No abstract available.
Adenoma* ; Hyperaldosteronism*

OBJECTIVE: To evaluate the risk of emergency cesarean section according to the prepregnancy body mass index (BMI) and gestational weight gain per the 2009 Institute of Medicine guidelines. METHODS: A retrospective analysis of data from 2,765 women with singleton full-term births (2009 to 2012) who attempted a vaginal delivery was conducted. Pregnancies with preeclampsia, chronic hypertension, diabetes, planned cesarean section, placenta previa, or cesarean section due to fetal anomalies or intrauterine growth restriction were excluded. Odds ratios (ORs) and confidence intervals (CIs) for emergency cesarean section were calculated after adjusting for prepregnancy BMI or gestational weight gain. RESULTS: Three-hundred and fifty nine (13.0%) women underwent emergency cesarean section. The adjusted OR for overweight, obese, and extremely obese women indicated a significantly increased risk of cesarean delivery. Gestational weight gain by Institute of Medicine guidelines was not associated with an increased risk of cesarean delivery. However, inadequate and excessive weight gain in obese women was highly associated with an increased risk of emergency cesarean section, compared to these in normal BMI (OR, 5.56; 95% CI, 1.36 to 22.72; OR, 3.63; 95% CI, 1.05 to 12.54; respectively), while there was no significant difference between normal BMI and obese women with adequate weight gain. CONCLUSION: Obese women should be provided special advice before and during pregnancy for controlling weight and careful consideration should be needed at the time of vaginal delivery to avoid emergency cesarean section.
Body Mass Index* ; Cesarean Section* ; Emergencies* ; Female ; Humans ; Hypertension ; Institute of Medicine (U.S.)* ; Odds Ratio ; Overweight ; Parturition ; Placenta Previa ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Weight Gain*

PURPOSE: Fast MRI has provided detailed and reproducible fetal anatomy. This study was performed to evaluate the usefulness of fetal MRI for prenatal diagnosis. MATERIALS AND METHODS: Fifty-six fetuses with congenital abnormalities on ultrasonography were evaluated by fetal MRI from 2001 to 2004 in Severance Hospital. Final diagnosis was made by postnatal pathology, postnatal MRI, and other modalities (such as ultrasound, retrograde pyelogram). A 1.5-Tesla superconductive MR imaging unit was used to obtain half-Fourier acquisition single-shot turbo spin images. RESULTS: Of the 56 fetuses, intracranial abnormalities were found in 26 fetuses, intraabdominal abnormalities in 17 fetuses, intrathoracic in 6 fetuses, head and neck in 5 fetuses, and other sites in 2 fetuses. There were six cases in which the diagnoses of fetal MRI and ultrasonography differed. In such cases, fetal MRI provided more exact diagnosis than ultrasonography (5 vs. 0). Three fetuses with intracranial abnormalities on ultrasonography were diagnosed as normal by fetal MRI and in postnatal diagnosis. CONCLUSION: Although ultrasonography is known as a screening modality of choice in the evaluation of fetus because of the cost-effectiveness and safety, the sonographic findings are occasionally inconclusive or insufficient for choosing the proper management. Thus, in this study, we suggest that fetal MRI is more useful than ultrasonography for the evaluation of intracranial abnormalities in some instances. For prenatal counseling and postnatal treatment planning, fetal MRI can be informative when prenatal ultrasonography is inadequate and doubtful.
Female ; Fetal Diseases/*diagnosis/ultrasonography ; Humans ; *Magnetic Resonance Imaging ; Pregnancy ; Prenatal Diagnosis/*methods ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography, Prenatal

