Comparison of Higher-order Aberrations between Eyes with Natural Supervision and Highly Myopic Eyes in Koreans

PURPOSE: To describe the characteristics and investigate the differences of higher-order aberrations (HOAs) between the eyes with a natural, uncorrected visual acuity (UCVA) of 20/12 and eyes with highly myopic eyes in Korean adults. METHODS: Thirty-one eyes of 20 subjects with UCVA of 20/12 (Group 1) and 54 eyes of 36 myopic patients with greater than -6 diopters (Group 2) were analyzed for type and magnitude of HOAs across a 6.0 mm pupil. HOAs were measured by Wavescan (VISX, Santa Clara, CA, USA) in natural scotopic conditions and were presented as root-mean-square (RMS: micrometer) in Belle aberration maps. RESULTS: The mean spherical equivalent (SE) of manifest refraction was -0.15+/-0.25 D (range: +0.37 to -0.50 D) in Group 1 and -7.25+/-0.78 D (range: -6.00 to -9.25 D) in Group 2. The total root-mean-square (RMS) values of HOAs for Group 1 and Group 2 were 0.28+/-0.09 micrometer and 0.27+/-0.087 micrometer, respectively (P>0.05). The mean values of coma, trefoil, and spherical aberration were 0.14+/-0.091 micrometer, 0.14+/-0.089 micrometer, 0.091+/-0.059 micrometer in Group 1 and 0.16+/-0.077 micrometer, 0.14+/-0.073 micrometer, 0.082+/-0.059 micrometer in Group 2, respectively. CONCLUSIONS: This study helped establish ocular aberration standards for those with natural supervision and those with highly myopic eyes among Koreans. Individuals with natural supervision had significant amounts of HOAs, and there was no significant difference in the amount of HOAs between the two groups. The index of higher-order aberrations may not be a perfect predictor of the amount of refractive error.

Comparison of Higher-order Aberrations between Eyes with Natural Supervision and Highly Myopic Eyes in Koreans

PURPOSE: To describe the characteristics and investigate the differences of higher-order aberrations (HOAs) between the eyes with a natural, uncorrected visual acuity (UCVA) of 20/12 and eyes with highly myopic eyes in Korean adults. METHODS: Thirty-one eyes of 20 subjects with UCVA of 20/12 (Group 1) and 54 eyes of 36 myopic patients with greater than -6 diopters (Group 2) were analyzed for type and magnitude of HOAs across a 6.0 mm pupil. HOAs were measured by Wavescan (VISX, Santa Clara, CA, USA) in natural scotopic conditions and were presented as root-mean-square (RMS: micrometer) in Belle aberration maps. RESULTS: The mean spherical equivalent (SE) of manifest refraction was -0.15+/-0.25 D (range: +0.37 to -0.50 D) in Group 1 and -7.25+/-0.78 D (range: -6.00 to -9.25 D) in Group 2. The total root-mean-square (RMS) values of HOAs for Group 1 and Group 2 were 0.28+/-0.09 micrometer and 0.27+/-0.087 micrometer, respectively (P>0.05). The mean values of coma, trefoil, and spherical aberration were 0.14+/-0.091 micrometer, 0.14+/-0.089 micrometer, 0.091+/-0.059 micrometer in Group 1 and 0.16+/-0.077 micrometer, 0.14+/-0.073 micrometer, 0.082+/-0.059 micrometer in Group 2, respectively. CONCLUSIONS: This study helped establish ocular aberration standards for those with natural supervision and those with highly myopic eyes among Koreans. Individuals with natural supervision had significant amounts of HOAs, and there was no significant difference in the amount of HOAs between the two groups. The index of higher-order aberrations may not be a perfect predictor of the amount of refractive error.

Loss of Fhit Expression in Cervical Intraepithelial lesion and Invasive Cervical Carcinoma / 대한산부인과학회잡지

OBJECTIVE: The author evaluated the relationship between the loss of Fhit and prognostic factors of invasive cervical carcinomas. METHODS: The formalin prepared tissue specimens of 64 CINs and 27 invasive cervical carcinomas patients diagnosed and treated at the department of obstetrics and gynecology, Yeungnam university hospital from June 1977 to February 2001 were obtained. And then the tissue specimens were analysed & measured by immunohistochemical methods. RESULTS: The loss of Fhit was significantly reduced in invasive cervical carcinomas compared to CINs. But we found there is no relationships between the loss of Fhit and prognostic factors, stage, tumor marker, lymphatic spread and radiation therapy of invasive cervical carcinomas. CONCLUSIONS: Although the loss of Fhit was not related to the precancerous lesion of cervix, we could confirm that the loss of Fhit was important in the progression of precancerous lesions to invasive cervical carcinomas.

