No abstract available.
Female ; Humans ; Necrosis*

OBJECTIVE: To assess whether there is correlation between serum concentrations of vascular endothelial growth factor(VEGF) and development of preeclampsia. METHODS: The authors measured serum concentrations of VEGF in 18 preeclamptic women admitted to Sanggye Paik Hospital, Inje University from February 1999 to September 1999 and in 18 normotensive pregnant women matched in maternal age, maternal body weight, parity and gestational age. VEGF was measured with a sensitive and specific enzyme immunoassays. RESULTS: VEGF was detected in all pregnant women. The results of this study showed that the serum concentrations of VEGF are significantly higher in the preeclamptic women than in the normotensive pregnant women. The values of median and range of VEGF are 7.74 ng/ml and 0.5-35.94 ng/ml in the preeclamptic women, and 0.5 ng/ml and 0.5-2.16 ng/ml in the normotensive pregnant women, respectively. There is significant difference in serum concentrations of VEGF between two groups(p<0.001, Mann-Whitney U test). Positive correlations were noted between VEGF concentraions and the systolic and diastolic blood pressure(Systolic BP: r2=0.688, Diastolic BP: r2=0.722, Spearman rank test). CONCLUSION: The high serum concentration of VEGF is thought to be important in the development or pathophysiologic mechanism of preeclampsia. In the next study, the prospective analysis will be necessary to identify whether serum concentration of VEGF is abnormally high in early gestational pregnant women who are destined to preeclampsia.
Body Weight ; Female ; Gestational Age ; Humans ; Immunoenzyme Techniques ; Maternal Age ; Parity ; Pre-Eclampsia ; Pregnant Women ; Vascular Endothelial Growth Factor A*

OBJECTIVE: Unexplained elevations of midtrimester human chorionic gonadotrophin(hCG) or alpha fetoprotein(AFP) have known to be at increased risk for a variety of third trimester pregnancy complication, such as preeclampsia. The causes of these were thought to be made by impaired placental function, as a reflection of impaired uteroplacental circulation. Our purpose was to determine if amniotic fluid total -hCG and AFP levels are elevated in women with severe preeclampsia and if these levels correlated with other laboratory features of disease severity. METHODS: Seventeen women with severe preeclampsia were matched with 16 women with the diagnosis of either preterm labor and intact membranes(n=10) or preterm premature rupture of membranes(n=6) who met the following criteria: 1) singleton gestation 2) absence of congenital anomaly 3) absence of active labor 4) confirmed getational age by ultrasonography 5) transabdominal amniocentesis performed to obtain amniotic fluid to assess fetal lung maturity. Amniotic fluid total -hCG and AFP were measured by double antibody radioimmunoassay(RADIM, Italy). Mann-Whitney U test and multiple linear regression analysis were used. RESULTS: 1) Concentrations of amniotic fluid total -hCG but not amniotic fluid AFP, maternal blood total -hCG and AFP were significantly higher in severely preeclamptic women than in their matched controls(amniotic fluid total -hCG; median 28.5, range 4.3-120.3 IU/ml vs. median 9.4, range 2.7-99 IU/ml, p < 0.01). 2) Amniotic fluid total -hCG levels correlated positively with maternal blood BUN(blood urea nitrogen) levels(r= 0.66, regression coefficients 5.57, standard error 2.4021, p< 0.05, multiple linear regression) after correction for known confounding variables(i.e., maternal weight, gestational age at sampling, hematocrit). CONCLUSION: Amniotic fluid total -hCG levels are elevated in women with severe preeclampsia and correlate closely with maternal blood BUN levels. These observation suggest that the pathologic changes of preeclampsia might occur in the placenta and involve in change of a significantly secretory reaction of the placenta.
alpha-Fetoproteins* ; Amniocentesis ; Amniotic Fluid* ; Chorion ; Chorionic Gonadotropin* ; Diagnosis ; Female ; Gestational Age ; Humans* ; Linear Models ; Lung ; Obstetric Labor, Premature ; Placenta ; Placental Circulation ; Pre-Eclampsia* ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Rupture ; Ultrasonography ; Urea

