Clinical efficiency of 50 g oral glucose challenge test, 75 g and 100 g oral glucose tolerance test for screening and diagnosis of gestational diabetes / 대한주산의학회잡지

OBJECTIVE: The purpose of this study was to compare the clinical efficiency of 75 g oral glucose tolerance test (OGTT) with those of 100 g OGTT for diagnosing gestational diabetes mellitus (GDM) after abnormal 50 g oral glucose challenge test (OGCT). METHODS: Data of 616 pregnant women delivered at Ewha Womans University Dongdaemoon hospital from January, 2003 to June, 2007 was reviewed and analyzed retrospectively. The positive diagnostic rate of GDM for the group resulted in the range of 130 and 140 mg/dl and in 140 mg/dl and higher on the 50 g OGCT group was analyzed. Pregnancy and fetal outcomes were compared for the women who showed positive results in the 75 g and 100 g OGTT. RESULTS: Of the 28 pregnant women whose results were in the range of 130 and 140 mg/dL on the 50 g OGCT, three women (10.7%) were diagnosed as GDM. Among women who showed the results of 140 mg/dL and higher, positive rate of GDM by 75 g OGTT (51.6%) was significantly higher than those by 100 g OGTT (31.6%) (p=0.047). The positive result group of 75 g and 100 g OGTT did not show significant differences in pregnancy and fetal outcomes except that BMI of 100 g OGTT positive group was more increased at early pregnancy (25.2+/-3.53 kg/m2 vs 22.9+/-3.26 kg/m2, p=0.043). CONCLUSION: 75 g OGTT may be a more convenient and useful tool in the diagnosis of GDM to protect for adverse outcomes in untreated gravidas with minimal hyperglycemia.

Analysis of chromosomal DNA aberrations in Korean cervical squamous cell carcinoma cell lines by CGH / 대한산부인과학회지

OBJECTIVE: Comparative genomic hybridization (CGH) is a new fluorescence in situ hybridization (FISH) technique to identify genomic aberrations in cancers. The purpose of this study was to analyze non-random chromosomal DNA aberrations involved in cervical squamous cell carcinoma cell lines from Korean women. METHODS: We analyzed non-random chromosomal DNA aberrations involved in cervical squamous cell carcinoma cell lines from Korean women, SNU-17, SNU-682, and SNU-902 using CGH. RESULTS: Chromosomal DNA gains of 5p, 5q22-q23, 8q11.2-q12, 14q21-qter, and 20 as well as chromosomal DNA losses of 21 were found frequently. Chromosomal DNA gains on chromosome 3q, 6P, 7p13-pter, 9p22-pter, 9q21-qter, 15q21-q22, 17q22-qter, 18p11.3-pter, 18q11.2-q21, 19p13.3-pter, 19q13.2-q13.3, and 22q12-qter, with losses on 4p14-pter, 10p11.2-p13 and 10q24 were observed in 2 of 3 cell lines. CONCLUSION: Non-random aberrations which were disclosed in this study might be candidate regions for the abnormal genes involved in the tumorigenesis of cervical squamous cell carcinomas. Datas about chromosomal aberrations of Korean squamous cell carcinoma cell lines in this study could afford very useful basic information for the development of diagnostic and therapeutic modalties targeting the abnormal genes associated with uterine cervical cancer in Korea.

Clinical Guidelines for Methotrexate in Conservative Treatment for Ectopic Pregnancy / 대한산부인과학회지

OBJECTIVE: To provide more useful guidelines for methotrexate (MTX) treatment in ectopic pregnancy, including patient selection, therapeutic dose, and reproductive outcome. METHODS: Retrospectively, records of 54 patients treated for ectopic pregnancy with systemic MTX were reviewed. MTX was administered 1.0 mg/kg intramuscularly, alternatively with leucovorin 0.1 mg/kg intramuscularly for up to four daily doses of each drug. Samples for beta-hCG detection were obtained on days +3, +7 after beginning of the therapy and then weekly until values were undetectable. RESULTS: 50 patients (92.6%) were treated successfully. 4 patients (7.4%) for whom MTX therapy failed, were treated surgically. The endometrial thickness significantly increased in the failed group, compared to the successful group (14.3+/-4.0 mm vs 7.0+/-2.8 mm, P=0.0001). The serum hemoglobin levels significantly changed in the failed group, compared to the successful group (2.1+/-0.9 g/dL vs 1.0+/-0.8 g/dL, P=0.044). Patients were divided into increasing group and decreasing group according to beta-hCG levels on day 0, that were higher or lower than day -2 level. The resolution time of beta-hCG between increasing group and decreasing group was significantly different (27.6+/-14.0 days vs 17.7+/-8.6 days, p=0.016). In 8 patients (15.1%), an immediate rise of beta-hCG was recorded on day 3 after MTX treatment, but on day 7, a rapid decrease was recorded. Women were treated with significantly different therapeutic dose of MTX according to initial level of serum beta-hCG (p=0.021). There were mild complications (12%). MTX treatment preserved the fallopian tube and thus preserved fertility (70%). CONCLUSION: Systemic MTX use with the dose according to initial level of serum beta-hCG is a safe and highly effective treatment in clinically stable ectopic pregnancy.