Lipid Peroxidation and Antioxidant Activity in Pregnant Women with Pregnancy-Induced Hypertension / 대한주산의학회잡지

OBJECTIVE: To assess maternal circulating levels of lipid peroxides, superoxide dismutase and total antioxidants of women with pregnancy-induced hypertension. METHODS: Cross-sectional study consisting of 18 preeclamptic, 21 uncomplicated pregnant and 22 healthy non-pregnant women. Fasting venous blood samples were collected during the 3rd trimester of antepartum period and maternal circulating levels of malondialdehyde as a lipid peroxidation product, superoxide dismutase activity and total antioxidants were measured. RESULTS: In the preeclamptic group, lipid peroxides were significantly increased, otherwise the activity of superoxide dismutase in the erythrocytes was significantly decreased compared to normal pregnant women. The value of serum total antioxidants was similar in both groups. Strong correlation was detected between malondialdehyde and blood pressure in the pregnant women. CONCLUSION: Preeclampsia is associated with decrease of antioxidant enzyme activity while lipid peroxidation was increased during the 3rd trimester of pregnancy. Therefore, a significant elevated lipid peroxidation and reduced superoxide dismutase activity may contribute to pathophysiology and pathogenesis of preeclampsia via vascular endothelial cell damage.

Two Cases of Advanced Ovarian Serous Tumor of Borderline Malignancy / 대한부인종양콜포스코피학회잡지

Ovarian serous tumors of low malignant potential (borderline serous tumors) are intermediate in their clinical behavior between benign serous cystadenoma and malignant neoplasm, and are associated with 10 year survival rates in excess of 90%. Borderline ovarian serous tumors are characterized by absence of stromal invasion but presence of some characteristics of malignancy. Borderline ovarian tumors occur predominantly in premenopausal women, and associated with a very good prognosis. The principal treatment of borderline malignancy is surgical resection of the primary tumor. But approximatley 20% of patients with ovarian tumors of low malignant potential present with Stage III or IV disease at the time of diagnosis. The benefit of postsurgical therapy in this group of patients has not been well established. We report two cases of advanced ovarian serous borderline tumor, one of which was treated with 3 cycles of cisplatin-taxol chemotherpy.

Quality of Life in Women Who Underwent Radical Hysterectomy / 대한산부인과학회잡지

OBJECTIVE: he authors evaluated the quality of life in women who underwent radical hysterectomy. METHODS: he protocol of functional assessment of chronic illness therapy by Cella was used to evaluate the quality of life after radical hysterectomy in 156 women. The data was standardized and scaled 0-100 points by Rasch's assessment model. The statistical analysis was done with ANOVA and post-Hoc test. RESULTS: Those with a lower ECOG performance score, housewives, workers, and those who are married had a higher sense of well-being than those with a higher ECOG performance score or who were jobless or widowed. Women with no family or who are single mothers showed lower emotional well-being (EWB) and Medicare patients had a lower social/family well-being (SFWB) or functional assessment of cancer therapy with general (FACT-G) than those who had medical insurances. The EWB and specific symptoms confined to cervical cancer (CxCs) were found to be higher in women who were diagnosed to be at stage I than those to be at stage II. The physical well-being (PWB) was found to be lower in women when adjunctive chemotherapy or radiation therapy had been performed than only the surgery had been done, and the CxCs was found to be lower in women when radiation therapy had been performed than only the surgery had been done. Conclusions: The results of this study suggest that familial, social condition, clinical stage, and treatment modality affect the quality of life of each patient. In conclusion, our results support the importance of earlier prediction and a proper management plan to improve the quality of life in women who had underwent radical hysterectomy.

