Angiotensinogen, Thermolabile Methylenetetrahydrofolate Reductase and Factor V Gene Variants among Korean Women with Preeclampsia, as Risk Factors / 대한산부인과학회잡지

OBJECTIVE: To know the genotypic distributions of Angiotensinogen, Thermolabile Methylenetetrahydrofolate Reductase (MTHFR) and Factor V Gene Variants, suggested as risk factors of preeclampsia, among Korean Women. METHODS: 113 preeclampsia patients and 70 normotensive pregnancy controls were evaluated. DNA was extracted from peripheral leukocytes, then PCR and restriction by appropriate enzymes were done to identify the single nucleotide polymorphism. The genotypic distributions of preeclampsia and the control group were compared. RESULTS: Nineteen of 113 women with preeclampsia (17%) and 14 of 72 with nulliparous preeclampsia (19%) were heterozygous for the angiotensinogen T704C mutation, and 94 of 113 women with preeclampsia (83%) and 58 of 72 women with nulliparous preeclampsia (81%) were homozygous. While 7/70 (10%) were heterozygous, and 59/70 (84%) were homozygous for the T704C mutation among the control subjects. The frequency of the MTHFR T677 allele was 36% in the preeclamptic group and 38% in the control group, and TT homozygosity was found in 26 preeclamptic women (23%) and in 13 controls (19%). No women were homozygous or heterozygous for the factor V Leiden mutation. CONCLUSION: Angiotensinogen T704C mutation is associated with preeclampsia in the Korean population. There was no association between the thermolabile variant of MTHFR and risk of preeclampsia in our study population. We observed no factor V Leiden mutation. We also suggested that a person with angiotensinogen T704C mutation plus MTHFR C677T variant does not have more of an increased risk for preeclampsia than with angiotensinogen T704C mutation only.

The Expression of c-Src and Csk in the Human Endometrium During the Normal Menstrual Cycle / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to investigate the transcriptional expression and translational localization of c-Src and Csk, related to signal transduction of cell growth, differentiation, death, and DNA synthesis in the human endometrium during the normal menstrual cycle. METHODS: The specimens were obtained from the hysterectomized uterus and endometrial biopsies that showed no endometrial pathology. The mRNA level of c-Src and Csk were examined by RT-PCR and the expression of these proteins were confirmed by immunohistochemistry. RESULTS: The c-Src mRNA was strongly expressed at all phases, except in late secretory phase. The Csk mRNA was highly expressed at all phases. In stromal cells and glandular cells, immunohistochemical expression of c-Src protein was moderate in proliferative phase and was strong in the secretory phase. The expression of Csk protein was strong at all phases and more intensive in glandular cell than stromal cell. CONCLUSION: It is suggested that c-Src may play an important role in the signaling of the differentiation of the human endometrium and the Csk may modulate the c-Src kinase activity.

Interrelationship of ageing of human ovary and mitochondrial DNA deletion / 대한산부인과학회잡지

OBJECTIVE: The age-associated changes of mtDNA include nucleotide deletion, point mutations, as well as modifications. Age associated alterations of mtDNA occur in several different species; however, their physiological relevance remains unclear. The function of human ovary changes dramatically around the menopausal period. However, the mechanism of menopause and ovarian aging is not well understood. Thus, to study the regulatory mechanism of ovarian dysfunction by aging, the accumulation of mtDNA deletions in human ovaries from pre-menopausal and menopausal women was analyzed and compared with mtDNA deletions in myoma and myometriums of the same subjects. METHOD: Total DNA was extracted from these tissues, an part of mtDNA were amplified by polymerase chain reaction. The detailed locations of each of the deleted mtDNA regions were identified by sequencing. RESULT: Four types of mtDNA deletions were identified: a 4977 bp deletion, a 3805 bp deletion, a 7150 bp deletion, and a 5777 bp deletion. In ovaries, the occurrence of a 4977 bp deletion of mtDNA in menopausal women was significantly higher than that in pre-menopausal women, i.e., 62.5% of that in menopausal women and 20.0% of that in pre-menopausal women. In menopausal women, the occurrence of all of those four mtDNA deletions identified in this study in ovaries was higher than that in myomas and myometriums. CONCLUSION: A 4977 bp deletion of mtDNA between the ATPase 8 and ND5 genes in ovaries can be related to ovarian aging, especially during menopause. A 4977 bp deletion in ovaries of menopausal women can be a usuful marker of natural ovarian aging and may have a relationship to dysfunction of the ovarian aging. Three other mtDNA deletions identified in this study, a 3809 bp deletion, 7150 bp deletion, and 5777 bp deletion, was newly reported. A 5777bp deletion was found in a large amount in Korean women and further studies about this racial specificity will be needed.

Study for the Outcome of Mid-Trimester, Emergency Cervical Cerclage in Patients with Painless Dilatation of Cervix / 대한산부인과학회잡지

A retrospective study was conducted to evaluate the clinical outcomes of midtrimester emergency cervical cerclage in patients with painless cervical dilatation with/without prolapsed amniotic sac, including cases of no previous history of cervical incompetence. 10 patients including 1 twin pregnancy were teviewed for study, All had received emergency cervical cerclage with Macdonald operation or Shirodka operation at 18 to 31 weeksgestation. The procedures were carried out without serious complication except for one patient who had received re-operation 3 days after Macdonald operation because of re-protrusion of amniotic sae. The mean procedure to delivery internal was 8.9+/-5.3 (range 1 to 17) weeks. The mean gestational age at delivery was 32.4+/-5.6 (range 22 to 39+6) weeks for the entire group, 36.1+/-2.6 (range 32+4 to 39+6) weeks for the 6 who achived viability, and 27.6+/-5.0 (range 22 to 29+4) weeks for the 3 who died during the neonatal period. 1 died during gestation and was delivered at 33+6 weeksgestation. The mean birthweight was 2181.6+/-971.6 (range 498 to 3500)g for the entire group, and 2712.9+/- 571.5 (range 1860 to 3500)g for the 7 infants who lived until after neonatal period. The total survival rate for 11 babies was 64%. This study demonstrates that midtrimester emergency cervical cerclage for the patients who have dilated cervix with/without prolapsed amniotic sac is valuable method to try in the cases predicted they would lost the baby with conservative treatment only.

Serum Concentration of CA-125 during the First Trimester of Normal and Abnormal Pregnancies / 대한산부인과학회잡지

A prospective study was initiated to compare maternal serum concentration of CA-125 during the first trimester of normal and abnormal pregnancies. Serum specimens were obtained from 87 women with a normal intrauterine pregnancy and 47 women with abnormal pregnancies which were ended in spontaneo abortion or pathologically confirmed to be missed abortion. In normal pregnancies, the mean serum CA-125 concentrations were increased significantly from amenorhea 6 weeks (139.838.7 IU/ml), and were higher statistically than the values tested in the same weeks of abnormal pregnancies. In abnormal pregnancies serum CA-125 concentations were relatively lower than those of normal pregnancies. But these differences were not statistically significant except the values tested in amenorhea 6weeks. So serum levels of CA-125 may not be proved useful in monitoring of early pregnancies outcome.