OBJECTIVE: To determine whether there is correlation between serum concentrations of lipoproteins (VLDL, HDL, LDL) and development of preedampsia. METHODS: The authors measured serum concentrations of lipoproteins(VLDL, HDL, LDL) and lipids(which are major components of lipoproteins) in 12 preeclamptic women admitted to Sanggye Paik Hospital, Inje University from March 1999 to August 1999 and 12 normal pregnant women matched in age, weight, parity and gestational age. RESULTS: The first, the values of median and range of VLDL are higher in preeclamptic women than in normal pregnant women(preeclamptic women : 244mg/dL & 124-521mg/dL, normal pregnant women : 149mg/dL & 68-308mg/dL, p=0.0005). But there are no difierences in serum concentrations of HDL(high-density lipoprotein) and LDL(low-density lipoprotein) between two groups. The second, the values of median and range of triglyceride and free fatty acids are higher in preedamptic women than in normal pregnant women(preeclamptic women : triglycerides : 305.5mg/dL & 231-545mg/dL, free fatty acids : 1,333mmol/L & 842- 1523mmol/L, normal pregnant women,: triglycerides : 239mg/dL & 151-414mg/dL, free fatty acids : 806.5mmol/L & 314-1517mmol/L, p=0.019 in triglycerides and p=0.033 in free Fatty acids). But the serum concentrations of cholesterol are similar in two groups. CONCLUSIONS: Overall, the results of this study showed the serum concentrations of VLDL, triglycerides and free fatty acids are significantly higher in preeclamptic women than in normal pregnant women. So, the high serum concentration of VLDL is thought to be important in the pathogenesis of preeclampsia. In the next study, the prospective analysis will be necessary to identify whether serum concentration of VLDL is abnormaUy high in early gestational pregnant women who are destined to preeclamsia. Also, the measurement of pI 5.6 isoelectric form of albumin which is suggested to prevent VLDL toxicity will be necessary.
Cholesterol ; Fatty Acids, Nonesterified ; Female ; Gestational Age ; Humans ; Lipoproteins* ; Parity ; Pre-Eclampsia* ; Pregnant Women ; Triglycerides

OBJECTIVE: Our purpose was to evaluate the effect of epidural anesthesia on labor course. METHODS: Between January 1998 and December 1998, we evaluated pregnant women at term with singleton fetus in vertex presentation and with spontaneous onset of labor at our hospital. Comparison of 120 women (100 cases of primiparous women, 20 cases of multiparous women) who received epidural anesthesia in labor with 120 women (100 cases of primiparous women, 20 cases of multiparous women) who did not receive epidural anesthesia was performed. Adverse pregnancy outcomes were obtained from hospital delivery records and neonatal records. Statistical analysis were performed by Student's t-test and Chi square test. RESULTS: The results of this study were as followings; 1. There was no significant difference in mean age, body weight, height, and gestational age between epidural anesthesia group and control group (P>0.05). 2. The frequency of oxytocin augmentation was significantly greater in the primiparous epidural anesthetic group than in primiparous control group (p<0.05). 3. The effect of epidural anesthesia on the first stage of labor revealed no significant difference in both group. 4. Prolongation of second stage of labor was noticed in nullipara of epidural anesthesia group compared to control group (p<0.05). 5. The incidence of instrumental delivery was significantly increased in the primiparous epidural group than in the primiparous control group(p<0.05). 6. The meconium-stained amnionic fluid, Apgar score and birth weight were similar in both groups. 7. The maternal blood loss was similar in both groups. CONCLUSION: Epidural anesthesia, significantly prolongs second stage of labor in induced patients. While instrumental delivery was more prevalent in these parturients, C-section rate and intra-partum complications were not increased in these patients.
Amnion ; Anesthesia, Epidural* ; Apgar Score ; Birth Weight ; Body Weight ; Female ; Fetus ; Gestational Age ; Humans ; Incidence ; Oxytocin ; Pregnancy ; Pregnancy Outcome ; Pregnant Women

OBJECTIVE: Our purpose was to assess the efficacy of routine ultrasonographic prediction of macrosomic fetal weight, to determine its influences on subsequent delivery type and to assess perinatal outcome by delivery type. METHODS: The hospital records of 177 patients delivered infants weighing > or =4000gm between January 1997 and December 1998 were reviewed. Statistical comparisons were made between patients in whom fetal macrosomia was predicted before delivery(n=71) and those in whom it was not(n=106) and between the perinatal outcomes for macrosomic fetuses delivered vaginally and by cesarean section. The statistical analysis was performed by student-t test, and Chi-square test and Fisher's exact test. RESULTS: The fetuses were consecutive singleton fetuses in vertex presentation delivered at a single institute. The sensitivity for identifying macrosomic fetus(birth weight >4000gm) with an estimated weight of > or =4000gm was 40%, Overall 60% of the infants had birth weights within 10% of the ultrasonographic estimates and 29% had birth weights within 5% of the ultrasonographic estimates. Cesarean sections were performed in 69% of the 'predicted' group and in 35% of the 'not predicted' group(69% vs 35%, p<0.0001, Fisher's exact test). Predicated group were more likely to be performed by elective cesarean section(48% vs 19%, p<0.0001, Fisher's exact test) and more like due to failed progress at<4cm cervical dilatation(27% vs 7%, p<0.05, Fisher's exact test). The proportion of patients delivered by cesarean section for failed progress at > or =4cm cervical dilatation was similar in the predicted and not predicted groups(19% vs 12%, NS). There was no significant difference in the incidences of the occurrence of birth trauma. CONCLUSION: There appears to be a limitation to obtain estimation of fetal weight by ultrasonography. The antenatal prediction of fetal macrosomia is associated with a marked increase in cesarean deliveries without a significant reduction in the incidence of fetal injury
Birth Weight ; Cesarean Section ; Female ; Fetal Macrosomia ; Fetal Weight* ; Fetus ; Hospital Records ; Humans ; Incidence ; Infant ; Labor Stage, First ; Parturition ; Pregnancy ; Ultrasonography*

