No abstract available.

OBJECTIVE: This study was designed to evaluate whether maternal serum human chorionic gonadotropin(hCG) level measured during second trimester could be used as a predictor of pregnancy-induced hypertension. METHODS: Between March 1996 and November l997, 505 pregnant women undergoing second trimester(14-22 weeks of amenorrhea) triple marker screening for neural tube defect and Down syndrome who delivered at our institution were reviewed. All samples were assayed in the same laboratory and medical records were reviewed about medical and obstetrical history. RESULTS: Maternal serum human chorionic gonadotropin level(multiples of the median, MoM) was significantly higher in the pregnancy-induced hypertension group than in the control group. With the use of 2. l multiples of the median as a cutoff value, the sensitivity of human chorionic gonadotropin as a screening marker for development of pregnancy-induced hypertension was 38.7%, the specificity was 95.9%, positive predictive value was 38.7% and negative predictive value was 95.9%. Conlusion: We suggest that second trimester maternal serum human chorionic gonadotropin levels can be used clinically as an early predictive marker for pregnancy-induced hypertension.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Humans ; Humans* ; Hypertension* ; Hypertension, Pregnancy-Induced ; Mass Screening ; Medical Records ; Neural Tube Defects ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Sensitivity and Specificity

Mullerian adenosarcoma is an uncommon variant of MQllerian mixed tumors of the uterus and a mixed, biphasic neoplasia in which the mesenchymal component is malignant and the epithelial component is benign. In contrast to typical malignant Miillerian mixed tumor(MMMT), Miillerian adenosarcomas are usually tumors of low malignant potential. These tumom usually present as pedunculated endometrial masses in postmenopausal women with vaginal bleeding. We experienced a case of Miillerian adenosarcoma of the uterus with squamous cell carcinoma of the uterine cervix and report with a brief review of literatures.
Adenosarcoma* ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Humans ; Uterine Hemorrhage ; Uterus*

The Obligatory Role of the Chorionic Membranes in the Synthesis of Myometrial cGMP during Pregnancyand Its Inhibition by Maternal and Fetal Plasma The mechanism of uterine quiescence during pregnancy and initiation of labor is unknown. In previousreport, we demonstrated myometrial cGMP rises dramatically during pregnancy and then declines just priorto the onset of labor. Further, pregnancy decrease myometrial soluble guanylate cyclase activity whileenhancing particulate activity. Theses findings suggest a natriureitc peptide(NP) is responsible for theincrease in cGMP. This study was undertaken to evaluate the source of that NP. We incubatedmyometrium from term guinea pigs in oxygenated buffer in the absence/presence of either amnionicmembranes(AM, 400mg), chorionic membrane(CM, 400mg), fetal guinea pig plasma(FP, 1ml), maternalguinea pig plasama(MP, 1ml), or a combination. After incubation, cGMP(mol/mg portein) was measuredby radioimmuno assay. Both AM and CM(CM>AM, significantly) increased myometrial cGMP. Thestimulation of myometrial cGMP by the CM has a significant linear relationship between fetal weight andthe greatest cGMP increase occurred between 51~60 days after which it showed a trend to decrease. BothFP and MP decrease myometrial cGMP and inhibition of cGMP by MP increase significantly withadvancing gestational age.Our date indicate that myometrial cGMP is stimulated by a compound produced by the CM and the actionof this compound is inhibited by a substance produced by the mother and fetus at the end of a normalpregnancy.
Animals ; Chorion* ; Fetal Weight ; Fetus ; Guanylate Cyclase ; Guinea Pigs ; Humans ; Membranes* ; Mothers ; Oxygen ; Plasma* ; Pregnancy*

Natural Killer (NK) cells are a subpopulation of in vivo activated lymphocytes that display spontaneous cytotoxicity against a variety of targets as virus-infeeted, and transformed neoplastic cells, in major histocompatibility-unrestricted fashion. Depression of the NK aetivity in patients with advanced stages of various types of solid neopls,sms appears to be dependent upon the prcgressive growth and metastatic spread of the tumor. There are many reports that different distribution of subpopulations of lymphocytes in neopiastic tissue may influence the prognosis of the patients, In this study, we have performed immunohistochemieal study with Leu-7, MT1, LN2, and antilysozyrne antiserum on the tissue of uterine cervieal dysplasia and cancer to investigate the distribution of the NK cell, T cell, B cell, and macrophage. The results were as follows ; 1. The major subpopulation of lymphocytes infiltrating the lesion of intraepithelial neoplasia and squamous cell carcinama was T cell. 2. The number of infiltrated. lymphocytes was layer in the lesion of keratinzing type than in that of non keratinizing and small cell earcinorna of the uterine cervix. 3. NK cell was more frequently noted in the malignant lesion than the dysplastic lesion.
Cervix Uteri ; Depression ; Female ; Humans ; Killer Cells, Natural ; Lymphocytes ; Macrophages ; Prognosis ; Uterine Cervical Neoplasms*

