Adolescent menstrual disorders: Comparison Between 1988 and 1998 / 대한산부인과학회잡지

OBJECTIVE: To compare the age of menarche, changing patterns of the menstrual characteristics in adolescent girls between 1988 and 1998. METHODS: A survey was undertaken for 1,500 highschool girls and compare with those of pervious study for 5,000 middle and highschool girls performed by same author in 1998 by means of questionnaire. RESULTS: During a decade, the mean menarcheal age decreased from 13.5+/-1.0 to 12.7+/-1.0 years(p=0.001). Gynecologic age, Body mass index were associated with age of menarche in both 1988 and 1998. The interval of menstruation was 30.6 3.5dyas in 1998 and shortened compared with 32.1+/-6.3 days in 1988(p=0.001). The duration of menstruation was lengthened in 1998 than in 1988(6.1+/-1.1 days vs 5.8+/-2.2 days, p=0.001). The incidence of irregular cycle(28.2% vs 58.2%, p=0.001), dysmenorrhea(73.9% vs 77.8%, p=0.001), and secondary amenorrhea(16.2% vs 27.2%, p= 0.001) decreased in 1998 compared with those of 1988. The incidence of agonies about menstruation was also decreased in 1998 than in 1988(26.2% vs 69.1%, p=0.001). The most common agony about menstruation in 1988 was irregular cycle(28.4%), but dysmenorrhea( 64.3%) in 1998. CONCLUSIONS: From the above results, the mean age of menarche was advanced since last decade but most of the adolescent girls still have suffered from dysmenorrhea.

Multivariate Analysis of Variables Affecting on Fetal Heart Rate / 대한산부인과학회잡지

OBJECTIVE: We aim to statistically analyze the variables affecting FHR using principal component analysis and multiple regression analysis. It is tried to find which variables significantly affect FHR. Thus, it would help further work of building objective decision basis to analyze variables affecting FHR. METHODS: The samples are chosen from pregnant women who took a NST at Hanyang University Hospital. It consists of 5,314 data which have been collected from 1989 to 1997. For collection of data and values of each variable, our own FHR interpretation softwares, HYFM-I (DOS version, since 1989) and HYFM-II (Windows version, since 1998) were used. Then, the principal component analysis is performed to find significant variable and multiple regression analysis is performed using these variables. RESULTS: The mean baseline FHR is not influenced by a specific factor in abnormal group. The gestational week, loss of signal, variability, and 5 minutes Apgar score are chosen as main effects through principal component analysis. From the results of regression analysis, it is noticed that 5 minutes Apgar score which is one of neonate prognosis after birth causes an increase of estimated FHR score (EFS), whereas the loss of signal causes a decrease of EFS. The variability in normal group is more active increasing factor of EFS than abnormal group. CONCLUSIONS: Based on gestational week, 5 minutes Apgar score is highly related with fetal maturity in both normal and abnormal groups. Also, it is found that different patterns of each variable by groups are due to delay of fetal growth that is caused by disease of a pregnant women. Thus, the further studies to build objective decision basis are need.

Clinical Study for The Ovarian Malignancy Under the Age of Twenty Years Old / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to review the incidence, types, chemotherapy regimens, operation methods, pregnancy rate and propiosis of the ov#arian malignancy under the age of twenty years old. METHODS: Retrospective reviews of the medical recordings for 22 patients with ovarian malignancy under the age of twenty years old in the Department of Obstetrics and Gynecology, Hanyang University from 1986 to 1997 were done. RESULTS: Gerin cell tumor accounts for the majority of cases (77%), whereas 5 patients(23%) belong to the common epithelial poup which were all mucinous type. Our experiences with 22 cases are as followings: 5 mucinous cystadenocarcinoma, 8 immature teratoma, 4 endodermal sinus tumor, 3 dysgernma and 2 mixed germ cell tumor. The incidence of this group was 8.2% (22/266) in all ovarian malignancy. Fourteen of them are stage I, each one is, stage II and IV, and six patients are stage III. The average age was 14.9 years old in germ cell tumor and 18.4 yems old in mucinous cystadenoearcinoma. Malignant ovarian cancer under the age of twenty can be treated with conservative surgery, followed by adjuvant chemotherapy. Commonly used chemotherapeutic regimens were VAC(Vincristine, Actinomycin-D; Cyclophosphamide), VBP(Vinblastine, Bleomycin, Cisplatin) and BEP(Bleomycin, Etoposide, Cisplatin). Second look operations were done in 11 patienth and histologic positive findings were detected in 4 of them. The length of follow-up ranged ftom 3 months to 137 months and median value was 44 rnonths. CONCLUSIONS: It is concluded that for young women who wish to preserve child-bearing capacity, regardless of the stage of the tumor, fertility preserving surgery with complete surgical staging, if necessary followed by combination chemotherapy is an appropriate treatment.