Variables of Fetal Heart Rate and Neonatal Outcome according to Fetal Sex / 대한산부인과학회잡지

OBJECTIVE: The differences between two fetal sexes have been a matter of great concern from ancient times to present day. This study was initiated to research the varying fetal behaviors which would differ according to the fetal sex. METHODS: With every 1,500 cases of each fetal sex selected, the patterns which the varying factors related to FHR and prognosis of neonates in normal pregnancy were compared by means of Factor Analysis (a linear method). Canonical Ensemble was performed to compare the relationship of intrauterine fetal behavioral developments, and neonatal prognosis of each fetal sex. And whether the different types of the fetal sex would have influence also on the chaotic behavior was analyzed by the methods of linear Power Spectrum of FHR and Approximate Enthropy. RESULTS: The consequences of Factor Analysis showed that it is Apgar score on the factor 1 axis, and signal loss on the factor 2 axis in the case of male babies. In the case of female babies it is Apgar score on the factor 1 axis, and fetal movement on the factor 2 axis. Speaking of the specific value regarding FHR, male babies displayed higher frequency only in terms of fetal movement sign than female babies (p=0.0394). No other differences between two fetal sexes in abnormal findings were indicated (p>0.05). Among the babies at 30~33 weeks' gestation female babies were more likely to reveal higher Canonical Ensemble (male=0.41+/-0.05, female=0.05+/-0.04; p=0.00411), whereas male babies have a higher Approximate Entropy (male=0.926+/-0.01, female=0.871+/-0.01; p=0.0037). However Power Spectrum Analysis indicated that there were no significant differences as I compared LF/HF (p>0.05), the ratio of LF and HF of two fetal sexes, and same result was also drawn by Power Low beta-slope (p>0.05). CONCLUSION: The linear patterns of the FHR signal from the fetus suggest that there is no variables resulting from the type of fetal sex, except for the fetal movement frequency and the height and weight of neonates. The sympathetic and parasympathetic balance of both fetal sexes also showed a similar development pattern. In the mean time the differences which could be visible were made among the male and female babies specifically at 30~33 weeks' gestation. This may correspond to the fact that the lung maturation of the female fetus is completed before the third trimester of pregnancy, and the male fetus after the period, and finally the differences between the fetal sexes generally become insignificant toward term.

Expression of Transforming Growth Factor-1, 2 in the Decidua of the Early Pregnancy: Comparison of Decidua Basalis and Decidua Parietalis / 대한산부인과학회잡지

OBJECTIVES: Implantation is a complex process between developing embryo and maternal endometrium, especially decidua. Decidua is a specialized endometrium during pregnancy and decidua basalis is the real implantation site infiltrated directly by trophoblast cells. The decidua parietalis lines the uterine cavity away from the implantation site, not real implantation site. TGF-beta1 and TGF-beta2 have known as multipotential cytokines and expression of TGF-beta1 and TGF-beta2 increased in decidua during pregnancy than secretory phase of endometrium. However, there is little known about their expression in decidua parietalis, compared with decidua basalis. The purpose of this study was to compare the expression of TGF-beta1 and TGF-beta2 in the decidua basalis and decidua parietalis during early pregnancy. METHODS: The early pregnant 26 samples were obtained at hysterectomy, which underwent surgery for cervical carcinoma, ovarian cancer, etc. Immunohistochemical staining of TGF-beta1 and TGF-beta2 was performed and staining intensity was semiquantified by using HSCORE. RESULTS: TGF-beta1 was slightly expressed in the decidua basalis and decidua parietalis and there were no differences among them. But the expressions of TGF-beta2 of stroma and glandular cells were higher in the decidua basalis than parietalis (p < 0.005). And the expressions of TGF-beta2 were stronger than that of TGF-beta1 in the both decidua of early pregnancy (p < 0.005). CONCLUSION: In decidua basalis, especially stromal cells, the expression of TGF-beta2 was increased than in the decidua parietalis. This suggests that TGF-beta2 may play an important role in decidua basalis that is directly invasion site by embryo and can be regulated by embryonic derived local factor. TGF-beta2, compared with TGF-beta1, was increased in both implantation site and suggest it may regulate implantation process during early pregnancy.

Clinico-Pathologic Study on Borderline Epithelial Tumors of the Ovary / 대한부인종양콜포스코피학회잡지

Twenty six cases of borderline ovarian tumor(BOT) were treated between Jan. 1985 and Dec. 1997 at the Department of Obstetrics and Gynecology, Hanyang University. The clinical records were reviewed for all patients including histopathology, clinical features, and follow-up. The frequency of BOT was 12%(26/214) of epithelial ovarian malignancies, and patients with these tumors tend to present at a younger age(36 yrs) than those with invasive carcinomas. In terms of histologic type, mucinous type(21/26: 81%) were more prevalent than serous tumor(5/21: 19%) in this study. The positive rate of CA 125 was 20% in serous, and the positive rate of CA 19-9 was 24% in mucinous tumor. The size of mucinous was larger than that of serous tumors(17.1 cm vs 9,3 cm). Almost all of these tumor categorized as early stage(stage I: 96%), however, only one patient with serous tumor had advanced stage of disease(stage III: 4%), Therefore BOT tend to be diagnosed as earlier than invasive carcinoma. About 2/3 of patients were treated as conservative surgery(unilateral salpingooophorectomy or enuclation). Postoperative adjuvant chemotherapy was not given about half of cases(13/26). Median follow-up was 43 months and recurrent case was found only one in serous tumor, All patients in this study are still alive and free of disease except one, 5-year survival rate was 100%. But large number of study and long-term follow-up are needed to make a decision to treat and manage of BOT.

Two Cases of Spontaneous Extradural Hematoma on the Lumbar Spine: Comparison of the Operative Results by the Delay Before Surgery

Two surgically treated cases of spontaneous spinal epidural hematoma are reported. We compared the operative results between these cases, and could conclude without difficulty the early diagnosis and operation were important in prognosis. A patient who had endured shorter interval, around 24 hours, between the beginning of paraplegia and surgical decompression recovered earlier, not longer than one month, than the other patient who had been operated on with five days of interval. This patient did not recover well even two months after the operation.

Multiple Meningiomas: Case Report

Multiple meningiomas are a seldom encountered neoplasm. Most authors report an incidence ranging from 1 to 3% of all meningioma prior to the introduction of computerized tomography(CT). The routine use of CT has resolved diagnostic problems involved with multiple meningiomas and the incidence was 8% since the introduction of CT scan. In fact, it may be difficult to differentiate "true multiple meningioma" from simple recurrences or the special variant(forme fruste) of Von Recklinghausen's disease, and the pathogenetic factors related to true multiple meningioma is unknown, but various theroies of the etiology are explored by literature reports. We report the rare case of multiple meningiomas which diagnosed by CT scan and confirmed by operation.