Human uterus has been known as a immune privileged site for the product of conception. At the feto-maternal interface, Fas system is a underlying main mechanism of maternal immune acceptance. To date, the TRAIL (TNF-related apoptosis-inducing ligand) system is known to be another pivotal mechanism. OBJECTIVE: To clarify the protein expression of TRAIL ligand and receptors in the normal and pathologic (preeclampsia, hydatidiform mole) placenta, chorioamnion, decidua. METHODS: we investigated the expression of TRAIL system in the above-mentioned tissues by using Western Hybridization. RESULTS: All tissues expressed TRAIL ligand and only a DcR2 among TRAIL receptors (DR4, DR5, DcR1, DcR2). CONCLUSION: we demonstrated the expression of TRAIL ligand and DcR2 protein at the feto-maternal interface of the normal and pathologic pregnancies. Further study regarding the expression of other receptors and quantitative analysis between normal and pathologic pregnancies should be followed.
Apoptosis* ; Decidua ; Female ; Fertilization ; Gestational Trophoblastic Disease* ; Humans* ; Placenta ; Pregnancy ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; Uterus

OBJECTIVE: To evaluate the relationship between increased nuchal translucency (NT) and abnormal pregnancy outcomes. METHODS: From January 1999 to December 2001, The 298 fetuses of increased nuchal translucency (>or=2.5 mm) in period of 10-14 weeks gestation were reviewed retrospectively. Amniocentesis and high resolution ultrasonography during second trimester were done for all cases. We analyzed septation within NT, karyotypes, structural anomalies, and adverse pregnancy outcomes such as spontaneous abortion, intrauterine fetal death and preterm delivery. RESULTS: The mean age of the patients was 30.5 +/- 3.5 years. The mean gestational age and CRL were 12.5 +/- 0.95 weeks and 6.5 +/- 1.15 mm. We observed 18 (6%) cases of abnormal karyotypes. 7/46 (15.2%) fetuses with internal septation had abnormal karyotype and 11/252 (4.4%) fetuses without internal septation had abnormal karyotype (p=0.013). Among the 280 fetuses with normal karyotype, 8 (2.8%) fetuses had structural anomalies and 18 (6.4%) fetuses had adverse pregnancy outcomes. The chromosomal abnormality and structural anomaly were significantly increased in the group of nuchal translucency thickness above 3.5 mm (p=0.001). CONCLUSION: Increased nuchal translucency is related with chromosomal abnormality and abnormal pregnancy outcomes.
Abnormal Karyotype ; Abortion, Spontaneous ; Amniocentesis ; Chromosome Aberrations ; Female ; Fetal Death ; Fetus ; Gestational Age ; Humans ; Karyotype ; Nuchal Translucency Measurement* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Retrospective Studies ; Ultrasonography

OBJECTIVE: To evaluate the relationship between results of 50-g one-hour glucose screening test (50 GTT) and gestational diabetes and to find cut-off result value of 50 g GTT which can diagnosis the gestational diabetes without other confirmative tests. METHODS: Retrospective study were performed from 1353 pregnant women between 24-28 weeks of gestation, whose results of 50 gGTT were the same or above 140 mg/dl. The diagnosis of gestational diabetes was determined by 100-g 3-hour oral glucose tolerance test (100 gGTT) result. RESULTS: From 1998 to 2002, One hundred twenty-six pregnant women were diagnosed as gestational diabetes among 1353 pregnant women performed 100 gGTT. We couldn't decide any diagnostic cutoff value to gestational diabetes. There was a correlation between the results of 50 gGTT and the incidence of gestational diabetes (p<0.0001). Twenty-one (63.64%) patients among 33 patients whose 50-g screening test result Diabetes, Gestational* ; Diagnosis ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Incidence ; Mass Screening* ; Pregnancy ; Pregnant Women ; Retrospective Studies

