A comparison of intravaginal misoprostol with intravenous oxytocin for labor induction at term / 대한산부인과학회잡지

OBJECTIVE: To compare the safety and efficacy of intravaginally administered misoprostol (PGE1 analogue) versus intravenously administered oxytocin for labor induction at term. METHODS: Among 63 patients over 37 weeks, randomly selected 42 patients were vaginally administered 25 micro gram of misoprostol every 3 hours and the other 21 patients were intravenously administered every minute from 1 mIU/min to 10 mIU/min increasingly. RESULT: The average interval from initiation of induction to labor was notably shorter in oxytocin group than in misoprostol group (204.5+/-332.6 min versus 528.1+/-591.8 min, p<0.02). The average interval from initiation of induction to vaginal delivery was shorter in oxytocin group than in misoprostol group (414.4+/-309.4 min versus 528.1+/-519.8 min, P<0.01) and the difference has statistical meaning. Procedure of labor were divided by 3 stages. We checked the duration of each stage between the two comparative groups. 1st stage (242.7+/-150.14 min versus 605.5+/-805.8 min, P<0.05) 2nd stage (12.6+/-11.9 min versus 19.5+/-11.2 min, P<0.05) The stage duration of oxytocin group was shortened. There was no difference between two groups at the third stage. The incidence of tachysystole, hypertonics, hyperstimulation, meconium passage, abnormal fetal heart rate, fetal weight, apgar score, neonatal morbidity were not different between two group. CONCLUSION: Intravenously administered oxytocin was more effective in shortening labor time than intravaginally administered misoprostol in overall induction labor, but there was no notable difference in the effects on mothers and babies. Considering various situational factors, careful selection should be administered.

Toremifene-associated endometrial polyp: A case report and review of the literature / 대한산부인과학회잡지

Antiestrogens have been widely used in the treatment of breast cancer patients. Although tamoxifen is one of the most prevalent antiestrogens, some reported its hepatocarcinogenic effects and the long-term treatment may increase the risk of endometrial and gastrointestinal cancer. Toremifene is an interesting new antiestrogen and have a similar antitumor efficacy as tamoxifen, with less side-effect including less uterotrophic effect compared to tamoxifen, in mice. we report a case of endometrial polyp which were associated with toremifene use, in postmenopausal woman with breast cancer, with a brief review of literature.

A case of carcinosarcoma of uterine endometrium associated with Tamoxifen use in breast cancer patient / 대한산부인과학회잡지

Tamoxifen, which is often used in breast cancer therapy, has also been used in the treatment of patients with advanced and recurrent endometrial carcinoma. Tamoxifen has been shown to have significant benificial effects in the treatment of breast cancer patients as hormonal therapy. However, there is evidence that tamoxifen may affect other hormone sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and endometrial cancer has been reported in tamoxifen treated women. We are able to make this report because we have experienced uterine endometrial carcinosarcoma which is developed in a patient treated with tamoxifen for five years following a modified radical mastectomy due to breast cancer in our hospital.

A survey of the contraceptive use and attitude of 1,131 Korean women / 대한산부인과학회잡지

OBJECTIVE: We conducted a research into the current method of contraception used by Korean women (1,130 were surveyed) in order to understand about any problems they may be experiencing and their levels of satisfaction. Our objective is to be able to suggest appropriate methods of contraception which are desired by Korean women. METHOD: We gave questionnaire to reproductive age women who visited Soonchunhyang University Hospital in Seoul from January 2000 to October 2001. Items of the survey contained general characteristics such as, the method of contraception, side effect (if any), and level of satisfaction. RESULTS: The mean age was 35.1+/-5.9 years and the most common occupation was that of housewife (68%), the mean parity was 1.7+/-1.1, and the mean abortion was 0.8+/-1.5. The mean contraception period was 4.6+/-4.9 years, of the methods used, condoms were the most common (29.0%), followed by intrauterine device (21.1%), tubal sterilization (13.5%), oral contraceptive (12.2%), periodic abstinence (9.3%), vasectomy (7.9%), coitus interruptus (6.4%) and others (12.4%). Among women above 41 years of age, sterilization was the most common method. Condom and oral contraceptives were the most common methods among women under the 40 years of age. The side effects, menorrhagia and leukorrhea were the most common among the women who had used the method of contraception with inrauterine divice. Tubal sterilization and vasectomy gave the most satisfaction. CONCLUSION: The most common used contraceptive method among Korean reproductive age women was the condom. We found that the form of contraception has been changing from permanent method to a temporary one. Therefore the education for women in the use of condom, oral contraceptives, and intrauterine device should be completed as soon as possible.

