ABSTRACT
PURPOSE: Adiponectin and resistin are potent regulators of glucose homeostasis and energy metabolism. In this study, we aimed to determine (1) the role of gestational diabetes (GDM) and pregnancy-induced hypertension (PIH) on the plasma levels of adiponectin and resistin in cord blood, and (2) the association of the hormones with anthropometric parameters at birth. METHODS: This study investigated 80 pregnant women at 26-41 weeks of gestation, including 46 healthy pregnant woman as controls; 14 women with GDM; and 20 women with PIH, and 80 newborn infants (36 male, and 44 female). The following anthropometric measurements were obtained: maternal weight, length, body mass index (BMI), neonatal birth weight, neonatal length, and ponderal index. Cord blood samples were obtained from 80 neonates at the time of delivery. Plasma adiponectin levels (RIA) and resistin levels (ELISA) were measured. RESULTS: Adiponectin levels were significantly lower in the fullterm group with GDM and fullterm group with PIH than the control group. Plasma resistin levels were significantly lower in the preterm and the fullterm groups with PIH than in the control group, and significantly higher in the fullterm group with GDM than in the PIH group. Similarly, adiponection was significantly lower in large for gestational age (LGA) infants than appropriate gestational age (AGA) and small for gestational age (SGA) infants, and resistin was significantly higher in LGA infants than in SGA infants. Adiponectin levels were negatively correlated with ponderal index, maternal HbA1c, and maternal body mass index (BMI). Plasma resistin levels were positively correlated with birth weight and maternal BMI. CONCLUSION: Alteration of adiponectin and resistin levels in cord blood of fetuses of women with GDM and PIH may influence the development of metabolic disorders at all stages of development.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Adiponectin , Birth Weight , Body Mass Index , Diabetes, Gestational , Energy Metabolism , Fetal Blood , Fetus , Gestational Age , Glucose , Homeostasis , Hypertension, Pregnancy-Induced , Parturition , Plasma , Pregnancy Complications , Pregnant Women , ResistinABSTRACT
PURPOSE: Adiponectin and resistin are potent regulators of glucose homeostasis and energy metabolism. In this study, we aimed to determine (1) the role of gestational diabetes (GDM) and pregnancy-induced hypertension (PIH) on the plasma levels of adiponectin and resistin in cord blood, and (2) the association of the hormones with anthropometric parameters at birth. METHODS: This study investigated 80 pregnant women at 26-41 weeks of gestation, including 46 healthy pregnant woman as controls; 14 women with GDM; and 20 women with PIH, and 80 newborn infants (36 male, and 44 female). The following anthropometric measurements were obtained: maternal weight, length, body mass index (BMI), neonatal birth weight, neonatal length, and ponderal index. Cord blood samples were obtained from 80 neonates at the time of delivery. Plasma adiponectin levels (RIA) and resistin levels (ELISA) were measured. RESULTS: Adiponectin levels were significantly lower in the fullterm group with GDM and fullterm group with PIH than the control group. Plasma resistin levels were significantly lower in the preterm and the fullterm groups with PIH than in the control group, and significantly higher in the fullterm group with GDM than in the PIH group. Similarly, adiponection was significantly lower in large for gestational age (LGA) infants than appropriate gestational age (AGA) and small for gestational age (SGA) infants, and resistin was significantly higher in LGA infants than in SGA infants. Adiponectin levels were negatively correlated with ponderal index, maternal HbA1c, and maternal body mass index (BMI). Plasma resistin levels were positively correlated with birth weight and maternal BMI. CONCLUSION: Alteration of adiponectin and resistin levels in cord blood of fetuses of women with GDM and PIH may influence the development of metabolic disorders at all stages of development.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Adiponectin , Birth Weight , Body Mass Index , Diabetes, Gestational , Energy Metabolism , Fetal Blood , Fetus , Gestational Age , Glucose , Homeostasis , Hypertension, Pregnancy-Induced , Parturition , Plasma , Pregnancy Complications , Pregnant Women , ResistinABSTRACT
