OBJECTIVE: To discover the etiology of birth defects and low birth weight, it is necessary to establish epidemiological birth defects monitoring system in Korea. Our aim was to develop new practical model in Incheon to establish birth defects monitoring system to evaluate the incidence rate and patterns of birth defects in Korea. METHODS: Public health center and private hospitals and clinics participated in this monitoring system. Web based reporting system have been built. Trained nurses actively collected the records obtained from delivery units in the participating hospitals during 2 years (first year: December 1st, 1998-November. 31, 1999; second year: January 1 st, 2000-December 31 th, 2000). RESULTS: Through this monitoring system at 1 st year and 2 nd year, we observed 25 birth defect cases from 2482 births, 28 birth defect cases from 3490 births including live births and stillbirths. The incidence of birth defect per thousand person was 10.1, 8.0 respectively. At 1st year, the highest proportion of birth defects was 28.0% in musculoskeletal system. The proportion of birth defects in gastrointestinal system, cardiovascular system and cleft lip & cleft palate were 20.0%, 12.0%. 12.0%. At 2 nd year, the highest proportion of birth defects was 21.4% in gastrointestinal system The proportion of birth defects in cardiovascular system and musculoskeletal system were 17.9% and 14.3%. CONCLUION: In conclusion, we could build population-based monitoring system for birth defects successfully in Yonsu gu, Incheon. To establish population-based monitoring system for birth defects in Korea, it is necessary to organize the reporters of public health center and private hospitals and clinics, to build an available reporting system, and to extend participating centers for birth defects monitoring systems.
Cardiovascular System ; Cleft Lip ; Cleft Palate ; Congenital Abnormalities* ; Environmental Exposure ; Hospitals, Private ; Humans ; Incheon* ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Live Birth ; Musculoskeletal System ; Parturition* ; Public Health ; Stillbirth

OBJECTIVE: Increasingly it is being recognized that genetic factors play a significant role in causing malformation. There are many available prenatal diagnostic methods including cytogenetic karyotyping using amniocentesis and cordocentesis, fluorescence in situ hybridization(FISH), and primed in situ labelling(PRINS). Our purpose was to attempt to discuss the clinical use of cytogenetic karyotyping, FISH, and PRINS. METHODS: We conducted 222 cases of cytogenetic karyotyping using amniocentesis and cordocentesis, l0 cases of FISH, and 10 cases of PRINS from January 1996 to July 1998 at Ewha Womans University Mokdong Hospital. Age distribution, chromosomal abnormalities by age group, indication, karyotype, and baby outcomes were performed. RESULTS: Overall incidence of chromosomal abnormalities was 7.7%(17cases) and chromosomal abnormalities were most frequently noted in 30-34 year old women and 35-39 year old women(2.3%, respectively). Among 222 cases, 25-29 year old women were highest(30.2%). Chromosomal abnormalities among cytogenetic karyotyping cases were Down syndrome, Edward syndrome, Patau syndrome, Deletion(8), Inversion(9), etc. The 5 cases of healthy baby among chromosomal abnormalities were delevered. Among 213 cases of karyotyping using amniocentesis, abnormal karyotyping cases were 15 cases. Among 15 cases, 8 cases were terminated and 5 cases of healthy baby were delivered. Among 9 cases of karyotyping using cordocentesis, 2 cases of chromosomal abnormalities(Edward, Down syndrome) were found and 3 cases healthy baby were delivered. Among 10 cases of FISH results, 6 case of FISH results were the same with G-banding and were different from G-banding. Among 10 cases of PRINS results, we got the PRINS results from 7 cases. CONCLUSION: It is concluded that cytogenetic karyotyping, FISH, and PRINS are very useful to detect chromosomal abnormalities.
Age Distribution ; Amniocentesis ; Chromosome Aberrations ; Cordocentesis ; Cytogenetics* ; Down Syndrome ; Female ; Fluorescence* ; Humans ; In Situ Hybridization* ; Incidence ; Karyotype ; Karyotyping* ; Prenatal Diagnosis* ; Primed In Situ Labeling