Expressions of MIB-1, p53 and CEA in Endocervical Glandular Lesions

BACKGROUND: Endocervical glandular lesions include glandular atypia (GA), endocervical glandular dysplasia (EGD), adenocarcinoma in situ (AIS), and invasive adenocarcinoma (IA). The diagnosis of malignant glandular lesions is occasionally difficult to distinguish from benign mimickers, and the morphologic features of EGD remain unsettled. METHODS: Immunohistochemical stains for MIB-1, p53 and CEA were performed on 81 cases of paraffin-embedded endocervical glandular lesions including 22 IA, 15 AIS, 15 EGD, 13 GA, 8 microglandular hyperplasia (MGH) and 8 tubal metaplasia (TM). RESULTS: The MIB-1 labelling index of IA was 59.68%, 69.53% for AIS, 26.60% for EGD, 16.03% for benign. p53 overexpression was noted in 4 (18%) cases of IA, 3 (20%) of AIS, but none of EGD and benign lesions. It was Interesting to note that one case of MGH showed p53 staining in low intensity. Diffuse strong cytoplasmic CEA positivity was present in all of IA and AIS, whereas seven (47%) of 15 EGD and 12 (41%) of 29 benign lesions showed focal cytoplasmic CEA positivity. There were significant differences in MIB-1 and CEA immunostainings among the adenocarcinoma, EGD, and benign glandular lesions. Adenocarcinoma was closely related to p53 overexpression, although occurring in a low percentage of the cases. CONCLUSION: MIB-1 immunostaining can be useful in differentiating among endocervical adenocarcinoma, endocervical glandular dysplasia and benign glandular lesions. p53 overexpression might be helpful in the diagnosis of adenocarcinoma.

A Case of Epithelioid Trophoblastic Tumor / 대한부인종양콜포스코피학회잡지

We report a rare case of epithelioid trophoblastic tumor. The patient was initially thought to have endometrial carcinoma with high possibility of clear cell carcinoma on endometrial biopsy and pelvic MRI. The Pap smear showed feature of squamous cell carcinoma and was not consistent with the physical findings. The serum beta-hCG was 33.26 mIU/ml. The initial biopsy and pelvic MRI findings lead the clinicians to misdiagnose the case as a carcinoma.

Three cases of symphysis pubis separation associated with delivery / 영남의대학술지

Symphysis pubis separation is an uncommon but not rare complication of delivery. Characteristic symptoms of symphyseal separation include suprapubic pain and tenderness which radiate to the back or legs, difficult ambulation, and bladder dysfunction. Clinical history, presenting symptoms, and response to therapy are sufficient to make the diagnosis, although radiographic documentation of symphyseal separation by x-ray or ultrasound are frequently used to confirm the diagnosis. The underlying etiology of symptomatic symphyseal separation has not been fully elucidated. Associations with macrosomia, pathological joint loosening, and increased force placed on the pelvic ring have been suggested as possible etiologies. Conservative therapy, including bed rest, pelvic binders, ambulation devices, and mild analgesics usually result in complete recovery within 4-16 weeks. Our experience of three cases of peripartum symphysis pubis separation delivered from 1998 to 1999 were reviewed with related articles.

Telomerase Activity in Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: Telomerase is a ribonucleoprotein that synthesizes TTAGGG repeats onto chromosome ends. The expression of telomerase is thought to be required for cellular immortality and carcinogenesis. This study was conducted to examine the telomerase activation occurs in cervical carcinogenesis. METHODS: The standard telomeric repeat amplification protocol(TRAP) was used to examine telomerase activity in tissues of 10 normal cervix, 10 carcinoma in situ, and 21 invasive cervical carcinoma. RESULTS: Telomerase activity was detected in tissues of 16/21(76.2%) invasive carcinoma, in 5/10(50.0%) carcinoma in situ, and in 3/10(30.0%) normal cervix. But the degree of telomerase activity in normal cervix was weak. There was significant difference in 3 groups(p<0.05). The results of neoadjuvant chemotherapy in 10 invasive cervical carcinoma were as follows. In 8 cases of which tumor size decreased more than 50%, 5 were positive for telomerase. In 2 cases that didn't respond to chemotherapy by tumor size, 1 was positive for telomerase. There was no significant difference between 2 groups. All of the 5 cases that had pelvic lymph node metastasis revealed positive telomerase activity, and the 11 cases of 16 cases that didn't have pelvic lymph node metastasis were positive for telomerase, but there was no significant difference in 2 groups. The positivity of telomerase activity in clinical stage of invasive cervical carcinoma was 73.3% in stage I(11/15), 75.0% in stage II(3/4), 100% in stage III(1/1), and 100% in stage IV(1/1), but there was no significant difference in each stages. CONCLUSION: Telomerase seems to be uniquely associated with malignant transformation of cervix and can be used as a tumor marker. Additional studies are needed to better clarify the biological significance of telomerase expression in cervical tumorigenesis.

