The detection rate of Ureaplasma urealyticum and Mycoplasma hominis in patients with impending preterm birth and mid-trimester cervical swab / 대한주산의학회잡지

PURPOSE: The purpose of this study was to examine the risk of preterm birth in pregnant women with Ureaplasma urealyticum and/or Mycoplasma hominis infection and the prevalence of these organisms in normal pregnancy. METHODS: Between February 2002 and July 2002, we included 43 pregnant women prior to 37 weeks of gestation with definite gross leakage of amniotic fluid (n=16) (group 1), 47 healthy women without any obstetric problems between 18 and 24 weeks of gestation (group 2) and 64 women who delivered fullterm fetuses who had taken cervical swabs around 36 weeks gestation (group 3). Cervical swabs (Dacron(R)) were taken on admission in group 1 and at outpatients in group 2 and 3. Detections of U. urealyticum and M. hominis were done using commercial kits (MYCOFAST(R) Evolution 2, International Microbio Signes, France). RESULTS: There was no significant difference between mid-gestation (group 2) and fullterm (group 3) in cervical swab result. In group 1, the detection rate of Ureaplasma uealyticum was higher in impending preterm birth over 32 weeks of gestational age (15/20, 75%) than 32 weeks or less (10/ 23, 43.4%) (p<0.05). In group 2, there was no significant difference in preterm birth rate between the exposed and the non-exposed to U. urealyticum and/or M. hominis in middle of 2nd trimester. CONCLUSION: U. urealyticum does not seem to be a predictor of preterm birth, and there seems to be some different mechanism according to gestational age. We couldn't varify that M. Hominis and U. urealyticum were related to preterm birth, although U. urealyticum was highly detected in impending preterm birth.

Expression of c-Met in ovarian epithelial tumor / 부인종양

OBJECTIVE: This study was performed to evaluate the expression of c-Met in epithelial ovarian carcinoma. METHODS: Paraffin-embedded tissues from 50 epithelial ovarian adenocarcinomas were stained immunohistochemically for c-Met expression. The expression of c-Met was correlated with clinicopathologic parameters including, histologic type, tumor size, and tumor stage. RESULTS: c-Met expression was found in 29 cases (58%) among 50 ovarian cancers. In clinicopathologic study, c-Met expression of epithelial ovarian carcinomas did not show the correlation with clinicopathologic parameters such as histologic type, tumor size and stage. CONCLUSION: c-Met expression might be a potential prognostic marker for patients with advanced stage epithelial ovarian cancers. However, larger population-based studies should be performed to determine the prognostic potential of c-Met expression in advanced ovarian carcinoma.

A case of severe hydronephrosis due to ureteral stricture from endometriosis / 대한산부인과학회지

Endometriosis is a relatively common disease, affecting 5-10% of women of reproductive age. But, endometriosis affecting the urinary tract is very rare entity. Involvement of urinary tract by endometriosis occurs in about 1% of women with pelvic endometriosis. Ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms at clinical presentation and difficult preoperative diagnosis. The involvement of the ureter is rarely intrinsic by implantation of endometrial tissue in the wall of the ureter, but rather due to external compression by adjacent endometriosis and its attendant inflammation and fibrosis. We have experienced a case of right severe hydroureteronephrosis due to ureteral stricture from endometriosis. Laparoscopic nephrectomy was done due to renal atrophy. At the same time, laparoscopic total hysterectomy with right salpingo-oophorectomy was performed because of the uterine adenomyosis and right ovarian endometrioma. So, we report that with a brief review of literatures.

Effect of Desexualization Care Guided by Dramaturgical Interaction on Women's Embarrassment during Cervical Cancer Screening / 여성건강간호학회지

PURPOSE: The aim of this study was to examine the effect of Desexualization Care guided by dramaturgical interaction on women's embarrassment during cervical cancer screening. METHOD: This study was carried out in a nonequivalent control group non-synchronized post-test only design. 62 women who had cervical cancer screening were conveniently recruited from a university hospital health promotion center. Embarrassment was measured under four distinctive sub-dimensions by the method of self-reported questionnaire and blood pressure and pulse rates monitoring. The data of control group had a conventional pap smear were collected in advance and then those of experimental group were gathered after completing data collection in the control group. Women in experimental group were provided with a newly developed cervical cancer screening programme in which interdisciplinary team conducted dramaturgical interaction. RESULT: There was no significant difference in the scores of VAS between the two groups. The score of physiological response of Embarrassment Measurement Scale was significantly lower in experimental group than in the control group (p<.05), while no significant difference was found in cognitive-emotional, non-verbal and verbal behavioral responses between the two groups. There was also no significant difference in blood pressure and pulse rates between the two groups during cervical screening. CONCLUSION: Desexualization Care guided by dramaturgical interaction during cervical screening was found to have positive effect on physiological response of women's embarrassment. Further research for identifying other main variables which might have influenced on women's embarrassment is needed.

