Prediction of Adverse Outcomes among Women in the Third Trimester of Pregnancy with Coronavirus Disease 2019 / 감염과화학요법

Background@#This study aimed to compare the clinical and laboratory characteristics of two groups of women (favorable and adverse outcome groups) in the third trimester of pregnancy with coronavirus disease 2019 (COVID-19) and to investigate the predictors of specific adverse outcomes. @*Materials and Methods@#We retrospectively reviewed the medical records of patients hospitalized with COVID-19 between November 2020 and October 2021 at Kyungpook National University Chilgok Hospital. Adverse outcomes were clinically defined using the Novel Coronavirus Pneumonia Emergency Response Epidemiology Team criteria. The group without adverse outcomes was defined as the “favorable outcome” group and the rest as the “adverse outcome” group. We compared the clinical characteristics between the two groups and examined the correlation between their laboratory results and adverse outcomes. @*Results@#Of the 70 pregnant women included, 37 were in their third trimester. No significant differences in clinical characteristics, except the length of hospitalization, were noted between the groups. In laboratory tests conducted immediately after hospitalization, C-reactive protein (CRP) (1.0 [0.3 - 1.4] vs. 2.3 [1.3 - 3.6], P = 0.001) and ferritin (25.0 [14.5 - 34.5] vs. 53.1 [36.0 - 98.0], P <0.03) levels were significantly different between the groups. Logistic regression analysis revealed that CRP (odds ratio [OR]: 2.26; 95% confidence interval [CI]: 1.09 - 5.51, P = 0.040) and ferritin (OR: 1.06; 95% CI: 1.01 - 1.15,P = 0.047) levels were predictors of adverse outcomes. @*Conclusion@#CRP and ferritin levels are associated with poor prognosis and can predict adverse outcomes in women with COVID-19 in the third trimester of pregnancy.

Association between gestational age at delivery and lymphocyte-monocyte ratio in the routine second trimester complete blood cell count / 영남의대학술지

Background@#We aimed to determine whether routine second trimester complete blood cell (CBC) count parameters, including neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and platelet-lymphocyte ratio (PLR), could predict obstetric outcomes. @*Methods@#We included singleton pregnancies for which the 50-g oral glucose tolerance test and CBC were routinely performed between 24 and 28 weeks of gestation in our outpatient clinic from January 2015 to December 2017. The subjects were divided into three groups according to their pregnancy outcomes as follows: group 1, spontaneous preterm births, including preterm labor and preterm premature rupture of membranes; group 2, indicated preterm birth due to maternal, fetal, or placental causes (hypertensive disorder, fetal growth restriction, or placental abruption); and group 3, term deliveries, regardless of the indication of delivery. We compared the CBC parameters using a bivariate correlation test. @*Results@#The study included 356 pregnancies. Twenty-eight subjects were in group 1, 20 in group 2, and 308 in group 3. There were no significant differences between the three groups in neutrophil, monocyte, lymphocyte, and platelet counts. Although there was no significant difference in NLR, LMR, and PLR between the three groups, LMR showed a negative correlation with gestational age at delivery (r=−0.126, p=0.016). @*Conclusion@#We found that a higher LMR in the second trimester was associated with decreased gestational age at delivery. CBC parameters in the second trimester of pregnancy could be used to predict adverse obstetric outcomes.

Postnatally diagnosed coexisting congenital diaphragmatic hernia with pulmonary sequestration: a report of two cases

While the associations between pulmonary sequestration (PS) and congenital diaphragmatic hernia (CDH) are known, CDH may be obscured by PS and thus, overlooked on prenatal ultrasonography when coexisting with PS. We present 2 cases of postnatally diagnosed CDH combined with PS. In both cases, PS was prenatally diagnosed as an isolated lung mass, while CDH was confirmed only after birth. Both newborns were sufficiently stable that management was not required immediately after birth. PS may function as an “anatomical barrier” to prevent herniation of the abdominal contents into the chest, thus acting as a “protector” providing normal lung maturation throughout pregnancy. If PS is suspected prenatally, coexisting CDH may be obscured; thus, close prenatal care and counseling of the parents regarding the possibility of CDH are essential. These infants should be delivered at a tertiary center, and imaging should be performed to exclude coexisting CDH.

