A Case of Acute Pancreatitis of the Pregnancy / 대한산부인과학회지

Acute pancreatitis is a rarely occurred during pregnancy, with few reports in the literature addressing the problem. Pregnancy complicated by pancreatitis may lead to significant fetal and maternal morbidity and mortality. The disease occurs predominantly in later pregnancy, and rarely during the postpartum period. We report a case of acute alcoholic pancreatitis during pregnancy with a brief review of literature.

A Case of Lipid Cell Tumor of the Ovary / 대한산부인과학회잡지

Lipid cell tumors of the ovary are the rarest functional ovarian neoplasm, and malignant variants are unusual. Although rare, due to endocrinological activity, these tumors are of great clinical interest. Recently we experienced a case of lipid cell tumor of the right ovary in 21 years old female, who presented with menometrorrhagia and menorrhagia, and reported it with a brief review of literatures.

A Case of Juvenile Granulosa Cell Tumor / 대한산부인과학회잡지

Granulosa cell tumors costitute 1% to 2% of all ovarian tumors and occur mostly in adult women. Juvenile granulosa cell tumor (JGCT) differs from the adult type in clinical and pathologic features as well as biological behavior. Usually associated with estrogen production, the tumor leads to endocrinologic symptoms such as isosexual precocity in premenarcheal girl and menstrual irregularities or amenorrhea in postpubertal woman. JGCT is diagnosed in early stage with favorable prognosis in most cases while in more advanced stage with grave outcome. The clinical stage at the time of diagnosis is considered the most important prognostic factor. If fertility is desired in the absence of contralateral or pelvic involvement, unilateral salpingo- oophorectomy is justifiable. We experienced a case of JGCT in 22 years old woman who presented with amenorrhea and low abdominal pain, and report this case with a brief review of literatures.

A Case of Term Delivery in Heterotopic Pregnancy / 대한산부인과학회잡지

Heterotopic pregnancy is that intrauterine pregnancy is accompanied by a coexisting ectopic pregnancy. The incidence of this disease was very rare, but it has been increased considerably with increasing cases of assisted reproductive technologies and tubal injuries resulted from tubal surgery, endometriosis, and PID. These are prerequisites for diagnosis that close monitoring of early pregnancy including serial serum hCG level and transvaginal sonography. We experienced a case of term delivery in heterotopic pregnancy following natural conception, so report this case with brief review of literatures.

A Case of Primary Transitional Cell Carcinoma of the Ovary / 대한산부인과학회잡지

Primary ovarian transitional cell carcinoma (TCC) is extremly rare tumor and has been recently classified into the one of the histologic subtypes of ovarian epithelial cell carcinomas. Primary ovarian TCC has been proven to differ from malignant Brenner tumor (MBT) and TCC of the bladder for it's histologic characteristics as well as therapeutic and prognostic implications. TCC of the ovary has been also recognized to have excellent response to chemotherapy and favorable prognosis although it's aggressive properties. We experienced a case of primary ovarian TCC (stage: IIc) in 57 year old woman who presented with low abdominal pain and report this case with a brief review of the concerned literatures.

A Clinical Review of Midtrimester Amniocentesis / 대한산부인과학회잡지

OBJECTIVE: We performed this study to analyze the indications, distributions of maternal age and cytogenetic results of midtrimester amniocentesis and to determine the complications and risks of it. METHODS: This study was retrospectively reviewed 674 cases of midtrimester genetic amniocentesis from January 1997 to October 2001 in Kangdong Sacred Hospital, Hallym University. We analyzed the indications, distributions of maternal and gestational age, chromosomal results, and of which accorded to indications of cytogenetic studies. RESULTS: The indications of amniocentesis were abnormal maternal serum screening (46.2%), advanced maternal age (> OR =35: 44.8%), abnormal ultrasonographic findings (5.9%), familial history of fetal anomaly (2.8%) and previous history of fetal chromosomal abnormalities (0.3%), in order. The overall incidence of chromosomal aberration was 3.6% (24/674), which were composed of 18 cases of numerical aberrations and 6 cases of structural aberrations. In autosomal aberrations, there were 7 cases of Down's syndrome, 6 cases of Edward syndrome, 1 case of Patau syndrome and 3 cases of Mosaicism. In sex chromosomal aberration, there was a case of Turner syndrome. In chromosomal aberrations according to indications, there was 7.5% (3/40) of chromosomal abnormalities in abnormal ultrasonographic findings group, 3.2% (10/311) in abnormal maternal serum screening group and 3.0% (9/302) in advanced maternal age group. There was statistical significance only in abnormal ultrasonographic findings group. There was no significant complication after amniocentesis except 0.3% (2 cases) of fetal loss. CONCLUSION: Maternal serum screening, advanced maternal age and antenatal ultrasonograms should be important screening methods for amniocentesis which is considered to the most effective diagnostic procedure for prenatal cytogenetic studies. The karyotyping analysis of midtrimester amniocentesis is efficacious method for evaluation of chromosomal aberrations and genetic counselling for parents.

