Tipos de partos y niveles de oxitocina, cortisol y hormonas tiroideas en plasma del cordón umbilical / Types of deliveries and levels of oxytocin, cortisol and thyroid hormones in umbilical cord plasma

Introducción: La placenta sintetiza y secreta varias hormonas que permiten la regulación del embarazo, el trabajo de parto y la adaptación metabólica materno-fetal. Su comportamiento asociado al tipo de parto puede dar información relevante sobre efectos epigenéticos. Objetivo: Describir el tipo de parto con los niveles de oxitocina, cortisol y hormonas tiroideas en plasma de cordón umbilical al nacer. Método: A 50 mujeres con embarazos principalmente normales se les cuantificaron los niveles neurohormonales en plasma de cordón umbilical, obtenido inmediatamente tras el periodo expulsivo. Los resultados se incorporaron a la base de datos clínicos de cada participante y se analizaron con Stata v.14.0. El protocolo fue aprobado por el comité de ética. Resultados: Hubo 33 partos vaginales (12 espontáneos, 13 acelerados y 8 inducidos) y 17 cesáreas (7 electivas y 10 de urgencia). Se observaron mayores niveles de cortisol en los partos vaginales acelerados; las cesáreas tuvieron menores niveles de cortisol y hormona estimulante de la tiroides. Las intervenciones clínicas, con altos o bajos niveles hormonales, están en directa relación con el tipo de parto. Conclusiones: El cortisol y la hormona estimulante de la tiroides medidos en plasma de cordón umbilical variaron según el tipo de parto. Esto es una primera cuantificación de hormonas en plasma de cordón umbilical y su posible regulación placentaria a propósito del tipo de parto.

Introduction: The placenta synthesizes and secretes several hormones allowing the regulation of pregnancy, labor and maternal-fetal metabolic adaptation. Their behavior associated with the type of delivery, may provide relevant information on epigenetic effects. Objective: To describe the type of delivery with the levels of oxytocin, cortisol and thyroid hormones in umbilical cord plasma at birth. Method: Neurohormonal levels from umbilical cord plasma obtained immediately post expulsion, were quantified in 50 women with mainly normal pregnancies. Results incorporated into the clinical database of each participant, statistically analyzed in Stata v.14.0. Protocol approved by ethics committee. Results: 33 were vaginal deliveries (12 spontaneous, 13 accelerated, 8 induced) and 17 cesarean sections (7 elective and 10 emergency). Higher cortisol levels were observed in accelerated vaginal deliveries, cesarean sections had lower cortisol and thyroid stimulating hormone levels. While clinical interventions, with high or low hormone levels, were related to the type of delivery. Conclusions: Cortisol and thyroid stimulating hormone measured in umbilical cord plasma varied according to the type of delivery. This is a first quantification of hormones in umbilical cord plasma and their possible placental regulation in relation to the type of delivery.

Les modifications morphologiques placentaires observees chez le nouveau ne hypotrophique Camerounais

Résumé Introduction. Le placenta est un organe nourricier assurant un lien vital entre le foetus et la mère. Les lésions placentaires ont des répercussions sur le développement foetal et peuvent expliquer l'hypotrophie.Objectif. Décrire les lésions anatomopathologiques des placentas des nouveaux nés hypotrophes observés en milieu hospitalier. Matériels et Méthodes. Il s'agissait d'une étude prospective, transversale et analytique couvrant une période de seizemois, du 1er juin 2010 au 31 octobre 2011. Le recrutement des placentas était consécutif. L'examen anatomopathologique a été effectué après examen systématique des placentas. Résultats. Un échantillon de 140 placentas parmi lesquels 70 placentas issus des nouveaux nés hypotrophes ont été appariés à 70 placentas des sujets normaux. Les placentas provenaient des femmes dont l'âge variait de 15 ans à 44 ans avec une moyenne de 27,16±5,91 ans. Les anomalies macroscopiques relevées dans les placentas des nouveaux nés hypotrophes comportaient 37,50% d'insertion marginale et vélamenteuse du cordon ainsi que 42,50% de brachy-cordon. Les différences concernant l'insertion du cordon étaient statistiquement significatives (P <,05). Les lésions histologiques étaient caractérisées par des villites, des intervillites, suivies des chorioamniotites, d'un excès de dépôts de fibrine, des amas trophoblastiques exubérants périvillositaires, de collapsus de la chambre intervilleuse, de nécrose ischémique, de diminution de la taille des villosités et de la congestion des vaisseaux, soit au total 37,10% des lésions. Par contre, seulement 20,10% de lésions microscopiques était retrouvée dans les placentas des nouveaux nés du groupe témoin, la différence dans les deux groupes étant statistiquement significative (P =, 039). Conclusion. Les placentas des nouveaux nés hypotrophes montrent plus fréquemment une diversité de lésions macroscopiques et histologiques avec une nette prédominance des villites et intervillites, comparés aux placentas des nouveaux nés normaux

