Intima Media Thickness(IMT) in Relation to Insulin Resistance and Subclinical Atherosclerosis in Polycystic Ovary Syndrome(PCOS) / 대한산부인과학회잡지

OBJECTIVES: The purpose of this study was to determine whether women with PCOS have greater subclinical atherosclerosis and evaluate the relationship to risk factors for atherosclerosis. METHODS: Women with PCOS(n=24) and age and body mass index(BMI)-matched cycling women(n=16) as control group underwent carotid scanning for the measurement of the IMT. We compared IMT and plaque between cases and controls, assessed some risk factors for atherosclerosis, and analyzed factors affecting IMT. RESULTS: There was no difference between the groups in waist-hip ratio(WHR) and in the levels of total cholesterol, triglyceride(TG), LDL, Lp(a), fibrinogen, homocystein, plasminogen activator inhibitor 1. However, HDL was significantly lower, and systolic and diastolic blood pressure, fasting blood sugar or insulin concentration and IMT was significantly higher in PCOS group than control group (51.1+/-11.6 vs 60.4+/- 10.0mg/dl, 119.4+/-12.5 vs 109.0+/-11.6mmHg, 79.1+/-11.1 vs 68.9+/-7.8mmHg, 93.6+/-11.1 vs 85.0+/-5.9 mg/dl, 8.9+/-5.2 vs 5.0+/-3.3milliunit/ml, 0.57+/-0.12 vs 0.49+/-0.11mm respectively, all p<.05). In the analysis of correlation between the IMT and clinical characteristics, PCOS status, BMI, systolic and diastolic blood pressure, fasting blood sugar or insulin concentration, TG, HDL, fibrinogen were significantly independent variables (Coefficients of correlation were 0.358, 0.461, 0.452, 0.349, 0.405, 0.466, 0.478, -0.433, 0.349 respectively, all p<.05). The factors affecting IMT by multivariate regression were PCOS status and fasting insulin concentration. CONCLUSIONS: We concluded that women with PCOS might have an increased risk of subclinical atherosclerosis and insulin resistance was assumed to be the main risk factor of atherosclerosis.

A Case of Full Term Delivery of a Child with 47,XYY Subsequent to Prenatal Diagnosis at Midtrimester / 대한산부인과학회잡지

47,XYY is a rare sex chromosomal disorder. Approximately 1.45 per 1,000 live births have on XYY chromosome pattern. The extra Y chromosome is paternal in origin and RESULTS: from nondisjunction in the second meiotic division. Although the phenotype is normal on the newborn, an increased incidence of minor anomalies has been reported. Recently, a 37-year-old primigravid woman received amniocentesis at 17 weeks gestation at a private clinic and was diagnosed as having a fetus with 47,XYY. We performed amniocentesis again at 20 weeks of pregnancy and confirmed fetal karyotype to be 47,XYY using the conventional cytogenetics and fluorescence in situ hybridization (FISH) techniques. As she did not want to terminate her pregnancy, she was put under antenatal care but ended up in vaginal delivery in 40 weeks. As a result of physical examination, the neonate showed a normal phenotype except for a mild hypospadia and a simian crease.

A Case of Sertoli-Leydig Cell Tumor / 대한산부인과학회잡지

The Sertoli-Leydig cell tumor is a rare sex cord stromal tumor of the ovary, accounting for less than 0.5% of all primary ovarian neoplasm. This tumor is the most common type of all virilizing ovarian tumors. However, only one-third of patients develop virilization. Recently, we experienced a case of intermediately differentiated Sertoli-Leydig cell tumor with amenorrhea and so we present it with brief review of literature.

The Role of Clinical and Biololgical Parameters to Predict Malignant Gestational Trophoblastic Tumor in Patients with Hydatidiform Mole / 대한부인종양콜포스코피학회잡지

OBJECTIVE: The purpose of this study is to reevaluate the prognostic factors by investigating the clinical and biological parameters concerned malignant gestational trophoblastic tumor in patients with hydatidiform mole. METHODS: From March 1995 to February 2000, 41 patients admitted to department of the Obstetrics and Gynecology, Yonsei University College of Medicine who were diagnosed with pathologically-proven gestational trophoblastic disease were selected. Parameters such as age, gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction were compared between malignant gestational trophoblastic tumor group and spontaneous remission group. RESULTS: Considering the clinical prognostic factors, the patients were divided into two age groups; the first group consisted of those older than 40 years of age and the second control group consisted of those under 40. The number of patients older than 40 in the spontaneous remission group and malignant gestational trophoblastic tumor group were 4(15.4%) and 7(46.7%), respectively, showing a significantly higher number in the group over 40years. Other parameters such as gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction showed no statistically significant difference between the two groups. CONCLUSION: The progression rate from hydatidiform mole to malignant gestational trophoblastic tumor was significantly higher in patients over 40 years of age. Therefore, more aggressive therapeutic approach should be considered in such patients.