Effects of Obesity on Pregnancy Outcomes / 대한주산의학회잡지

OBJECTIVE:To compare pregnancy outcomes between obese and nonobese women and to determine the effect of gestational weight gain on pregnancy outcome in obese women. METHODS: A retrospective cohort study was conducted comparing 100 obese and 300 nonobese women who delivered a singleton live birth at Yeungnam university hospital from June 1998 to Dec 1998. Morbid obesity was defined as a body mass index greater than 30. The incidence of selected perinatal and neonatal outcome was assessed for two groups. RESULTS: Morbidly obese patients were more likly to experience pregnancy complications including gestational diabetes mellitus, preeclampsia, placental abruption, fetal distress, meconium aspiration, cesarean delivery & birth trauma. However, these were not affected by gestational weight gain in morbidly obese women. Weight gains more than 12kg were strongly associated with birth of a large for gestational age(LGA) neonate, however, poor weight gain did not appear to incrcase the risk of delivery of a low birth weight neonate. CONCLUSION: To optimize fetal growth, weight gain of 7-12kg for obese women appear to be appropriate. To reduce the risk of delivery of an LGA neonate, the optimal gestational weight gain for obese women should not exceed 12kg.

Human Papillomavirus Detection and E6 Oncoprotein Expression in Uterine Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: To evaluate the correlation of HPV infection and E6 oncoprotein expression with carcinogenesis and prognostic role of cervical carcinoma METHODS: Paraffin embedded tissues were obtained from 35 invasive cervical carcinoma, 15 carcinoma in situ, 12 dysplasia of cervix and 20 patients with benign uterine disease as control. HPV type was determined by polymerase chain reaction using type specific primers. E6 oncoprotein expression was analyzed by immunohistochemical staining using C1P5 mouse monoclonal antibody. RESULTS: 1. The positivity of HPV type 16 PCR in invasive cervical carcinoma was 77.1% and it was significantly higher than carcinoma in situ(53.3%), cervical dysplasia(25%), and control (10%). But the positivity of HPV type 18 was not correlated between above groups. 2. The positivity of HPV type 16/18 in cervical carcinoma was not correlated to patient's age. 3. The positivity of HPV in cervical carcinoma was correlated to clinical stage of cervical carcinoma but the positivity of HPV in cervical dysplasia was not correlated to the degree of dysplasia. 4. The positivity of E6 oncoprotein expression was 77.1% in invasive cervical carcinoma, 66.7% in carcinoma in situ and 20% in control group. E6 oncoprotein was not decteted among the cases which negative was for HPV 16/18. The E6 oncoprotein expression in 35 cases of invasive cervical carcinoma was negative in 8, weakly positive in 7, positive in 12, and strong positive in 8 ases. But in 20 cases of normal control group, there was no case of strong positive or posirive E6 oncoprotein expression. 5. The E6 oncoprotein expression was significantly correlated to the clinical stage and lymph node metastasis. The incidence of lymph node metastasis increased and the stage became higher as the E6 oncoprotein expression increased. CONCLUSION: These results suggest that HPV is one of the most important factors in the carcinogenesis of cervical carcinoma and the E6 oncoprotein expression may be associated with biological aggressiveness of cervical carcinoma.

A Case of Prenatal Ultrasonic Diagnosis of Extrathoracic Ectopia Cordis / 대한주산의학회잡지

Ectopia cordis is a rare congenital anomaly in which the heart is situated outside the chest cavity and has been known for many years, being reported first in 1671 by Neil Stenson. Ectopia cordis appears closely related with defective embryonic development, arising as the result of defective formation and differentiation of the ventral mesoderm at 14 to 18 days of embryonic life. Ectopia cordis is usually classified into many types according to the site at which the heart protrudes: thoracic type, abdominal type, thoraco-abdominal type, cervical type. We have experinced one case of ectopia cordis which was diagnosed by ultrasonography at 16th gestational weeks in 30 year old multiparity. We report this case with brief review of literatures.

