Changes of Interleukin-6, C-reactive Protein, and Lipid Peroxide Levels in the Umbilical Venous Plasma of Preterm Birth with or without Chorioamnionitis / 대한주산의학회잡지

OBJECTIVE:To investigate interleukin-6 (IL-6), C-reactive protein (CRP), and lipid peroxide levels in the umbilical venous plasma of preterm birth with or without histologic chorioamnionitis and to evaluate their roles in the pathophysiology in preterm labor and perinatal outcome. METHODS:This cohort study included 66 cases of preterm delivery with preterm labor and intact membranes (PTL) (n=39) and preterm premature rupture of membranes (PPROM) (n=27). The umbilical venous blood samples were collected at the time of delivery. IL-6, CRP, and lipid peroxide levels were measured by ELISA Kit, latex agglutination assay, and thiobarbituric acid reaction. Histologic chorioamnionitis was diagnosed by the presence of neutrophil infiltration into the subamnionic space. RESULTS:The prevalence of histologic chorioamnionitis was significantly higher in PPROM (59.3 %, 16/27) than in PTL (20.5%, 8/39). IL-6, CRP, and lipid peroxide levels in the umbilical venous plasma of histologic chorioamnionitis were significantly higher than those without histologic chorioamnionitis. IL-6, CRP, and lipid peroxide levels in the umbilical venous plasma of PTL with histologic chorioamnionitis were significantly higher than those of PTL without histologic chorioamnionitis. CRP levels in the umbilical venous plasma of PPROM with histologic chorioamnionitis were significantly higher than those of PPROM without histologic chorioamnionitis. Three suspected neonatal sepsis patients have increased IL-6 and lipid peroxide levels in the umbilical venous plasma compared with patients without neonatal sepsis. IL-6 levels in the umbilical venous plasma of histologic funisitis were significantly higher than those without funisitis. CONCLUSION:Preterm birth with chorioamnionitis is associated with an increased level of IL-6, CRP, and lipid peroxide in umbilical venous blood. Preterm birth with chorioamnionitis may have an effect on perinatal outcome.

Increase in the lipid peroxidation and protein oxidation in the venous plasma of women with preterm pemature rupture of membranes / 대한산부인과학회지

OBJECTIVE: This study was performed to investigate the lipid peroxide levels and the protein carbonyl groups content in the venous plasma of pregnant women with preterm premature rupture of membranes (PPROM), non-pregnant, and normal pregnant women. METHODS: Samples of venous blood were obtained from women with non pregnancy (n=20), normal pregnancy between 25 and 37 weeks gestation (n=20), and PPROM before 37 completed weeks gestation (n=20). Lipid peroxide levels in the venous plasma of women of each group were measured by thiobarbituric acid reaction. The basal, amoxacillin and moxalactam-induced protein carbonyl contents in the venous plasma of women of each group were determined by the 2,4-dinitrophenylhydrazine (DNPH) method. RESULTS: 1. Lipid peroxide levels in the venous plasma of PPROM was significantly higher than that of non-pregnant and normal pregnant women (5.66+/-0.43 vs. 3.78+/-0.24 vs. 3.56+/-0.30 nmol/mg protein, p0.05). 5. There were significant positive correlations between lipid peroxide and moxalactam-induced protein carbonyls levels of the venous plasma (p<0.05). There were no significant positive correlations between lipid peroxide and amoxacillin-induced protein carbonyls levels of the venous plasma. CONCLUSION: In the venous plasma of pregnant women with PPROM, the lipid peroxidation and the protein carbonyl formation were increased. And moxalactam-induced protein carbonyl levels were increased in PPROM. These results suggest that oxydative stress was increased in pregnant women with PPROM.

