Differential Effects of High-carbohydrate and High-fat Diet Composition on Muscle Insulin Resistance in Rats

This study was conducted to evaluate whether the composition of carbohydrate or fat diet affects insulin resistance by measuring the muscle glucose transport rate. Both high-sucrose and high-starch diet with or without high-fat decreased insulin-stimulated glucose transport, but there were no significant differences among groups. Calorie intake in both high-sucrose and high-starch diet groups was higher than in chow group. The high-fat high-sucrose diet induced decrease in insulin-stimulated glucose transport was partially improved by supplement with fish oil. Calorie intake in high-fat high-sucrose and fish oil supplemented groups was higher than in chow group. The decreased insulin-stimulated glucose transport was accompanied by the increase in visceral fat mass, plasma triglyceride and insulin levels. These changes were improved by the supplement with fish oil. These results demonstrate that the composition of fat in diet is clearly instrumental in the induction of muscle insulin resistance. However, in high carbohydrate diet, it is likely that the amount of calorie intake may be a more important factor in causing insulin resistance than the composition of carbohydrate. Thus, the compositions of carbohydrate and fat in diet differentially affect on muscle insulin resistance.

The Effect of Probiotic on Constipation in Rats / 영남의대학술지

BACKGROUND: Constipation is one of the most common disorders in Korea and Western countries. It may be related with life style, diet, physical activity, age, stress and gender, and particularly premenopausal women experience constipation more often than men due to the significant prolongation of the mean colonic transit in women. The aim of this study was to evaluate the effect of a probiotic on constipation in loperamide-induced constipated rats. MATERIALS AND METHODS: The rats were divided into 3 groups. Constipation was induced by administration of loperamide for 5 days, and the excreted amount as well as the number of feces was observed. Lactic acid bacteria as a probiotic were administered orally every day for 5 days. RESULTS: The results showed that loperamide administration induced severe experimental constipation in rats. The amount of feces was decreased and the number of pellets was increased by loperamide. The water content in the feces as a parameter of constipation was also decreased by loperamide. On the other hand, the dry weights of feces were not significantly different among the groups. It represents that the amount of food consumption might have been similar among the groups, and constipation was caused by delayed intestinal movement. CONCLUSION: Probiotic administration for 5 days in rats partly alleviated or prevented the constipation induced by loperamide.

A case of normal delivery in a patient with aplastic anemia / 대한주산의학회잡지

Aplastic anemia is a serious hematological disorder characterized by pancytopenia and bone marrow hypocellularity. Pregnancy associated with aplastic anemia is fortunately uncommon considering the significant morbidity and mortality for both mother and the fetus. The risk to the mother is mainly in the form of hemorrhage and sepsis, while the fetus may suffer from growth restriction and even intrauterine death. Maternal mortality has been reported variously from 20% to 60%. The relationship between pregnancy and aplastic anemia remains controversial. We experienced a patient with severe aplastic anemia in pregnancy who was treated with supportive transfusion of red blood cells and platelets. Here, we present a case with a brief review of the literature.

A Case of Leiomyoma of The Lateral Vaginal Wall / 영남의대학술지

Leiomyomas are common in the myometrial layer of the uterus, though they are rarely found in other reproductive organs. Leiomyomas are benign, hormone-sensitive smooth muscle tumors. They develop during the reproductive years and regress after menopause. Preoperative diagnosis is difficult to make. We present a case of a 54-year-old woman with a vaginal wall tumor. The management in this case included surgical excision. Histologic examination definitively confirmed the diagnosis of a vaginal leiomyoma. We report the details of this case along with a brief review of the literature.

Conservative treatment of advanced cervical pregnancy / 대한산부인과학회지

Cervical pregnancy is an uncommon life threatening form of ectopic pregnancy. It is associated with the unexpected occurrence of uncontrollable hemorrhage from the cervix. This condition is usually treated with hysterectomy. And thus the patient loses her fertility potential. To avoid hysterectomy and to maintain fertility, several conservative methods of termination have been used. We report a case of cervical pregnancy treated conservatively without hysterectomy. Hemorrhage from the implantation site was controlled with an inflated Foley catheter balloon positioned within the cervical canal. Foley catheter ballooning after endocervical suction curettage seems to be a simple and effective treatment of cervical pregnancy as conservative treatment to maintain fertility.