A Clinical Study of 20 Uterine Sarcomas / 영남의대학술지

Sarcoma of the uterus is very rare malignant tumor originating from uterine muscle or connective tissue. We have experienced 20 cases of uterine sarcoma from January 1991 to June 1998. The results were as follows: 1. The pathologic types were 13 cases(65.0%) of leiomyosarcoma, 5 cases(25.0%) of malignant mixed Mullerian tumor, 1 case of rhabdomyosarcoma, and 1 case of angiosarcoma. 2. The average age and parity was 50.2 and 3.7. The chief complaints were irregular vaginal bleeding(35.0%), lower abdominal pain(25.0%), and abdominal mass(25.0%). 3. Nine cases(45.0%) were FIGO stage I, 1 case(5.0%) was stage II, 6 cases(30.0%) were stage III, and 4 cases(20.0%) were stage IV. 4. The survival was from 1.5 months to over 130 months(median 16.5 months), and there was no correlation between survival and FIGO stage or pathologic type. The correlation between survival and number of mitotic figure was incalcurable. 5. CA 125 levels were serially measured as a tumor marker in monitoring patients and the positive rate was 40%. Further study was needed to make a conclusion for usefulness of CA 125 as a tumor marker.

Maternal Weight Gain Pattern and Birth Weight / 영남의대학술지

Maternal weight gain during pregnancy has been consistently associated with infant birth weight and pregnancy outcome. Our purpose was to determined the relationship between maternal weight gain pattern and birth weight. Consequently, maternal weight gain is monitored carefully and is encouraged during prenatal care in order to improve pregnancy outcome. Our study group included both 424 uncomplicated women and infant delivered at the Yeungnam University Hospital between 1993-1996. All recorded prenatal weight gain measurements were used to estimate maternal trimester weight gain, pattern of gain (based on low versus not-low gain at each trimester), and total gain at delivery. Multiple linear regression analysis was used to assess the relationship between these weight gain measurements and fetal birth weight. Each kilogram of maternal gain in the first, second, and third trimesters was associatedwith statistically related to the increase in fatal birth weight by 31.3, 19.0, and 24.5g, respectively. When compaired with the pattern of gain that was not low in any trimester, patterns with low gain in the first trimesters were associated with significant decreases in birth weight, but no important change in birth weight was seen for the group whose gains were not low in the first trimester. The results suggest that specific patterns of maternal weight gain, particularly weight gain during the first trimester, are related to fetal birth weight.

Values of Alpha-fetoprotein of Maternal Serum in Normal Pregnancy / 영남의대학술지

Alphafetoprotein(AFP) is a glycoprotein synthesized by the fetus early in gestation by the yolk sac and later by the gastrointestinal tract and liver. The concentration of AFP is highest in fetal serum and amniotic fluid around 13th week, and 32nd week in maternal serum. Some conditions are associated with abnormal maternal serum AFP concentration. For examples, neural tube defects, omphalocele, renal anomalies are associated with elevated maternal serum AFP and fetal death, chromosomal trisomies are associated with low level of maternal serum AFP. So maternal serum AFP screening plays a significant role in assessing candidates for prenatal diagnosis and prenatal counselling in pregnant women. This study evaluates the normal ranges of AFP using enzyme immunoassay in normal pregnant women. We studied 500 normal pregnant women who visited the Department of Obstetrics & Gynecology, Yeungnam Medical Center, Yeungnam University during the period through January, 1993 to September, 1996. The group of the study were selected randomly at various gestational ages from 8 to 41 weeks. The results were summarized as follows: 1. The lowest level of AFP in our study group was 2.1ng/ml at 8 weeks of gestation. Thereafter serum alpha-fetoprotein concentrations rose rapidly to reach a peak value at 32nd week. 2. The mean levels of AFP in the primipara and multipara were 166.37+/-12.06ng/ml, and 223.78+/-14.00ng/ml, respectively, showing stastiscally significant difference between these two groups(p0.05). 4. The normal ranges of maternal serum AFP according to each gestational week were evaulated.