Histoquímica e morfometria da placenta de ratas tratadas com dexametasona / Placental morphometry and histochemistry in rats treated with dexamethasone in early pregnancy

A dexametasona, um glicocorticóide sintético, tem a capacidade de atravessar a placenta aumentando o nível de circulação de corticosteróides da mãe para o feto durante a prenhez. Quando administrada nas fases finais da prenhez pode produzir efeitos indesejáveis na formação da placenta e em vários órgãos da prole. Assim, o presente estudo objetivou investigar o efeito da administração da dexametasona (0,8mg/dia/animal) nos cinco primeiros dias da prenhez, sobre o desenvolvimento placentário de ratas. Utilizou-se 30 ratas albinas, divididas em dois grupos: Grupo I -ratas prenhes sem aplicação de dexametasona, sacrificadas ao 7º e 14º dia; Grupo II -ratas submetidas à aplicação de dexametasona nos cinco primeiros dias de prenhez, sacrificadas ao 7º e 14º dia. Os resultados mostraram que a dexametasona não afetou o número e a histologia dos sítios de implantação, porém, promoveu alteração no disco placentário ocasionando hipertrofia na camada de células trofoblásticas gigantes. Não foram evidenciadas alterações no teor de colágeno, porém houve interferência no metabolismo do glicogênio no espongiotrofoblasto trofospongio. Na morfometria de linhas houve diferença entre os grupos na região de labirinto e células trofoblásticas gigantes, porém a morfometria de pontos só ratificou as alterações percebidas na região do labirinto.

The dexamethasone, a synthetic glucocorticoid, has the ability to cross the placenta by increasing the level of movement of corticosteroids from mother to fetus during pregnancy. When administered in the late stages of pregnancy can produce effects undesirable on placental formation. The present study aimed to investigate the effect of administration of dexamethasone (0.8mg/day/animal) in the first five days of pregnancy, on placental development in rats. We used 30 albino rats, divided into two groups: Group I -pregnant rats without the application of dexamethasone, sacrificed to the 7th and 14th day. Group II -rats subjected to the application of dexamethasone in the first five days of pregnancy, sacrificed to the 7th and 14th day. The results showed that dexamethasone did not affect the number and histology of the implantation sites, but promoted changes in the disk placental causing hypertrophy in trophoblastic giant cell layer. No changes were found in the content of collagen, but there was interference with the metabolism of glycogen in spongiotrophoblast. The morphometry of lines showed, a difference between groups in the region of labyrinth and trophoblast giant cell. However, in morphometry of points there was a difference between groups in the region of labyrinth.

Insulin Resistance During Pregnancy / 당뇨병

Pregnancy is a complex metabolic state involving dramatic alterations in the hormonal or cytokine environments (increases in estrogen, progesterone, prolactin, cortisol, human chorionic gonadotropin, placental growth hormone and human placental lactogen, TNF-alpha, resistin, leptin, and a decrease in adiponectin) as well as an increasing burden of fuel utilization by the conceptus. Metabolically, the first trimester is characterized by increased insulin sensitivity and lipogenesis. The second and third trimesters, in contrast, are characterized by insulin resistance and increased lipolysis.