Cyclooxygenase-2 Expression and Angiogenesis in Invasive Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: A large body of evidence suggests that cyclooxygenase-2 (COX-2) is important in tumor growth and angiogenesis of gastrointestinal and other cancers. This was the study to determine the relationship between tumor vascularity and COX-2 expression in invasive cervical cancer. METHODS: We examined the expression of COX-2 and microvessel density (MVD) by immunohis- tochemical staining in 21 specimens collected from invasive cervical cancer patients. RESULTS: All specimens showed weak and strong immunoreactivity, with 52.4% strong reactivity. Microvessel count was higher (median 136) in the strong COX-2 immunoreactivity specimens than the weaks (median 90), and MVD was significantly correlated with the COX-2 immunoreactivity (P=0.002). CONCLUSION: These preliminary data indicate that overexpression of COX-2 may play an important role in carcinogenesis of cervical cancer and this could be partially attributable to modulation of angiogenesis by COX-2. COX-2 maybe a target for future research in the tumorigenesis of the invasive cervical cancer.

Clinical Evaluations of the Classical Intrafascial SEMM Hysterectomy (CISH) / 대한산부인과학회잡지

Objectives: We performed this study to review the clinical availability of the classical intrafascial SEMM hysterectomy (CISH), and report our experience for 2 years restrospectively. METHODS: From March 1999 to February 2001, 100 cases of CISH were performed at the Department of Obstetrics and Gynecology, College of Medicine, Kangdong Sacred Heart Hospital, Hallym university. We performed this procedure by 3 steps. The dissection of uterus was done by classical suture methods (including extracorporeal and intracorporeal suture techniques) to uterine isthmic portion. And then transvaginal cylindrical coring out of the cervical tissue was done using a cervix corer, the Calibrated Uterine Resection Tools (CURT) for resection of cervical tissue especially transformation zone. Finally, the dissected uterus was extracted by using a Serrated Edged Macro-Morcellator (SEMM) without colpotomy. We reviewed the patient's data retrospectively and made phone calls to each patients. RESULTS: The indications for CISH, based on the pre-and intraoperative diagnosis, were leiomyoma, adenomyosis, endometrial hyperplasia and chronic pelvic inflammatory disease or pelvic pain, in order of frequency. The mean operative time was 126 minutes and the mean hemoglobin change was 1.27 gm/dL. The mean hospital days were 5.7 days and the mean age of the patients was 44.6 years old. There were no definite intra- and postoperative complications except for 3 cases of CO2 retentions and 2 cases of delayed bleeding on cervical stump. The mean days to first sexual contact after surgery were 34.5 days. In view of sexual feeling, 86% of the patients didn't feel any difference and only 13% felt worse than before. During postoperative follow-up, the cervical cytologic study were found no endocervical cells at all of 44 checked patients. CONCLUSION: The CISH procedures can be safely performed by well-trained laparoscopists, and this technique minimally alters the anatomy and integrity of the pelvic floor and vagina. Therefore the reductions of surgical morbidity, blood loss, hospitalization and postoperatve discomfort were obtained. Through the preservation of the anatomical relations of the pelvic floor and the function of female sexuality, this technique is the new proposal in gynecologic surgery.

A Case of Heterotopic Pregnancy in Natural Cycle / 대한주산의학회잡지

No abstract available.

A Case of Tuberculous Peritonitis in Pregnancy / 대한산부인과학회잡지

The tuberculous peritonitis, especially in pregnancy, is very rare and difficult to diagnose since there is no diagnostic clue and limitation of diagnostic means. The clinical features may vary such as fever, chill, tachycardia, abdominal tenderness or rebound tenderness which are not controlled easily with antibiotics. It is possible to diagnose by AFB culture and biopsy through exploro-laparotomy which is done due to uncontrolled symptoms even to unstable vital signs. It's clinical symptoms and signs are dramatically improved with antituberculotic therapy. Recently we have experienced a case of tubeculous peritonitis at 29 weeks gestation which was diagnosed through exploro-laparotomy including cesarean section. So we report this case with a brief review of literature

The Study for Fetal Karyotyping of spntaneous Abortions on Early Pregnancy / 대한주산의학회잡지

No abstract available.