Current Approach in the Treatment of Preterm Premature Rupture of Membrane / 대한산부인과학회지

Preterm premature rupture of membrane (PPROM) is common and significant cause of preterm birth and perinatal morbidity and mortality. It has been poorly defined with an obscure etiology, difficult to diagnose, and management strategies that are often diverse and controversial. Treatment options include bed rest, steroids, antibiotics, fetal and maternal surveillance, and ultimately, delivery. Determining the optimal gestational age for delivery in otherwise uncomplicated patients with PPROM involves consideration of fetal, maternal and neonatal health. In the absence of amnionitis, placental abruption, fetal distress, or advanced labor, gestational age-based conservative management of the patient with PPROM may be appropriate.

A case of Intrapartum Subcutaneous Emphysema After Spontaneous Vaginal Delivery with Vacuum Extraction / 대한주산의학회잡지

A 30-year-old primipara at 41 weeks gestation was admitted with regular labor pain and delivered a healthy male infant without complications except for a 4th degree tear of perineum. Two hours after delivery, she complained of sore throat and developed mild swelling of left side face, neck and upper chest. A chest radiography showed mild subcutaneous emphysema of neck. There was no pneumomediastinum and pneumothorax. She was managed conservatively and discharged without any complication at the 6th postpartum day. We report a rare case of subcutaneous emphysema with a brief review of literatures that presented shortly after vaginal delivery without complications except for a 4th degree perineal tear and resolved without special treatment.

A Case of Primary Endometrioid Adenocarcinoma of the Vagina / 대한산부인과학회지

Primary cancer of the vagina is very rare, accounting for 1-2% of gynecologic malignancies. Vaginal cancers are composed of primary and metastatic one. Of them, metastatic cancers constitute the majority of vaginal cancers, as 80-90%. Differentiating as type of cancer cell, the squamous cell carcinoma is the most common, as 80-90%, but, the adenocarcinoma is rare, as 9% of primary vaginal cancer. Same as other disease, if there is a symptom, the 5 year-survival rate of the vaginal cancer is 37%, but, if not in early stage, that becomes higher, as 61%. So, the early diagnosis and treatment are very important for patients' prognosis. A woman who had underwent both ovarian cystectomy due to both ovarian endometriomas 2 years ago visit us complaining of vaginal spotting, mild lower abdominal discomfort and pelvic pain for 2 months. She underwent operation at the impression of primary vaginal cancer and was irradiated. We report a case of primary endometrioid adenocarcinoma of the vagina with review of literatures.

The Production Mechanism of TNF-alpha and IL-6 by Group IIA Phospholipase A2 / 영남의대학술지

BACKGROUND: Secretory phospholipase A2 (sPLA2) are a group of extracellular enzymes that release fatty acids at the sn-2 position of phospholipids. Group IIA sPLA2 (sPLA2-IIA) has been detected in the inflammatory fluids, and its plasma level increases in the inflammatory disease. This study examined the effect of sPLA2-IIA on mouse macropahges in order to investigate the potential mechanism of sPLA2-induced inflammation. MATERIALS AND METHODS: Wild type PLA2 and mutant H48Q PLA2 were purified from HEK293 cells transfected with the corresponding plasmids, and the PLA2 activities were measured using 1-palmitoyl-2-[1- (14) C]linoleoyl-3-phosphatidylethanolamine as substrates. The TNF-alpha and IL-6 released in the supernatants were determined by ELISA. In addition, the TNF-alpha and IL-6 mRNA were analyzed by RT-PCR. RESULTS: sPLA2-IIA stimulated the production of TNF-alpha and IL-6 in a dose- and time-dependent manner. In addition, the effect of sPLA2-IIA on cytokine production from the macrophage was found to be associated with the accumulation of their specific mRNA. The mRNA levels of TNF-alpha and IL-6 peaked at 2 and 6 hours in a time-dependent manner, respectively. CONCLUSION: In conclusion, the production of proinflammatory cytokine might be mediated by the binding of sPLA2-IIA to the receptors.

