RESUMO
PURPOSE: Postpartum depression (PPD) is a common postnatal problem. PPD has a negative influence on maternal functioning and child development. We examined the result of Edinburgh Postnatal Depression Scale (EPDS) after delivery. METHODS: Three hundred two postpartum mothers were enrolled in the study. The Korean version of EPDS was completed and scored at postpartum visits. Mothers whose score was 10 or more were classified as an EPDS positive for PPD. We reviewed their medical records and determined risk factors for positive EPDS result. RESULTS: The positive rate of EPDS was 27.8% (84/302). Among various factors, a newborn's body weight more than 4.0 kg was statistically related to the positive result. The positive rate of EPDS was significantly higher when performed within postpartum 60 days than after postpartum 60 days. Among 84 positive women, only three mothers visited a psychiatric clinic for further evaluation and management of PPD. CONCLUSION: The EPDS was a useful tool for PPD screening. Obstetricians should consider an EPDS for effective screening of PPD. It would be the next important issue to encourage a screening positive mother to visit a psychiatric clinic.
Assuntos
Criança , Feminino , Humanos , Peso Corporal , Desenvolvimento Infantil , Depressão Pós-Parto , Programas de Rastreamento , Prontuários Médicos , Mães , Período Pós-Parto , Fatores de RiscoRESUMO
Human papillomavirus (HPV)infection are now generally accepted as the most important factor for development of uterine cervical cancer and its precursor lesions. With increasing evidences that the HPV E7 encodes for oncoproteins critical for viral replication, host cell immortalization and transformation. Based on the previous reports that the high risk HPV type 16 DNA is frequently detected in specimens from Korean women with cervical cancer and that there is the sequence variation and geographical dependence of HPV 16 E7 gene in preinvasive and invasive cervical lesions, it is crucial to determine the prevalence of HPV 16 variants in uterine cervical lesions of Korean women. This study was performed to identify sequence variations of HPV 16 E7 gene and an association between HPV 16 E7 variants and uterine cervical cancer. The author has determined nucleotide sequences of the E7 gene of HPV 16 isolated from uterine cervical tissues in Korean women. HPV 16 DNAs were detected by the nested PCR in 112 (24.5%) of a total of 457 samples. By direct sequencing of PCR-HPV 16 E7 positive cases, 79 samples (70.5%) showed variant sequences, while the prototype sequence was found in only 33 samples (29.5%). Twenty-three cases (57.5%) of 40 normal cervical samples showed sequence variation. Forty-eight (77.4%) of 62 cervical cancer cases showed sequence diversity from prototype HPV 16 E7 gene. There were four types of sequence variations. A single nucleotide change at position 647 (A-->G) was found in 52 cases (65.8%) of 79 HPV 16 E7 variants. Predicted amino acid change (Asn -->Ser) was found in the HPV 16 E7 oncoproteins at amino acid position at 29. And this KE7-1 variant was commonly detected in the uterine cervical cancer compared to the normal cervix. The second most common variant, detected in 16 cases (20.3%), had three silent mutations at nucleotide positions 732 (T-->C), 789 (T-->C) and 795 (T-->G). The third variant had a single nucleotide change at position 666 (G-->A), and the fourth had a change at position 796 (T-->C). Furthermore, PCR-SSCP clearly showed distinct bands compatible with HPV 16 E7 variants as with the direct-sequencing method. PCR-SSCP was also an effective and reliable tool in detecting HPV 16 E7 variants. This study showed that there were four variant types of HPV 16 E7 in uterine cervical tissues and KE7-1 with corresponding amino acid change was the most commonly detected type in E7 variants of HPV 16 isolated from uterine cervical cancer in Korean women.