Changes of interleukin-6, tumor necrosis factor-alpha, and total antioxidant ability in the umbilical venous plasma of preterm birth with or without premature rupture of membranes / 대한산부인과학회지

OBJECTIVE: To compare interleukin-6 (IL-6), tumor necrosis factor-alpha(TNF-alpha), oxygen-radical absorbance capacity (ORAC), and antioxidant vitamin levels in the umbilical venous plasma of preterm labor with intact membranes (PTL) and preterm premature rupture of membrane (PPROM) with that of full term normal pregnancy (NP) and to evaluate their roles of pathophysiology in preterm labor and PPROM. METHODS: Umbilical venous blood samples were collected from women with PTL (n=30), PPROM (n=30) and NP (n=30). IL-6 and TNF-alpha were measured by enzyme-linked immunosorbent assay. Lipid peroxide levels were measured by thiobarbituric acid reaction. The ORAC was mesured by Cao's method. Antioxidant vitamin levels were measured by high performance liquid chromatography. RESULTS: IL-6 and TNF-alpha levels in the umbilical venous plasma of PPROM were significantly higher than that of PTL and NP (3.28+/-0.31 vs. 2.84+/-0.19 vs. 2.79+/-0.22 pg/ml, p<0.05), (2.30+/-0.27 vs. 1.64+/-0.23 vs. 1.40+/-0.25 pg/ml, p<0.01). Lipid peroxide levels in the umbilical venous plasma of PPROM were significantly higher than that of NP and PTL (2.78+/-0.27 vs. 2.54+/-0.32 vs. 2.24+/-0.24 nmol/mg protein, p<0.01). ORAC levels in the umbilical venous plasma of PTL and PPROM were significantly lower than that of NP (967425.4+/-98.99 vs. 965165.8+/-91.20 vs. 1011328.5+/-85.96 U/ml, p<0.05). Ascorbic acid levels in the umbilical venous plasma of PPROM were significantly lower than that of NP and PTL (125.6+/-2.33 vs. 158.3+/-3.08 vs. 221.7+/-2.82 nmol/ml, p<0.01). CONCLUSION: Increase in inflammatory cytokines (IL-6, TNF-alpha) and imbalance of increased lipid peroxidation and decreased antioxidant activity in umbilical venous blood may be involved in the pathophysiology of PPROM.

The accuracy of frozen section in the diagnosis of ovarian tumors / 부인종양

OBJECTIVE: As frozen sections play the role of determining the method or scope of operation for ovarian tumors, the present study examined the accuracy, limitations and clinical utility of frozen sections. METHODS: Among 1583 cases of ovarian tumor surgery conducted during the period from January 1999 to September 2005, 372 for which frozen sections were sent to the Department of Pathology were analyzed through comparison between their frozen section diagnosis and final histopathological diagnosis. RESULTS: Among the ovarian tumor cases, the accuracy of frozen section diagnosis was 91.1% and its sensitive to final diagnosis was highest as 96.0% for benign tumors, and 85.7% for malignant tumors, and as low as 62.9% for borderline?tumors (p<0.01). The positive predictive value was 87.1% for malignant tumors, 68.8% for borderline tumors, and 94.6% for benign tumors. Among the 33 cases for which frozen section did not agree with final diagnosis, 15 cases were false positive and 18 cases were false negative. Among them, 14 cases were mucinous tumors (15.4%, 14/91), showing difficulty in diagnosis compared to non-mucinous tumors (6.8%, 19/281) (p=0.018). CONCLUSION: Despite its limitations, frozen section is a very useful method of high accuracy in diagnosing ovarian tumors. Thus, gynecologists and pathologists need to make efforts to understand the limitations and problems of frozen section, which is not highly sensitive to borderline tumors and mucinous tumors, and to make accurate diagnosis.