Detection of Ureaplasma urealyticum and Mycoplasma hominis in Pregnant Women Using MYCOFAST(R) Evolution 2 and PCR / 대한임상미생물학회지

BACKGROUND: The associations between preterm labor or premature rupture of membrane (PROM) and urogenital infections of pregnant women are reported. Ureaplasma urealyticum and Mycoplasma hominis are well known as important pathogens of urogenital infections in pregnant women. In routine clinical laboratory, conventional culture for these microorganisms has not been made generally because of the requirements for strict growth condition. MYCOFAST(R) Evolution 2 is an easy and rapid liquid microculture method using metabolism of these microorganisms. Author investigated the relationship between U. urealyticum or M. hominis infections and preterm labor or PROM by MYCOFAST Evolution 2 and PCR. Also it was reviewed that the possibility of substitution of MYCOFAST Evolution 2 for conventional culture method by comparing with PCR methods. METHODS: This study was done on 91 pregnant women. They were composed of two groups; group I(n=48) had full-term delivery and group II(n=43) had preterm labor or PROM before the 37th week.Two cervical swabs were made each time. One was used for MYCOFAST(R) Evolution 2 and the other for PCR. RESULTS: The positivity of U. urealyticum was 39.6% in group Iand 58.1% in group IIby MYCOFAST Evolution 2 and 39.6% and 58.1% by PCR method, respectively. The positivity of M. hominis was 4.2% in group Iand 11.6% in group IIby MYCOFAST Evolution 2 and 4.2% and 7.0% by PCR method, respectively. The positivity of U. urealyticum and M. hominis in group IIwas higher than that in group Ibut was not significant statistically. The concordance rates between two methods were 86.8% for U. urealyticum and 97.8% for M. hominis. It showed good correlation between two methods (U. urealyticum, r=0.736; M. hominis, r=0.835). CONCLUSIONS: The infections of U. urealyticum and M. hominis were related to preterm labor or PROM. Considering vertical transmission to fetus or neonates resulting in perinatal morbidity or mortality, the detection of these microorganisms is important. MYCOFAST(R) Evolution 2 was an easy, rapid and reliable method substituting conventional culture method.

A Clinical Study on Adnexal Tumors in Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To evaluate the clinicopathologic features and clinical outcomes of adnexal tumors in pregnancy. METHODS: After review of charts of 51 patients managed at Kyungpook National University Hospital from January 1996 to June 2002, data including clinical findings, treatments and outcomes were analyzed. RESULTS: The mean age of pregnant women with adnexal tumors was 28.5 years old and the adnexal tumors were more common in nulliparous pregnant women (74.5%) than parous those. There were asymptomatic or no signs in 40 cases (78.4%), lower abdominal pain in 9 cases (17.6%), vaginal bleeding in 1 case (2.0%) and palpable mass by patient herself in 1 case (2.0%). The surgical treatments were performed at first trimester in 9 cases (19.1%), second trimester in 31 cases (66.0%) and third trimester in 7 cases (14.9%). Postoperative histopathologic diagnoses of adnexal tumors were 22 cases (43.1%) of benign cystic teratoma, 7 cases (13.8%) of functional cyst, 6 cases (11.8%) of serous cystadenoma, 4 cases (7.8%) of mucinous cystadenoma, 4 cases (7.8%) of endometrioma, 3 cases (5.9%) of parovarian cyst and 4 cases (7.8%) of malignancy including 2 cases of mucinous cystadenocarcinoma and 2 cases of mucinous tumor, borderline. The complication resulting from adnexal tumors was torsion of 6 cases (11.8%). The outcome of pregnancy was available in 30 cases, term delivery in 25 cases (83.3%), preterm delivery in 3 cases (10%) and spontaneous abortion in 2 cases (6.7%). CONCLUSION: Although the incidence of adnexal tumors with pregnancy is variable according to the reports, the detection rate is more and more increasing due to a widespread application of ultrasound. Thus, obstetricians must always consider adnexal tumors combined with pregnancy and try to minimize the complications of surgery during pregnancy to prevent adverse fetal outcome and maternal morbidity.