The Diagnostic Value of PCR in Gestational Trophoblastic Disease / 대한산부인과학회잡지

This study was conducted to assess the value of DNA diagnosis of gestational trophoblastic disease using polymerase chain reaction method. The 3 genetic loci including a variable number of tandem repeats regions were amplified by the PCR method on DNA of lymphocytes separated from the peripheral blood of the 53 uterine myoma patients. The distribution ranges of the APOB/VNTR, COL2A1/VNTR and MCT 118/VNTR were 691~850 bp, 651~720 bp and 501~720 bp respectively. The heterozygosity indices of the APOB/VNTR, COL2A1/VNTR and MCT 118/VNTR were 66.0%, 64.2% and 67.9% respectively. The author used the hypervariable 3' flanking region of the APOB/VNTR locus as target for DNA diagnosis of gestational trophoblastic disease. In 12 cases of hydatidiform mole, 1 case of invasive mole, and 1 case of choriocaricinoma, the target locus was amplified by the PCR method on DNA from lymphocytes of patients and their husbands, on DNA from the tisues. 10 cases of hydatidiform mole revealed DNA segments unique to the paternal APOB allele showing androgenesis. Two of theses androgenetic hydatidiform noles were heterozygous and the others were homozygous. A case of invasive mole showed normal genetic combination and a case of choriocarcinoma showed homozygosity. The heterozygous hydatidifomr moles as well as the homozygous ydatidiform moles were good in prognosis. The PCR method for targeting the APOB/VNTR appeared useful for the early diagnosis of hydatidiform mole.

A Case of Mixed Germ Cell Tumor Associated with Dysgenetic Gonad / 대한산부인과학회잡지

Gonadal tumors occur in a small percentage of patients who are diagnosed as having gonadal dysgenesis. Most of the tumors were gonadoblastomas and dysgerminomas. We present here with brief review of literature one case of mixed germ cell tumor of phenotycally typical female without sexual ambiguity who presented with primary amenorrhea, short stature and minimal abnormal somatic features, whose chromosome analysis showed 45,X/ 46,X, +mar karyotype.

A Case of Surgical Arterial Ligation in Combination with Transarterial Embolization in the Management of Recurrent Uterine Arteriovenous Malformation / 대한산부인과학회잡지

Although uterine arterovenous malformation(AVM) is a rare cause of menorrhagia or postmenopausal bleeding, it is important to consider that curettage may precipitate life-threatening hemorrhage and therefore it is contraindicated when AVM is suspected. Special investigations such as hysteroscopy, Doppler flow ultrasound and angiography are important diagnostic tools, and transarterial embolization(TAE) has replaced hysterectomy as the treatment of choice in women who wish to retain their fertility. But due to the high incidence of collateral vessels, recurrence of the vascular malformation after TAE is common. We have experienced two cases of AVM, one of which was managed by TAE in combination with surgical arterial ligation.

A Comparative Study of Inhibition of Postsurgical Adhesion Formation in the Rat Model by Nonsteroid Antiinflammatory Drugs , Heparin , Hyskon , and TC-7 / 대한산부인과학회잡지

The purpose of this study was to evaluate and compare the effect of inhibition of postsurgical adhesion formation in the rat model by meclofenamate, tolmetin, TC-7, Hyskon, and heparin. Laparotomies were performed on grossly healthy, mature nonpregnant female rats, and proximal 1 cm of each uterine horn was traumatized with unipolar electrocautery. Each rat was randomly assigned to one of six different groups(control, meclofenamate, tolmetin, heparin, TC-7, and Hyskon group), and different solutions or an adhesion barrier were placed into traumatized uterine horn before closure. One week later adhesion formation was scored according to percent involvement of each traumatized uterine horn(0 to 4), and adhesion density(0 to 2), and compared using one-way analysis of variance and Fishers exact test. Compared with the control group, postsurgical adhesion formation was significantly decreased in the TC-7 group(average adhesion score, 1.72), the meclofenamate group(2.19), the Hyskon group(2.53), and the tolmetin group(2.93). The TC-7 group was also significantly decreased in adhesion formation compared with the Hyskon, tolmetin, heparin groups, and meclofenamate group was significantly decreased in adhesion formation compared with tolmetin and heparin groups. There were no significant differences between groups in adhesion density. So we suggest that meclofenamate is a cost-effective agent in inhibition of postsurgical adhesion formation.