Interleukin-6, tumor necrosis factor-alpha, and antioxidant levels in the umbilical venous plasma of preeclampsia / 대한산부인과학회지

OBJECTIVE: Our purpose was to investigate Interleukin-6 (IL-6), tumor necrotic factor-alpha (TNF-alpha), lipid peroxide levels, oxygen-radical absorbance capacity (ORAC), and antioxidant levels in umbilical venous blood plasma and to evaluate the roles of them in the pathophysiology of preeclampsia. STUDY DESIGN: Samples of umbilical venous plasma were obtained from 20 normal and 20 preeclamptic women between 33 and 40 weeks gestation. IL-6 and TNF-alpha was assayed by an enzyme-linked immunoassay. Lipid peroxide levels were measured by thiobarbituric acid reaction. The ORAC values were measured by Cao's method. Ascorbic acid, retinol, alpha-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. RESULTS: There was no significant differences of IL-6 levels in umbilical venous plasma between women with normal and preeclampsia (2.79+/-0.21 vs. 2.94+/-0.17 ng/ml). TNF-alpha levels in umbilical venous plasma of women with preeclampsia were significantly higher than that of women with preeclampsia (3.04+/-0.01 vs. 1.40+/-0.01 ng/ml, p<0.01). Lipid peroxide levels in umbilical venous plasma of women with preeclampsia were significantly higher than that of women with normal pregnancy (7.32+/-0.09 vs. 5.18+/-0.14, p<0.01). The ORAC values in umbilical venous plasma of women with preeclampsia were significantly lower than that of women with normal pregnancy (12,836.5+/-249.4 vs. 10,490.2+/-276.9 U/ml, p<0.05). Ascorbic acid levels in umbilical venous plasma of women with preeclampsia were significantly lower than those of women with normal pregnancy (320.2+/-48.5 vs. 538.5+/-68.2 nmol/ml, p<0.05). CONCLUSION: The above results in umbilical venous plasma suggest that the imbalance of lipid peroxidation and antioxidant activity in placenta is involved in the pathophysiology of preeclampsia. Increased TNF-alpha in the umbilical venous plasma showed inflammatory reaction in the placenta would be one of the cause of preclampsia. An antioxidant vitamin, ascorbic acid, may act an important antioxidant factor in preeclampsia.

A case of right femur-ulna-radius complex diagnosed by prenatal ultrasonography / 대한산부인과학회지

The birth prevalence of limb reduction defect is 6 per 10,000 births. Most common type of limb reduction defect is terminal transverse defect and its birth prevalence is 1.6 per 10,000 births. Genetic variation, environmental teratogen, genetic-environmental interactions are known to causes of congenital limb defect. But, its exact causes are not known. Especially, congenital limb deficiency of right upper and lower limb has a very low incidence. We experienced one case of right femur-ulna-radius complex among recently delivered fetuses. So, we report this case with review of the literatures.

A Case of Fetal Congenital Mesoblastic Nephroma with Oligohydramnios

Although congenital renal tumors are rare, congenital mesoblastic nephroma (CMN) is the most common renal tumor in early infancy. It is non-metastatic, well differentiated, amenable to surgical removal, and carries a good prognosis. Polyhydramnios has been detected in most of the published cases of CMN. However, we experienced a rare case of fetal CMN associated with oligohydramnios. A 28-yr old woman at 34 weeks of gestation was referred to our hospital for oligohydramnios and a fetal abdominal mass. An ultrasonography revealed a huge, well-encapsulated mass arising from the right kidney. An emergency cesarean section was performed due to fetal distress. After birth, despite intensive neonatal care, the baby died because of renal failure, disseminated intravascular coagulopathy, pulmonary edema, together with other problems.