OBJECTIVE: Currently, preparation for childbirth is becoming an increasingly popular addition to patient education. Because of this interest, it seems advisable to review the evidence on the effect of prepared childbirth. The objective of this study is to evaluate the effectiveness of Lamaze preparation on labor and delivery. METHODS: To investigate whether prepared-childbirth courses offer measurable physical advantages, we compared the labor and delivery characteristics of 80 primiparas who had taken Lamaze-training classes with 76 control patients who had not. We reviewed retrospectively obstetrical records of 156 pregnant women delivered in Ewha Womans University MokDong Hospital from January to December, 1997. RESULT: The length of the first stage of labor in the group that attended childbirth preparation classes was 5.70 hours and 6.93 hours in the comparison group. This difference was statistically significant (P= .040). The mean duration of the second stage of labor in attenders was 42.43 minutes and 41.16 minutes in the nonattenders(P= .719). Average duration of labor in attenders was 1.07 hours shorter than in nonattenders (P= .075). The cesarean section rate in attenders was 25% compared with 36.8% in nonattenders (P= .10920). CONCLUSION: No statistical significance was found in this study. However we need to be aware that the length of first stage of labor was shorter and the rate of cesarean section was lower in prepared group. Childbirth education should be integrated into prenatal health care to be readily available for all women.
Cesarean Section ; Delivery of Health Care ; Female ; Humans ; Parturition ; Patient Education as Topic ; Pregnancy ; Pregnant Women ; Prenatal Education ; Retrospective Studies

The nm23 gene was originally identified by differential screening of a cDNA library with RNA from low and high metastatic clones of a murine melanoma cell line. And the nm23 gene has been represented as a metastasis suppressor gene. The product of nm23 gene is known to be identical to nucleoside diphosphate(NDP) kinase. The lack of expression of nm23 protein has been correlated with a poorer prognosis in some human tumors, among which are breast carcinoma, malignant melanoma, gastric carcinoma and hepatcelluar cacin-oma. However, in several types of malignant tumors such as colon carcinoma, neuroblastoma and pancreatic carcinoma, unexpected overexpression of nm23 protein was found as compared with normal tissues. Also in a few studies with cervical carcinoma, the expression of nm23 protein was found to be increased as compared with normal cervical tissue recently. Therefore, in this study, we analyzed the expression of nm23-H1 protein by immunohistochemistry method in a series of 40 cervical carcinomas, to determine whether the alterations in the expression of nm23-H1 protein occured in cervical carcinoma as compared with cervical intraepithelial neoplasia(CIN) and normal cervices, and also analyzed the possible association between nm23 protein expression and prognostic parameters of cervical carcinoma at Ewha Womans University Mokdong Hospital from September 1993 to March 1997. The results obtained were as follows; 1. The mean ages of normal control patients, CIN and cervical carcinomas were 42.9 (+/-5.1) years, 39.5(+/-7.7) years, and 49.3(+/-11.7) years respectively. All cases of cervical carcinoma were squamous cell carcinomas. And the number of each stages Ia, Ib, IIa, IIb, III and IV were 13 cases, 8 cases, 6 cases, 9 cases, 2 cases, and 2 cases respectively. 2. In cervical carcinoma, nm23-H1 protein expression was significantly increased as compared with CIN and normal cervical tissue(t=5.017>1.96). 3. In cervical carcinoma, the nm23-H1 protein expression was more increased in higher stages(p=0.021). But it had no significant correlations with primary tumor size, lymphovascular space invasion, parametrial invasion or lymph node metastasis. Our results on nm23-H1 protein expression in cervical carcinoma suggest that cervical carcinoma seems to belong to the group of tumors, like colon carcinoma and neuroblastoma, pancreatic carcinoma in which nm23-H1 overexpression is associated with a more malignant phenotype. In this study, nm23-H1 protein was more expressed in higher clinical stages of cervical carcinoma. Therefore the expression of nm23-H1 protein probably may have a prognostic significance in cervical carcinoma. But a further prospective study on a larger population is needed to establish the role of nm23 gene in this kind of tumor.
Breast Neoplasms ; Carcinoma, Squamous Cell ; Cell Line ; Cervix Uteri* ; Clone Cells ; Colon ; Female ; Gene Library ; Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Lymph Nodes ; Mass Screening ; Melanoma ; Neoplasm Metastasis ; Neuroblastoma ; Phenotype ; Phosphotransferases ; Prognosis ; RNA

