The Influence of Human Chorionic Gonadotropin and Human Placental Lactogen on Growth and Differentiation of Placental Trophoblast / 대한산부인과학회잡지

BACKGROUND: There are many factors that influence the differentiation and growth of trophoblasts. During differentiation of trophoblasts, two major hormones are secreted ; human chorionic gonadotropin (hCG) and human placental lactogen (hPL). These two hormones are secreted in a peculiar pattern during pregnancy and function of these hormones is not yet fully understood. Also, it is not known whether these hormones directly influence the differentiation and growth of trophoblasts. On the other hand, it is known that choriocarcinoma cells are undifferentiated, so they are unable to form syncytiotrophblasts. And many factors may be associated with this inhibitory potential. OBJECTIVE: The purpose of this study was to observe whether the hCG and hPL are associated with differentiation and growth of early placental trophoblasts and becoming malignant. METHOD: The hCG, hPL, IL-6 and insulin were added to cytotrophoblasts isolated from normal 8 to 10 gestational weeks' placental tissues by a degree of concentration, and observed the secreted hPL concentration and morphological change to syncytiotrophoblasts daily. And it was performed in Bewo cells in same manner. RESULT: The increased hPL secretion was noted in hCG, hPL, IL-6 and insulin were added normal trophoblasts and this may result from differentiation of cytotrophoblasts to syncytiotrophoblasts. Also, morphological changes to syncytiotrohoblasts was observed at the same time. But, Increased hPL secretion and syncytiotrophoblasts formation was not detected in Bewo cells. CONCLUSION: In this study, it seems that hCG, hPL, IL-6 and insulin had an influence on differentiation and growth of normal trophoblasts. On the other hand, no changes in hPL secretion and morphology at the choriocarcinoma cell line tells us that defects of differentiation in choriocarcinoma is due to abnormalities of the receptors on hCG and hPL or a differentiation associated gene, not a defect of these hormones themselves.

The differences of fetal heart rate according to fetal sex / 대한산부인과학회잡지

OBJECTIVES: The purpose of this study is to analyze the previously unreported effect of fetal sex on the fetal heart rate and to measure its magnitude in relation to the effects of other independent clinical variables. METHODS: Three hundred and seventeen pregnant women who were able to provide electronic fetal heart rate monitoring were evaluated. On the basis of fetal sex after birth, 167 pregnant women who delivered male neonate were for males group and 146 examples who delivered female neonate were for female group. We analyzed fetal heart rate data using the Catholic Computer Assisted Obstetric Diagnosis System(CCAOD). RESULTS: Female fetuses had significantly faster basal heart rate(140.51+/-12.43bpm) than male fetuses(137.64+/-13.68 bpm).(P=0.007) Percent acceleration time(PAT) increased significantly for males(6.10+/-4.00bpm), comparing to females(4.90+/-3.34bpm).(P=0.001) Also percent deceleration time(PDT) was significantly higher in male fetuses(7.50+/-8.70bpm) than female fetuses(6.18+/-7.70bpm).(P=0.039) But there was no differences in standard deviation(SD)(8.84+/-10.11bpm, 8.11+/-3.56bpm), long term variation(LTV)(80.38+/-62.79msec, 73.65+/-54.60msec), and short term variation(STV)(14.06+/-9.79msec, 13.33+/-12.32msec) between male and female fetuses. CONCLUSION: The fetal heart rate of female fetuses differ from that of male fetuses. Computerized linear analysis and nonlinear analysis of antepartum fetal heart rate will need to take into account the multiple factors that influence the fetal heart rate to identify precisely which pattern predict clinical outcome.

A Case of Fetus-in Fetu / 대한주산의학회잡지

No abstract available.

A Case of Retroperitoneal Teratoma Antenatally Diagnosed / 대한주산의학회잡지

No abstract available.

A Case of Pulmonary Embolism After Cesarean Delivery / 대한산부인과학회잡지

Pulmonary Embolism, one of the causes of maternal death, is a life threatening disease that needs early and accurate diagnosis. We have exprerienced a case of a fatal pulmonary embolism which was diagnosed by lung perfusion scan on the postoperative 1 day after cesarean delivery and was managed with heparin therapy. We present this case with a brief review of literatures.

A Case of Agenesis of Corpus Callosum with Chromosome anomaly / 대한산부인과학회잡지

The corpus callosum consists of white fibers connecting the cerebral hemispheres. Agenesis of the corpus callosum is an uncommon congenital anomaly which is easily diagnosed in the postnatal period by ultrasound and computed tomographic scan or MRI, but its prenatal sonographic diagnosis is difficult because of fetal head positioning and limiting trans-axial scans. We experienced a case of agenesis of the corpus callusum with chromosomal anomaly. The prenatal sonographic findings are ventricular abnormalities that demonstrated dilatation of lateral ventricles and disproportionate enlargement of the occipital horns, which were suggestive findings for the corpus callosal agenesis. We could confim the diagnosis of the corpus callosal agenesis with chromosome anomaly by postnatal MRI and chromosome analysis.