Significance of morphologic score and vascular index in the diagnosis of ovarian malignancy using ultrasonography / 대한산부인과학회지

OBJECTIVE: The aim of this study was to know whether we can distinguish benign from malignant ovarian tumors according to morphologic scoring system (MS), blood flow characteristics (Resistance index (RI), Pulsatility index (PI)) using color doppler sonography and a combination of both in patients undergoing laparotomy or laparoscopy for a clinically diagnosed ovarian mass. METHODS: From January 2001 to December 2003, 99 patients with ovarian tumors scheduled for laparotomy or laparoscopy were studied at our institute. Ultrasound was carried out to study the ovarian morphology followed by color doppler sonography. A score of > or =9 on MS, a PI or =9 on MS as indicative of malignancy was associated with the following statistical parameters: sensitivity 69.6%, specificity 69.8%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 63.8%. A mean score of malignant tumor (9.8+/-2.64) is significantly higher than that of benign tumor (7.5+/-2.44). This was statistically significant (p[t]<0.05). A resistance index (RI) < or =0.4 was associated with sensitivity 19.6%, specificity 97.6%, PPV 91.6%, NPV 48.2%. A pulsatility index (PI) < or =1.0 was associated with sensitivity 44.6%, specificity 81.3%, PPV 75.7%, NPV 53.0%. A mean of RI in malignancy (0.64+/-0.277) is lower than that of RI in benign tumor (0.79+/-0.299). A mean of PI in malignancy (1.34+/-0.982) is lower than that of PI in benign tumor (2.06+/-1.310). These was statistically significant (p[t]<0.05). The addition of RI or PI to MS did not improve the accuracy in predicting ovarian malignancy. CONCLUSION: Although RI or PI achieved better specificity and PPV compared to MS, the addition of RI or PI to MS did not increase its accuracy in the discrimination between benign and malignant ovarian tumors.

Hydrogen Peroxide Producing Lactobacilli in Women with Cervical Neoplasia / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: It is well known that human papillomavirus (HPV) is the main cause of cervical neoplasia, and hydrogen peroxide-producing lactobacilli are the most important microorganisms for maintaining the balance of the vaginal ecosystem. The purpose of our study was to investigate the relationship of hydrogen peroxide-producing lactobacilli, cervical neoplasia and high-risk HPV. MATERIALS AND METHODS: We enrolled 1138 women with abnormal cervical smears or cervicograms who were referred to the department of Obstetrics and Gynecology at Chonnam National University Medical School. In all of them, 1,138 vaginal swabs were collected for the qualitative assay of hydrogen peroxide producing lactobacilli and 150 cervical swabs were used for the HPV hybrid capture II test without regard to the subjects' pregnancy status. In the non-pregnant women, 880 cervical biopsies and/or loop electrosurgical excision procedures were performed for making the histological diagnosis. RESULTS: There was no significant difference not only between the distribution of H2O2 producing lactobacilli and the cervical histology, but also between the distribution of H2O2 producing lactobacilli and the positivity for high-risk HPV. CONCLUSIONS: Both cervical neoplasia and high-risk HPV may not be influenced by the existence of hydrogen peroxide producing lactobacilli in the vagina.

The availability of ultrasonography as the method for early detection of fetal chromosomal abnormalities / 대한산부인과학회지

OBJECTIVE: For the early detection of fetal chromosomal abnormalities in highpregnancy, most obstetricians have performed the prenatal fetal ultrasonogram as an obstetrical diagnostic tool. METHODS: Fetal ultrasonogram and fetal chromosomal analysis were carried out to 68 patients, from Jan. 1996 to July 2004. RESULTS: 1. The causes of patients visited the hospital were as follows; 39.5% (27/68) of them had abnormal results of Triple test, 32.1% (20/68) abnormal fetal ultrasonographic findings, 9.2% (7/68) old maternal age, 4.3% (3/68) previous fetal anomaly, 2.8% (2/68) abnormality in amniotic fluid, 2.8% (2/68) intrauterine growth restriction and 9.2% (7/68) others reasons. 2. The prevalence of abnormal fetal ultrasonographic findings was 48.5% (33/68). Several fetuses were presented the combination of anomaly. 3. The average gestational age for the fetal chromosomal analysis was 19.9+/-6.8 weeks, and the methods for the analysis were amniocentesis 80.9% (55/68), cordocentesis 8.8% (6/68), chorionic villi sampling 4.4% (3/68), and others 5.9% (4/68). 4. The results of the fetal chromosomal analysis showed numerical aberration 61.7% (42/68). structural aberration 36.8% (25/68) and Mosaicism 1.5% (1/68). CONCLUSION: The Fetal ultrasound examinations are useful for the early and accurate detection of fetal chromosomal abnormalities. Especially, when fetuses show anomalies in hears and central nervous systems, fetal chromosomal analysis should be done.