Postnatally diagnosed coexisting congenital diaphragmatic hernia with pulmonary sequestration: a report of two cases

While the associations between pulmonary sequestration (PS) and congenital diaphragmatic hernia (CDH) are known, CDH may be obscured by PS and thus, overlooked on prenatal ultrasonography when coexisting with PS. We present 2 cases of postnatally diagnosed CDH combined with PS. In both cases, PS was prenatally diagnosed as an isolated lung mass, while CDH was confirmed only after birth. Both newborns were sufficiently stable that management was not required immediately after birth. PS may function as an “anatomical barrier” to prevent herniation of the abdominal contents into the chest, thus acting as a “protector” providing normal lung maturation throughout pregnancy. If PS is suspected prenatally, coexisting CDH may be obscured; thus, close prenatal care and counseling of the parents regarding the possibility of CDH are essential. These infants should be delivered at a tertiary center, and imaging should be performed to exclude coexisting CDH.

Antioxidant and antiobesity activities of oral treatment with ethanol extract from sprout of evening primrose (Oenothera laciniata) in high fat diet-induced obese mice / 한국영양학회지

PURPOSE: Sprouts of evening primrose (Oenothera laciniata, OL) were reported to have high contents of flavonoids and potent antioxidant activity. This study examined the antioxidant and antiobesity activities of OL sprouts to determine if they could be a natural health-beneficial resource preventing obesity and oxidative stress.METHODS: OL sprouts were extracted with 50% ethanol, evaporated, and lyophilized (OLE). The in vitro antioxidant activity of OLE was examined using four different tests. The antiobesity activity and in vivo antioxidant activity from OLE consumption were examined using high fat diet-induced obese (DIO) C57BL/6 mice.RESULTS: The IC₅₀ for the 2,2-diphenyl-1-picryl-hydrazyl (DPPH) radical scavenging and superoxide dismutase (SOD)-like activities of OLE were 26.2 µg/mL and 327.6 µg/mL, respectively. OLE exhibited the ferric reducing antioxidant power (FRAP) activity of 56.7 µg ascorbic acid eq./mL at 100 µg/mL, and an increased glutathione level by 65.1% at 200 µg/mL compared to the control in the hUC-MSC stem cells. In an animal study, oral treatment with 50 mg or 100 mg of OLE/kg body weight for 14 weeks reduced the body weight gain, visceral fat content, fat cell size, blood leptin, and triglyceride levels, as well as the atherogenic index compared to the high fat diet control group (HFC) (p < 0.05). The blood malondialdehyde (MDA) level and the catalase and SOD-1 activities in adipose tissue were reduced significantly by the OLE treatment compared to HFC as well (p < 0.05). In epididymal adipose tissue, the OLE treatment reduced the mRNA expression of leptin, PPAR-γ and FAS significantly (p < 0.05) compared to HFC while it increased adiponectin expression (p < 0.05).CONCLUSION: OLE consumption has potent antioxidant and antiobesity activities via the suppression of oxidative stress and lipogenesis in DIO mice. Therefore, OLE could be a good candidate as a natural resource to develop functional food products that prevent obesity and oxidative stress.

Cervical varix with thrombosis diagnosed in the first trimester of pregnancy

Cervical varix is rare and can develop due to various conditions in pregnancy. Most cases of cervical varix during pregnancy are diagnosed in the second or third trimester and are usually associated with abnormal placental location, such as placenta previa or low-lying placenta. A 23-year-old woman with cervical varix bleeding visited our institution at 8 weeks of gestation. This case report describes cervical varix bleeding that developed into a venous thrombus in the first trimester. Ultrasonography with color Doppler and magnetic resonance imaging could be helpful in diagnosis.