PURPOSE: We wanted to evaluate the effect of high dose involved field radiotherapy and concurrent chemotherapy for treating patients with limited disease, small cell lung cancer. MATERIALS AND METHODS: We reviewed the medical records of 37 patients who had a limited stage of small cell lung cancer. All the patients were treated with induction chemotherapy followed by definitive radiotherapy and concurrent chemotherapy. The radiation dose was 60 Gy for 31 patients and 50~58 Gy for 6 patients with once-daily 2 Gy fractions. Elective nodal irradiation was not performed. The chemotherapy regimen was either combinations of etoposide and cisplatin or irinotecan and cisplatin. Prophylactic cranial irradiation of 25 Gy at 2.5 Gy per fraction was administered to the patients who had a complete or near complete response. The median follow-up period was 17 months (range, 5~57). RESULTS: The 2-year overall survival and locoregional control rates were both 55%. A complete response was achieved in 17 patients (46%), a partial response was achieved in 19 patients (51%) and 1 patient (3%) had progressive disease. Seven patients experienced tumor recurrence in the radiation field and four of those recurrences were isolated local recurrences. There was only one isolated regional recurrence outside the radiation field. Grade 3 treatment-related esophageal toxicity occurred in 2 patients. Two patients died of treatment-related pulmonary complications. CONCLUSION: Involved field radiotherapy of 60 Gy can achieve favorable survival and a low rate of isolated nodal failure outside the radiation field. However, a considerable number of patients still experienced in-field failure. Further studies to establish the optimal radiation doses and fractionation are needed in the future.
Subject(s)
Humans , Camptothecin , Cisplatin , Cranial Irradiation , Etoposide , Follow-Up Studies , Induction Chemotherapy , Lung , Medical Records , Recurrence , Small Cell Lung CarcinomaABSTRACT
PURPOSE: This study was performed to retrospectively analyze patient survival by weighting according to the primary tumor oncotype in 160 patients with brain metastasis and who underwent whole brain radiotherapy. MATERIALS AND METHODS: A total of 160 metastatic brain cancer patients who were treated with whole brain radiotherapy of 30 Gy between 2002 and 2008 were retrospectively analyzed. The primary tumor oncotype of 20 patients was breast cancer, and that of 103 patients was lung cancer. Except for 18 patients with leptomeningeal seeding, a total of 142 patients were analyzed according to the prognostic factors and the Recursive Partitioning Analysis (RPA) class. Weighted Partitioning Analysis (WPA), with the weighting being done according to the primary tumor oncotype, was performed and the results were correlated with survival and then compared with the RPA Class. RESULTS: The median survival of the patients in RPA Class I (8 patients) was 20.0 months, that for Class II (76 patients) was 10.0 months and that for Class III (58 patients) was 3.0 months (p<0.003). The median survival of patients in WPA Class I (3 patients) was 36 months, that for the patients in Class II (9 patients) was 23.7 months, that for the patients in Class III (70 patients) was 10.9 months and that for the patients in Class IV (60 patients) was 8.6 months (p<0.001). The WPA Class might have more accuracy in assessing survival, and it may be superior to the RPA Class for assessing survival. CONCLUSION: A new prognostic index, the WPA Class, has more prognostic value than the RPA Class for the treatment of patients with metastatic brain cancer. This WPA Class may be useful to guide the appropriate treatment of metastatic brain lesions.