Prediction of infants who may develop bronchopulmonary dysplasia in preterm babies with respiratory distress syndrome

The objective of this study was to test the neonatal polymorphism of TNF alpha to measure the day one levels of sL-selectin, sE-selectin and sICAM-1 in sera of neonate and placenta growth factor in cord blood, for the prediction of development of bronchopulmonary dysplasia [BPD]. The study design was a cross sectional one. Forty preterm neonates with respiratory distress and 10 normal full term neonates were enrolled. The neonates were divided into 2 subgroups; 15 who developed bronchopulmonary dysplasia and 25 without. Sampling was done and diagnostic evaluation of all parameters was accomplished. The results proved that infants. None of the infants with BPD carried the AA TNF- alpha -238 genotype, compared with 3 infants without BPD, and only 1 infant with BPD carried the GA TNF- alpha -238 genotype, compared with 7 infants without BPD. Higher sE-selectin has a diagnostic ability [sensitivity 73%, specificity 76%] higher PLGF has a sensitivity of 67% and specificity 68%. Combination of both, improved specificity to 80%. If we add to them, cases which have absence of GA TNF- alpha -238 genotype, we have got a very high sensitivity [93%] but with lower specificity. Combined all data supported a specificity 80% with a sensitivity of 86%. What had been found in this study might clarify the role of adhesion molecules, P1GF and TNF polymorphism as biological marker to determine which premature infants with RDS are at risk for development of BPD and to permit early intervention and might provide a new therapeutic target to prevent BPD

Inhibitory effect of ginsenoside-Rg3 on lung metastasis of mouse melanoma transfected with ribonuclease inhibitor / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effect of ginsenoside-Rg3 on lung metastasis of ribonuclease inhibitor (RI) gene-transfected mouse B16 melanoma.</p><p><b>METHODS</b>C57BL/6 mice were iv injected with parental or RI-transfected B16 melanoma cells. Lung metastasis was assessed by the number of surface tumor nodules. Mice were divided into 6 groups. Group I, II and III of mice were given parental, mock-transfected and RI-transfected B16 melanoma cells, respectively while in group IV, V and VI, Rg3 (1.5 mg/kg, iv q.o.d. x 10) was given to mice bearing parental, mock-transfected and RI-transfected B16 melanoma, respectively. Micovessel density (MVD) of the lung metastatic tumor was assessed by immunohistochemical staining of factor VIII-R expression.</p><p><b>RESULTS</b>The number of tumor nodules was significantly decreased in mice injected with RI-transfected B16 melanoma (Gp III, compared to Gp I and II). Rg3 treatment per se could also decrease the number of lung tumor nodules but to a lesser extent (Gp IV and V compared to Gp III). However, Rg3 synergized with RI transfection resulting in most significant inhibition of lung metastasis (Gp VI). Mice in Gp I and II died within 26 days of the experiment, whereas all the mice in Gp VI were alive during the observation period of one and one half month. MVD was significantly decreased in the lung tumor nodules in mice injected with RI-transfected B16 melanoma. It was further decreased when additional Rg3 was given (Gp VI).</p><p><b>CONCLUSION</b>Transfection of ribonuclease inhibitor gene significantly reduces the metastatic potential of B16 melanoma. Ginsenoside-Rg3 has a synergistic effect.</p>

Influência de hormonios placentários no parto prematuro / Placentary hormonal influences in premature delivery

Esta revisäo tem por finalidade verificar a correlaçäo existente entre a influência hormonal placentária e a parte prematura. Mesmo sendo discutivel o papel dos hormonios placentários, a queda da progesterona e tida como importante fator desencadeante das contraçöes uterinas. Em vista disto, embora sejam necessários estudos duplo-cegos controlados, recomendamos o uso da progesterona via vaginal em determinadas pacientes com risco elevado para o parto prematuro

Participación de hormonas y factores reguladores de la implantación y el desarrollo de la unidad fetoplacentaria / Hormonal participation and regulating factors of implantation and the fetoplacentary unity development

Si bien el embrión tiene un programa genético de su propio desarrollo, para que se lleven a cabo el desarrollo y diferenciación embrionaria, así como la gestación normal, deben establecerse una serie de interacciones coordinadas entre el concepto y la madre, las cuales son mediadas por mensajeros químicos mediante mecanismo autocrinos, paracrinos y endocrinos. En el presente trabajo se analiza la participación de hormonas y factores réguladores de la implantación y el desarrollo de la unidad feto-placentaria