Comparison of perinatal outcomes in late preterm birth between singleton and twin pregnancies

OBJECTIVE: To determine whether late preterm twin neonates have a more favorable perinatal outcome than singleton late preterm neonates. METHODS: We studied 401 late preterm births between 34+0 and 36+6 weeks of gestation, from January 2011 to December 2014 in our institution. We compared the maternal and neonatal characteristics and perinatal outcomes between singleton and twin pregnancies. Perinatal outcomes included Apgar score, admission to the neonatal intensive care unit (NICU) or special care nursery, duration of NICU stay, and the rate of composite morbidity (antibiotic use, hypoglycemia, hypocalcemia, hyperbilirubinemia requiring phototherapy, respiratory support, and respiratory distress syndrome). RESULTS: A total of 289 neonates were in the singleton group and 112 in the twin group. The twin group showed smaller mean birth weight despite of longer gestational age at delivery. In addition, there were significant differences in the indication of delivery and cesarean section rate between the 2 groups. Overall, the risk of composite morbidity was similar between 2 groups (odds ratio, 1.4; 95% confidence interval, 0.8 to 2.4). CONCLUSION: Our findings suggest that late preterm twins do not show a more favorable outcome than singleton late preterm births.

Incarceration of a pedunculated uterine fibroid in an umbilical hernia

Uterine fibroids are common benign tumors that may cause an umbilical hernia in patients with increased intra-abdominal pressure due to pregnancy, obesity, ascites, and intra-abdominal tumors. However, the simultaneous occurrence of uterine fibroids and umbilical hernias, or fibroids and an associated umbilical hernia, during pregnancy has rarely been reported. Here, we present the case of a fibroid presenting as an incarcerated umbilical hernia in a menopausal patient.

Anti-inflammatory effects of Salvia plebeia R. Br extract in vitro and in ovalbumin-induced mouse model

BACKGROUND: Asthma is an increasing global health problem, and novel strategies to prevent or ameliorate the condition are needed. Here, the effects of 80 % ethanol extracts of Salvia plebeia R. Br. (SE) on an induced inflammatory response were investigated RESULTS: Salvia plebeia R. Br. inhibited production of pro-inflammatory cytokines, such as TNF-α and IL-6, as well as nitric oxide (NO) in LPS-stimulated RAW 264.7 cells. NO and pro-inflammatory cytokine production was suppressed more effectively by SE of the aerial parts (SE-A) than of the roots (SE-R) of S. plebeia. In BEAS-2B cells, both SE-A and SE-R inhibited the increase in production of the inflammatory cytokines IL-6 and IL-8. We also investigated the antiasthmatic effects of SE in an ovalbumin (OVA)-induced BALB/c mouse model. SE-A treatment significantly reduced the number of airway eosinophils, IL-4 and IL-13 levels, mucus production, and inflammatory infiltration, as compared with the corresponding levels in the untreated, OVA-induced mice, and had similar effects to dexamethasone CONCLUSIONS: Salvia plebeia ethanol extract ameliorated the induced inflammatory response in RAW 264.7 and BEAS-2B cells, with more effective inhibition noted for SE-A than for SE-R. SE-A treatment was effective in improving the histopathological changes in the lungs of asthma model mice via modulation of eosinophils and Th2 cytokines. These results suggest that SE-A can be considered as a therapeutic agent that can potentially relieve asthma

A case of cystic adenomyoma of the uterus after complete abortion without transcervical curettage

We diagnosed a 2-cm, large cystic adenomyoma after complete abortion without transcervical curettage, based on symptoms of dysmenorrhea, time of onset, and sonographic findings. The cystic adenomyoma was treated successfully with laparoscopic mass excision.

Erratum: Author's name correction

The Editorial Office of Obstet Gynecol Sci would like to correct the author's name. The Editorial Office apologizes for any inconvenience that it may have caused.

Vaginal adhesions in a woman with the history of dystocia

Postpartum genital tract adhesions are unusual, and their cause has not been evaluated. However, severe dystocia and numerous pelvic examinations have been suggested as possible causes. Here, we report a case of vaginal adhesions following a difficult labor that presented as dyspareunia for 5 months. Pelvic examination and ultrasonography revealed a transverse vaginal septum that obstructed the vaginal cavity, and fluid collection proximal to this septum. The patient was successfully treated with surgical resection and administration of antibiotics.

The effect of a nutritional education program on the nutritional status of elderly patients in a long-term care hospital in Jeollanamdo province: health behavior, dietary behavior, nutrition risk level and nutrient intake

This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P < 0.001) and of depression (P < 0.001) improved significantly and that dietary behavior scores also improved significantly (P < 0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P < 0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.