Changes in the Total Antioxidant Ability and Antioxidant Vitamin Levels in the Maternal Venous Plasma of Preeclampsia / 대한산부인과학회지

OBJECTIVE: This study was aimed to compare lipid peroxide level, total peroxyl radical-trapping antioxidative parameter (TRAP) value, and antioxidant vitamin level in the maternal venous plasma between normal pregnancy and preeclampsia. METHODS: Samples of venous plasma were obtained from 38 normal and 24 preeclamptic women. Lipid peroxides levels were measured by thiobarbituric acid reaction. The TRAP values were measured by Wayner's method, although some reaction conditions were modified. Ascorbic acid, retinol, alpah-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. RESULTS: There was no significant correlation between the lipid peroxides level in the maternal venous plasma and gestational age in normal pregnancy (n=38, r=0.04, p=NS). The lipid peroxide level in the maternal venous plasma of preeclampsia (n=24) was significantly higher than that of gestational age-matched normal pregnancy (n=26), (4.39 +/- 0.38 vs. 3.23 +/- 0.15 nmol/mg protein, p<0.01). There was no significant correlation between the TRAP value in the maternal venous plasma and gestational age in normal pregnancy (n=38, r=0.02, p=NS). The TRAP value in the maternal venous plasma of preeclampsia (n=24) was significantly lower than that of gestational age-matched normal pregnancy (n=26), (0.33 +/- 0.02 vs. 0.38 +/- 0.02 mM, p<0.05). Ascorbic acid level in the maternal venous plasma of preeclampsia was significantly lower than that of normal pregnancy (377.8 +/- 23.6 vs. 552.2 +/- 52.1 nmol/mL, p<0.05). However, there was no significant difference in maternal venous plasma retinol, alpah-tocopherol, and gamma-tocopherol levels between normal pregnancy and preeclampsia. CONCLUSION: The above results suggest that the imbalance of increased lipid peroxidation and decreased antioxidant activity were in the maternal blood of preeclampsia, and an antioxidant vitamin, ascorbic acid, may be decreased result from counteracting free radical-mediated cell disturbance.

The Protein Oxidation-Stimulating Activities in the Uterine Venous, Umbilical Venous, and Umbilical Arterial Plasma of Preeclampsia / 대한산부인과학회지

OBJECTIVE: This study was performed to compare the prooxidative activity stimulating the protein carbonyl formation by 3rd generation cephalosporin (moxalactam) and amoxacillin in the uterine venous, umbilical venous, and umbilical arterial plasma of preeclampsia with that of normal pregnancy. METHODS: Lipid peroxide levels in the uterine venous, umbilical venous, and umbilical arterial plasma of normal pregnancy (n=16) and preeclampsia (n=16) were measured by thiobarbituric acid reaction. The basal protein carbonyl contents in the uterine venous, umbilical venous, and umbilical arterial plasma of normal pregnancy (n=16) and preeclampsia (n=16) were determined by the 2,4-dinitrophenylhydrazine (DNPH) method. After plasma of them were mixed and incubated up to 5 hours with 0.2 mL of 1 mM moxalactam or amoxacillin, the protein carbonyl contents in them were measured by DNPH. RESULTS: Lipid peroxide levels in the uterine venous plasma, umbilical venous plasma, and umbilical arterial plasma of preeclampsia were significantly higher than those of normal pregnancy (3.11+/-1.21 vs. 2.18+/-1.16 nmol/mg protein, p<0.05, 5.85+/-1.67 vs. 3.79+/-1.66 nmol/ mg protein, p<0.01, 6.00+/-1.91 vs. 4.99+/-1.78 nmol/mg protein, p<0.01). Protein carbonyls formation by moxalactam in the uterine venous plasma, umbilical venous plasma, and umbilical arterial plasma of preeclampsia were signigicant higher than those of normal pregnancy (19.69+/-8.43 vs. 10.84+/-3.00 nmol/mg protein, p<0.01, 18.94+/-6.96 vs. 10.63+/-1.81 nmol/mg protein, p<0.01, 14.62+/-5.77 vs. 11.21+/-2.08 nmol/mg protein, p<0.05). There were significant positive correlations between lipid peroxide and moxalactam-induced protein carbonyls levels of the uterine venous plasma, umbilical venous plasma, and umbilical arterial plasma (p<0.01). CONCLUSION: These results suggest that increase in the prooxidative activity stimulating the oxidative modification of proteins in utero-placental unit may be involved in the pathogenesis of preeclampsia.

