No abstract available.
Aorta, Thoracic* ; Female ; Humans

No abstract available.
Acidosis* ; Aorta, Thoracic* ; Umbilical Arteries*

No abstract available.
Fluoroimmunoassay* ; Immunoenzyme Techniques*

Bacterial infection has been implicated in premature labor in human. But it is impossible to undergo human study of bacteria-induced preterm delivery. If we carry out animal experiment which simulate human preterm delivery induced by bacteria, studies for mechanism, diagnosis, and treatment of preterm delivery will be progressed rapidly. To elucidate mechanisms and potential intervention strategies in preterm pregnancy loss, we observed bacteria-induced preterm labor and the protecting effect of administration of antibiotics with hysteroscopy-guided intracervical inoculation of Escherichia coli. Sterile saline solution(group I, n=5) or 2x10(7)cfu (colony-forming units) of E. coli bilaterally in the cervix of pregnant New Zealand White rabbits on day 20 or 21(70% of gestation) by hysteroscopy was inoculated and rabbits were assinged to ampicillin-sulbactam therapy beginning at 0hr(group II, n=4), 2 hr(group III, n=4), 4 hr(group IV, n=2), and 16 hr(group V, n=2) after inoculation with E. coli, or to no antibiotic therapy(group VI, n=3). Unasyn(ampicillin-sulbactam) was used and its daily dosage was 100 mg/kg/day. The occurrence of vaginal bleeding or preterm birth was observed every two hours. If one rabbit fetus was found to be delivered, exploratory laparotomy was done. Amniotic fluid culture on each sac, decidual culture on each uterine cavity, and pathologic examinations on each placenta were done. The results of experiments are as follows. In control group(0.2cc sterile saline inoculation only), there was no preterm labor and no bacterial growth in culture. In all three rabbits in group VI, preterm delivery occurred and the culture results were all positive in maternal blood, decidua, and amniotic sacs. Preterm delivery also occurred in group V, but results of maternal blood culture were all negative. Increased trend in the occurrence of preterm delivery was statistically significant in the order(p < 0.05) : group I(0/5), group II(0/4), group III(0/4), group IV(0/2), group V(2/2), and group VI(3/3). Pregnancy outcomes on the basis of the number of living fetus, dead fetus, and macerated fetus, have significant trend in the above order. Amniotic fluid culture results also had significant relationship(p < 0.05) : group I(0.20), group II(20/26), group III(18/30), group IV(10/11), and group VI(7/7). In group V, amniotic fluid fail to be obtained due to severe oligohydramnios. Decidual culture results also had an increased trend; group I(0/32), group II(21/29), group III(20/30), gorup IV(16/16), gorup V(11/11), and group VI(25/25). It is statistically significant(p < 0.05) Incidence of histologic chorioamnionitis was also significantly increased from group I to VI. These results indicate that E. coli inoculation has induced preterm delivery and antibiotic therapy has somewhat prevented preterm birth, amniotic fluid infection, decidual infection, and histologic chorioamnionits. Antibiotic effects were attenuated in cases of delayed antibiotic administration.
Amniotic Fluid ; Animal Experimentation ; Anti-Bacterial Agents* ; Bacteria ; Bacterial Infections ; Cervix Uteri ; Chorioamnionitis ; Decidua ; Diagnosis ; Escherichia coli ; Female ; Fetus ; Humans ; Hysteroscopy ; Incidence ; Laparotomy ; Models, Animal ; Obstetric Labor, Premature ; Oligohydramnios ; Placenta ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Prognosis* ; Rabbits ; Uterine Hemorrhage

Aneurysms of the coronary arteries are rare. They may be due to atheroselerosis, mucocutaneous lymph node syndrome, mycotic emboli, syphilis or trauma and occasionally they are congenital. The prognosis appears to be poor and death can occur suddenly from rupture of the aneurysm, peripheral coronary embolism or bacterial endocarditis. Recently surgical treatment has been successful. In a 5 year old patient with ventricular septal defect, two aneurysmal sacs located at the cardiac crux and just posterior to it was proved by coronary angiography and MRI, and successfully excised at operation.
Aneurysm* ; Child, Preschool ; Coronary Angiography ; Coronary Vessels* ; Embolism ; Endocarditis, Bacterial ; Heart Septal Defects, Ventricular ; Humans ; Magnetic Resonance Imaging ; Mucocutaneous Lymph Node Syndrome ; Prognosis ; Rupture ; Syphilis

