Moon Il Park

Computerized analysis of fetal heart rate parameters by gestational age

Objective: The aim of this study is to define the reference ranges for fetal heart rate (FHR) parameters according to gestational age, by determining the relationship between the FHR and gestational age using a computerized FHR analysis system. Methods: Using our own software developed by Hanyang University Hospital in Korea, non‐stress tests were performed for 20 min. FHR parameters for 6455 subjects were analyzed for various gestational groups; <25 weeks, 25–28 weeks, 29–32 weeks, 33–36 weeks, 37–40 weeks, and >40 weeks. Results. The FHR parameters were related to gestational age. The mean baseline FHR, signal loss, and fetal movements decreased significantly with gestation (P<0.0001). The variability and accelerations of FHR were highest for the 37–40 weeks gestational group (P<0.05). Conclusions: The results showed that overall, the differences in the FHR parameters between gestational groups were statistically significant, and the gestational age of the fetus should be considered when interpreting FHR patterns.

Laparoscopic appendectomy performed during pregnancy by gynecological laparoscopists

OBJECTIVE To evaluate the safety, feasibility, and pregnancy outcomes of laparoscopic appendectomy (LA) during pregnancy. STUDY DESIGN A retrospective review of eight pregnant women who underwent LA from January 2007 to December 2008. RESULTS The median age of the patients and median parity were 29.5 years (range, 25-34 years) and 0 (range, 0-1), respectively. The median operating time of LA was 22.5 min (range, 15-40 min). The median length of hospital stay was 3 days (range, 2-4 days). There was no maternal or fetal mortality or morbidity, conversion to laparotomy, or uterine injury. Seven women delivered seven healthy infants. One patient chose to have an elective abortion in another hospital. The histopathological diagnoses of the resected appendices were of acute appendicitis. CONCLUSION LA performed by gynecologic laparoscopists in pregnant women is safe, feasible, and effective.

Laparoscopic Ureteroureteral Anastomosis for Distal Ureteral Injuries during Gynecologic Laparoscopic Surgery

STUDY OBJECTIVE To estimate the feasibility and surgical outcomes of laparoscopic ureteroureteral for treatment of distal ureteral injuries. DESIGN Retrospective clinical study (Canadian Task Force classification II-2). SETTING University teaching hospital. PATIENTS Four women with ureteral transection or ureterovaginal fistula. INTERVENTION Laparoscopic ureteroureteral . MEASUREMENTS AND MAIN RESULTS Median age of patients was 44 (range, 33-63) years, and median operating time was 110 (range, 85-150) minutes. There were no conversions to laparotomy. No intraoperative or postoperative complications occurred. Follow-up ranged from 20 to 46 months. All patients have been asymptomatic, and follow-up intravenous pyelograms and ultrasound examinations have been normal. CONCLUSION Laparoscopic ureteroureteral anastomosis is an alternative surgical option in women with distal ureteral injuries during gynecologic laparoscopic surgery.

The characteristics of integrins expression in decidualized human endometrial stromal cell induced by 8-Br-cAMP in in vitro

Integrins are heterodimeric glycoproteins that have been found to undergo dynamic temporal and spatial changes in the endometrium during the menstrual cycle and in early pregnancy. Specificity of integrins is known to be different in human endometrial stromal cells and decidual cells. These shifts of integrins suggested to play an important role in embryo implantation and can be modulated by progesterone, cAMP derivatives, and cytokines. The mechanisms of decidualization and its precise physiological role are still not clearly understood and in vitro systems could provide an alternative that overcomes limitations of studying such complex biological phenomena in vivo at the time of implantation. This study was undertaken to establish an in vitro model system for human decidualization using 8-bromo-cAMP and to investigate the characteristics of stromal integrin expression in vitro by 8-Br-cAMP. Endometrial stromal cells were isolated and cultured, and then were induced to decidualize by 0.5 mM 8-Br-cAMP for 15 days. Immunofluorescence staining and flow cytometric analyses of the integrin subunits (α1, α4, α5, α6, β1 and αvβ3) were performed at day 9. In the presence of 8-Br-cAMP, the staining intensity of αvβ3 was significantly higher than control and measurements for α1, α4, α5, α6, and β1 were similar. Immunofluorescent localization of the integrins reflected the differences obtained from the flow cytometric analyses described above. In summary, the expression of αvβ3 integrin increased in stromal cells in vitro decidualized by 8-Br-cAMP and this up-regulation of αvβ3 integrin expression during decidualization might influence on human implantation.

Estimates of induced abortion in South Korea: Health facilities survey

Aim:  The aim of this study was to estimate the national rates of induced abortion in South Korea, where no quantitative national studies of abortion exist because the procedure is illegal.

The correlation of pregnancy complications with C3/C4 levels, anti-dsDNA titers, and autoimmune target testing in gravidas with systemic lupus erythematosus

THE CORRELATION OF PREGNANCY COMPLICATIONS WITH C3/C4 LEVELS, ANTI-DSDNA TITERS, AND AUTOIMMUNE TARGET TESTING IN GRAVIDAS WITH SYSTEMIC LUPUS ERYTHEMATOSUS Il Dong Kim, MD, Ra Hyun Kim, MD, Gui Un Kang, MD, Sung Ah Jin, MD, Hye Jin Lee, MD, Jeong Kyu Hoh, MD, Ho Sun Chang, MD, Kyung Jin Hwang, MD, Moon Il Park, MD Department of Obstetrics and Gynecology, Grace Womens Hospital, Goyang; Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Korea

Histologic disappearance of locally advanced vaginal cancer after combination chemotherapy

Clinically and histologically complete disappearance of local tumor and pelvic sidewall involvement was achieved in a patient with primary advanced squamous cell carcinoma of the vagina administered combination chemotherapy prior to operation. Radical hysterectomy, total vaginectomy, bilateral salpingo-oophorectomy, bilateral pelvic lymphadenectomy, and paraaortic lymph node biopsy were performed after seven courses of combination chemotherapy with vinblastine, bleomycin, and cis-platinum. This encouraging result warrants further investigation of combination chemotherapy in other patients.