A Case of Spontaneous Uterine Rupture of the Unscarred Uterus in 14 Weeks Gestation / 영남의대학술지

Spontaneous uterine rupture of the unscarred uterus during the second trimester of pregnancy is rare, but it is a surgical emergency. Because it results in rapid deterioration of patient and high mortality despite of prompt operation and massive transfusion, early diagnosis and proper management are critical for optimizing patient care. We present a case of spontaneous uterine rupture with fetal death in 14 weeks gestation with a brief review of literatures.

Cotyledonoid Dissecting Leiomyoma of the Uterus: A Case Report and Review of the Literature

"Cotyledonoid dissecting leiomyoma" or "Sternberg tumor" is a very rare variant of smooth muscle tumors with a distinctive gross appearance. We describe a similar lesion, probably the sixth reported case, comparing its clinicopathological features with those of previous cases. A 26-yr-old nulliparous woman underwent laparotomy for a large pelvic mass replacing the postero-lateral aspect of the uterus with extension into the left pelvic cavity in the form of numerous exophytic congested small nodules. The tumor was removed by resection without hysterectomy after frozen section examination. Histologically, there were variable sized micronodules of benign smooth muscle fascicles, which were separated by fibrous connective tissue with a marked hydropic change and rich vascularity. Immunohistochemical and ultrastructural studies were helpful for confirmation of the smooth muscle nature, but not useful for the definitive diagnosis. Due to bizarre, sarcoma-like gross appearances, this type of lesion should be subjected to frozen section examination in order to avoid overtreatment and preserve the fertility in young women.

Lipid Peroxidation and Antioxidant Activity in Pregnant Women with Pregnancy-Induced Hypertension / 대한주산의학회잡지

OBJECTIVE: To assess maternal circulating levels of lipid peroxides, superoxide dismutase and total antioxidants of women with pregnancy-induced hypertension. METHODS: Cross-sectional study consisting of 18 preeclamptic, 21 uncomplicated pregnant and 22 healthy non-pregnant women. Fasting venous blood samples were collected during the 3rd trimester of antepartum period and maternal circulating levels of malondialdehyde as a lipid peroxidation product, superoxide dismutase activity and total antioxidants were measured. RESULTS: In the preeclamptic group, lipid peroxides were significantly increased, otherwise the activity of superoxide dismutase in the erythrocytes was significantly decreased compared to normal pregnant women. The value of serum total antioxidants was similar in both groups. Strong correlation was detected between malondialdehyde and blood pressure in the pregnant women. CONCLUSION: Preeclampsia is associated with decrease of antioxidant enzyme activity while lipid peroxidation was increased during the 3rd trimester of pregnancy. Therefore, a significant elevated lipid peroxidation and reduced superoxide dismutase activity may contribute to pathophysiology and pathogenesis of preeclampsia via vascular endothelial cell damage.

The Regulation of Cyclooxygenase-2 Expressionby Interleukin-1beta in WISH cells / 대한산부인과학회잡지

OBJECTIVE: To determine of the regulation of cyclooxygenase-2 (COX-2) expression by Interleukin-1beta in WISH cells. METHODS: Amnion WISH cells were incubated in media containing increasing concentrations of IL-1beta or with various inhibitors. Increased COX-2 expression was determined by Western blot analysis with anti-COX-2 antibody. Concomitant measurements of culture media PGE2 were made by an enzyme immunoassay. RESULTS: The COX-2 and prostaglandin E2 production induced by IL-1beta increased in a dose- and time-dependent manner. One of the regulating factors that induced COX-2 by IL-1beta was protein kinase C (PKC). PKC inhibitor, Ro 31-8220 was pretreated and continued treating by IL-1beta. Then, PKC inhibitor completely blocked COX-2 protein induction by IL-1beta. In contrast, COX-2 induction by IL-1beta after pretreating PKC stimulator, phobol 12-myristate 13-acetate was potentiated with synergism. Another factor in controlling COX-2 protein induction was identified as phosphatidylinositol 3-kinase (PI 3K). COX-2 protein induction by IL-1beta after pretreating PI 3K inhibitors, wortmannin and LY294002 strongly increased. This kind of result reflected that PI 3K act as negative regulator. COX-2 induction by IL-1beta was known to be regulated in not only transcription step, but also translation step after performing experiment of actinomycin and cycloheximide treatment. CONCLUSION: COX-2 protein and prostaglandin E2 production induced by IL-1beta were controlled by many factors in amnion cell. Among those factors, PKC and PI 3K have an important role, but their control mechanism act as positive and negative, respectively.