The detection rate of Ureaplasma urealyticum and Mycoplasma hominis in patients with impending preterm birth and mid-trimester cervical swab / 대한주산의학회잡지

PURPOSE: The purpose of this study was to examine the risk of preterm birth in pregnant women with Ureaplasma urealyticum and/or Mycoplasma hominis infection and the prevalence of these organisms in normal pregnancy. METHODS: Between February 2002 and July 2002, we included 43 pregnant women prior to 37 weeks of gestation with definite gross leakage of amniotic fluid (n=16) (group 1), 47 healthy women without any obstetric problems between 18 and 24 weeks of gestation (group 2) and 64 women who delivered fullterm fetuses who had taken cervical swabs around 36 weeks gestation (group 3). Cervical swabs (Dacron(R)) were taken on admission in group 1 and at outpatients in group 2 and 3. Detections of U. urealyticum and M. hominis were done using commercial kits (MYCOFAST(R) Evolution 2, International Microbio Signes, France). RESULTS: There was no significant difference between mid-gestation (group 2) and fullterm (group 3) in cervical swab result. In group 1, the detection rate of Ureaplasma uealyticum was higher in impending preterm birth over 32 weeks of gestational age (15/20, 75%) than 32 weeks or less (10/ 23, 43.4%) (p<0.05). In group 2, there was no significant difference in preterm birth rate between the exposed and the non-exposed to U. urealyticum and/or M. hominis in middle of 2nd trimester. CONCLUSION: U. urealyticum does not seem to be a predictor of preterm birth, and there seems to be some different mechanism according to gestational age. We couldn't varify that M. Hominis and U. urealyticum were related to preterm birth, although U. urealyticum was highly detected in impending preterm birth.

The prevalence of endometriosis in cases of total hysterectomy / 대한산부인과학회지

OBJECTIVE: We investigated whether surgical methods, age, parity and obesity were correlated to endometriosis in patients who had hysterectomy. METHODS: This research was surveyed and reviewed of patients who underwent total abdominal hysterectomy, laparoscopic hysterectomy and vaginal hysterectomy in Kyungpook National University Hospital from 1999 to 2006, based on clinical recordings and pathologic reports. Based on these data, we investigated whether age, parity, obesity and pathologic diagnosis were correlated to prevalence rate of endometriosis. Also we investigated the correlations with anatomic lesion of endometriosis and surgical methods. SPSS version 12.0 chi- square test was conducted as the statistical data. RESULTS: The total 4,830 cases of hysterectomy were undergone. Out of these, endometriosis was found at 125 cases (2.5%). Among them, 76 cases of endometriosis were found at 2,260 cases of abdominal hysterectomy (3.3%). 31 cases of endometriosis were found at 1,589 cases of vaginal hysterectomy (1.95%), and 18 cases of endometriosis were found at 981 cases of laparoscopic hysterectomy (1.83%). The correlation with laparoscopic hysterectomy and endometriosis had the statistically significant high rate (P0.05). CONCLUSION: Even the prevalence of endometriosis was low (2.5%) in total cases of hysterectomy, laparoscopic hysterectomy had more prevalence rate of endometriosis than other types of hysterectomy. because suspicious lesions were inspected carefully, Magnified laparoscopic view make us to identify suspicious endometriotic lesion more clearly than other type of hysterectomy.

Radiosensitization by targeting radioresistance-related genes with protein kinase A inhibitor in radioresistant cancer cells

Here we determined which radiation-responsive genes were altered in radioresistant CEM/IR and FM3A/IR variants, which showed higher resistance to irradiation than parental human leukemia CEM and mouse mammary carcinoma FM3A cells, respectively and studied if radioresistance observed after radiotherapy could be restored by inhibition of protein kinase A. The expressions of DNA-PKcs, Ku70/80, Rad51 and Rad54 genes that related to DNA damage repair, and Bcl-2 and NF-kappaB genes that related to antiapoptosis, were up-regulated, but the expression of proapototic Bax gene was down-regulated in the radioresistant cells as compared to each parental counterpart. We also revealed that the combined treatment of radiation and the inhibitor of protein kinase A (PKA) to these radioresistant cells resulted in synergistic inhibition of DNA-PK, Rad51 and Bcl-2 expressions of the cells, and consequently restored radiosensitivity of the cells. Our results propose that combined treatment with radiotherapy and PKA inhibitor can be a novel therapeutic strategy to radioresistant cancers.