Uterine Artery Doppler Velocimetry During Mid-second Trimester to Predict Complications of Pregnancy Based on Unilateral or Bilateral Abnormalities

We performed this study to evaluate uterine artery Doppler velocimetry (UADV) measurement of unilateral or bilateral abnormalities as a predictor of complications in pregnancy during the mid-second trimester (20-24 weeks). We enrolled 1, 090 pregnant women who had undergone UADV twice: once between the 20th and 24th week (1st stage) and again between the 28th and 32nd week (2nd stage) of pregnancy, and then delivered at Yonsei Medical Center. UADV was performed bilaterally. Follow-up UADV was performed between the 28th and 32nd week, and the frequencies of pregnancy-induced hypertension (PIH), fetal growth restriction (FGR), and preterm delivery (before 34 weeks of gestation) were determined. Chi-squared and t-tests were used where appropriate, with p < .05 considered significant. According to the results of UADV performed between 20-24 weeks of gestation, 825 women (75.7%) were included in the normal group, 196 (18.0%) in the unilateral abnormality group, and 69 (6.3%) in the bilateral abnormality group. The incidences of FGR were 8.0%, 10.2%, and 26.1%, and the incidences of PIH were 0.1%, 3.6%, and 14.5%, respectively. The incidence of PIH was significantly lower in the normal group. The incidences of preterm delivery were 2.2%, 5.6%, and 8.7%, respectively. PIH developed in 46.7% of patients with bilateral abnormal findings in both the 1st and 2nd stage tests, and developed in none of the patients with normal findings in both tests. Abnormal results found by UADV performed between the 20-24th weeks of pregnancy, such as high S/D ratios regardless of placental location and the presence of an early diastolic notch, were associated with significant increases in the incidences of intrauterine growth restriction (IUGR) and PIH. This was true for both bilateral and unilateral abnormalities. Abnormal findings in bilateral UADV during the second trimester especially warrant close follow up for the detection of subsequent development of pregnancy complications.

Imaging Diagnosis of Fetal Abdominal Solid Tumor / 대한산부인과학회잡지

OBJECTIVE: Ultrasonography is screening modality of choice and plays an important role in prenatal diagnosis of various diseases and neoplasm of fetus. Recently, Magnetic Resonance Imaging was used as a diagnosis tool to fetal disease. We would like to evaluate efficacy of ultrasonography and magnetic resonance imaging for the diagnosis of fetal abdominal solid tumor. METHODS: Among 2,055 cases of abnormal ultrasonography findings detected by prenatal ultrasonography from January 1996 and June 2002, a comparison between the diagnosis made by prenatal ultrasonography, fetal magnetic resonance imaging (MRI), postnatal radiological studies and histopathologic studies was made in four cases with fetal abdominal solid tumor. RESULTS: The first case was diagnosed as adrenal tumor or hepatic tumor by US, hemangioedothelioma of liver by fetal MRI, and confirmed as hemangioendothelioma postnatally. The second case showed concordance with mesoblastic nephroma among the diagnosis made by US, fetal MRI, and postnatal histopathologic studies. The third case was diagnosed as extrathoracic pulmonary sequestration by US and MRI, and the same diagnosis was made by postnatal histopathologic studies. The fourth case was suspected as kidney tumor by US and was diagnosed as adrenal as adrenal neuroblastoma postoperatively. CONCLUSION: Fetal solid tumor is not a common disorder, but the location, size and orgin of tumor plays important role in the prognosis of neonatal period; additional workup by fetal MRI would improve the diagnosis of such tumors.

Prenatal Ultrasonograpy of Cystic Hygroma in Unusual Site / 대한산부인과학회잡지

Among 2,055 cases of abnormal findings detected by prenatal ultrasonography at Yonsei University College of Medicine from January 1996 to June 2002, the incidence and the site of cystic hygroma were evaluated. The clinical courses and postnatal prognosis were studied in four cases with cystic hygroma developed in unusual sites. Among 2,055 cases of abnormal ultrasonographic findings, 76 cases (3.70%) were diagnosed as cystic hygroma. Among 76 cases of cystic hygroma, 4 cases (5.3%) were detected in unusual sites; 1 case in mediastinum, 1 right axillary area, and 2 in anterolateral portion of neck. In cystic hygroma, prenatal accurate ultrasonographic findings including size and site of mass are important. Cystic hygroma developed in unusual sites are associated with perinatal complications including airway obstruction and compression of the surrounding organs. In giant cystic hygroma, cesarean section should be considered to avoid trauma and birth injury. After delivery, close observation and proper management are required.

Influence of cathepsin D expression on prognosis in non-small cell lung cancer / 결핵

BACKGROUND: Cathepsin D, an aspartic lysosomal proteinase, is believed to be involved in local invasion and metastasis of tumor cells by its proteolytic activity and has been described to be associated with tumor progression and prognosis in some human malignancies including breast cancer. But, its prognostic value for human lung cancer remains to be determined. The purpose of this study is to determine clinicopathological and prognostic significance of cathepsin D expression in non-small cell lung cancer. METHOD: Using a polyclonal antibody, immunohistochemical analysis of cathepsin D was performed on paraffin embedded sections of tumors obtained surgically from 54 patients with non-small cell lung cancer (37 squamous cell carcinoma, 14 adenocarcinoma, 2 large cell carcinoma, and 1 undifferentiated carcinoma). RESULTS: Eighteen patients (33.3%) showed positive immunoreactivities of cathepsin D in tumor cells. No significant correlation of cathepsin D expression in tumor cells was found in p-stage (surgical-pathologic stage), tumor size, tumor factor, nodal involvement, and differentiation. Of 54 patients, 29 (53.7%) patients showed moderate to massive cathepsin D-positive stromal cells within the tumor tissues, while the rest (46.3%) showed few cathepsin D-positive stromal cells within the tumor tissues. Cathepsin D expression n stromal cells was significantly associated with p-stage in non-small cell lung cancer (p=0.031). No significant correlation of the degree of cathepsin D-positive stromal cells was found in tumor size, T-factor, nodal involvement, differentiation. Cathepsin D expression status in tumor cells and stromal cells was not significantly associated with prognosis expressed by survival rate. The results of multivariate analyses of variables possibly associated with progonosis showed that nodal involvement was the only independent prognostic factor in all patients. CONCLUSION: Cathepsin D expression in stromal cells was significantly associated with p-stage in non-small cell lung cancer. However, it was not related to other clinicopathologic features and prognosis, and Cathepsin D expression in tumor was not related to p-stage and prognosis.