Clinical analysis of Pelviscopic surgery / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to evaluate the safety and efficacy of pelviscopic surgery. METHODS: Between May 1996 and April 2000, we evaluated indication of operation, mean age, parity, previous operation history, type of operation, duration of hospitalization and complications. RESULTS: The results are summarized as follows ; 1) The mean age of patients was 34.8 years with ranges between 20 and 55 years old. 2) The majority of patients were between 36 years and 40 years old(23.6%). 3) The major clinical indications included 174 cases of adnexal mass(33.4%), 125 cases of ectopic pregnancy(24.0%), 59 cases of endometriosis(11.3%). 4) The types of operation composed of 168 cases diagnostic laparoscopy(30.7%), salpingectomy(17.2%), cystectomy(11.4%), LAVH(11.2%). 5) Previous laparotomy history was found in 146 cases(28.0%). 6) The mean duration of hospitalization was 4.4 days. CONCLUSIONS: The pelviscopy can be safely performed, resulting in reduced surgical morbidity, less blood loss, less postoperative discomfort and pain, shortened hospital stays and shorter recovery days. With the increased use of markers and ultrasonography to decrease the possibility of inappropriate surgery, combined with more defined exterpation techniques, the interest in laparoscopic ovarian surgery is burgeoning. And technologic advances afford us the opportunity to offer patients a number of alternatives to open surgery. The choice of anesthetic technique varies with requirements of the surgeon, the health status and preference of the patient, the type of facility and the availability of well trained professionals, support personnel and equipment. In conclusion, the pelviscopic surgery is alternative to laparotomy.

The significance of the TDx-FLM assay in the fetal lung maturity / 대한산부인과학회잡지

OBJECTIVE: The TDX analyzer, an automated fluorescence polarimeter, has been utilized to assess surfactant content in amniotic fluid. Amniostat-FLM is an immunologic semiquantitative agglutination test for determining the presence of phosphatidylglycerol in human amniotic fluid at concentration indicative of fetal lung maturity. We evaluated the usefulness of the recently introduced TDx-FLM assay in determining fetal lung maturity. METHODS: Seventy-three samples of amniotic fluid were analyzed. Among them, 18 samples were compared with Amniostat-FLM assay. RESULTS: Surfactant/albumin ratio using TDx-FLM assay increased with longer gestational age. And the concordance rate between Amniostat-FLM assay and TDx-FLM assay was 66.9%. CONCLUSION: The TDx-FLM assay appears to be a useful test in the field of fetal lung maturity testing.

The significance of the TDx-FLM assay in the fetal lung maturity / 대한산부인과학회잡지

OBJECTIVE: The TDX analyzer, an automated fluorescence polarimeter, has been utilized to assess surfactant content in amniotic fluid. Amniostat-FLM is an immunologic semiquantitative agglutination test for determining the presence of phosphatidylglycerol in human amniotic fluid at concentration indicative of fetal lung maturity. We evaluated the usefulness of the recently introduced TDx-FLM assay in determining fetal lung maturity. METHODS: Seventy-three samples of amniotic fluid were analyzed. Among them, 18 samples were compared with Amniostat-FLM assay. RESULTS: Surfactant/albumin ratio using TDx-FLM assay increased with longer gestational age. And the concordance rate between Amniostat-FLM assay and TDx-FLM assay was 66.9%. CONCLUSION: The TDx-FLM assay appears to be a useful test in the field of fetal lung maturity testing.

Three dimensional ultrasound volumetry of amniotic fluid in pregnant women / 대한산부인과학회잡지

OBJECTIVES: Our study was to measure how well semiquantitative three-dimensional ultrasonographic measures of amniotic fluid in the third trimester, to investigate the relationship between three-dimensional amniotic fluid volume and amniotic fluid index, two dimensional amniotic fluid volumes. METHODS: We compared amniotic fluid volume as measured by three-dimensional ultrasonographic techniques with amniotic fluid index including two dimensional amniotic fluid volume in 33 women during in the third trimester. RESULTS: There was highly significant linear correlations of three-dimensional amniotic fluid volumes with AFI (r=0.6898) and two dimensional amniotic fluid volume (r=0.7926). CONCLUSION: Three-dimensional ultrasonographic technology has clinical significance as a tool to measure amniotic fluid volume. There are highly significant correlations of three dimensional amniotic volumes with AFI and two dimensional volume.

