K.J. Hwang

Effects of Low Oxygen Condition on the Generation of Reactive Oxygen Species and the Development in Mouse Embryos Cultured in vitro

Objective(s): To elucidate the relationship between intracellular H2O2 production and embryo development in different oxygen culture conditions.

Conservative therapy of adnexal torsion employing color doppler sonography

STUDY OBJECTIVE To ascertain if color Doppler sonography (CDS) can detect viability of adnexa in torsion. DESIGN Concurrent, nonrandomized study (Canadian Task Force classification II-2). SETTING Tertiary medical care center in a university hospital. PATIENTS Twenty-seven women suspected of having torsion of the ovary in which a benign tumor was present. INTERVENTIONS Color Doppler sonography of the ovarian pedicle suggested torsion. Laparoscopy or laparotomy was performed in 19 patients and confirmed the diagnosis. MEASUREMENTS AND MAIN RESULTS We identified a twisted vascular pedicle of the ovarian tumor by CDS in 24 (88%) of 27 women. Pedicle arterial and venous blood flow was observed in 10 women; pathology specimens revealed normal tissue, edema with congestion, or early hemorrhage. In all nine in whom only arterial blood flow or no blood flow was observed, pathology revealed hemorrhagic necrosis. In five women with arterial and venous blood flow the tumor was managed conservatively, either by detorsion or cystectomy, after which no embolism or tumor recurrence was seen at follow-up ultrasonography. Normal follicular development and ovulation occurred in these patients. CONCLUSION For women of childbearing age in whom torsion of benign adnexal tumors is suspected, CDS should be performed to confirm the diagnosis and ascertain whether or not pedicle arterial and venous blood flow is present. If such blood flow is detected, the adnexa is considered to be viable and detorsion or cystectomy may be performed, thus preserving the ovary. It is recommended that further studies with a larger group be undertaken to provide a basis for statistical analysis.

O-047 Conservative therapy of adnexal torsion employing color doppler sonography

Study Objective. To ascertain i f color Doppler sonography (CDS) can detect viability of adnexa in torsion. Design. Concurrent, nonrandomized study (Canadian Task Force classification 11-2). Setting. Tertiary medical care center in a university hospital. Patients, Twenty-seven women suspected of having torsion of the ovary in which a benign tumor was present. Interventions. Color Doppler sonography of the ovarian pedicle suggested torsion. Laparoscopy or laparotomy was performed in 19 patients and confirmed the diagnosis. Measurements and Main Results. We identifed a twisted vascular pedicle of the ovarian tumor by CDS in 24 (88%) of 27 women. Pedicle arterial and venous blood f low was observed in 10 women; pathology specimens revealed normal tissue, edema with congestion, or early hemorrhage. In all nine in whom only arterial blood f low or no blood f low was observed, pathology revealed hemorrhagic necrosis. In five women with arterial and venous blood f low the tumor was managed conservatively, either by detorsion or cystectomy, after which no embolism or tumor recurrence was seen at follow-up ultrasonography. Normal follicular development and ovulation occurred in these patients. Conclusion. For women of childbearing age in whom torsion of benign adnexal tumors is suspected, CDS should be performed to confirm the diagnosis and ascertain whether or not pedic/e arterial and venous/~/ood f low is present. I f such blood f low is detected, the adnexa is considered to be viable and detorsion or cystectomy may be performed, thus preservin~ the ovary. It is recommended that further studies with a larger group be undertaken to provide a basis for statistical analysis. (l Am Assoc Gynecol Laparosc 5(1):13-17, 1998) Tors ion of uter ine adnexa accounts for approximate ly 2.7% of all gyneco log ic emergenc ie s and may be a rare but impor tant e t io logy of acute a b d o m i n a l pain ~ as first reported by J, B land Sut ton in 1890. In adnexal torsion the ovary and ipsilateral fal lopian tube twist with the pedicle as the axis, thereby b lock ing From the Departments of Obstetrics and Gynecology (Drs. Chang, Hwang, Kwon. Yoo, Ryu, and Oh) and Radiology (Dr. Lee), Ajou University School of Medicine. Suwon, Korea. Address reprint requests to Ki-Hong Chang, M.D., Department of Obstetrics and Gynecology, Ajou University School of Medicine, 5 Wonchon dong, Paldal-ku, Suwon, Korea 112-749; fax 082 331 219 5250. CTF II-2: Evidence obtained from well-designed cohort or case control studies, preferably from more than one center or research group.

Effect of insemination timing on pregnancy outcome in association with female age, sperm motility, sperm morphology and sperm concentration in intrauterine insemination

We investigated the effect of insemination timing on pregnancy outcomes in intrauterine insemination (IUI) cycles.

P-409: Role of ERK (Extracellular signal regulated kinas) and PPARγ (Peroxisome proliferator-activated receptor gamma) on TGF-β1 induced human endometrial stromal cell decidualization

Role of ERK (Extracellular Signal Regulated Kinas) and PPARγ (Peroxisome Proliferator-Activated Receptor Gamma) on TGF-β1 Induced Human Endometrial Stromal Cell Decidualization Hye Jin Chang, Jae Hoon Lee, Mi Ran Kim, Kyung Joo Hwang, Dong Wook Park, Churl K. Min 1Department Molecular Science and Technology, 2Department of Obstetrics and Gynecology, School of Medicine, Ajou University, Suwon, Korea

OC014: Clinical significance of sonographic findings in placenta previa with prior Cesarean section

Objective: To evaluate the efficacy of intraplacental lacunae by transvaginal sonography in diagnosing the placenta accreta and increta and the prediction of clinical outcome. Methods: Forty-seven patients delivered in our hospital with history of cesarean section, diagnosis of placenta previa totalis by transvaginal sonography, and postpartum placental pathology were included in the study. Intraplacental lacunae were classified into 4 different grades from 0 to 3 by the degree (HJ Finberg, 1992). Placental pathology was done to all the patients delivered, and in case of hysterectomy, pathologic examination of removed uterus was also performed.Then they were compared with antepartum sonographic findings. Results: The lacunae was found in 8 cases with grade 1, 11 cases with grade 2, 5 cases with grade 3, and they were not showed in 23 cases. Sensitivity, specificity, positive predictive value, and negative predictive value of diagnosing placenta accreta above grade 1 lacunae were 79.2%, 87.0%, 86.4%, and 80%, respectively. When the pathologic diagnosis of placenta and removed uterus were placenta increta or percreta, all sonographic findings were above grade 2 lacunae. Sensitivity, specificity, positive predictive value, and negative predictive value of diagnosing placenta increta with lacunae above grade 2 were 93.8%, 100%, 100%, and 96.9%. Hysterectomy was performed to 17 cases, among them, 1 case showed grade 1 lacuna, 11 cases showed grade 2 lacunae, and 5 cases showed grade 3 lacunae. Without lacunae, no hysterectomy was done. Comparing the absence of lacunae or grade 1 lacunae, the relative risks of cesarean hysterectomy was 17 folds in the above grade 2 lacunae. Conclusions: Lacunar findings of transvaginal ultrasonography in patients with placenta previa totalis and history of cesarean section are very usefulness for diagnosis of placenta accreta and increta. These might be used as a valuable clinical prognostic marker.