Recently pregnant women take more drugs than before due to the trend of increasing maternal age. Though most drugs are safe, a small percentage of them may have unintended adverse consequences for either mother or child. So any unnecessary drug should not be given to pregnant women; however, when necessary, some medications cannot be withheld. Counseling for drugs during pregnancy is one of most important and difficult tasks of obstetricians. Most drugs are classified FDA category C, and there are many new drugs that have not been categorized yet. In addition, many drugs in category X are not absolutely contraindicated during pregnancy, and several drugs in category C or D are clear human teratogens. In this article, the author introduces drugs that we can use for common illnesses during pregnancy available in Korea.
Child ; Counseling ; Female ; Humans ; Korea ; Maternal Age ; Mothers ; Pregnancy* ; Pregnant Women ; Teratogens

No abstract available.
Animals ; Fertilization in Vitro* ; Herpes Zoster* ; Mice* ; Oocytes*

OBJECTIVE: To compare the efficacy and side effects of single-dose and multiple-dose systemic methotrexate (MTX) regimen for ectopic pregnancies. METHODS: Between January 1999 and December 2002, 192 of 947 cases of ectopic pregnancies were treated with systemic methotrexate therapy at the Department of Obstetrics and Gynecology, Bundang CHA Hospital. The patients were treated with either of the two regimens: a) Single dose regimen: 50 mg/m2 of intramuscular MTX without leucovorin rescue (87 cases) b) Multiple dose regimen: two to five doses of 1 mg/kg of IM MTX with leucovorin rescue (105 cases) Baseline characteristics, regimen used and the number of doses administered, treatment outcome, presence and severity of side effects were analyzed. Serum beta-hCG value at initiation of treatment and the presence of cardiac activity were controlled for with multivariate logistic regression. RESULTS: The mean age of the patients was 30.2 years (range 20-41) and gestational age at diagnosis was 45.8 days (range 28-70). Initial level of serum beta-hCG ranges from 1650 to 114332 mIU/ml (mean 3670.4). Non-tubal ectopic pregnancy occupied 23.4% of the study group. The multiple dose regimen was more commonly used. There were no significant differences in initial beta-hCG values, gestational age and presence of cardiac activity between single-dose arm and multiple-dose arm, between treatment success group and failure group. The overall success rate of MTX management for an ectopic pregnancy was 85.9% (165 of 192) with 79.3% and 91.4% for single and multiple dose regimen arms respectively. Side effects occurred in 22.9% (44 of 192) of the study group but no treatment was needed in most cases. CONCLUSION: Systemic methotrexate therapy is an effective and safe treatment modality for some selected ectopic pregnancies. Neither regimen showed definite superiority over the other. Further comparative studies with long-term follow-up are needed to evaluate reproductive outcome and to reduce side effects.
Arm ; Diagnosis ; Female ; Follow-Up Studies ; Gestational Age ; Gynecology ; Humans ; Leucovorin ; Logistic Models ; Methotrexate* ; Obstetrics ; Pregnancy ; Pregnancy, Ectopic* ; Treatment Outcome

Primary cardiac sarcoma is a rare disease in adults. It is also associated with poor prognoses, due to diagnostic delay, therapeutic difficulty, and high metastatic potential. The coincidence of pregnancy and a primary cardiac intimal sarcoma is extremely rare. We report a pregnant woman at 27(+5) weeks gestation who was admitted to the hospital with acute-onset dyspnea. A mass was found on the left atrium by transthoracic echocardiography. Subsequently, the intracardiac mass was removed, and mitral valve replacement and modified DeVega tricuspid annuloplasty were performed. The patient was diagnosed with a undifferentiated sarcoma, and gave birth to a 1,230 g living baby boy by Caesarean section from preterm contraction at 29(+5) weeks gestation. The patient then received systemic chemotherapy. However, 10 months after the initial clinical onset, the patient suddenly died. Surgery is the standard treatment for cardiac tumors, and their removal should always be attempted, even in pregnant women. Although the overall survival rates of the patients are rather poor, palliative cardiac surgery allows the prolonging of pregnancy, until an acceptable fetal viability level is reached.
Sarcoma/*surgery ; Pregnancy Complications, Neoplastic/*surgery ; Pregnancy ; Humans ; Heart Neoplasms/*surgery ; Female ; Cardiopulmonary Bypass ; Adult

Usual managements of flat anterior chamber following filtering surgery are deepening of anterior chamber using cycloplegics and mydriatics, and pressure patch technique compressing the fistula. But the pressure patch technique may worsen chamber depth problem because exact compression on the filtering area is difficult by pressure patching. Prolonged pressure patching may also cause deterioration of filtering function. The tampon with glaucoma shell provides enough resistance to excessive outflow, allows the anterior chamber to reform promptly, and can prevent choroidal separation. We treated the flat anterior chamber following trabeculectomy using glaucoma shell in 7 eyes. The anterior chamber in each eye was restored promptly within 2-4 days after the placement of glaucoma shell. Glaucoma shell is easy to handle, gives minimal discomfort to patient, and may need less time to restore flat anterior chamber than pressure patching.
Anterior Chamber* ; Choroid ; Filtering Surgery ; Fistula ; Glaucoma* ; Humans ; Mydriatics ; Trabeculectomy*