Differential Effects of Typical and Atypical Antipsychotics on MK- 801-induced EEG Changes in Rats

We examined whether the abnormal EEG state by NMDA receptor blocker MK-801 can be reversed by typical and atypical antipsychotics differentially by comparing their spectral profiles after drug treatment in rats. The spectral profiles produced by typical antipsychotics chlorpromazine (5 mg/kg, i.p.) and haloperidol (0.5 mg/kg, i.p.) were differ from that by atypical antipsychotic clozapine (5 mg/kg, i.p.) in the rats treated with or without MK-801 treatment (0.2 mg/kg, i.p.) which produce behavioral abnormalities like hyperlocomotion and stereotypy. The dissimilarity between the states produced by antipsychotics and the control state was examined with the distance of the location of the canonical variables calculated by stepwise discriminant analysis with the relative band powers as input variables. Although clozapine produced more different state from normal state than typical antipsychotics, clozapine could reverse the abnormal schizophrenic state induced by MK-801 to the state closer to the normal state than the typical antipsychotics. The results suggest that atypical anesthetic can reverse the abnormal schizophrenic state with negative symptom to the normal state better than typical antipsychotic. The results indicate that the multivariate discriminant analysis using the spectral parameters can help differentiate the antipsychotics with different actions.

Surgical treatment of ovarian dermoid cysts: a clinical evaluation between vaginal and laparoscopic removal / 대한산부인과학회지

OBJECTIVE: This study was conducted to compare the results between vaginal and laparoscopic removal for surgical treatment of ovarian dermoid cysts. METHODS: This retrospective study was performed in 228 patients, who underwent vaginal (Group A: 159) or laparoscopic (Group B: 69) removal of ovarian dermoid cysts between January 1998 and May 2004. The vaginal removal was performed after reduction of mass size by suction of its contents, and laparoscopic removals with Lapbag(R). RESULTS: The mean age was 37.7 +/- 9.7 years in Group A and 30.5 +/- 9.2 years in Group B. The number of patients had a previous abdominal open surgery was 30 (17.8%) in Group A and 15 (21.7%) in Group B. The mean diameter of the ovarian dermoid cysts was 6.1 +/- 2.1 cm in Group A and 5.7 +/- 2.0 cm in Group B. The differences between preoperative and postoperative hemoglobin was 1.8 +/- 1.4 g/dL in Group A and 1.5 +/- 0.8 g/dL in Group B (p<0.05). Operating time was 34 +/- 16 minutes in Group A and 82 +/- 36 minutes in Group B (p<0.01). The number of patients had febrile morbidity (greater than 38 degrees C 24h after surgery) was 3 (1.7%) in Group A and 2 (2.8%) in Group B. The feeling of satisfaction was very high in both groups. CONCLUSION: Both vaginal and laparoscopic removal of ovarian dermoid cysts are useful and effective treatment. However, the vaginal removal have cheap hospital expenses, shorter operating time, and no surgical trauma on abdominal wall. So, it have great advantages compare with laparoscopic removal. Vaginal removal can be considered a useful alternative procedure.