Assuntos
Feminino , Humanos , Sequência de Bases , Colo do Útero , DNA , Papillomavirus Humano 16 , Proteínas Oncogênicas , Reação em Cadeia da Polimerase , Polimorfismo Genético , Prevalência , Neoplasias do Colo do ÚteroRESUMO
OBJECTIVE: The ovarian cycle is characterized by repeating patterns of cellular proliferation and differentiation that accompany follicular development and the formation and regression of the corpus luteum (CL). That angiogenesis may play an important role in this process. Angiogenesis is supposed to be regulated by vascular endothelial growth factor (VEGF). The goal of the present investigation, therefore, was to determine whether the expression of VEGF was changed in the normally cycling human ovary. We also investigated VEGF expression in the regressed CL (ie, nonfunctiong CL) of normal term pregnancy to define the association with steroidogenic activity. To our knowledge there is no report available on VEGF expression in the CL of term pregnancy. METHODS: We assessed VEGF expression in ovaries obtained from, 26-42 yr of age, and from patients undergoing hysterectomy and salpingo-oophorectomy for nonendocrinological or nonovarian disorders. Tissue samples from premenopausal women included specimens from follicular (n=4) and luteal (n 4) phases. In addition, we studied ovarian specimens from pregnant women (n=3). Immunohistochemical analysis for VEGF was performed using a rabbit polyclonal antibody directed against human VEGF. RESULTS: These data demonstrate a development-related VEGF expression in the follicle and indirectly show that VEGF expression may be up to the existence of LH-receptor. And also, VEGF was overexpressed in the regressed CL of pregnant women compared with the functioning CL of nonpregnant cycles CONCLUSION: This study suggests that the intensity of VEGF expression is not correlated with steroidogenic activity, although both of them are stimulated by LH.
Assuntos
Feminino , Humanos , Gravidez , Proliferação de Células , Corpo Lúteo , Histerectomia , Ciclo Menstrual , Folículo Ovariano , Ovário , Gestantes , Fator A de Crescimento do Endotélio VascularRESUMO
The association of major fetal malformations with amniotic bands has been known for many years. However, we are apt to ignore the possibility of amniotic band syndrome. In this case, fetal anencephaly was diagnosed at 17 weeks, menstrual age on the basis of sonographic findings. Following pregnancy termination, examination of the abortus rev- ealed the cerebral remnant which is similar to that found in dysraphic anencephaly, but collateral evidence of amniotic band was found. Therefore, when confronted with severe cranial or cerebral malformation amniotic band syndrome should be in the differential dia- gnosis.
Assuntos
Recém-Nascido , Gravidez , Síndrome de Bandas Amnióticas , Anencefalia , Pele , UltrassonografiaRESUMO
Since Folkman's novel hypothesis, it is well known that tumors depend on the angiogenesis for their growth, expansion, and possibly metastasis. Several angiogenic factors have been identified and shown to be produced by tumors. In some cancers, the angoigenic activity in the tumor is correlated with the clinical outcome. Clinically, the presence of macroscopic or colposcopic abnormal vascular patterns of the uterine cervical lesions would suggest that the angiogenic activities are associated with various cervical squamous epithelial lesions. This study was designed to look at the relationship between angiogenesis and squamous epithelial lesions of the uterine cervix and to determine whether squamous intraepithelial lesions are angiogenic as cervical cancers are. Tissue sections from 53 surgical specimens(6 normal cervix, 4 chronic cervictis, 9 low grade SII, 8 high grade SIL, 7 MIC, 19 squamous cell carcinoma) were immunohistochemically stained for CD 34 a specific marker for endothelial cels. Stained vessels in the most intense area on a X200 light microscopic field were selected and counted automatically using computer software for color-image analysis. Stained vessel counts were 19.7 +/- 9.1 in normal cervix, 33.5 +/-5.8 in chronic cervicitis, 38.8 +/- 10.9 in LGSIL, 67.0 +/- 23.6 in HGSIL, and 73.4 +/- 20.6 in microinvasive carcinoma, 77.8 +/- 28.7 in squamous cell carcinoma, respectively. Vessel counts showed a statistically increasing tendency in more advanced squamous epithelial lesins. Tumor angiogenesis is not related to inflammatory response. Also, the process of the angiogenic switching may begin from low grade SIL to high grade SIL. This study suggests that the angiogenic activity also involved in SILs as invasive cancer are and may be related to grade of SELs.