OBJECTIVE: In a rabbit model using hysteroscopy-guided inoculation of E.coli with antibiotic administration, we determine the effects of persistent intrauterine infection on perinatal outcome including fetal death, congenital sepsis, and abnormal fetal-placental growth and amniotic fluid volume in live fetuses. METHODS: Rabbits with timed pregnancies underwent hysteroscopy at 20 to 21 days of gestation(70%). Animals were inoculated with E. coli (0.2 ml containing 10 cfu/ml) and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) every 8 hours beginning 30 minutes after microbial inoculation until they were killed 5 days after hysteroscopy. In the first study, the following outcome parameters were evaluated between fetuses with and without pe#rsistent intrauterine infection: fetal survival, congenital sepsis, maternal morbidity, and placental pathology. In second study was performed in 16 rabbits having only both live fetuses with and without persistent intrauterine infection in a rabbit simultaneously. We evaluate the effects of persistent intrauterine infection on fetal-placental weight and amniotic fluid volume in live fetuses. RESULTS: 1) Fetuses with persistent intrauterine infection had significantly fewer live fetuses, more positive cord blood cultures than those without (live fetuses: 44% vs 82%, p<0.000001; positive cord blood cultures: 44% vs 3%, p<0.000001, respectively; Fishers exact test). However the rates of maternal morbidity and placental inflammatory lesions were similar between the two groups. 2) The placental weight and amniotic fluid volume were significantly less in live fetuses with than in those without persistent intrauterine infection. Moreover the fetal weight was decreased in live fetuses with persistent intrauterine infection, but it was not statistically significant(placental weight: p<0.05; amniotic fluid volume: p<0.05; fetal weight: p 0.051, respectively; Wilcoxon matched-pairs signed ranks test). CONCLUSION: Fetal complications including fetal death, congenital sepsis, and decreased fetal-placental weight and amniotic fluid volume wae produced in utero when pasistent intrauterine infection was present with antibiotics administration after inoculstion of E. coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitar the presence of persistent intrauterine infection, and if it is peristent, delivery may be considered for the improvement of pregnancy outcome.
Amniotic Fluid ; Animals ; Anti-Bacterial Agents ; Female ; Fetal Blood ; Fetal Death ; Fetal Weight ; Fetus ; Hysteroscopy ; Obstetric Labor, Premature ; Pathology ; Pregnancy ; Pregnancy Outcome ; Rabbits ; Sepsis

Hypertensive diseases during pregnancy have a critical impact on morbidity and mortality of mother and fetus. They consist of gestational hypertension, preeclampsia-eclampsia, preeclampsia superimposed on chronic hypertension and chronic hypertension. Maternal and fetal surveillance is very important for early detection of disease progression and maternal and fetal deterioration. History taking, physical examination and laboratory tests for mother and non-stress test, biophysical profile and ultrasonography for fetus should be done on the regular base and immediately after changes of clinical symptoms and signs. Mainstays of treatment include rest, antihypertensive drugs, anticonvulsants, and corticosteroid. The decision for delivery is made on the basis of maternal and fetal conditions. Normal vaginal delivery is usually acceptable unless cesarean section is indicated because of obstetric reasons. To date, we have no effective screening markers and preventive measures for hypertensive diseases during pregnancy. Large-scaled well-designed clinical studies will show better measures which improve maternal and fetal-neonatal outcomes.
Anticonvulsants ; Antihypertensive Agents ; Cesarean Section ; Early Diagnosis ; Female ; Fetus ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Mass Screening ; Mortality ; Mothers ; Physical Examination ; Pre-Eclampsia ; Pregnancy* ; Ultrasonography

BACKGROUND: Pruritus, which is a frequent accompanying symptom of dermatological diseases, is also common during pregnancy, either localized or generalized. It may be related to specific dermatoses of pregnancy. OBJECTIVE: A clinical study was performed to know the exact nature of pruritus in pregnancy. METHODS: Subjects with systemic diseases, or laboratory abnormalities were excluded. People who have had pruritic dermatologic diseases before pregnancy were also excluded. One hundred and fifty five pregnant women were interviewed with physical examinations and followed up to the date of delivery. Pruritus was graded. RESULTS: Pruritus was present in 31.6%. Most affected subjects had mild or moderate severity. The abdomen was the most common site. There was a tendency for the duration of itching to increase with the duration of pregnancy. CONCLUSION: Conclusion: These findings may provide basic and useful data on pruritus during pregnancy.
Abdomen ; Clinical Study* ; Female ; Humans ; Physical Examination ; Pregnancy* ; Pregnant Women ; Pruritus* ; Skin Diseases

No abstract available.
Diagnosis* ; Fetal Development*

OBJECTIVE: Hypertensive disorder in pregnancy is one of the most serious obstetrical complications. Apolipoprotein E (Apo E) genotype is polymorphic and recently it was reported to be associated with preeclampsia. We undertook this study to clarify whether polymorphic marker of apolipoprotein E is associated with the development of hypertensive disorder in pregnancy. METHODS: Retrospective chart review was done. DNA was extracted from maternal blood of 124 healthy pregnant women and 253 women with hypertensive diseases in pregnancy. Hypertensive disorders complicating pregnancy include gestational hypertension (n=44), preeclampsia (n=158; mild=56, severe=102), preeclampsia superimposed preeclampsia (n=30), and chronic hypertension (n=21). Apo E allele was amplified by polymerase chain reaction, size fractionated on 4% agarose gels, and stained with ethidium bromide. RESULTS: We found all six possible genotypes of Apo E. However, three genotypes, E2/2, E2/4 and E4/4, were uncommon in Korean. We analysed the data according to each allele. Allele frequencies of the Apo epsilon2, epsilon3 and epsilon4 were as follows: 6.8%, 83.0%, 10.2% in women with gestational hypertension, 4.5%, 84.8%, 10.7% in women with mild preeclampsia, 5.9%, 85.3%, 8.8% in women with severe preeclampsia, 1.7%, 91.7%, 6.7% in women with superimposed preeclampsia, 0.0%, 90.5%, 9.5% in women with chronic hypertension, and 5.2%, 86.5%, 8.5% in normal controls. No significant difference in Apo E alllele frequency was found among these groups (P>0.05). CONCLUSIONS: The study suggests that specific allele of apolipoprotein E does not appear to be a risk factor for hypertensive disorders complicating pregnancy in Korean population.
Alleles ; Apolipoproteins ; Apolipoproteins E ; DNA ; Ethidium ; Female ; Gels ; Gene Frequency ; Genotype ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Risk Factors ; Sepharose