OBJECTIVE: The purposes of this study were 1) to determine whether preeclampsia itself affects failure of labor induction with prostaglandin E2 and oxytocin and 2) to investigate risk factors for failed induction in women with preeclampsia. METHOD: Fifty preeclamptic women and 175 nonpreeclamptic women requiring labor induction were studied prospectively. Intravaginal prostaglandin (PG) E2 tablet (Dinoprostone, The Upjohn company, 3 mg) followed by a second dose if the cervix assessed 6 hours later was 5 or less of Bishop score, and oxytocin were used for labor induction. Women with rupture of membrane, spontaneous contraction resulting in cervical change or an initial cervical examination showing more than 2 cm dilatation and 50% effacement were excluded. Statistics were analyzed with 2 test, Student t test, and multiple logistic regression. RESULTS: 1) The women with preeclampsia had a significantly higher rate of failed induction than did those without preeclampsia [24% (2/50) versus 9% (16/175); p <0.05]. However, the women with preeclampsia had a higher rate of the use of magnesium sulfate, and were more likely to decrease gestational age at induction and increase maternal weight than those without preeclamp sia (p <0.0001, respectively). There were no significant differences in prevalence of nulliparity and low initial Bishop score (< or =3) between the women with and without preeclampsia. 2) Multiple logistic regression showed that preeclampsia itself was not associated with failed induction after correction of known confounding variables (odds ratio 0.22, 95% confidence interval 0.03-2). 3) In women with preeclampsia, the use of magnesium sulfate only was associated with increased risk of failed induction analyzed by multiple logistic regression(odds ratio 38.5, 95% confidence interval 1.6-897). Maternal weight with 70 kg or more was associated with increased risk of failed induction, but it is not statistically significant (p=0.055). CONCLUSIONS: 1) The risk of failed induction is increased in women with preeclampsia, but not by preeclampsia itself but by the use of magnesium sulfate, prematurity, and increased maternal weight secondary to preeclampsia. 2) The use of magnesium sulfate is independent risk factor for failed induction in women with preeclampsia.
Cervix Uteri ; Confounding Factors (Epidemiology) ; Dilatation ; Dinoprostone* ; Female ; Gestational Age ; Humans ; Logistic Models ; Magnesium Sulfate ; Membranes ; Oxytocin* ; Parity ; Pre-Eclampsia* ; Prevalence ; Prospective Studies ; Risk Factors ; Rupture