Three cases of symphysis pubis separation associated with delivery / 영남의대학술지

Symphysis pubis separation is an uncommon but not rare complication of delivery. Characteristic symptoms of symphyseal separation include suprapubic pain and tenderness which radiate to the back or legs, difficult ambulation, and bladder dysfunction. Clinical history, presenting symptoms, and response to therapy are sufficient to make the diagnosis, although radiographic documentation of symphyseal separation by x-ray or ultrasound are frequently used to confirm the diagnosis. The underlying etiology of symptomatic symphyseal separation has not been fully elucidated. Associations with macrosomia, pathological joint loosening, and increased force placed on the pelvic ring have been suggested as possible etiologies. Conservative therapy, including bed rest, pelvic binders, ambulation devices, and mild analgesics usually result in complete recovery within 4-16 weeks. Our experience of three cases of peripartum symphysis pubis separation delivered from 1998 to 1999 were reviewed with related articles.

The Changes in the Activity of Oxygen Free Radical Generating and Scavenging System as the Pregnant Period / 대한산부인과학회잡지

OBJECTIVE; This study was conducted to evaluate the effect of pregnancy on the activities of oxygen hee radical generating and scavenging system in the female rats. MATERIAL & METHOD; Rats weighing 200-220 gm were grouped to non-pregnant, 2nd trimester and 3rd trimester of pregnancy. The experiment was carried out following overnight fasting. Animals were anesthetized by administration of pentothal sodium, and blood was drawn via abdominal aorta. After exsanguination, the liver, kidney, heart, lung, with or without placenta tissues were excised immediately. The excised tissue was frozen in liquid nitrogen rapidly, and stored in liquid nitrogen for analysis. RESULTS; The gain in body weight was higher in pregnant rats than in normal rats. Lipid peroxidation was not significantly different among all groups in the liver, kidney, heart, lung, and placenta tissue. Xanthine oxidase activity of the kidney in the 3rd trimester of pregnancy was lower than that of non-pregnant rats. Superoxide dismutase activity of the liver was significantly decreased in the 2nd and 3rd trimester of pegnancy compared with that of non-pregnant rats, and that of lung was also decreased than that of non-pregnant rats. Catalase activity of the kidney was decreased in the 2nd and 3rd trimester of pregnancy compared with that of non-pregnant rats. Glutathione content of the liver was markedly decreased in the 2nd and 3rd trimester of pregnancy compared with that of non-pregnant rats. CONCLUSION; In conclusion, these results suggest that oxygen free radical will not increase in the liver, kidney, heart, lung, and placenta during normal pregnancy, but in the cases of overproduction of oxygen free radical, the liver, kidney, and lung will have me chance of tissue damage because of decreased activity of some anti-oxidant enzymes and/or decreased amount of anti-oxidant materials.

Effects of Obesity on Pregnancy Outcomes / 대한주산의학회잡지

OBJECTIVE:To compare pregnancy outcomes between obese and nonobese women and to determine the effect of gestational weight gain on pregnancy outcome in obese women. METHODS: A retrospective cohort study was conducted comparing 100 obese and 300 nonobese women who delivered a singleton live birth at Yeungnam university hospital from June 1998 to Dec 1998. Morbid obesity was defined as a body mass index greater than 30. The incidence of selected perinatal and neonatal outcome was assessed for two groups. RESULTS: Morbidly obese patients were more likly to experience pregnancy complications including gestational diabetes mellitus, preeclampsia, placental abruption, fetal distress, meconium aspiration, cesarean delivery & birth trauma. However, these were not affected by gestational weight gain in morbidly obese women. Weight gains more than 12kg were strongly associated with birth of a large for gestational age(LGA) neonate, however, poor weight gain did not appear to incrcase the risk of delivery of a low birth weight neonate. CONCLUSION: To optimize fetal growth, weight gain of 7-12kg for obese women appear to be appropriate. To reduce the risk of delivery of an LGA neonate, the optimal gestational weight gain for obese women should not exceed 12kg.

