Subtotal vaginal hysterectomy / 대한산부인과학회지

The importance of minimal invasive surgery has increased. Interest in vaginal hysterectomy is rising. Controversy remains regarding the value of conservation of the cervix at hysterectomy. These factors stimulate interest in subtotal vaginal hysterectomy (SVH). SVH is a simple procedure that carries a low risk of morbidity. It can be an option in the treatment of patient with benign conditions of the uterine corpus who desire the retention of the cervix. This desire may arise from concern about possible subsequent bowel, urinary, sexual dysfunction, as well as from other non-clinical issues. We performed SVH in two patients of uterine leiomyoma. Our report includes a brief review of literature.

Clinical Analysis of 739 Cases of Midtrimester Amniocentesis / 대한주산의학회잡지

OBJECTIVE: To analyze the change of indications and chromosomal abnormalities according to patient's age and indications in midtrimester genetic amniocentesis. METHODS: This study was reviewed 739 genetic amniocentesis results which were performed at Kwangju Christian Hospital from 1995 to 2004, as prenatal genetic diagnosis for the possibility of chromosomal abnormality of fetus. Age distribution, gestational weeks, indications of amniocentesis and cytogenetic results were the key factors for the analysis. RESULTS: Maternal ages were ranged from 25 to 45, mostly 25~39, Of indications of prenatal genetic amniocentesis, abnormal maternal serum marker was the most common (49.8%), and followed by advanced maternal age (31.1%). The frequency of abnormal karyotypes was 4.6% (34/739). The incidence of abnormal karyotype according to indication had statistical significance in abnormal ultrasonographic finding. CONCLUSION: Among the several indications for prenatal cytogenetic diagnosis, ultrasonographic abnormalities and abnormal maternal serum markers might be important indications. Especially, ultrasonographic abnormalities could be the predictive markers for abnormal fetal karyotypes.

A Case of Primary Carcinoma of the Fallopian Tube / 대한산부인과학회잡지

Primary carcinoma of the fallopian tube is an extremely rare and accounts for approximately 0.34-1.8% of all gynecologic malignancies. Preoperative diagnosis was difficult due to nonspecific symptoms and signs. This case of primary fallopian tube adenocarcinoma was confirmed postoperatively on the basis of the pathologic examination. The histology and behavior of fallopian tube cancer are simillar to ovarian cancer, so evaluation and treatment are similar to that of the ovarian cancer. We have experienced a case of primary carcinoma of the fallopian tube and so report with brief review of the literature.

A Case of Squamous Cell Carcinoma of Right Ovary Developed in a Patient with Bilateral Mature Cystic Teratomas / 대한산부인과학회잡지

Squamous cell carcinoma of the ovary is a very rare malignant tumor originating from malignant transformation of mature cystic teratoma, usually being reported in about 1-3%. It is hard to know the presence of malignant transformation of mature cystic teratoma before operation. So, in case of old age, huge ovarian mass, elevated tumor marker, and operative findings including adhesion, hemorrhage, necrosis and irregular cystic wall, we should suspect malignant transformation. And then we had better do frozen biopsy. Several authors reported the poor prognosis of this malignancy but there is no consensus on optimal therapy because of its rarity. In early stage, curative treatment is possible through only surgical intervention. We experienced a case of squamous cell carcinoma of right ovary developed in a patient with bilateral mature cystic teratomas. We present it with a brief review of literatures.

Cloning and Expression Pattern of FSTL1 mRNA in Normal Myometrium and Uterine Leiomyoma / 대한산부인과학회잡지

OBJECTIVE: To study the influence and cloning of differentially expressed genes in human female normal myometrium and uterine leiomyoma tissue. METHODS: In this experiment, human uterus tissues (n=25) were taken for total RNA isolation by using Trizol reagent. Differential display was performed by using GeneFishingTM DEG Kit and processed to cDNA sequencing and gene cloning for Follistatin-like 1 (FSTL1). Data were analyzed with the image Master VDS software and statistical significance was defined as p<0.05 by paired t test results. RESULTS: FSTL1 mRNA expression level was significantly higher (p<0.05) in normal and adjacent normal myometrium tissues than uterine leiomyoma tissue of women in the reproductive age. Whereas in the menopausal age, FSTL1 mRNA expression level was significantly higher (p<0.05) in uterine leiomyoma than normal myometrium. There was no significant differences between uterine leiomyoma and adjacent normal myometrium. CONCLUSION: Although the mechanisms of FSTL1 gene were uncertain, FSTL1 seemed to play an important role in the growth of uterine leiomyoma, it also might be related to the regulation of uterine leiomyoma growth inhibiting factors by modulating Follistatin related protein gene (FLRG) system.

Clinical Study of Vaginal Total Hysterectomy: A Review of 110 Cases / 대한산부인과학회잡지

OBJECTIVE: To evaluate the effectiveness and the safety of vaginal total hysterectomy. METHODS: We reviewed the medical records of the 110 patients who underwent vaginal total hysterectomy for the indications other than uterine prolapse from August 2001 to September 2002 at our hospital. RESULTS: The average operating time was 48.7 minutes (range from 20 min to 180 min) and the mean uterine weight was 331 gram (range from 60 g to 890 g). The most common indication for hysterectomy was uterine myoma (59%). No serious complications were occurred but conversion to laparotomy was occurred in 1 case. CONCLUSION: Vaginal total hysterectomy would be recommended method for removing uterus even in the absence of prolapse and previous operation history.

The Comparative Analysis of Cytology, Colposcopically Directed Biopsy and Final Histopathology in Diagnosis of Cervical Neoplasia / 대한산부인과학회잡지

OBJECTIVE: To investigate the necessity of colposcopically directed biopsy for more accurate detection of cervical neoplasm. METHODS: Cytology and colposcopically directed biopsy were performed in 114 patients and the patients were subsequently underwent conization or hysterectomy from January, 1998 to December, 2001. RESULTS: The complete diagnostic agreement of cytology with permanent biopsy was 57.9% (66 of 114) and the diagnostic agreement within one degree was 80.6% (92 of 114). The complete diagnostic agreement of colposcopically directed biopsy with permanent biopsy was 62.3% (71 of 114) and the diagnostic agreement within one degree was 85.1% (97 of 114). The difference between two tests was statistically significant (p<0.001). CONCLUSION: We concluded that colposcopically directed biopsy can reduce the false negative rate of cytology for screening test of cervical neoplasm. The difference between colposcopically directed biopsy and permanent biopsy was caused by inappropriate resection of the lesion and unskilled physician.

A case of prune-belly syndrome in antenatal ultrasonography / 대한산부인과학회잡지

Prune-belly syndrome is a rare compound fetal anomaly, characterized by absence or hypoplasia of abdominal wall musculature associated with urinary tract abnormalities and cryptorchidism. The prenatal ultrasound diagnosis was based on the findings of a lower abdominal cystic echo caused by abnormal dilatation of the bladder, upward compression of small intestines and decreased amniotic fluid volume. We experienced a case of Prune-belly syndrome diagnosed by ultrasound in a 12 weeks fetus following to IVF-ET pregnancy. Termination was performed at 12 weeks and autopsy confirmed the distended bladder, absence of abdominal muscles and urethra. So, we reported this case with a brief review of literature.