The incidence of acute leukemia in pregnancy is estimated to be about 1 per 75000 pregnancies, and the incidence of lymphocytic leukemia is known to be lower than myelocytic leukemia. Pregnancy dose not affect the course of acute leukemia, but thrombocytopenia, anemia and leukopenia resulting from leukemia may lead to hemorrhage, infection, and insufficient supply of oxygen and nutrition to fetus. The most important factor for chemotherapy is gestational age. Since no evidence on adverse effect of chemotherapeutic agents on fetus when given after the first trimester, aggressive chemotherapy is recommended during pregnancy. However, during chemotherapy, caution regarding risk of spontaneous abortion, intrauterine fetal growth retardation, teratogenicity, intrauterine fetal death, fetal immunosupression and preterm labor should be taken. Acute leukemia in pregnancy is extremely rare, so treatment and management of the pregnant mother bearing viable fetus in her 3rd trimester is not established clearly. We experienced a patient with acute lymphocytic leukemia who was first diagnosed at 27 gestational weeks and immediately started with chemotherapy. But due to preterm labor and impending fetal distress, emergency cesarean section was performed at 28 gestational weeks. We present this patient along with past experiences of acute leukemia in pregnancy.
Abortion, Spontaneous ; Anemia ; Cesarean Section ; Drug Therapy ; Emergencies ; Female ; Fetal Death ; Fetal Distress ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myeloid ; Leukopenia ; Mothers ; Obstetric Labor, Premature ; Oxygen ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pregnancy Trimester, First ; Pregnancy* ; Thrombocytopenia

OBJECTIVE: To investigate the differential expression of junctional proteins in the normal and preeclamptic human placenta and the effect of ginsenoside Rk1 in junctional proteins. METHODS: Placental tissues from 10 women with severe preeclampsia and 5 normal women were collected at the time of their cesarean section. Five of 10 preeclamptic women were complicated with intrauterine growth restriction (IUGR). Immunohistochemistry and Western blotting was employed to localize junctional proteins (zo-1, occludin and plakoglobin) positive cells. The placental explant culture was performed to investigate if Rk1 can attenuate the expression of junctional proteins (zo-1, occluding and plakoglobin) induced by deferoxamine-induced hypoxia. Rk1 was treated at the day 3 and Western blot analysis was performed for protein quantification. RESULTS: There was no different expression of zo-1 and plakoglobin among all the study groups. Occludin showed negative at the endothelial cells of the terminal villi in both normal and preeclampsia groups. At the endothelial cells of the stem villi, occludin was detected in both normal and severe preeclamptic placenta with normal fetal growth. However, severe preeclampsia with IUGR were decreased expression of occludin at the endothelial cells of the stem villi. When we administered Rk1 to the placenta treated with DFO, expression of occludin was not different. CONCLUSION: The placental expression of zo-1 and plakoglobin were not different among the study groups, while that of occludin was significantly decreased at the endothelium of stem villi in severe preeclampsia with IUGR. Rk-1 showed no effect on the placental junctional proteins. These results suggest that occludin may play a role in pathophysiology of fetal growth restriction in utero.
Anoxia ; Blotting, Western ; Cesarean Section ; Endothelial Cells ; Endothelium ; Female ; Fetal Development ; Fetal Growth Retardation ; gamma Catenin ; Ginsenosides ; Humans ; Immunohistochemistry ; Occludin ; Placenta ; Pre-Eclampsia ; Pregnancy ; Proteins

OBJECTIVE: We studied relationship between average amount of fish consumption and blood mercury level in pregnant women, in addition we would like to know the blood mercury level in pregnant women in Korea and we compared the initial blood mercury level in pregnant women and followed up how much blood mercury level decreased after counseling and prenatal education. METHODS: Pregnant women who received prenatal care at the Yonsei medical center from March 2004 to September 2004, were targeted. They were divided into two groups. One was the study group who was educated to restrict the intake of fish, the other was the control group who was not given any prenatal education. We measured their blood mercury level and followed up until 2nd and 3rd trimester, to find out the differences between two groups. RESULTS: Out of the 63 pregnant women who participated in our study, we followed up 11 pregnant women in the study group and 13 pregnant women of control group. The initial mean blood mercury level of both groups was 2.94 (0.14-10.75) microgram/L. Blood mercury level in fish eating group of more than 4 times a month was higher than the others, which was statistically significant (p=0.02). Followed up blood mercury levels were increased in both groups, but there was not statistically significant between two groups. CONCLUSION: Pregnant women who consume a large amount of fish may have high blood mercury level. As fish intake seems to influence blood mercury level, to lower their blood mercury level, periconceptional education to decrease fish consumption might be necessary.
Counseling ; Eating ; Education ; Female ; Fishes ; Humans ; Korea ; Pregnancy ; Pregnant Women* ; Prenatal Care ; Prenatal Education