The effect of the sera from severe preeclamptic patients on endothelial cell viability and endothelin-1 in cultured human umbilical vein endothelial cells / 대한산부인과학회잡지

OBJECTIVES: In order to assess the effects of sera from severe preeclamptic patients on endothelial cell viability in vitro and endothelin-1 synthesis in cultured human umbilical vein endothelial cells. METHODS: The cultured human umbilical vein endothelial cells were incubated with media containing 10% sera from women with either preeclamptic patients or normal pregnancies for 24 hours or 48 hours. After then, their viability was measured by colorimetric MTT{3-(4,5-dimethylthiazol-2yl)2,5-diphenyl tetrazolium bromide} assay and their production of endothelin-1 was measured. We also measured the serum levels of endothelin-1 level in sera obtained from the normal and severe preeclamptic pregnancies. RESULTS: The calorimetric MTT assay revealed that after 24 hours, the absorbances in the media treated with normal pregnancies and severe preeclampsia sera were 0.0718+/-0.0078 and 0.0837+/-0.0129, respectively and after 48 hours, they were 0.1133+/-0.0103 and 0.1268+/-0.0186, respectively. Serum obtained from severe preeclampsia did not affect endothelial cell viability. 2. The serum mean levels of endothelin-1 in normal and severe preeclamptic pregnancies were 22.66+/-8.6 fmol/ml and 48.98+/-25.27 fmol/ml. The mean level in preeclamptic sera was significantly higher than that of normal pregnant women. (P<0.05) 3. After 24 hours, the mean amount of endothelin-1 stimulated by normal pregnant and severe preeclamptic sera were 37.52+/-18.41 fmol/ml and 97.58+/-53.64 fmol/ml, respectively. The mean amount of endothelin-1 in preeclamptic sera-treated cells was significantly higher than that of normal pregnant sera-treated cells. (P<0.05). CONCLUSION: The sera from severe preeclamptic women do not affect cell viability but act selectively on specific activation of their function such as endothelin-1 production. And it is necessary that the identification and isolation of the putative serum factor(s) will be performed to resolve the pathogenesis in future.

Clinical Study of Maternal and Perinatal Complication in Pregnancy with Diabetes Mellitus / 대한산부인과학회잡지

OBJECTIVES: The aim of the current paper is to analyze maternal and neonatal complication of pregestational diabetes mellitus and gestational diabetes mellitus, and to compare with the outcome METHOD: The study included 108 pregnancies with diabetes mellitus among 8,495 admitted to the Department of Obstetrics and Gynecology, Catholic University of Korea Medical College, Holy Family Hospital from January 1, 1995 to December 31, 1998. The pregnancies were divided into pregestational diabetes mellitus group and gestational diabetes mellitus group. The data were analyzed and reviewed retrospectively based on medical records RESULTS: 1) Incidence of maternal complication in gestational diabetes mellitus was 7% of pregnancy induced hypertension, 3% of pyelonephritis, 1% of retinopathy and 1% of chronic hypertension. In case of pregestational diabetes mellitus, 18% of pregnancy induced hypertension, 5% of nephropathy, 9% of retinopathy and 14% of pyelonephritis. 2) Incidence of neonatal complication in gestational diabetes mellitus was 1% of congenital malformation, 1% of shoulder dystorcia, 7.3% of polyhydramnios, 17.7% of hyperbilirubinemia, 40.6% of hypoglycemia and 1% of FDIU. In case of pregestaional diabetes mellitus, 1% of congenital malformation, 18.2% of polyhydramnios, 22.7% of hyperbilirubinemia, 27.3% of hypoglycemia, 18.6% of RDS and 4.6% of FDIU. 3) The outcomes of the treatment of pregestational diabetes; There was no significant difference in the maternal weight gain, neonatal birth wight but the incidence rates of neonatal complication was lower in case of insulin treatment 4) The outcomes of the treatment of gestational diabetes; There was significant difference in the maternal weight gain, neonatal birth weight and the incidence rates of maternal and neonatal complication was decreased in case of treatment. CONCLUSION: Incidence of maternal complication and perinatal complication was higher in pregestaional diabetes mellitus compared with gestational diabetes mellitus, so strict control of blood glucose level and education for diabetes mellitus were essential before gestation. And the proper treatment of gestational DM was necessary because maternal weight gain during pregnancy, neonatal birth weight and the maternal and neonatal complication were affected by treatment.