Maternal Weight Gain Pattern and Birth Weight / 영남의대학술지

Maternal weight gain during pregnancy has been consistently associated with infant birth weight and pregnancy outcome. Our purpose was to determined the relationship between maternal weight gain pattern and birth weight. Consequently, maternal weight gain is monitored carefully and is encouraged during prenatal care in order to improve pregnancy outcome. Our study group included both 424 uncomplicated women and infant delivered at the Yeungnam University Hospital between 1993-1996. All recorded prenatal weight gain measurements were used to estimate maternal trimester weight gain, pattern of gain (based on low versus not-low gain at each trimester), and total gain at delivery. Multiple linear regression analysis was used to assess the relationship between these weight gain measurements and fetal birth weight. Each kilogram of maternal gain in the first, second, and third trimesters was associatedwith statistically related to the increase in fatal birth weight by 31.3, 19.0, and 24.5g, respectively. When compaired with the pattern of gain that was not low in any trimester, patterns with low gain in the first trimesters were associated with significant decreases in birth weight, but no important change in birth weight was seen for the group whose gains were not low in the first trimester. The results suggest that specific patterns of maternal weight gain, particularly weight gain during the first trimester, are related to fetal birth weight.

A Case of Prenatal Ultrasonic Diagnosis of Extrathoracic Ectopia Cordis / 대한주산의학회잡지

Ectopia cordis is a rare congenital anomaly in which the heart is situated outside the chest cavity and has been known for many years, being reported first in 1671 by Neil Stenson. Ectopia cordis appears closely related with defective embryonic development, arising as the result of defective formation and differentiation of the ventral mesoderm at 14 to 18 days of embryonic life. Ectopia cordis is usually classified into many types according to the site at which the heart protrudes: thoracic type, abdominal type, thoraco-abdominal type, cervical type. We have experinced one case of ectopia cordis which was diagnosed by ultrasonography at 16th gestational weeks in 30 year old multiparity. We report this case with brief review of literatures.

A Clinical Study of Ectopic Pregnancy / 대한산부인과학회잡지

The term'ectopic pregnancy'refers to a gestation in which the fertilized ovum impl-ants on any tissue other than the mucous membrane lining the uterine cavity. The number of patients per year with an ectopic pregnancy is increasing. So we revi- ewed clinical characteristics of 503 cases of ectopic pregnancies, who were admitted and treated at the department of obstetrics and gynecology of Yeungnam University from July, 1991 to December, 1995. The results were as follows; 1. The incidence of ectopic pregnancy was 1 in 30 deliveries. 2. The most common age group was 26~30 years of age(34.5%). 3. According to obstetrical history, nullipara was 35.7% and the cases who experienced artificial abortion was 50.9%. 4. In past history, 50.9% of total cases has artificial abortion and 10.1% experienced previous ectopic pregnancy, tubal sterilization was 8.0%. 5. For chief complaints, lower abdominal pain was observed in 359 patient(71.0%), am- enorrhea in 238 patients(47.3%), and vaginal spotting in 209 patients(42.1%). 6. In oder of incidence, the site of ectopic pregnancy was fallopian tube(91.5%), cervix (1.4%) and ovary(0.8%). In tubal pregnancy, the most frequent implantation site was am- pullar portion in 373 cases(74.2%) and ruptured tubal pregnancies were 306 cases(60.8%). 7. The interval between last menstrual period(LMP) and onset of symptoms was gene- rally 6~8 weeks(36.3%). 8. 65.4% of total cases were treated by salpingectomy, 14.1% by pelviscopic operati- on, and 5.8% by salpingo-oophorectomy.

Gait abnormality of children without specific identified disease

No abstract available.