A Clinical Study on Adnexal Tumors in Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To evaluate the clinicopathologic features and clinical outcomes of adnexal tumors in pregnancy. METHODS: After review of charts of 51 patients managed at Kyungpook National University Hospital from January 1996 to June 2002, data including clinical findings, treatments and outcomes were analyzed. RESULTS: The mean age of pregnant women with adnexal tumors was 28.5 years old and the adnexal tumors were more common in nulliparous pregnant women (74.5%) than parous those. There were asymptomatic or no signs in 40 cases (78.4%), lower abdominal pain in 9 cases (17.6%), vaginal bleeding in 1 case (2.0%) and palpable mass by patient herself in 1 case (2.0%). The surgical treatments were performed at first trimester in 9 cases (19.1%), second trimester in 31 cases (66.0%) and third trimester in 7 cases (14.9%). Postoperative histopathologic diagnoses of adnexal tumors were 22 cases (43.1%) of benign cystic teratoma, 7 cases (13.8%) of functional cyst, 6 cases (11.8%) of serous cystadenoma, 4 cases (7.8%) of mucinous cystadenoma, 4 cases (7.8%) of endometrioma, 3 cases (5.9%) of parovarian cyst and 4 cases (7.8%) of malignancy including 2 cases of mucinous cystadenocarcinoma and 2 cases of mucinous tumor, borderline. The complication resulting from adnexal tumors was torsion of 6 cases (11.8%). The outcome of pregnancy was available in 30 cases, term delivery in 25 cases (83.3%), preterm delivery in 3 cases (10%) and spontaneous abortion in 2 cases (6.7%). CONCLUSION: Although the incidence of adnexal tumors with pregnancy is variable according to the reports, the detection rate is more and more increasing due to a widespread application of ultrasound. Thus, obstetricians must always consider adnexal tumors combined with pregnancy and try to minimize the complications of surgery during pregnancy to prevent adverse fetal outcome and maternal morbidity.

Induction of Labor with Oral Prostaglandin E2 or E1 Plus Oxytocin / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to complete delivery during daytime through rapid and safe management with oral prostaglandin plus oxytocin, and to reduce the duration of induced labor, hospital stay and dispersion of human power. METHODS: Ninety pregnancies requiring induction of labor between December 1998 and July 1999 were analyzed prospectively. Patients were assigned to receive either oral PGE2 or oral PGE1. In one group, labor induction was performed with 0.5 mg of oral PGE2 (group 1, n=46), was orally taken every one hour since 06:00 AM to 09:00 AM and intravenous oxytocin infusion (The beginning dose was 2 mU/min, the dose increased by 2 mU/30 min) beginning at 09:00 AM, and in the other group (group 2, n=44), 100 microgram of PGE1 was orally taken at 11:00 PM the day before oxytocin infusion was commenced at 07:00 AM. If there was uterine contraction of more than 200 Montevideo units, intravenous oxytocin would not be given. RESULTS: The mean time (+/-standard deviation) to active phase labor (cervical dilatation more than 3 cm and uterine contraction more than 200 Montevideo units) with PGE2 group was 335.16+/-157.89 minutes versus 534.16+/-211.79 minutes with PGE1 group (Por= 4, 0%) and the cesarean section rate was also (if or= 4, 19.4%) in the two groups (P<0.05). There were no clinical or statistical differences in demographic data, clinical characteristics, maternal outcomes and complications, and neonatal outcomes. CONCLUSION: Both may be proper methods of inducing delivery during daytime and begun at outpatient office base.

Diagnostic Efficiency of Peritoneal Fluid and Serum Lactate Dehydrogenase(LDH) in Ovarian Cancer Patients / 대한부인종양콜포스코피학회잡지

OBJECTIVES: We studied peritoneal fluid and serum LDH levels to identify patients with ovarian carcinoma and differentiate them from patients with benign ovarian tumor or other gynecological tumors. METHODS: From July 1998 to May 1999, peritoneal fluid and serum LDH, serum CA-125 levels were measured in 95 patients: 11 with ovarian carcinoma, 2 with borderline ovarian tumor, 45 with benign ovarian tumor, 2 with endometrial carcinoma, 21 with CIS, 7 with cervical cancer and 7 with uterine myoma. RESULTS: Peritoneal fluid LDH and serum LDH and CA-125 levels in ovarian cancer patients were significantly higher than those in patients with benign ovarian tumor and other gynecological tumors(p<0.05). Peritoneal fluid LDH demonstrated higher sensitivity(100%) and greater diagnostic efficiency(86%) than serum LDH(73% and 84%, respectively) or serum CA-125.(82% and 83%, respectively) CONCLUSION: Peritoneal fluid LDH, compared to serum LDH and serum CA-125, presented the greatest diagnostic efficiency in discriminating ovarian cancer from benign ovarian tumor and, therefore, it may be efficient as a biochemical marker in diagnosis of ovarian cancer, even in early stages of the disease.

