Role of nitric oxide and interleukin-1beta on expression of matrix metalloproteinase-2 in TL cell line / 대한산부인과학회잡지

OBJECTIVE: We studied to investigate whether nitric oxide (NO) and IL-1beta modulate MMP-2 and MMP-9 using TL cell line obtained from the normal term placenta. METHODS: After culturing TL cell line for 4 hours, we treated 0.1 mM of SNAP (NO donor) and 50 ng/ml of IL-1beta for 0, 1, 3, 6, and 12 hours, for investigating changes from time. We treated SNAP of 0, 0.01, 0.1, and 0.5 mM for 12 hours and IL-1beta of 0, 1, 10, and 50 ng/ml, for investigating changes from concentration. After extraction of total RNA, we performed reverse transcriptase-polymerase chain reaction (RT-PCR), gelatine zymography and Western blot analysis, for investigating expression of MMP-2 and MMP-9. RESULTS: MMP-9 was not observed in TL cell line. The expressions of MMP-2 mRNA and protein were gradually increased according to the culture time in SNAP treated group. The expressions of MMP-2 mRNA and protein were gradually increased according to the culture time in IL-1beta treated group. The expression of MMP-2 protein was not more increase in SNAP/IL-1beta-treated group than in IL-1beta treated group. The expression of MMP-2 protein was more reduced in SNAP/hemoglobin treated group than in SNAP treated group. MMP-2 protein activity was only increase in SNAP treated group. CONCLUSION: These results indicate that NO, rather than IL-1beta, upregulates the MMP-2 in TL cell line and furthermore may influence in the invasive process of trophoblasts.

Cord Blood Erythropoietin Complicated By High Risk Pregnancies / 대한산부인과학회잡지

OBJECTIVE: To investigate the relationship between umbilical plasma erythropoietin(epo) concentrations and umbilical cord pH in high risk pregnancies. METHODS: We measured epo concentrations and gas in 103 cases of cord blood obtained from 88 cesarean section (15 of twin) composed of 39 cases of normal control (12 of normal twins), 45 cases of high risk pregnancies and 4 cases of unclassified group using an RIA kit from december,1998 to December, 1999. Statistical analysis was performed using the student's t test and regression analysis. P values less than 0.05 were considered statistically significant. RESULTS: Umbilcal plasma epo concentrations revealed significant inverse correlation (P<0.05) with umbilical acidosis and cord blood epo levels, and it were significantly higher in GDM and IUGR than normal pregnancies (control: 1.60 1.15, n=39 versus GDM: 7.78 7.18, n=11 versus IUGR: 64.77 90.57 n=10, p<0.05), but 11 cases of fetal distress and 13 cases of preeclampsia did not differ significantly from umbilical plasma epo of normal control. CONCLUSIONS: Elevated epo concentrations in cord blood indicate fetal hypoxia and It is significantly increased in IUGR and GDM, these findings show that cord blood epo may serve as a clinically useful marker for chronic fetal hypoxia.

Randomized comparison of the effects of the endocervical and the vaginal prostaglandinE2 in women with various degrees of cervical ripeness / 대한산부인과학회잡지

OBJECTIVES: The trial was performed to obtain an unbiased comparison of the relative merits of endocervical and vaginal prostaglandin E2(PGE2) in the case of parous and nulliparous woman with favorable and unfavorable cervical features. This study was performed to determine the clinical usefullness of endocervical PGE2 comparing with the vaginal PGE2 in cervical ripening and induction of labor. METHOD: The randomized trial with 65 Participants was performed with sealed envelopes for parity and Bishop score (from March to september, 1998). PGE2 tablet(3mg Dinoprostone) was administrated intravaginally to the 32 pregnant women and endocervically to the 33 pregnant women every eight hours with maximum three times until the regular labor develped. RESULT: Outcomes of labor and delivery were clearly related to cervical score at trial entry. endocerval PGE2 had a more marked effect on cervical ripeness than did vaginal PGE2. There were no significant differences on age distribution, gestatioanal period, primiparity, cervical status, initial B-score in each group. There were no significant differences in cesarian section rate, fetal distress, uterine hyperstimulation, side effect and poor infant outcome between the groups The mean induction time was statistically shorter in cervical group with multiparous women than other group(p=0.0195). In the induction-active labor time, cervical with primi group was statistically shorter than other group(p=0.0245). Statistically significant differences were noted between the nulliparous woman and multiparous women in mean induction time, induction-active labor time, time to B-score 8. In the factor that effects induction-active labor, route was significantly better than other factor.(p=0.0001) CONCLUSION: edocervical PGE2 is more effctive than vaginal PGE2 in cervical ripening and induction of active labor. the endocervical PGE2 resulted in a significantly shorter induction to active labor time compared with vaginal PGE2 and has almost no side effect. Because differences in effectiveness between endocervical and vaginal PGE2 are marginal, preference of woman and clinicians can the choice between them.

