The efficacy and safety of the combined preparation of Black Cohosh and St. John's wort in menopausal women / 대한산부인과학회지

OBJECTIVE: The aim of this study was to assess the efficacy and safety of the combined preparation of black cohosh and St. John's wort (GYNO-Plus(R)) in post menopausal women with symptoms. METHODS: A total number of 60 postmenopausal women with climacteric symptoms was allocated to take GYNO-Plus(R) for 3 months. And the change of the Kupperman menopausal index (KI), serum FSH and E2 level, bone densitometry (BMD), mammographic density, liver function test (LFT) and adverse effects were assessed. RESULTS: There was statistical difference in the decline of KI after 3 months treatment. But, there were no statistical differences in the change of serum FSH and E2 level, BMD, mammographic density, and LFT. There were nine adverse events in study, but two cases were directly related to the drug and they were resolved without any sequela. CONCLUSION: This study suggests that the combined preparation of black cohosh and St. John's wort is a safe, effective alternative treatment option for patients in whom hormone replacement therapy is either refused or contraindicated.

Umbilical artery blood gas analysis and its relationship with the placenta to birth weight ratios at birth in preeclampsia and small for gestational age / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to compare the umbilical artery blood gas analysis and assess the relationship between fetal oxygenation and placenta to birth weight ratios in preeclampsia and small for gestational age. METHODS: We compared the results of umbilical artery blood gas analysis and placenta to birth weight ratio in group of preeclampsia (N=28), group of small for gestational age (N=15), group of large for gestational age (N=15), and controls (N=24). And we also divided all of them into 3 groups by placenta to birth weight ratio at birth, 0.25 (N=18). We compared umbilical artery gas analysis in each groups. RESULTS: The placenta to birth weight ratio in PE was significantly lower than control group (p<0.05). Umbilical artery pO2 and O2 saturations in each group of preeclampsia and small for gestational age were significantly lower than group of large for gestational age and controls (p<0.05). But we could not find any differences in other umbilical artery blood gas analysis (pH, pCO2, HCO3-). Umbilical artery pO2 and O2 saturations of higher placenta to birth weight ratio were stepwise lower than those of lower placenta to birth weight ratio but, pCO2 of higher placenta to birth weight ratio was stepwise lower than those of lower placenta to birth weight ratio. But there was no significant difference. CONCLUSION: Our data suggested that fetal oxygenation is significant determinant of fetal growth from small for gestational age and preeclampsia. And it may be related to placental implantaton and growth.

Clinical Efficacy of Cervicography in Patients with Atypical Squamous Cells of Undetermined Significance (ASCUS) on Cervical Cytology / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to investigate the correlation between the cervicographic diagnoses and histologic diagnoses in patients with ASCUS cytologic diagnosis according to The Bethesda System. METHODS: This study was performed in outpatient clinic of Department of Obstetrics and Gynecology at Dankook University Medical Center from January 1, 2000 to July 31, 2000. Of the 120 patients who underwent both conventional Papanicolaou cervical cytologic test and cervicographic examination, 30 cases with ASCUS cytologic diagnosis were analyzed. Cervicographic diagnoses were compared with histologic diagnoses as a reference standard. RESULTS: Followings are the results summarized. 1. Age distribution was between 26 and 62. The mean age was 43.1 years. 2. The mean gravidity was 4.5 and the mean parity was 2.5. 3. There were 19 (63.3%) cervicographic diagnoses of Negative, 6 (20.0%) of Atypical, and 5 (16.7%) of Positive. Of the 5 Positive diagnoses, there were 3 cases of P0 and 2 cases of P1. 4. There were 1 (3.3%) histologic diagnosis of WNL, 23 (76.7%) diagnoses of cervicitis, 3 (10.0%) of LSIL, and 3 (10.0%) of HSIL. 5. Of the 19 cervicographic diagnoses of Negative, there were 17 histologic diagnoses of cervicitis, and 2 of LSIL. Of 6 cases of Atypical, there were 4 histologic diagnoses of cervicitis and 2 of HSIL. Of 5 cases of Positive, there were 3 histologic diagnoses of cervicitis, 1 of LSIL, and 1 of HSIL. 6. Cervicography for detecting LSIL or worse yielded sensitivity of 33.3%, specificity of 87.5%, positive predictive value of 40.0%, and negative predictive value of 84.0%. CONCLUSION: There was no statistical significance because of small data. Cervicography does not seem to replace conventional Papanicolaou cervical cytologic screening test or play an adjunctive role for detection of LSIL or worse in patients with ASCUS on cervical cytology. But a multicenter study with large data will be required to get the proper conclusion.

A Case of Low-Grade Endometrial Stromal Sarcoma of the Uterus (So-Called "Endolymphatic Stromal Myosis") / 대한산부인과학회잡지

Uterine sarcomas are relatively rare tumors of mesodermal origin that constitute 2-6% of uterine malignancies. Uterine sarcomas include endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), malignant mixed m llerian tumor (MMMT) of both homologous and heterologous type, pure heterologous sarcomas, blood vessel sarcomas, and lymphoma. Endometrial stromal tumors are divided into three types: 1) endometrial stromal nodule, 2) low-grade stromal sarcoma or endolymphatic stromal myosis, and 3) endometrial stromal sarcoma. The low grade endometrial stromal sarcoma is very rare. It shows occasional local recurrence, which might arise from endometrial stroma, from adenomyosis, and rarely from endometriosis. We have experienced a case of low grade endometrial stromal sarcoma of the uterus in a 54-year-old woman, which is presented with a review of literatures.