Subject(s)
Humans , Brain , Brain Neoplasms , Breast Neoplasms , Lung Neoplasms , Neoplasm Metastasis , Retrospective Studies , Seeds , Survival AnalysisABSTRACT
PURPOSE: To report on the changes in the patterns of care and survival over time for esthesioneuroblastoma. MATERIALS AND METHODS: We retrospectively analyzed 42 previously untreated and histologically confirmed esthesioneuroblastoma patients seen between March 1989 and June 2007. According to Kadish's classification, 3 patients (7%) were stage A, 6 (14%) at stage B, and 33 (79%) at stage C. Of the 33 Kadish C patients, 19 and 14 patients were treated from 1989 through 2000 and from 2001 through 2007, respectively. Treatment included surgical resection, radiotherapy, chemotherapy, or a combination of these methods. Chemotherapy was administered to 8 of 19 patients (42%) seen from 1989 through 2000, whereas all of the 14 patients seen from 2001 through 2007 received chemotherapy (p<0.001). No patient was treated by three-dimensional conformal radiotherapy (3D-CRT) from 1989 through 2000, however 8 of 14 patients (67%) seen from 2001 through 2007 underwent 3D-CRT (p<0.001). The median follow-up time for surviving patients was 6.5 years (range, 2.2~15.8 years). RESULTS: The 5-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 53% and 39%, respectively. The 5-year OS was 100% for Kadish stages A or B and 39% for stage C (p=0.007). For patients with stage C disease who were treated from 1989 to 2000 and from 2001 to 2007, the 5-year OS rate was 26% and 59% (p=0.029), respectively and the corresponding 5-year PFS rate was 16% and 46% (p=0.001), respectively. Intraorbital extension and treatment era (1989~2000 vs. 2001~2007) were found as independent factors for OS and PFS in a multivariate analyses. CONCLUSION: The results of this study suggest that treatment era, which features a distinction in treatment modality and technique with the introduction of 3D-CRT, may be the cause of improved OS and PFS in Kadish stage C patients. To achieve better outcomes for patients with Kadish stage C, combined chemoradiotherapy, especially 3D-CRT, is recommended in addition to surgery.
Subject(s)
Humans , Chemoradiotherapy , Cohort Studies , Disease-Free Survival , Esthesioneuroblastoma, Olfactory , Follow-Up Studies , Multivariate Analysis , Prognosis , Radiotherapy, Conformal , Retrospective StudiesABSTRACT
BACKGROUND: Intravenous hypnotics are used in pregnancy, labor and delivery. The aim of the present study was to investigate and compare the relaxant effects of propofol, thiopental, ketamine, and etomidate on isolated rat uterine smooth muscles. METHODS: Uterine smooth muscle preparations were obtained from non-pregnant female rats. The uterus of the rat was dissected and cut into 10 mm strips. The muscle strips were bathed in Krebs solution. After spontaneous uterine contractile activity had been accomplished, propofol, ketamine, thiopental, and etomidate in various concentrations were added cumulatively to the baths and resting tension, active tension, and frequency of contration were recorded at each concentration of agents. EC(5), EC(25), EC(50), EC(75), and EC(95) of each drug on active tension and frequency of contraction were calculated using a probit model. RESULTS: Propofol, thiopental, and etomidate reduced uterine contractions in a concentration-dependent manner. Ketamine concentrations of 10(-7) to 10(-5) M augmented uterine contractions but ketamine concentrations of 10(-4) to 10(-3) M attenuated uterine contractions. The EC(50)'s of propofol, thiopental, ketamine, and etomidate on active tension were 1.56 x 10(-5) M, 4.97 x 10(-5) M, 3.52 x 10(-4) M, and 2.73 x 10(-5) M, respectively. CONCLUSIONS: All four intravenous hypnotics relaxed the uterine smooth muscle of rats except for ketamine in low concentrations (10(-7) to 10(-5) M). Propofol had the greatest relaxant effects on isolated rat uterine smooth muscle among these hypnotics. It seems that ketamine is a suitable obstetric hypnotic agent for hypovolemic parturients and propofol is a useful hypnotic agent for uterine relaxation during pregnancy.