A case of primary peritoneal leiomyoma / 대한산부인과학회잡지

Primary peritoneal leiomyoma is histologically benign and rare non-neoplastic proliferation of smooth muscle that occurs in the peritoneal wall during the reprodutive years of women. A 51-year old patient had a solid tumor of 18cm diameter in the peritoneal wall, which was pathologically confirmed as a benign leiomyoma primarily originated from the retroperitoneal wall. Laparotomy revealed a solid tumor in the peritoneal wall, about 18cm, and histologically diagnosed as a leiomyoma. We report a case of primary peritoneal leiomyoma with a brief review of literatures.

Comparison of Cost Efficacy of Ectopic Pregnancy Management / 대한산부인과학회잡지

The incidence of ectpic pregnancy has increased rapidly over the past decade. Currently, the complications of this disorder make it one of the leading causes of maternal mortality and morbidity. In the late 1980s, reports of successful use of methotrexate (MTX) as a non surgical treatment for ectopic pregnancy (EP) also began to appear in the literature. With MTX emerging as a possible alternative management of selected women with an EP, an analysis of its comparative costs is now needed. We examined retrospectively the costs associated with management of EP in our hospital. We selected 30 women with EPand divided them into two groups of MTX treated group (n= l0) and surgically treated group (n=20). There were no statistically significant differences in the doctors fee, room, charge and cost of laboratory and radiologic examination between two groups. But We found significant reduction in cost with regard to pharmacy, injection, procedure and operation of MTX treated group compared to surgically treated group (p<0.05). Consequently the use of MTX for EP should still be considered investigational; we recognize and agree that the evolution of this remedial option should be based primarily on its ability to decrease morbidity and mortality rather than on its ability to reduce costs. If medical treatment proves to be effective, the potential cost savings demonstrated in this report will become an important influential factor on selecting alternative remedy.

Comparison of Distribution of Fibronectin and Fibrinogen in Placenta between Normotensive and Preeclamptic Pregnancies / 대한산부인과학회잡지

In order to find out the distribution of fibronectin and fibrinogen in placenta among pregnancy induced hypertensive (PIH) patients, 6 normotensive pregnancies and 17 PIH patients were chosen. The placentas were obtained right after delivery and soaked in the 10% formalin solution. The score was measured in terms of the positiveness of the stain in immunohistochemical stain by using I antibody with the rabbit antihuman fibronectin and the rabbit anti-human fibrinogen. Comparison between two groups are as following: 1.The placenta of PIH patients showed significantly reduced positiveness of fibronectin in their fetal villous vessels and villous stroma. 2. In the PIH patients, the positiveness was reduced in the group giving the birth to intrauterine fetal growth retardation compared to giving birth to normal baby. 3. In both normotensive and PIH patients, the villous basement membrane did not show the staining response to fibronectin, while showing heavy staining response to fibrinogen. 4. The positiveness of fibrinogen in fetal vessels, villous basement membrane, intervillous space and stroma were almost same in both normotensive and PIH patients. From above results, we can conclude that there is abnormality in the distribution of fibronectin especially in the fetal vessels and the villous stroma of placenta among PIH patients. The cause of this result needs further study.