Morphological Study on the Radiation-induced Follicular Atresia and the Follicular Macrophage / 대한산부인과학회잡지

OBJECTIVE: It is well known that X-ray induces follicular atresia, but the exact mechanism of atresia is not still unveiled completely. In addition, the role of macrophage related with clean-up the dead granulosa cells and other functions within the ovarian follicle is emphasized recently. The aim of this study is to assess the radiation-induced morphological changes of ovarian follicles and follicular macrophages. METHODS: 8 Gy X-ray irradiated on the 3-week old rats (Sprague-Dawley strain), sacrificed at 6, 12, and 24 hours after irradiation, and performed morphological studies with light and transmission electron microscopy, TUNEL, and macrophage immunohistochemistry. RESULTS: Follicular atresia increased significantly (p<0.01) at 6 hours after X-irradiation, and it was decreased significantly (p<0.01) at 12 and 24 hours after irradiation. X-ray induced chromatin condensation in the nucleus and nuclear fragmentation of granulosa cells, which were the typical features of apoptosis. Apoptotic granulosa cells were phagocytosed by the neighboring normal granulosa cells and the macrophages. During atresia of follicles, radioresistant granulosa cells were found in some follicles, which showed similar features morphologically with the granulosa cells of normal follicles. Macrophages were found both within the antrum and at the follicular granulosa layer. CONCLUSION: X-radiation induced follicular atresia by means of granulosa cell apoptosis, and radioresistant granulosa cells which have similar features morphologically with the granulosa cells of normal follicles were observed in some follicles. And the macrophages which phagocytose the apoptotic granulosa cells were located within the follicular antrum and at the follicular granulosa layer.

A Clinical Analysis of Severe PreeclamsiaHypertensive Disorders / 대한산부인과학회잡지

Traditionally, preeclamptic women who meet established criteria for severe disease aredelivered expeditiously. Although delivery is always appropriate thrapy for the mother, itmay not be for the fetus remote from term. The purpose of this investigation was to evaluatethe differences of pregnancy and neonatal outcome of severe preeclampsia and normalpregnancy, especially before 34 weeks gestational age, and to determine whether aggressiveor expectant management of severe preeclampsia before 34 weeks is more beneficial tomaternal and fetal outcome. A hundred and twenty consecutive pregnancies complicated bysevere preeclampsia and a hundred and twenty normal pregnancies were stuided.The results were as follows:1. The incidence of severe preeclampsia was 3.9%(130 of 3328). The 26~30 year oldage group was most common, 43%(52 patients).2. In case of study between severe preeclamptic patients and normal pregnant patient,there was no differences regarding gestational age at delivery, birth weight, cesarean sectionrate, incidence of RDS, perinatal death. The 1min/5 min Apgar scores of severe preeclampsiais significantly lower than control group(6/7 vs 7/8, p < 0.05). Neonates with SGA(small for gestational age) were found in 29% neonates of patients with severe preeclampsia,which is significantly higher than normal pregnancy group(6%, p < 0.05).3. There was no significant difference between expectant(n=10) and aggressive(n=21)management group less than 34 weeks gestation regarding the gestational age of admissionand delivery, blood pressure, proteinuria, serum creatinine, hemoglobin, hematocrit, pletelets,liver enzymes, and LDH. Only the prolongation of gestational age in the expectant managementgroup is significantly higher than in the aggressive management group(7 vs 2 days,p < 0.05).4. The neonatal and pregnancy outcome of expectant(n=10) and aggressive managementgroup(n=15) were as follow: The birth weight in the expectant management groupis lower than in the aggressive management group(1316.7+/-668.8g vs 1576.2+/-428.7 g, p < 0. 05). The incidence of SGA in the expectant management group is higher than in theaggressive management gorup(50% vs 27%, p=not significant). There was no significant differencebetween expectant and aggressive management group regarding the 1 min/ 5 minApgar score, the cesarean section rate, and the frequency of respiratory distress syndrome,cerebral hemorrhage, renal failure, sepsis, DIC of neonates.

The Efficacy of Cervicography in Cervical Cancer Screening / 대한산부인과학회잡지

Cervicography is an adjunct method of cervical cancer screenign intended to complement papanicolaou smear. Cervicography involves obtaing and evalutionag a photographic image of the cervix.the purpose of this investigation was to evalute the efficacy of cervicography in cervicla cancer screening. Papanicolaou smear and cervigram data were obtainde for 169 patients who visited Department of Obstetrics and Gynecology, Chungnam Nationa University Hospital form September 1995 to march 1996. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen.the resunt wre as follows:1. the sensitivity and the specificity of cervicography was 78.8% and 86.3% respcetively. 2. the positive predictive value, negative predictive value, false negative rate, and false positive rate of cervicography were 71.9%, 90.15%, 13.7%, 21,2% respectively. 3. The sensitivity and the specifictiy of Papanicolaou smear was 84.6% and 92.3% respectivesly. 4. the positivie predictive value, negative predictive value, false negative rate, and false positive rate of Papanicoloau smear were 83.0%, 93.1%, 7.7%, 15.4% respecitively. 5. There was no significant difference between the sensitiviey and the specificity of cervicography and Papanicolaou smear (p=0.449, p=0.139) 6. When cervicography and Papanicolaou smear were used donjointly, the sensitivity was higher than for cervicography or Papanicolaou smear used alone (96.1% vs 78.8% p= 0.008, 96.1% vs 86.3%. p=0.047) However the specificity of the combined tests was lower than Papanicicolaou smear(80.3% vs 92.3% p=0.008). Cervicography is a useful method to detect cevical cancer. Howerver when cervigrams are used in conjuction with Papanicolaou smear, the detection rate of cervical cancer will be increased.

The Efficacy of Cervicography in Cervical Cancer Screening / 대한산부인과학회잡지

Cervicography is an adjunct method of cervical cancer screenign intended to complement papanicolaou smear. Cervicography involves obtaing and evalutionag a photographic image of the cervix.the purpose of this investigation was to evalute the efficacy of cervicography in cervicla cancer screening. Papanicolaou smear and cervigram data were obtainde for 169 patients who visited Department of Obstetrics and Gynecology, Chungnam Nationa University Hospital form September 1995 to march 1996. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen.the resunt wre as follows:1. the sensitivity and the specificity of cervicography was 78.8% and 86.3% respcetively. 2. the positive predictive value, negative predictive value, false negative rate, and false positive rate of cervicography were 71.9%, 90.15%, 13.7%, 21,2% respectively. 3. The sensitivity and the specifictiy of Papanicolaou smear was 84.6% and 92.3% respectivesly. 4. the positivie predictive value, negative predictive value, false negative rate, and false positive rate of Papanicoloau smear were 83.0%, 93.1%, 7.7%, 15.4% respecitively. 5. There was no significant difference between the sensitiviey and the specificity of cervicography and Papanicolaou smear (p=0.449, p=0.139) 6. When cervicography and Papanicolaou smear were used donjointly, the sensitivity was higher than for cervicography or Papanicolaou smear used alone (96.1% vs 78.8% p= 0.008, 96.1% vs 86.3%. p=0.047) However the specificity of the combined tests was lower than Papanicicolaou smear(80.3% vs 92.3% p=0.008). Cervicography is a useful method to detect cevical cancer. Howerver when cervigrams are used in conjuction with Papanicolaou smear, the detection rate of cervical cancer will be increased.