A Clinical Study on Malignant Germ Cell Tumor of Ovary / 대한산부인과학회지

OBJECTIVE: to evaluate the clinicopathologic characteristics of patients with ovarian malignant germ cell tumor. METHODS: We reviewed records of women who had malignant germ cell tumors of the ovary from 1991-2000. RESULTS: Thirty-seven women had surgical resections of malignant ovarian germ cell tumors and most received adjuvant therapy. Twenty-five women (68%) presented with stage I disease, and 12 (32%) had more advanced disease. Histology subtypes were: immature teratoma (n=16), dysgerminoma (n=9), yolk sac tumor (n=8), choriocarcinoma (n=2), embryonal carcinoma (n=1), and mixed germ cell tumor (n=1). The frequency of positive tumor markers were aFP, CA-125, beta-hCG, CA 19-9 and LDH in decreasing order. The mean age of the patients at presentation was 23.9 years (4-58). Surgical management of the 32 patients consisted of unilateral oophorectomy, or salpingo-oophorectomy, 1 woman with stage III disease underwent bilateral salpingo-oophorectomy and 4 women underwent total abdominal hysterctomy, bilateral or unilateral adnexectomy. Thirty-two women were treated with adjuvant combination chemotherapy (BEP, VAC, VBP) according to indications. The 5-year survival rate was 100%, and 5-year disease-free rate was 91.8%. Among twelve patients who attempted pregnancy, 8 succeeded in it and delivered normal full term babies. CONCLUSION: Current therapeutic strategies can allow most women with ovarian malignant germ cell tumors to have conservative surgery without compromising survival and to preserve their reproductive potential.

Total Antioxidant Ability and Antioxidant Vitamins in Uterine Venous, Umbilical Venous, and Umbilical Arterial Plasma of Preeclampsia / 대한산부인과학회잡지

OBJECTIVE: This study was aimed to investigate lipid peroxide levels, oxygen-radical absorbance capacity (ORAC), and antioxidant vitamin levels in uterine venous plasma, umbilical venous and arterial plasma and to evaluate their roles in the pathophysiology of preeclampsia and effects of oxidative stress on fetus. METHODS: Samples of uterine venous plasma before and after delivery, umbilical venous and arterial plasma were collected from 18 normal and 16 preeclamptic women between 34 and 38 weeks gestation during Cesarean section. Lipid peroxide levels were measured by thiobarbituric acid reaction. The ORAC values were measured by Cao's method. Ascorbic acid, retinol, alpha-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. RESULTS: 1. Lipid peroxide levels in uterine venous plasma before and after delivery of women with preeclampsia were significantly higher than that of women with normal pregnancy (5.56 +/- 0.57 vs. 3.48 +/- 0.29, p<0.01, 5.37 +/- 0.41 vs. 3.93 +/- 0.38 nmol/mg protein, p<0.01). 2. Lipid peroxide levels in umbilical venous and arterial plasma of women with preeclampsia were significantly higher than that of women with normal pregnancy (7.32 +/- 0.55 vs. 5.18 +/- 0.38, p<0.01, 8.21 +/- 0.81 vs. 5.14 +/- 0.39 nmol/mg protein, p<0.01). Lipid peroxide levels in umbilical arterial plasma were significantly higher than that of umbilical venous plasma of women with preeclampsia (8.21 +/- 0.81 vs. 7.32 +/- 0.55 nmol/mg protein, p<0.05). 3. The ORAC values in uterine venous plasma before delivery of women with preeclampsia were significantly lower than that of women with normal pregnancy (10993.8 +/- 622.2 vs. 12596.1 +/- 726.1 U/mL, p<0.05). 4. The ORAC values in umbilical venous plasma of women with preeclampsia were significantly lower than that of women with normal pregnancy (10515.1 +/- 683.4 vs. 12804.6 +/- 463.7 U/mL, p<0.05). 5. Ascorbic acid levels in uterine venous plasma before and after delivery of women with preeclampsia were significantly lower than that of women with normal pregnancy (419.2 +/- 64.6 vs. 551.4 +/- 57.6 nmol/mL, p<0.05, 398.1 +/- 45.2 vs. 450.8 +/- 33.6 nmol/mL, p<0.05). 6. Ascorbic acid levels in umbilical venous plasma of women with preeclampsia were significantly lower than that of women with normal pregnancy (401.8 +/- 47.8 vs. 561.4 +/- 53.1 nmol/mL p<0.05). Uric acid levels in umbilical venous plasma of women with preeclam psia were significantly higher than that of women with normal pregnancy (7789.2 +/- 551.7 vs. 6419.5 +/- 452.2 nmol/mL p<0.05). CONCLUSION: The above results suggest that increased oxidative stress in uteroplacental unit is involved in the pathophysiology of preeclampsia and ascorbic acid may act as an important preventive factor in the development of preeclampsia.