Study on the Factor V Leiden Mutation in Pregnant Women and Relationship with Preeclampsia Severe Form / 대한주산의학회잡지

OBJECTIVE: A study showed that resistance to activated protein C may develope some cases of severe preeclampsia. A common missense mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C. Our objective was to determine whether this mutation is more prevalent in patients with severe preeclampsia than in normotensive controls. METHOD: Deoxyribonucleic acid was extracted from whole blood of 158 gravid women of severe preeclampsia and 403 normotensive gravid women. The polymerase chain reaction was used to amplify exon 10 of the factor V gene, followed by allele-specific restriction with Mnl 1 for mutation detection. RESULTS: No patients were homozygous for the Leiden mutation. We could not find any positive case with FV:Q506 in the normal or patient group. CONCLUSION: We could not find that carriers of the factor V Leiden mutation are increased risk for severe preeclampsia. In contrast to the reports in Caucasian, the prevalence of APC resistance and FV:Q506 might be very low or absent in the Korean population. But, carriers of this common thrombophilic mutation may be identified so that other causes and risk factors for inherited thrombophilia should be investigated in the Korean population.

An Immunohistochemical study on the Expression of EGFR, TGF-alpha and Ki-67 in the Uterine Cervical Neoplasia / 대한산부인과학회잡지

OBJECTIVE: Cervical carcinoma of the uterus, the most common maliganacy among women in Korea, which its etiology and pathogenesis are not yet determined. Recently, since it has been found about the function of the growth factor and its receptor, involved in the regulation of cellular growth and differentiation, many studies have been undertaken about the role of growth factors and its receptors in the growth and differentiation of the tumor cell. METHODS: In this study, we examined the expression of EGFR, TGF-alpha and Ki-67 in 50 CINs and 20 invasive cervical cancers using immunohistochemical stain. RESULTS: Positive rate of EGFR was 92% in CIN, 80% in invasive cancer, negative rate of TGF-alpha was 74% in CIN, 80% in invasive cancer and Ki-67 labelling index(LI) in normal basal cell, CIN I-II, CIN III were 5+/-0.7, 13+/-2.5, 65+/-5.4 repectively and in invasive cancer, LI was over 90. from this result as cervical carcinoma progresses, the expression of EGFR and Ki-67 increase while that of TGF-alpha decreases. CONCLUSION: As cervical carcinoma progress, the expression of EGFR and Ki-67 increase while that of TGF-alpha decreases. Further studies on the expression of EGFR and TGF-alpha and its growth-stimulation mechanism in cervical carcinoma are warranted to establish the pathogenesis of the cervical carcinoma.

The Study to Detect Chlamydia Trachomatis by Polymerse Chain reaction in Vaginal Swabs at the Third Trimester of Pregnancy in Korean Women and in Nasal Cavity Swabs of Their Newborn Infants / 대한주산의학회잡지

No abstract available.

A Case Report of Early Abdominal Pregnancy / 대한주산의학회잡지

Abdominal pregnancy that is a life threatening variant of ectopic pregnancy, has been a rare event with high maternal mortality. It is very difficult to diagnose a abdominal pregnancy clinically. We have experienced a case of early abdominal pregnancy diagnosed at emergency laparotomy and this case was presented with a brief review of the literatures.