A Prospective Study of Comparison of Cervical Ripening with Oral vs Vaginal Misoprostol in Nulliparous Women / 대한주산의학회잡지

OBJECTIVE: To compare the safety and efficacy of oral misoprostol, vaginal misoprostol, and oxytocin-only users for cervix ripening and labor induction in nulliparous women. METHODS: Randomly selected 11 patients were orally administered 50 microgram of misoprostol at first and then 100 microgram every 4 hours and the other 9 patients were vaginally administered 25 microgram of misoprostol at first after then the same doses every 4 hours. They all were nulliparous women with Bishop score 6 or less. Another 19 patients were oxytocin only users for cervical ripening and labor induction, who were nulliparous women with Bishop score 6 or less, and reviewed these medical records retrospectively. RESULTS: There were no differences among these three groups in patient characteristics such as maternal age, gestational age, parity and initial Bishop score. In oral misoprostol group, it took shorter time to get Bishop score 8 or more and become effacement 60% or more than vaginal misoprostol group. On the contrary, in vaginal misoprostol group, it took shorter time to become full dilatation and deliver than oral misoprostol group. However there were no significant statistical differences between two groups in obstetric and neonatal outcomes. CONCLUSION: Oral and vaginal misoprostol are effective in cervical ripening but there were no significant statistical differences in perinatal outcomes. Among many regimens of misoprostol administration for cervix ripening in nulliparous women, there is no standardized method until now. More studies will be needed for safe application of this drug.

A case of solitary fibrous tumor arising from the vagina / 부인종양

Solitary fibrous tumor (SFT) arising from the vagina is a very rare benign stromal tumor, which has a well-demarcated margin and proliferation of spindle cells with the absence of any atypical features. Immunohistochemically, the cells are strongly positive for CD34. Surgical resection of the tumor is recommended as a definite treatment. Clinical courses of SFT are almost benign but long-term follow-up of SFT of the vagina have not been reported yet. We have experienced a case of solitary fibrous tumor arising from the vagina and report this case with a brief of literature.

Survivin and Bcl-2 expression in eutopic endometrium with and without endometriosis / 대한산부인과학회지

OBJECTIVE: To examine expression of survivin and Bcl-2 in eutopic endometrium with endometriosis and without endometriosis by immunohistochemical stain. METHODS: Expression of survivin and Bcl-2 was immunohistochemically investigated in eutopic endometrium with endometriosis (n=30, study group I; laparoscopy-proved endometriosis, study group II; adenomyosis) or without endometriosis (n=34, control group). The score of immunohistochemical staining was evaluated semi-quantitative method modified by Sinicrope and Lu. Statistical analyses was carried out using one-way ANOVA with Turkey test. RESULTS: Survivin expression was significantly higher in nucleus of glandular epithelium of eutopic endometrium with endomtriosis compared to that without endometriosis (p<0.05). Increased expression of Bcl-2 was found in glandular epithelium of eutopic endometrium with endometriosis than without endometriosis, but there was no significantly difference. CONCLUSION: Our findings suggest that increased survivin expression may contribute to survival of endometriosis. Moreover, survivin could play an important role in pathogenesis of endometriosis.

A case of mixed type large cell neuroendocrine carcinoma of the uterine cervix / 대한산부인과학회잡지

Neuroendocrine carcinomas of the uterine cervix are very rare cervical neoplasms. It has frequent distant metastasis at diagnosis and high recurrent rate against multimodality therapies such as surgery, chemotherapy and radiation therapy. In 1997, four categories of endocrine tumors of uterine cervix were recommended by the Cancer Committee of the College of American Pathologists and the National Cancer Institute. It has been suggested that infection of human papillomavirus and molecular biologic abnormalities in genomic level are causes of this disease. Although a lot of studies about this disease concerning therapies and prognostic factors have been reported, there is no standard therapeutic regimens because of low incidence and difficulties of histologic diagnosis, so further studies about this issues are required. We report a case of large cell neuroendocrine uterine cervical carcinoma treated with chemotherapy followed by surgery.