ABSTRACT
The balance between coagulation and fibrinolysis is an essential part in early pregnancy. Mutations in methylenetetrahydrofolate reductase (MTHFR) gene lead to decreased activity of the enzyme and hyperhomocysteinemia, which then induces platelet aggregation by promoting endothelial oxidative damage, possibly resulting in adverse effect on maintenance of pregnancy. We investigated the role of MTHFR single nucleotide polymorphisms (SNPs), C677T and A1298C, in Korean patients with recurrent pregnancy loss (RPL). We conducted a prospective case-control study in the Korean population. Subjects included 302 women with 2 or more consecutive, unexplained, spontaneous miscarriages before 20 weeks of gestation and 315 control women without a history of recurrent miscarriages. The genotyping for C677T and A1298C polymorphisms was performed using the TaqMan assay. Continuous variables were compared using Student's t-test, and χ² test was used to evaluate differences in the genotype distributions between the RPL and the controls. The genotype distribution of both polymorphisms in the RPL group did not differ from those of the controls. For further analysis, if RPL patients were divided according to the numbers of pregnancy losses (≥ 2 and ≥ 3) neither group was significantly different compared with controls. MTHFR gene C677T and A1298C polymorphisms are not associated with idiopathic RPL in Korean women, suggesting that those may not be susceptible allelic variants or be deficient to cause RPL.
Subject(s)
Female , Humans , Pregnancy , Abortion, Habitual , Abortion, Spontaneous , Case-Control Studies , Fibrinolysis , Genotype , Hyperhomocysteinemia , Methylenetetrahydrofolate Reductase (NADPH2) , Platelet Aggregation , Polymorphism, Single Nucleotide , Prospective StudiesABSTRACT
OBJECTIVES: To investigate the effect of LH receptor in folliculogenesis, we confirm the expression level of LH receptor (LH-R) mRNA in human granulosa cells (GCs) and its expression levels were analyzed by comparison to embryo developmental rate and pregnancy rate. MATERIALS AND METHODS: GCs were obtained at the time of oocyte retrieval from the patients undergoing IVF-ET program. The patients were divided into two groups: Group I (n=20) is poor responder (retrieved oocyte(s)3ea). After the extraction of total RNA, semiquantitative RT-PCR was performed and the expression level of LH-R mRNA was normalized by beta-actin. Statistical analysis was performed by using Chi(2) test, Student's t-test and Pearson correlation. RESULTS: In Group II, the relative values of LH-R mRNA (0.680 vs. 0.463, p<0.005) and pregnancy rate (54.7% vs. 23.1%, p<0.05) were significantly higher than in Group I. Number of retrieved oocyte(s) was gradually increased when the expression of LH-R mRNA was increased (p<0.05). But the quality of retrieved oocyte and transferred embryo were not related with the expression of LH-R mRNA. When the pregnancy rate was compared with FSH only group and FSH combined with hMG group in the ovarian stimulation protocol, FSH combined with hMG group was significantly higher than FSH only group in Group I (37.5% vs. 0%), and the expression of LH-R mRNA was significantly higher in hMG combined group than FSH only group (p<0.05). CONCLUSION: Expression level of LH-R mRNA has important role in ovarian function related with the response to gonadotrophin in human folliculogenesis. Furthermore these data might provide the evidence that additional use of hMG is helpful to poor responders.
Subject(s)
Female , Humans , Pregnancy , Actins , Embryonic Development , Embryonic Structures , Granulosa Cells , Oocyte Retrieval , Oocytes , Ovulation Induction , Pregnancy Rate , Receptors, LH , RNA , RNA, MessengerABSTRACT
OBJECTIVE: To identify the causes of primary amenorrhea in the Korean population. METHODS: We reviewed the available medical records of the 100 patients who had visited the Department of Obstetrics and Gynecology at Seoul National University Hospital with the complaint of primary amenorrhea and examined their karyotypes between January 1989 and December 2000. Review of history, physical examination, laboratory findings, imaging studies, and operative findings was done, when needed. RESULTS: The mean age at diagnosis was 25.1+/-6.1 (mean+/-S.D.) years of age, ranged 14 to 40. Mllerian agenesis was the most common cause (40.0%), followed by primary ovarian failure (33.0%), and then followed by hypothalamic-pituitary failure (12.0%). Androgen insensitivity syndrome and Swyer syndrome were found in four patients (4.0%), respectively. CONCLUSION: This study shows that the common cases of primary amenorrhea in Korean women are Mllerian agenesis, primary ovarian failure and hypothalamic-pituitary failure.
Subject(s)
Female , Humans , Male , Amenorrhea , Androgen-Insensitivity Syndrome , Diagnosis , Gonadal Dysgenesis, 46,XY , Gynecology , Karyotype , Medical Records , Obstetrics , Physical Examination , SeoulABSTRACT
Cancer of the vulva accounts for approximately 0.5% of all gynecologic malignancies. At diagnosis, one-third of these cases is detected in an advanced stage (FIGO stages III, IV), and local extension of primary vulvar cancer may involve adjacent midline structures such as the clitoris, urethra, vagina, and anus. Initial surgical therapy of such locally advanced primary cancers may compromise the functional integrity of midline structures, necessitating ultraradical surgery including pelvic exenteration. In view of the relatively elderly age of the patients and the morbidity of this ultraradical dissection, concomitant chemoradiation therapy - that the efficacy had been proven in head and neck cancer, anal cancer has approached for patients with locally advanced vulvar cancer. We experienced a case of stage III vulvar cancer patient, who underwent concomitant chemoradiation therapy with 5-fluorouracil(FU) and cisplatin and who showed complete response. So, we report this case with brief review of the literatures.