Assuntos
Feminino , Indutores da Angiogênese , Carcinoma de Células Escamosas , Colo do Útero , Metástase Neoplásica , Cervicite UterinaRESUMO
Pregnancy maintenance is dependent on the presence of a functional corpusluteum (CL) for a few weeks after implantation. However, the factors responsible for the rescue of the CL during earlypregnancy have not been fully clarified. This study was designed to evaluate whether the change in size of the CL ofearly pregnancy, serum concentration of progesterone, 17alpha-hydroxyprogesterone,or beta-hCG correlated with the gestational age or were predictive of pregnancyoutcome. We retrospectively analysed thirty-six women between 4~9 weeks' gestation. All women underwent transvaginal ultrasound measurement of the CL size andgestational sac(or crown-rump length). Blood was drawn from each patient on the day of the ultrasound examinationto measure hormone concentration. Fifteen women experienced vaginal bleeding and abdominal pain.Among them, four women were aborted. There was no significant positive correlation between CL size and serumprogesterone, 17alpha-hydroxyprogesterone or beta-hCG both in normal and abnormal pregnancy. A positive correlation was observed between the gestational age and progesterone orbeta-hCG in normal pregnancy, but not in abnormal pregnancy(threatened or spontanousabortion). In conclusion, close correlation between the gestational age and serum concentrationof progesterone or beta-hCG may reflect the normal function of CL. Therefore, abnormal response of CL or abnormal production of beta-hCG cause a disturbancein progesterone secretion leading to the abnormal pregnancy.
Assuntos
Feminino , Humanos , Gravidez , Corpo Lúteo , Idade Gestacional , Manutenção da Gravidez , Progesterona , Estudos Retrospectivos , Ultrassonografia , Hemorragia UterinaRESUMO
Pregnancy maintenance is dependent on the presence of a functional corpusluteum (CL) for a few weeks after implantation. However, the factors responsible for the rescue of the CL during earlypregnancy have not been fully clarified. This study was designed to evaluate whether the change in size of the CL ofearly pregnancy, serum concentration of progesterone, 17alpha-hydroxyprogesterone,or beta-hCG correlated with the gestational age or were predictive of pregnancyoutcome. We retrospectively analysed thirty-six women between 4~9 weeks' gestation. All women underwent transvaginal ultrasound measurement of the CL size andgestational sac(or crown-rump length). Blood was drawn from each patient on the day of the ultrasound examinationto measure hormone concentration. Fifteen women experienced vaginal bleeding and abdominal pain.Among them, four women were aborted. There was no significant positive correlation between CL size and serumprogesterone, 17alpha-hydroxyprogesterone or beta-hCG both in normal and abnormal pregnancy. A positive correlation was observed between the gestational age and progesterone orbeta-hCG in normal pregnancy, but not in abnormal pregnancy(threatened or spontanousabortion). In conclusion, close correlation between the gestational age and serum concentrationof progesterone or beta-hCG may reflect the normal function of CL. Therefore, abnormal response of CL or abnormal production of beta-hCG cause a disturbancein progesterone secretion leading to the abnormal pregnancy.
Assuntos
Feminino , Humanos , Gravidez , Corpo Lúteo , Idade Gestacional , Manutenção da Gravidez , Progesterona , Estudos Retrospectivos , Ultrassonografia , Hemorragia UterinaRESUMO
This studly was perormed 10 define the role of compulerized quantitative analysis in ewalualion for overexpression of p53 by immunohistochemistry. Total and ladeled cells wers counted automatically using commercially available software for color-image analysis. In 16 uterine cerwical carcinomas, the p53 ladeling index calculted bycomputerized5quantitatiwe analysis was 9.22%+/-8.70% and by visual analysis 5.90+/-6.51%. The present results suggest that the computerized quantitative analysis may be valuadle in objective interetation of immunohistochemical expression of p53 and reliable than conventional ways of visual analysis.
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Feminino , Colo do Útero , Imuno-HistoquímicaRESUMO
Pure, nongestational ovarian choriocarcinomas is extremely rare. Most ovarian choriocarcinoma are combined with other malignant germ cell tumors or can arise as a metastaais from a primnry gestational choriocarcinoma. We experienced a case of primary ovarian choriocarcinoma that probably was associated with a past history of the mixture of germ cell tumor and present it with a review of literature.
Assuntos
Feminino , Gravidez , Coriocarcinoma , Neoplasias Embrionárias de Células GerminativasRESUMO
No abstract available.