Plasma Lipid Alteration in Leukemia and Solid Tumor

PURPOSE: A sensitive, specific blood test to detect cancer would be of great value but the search for such a test has been fruitless so far. In actual practice, there is often a considerable interval between the point at which a tumor could have been detected and the point at which it produces symptoms as a result of tumor growth. The research has been largely directed toward the identification of tumor-specific subtances that are liberated into body fluid. These tumor markers will not only indicate the presence of a cancer but also identify its site of origin and morphology. The available tumor markers, including the oncofetal antigen, placental hormones and enzymes, do not have enough tumor specificity or sensitivity to be used in diagnosis, but they do have a selective role monitoring the progression of tumor growth and assessing the response to treatment. Plasma lipid abnormality occurs regularly in many experimental animal tumor system. In some cases, their pattern and pathogenesis as well as their correlation with tumor volume and histologic features have been well characterized. Since both in vivo and in vitro celluar lipid alterations have been studied most intensively and found most commonly in lymphoproliferative and myeloproliferative disease, these form a particularly interesting group of malignancies for further investigation. In this study, we prospectively evaluated 26 patients with leukemia and 10 patients with solid tumor with full plasma lipid profiles. METHODS: Plasma lipids and lipoproteins were studied in 36 patients with acute leukemia and solid tumor at initial presentation or relapse and lipid studies were regularly repeated during a period of clinical remission. Patients were admitted to the department of pediatrics Eulji general hospital between March 1988 and June 1992 and they had no drugs known to alter lipid metabolism. No patient had a history of thyroid disease or diabetes and none had evidence of hepatic or renal dysfunction. Full serum chemistry analysis was performed utilizing Automated Analyzer and total serum lactic acid dehydrogenase was used as an additional parameter of tumor burden in all patients. Lipoprotein concentrations in plasma were measured b electrophoresis, and total lipid, phospholipid and free fatty acid by enzyme immunoassay. RESULTS: A consistent and predictable pattern of alterations in plasma lipid and lipoproteins were found. This pattern consisted of a marked decrease in aloha-lipoprotein(p=0.0001) and total cholesterol(p=0.0066), and increase in beta-lipoprotein(p=0.0001). Changes in triglyceride, phospholipid, free fatty acid and pre-beta-lipoprotein levels were net significant. The degree of lipid abnormality was directly related to the underlying tumor burden in leukemia. Among the lipid and lipoprotein alteration, aloha-lipoprotein appeared to be most sensitive indicator for the presence of tumor. CONCLUSIONS: The result suggest that an abnormality in systemic lipid metabolism, possibly in cholesterol clearance, is present in cancer patient. There appeared to be a direct relationship between magnitude of lipid abnormality and the amount of tumor burden but at the present time the exact mechanism of tumor-host interaction and its possible clinical implications remain to be determined.

Immunologic and neuroendocrine interactions in pregnancy.

The neuroendocrine system helps in the success of the fetal graft by suppressing maternal cellular immune response against the foreign paternal histocompatibility (HLA) antigens. In addition, placenta absorbs the antibodies directed against the paternal HLA antigens, thus inhibiting the humoral rejection of the fetal graft. In contrast, neuropeptides released in the maternal blood stream under adverse mental states may stimulate lymphocyte blastogenesis and natural killer (NK) cell activity resulting in premature loss of the fetus. Further, homozygosity of a lethal gene which is in linkage disequilibrium with HLA genes may have a role in some unexplained fetal deaths.

Embarazo ectópico en Tingo María / Ectopic pregnancy in Tingo María

Es unánime la aceptación de que el embarazo ectópico se encuentra con más frecuencia en la trompas. En la práctica se usa los términos de embarazo ectópico y embarazo tubárico como sinónimos. Se investiga los resultados de 39 embarazos ectópicos atendidos en el Hospital de Tingo María entre el 1 de Enero de 1971 al 31 de Diciembre de 1985. Se halló un ectópico por cada 530 recien nacidos vivos; el 53.84 por ciento tenían 15 a 29 años; 100 por ciento presentaron dolor; sangrado vaginal 94.87 por ciento y shock, 5.12 por ciento; hubo 12.82 por ciento de error diagnóstico; las multiparas pagaron mayor tributo (71.79 por ciento), presentaron los síntomas antes de las 9 semanas de gestación, 92.30 por ciento; como pruebas de ayuda diagnóstica, se usó culdocentesis y dosaje de B*HCG prueba inmunológica simple cualitativa, además de análisis de rutina; la salpinguestomía se utilizó como tratamiento en 94.87 por ciento. La totalidad de los embarazos ectópicos se halla en las trompas. No tuvimos ninguna muerte materna. La frecuencia de embarazo ectópico en Tingo María es reducida