BACKGROUND: To ensure the safety of plasma derivatives, some countries have been screening for the human parvovirus B19 (B19V) antigen or DNA in blood donors. We investigated the prevalence of B19V DNA and anti-B19V antibodies in Korean plasmapheresis donors to evaluate the necessity of B19V DNA screening test. METHODS: Plasma samples were collected between March and July 2008 from 10,032 plasmapheresis donors. The B19V DNA test was performed using the LightCycler 2.0 (Roche, Germany) with quantification kits. Anti-B19V IgM and IgG were tested in 928 randomly selected samples from the 10,032 donors using recomWell Parvovirus B19 ELISA IgM, IgG assay (Mikrogen, Germany). RecomLine Parvovirus B19 LIA IgG, IgM assay (Mikrogen, Germany) was used to analyze the epitopes of antibodies in donors showing positive results for B19V DNA and anti-B19V antibodies. DNA sequencing was performed to identify the genotypes. RESULTS: The prevalence of B19V DNA was 0.1% (10/10,032). Virus titers in B19V DNA positive donors were less than 10(5) IU/mL (range: 2.7x10(1)-3.2x10(4) IU/mL) except for 1 donor (1.33x10(8) IU/mL). All the isolated B19V DNAs from 6 donors were identified as genotype I. Nine out of 10 B19V DNA positive donors also possessed anti-B19V IgG only or IgG and IgM. The prevalence of anti-B19V IgG was 60.1% (558/928). CONCLUSIONS: The prevalence of B19V DNA in Korean blood donors was not high and most donors also possessed neutralizing anti-B19V antibodies. Thus, the implementation of a B19V screening test for Korean blood donors does not appear to be imperative.
Adolescent ; Adult ; Aged ; Antibodies, Viral/blood ; *Blood Donors ; DNA, Viral/*blood ; Enzyme-Linked Immunosorbent Assay/methods ; Female ; Follow-Up Studies ; Genotype ; Humans ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Male ; Middle Aged ; Parvoviridae Infections/epidemiology ; Parvovirus B19, Human/genetics/immunology/*isolation & purification ; *Plasmapheresis ; Polymerase Chain Reaction/methods ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies

BACKGROUND: The safety of plasma derivatives has been reinforced since 1980s by variable pathogen inactivation or elimination techniques. Nucleic acid amplification test (NAT) for the source plasma has also been implemented worldwide. Recently nanofiltration has been used in some country for ensuring safety of plasma derivatives to eliminate non-enveloped viruses such as parvovirus B19 (B19V) and hepatitis A virus (HAV). We evaluated the efficacy of nanofiltration for the elimination of B19V and HAV. METHODS: To verify the efficacy of nanofiltration, we adopted a 20 nm Viresolve NFP (Millipore, USA) in the scaling down (1:1,370) model of the antithrombin III production. As virus stock solutions, we used B19V reactive plasma and porcine parvovirus (PPV) and HAV obtained from cell culture. And 50% tissue culture infectious dose was consumed as infectious dose. The methods used to evaluate the virus-elimination efficacy were reverse-transcriptase polymerase chain reaction for B19V and the cytopathic effect calculation after filtration for PPV and HAV. RESULTS: B19V was not detected by RT-PCR in the filtered antithrombin III solutions with initial viral load of 6.42x10(5) IU/mL and 1.42x10(5) IU/mL before filtration. The virus-elimination efficacy of nanofiltration for PPV and HAV were > or =10(3.32) and > or =10(3.31), respectively. CONCLUSIONS: Nanofiltration would be an effective method for the elimination of B19V and HAV. It may be used as a substitute for NAT screening of these viruses in source plasma to ensure safety of plasma derivatives in Korea.
Antithrombin III/isolation & purification ; DNA, Viral/analysis ; Filtration/*methods ; Hepatitis A virus/genetics/*isolation & purification ; Humans ; Nanotechnology/*methods ; Parvovirus B19, Human/genetics/*isolation & purification ; RNA, Viral/analysis ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUND AND OBJECTIVES: Human rhinovirus (HRV) infection is the primary cause of the common cold. It was often reported that the frequency of viral rhinitis is higher among patients with chronic rhinosinusitis with nasal polyposis (CRS/ NP) than normal subjects. And, patients with nasal polyps often complain that they suffer from a relatively severe degree of URI. The purpose of this article was to evaluate whether the HRV infection rate and virus-induced cytokine secretion is different between the organ culture model of the nasal polyp mucosae and the sinus mcuosae. MATERIALS AND METHODS: Organ cultures of nasal polyps from sixteen CRS/NP patients and normal sphenoid sinus mucosae from nineteen patients who underwent the trans-sphenoidal pituitary surgery were tested. The successful viral infection by HRV-16 was determined by seminested reverse transcription-PCR. Immunoreactive IL-6 and IL-8 were quantitated using the ELISA. RESULTS: A PCR product indicating the successful RV infection was detected in nine of sixteen (56.3%) polyp samples and eleven of nineteen (57.9%) normal sphenoid sinus samples were tested positive for HRV-16. Rhinovirus infection increased the IL-6 and IL-8 secretion to 236% and 173% in polyp samples and to 231% and 145% in sphenoid mucosa samples respectively. However, there was no significant difference in rhinovirus infection rate and in the rhinovirus-induced IL-6 and IL-8 secretion between the groups. CONCLUSION: The results of this study may suggest that the nasal polyp mucosae, when compared with normal sinus mucosae, did not show more vulnerability to HRV infection nor more intense cytokine response by HRV infection.
Common Cold ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6 ; Interleukin-8 ; Mucous Membrane* ; Nasal Polyps* ; Organ Culture Techniques* ; Polymerase Chain Reaction ; Polyps ; Rhinitis ; Rhinovirus* ; Sphenoid Sinus*

OBJECTIVE: The aim of the study was to investigate the differential expression of Matrix Metalloproteinase (MMP) -2,-9 in the normal and severe preeclamptic placenta. METHODS: Placentas were obtained from women undergoing cesarean section with normal (n=10) and severe preeclamptic (n=10) pregnancies. Semi-quantitative RT-PCR was done to detect the placental gene expression of MMP-2,-9. Western blot analysis was performed to identify MMP-2,-9 protein expression in each placenta. Immunohistochemical staining were employed to localize MMP-2,-9 in placental tissues. RESULTS: MMP-2,-9 genes were expressed in both normal and severe preeclamptic placenta. There were lower expressions MMP-2,-9 in severe preeclamptic placentas than in normal. MMP-2,-9 proteins were all present in each placental tissue. The expression for MMP-2,-9 was weaker in severe preeclamptic placenta than in normal. MMP-2,-9 were localized only to the trophoblast, and were also weakly positive in severe preeclamptic placenta compared with normal. CONCLUSIONS: MMP-2,-9 expressions were decreased in severe preeclampsia placenta compared to those from normal placenta. This study suggests that decreased expression of MMP-2,-9 may have a role in the development of severe preeclampsia.
Blotting, Western ; Cesarean Section ; Female ; Gene Expression ; Humans ; Placenta ; Pre-Eclampsia ; Pregnancy ; Proteins ; Trophoblasts