Subject(s)
Animals , Female , Humans , Pregnancy , Rats , Baths , Contracts , Etomidate , Hypnotics and Sedatives , Hypovolemia , Isotonic Solutions , Ketamine , Muscle, Smooth , Muscles , Propofol , Relaxation , Thiopental , Uterine Contraction , UterusABSTRACT
OBJECTIVE: Burch operation has been effective method for the treatment of stress incontinence. Burch operation is a well-accepted procedure for treating stress urinary incontinence secondary to urethral hypermobility without intrinsic sphincter deficiency and is the reference standard with which other procedures are compared. This study is to evaluate the effectiveness of the Choi's hook in laparoscopic Burch operation. METHODS: This study included 47 patients who had undergone laparoscopic Burch operation from October 2000 through March 2005. Of these 47 patients, 27 patients underwent traditional laparoscopic Burch operation (Group 1) and 20 patients underwent laparoscopic Burch operation with Choi's Hook on anchoring the endopelvic fascia to the Cooper's ligament (Group 2). RESULTS: The mean age of patients of Group 1 was 55.6+/-9.37 years of age and that of Group 2 was 56.0+/-5.93 years of age. There is no difference in the mean age of patients (P>0.05). The mean operating time was 90.5+/-15.32 minutes for Group 1 and 38.5+/-10.14 minute for Group 2. The mean operating time was shorter in Group 2 than Group 1 (P0.05). CONCLUSION: We performed laparoscopic Burch operation with the Choi's Hook on anchoring the endopelvic fascia to the Cooper's ligament. When we compared traditional laparoscopic Burch operation with laparoscopic Burch operation with Choi's Hook, we could shorten the operation time using the Choi's Hook.
Subject(s)
Humans , Fascia , Ligaments , Recurrence , Urinary IncontinenceABSTRACT
BACKGROUND: It has been reported that nitroglycerin relaxes not only vascular smooth muscle but also uterine smooth muscle. The aim of the present study was to investigate the effect of nitroglycerin on rat uterine contractile activity in vitro. The effects of nitroglycerin on myometrial spontaneous activity and oxytocin-induced contractions were also observed. METHODS: Uterine smooth muscle tissues were obtained from non-pregnant female rats (n = 21). The uterine segments were mounted in tissue baths. After spontaneous or oxytocin-induced activity had been accomplished, nitroglycerin in various concentrations was added to the bath and the effects were continuously registered. RESULTS: Nitroglycerin induced a dose-dependent inhibition of spontaneous as well as oxytocin-induced myometrial contractile activity. Complete muscular relaxation on spontaneous contractility was obtained at a concentration of 50 microgram/ml. Complete muscular relaxation on oxytocin-induced contractility was obtained at a concentration of 75 microgram/ml. CONCLUSIONS: Nitroglycerin inhibited the uterine contractile response to exogenous oxytocin as well as spontaneous in the estrous rat.
Subject(s)
Animals , Female , Humans , Rats , Baths , Muscle, Smooth , Muscle, Smooth, Vascular , Nitroglycerin , Oxytocin , RelaxationABSTRACT
TTP is a thrombotic microangiopathy not unique to pregnancy and with the increasing incidence in reproductive aged women. The estimated incidence is around one case per million people, sixty percent of the cases occur in women, the median age of onset is 35 years. Pregnancy is a predisposing factor of TTP and may be an inciting state for relapse. TTP usually develops during the antepartum, the mean gestational age of onset of the symptoms is 23.5 weeks, and 58% of patients initially present at or before 24 weeks of gestation. This report was a case of 36 years old mother who was performed cesarean-section at 31 weeks gestational age because of severe preeclampsia. Febrile sensation, convulsion, comatous mentation abruptly developed after cesarean section and we diagnosed TTP. The patient recovered after she was treated with plasmapheresis for 7 days. We recently experienced a unique case of TTP, which was diagnosed after cesarean delivery, because it overlapped with symptoms and thus report this case.
Subject(s)
Adult , Female , Humans , Pregnancy , Age of Onset , Causality , Cesarean Section , Gestational Age , Incidence , Mothers , Plasmapheresis , Pre-Eclampsia , Purpura, Thrombotic Thrombocytopenic , Recurrence , Seizures , Sensation , Thrombotic MicroangiopathiesABSTRACT
Fentanyl is an opiate-like, pain-killing drug. It was found in the 1950s and prescribed from the 1960s. Fentanyl shows its effect by acting on opiate-like receptors. This case was a case of a 24-year-old primiparous woman who was referred from local clinic due to fetal pleural effusion in the left lung on antenatal ultrasonographic examination at 32 weeks of gestational age. The amount of pleural effusion increased and fetal heart deviated to the right side. We injected fentanyl 2 microgram intramuscularly into the fetal left thigh under ultrasound-guide for fetal anesthesia at 34 weeks of gestational age. After 5 minutes, we inserted 22 gage spinal needle to the left pleural cavity and aspirated 50 mL pleural fluid under ultrasound-guided. After aspiration, follow-up was performed oat one week interval and there was no more pleural fluid until delivery. At gestational age 41 weeks, the fetus was delivered vaginally as a 3.2 kg, healthy male baby. This is a case of fentanyl injection to fetus as a fetal anesthesia during thoracentesis for fetal pleural effusion at gestational age 34 weeks, we think that fentanyl is useful drug for fetal anesthesia.