Peritoneal Fluid levels of various Cytokines in Patients with Ovarian Lesions / 대한산부인과학회잡지

OBJECTIVE: Recent studies have shown that multifunctional cytokines have been implicated in the pathogenesis and pathophysiology of various ovarian lesions including ovarian cancer and endometriosis. This study was performed to determine the possibility of the clinical usefulness of peritoneal cytokines in patients with various ovarian lesions. METHODS: Peritoneal fluid was obtained from patients with benign cystic adenoma(n=11), benign cystic teratoma(n=10), endometriosis(n=23), malignant ovarian tumor(n=11), and women without evidence of any pathology(n=7) at the time of laparotomy or operative laparoscopic surgery and were examined for the levels of IFN-gamma, IL-1beta, IL-5, IL-6, IL-10 and TNF-alpha using enzyme-linked immunosorbent assay(ELISA). Statistical analysis was performed with the one way ANOVA, Scheffe test or Mann-Whitney test. RESULTS: The mean concentration of IL-6 and IL-10 was significantly higher in peritoneal fluid specimens with ovarian cancer than other benign pathology(p<0.05). Both IL-6 and IL-10 levels in peritoneal fluid specimens with endometriosis tended to be higher than normal, and the levels of IL-6 and IL-10 were significantly higher in peritoneal fluid of women with severe endometriosis compaired to women with mild endometriosis (p<0.05). CONCLUSION: This study supports the concept that regional immunologic dysfunction might be involved in the disease process of various ovarian pathology such as ovarian cancer and endometriosis. A larger study would help in evaluating the potential use of local peritoneal cytokines in differentiating ovarian cancer from other benign pathology, and demonstrating any association between concentrations of cytokines and severity of endometriosis.

Clinical Study of Cesarean Section / 대한주산의학회잡지

No abstract available.

Expression of VEGF and PD-ECGF, and Proliferative Activity of Ki-67 according to Clinicopathologic Feature in Cervical Tumor / 대한부인종양콜포스코피학회잡지

OBJECTIVE: The objective of this study is to evaluate the expressions, microvessel counts and angiogenic pathway of VEGF and PD-ECGF and proliferative activity of Ki-67 according to clinicopathologic feature of cervical tumor. METHODS: Two hundred three cervical specimens were evaluated; among these 20 were designated normal epithelium, 36 mild dysplasia, 28 moderate dysplasia, 36 severe dysplasia, 28 carcinoma in situ, 17 microinvasive carcinoma and 38 invasive cervical carcinoma (21 squamous cell carcinoma and 17 adenocarcinoma). Microvessel count was determined by immunohistochemical staining using anti-factor VIII-related monoclonal antibody. The expression of VEGF (vascular endothelial growth factor) and PD-ECGF (platelet-derived endothelial cell growth factor) were evaluated by immunohistochemical staining with anti-human VEGF monoclonal antibody and anti-dThdPase monoclonal antibody. The proliferative activity was examined using a Ki-67 equivalent monoclonal antibody (MIBl). RESULT: There was no statistical significance on microvessel count except invasive cancer comparing with mild dysplasia including normal tissue, but there was a little increase in microvessel counts according to severity of tumor. The intensity of VEGF and PD-ECGF expression was significantly correlated with severity of cervical tumor. And the microvessel density was significantly higher in the positive expression of VEGF and PD-ECGF than in the negative expression. The intensity of PD-ECGF expression in invasive adenocarcinoma was significantly lower in comparison with VEGF expression. The intensity of Ki-67 expression had no correlation with severity of cervical tumor and was significantly higher in moderate and severe dysplasia than in microinvasive and invasive carcinoma. Ki-67 expression had no statistical correlation with VEGF and PD-ECGF. CONCLUSION: The VEGF and PD-ECGF are important angiogenic factors and associated with progression of cervical tumor. The VEGF may be involved in the progressions of squamous cell carcinoma and adenocarcinoma, but the PD-ECGF may not be involved or be minimally involved in the progression of adenocareinoma. There seems to be a different angiogenic pathway pertaining to the histologic difference of cervical cancer. There was no difference of Ki-67 expression according to severity of cervical tumor.