Three dimensional ultrasound volumetry of amniotic fluid in pregnant women / 대한산부인과학회잡지

OBJECTIVES: Our study was to measure how well semiquantitative three-dimensional ultrasonographic measures of amniotic fluid in the third trimester, to investigate the relationship between three-dimensional amniotic fluid volume and amniotic fluid index, two dimensional amniotic fluid volumes. METHODS: We compared amniotic fluid volume as measured by three-dimensional ultrasonographic techniques with amniotic fluid index including two dimensional amniotic fluid volume in 33 women during in the third trimester. RESULTS: There was highly significant linear correlations of three-dimensional amniotic fluid volumes with AFI (r=0.6898) and two dimensional amniotic fluid volume (r=0.7926). CONCLUSION: Three-dimensional ultrasonographic technology has clinical significance as a tool to measure amniotic fluid volume. There are highly significant correlations of three dimensional amniotic volumes with AFI and two dimensional volume.

Early prediction of birth weight percentile and large for gestational age fetuses using gestation-adjusted projection of estimated fetal weight / 대한산부인과학회잡지

OBJECTIVE: To evaluate the accuracy of predicted birth weight percentile and large for gestational age(LGA) fetuses by the gestation-adjusted projection method using estimated fetal weight. METHODS: From 462 low-risk pregnancies with singleton fetus, fetal biometry including fetal biparietal diameter(BPD), head circumference(HC), abdominal circumference(AC), and femur length(FL) was made from 30 weeks of gestation until term. Estimated fetal weight(EFW) by combinations of fetal biometry were made by Campbell, Hadlock1, Hadlock2, and Shepard formulas respectively. The diagnostic accuracy according to 4 formulas was assessed by correlation between EFW percentile and birth weight percentile, prediction of LGA fetuses, and prediction error(percentile difference between birth weight and EFW). RESULTS: The mean gestational age on ultrasound and on birth, and birth weight were 33.21 +/- 2.08(30-40) weeks, 38.43 +/- 1.72(30-42) weeks, and 3.14 +/- 0.47(0.99-4.38) Kg, respectively. The diagnostic accuracies of gestation-projection method using EFW were similar result to predict birth weight percentile and LGA fetuses according to 4 formulas. Correlation between EFW percentile and birth weight percentile(correlation coefficient, r) were Campbell: 0.644(p <0.001), Hadlock 1: 0.682(p <0.001), Hadlock 2: 0.681(p <0.001), Shepard: 0.638(p <0.001), respectively. Youden's index(sensitivity + specificity - 1) in prediction of LGA fetuses were Campbell: 0.532, Hadlock1: 0.525, Hadlock2: 0.520, Shepard: 0.549, respectively. Prediction error were Campbell: 18.14+/-16.56, Hadlock1: 16.19+/-14.35, Hadlock2: 16.10+/-14.29, Shepard: 19.68+/-17.00, respectively. The prediction error was increased according to increasing of lapse time(p <0.001), gestational weeks on ultrasound, and estimated fetal weight percentile, and decreasing birth weight percentile(p <0.001)(R square=0.411, (p <0.001). But, amniotic fluid index did not affect to prediction error(p=0.199). CONCLUSION: Our study presented relatively accurate prediction for birth weight percentile and LGA fetuses from remote sonographic examination. If LGA fetuses was suspected by antenatal ultrasound, adequate therapy and periodic observation are recommended for good perinatal outcome.

The Distribution of CA-125 Level Among the Patients Who Underwent Hysterectomy / 대한부인종양콜포스코피학회잡지

OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.