BACKGROUND/AIM: Recent studies have suggested an association between genetic background of renin-angiotensin(RA) system and the pathogenesis of pregnancy induced hypertension(PIH). Even though various single nucleotide polymorphism(SNP) such as M235T, T174M polymorphism in angiotensinogen gene(AGT) and I/D polymorphism in angiotensin I-converting enzyme gene(ACE) have been studied extensively among essential hypertension and PIH in various population, its association was still inconclusive. Previous studies within Korean PIH patients also revealed that M235T or T174M single nucleotide polymorphism in AGT gene or I/D polymorphism in ACE gene were not linked tightly with PIH. However, recent studies on angiotensin II type I receptor(AT1) polymorphism A1166C with PIH in Polish or in Chinese suggested its possible correlations to a pathogenesis of PIH. Thus the aim of the present study was to determine the frequency of genotypes of A1166C mu-tation in women with PIH and to establish the role of this polymorphism on the susceptibility to the PIH development. PATIENTS AND METHODS: We have analysed 121 women with PIH and 98 healthy normotensive gravid women as a control. Genomic DNA was used for PCR. To genotype the A1166C polymorphism in angiotensin II receptor(AT1) gene, primers(sense 5'-CGA CTA CTG CTT AGC ATA-3', antisense 5'-GCA CCA TGT TTT GAG GTT-3') were employed to make 546bp PCR product. There was an initial denaturation at 94degrees C 5 minutes, followed by 30 cycles of one minute at 94degrees C, one minute at 58degrees C, and two minutes at 7degrees C. A 546bp PCR product was further digested with DdeI for 2 hour at 37degrees C and analysed through 2% agarose gel electrophoresis to determine genotype. Allele C1166 yielded 435bp, 111bp fragment and allele A1166 yielded intact 546 bp fragment RESULTS: We found that frequency of genotype A1166/C1166 and A1166/A1166 in PIH were 9.9% (12) and 90.1%(109), while in controls were 17.3%(17) and 82.7%(81). There was no statistical significance between development of PIH and A1166C polymorphism in type I receptor for Angiotensin II. Homozygous mutated genotype(C1166/C1166) was not detected in this study. CONCLUSION: Our results found no possible correlation of A1166C polymorphism in angiotensin II receptor(AT1) with PIH in Korean and found that allele C might behave as a protective factor rather than as a risk factor in the pathogenesis of PIH. We suggest a large-scale study to evaluate relevance to this polymorphism for PIH.
Alleles ; Angiotensin II* ; Angiotensinogen ; Angiotensins* ; Asian Continental Ancestry Group ; DNA ; Electrophoresis, Agar Gel ; Female ; Genotype ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Pregnancy* ; Risk Factors

OBJECTIVE: SELDI-ToF-MS is an affinity-based mass spectrometric method. This study was performed to determine feasibility of serum proteomic pattern analysis using SELDI-ToF-MS for the detection of ovarian cancer. METHODS: Forty-three epithelial ovarian cancer patients and seventy-seven controls were included in the study from October 2003 to March 2005 in Sanggye Paik Hospital. Potential tumor biomarkers in sixty serum samples were screened, including twenty-one ovarian cancers and thirty-nine controls. Proteomic pattern was analyzed by SELDI-ToF-MS and optimal discriminating m/z value with proper cutoff of log-normalized intensity was determined by decision tree analysis (Phase I). Another sixty serum samples were obtained from twenty-two ovarian cancers and thirty-eight controls. Through analysis using SELDI-ToF-MS, the performance of diagnosing ovarian cancer was determined by applying previously adopted cutoff log-normalized intensity of m/z value determined in Phase I experiment (Phase II). RESULTS: A biomarker of 3501.23 kDa was selected based on the collective contribution to the optimal separation between ovarian cancers and controls. Sensitivity of 90.9% and specificity of 84.2% was achieved by SELDI-ToF-MS in Phase II experiment. Age, stage, and histologic type did not affect performance of SELDI-ToF-MS for diagnosing ovarian cancer. CONCLUSION: Serum proteomic analysis by biochip and mass spectrometry is a feasible method in diagnosing ovarian cancer.
Biomarkers ; Computational Biology ; Decision Trees ; Humans ; Mass Spectrometry ; Ovarian Neoplasms* ; Proteomics ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization*

OBJECTIVE: SELDI-ToF-MS is an affinity-based mass spectrometric method. This study was performed to determine feasibility of serum proteomic pattern analysis using SELDI-ToF-MS for the detection of ovarian cancer. METHODS: Forty-three epithelial ovarian cancer patients and seventy-seven controls were included in the study from October 2003 to March 2005 in Sanggye Paik Hospital. Potential tumor biomarkers in sixty serum samples were screened, including twenty-one ovarian cancers and thirty-nine controls. Proteomic pattern was analyzed by SELDI-ToF-MS and optimal discriminating m/z value with proper cutoff of log-normalized intensity was determined by decision tree analysis (Phase I). Another sixty serum samples were obtained from twenty-two ovarian cancers and thirty-eight controls. Through analysis using SELDI-ToF-MS, the performance of diagnosing ovarian cancer was determined by applying previously adopted cutoff log-normalized intensity of m/z value determined in Phase I experiment (Phase II). RESULTS: A biomarker of 3501.23 kDa was selected based on the collective contribution to the optimal separation between ovarian cancers and controls. Sensitivity of 90.9% and specificity of 84.2% was achieved by SELDI-ToF-MS in Phase II experiment. Age, stage, and histologic type did not affect performance of SELDI-ToF-MS for diagnosing ovarian cancer. CONCLUSION: Serum proteomic analysis by biochip and mass spectrometry is a feasible method in diagnosing ovarian cancer.
Biomarkers ; Computational Biology ; Decision Trees ; Humans ; Mass Spectrometry ; Ovarian Neoplasms* ; Proteomics ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization*