A case of intestinal obstruction caused by intestinal endometriosis / 대한산부인과학회지

Endometriosis is a common disease in women of reproductive age, intestinal involvement has been estimated to occur in 3% to 37% of women with endometriosis, in rectosigmoid colon, appendix, ileum and cecum, in order of decreasing frequency. On the other hand, endometriosis of the small bowel, especially symptomatic small bowel involvement, is very unusual. Endometriosis is a rare cause of intestinal obstruction, and preoperative diagnosis is very difficult. It should be considered in the differential diagnosis of women of reproductive age who present with symptoms of obstruction. The definitive treatment includes resection of the involved segment with primary anastomosis. We report a 34-year-old woman following up infertility and ovarian endometrioma. She had nausea, vomiting and low abdominal pain who was operated on acute intestinal obstruction. Pathologic finding was endometriosis involving the ileum, cecum, appendix We present the case with a brief review of literature.

Comparison of postoperative radiotherapy versus postoperative paclitaxel and platinum chemotherapy in uterine endometrial carcinoma / 대한산부인과학회지

OBJECTIVE: This study was performed to compare postoperative adjuvant paclitaxel and platinum (TC) chemotherapy and radiation therapy in women with uterine endometrial carcinoma. METHODS: Total one hundred five patients were entered into this trial. Non-endometrioid histologic subtypes such as serous, clear cell and small cell types were excluded from the study because they have different biological potentials. Of 58 assessable patients, who were needed adjuvant treatment according to surgico-pathologic reports, after surgery, 34 were received TC chemotherapy and 24 were received radiation therapy. Chemotherapy consisted of paclitaxel 175 mg/m2 and carboplatin AUC 5 (or cisplatin 50 mg/m2) every 3 weeks for 3 or 6 cycles. Irradiation dosage was 4,500~5,040 cGy in 28 fractions. RESULTS: In 58 evaluated patients, median follow-up time was 40.3 months (range 7~64 months). The 5-year overall survival and 5-year disease-free survival were 91.3% and 91.0% in 34 patients treated with TC chemotherapy, and 91.4% and 82.8% in 24 cases who treated with radiation therapy, however, there were no significant difference (P=0.646, P=0.129). The most common adverse effect of TC chemotherapy was hematologic toxicity, which was manageable conservatively. The serious gastrointestinal complication of radiotherapy was noted in 5 patients (20.8%), three of these patients were received another bowel surgery, such as ileo-cecal bypass, however, symptoms were persisted after surgery. CONCLUSIONS: These data suggest that postoperative adjuvant TC chemotherapy is a promising treatment which could be substituted for radiation therapy, with major activity and a acceptable toxicity profile for the treatment of uterine endometrial carcinoma.

Clinical Study on Intrauterine Growth Restriction / 대한주산의학회잡지

OBJECTIVES: Intrauterine growth restriction(IUGR) accounts for significantiy increased perinatal mortality and neonatal morbidity rates. The Purpose of this study is to investigate the association between some of the risk factors and the incidence of fetal growth restriction. PATIENTS AND METHOD: The retrospective survey of obstetric records of 2188 mothers, who delivered between July, 1995 and June, 1998, was carried out in Hanyang University Kuri Hospital, with the following inclusion criteria: Korean, singleton pregnancy with live birth and a gestational age of more than 32 weeks. RESULTS AND CONCLUSION: 1) The incidence rate for IUGR was 4,7% during the period of 1995 through 1998. 2) 41.2% of IUGR was due to unknown causes, 58.8% of IUGR was due to known. Among known causes the maternal factor was 40.2%, the placenta factor was 14.7%, and the fetal anomaly was 4%. 3) Among maternal factors, pregnancy induced hypertension was the most common cause. 4) The incidence of IUGR was higher in primiparous women and in female babies. 5) The IUGR group showed lower Apgar scores at 1 and 5 minutes than control group,

Fetal Heart Rate Telemetry System for Monitoring of High Risk Pregnancies / 대한주산의학회잡지

OBJECTIVE: Our purpose was to establish whether FHR recording tape and telemetry system at home interpreted by remote telemedicine link is comparable to interpretation at hospital in a high-risk patient population. Patients and METHODS: Twenty women whose pregnancy was suspected as high risk were entered to study. All pregnancies were at term(7 at 38th weeks, 7 at 39th weeks, 6 at 40th weeks). Remote FHR monitoring at hospital was made for consecutive 6 days, using FHR-telemetry system at home which already developed and used by authors from 1991. Patients recorded FHR sound using recording tape for 5 days. On the 5th day, real-time transmitting of FHR sound to the hospital was also done via telephone lines after recording of FHR sound. On the 6th day, FHR test(NST) was performed at hospital. The signal loss(%), baseline FHR(bpm), and FHR variability were compared using computerized FHR analysis system(HYFM-I) after re-play of 5-days recording tapes at hospital with real-time transmitting data and in-hospital FHR test results. RESULTS: The signal loss was highest with real-time transmiting data when comparing with in-hospital FHR analysis. No significant differences were observed among 5-days data of FHR recording tapes. CONCLUSIONS: Frequent antenatal visit of high-risk pregnancy patients were in diHuities of their pregnancy outcomes. And many rural areas of our country are without adequate access to basic maternity services. From this point of view, a fetal telemedicine service is needed, and in fact, technically and clinically feasible. Our demonstration suggests that such a service reduces the need for hospital visit of high risk pregnancy women. Further evaluation in a variety of clinical settings is now indicated, along with cost-benefit analysis.

Chromosime Analysis from Chorionic Villi Samples in Recurrent Sponataneous Abortion / 대한주산의학회잡지

Recurrent abortion has been defined as the occurrence of three or more clinically recognized pregnancy loss before 20 weeks and it occurs in 1% of women. The chromosomal abnormalities of abortuses have been suggested as the most common causes of recurrent abortion. We have studied the incidence of chromosomal abnormalities in 57 patients with recurrent abortion using the chorionic villi samples. Of the 57 abortuses analysed, 32 (56.1%) had chromosomal abnormalities. Trisomy was predominant (23 cases, 40.4%), followed by mosaicism 3 (5.2%), tetraploidy 2 (3.5%), monosomy 2 (3.5%), and structural anomaly 1 (1.8%). Trisomy for the chromosome 16 was most prevalent among trisomies. The incidence of trisomy was positively related to matemal age above 35 year-old. But there is not statistically significant. And there are no correlation between gestational age and chromosomal abnormalities. In conclusion, the incidence of chromosomal abnormalities of recurrent abortuses was 56.1% which was similar to that of the other reports. This means that the analysis of karyotype of chorionic villi, as the first test to investigate the cause of recurrent abortion, may be not useful, however, it will require further.

Squamous Cell Carcinoma arising in Cystic Teratoma of the Ovary / 대한산부인과학회잡지

The cystic teratoma is the most common germ cell tumors in reproductive age women. The malignant change of cystic teratoma is rare, about 1~2%, and mostly change to squ-amous cell carcinoma. We experienced 4 cases of squamous cell carcinoma arising in cystic teratoma and re- port our cases with a brief review of the literature.

The peripatetic placenta(II) / 대한주산의학회잡지

No abstract available.