The Effect of Blood and Meconium Contamination on the TDx - FLM Assay for the Assessment of Fetal Lung Maturity / 대한산부인과학회잡지

OBJECTIVE: We studied to determine the effect of blood or meconium contamination on the TDx-FLM assay for the assessment of fetal lung maturity. We also studied to evaluate the degree of diluted contaminants that affect the results. METHODS: Nineteen samples of amnotic fluid-14 cases GA 37weeks-were collected and assayed for assessment of fetal lung maturity using tbe TDx-FLM assay. Among the above 19 samples, we used 12 samples-7 cases GA37 weeks-to contaminate with blood or meconium. Maternal blood was added to the amniotic fluid at increasing concentrations fro 1:10 to 1:1280. Diluted meconium (0.5g meconium/10ml amniotic fluid) was added at increasing concentration fiom 1:1 to 1:128. Each samples were assessed by TDx assay. RESULTS: TDx values in the cases of gestational age 37 weeks or more were matured level or borderline level(TDx value > 50mg/g), but below 37 weeks, TDx values wae immature level(TDx value < 50mg/g) except one case. In preterm cases, blood or meconium contamination did not affect the TDx values significantly, although the thick meamium contamination (diluted meconium: amniotic fluid 1:1 - 1:4) increased the TDx values. In term cases, they did not affect the TDx values. CONCLUSION: TDx test was suitable for the evaluation of fetal lung maturity regardless of blood or meconium contamination.

Gene Expression of Vascular Endothelial Growth Factor(VEGF) and Placental Growth Factor(PlGF) in Human Placenta / 대한산부인과학회잡지

OBJECTIVE: To determine whether gene expressions of VEGF and PlGF are different between the human placenta of normal and abnormal pregnancy. METHODS: Placenta was collected at each trimester of normal pregnancy, missed abortion, intrauterine growth retardation and pre-eclampsia. Total RNA was extracted from placenta. Reverse transcription-polymerase chain reaction(RT-PCR) was performed using VEGF and PlGF primer. RESULTS: VEGF121, VEGF165 and VEGF189 were identified in normal pregnancy and missed abortion. In two cases of four IUGR and one case of three pre-eclampsia, four of isoforms (VEGF121, VEGF145, VEGF165, and VEGF189) were identified. The intensity of signal was strongest for VEGF165 in all cases. PlGF131 and PlGF152 were identified in all cases. However, the signal intensities of VEGF121, VEGF165, VEGF189, PlGF131 and PlGF152 were not different according to the gestational age. They were also not different between normal pregnancy and abnormal pregnancy. CONCLUSION: VEGF and PlGF were not only expressed at placenta but also overexpressed in part of IUGR and pre-eclampsia. The results suggest that VEGF may play a role in the induction of angiogenesis of placenta in normal pregnancy and its production may be increased under the hypoxic condition.

One Case of Neuroblastoma arising in Mature Cystic Teratoma of the Ovary / 대한부인종양콜포스코피학회잡지

The incidence of malignant change of ovarian mature teratoma is 1~2%. The majority is squamous cell cancer, the others was adenocarcinoma. Neuroepithelial tissue was frequently detected in mature cystic teratoma, but their malignant change was extremely rare. Only, two cases of neuroblastoma of ovarian teratoma were reported in the world. We report one case of neuroblastoma arising in ovarian mature teratoma with a brief review. Our case is the third reported one in the world.

Diagnosis of Chlamydia trachomatis Infection from Transcervical Cells of Pregnant Women by PCR Assay / 대한주산의학회잡지

BACKGROUND: Chlamydia trachomatis is most common sexually transmitted pathogen in the world, and a common cause of urethritis and cervicitis. Also it is common cause of preterm premature rupture of membranes and premature labor in pregnant women, and pneumonitis and conjunctivitis in neonate. A rapid and sensitive polymerase chain reaction(PCR)-based assay for detection of C. trachomatis is recently introduced. OBJECTIVES: We studied to determine whether a PCR assay is useful to detect Chlamydial infection in pregnant women. We also studied to compare its prevalence rate according to maternal age, trimester and parity, respectively. Study Design: Specimens were collected from 149 pregnant women by transcervical swab or endocervical lavage. If a specific band was detected in PCR assay, we considered as Chlamydial infection. RESULTS: In general, the positive bands were detected in the 45 of 149 pregnant women(30.2%). The positive bands were detected the 6 of 55(10.9%), 16 of 49(32.7%), and 23 of 45(51.1%) pregnant women in each trimester, respectively. Therefore, there was significantly increased according to the gestational age(p 0.05). CONCLUSION: We concluded that the PCR assay is a fast and useful test for the detection of C. trachomatis in transcevical cells from the pregnant women. This study suggested that Chlamydial infection seems to be increased according to the gestational age.