Efficacy of Ferritin - folate - cyanocobalamin Supplementation during Pregnancy for Prevention of Anemia / 대한주산의학회잡지

OBJECTIVE: The purpose of this study is to evaluate the efficacy of ferritin-folate-cyanocobalamin supplementation for prevention of anemia during pregnancy. METHODS: The authors conducted a clinical investigation on 50 pregnant women from 20th to 36th gestational weeks. The cobination of cyanocobalamin coenzyme 500mg, folic coenzyme 800mcg, and ferritin 20mg constituted the supplementation. The parameters examined in first trimester as baseline, before treatment(at 20th weeks), and after treatment(at 36th weeks) were : hemoglobin, hematocrit, ferritin, mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), mean corpuscular volume(MCV), red blood cell count(RDW), folic acid, and vit. BPaired sample t-test was used for comparison. RESULTS: The results indicated a significant increase in the value of hemoglobin(p<0.05) and hematocrit(p<0.01) in comparison to before and after the treatment. The values of serum ferritin, folic acid, vitamin Bwere increased after the treatment compared to those of before the treatment, though there was no statistical significance. The results of MCV, MCH, MCHC, and RDW showed no statistically significant in comparison to before and after the treatment. CONCLUSIONS: These data indicate that supplementing ferritin 20mg-folate 800mcg-cyanocobalamine 500mcg per day from 20th to 36th weeks' gestation can increase values of hemoglobin, hematocrit, and ferritin concentration and can be cosidered as an appropriate method to prevent iron deficient anemia. It also might increase the value of folic acid and vitamin B12, concentration, but further study is stiU needed to determine whether the supplementation of folate and cyanocobalamine in combination with iron can have better eflicacy than iron alone in prevention of iron deficiency anemia.

Clinical and Pathological Analysis of Germ cell Tumors

The germ cells first appear from the primitive streak, the splanchnopleure and the allantoic membrane of the embry and they migrate toward the gonadal ridge. It can happen, however, that some of these germ cells may not migrate to the gonadal ridge and may remain at ectopic sites such as the mediastium, the central nervous system, the sacrococcygeal region and the retroperitoneum. Therefore, germ cell tumors can arise from these ectopic sites and according to their totipotentiality of differentiating into embryonic and extraembryonic tissues, such as chorionic tissues and yolk sac, they can develop into various tumors. Generally, the sites in which these tumors are frequently found are the gonads, the sacrococcygeal region, the mediastinum, the retroperitoneum and the intracranial region. The aim of this study was to organize and report the data found on these tumors in the records of 412 patients whose tumor specimens were examined in the Department of Pathology of the Yonsei University, college of Medicine within the 10 year period, 1976~1985. The findings are as follows: 1) In total 412 cases, the ratio of benign to malignant tumors was 5.8:1. 2) Germ cell tumors occur commonly in the ovary (326 cases: 78.6%). It's incidence was followed by the descending order, in the mediastinum (26 cases: 6.3%), testis (23 cases: 5.6%), central nervous system (15 cases: 3.6%), sacrococcygeal region (11 cases: 2.7%) and retroperitoneal space (7 cases: 1.7%). Also, 2 were found in the intraorbital region and 1 each in the pericardium and the kidney. 3) In extragonadal sites, female were much more common and the sex ratio (M:F) showed 1:10 in sacrococcygeal region. 1:2.5 in retroperitoneum and 1:2.3 in mediastinum. 4) Mature teratoma was found most commonly (85.4%). It's incidence was followed by in descending order, seminoma (including dysgerminoma and germinoma) (6.8%), embryonal carcinoma (2.9%), endodermal sinus tumor (2.0%), immature teratoma (1.7%) and mixed forms (1.2%). 5) Benign teratoma takes up mostly at ovary, retroperitoneal space, sacrococcygeal region and mediastinum by 93.3%, 100.0%, 81.8%, 80.9%, respectively. But in testis and intracranial region, malignancy were more common. 6) Embryonal carcinoma and endodermal sinus tumor occured at similar aged group and each was distributed 41.7% and 62.5% respectively at first decade. 87.5% of dysgerminoma occured at 11~30 aged group, 91.7% of germinoma at 11~20 aged group, 67% mature teratoma at 20~40 aged group, 75% of seminoma at 31~50 aged group, so age distribution showed embryonal carcinoma, endodermal sinus tumor, dysgerminoma/germinoma, mature teratoma and seminoma, in increasing order. 7) In 352 cases of mature teratoma, 347 cases (98.6%) were cystic type and 5 cases (1.4%) were solid type. In 7 cases of immature teratoma, 5 cases (71.4%) were solid and 2 cases (28.6%) were cystic. 8) The incidence of bilaterality were 10.2% in mature teratoma, 12.5% in dysgerminoma and 16.7% in seminoma. 9) When the corredation of the tumor markers, alphafetoprotein and human chorionic gonadotropin, with malignancy was checked in 12 out of 28 cases of tumor of the testis. Either alpha fetoprotein of human chorionic gonadotropin was found to be elevated in 3 cases (75%) in which metastasis was already present at the time of diagnosis, where in 8 cases in which neither marker was elevated, metastasis was found to be present in only 1 (12.8%).