OBJECTIVE: To know whether HPV Oligonucleotide Microarray (HPVDNAChip) can detect the HPV DNA in the urine and, if it can, to compare the results with Pap smear, biopsy, and cervix HPVDNAChip. METHODS: The authors had done Pap smear, cervix HPVDNAChip and colposcopy-guided punch biopsy as well as detailed information to those who visited Dept. of Ob. And Gyn. during 1st of April to 31st of May in 2003 for their uterine cervical problems related to the neoplasia. When they were determined to admit for treatment, urine had been collected to be tested by HPVDNAChip. RESULTS: Among 25 patients enrolled in this study, there were 10 whose urine HPVDNAChip test turned out positive (40%). Among 10 positive results, 9 patients had HPV 16 subtypes. Among 10 urine HPVDNAChip positive patients, there were 5 HSIL, 4 squamous cell cancer (SCC), and 1 ASCUS cell types on the Pap smears. Among 15 urine HPVDNAChip negative patients, there were 7 HSIL, 5 SCC, 1 ASCUS, 1 LSIL, and 1 AGUS. Among 10 urine HPVDNAChip there are 5 CIN3, and 4 invasive SCC, and 1 adenocarcinoma at the biopsy. Among 15 urine HPVDNAChip negative patients, there are 7 CIN3, 6 invasive SCC, 1 adenocarcinoma in situ, and 1 CIN1 patient. Whenever there were a urine HPVDNAChip 16 subtype positive, there were always cervix HPVDNAChip 16 subtype positive, but among the 12 urine HPVDNAChip negative patients, 5 had HPV 16 subtype positive and 4 had another subtypes and 3 had negative on cervix HPVDNAChip tests. CONCLUSION: Using HPVDNAChip, we verified that 40% of patients had the HPV DNA in their urine who had admitted for the treatment of their cervical neoplasm. And HPV 16 subtype was the most common type in the urine. If we can extend this data more widely, we might use it as an auxiliary tool for cervical HPV infection.
Adenocarcinoma ; Biopsy ; Cervix Uteri* ; DNA ; Female ; Human papillomavirus 16 ; Humans ; Neoplasms, Squamous Cell ; Oligonucleotide Array Sequence Analysis* ; Uterine Cervical Neoplasms*

OBJECTIVE: The purpose of this study was to define the normal variation of fetal heart rate (FHR) and to analyze whether first-trimester fetal heart rate (FHR) are useful in predicting pregnancy outcome. METHODS: We prospectively studied 162 singleton pregnancies with gestational ages ranging from 5 to 10 weeks between Mar. 1999 and Jan. 2003 visting our hospital. Color doppler sonography was used to calculate the fetal heart rate in beats per minute as the mean of 3 waves. RESULTS: The following results were obtained. 1. Overall, 149 pregnancies reached viability and 13 resulted in fetal loss before 13 weeks' gestation. 2. A significantly higher number of viable pregnancies, compared with fetal losses, had FHR within one (73.1% compared with 38.5%, p<0.001) and two (94.6% compared with 69.2%, p<0.001) standard deviations of the mean for viable pregnancies at corresponding gestational ages. 3. A significant correlation was seen between gestational age and fetal heart rate (p<0.001). The regressing equation for heart rate was as follows: heart rate = 3.40 X gestational age (days)-30.15 (r = 0.87). 4. There was no significant difference in the fetal heart rates between male and female embryos during this early stage of pregnancy. CONCLUSION: First-trimester FHR can be helpful to predict pregnancy outcome. Women with FHR outside the reference range from the mean for viable pregnancies at corresponding gestational ages may be at risk for eventual pregnancy loss.
Embryonic Structures ; Female ; Fetal Heart* ; Gestational Age ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Male ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Trimester, First* ; Pregnancy* ; Prospective Studies ; Reference Values

OBJECTIVE: This study is aimed to evaluate whether lamellar body count (LBC) in amniotic fluid could be used as a predictor of neonatal morbidity as well as respiratory distress syndrome (RDS) and to determine the value of lamellar body count that maximizes sensitivity and specificity. METHODS: We conducted a prospective clinical outcome study. Amniotic fluid was obtained from 39 pregnant women at various gestational ages (29 to 36 weeks) from March 1, 2002 to February 28, 2003. They delivered within 72 hours of amniocentesis, excluding 6 cases of contaminated amniotic fluid. A LBC was performed on each specimen. The frequencies of RDS, minor and major morbidity of newborn in different LBC cutoff value were analyzed. Statistic analysis was done by Chi-square test. RESULTS: LBCs increased with gestation (r=0.533, p<0.05). The LBC cutoff value that best agreed with RDS (sensitivity 36.4%, specificity 93.8%), minor morbidity (sensitivity 100.0%, specificity 50.0%) and major morbidity (sensitivity 45.5%, specificity 81.3%) was 30,000/ l. CONCLUSION: These results indicate that LBC might be useful as a predictor of neonatal morbidity as well as respiratory distress syndrome.
Amniocentesis ; Amniotic Fluid ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Outcome Assessment (Health Care) ; Pregnancy ; Pregnant Women ; Prospective Studies ; Sensitivity and Specificity

