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

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

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: 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: In the Korean Red Cross, anti-HTLV (Human T-cell lymphotropic virus)-1/2 screening assay has been performed in all donated blood except plasmapheresis since April 2009. For anti-HTLV-1/2 positive donors, both Western blot (WB) and nucleic acid amplification test (NAT) are performed as confirmatory assays. In this study, we evalutated the efficiency of the current confirmatory assay scheme to improve the confirmatory assay scheme for anti-HTLV1/2. METHODS: The results of the HTLV confirmatory assay from April 15th 2009 to April 14th 2015 were analyzed using the Blood Information Management System of the Korean Red Cross. We also investigated the current situation in other countries. RESULTS: Of 12,923,854 donations, 3,483 (0.027%) showed positive results in anti-HTLV-1/2. Of the 3,483 donations, 499 (14.3%) showed positive results in WB or NAT or both. The number of positive cases in both was 461. Therefore, the concordance rate was 92.4%. In the cases of positive results only in NAT, the WB results were all indeterminate (ID). Most countries are using immunoblot assay as a confirmatory assay for anti-HTLV positive blood donors. In the results, there were no cases of positive result in only NAT with a negative result in immunoblot assay. CONCLUSION: It was considered that the accomplishment of only WB as a confirmatory assay for anti-HTLV-1/2 positive donors may be sufficient in the aspect of safety and economics. However, in the case of WB ID result, it may be better to perform NAT as a supplemental test.
Blood Donors* ; Blotting, Western ; Humans ; Information Management ; Mass Screening ; Nucleic Acid Amplification Techniques ; Plasmapheresis ; Red Cross ; T-Lymphocytes ; Tissue Donors

BACKGROUND: While plateletpheresis donation results in less red blood cell loss and therefore less depletion of storage iron, repeated plateletpheresis can also lead to iron depletion. To determine the safety of regular plateletpheresis donations, this study estimated donor's iron status according to age, gender, number of donations, and donation interval. METHODS: The study population included 5,109 plateletpheresis donors (4,824 males, 285 females), who passed the hemoglobin (Hb) criteria for plateletpheresis donation of 12.0 g/dL or more in an inclusion period (September 2013~November 2013). During donor screening, serum ferritin levels were measured for assessment of iron status of plateletpheresis donors. RESULTS: Mean age of donors was 30.4 years (range: 17~59). Donors with a history of donation of more than 3 years accounted for 89.3% and 74.0% in males and females, respectively. Mean donation interval and annual donation number in male (female) donors was 11.9 (7.2) weeks and 4.2 (8.7) times, respectively. Approximately 37.8% of male donors and 64.2% of female donors had a serum ferritin level of less than 15 ng/mL. Serum ferritin levels showed correlation with donation interval, as the percentage of donors with a low ferritin level decreased with increase in donation interval (rho: 0.191~0.438, P<0.001). Serum ferritin levels also showed correlation with annual plateletpheresis number (rho: -0.261~-0.411, P<0.001). CONCLUSION: Depleted iron store was observed in nearly 40% of donors who had acceptable Hb levels for plateletpheresis donation. Hb pre-donation screening is not sufficient to reduce the risk of iron deficiency in regular plateletpheresis donors.
Anemia, Iron-Deficiency ; Blood Donors ; Donor Selection ; Erythrocytes ; Female ; Ferritins* ; Humans ; Iron ; Male ; Mass Screening ; Plateletpheresis* ; Tissue Donors*

BACKGROUND: Determination of the hemoglobin (Hb) levels of prospective blood donors has been performed on capillary blood obtained by finger prick using a gravimetric CuSO4 method. Noninvasive Hb testing devices based on pulse oximetry technology have recently been developed. This study was conducted to evaluate the performance of two noninvasive Hb testing devices, NBM 200 and Pronto-7 as a predonation Hb screening test. METHODS: Hb levels of 993 blood donors (727 males, 266 females) were measured using five methods: two noninvasive methods, CuSO4 method, HemoCue, and hematology analyzer (Sysmex KX-21N). The hematology analyzer was considered as the reference method. RESULTS: Compared with Hb levels of the hematology analyzer, the bias was 0.7 g/dL for NBM 200, 0.1 g/dL for Prtonto-7, and 0.4 g/dL for HemoCue. The intraclass correlation coefficients of Hb measurements compared to the hematology analyzer were 0.57 (95% CI: 0.25~0.73) for NBM 200, 0.73 (95% CI: 0.69~0.75) for Pronto-7, and 0.87 (95% CI: 0.69~0.93) for HemoCue. The ability to detect Hb <12.5 g/dL and > or =12.5 g/dL was 16.4% and 99.2% for NBM 200, 55.8% and 95.9% for Pronto-7, 60.0% and 98.6% for HemoCue and 81.8% and 95.2% for the CuSO4 method, respectively. CONCLUSION: Unsatisfactory results were obtained using the noninvasive Hb testing devices for a predonation Hb screening test, although they have the apparent advantage of reducing pain and stress in donors thereby increasing donor satisfaction. However, for application in the blood donation setting, performance of these devices should be improved.
Bias (Epidemiology) ; Blood Donors ; Capillaries ; Fingers ; Hematology ; Humans ; Male ; Mass Screening ; Oximetry ; Prospective Studies ; Tissue Donors

BACKGROUND AND OBJECTIVES: Rhinovirus enters into airway epithelial cells via the membrane bound receptor ICAM-1. Infected epithelial cells secrete the cytokines such as IL-6 and IL-8, which induce neutrophil migration into the epithelium. Clarithromycin has been found to inhibit ICAM-1 production and secretion of IL-6 and IL-8. We hypothesized that these properties of clarithromycin may be applicable in treating rhinovirus infection. MATERIALS AND METHOD: We assayed the effects of clarithromycin on rhinovirus infected A549 cells. ICAM-1 expression was assessed by flow cytometry, and cytokine secretion was assayed by ELISA. The level of viral replication was expressed as viral titer, which was determined through viral culture on MRC-5 cells. RESULTS: The mean fluorescence intensity of ICAM-1 in rhinovirus infected cells decreased from 12.4+/-0.59 to 9.2+/-0.72 after treatment with clarithromycin. The production of IL-1beta, IL-6, and IL-8 was decreased after rhinovirus infected cells were treated with clarithromycin. In the absence of rhinovirus infection, clarithromycin had no effect on ICAM-1 expression or cytokine secretion. The rhinovirus titer in infected cells was 10(3.71) TCID 50 U/ml, which was reduced following clarithromycin treatment to 10(2.14) TCID 50 U/ml. CONCLUSION: These findings suggest that clarithromycin treatment of rhinovirus infected A549 cells inhibited rhinovirus induction of increased ICAM-1 expression, cytokine elaboration, and viral replication.
Clarithromycin* ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Epithelium ; Flow Cytometry ; Fluorescence ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Interleukin-8 ; Macrolides ; Membranes ; Neutrophils ; Rhinovirus