Induction of labor in patients with a previous cesarean birth / 대한산부인과학회잡지

OBJECTIVE: To determine the efficacy and safety of labor induction in patients previously delivered by a low transverse cesarean section. METHOD: A retrospective review was done at Chonnam National University Hospital, Kwangju, Korea. All patients with a previous cesarean section who required labor induction from April, 1986 to June, 1999 were identified. Outcome of labor induction, including mode of delivery, maternal and perinatal morbidity, and birth trauma were evaluated. RESULTS: Trial of labor was undertaken by 1256 women(55.8%) who had previously been delivered by a low transverse cesarean section. 973 patients(77.5%) with a previous cesarean birth had a spontaneous onset of labor. Labor was induced in 283 patients(22.5%) with a previous cesarean birth. Successful vaginal delivery rate were 82.9%(807/973) in spontaneous labor and 79.2%(224/283) in induced labor group (p= NS). There were no differences in uterine dehiscence and rupture rate, perinatal and maternal mortality rate, and the rate of infants with low 1 or 5-minute Apgar scores between patients attempting a trial of labor after cesarean, spontaneous and induced. CONCLUSION: we conclude that labor induction in patients with a previous low transverse cesarean section is a safe procedure requiring close peripartum maternal and fetal surveillance.

Preoperative Diagnosis of Ovarian Cancer by Serum CA-125 and Sonographic Morphologic Scoring System / 대한부인종양콜포스코피학회잡지

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.

A Case of Congenital Hemangiopericytoma of Small Bowel Associated with Intestinal Obstruction

Hemangiopericytoma was first described by Stout & Murray in 1942 and was an uncommon soft tissue tumor thought to be derived from vascular pericytes. Approximately 10-15% of the cases occur in children have a propensity to develop in the region of head, neck and lower extremities. We experienced a case of congenital hemangiopericytoma of small bowel in a male neonate who showed vomiting and abdorninal distension. We reported a case of congenital hemangiopericytoma of small bowel with brief review of related literature.

A Case of Craniodiaphyseal Dysplasia

Craniodiaphyseal dysplasia is a rare hereditary bone dysplasia, transmitted as autosomal recessive trait. This disorder is defined by Gorlin in 1969 as one of a family of severe bone disorders called "Craniotubular bone dysplasia", which is charaterized by massive and generalized hyperostosis and sclerosis, especially involving the skull facial bones. The major clinical features include marked craniofacial changes associated with bony overgrowth such as an enlarged head circumference, cranial nerve palsies and severe facial distortion. We experienced a case of craniodiaphyseal dysplasia in 2 year-9 month-old female patient who presented with typical clinical manifestation and radiologic findings nearly identical to those described by Gorlin. This is the first description of this rare disease in the Korean literature. Thus, we report a case of craniodiaphyseal dysplasia with brief related literature.