OBJECTIVE: The authors have aimed to compare the efficacy of the computed tomography with other study methods, and to investigate if replacement by computed tomography is possible METHODS: From January 1998 to December 2002, 203 cervical cancer patients underwent pre-staging studies including computed tomography. The positive predictive values, negative predictive values, sensitivity, specificity of each method of study were compared. RESULTS: 1. Compared computed tomography with intravenous pyelonephrography. Each values of computed tomography for hydronephrosis or non visualization of kidney were sensitivity 91.7%, specificity 97.8%, positive predictive values 84.6%, negative predictive values 98.9%. 2. Compared computed tomography with cystoscopy. Each values of computed tomography for bladder invasion were sensitivity 90%, specificity 95.8%, positive predictive values 52.9%, negative predictive values 99.4%. 3. Compared computed tomography with sigmoidoscopy. Each values of computed tomography for rectal invasion were sensitivity 80%, specificity 94.4%, positive predictive values 26.6%, negative predictive values 99.4%. CONCLUSION: Rather than routine examination for staging of invasive cervical cancer in all patients, it is more ideal to first take a non invasive technique. then perform on intravenous pyelonephrography, cystoscopy and sigmoidoscopy only in patient showing positive findings of hydronephrosis or non visualization of kidney, bladder or rectal invasion on computed tomography.
Cervix Uteri* ; Cystoscopy ; Female ; Humans ; Hydronephrosis ; Kidney ; Sensitivity and Specificity ; Sigmoidoscopy ; Urinary Bladder ; Uterine Cervical Neoplasms

OBJECTIVE: The purpose of this study was to evaluate value of methotretrexate (MTX) in the treatment of tubal pregnancy. METHODS: 28 patients with unruptured tubal pregnancy were treated alternately with four doses of intramuscular MTX (1.0 mg/kg) and four doses of intramuscular citrovorum factor (0.1 mg/kg). Patients considered eligible for MTX treatment of tubal pregnancy were those with unruptured tubal pregnancy Alopecia ; Bone Marrow ; Chorionic Gonadotropin ; Dermatitis ; Diagnosis ; Diarrhea ; Female ; Fetal Heart ; Gestational Age ; Gestational Sac ; Gingivitis, Necrotizing Ulcerative ; Humans ; Leucovorin ; Methotrexate* ; Pneumonia ; Pregnancy ; Pregnancy, Tubal* ; Salpingectomy ; Ultrasonography ; Vomiting

OBJECTIVE: To explore the association of the N-acetyl transferase 2 (NAT 2) gene polymorphisms with endometriosis. METHODS: One hundred seventy-two women with surgically or histologically diagnosed endometriosis of stages I-IV, and 205 patients with no evidence of endometriosis by laparoscopy or laparotomy served as control. Genotype distribution of NAT 2 polymorphisms and frequencies of slow and fast acetylators in affected women and controls were evaluated. RESULTS: There was no statistically significant difference in the genotype distribution of NAT 2 polymorphisms and frequencies of slow and fast acetylators between the patients with endometriosis and the controls. CONCLUSION: These results suggest that N-acetyl transferase 2 gene polymorphisms is not associated with the risk for endometriosis in the Korean population.
Endometriosis* ; Female ; Genotype ; Humans ; Laparoscopy ; Laparotomy ; Transferases*

Fitz-Hugh-Curtis syndrome is a condition in which, as a result of pelvic inflammatory disease, the liver capsule becomes involved with inflammatory exudate that later leaves violin string adhesions. Although in the past Neisseria gonorrhea was thought to be the only etiological agent, recent data indicate that Chlamydia trachomatis may play an important role in perihepatitis. Perihepatic adhesions may be an aftereffect of the acute hepatic episode, and because the cause of ectopic pregnancy is thought to be salpingitis, women with an ectopic pregnancy may have a higher prevalence of coexisting perihepatic adhesion. The incidence of this conditon in ectopic gestation was reported to be 14-34 %. Direct observation of the liver and pelvis through laparoscope is the most definitive method of diagnosing salpingitis and perihepatitis. Standard treatement regimens recommended for salpingitis are adequate also for treatement of perihepatitis. We have experienced two cases of Fitz-Hugh-Curtis syndrome associated with ectopic pregnancy, and report with the brief review of the literatures.
Chlamydia trachomatis ; Exudates and Transudates ; Female ; Gonorrhea ; Humans ; Incidence ; Laparoscopes ; Liver ; Neisseria ; Pelvic Inflammatory Disease ; Pelvis ; Pregnancy ; Pregnancy, Ectopic* ; Prevalence ; Salpingitis