Subject(s)
Female , Humans , Male , Young Adult , Anesthesia , Avena , Fentanyl , Fetal Heart , Fetus , Follow-Up Studies , Gestational Age , Lung , Needles , Pleural Cavity , Pleural Effusion , ThighABSTRACT
OBJECTIVE: The objective of this study was to determine relationship between alteration of expression of E-cadherin, beta-catenin and tumor progression, clinical stage, lymph node metastasis, age of patients with uterine cervical cancer. METHODS: The authors evaluated the immunohistochemical expression pattern of E-cadherin and beta- catenin in relationship with tumor stage and clinicopathologic parameters in 71 cervical neoplasia including 36 cases of squamous cell carcinoma (SCC), 10 cases of microinvasive SCC, 22 cases of squamous cell carcinoma in situ, and 3 cases of severe dysplasia. RESULTS: There were aberrant expression in 76.1% of E-cadherin (54 of 71) and 74.6% of beta-catenin (53 of 71) in the cervical cancer. There was positive correlation of aberrant expression of E-cadherin with tumor progression and clinical stage (<0.005). There was positive correlation of aberrant expression of beta- catenin with tumor progression and clinical stage (<0.005). CONCLUSION: These results suggest that the degree or the pattern of E-cadherin, beta-catenin, and E-cadherin/beta-catenin complex may be related to histologic grade and clinical stage of uterine cervical cancer.
Subject(s)
Female , Humans , beta Catenin , Cadherins , Carcinoma, Squamous Cell , Cervix Uteri , Lymph Nodes , Neoplasm Metastasis , Uterine Cervical NeoplasmsABSTRACT
PURPOSE: This study was undertaken to review the clinical and hematologic findings of the preterm infants delivered from pregnancy induced hypertension(PIH) mothers. METHODS: The data were collected by reviewing the medical records on the current prognosis of preterm birth and sending questionnaires on the status of NICU. We reviewed the medical records from two university hospitals and two resident training hospitals in Gwangju-Chonnam to evaluate the neonatal prognosis of preterm birth from Jan. 1, 1995 to Dec. 31, 1997. RESULTS: The average survival rate of total preterm babies was 79.6%. According to birth weights, survival rate from less than 1,000 gm was 10%, 1,000-1,499 gm was 55.3%, 1,500-1,999 gm was 82.2%. Maternal risk factors were pretmature rupture of membrane(42.2%), preterm labor (21.3%), PIH(10.7%), multiple pregnancy(8.2%) and incompetent internal os of cervix(4.2%). The average gestational age and birth weight were 34.2+/-2.3 weeks and 1,940+/-620 gm in the preterm infants born to mothers with PIH. The death rate was 12.9% in the preterm infants born to mothers with PIH. There were no significant differences in the incidence of RDS, use of assisted ventilation and surfactant, and frequency of the blood transfusion between the preterm infants born to normotensive mothers and those to mothers with PIH. There were significant differences in the total WBC count, platelet count and the concentration of the Mg, Ca and P between the preterm infants born to normotensive mothers and those to mothers with PIH. CONCLUSION: Our results may be helpful to predict the perinatal complications and manage the preterm infants by considering the clinical and hematologic findings of preterm infants born to mothers with PIH.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , Blood Transfusion , Gestational Age , Hospitals, University , Hypertension, Pregnancy-Induced , Incidence , Infant, Premature , Medical Records , Mortality , Mothers , Obstetric Labor, Premature , Platelet Count , Premature Birth , Prognosis , Surveys and Questionnaires , Risk Factors , Rupture , Survival Rate , VentilationABSTRACT
No abstract available.