The Efficacy of Laparoscopic Surgery in the Treatment of Endometriosis, especially Deep Endometriosis / 대한산부인과학회잡지

OBJECTIVE: To evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis, we have studied 30 cases of deep endometriosis. Endometriosis is classified into superficial(5mm) and very deep(>10mm) endometriosis by the infiltration depth from the peritoneal surface. In the treatment of deep endometriosis, medical hormonal therapy is not effective, so surgical treatment is required. There are many difficulties in surgiacal treatment ; hard lesion to excise, ditsorted pelvic anatomy after excision, easy to damage to ureter and uterine artery, and limitation for potentially morbid procedure to whom wants to conceive. Especially laparoscopic surgery in the treatment of deep endometriosis is very difficult because it is impossible to know the depth by palpation. In deep endometriosis type II, the lesion is concealed due to rectal adhesion to cul de sac, uterosacral ligament and in type III, the lesion is regarded as a small lesion or missed due to invagination into pelvic floor. The authors compared the laparoscopic surgery with laparotomy to evaluate the efficacy of laparoscopic surgery in the treatment of deep endomtriosis. METHODS: Deep endometriosis, 30 cases out of 102 cases, which were histologically comfirmed as endometriosis were studied. The authors compared the laparoscopic surgery(15 cases) with laparotomy(15 cases) in the surgical treatment of deep endometriosis for operation procedure, operation time, hospital stay and symptoms improvement. RESULTS: The mean operation time of laparoscopic surgeries in deep endometriosis was 178.7(+/-43.1)min while type I, II and III in deep endometriosis took 148.5(+/-21.2)min, 162.0(+/-30.7)min and 245.0(+/-36.1)min respectively and took a little more time than laparotomy. Mean hospital stay in laparoscopic surgeries was 5.7(+/-1.8)days and laparotomy took 10.0(+/-2.3)days that was statistically significant. CONCLUSION: If patients are chosen adequately and operator's skills are satisfactory, laparoscopic surgery is very valuable in the treatment of deep endometriosis. More datas will be required to confirm the efficacy.

A Case of Primary Papillary Serous Carcinoma of the Peritoneum / 대한산부인과학회잡지

Primary papillary serous carcinoma of the peritoneum(PPSCP) is vere rare. It has been suggested that PPSCP derives from embryonal coelomic epithelium with m llerian ducts potential. PPSCP can develop from a single or multicentric focus. The clinical and histologic disease entities are similar to those of primary papillary serous carcinoma of the ovary, but PPSCP involves the ovarian surface only minimally(microscopic disease) or spares the ovaries entirely. We have experienced a case of primary papillary serous carcinoma of the peritoneum and report this case with brief review of the concerned literature.

Fetal Nuchal Translucency Measurement for Detection of Chromosomal Abnormalities in the First Trimester of High Risk Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To determine the value of sonographic nuchal translucency measurement for the detection of chromosomal abnormalities in high risk pregnancies. METHOD: The feasibility of nuchal translucency was tested in a prospective study of 1260 pregnancies at 10- 13 weeks' gestation. RESULTS: The nuchal translucency of 3 mm or greater was identified in 41 fetuses (3.2%), 19 of whom proved subsequently by either amniocentesis or postnatal follow-up have chromosomal abnormalities. The sensitivity of nuchal translucency for chromosomal abnormalities was 82.6% (19 of 23 cases), the positive predictive value of nuchal translucency for chromosomal abnormalities detection was 46.3% (19 of 41 cases). CONCLUSION: The observed sensitivity, false-positive rate and predictive value suggest that sonographic nuchal translucency should be undertaken at 10 to 13 weeks of gestation.

Management of Incompetent Cervix and Bulging Fetal Membrane by Modified Shirodkar Method / 대한산부인과학회잡지

Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.

A Case Using Misoprostol When Surgical Abortion Failed / 대한산부인과학회잡지

Suction curettage is a relatively safe procedure to induce abortion of first trimester pregnancy with a very low complication rate. But, in order to do that, cervix should be dilated enough to pass operating devices. We experienced a case of first trimester pregnancy terminated successfully using transvaginal misoprostol when suction curettage was failed due to severely cervical stenosis after LEEP conization.

Seventy cases of endoscopic surgery in gynecologic patients / 대한산부인과학회잡지

No abstract available.

Clinical significance of serum CA 125 in patients with pelvic masses / 대한산부인과학회잡지

No abstract available.

42 cases of pelvic scopic surgery / 대한산부인과학회잡지

No abstract available.

Comparison of ultrasonic study following transabdominal and transvaginal procedure between normal and abdominal pregnancy / 대한산부인과학회잡지

No abstract available.