Expression of Survivin in extrapelvic endometriosis / 대한산부인과학회지

OBJECTIVE: To examine survivin expression in extrapelvic endometriosis. METHODS: The study group consisted of 14 cases with extrapelvic endometriosis which were confirmed histologically. The control group (total, n=47) was divided into 2 groups. Group I included normal endometrium (n=34) obtained from hysterectomy specimens with myoma and without endometriosis. Group II included ovarian endometrioma (n=13) obtained from laparoscopy. Expression of survivin was immunohistochemically confirmed. RESULTS: In extrapelvic endometriosis, the expression of nucleus in glandular epithelium and stromal cells were significantly stronger than normal endometrium. But cytoplasm expression of glandular epithelial cells and stromal cells in extrapelvic endometriosis showed statistically lower in comparison with normal endometrium. In ovarian endometrioma, the expression of nucleus in glandular epithelial cells and stromal cells was significantly stronger than normal endometrium. But the expression of nucleus in glandular epithelial cells with ovarian endometrioma was stronger than during proliferative phase but was not significant. Also cytoplasm expression of ovarian endometrioma was lower than normal endometrium. There was no difference in survivin expression between extrapelvic endometriosis and ovarian endometrioma. CONCLUSIONS: In extrapelvic endometriosis, survivin expression was stronger than normal endometrium except cytoplasm. Our findings suggest that increased survivin expression may contribute to survival of extrapelvic implants.

Comparison of perinatal outcomes with gestational weeks and severity of disease in the preterm delivery associated with preeclampsia / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to comparison of perinatal outcomes with gestational weeks and severity of disease in the preterm delivery associated with preeclampsia. METHODS: Of the 274 cases, we reviewed retrospectively the medical records of 176 preeclampsia mothers and infants delivered before 37 weeks of gestation in the Department of Obstetrics and Gynecology, Inje University Ilsanpaik Hospital from January 2000 to December 2006. RESULTS: In preeclampsia related to premature birth, it was not different the frequency of maternal age and parity in both mild and severe group. Among indications of delivery, nonreassuring fetal heart rate pattern was most frequent in mild preeclampsia, and maternal condition was in severe preeclampsia. In addition, the rate of cesarean section was higher in severe preeclampsia. Only the severity of preeclampsia was related to prognosis in mothers. On the other hands, gestational weeks on delivery and severity of preeclampsia were related to prognosis in neonates who were born 27(+0)~33(+6) gestatonal weeks. In each group of delayed birth, no statistical significance was observed in maternal and neonatal complications according to birth delay. CONCLUSIONS: In case of maternal complications, severity of preeclampsia is related to prognosis. In case of neonatal complications, if the delivery is between 27(+0)~33(+6) gestational weeks, gestational weeks and severity of preeclampsia are importatnt indicators related to the neonate's prognosis. After 34(+0) gestational weeks, severity of preeclampsia and gestational weeks of delivery are not related to the neonate's prognosis.

Evaluation of Preterm Delivery between 32(+0)-33(+6) Weeks of Gestation

Preterm labor after 34 weeks of gestation has shown no great difference from fullterm labor in terms of neonatal morbidity and mortality when proper antepartum management (antibiotics or steroids treatment) is done. However, various studies have discussed different views on the risks and safety of preterm delivery at 32(+0)- 33(+6) weeks of gestation. We evaluated the complications of different preterm groups that included the neonates born at 32(+0)-33(+6) weeks of gestation (142), stratified randomly selected neonates born at 34(+0)-36(+6) weeks of gestation (267) and neonates born after 37(+0) weeks of gestation (356) at our hospital between December 1999 and April 2006. As a result, it was found that neonates born at 3(+0)-36(+6) weeks of gestation showed no great difference from infants born at full term. However, neonates born at 32(+0)-33(+6) weeks were more likely to be admitted to neonatal intensive care unit or develop neonatal complications significantly than the neonates born at 34(+0)- 36(+6) weeks and at full term. Therefore, it is suggested that neonates born at 32(+0)-33(+6) weeks have higher risk of neonatal complications following their preterm labor than those born at later than 34(+0) weeks. Thus, it would be difficult to accept the idea that preterm labor at 32(+0)-33(+6) weeks is safe.