Subject(s)
Female , Pregnancy , Apoptosis , Hypertension, Pregnancy-Induced , PlacentaABSTRACT
Acardiac twin is a rare complication of multifetal gestation occurring in 1% of monozygotic twin pregnancies and 1 of 35,000 pregnancies. Acardia shows various other defects in addition to the absence of heart and the most common form is the acardius, acephalus, in which there is an absence of the fetal head and thoracic organs. The presence of an acardiac twin requires the normal (or "pump") twin to provide circulation for itself, as well as the acardiac (or "perfused") sibling. The mortality is 100% for the acardiac or perfused twin and for pump twin is about 50%, resulting from heart failure, prematurity, or cord entanglement. We report two cases of acardiac anomalies at 32 weeks gestation in 30 year-old primigravida woman and 26 weeks gestation in 30 year-old multigravida. A brief review of the literature is included.
Subject(s)
Adult , Female , Humans , Pregnancy , Head , Heart , Heart Failure , Mortality , Siblings , Twins, MonozygoticABSTRACT
the ineidence of abdominal subcutaneous endometriosis is quite rare we have experienced one case of subcutaneous endometriosis. The typical clinical bistory and local findings of endometriasis enabk us to make the conect diagnosis. the treatment of choice is complete surgical excision of endometrial tissue and post operative medical therapy. This case was reported with a brief review of the comcemed literatures.
Subject(s)
Female , Diagnosis , Endometriosis , Subcutaneous TissueABSTRACT
The content of meconium in amniotic fluid(AF) is important for assessing the risk of several perinatal problems such as asphyxia, meconium aspiration syndrome and various perinatal infections. This estimate is usually performed subjectively by visual inspection. The purpose of this study is to develop the objective method for quantitative measurement of meconium content in AF. Absorption spectra and meconium-crit of the solutions with various concentrations of meconium were measured. EfFects of filtration and blood contamination on the measurement of meconium content were also estimated by the same methods. Optical densities(OD) were correlated with concentrations of meconium in the whole range of scanned wavelengths. A specific peak of meconium was not available but the highest OD around 410 nm was shown. OD were linearly related to the concentrations of meconium. Meconium-crits were also well-correlated with the concentrations of meconium. Filtration of AF as well as blood contamination in AF severely affected the measurement of meconium content in AF. From the results of this study, both the spectrophotometric method and meconium-crit couid be objective methods for measuring meconium content. Both methods had merits and shortcomings. Filtration and blood contamination should be avoided for the measurement of meconium content in AF. We hope that both or either one of the two methods will be clinically used.
Subject(s)
Female , Infant, Newborn , Absorption , Amniotic Fluid , Asphyxia , Filtration , Hope , Meconium Aspiration Syndrome , MeconiumABSTRACT
Limb-Body Wall complex is a complicated with the essential features of neural-tube defects, body-wall disruption, and limb abnormalities. This complex should be distinguished from other body-wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall is uniformly poor. We have experienced one case of limb-body wall complex in a 22-year-old primigravida, which is presented with a brief review of the literature.
Subject(s)
Humans , Young Adult , Extremities , Gastroschisis , Hernia, Umbilical , PrognosisABSTRACT
Nonimmune hydrops fetals is defined as generalized edema of the fetal soft tissue in utero and may be associated with effusion in the serous cavities without hematologic evidence of isoimmunization. The most common demonstrable causes are cardiac anomalies, followed by chromosomal disorders, congenital malformations, alpha-thalassemia, and the twin-twin transfu-sion syndrome. We have experienced a case of nonimmune hydrops fetalis in identical twin which caused by congenital mitral valve insufficiency and disappeared spontaneously at 35 wks. Now we report a case of nonimmune hydrops fetalis that slowly and spontaneously imp-roved without interventions with a brief review of related literatures.