OBJECTIVE: Our purpose was to determine whether amniotic amniotic fluid concentrations of interleukin-6 are valuable in the prediction of histologic chorioamnionitis and in the prediction of perinatal morbidity. STUDY DESIGN: The relation among amniotic fluid imterleukin-6, histologic chorioamnionitis, and perinatal outcome was examined in patients with preterm labor and intact membranes. Interleukin-6 was determined by ELISA method. RESULTS: Patients with histologic chorioamnionitis had significantly higher amniotic fluld interleukin-6 concentrations than patient without histologic chrioamnionitis. Also, patient with histologic chorioamnioitis had significantly higher perinatal morbidity rate than patient without histologic chorioamnionitis. An ammiotic fluld interlerkin-6 concentration had a sensitivity of 75% and a specificity of 62.5% in the diagnosis of preterm delivery. CONCLUSION: Amniotic fluld interleukin-6 is a sensitive test for the prediction of histologic chorioamnionitis and of perinatal morbidity.
Amniotic Fluid* ; Chorioamnionitis* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-6* ; Membranes* ; Obstetric Labor, Premature* ; Pregnancy ; Sensitivity and Specificity

Massive congenital intracranial teratoma is a very rare. We report the prenatal ultrasonographic diagnosis of a massive intracranial teratoma in a 323 weeks pregnancy associated with severe hydrocephalus and polyhydroamnios. Prenatal ultrasound revealed a large heterogeneous echoic mass which almost replaced the normal intracranial structure. By transabdominal and transvaginal cephalocentesis, fetus was terminated vaginally and safely. We have reviewed with attention to clinical presentation, sonographic characteristics and associated findings and man-agement and prognosis of massive congenital intracranial teratoma.
Diagnosis ; Fetus ; Hydrocephalus ; Pregnancy ; Prognosis ; Teratoma* ; Ultrasonography

The mechanisms responsible for the onset of preterm labor in women are poorly understood. It is widely accepted that increased biosynthesis of PGE2 by intrauterine tissues seems to be a key event in the initiation of preterm parturition.However, the mechanisms for the increased PG formation during parturition have not yet been explained.Growing evidednce suggesis an association between intraamniotic infection and preterm labor. It is suggested that bacterial products can signal the increased PG biosynthesis associated with parturition, and that decidua can induce the onset of preterm labor by using inflammatory mediators(for example, IL-1beta) produced in response to bacterial invasion. The purposes of this study were to determine the effect of LPS on the production of IL-1beta and PGE2 and to determine the inhibitory effect of anti-IL-1beta and TGF-beta2 on the production of IL-1beta and PGE2 BY HUMAN DECIDUAL CELLS. The results were as follows : 1. The production of PGE2 AND IL-beta by decidual cells after incubation with LPS for 24 hours culture significantly increased in comparison with controls, respectively. 2. The production of PGE2 by decidual cells after incubation with il-1beta for 24 hours culture significantly increased in comparision with controls. 3. The production of PGE2 by decidual cells after incubation with LPS and anti-IL-1beta for 24 hours culture significantly decreased in comparision with LPS treated groups, respectively. 4. The production of PGE2 by decidual cells after incubation with LPS and TGF-beta2 for 24 hours culture significantly decreased, but IL-1beta production significantly increased in comparision with LPS treated groups. In conclusion, LPS may induce the formation PGE2 through IL-1beta, and LPS induced preterm labor may be prevented by anti-IL-1beta and TGF-beta2.
Decidua ; Dinoprostone ; Female ; Humans* ; Interleukin-1beta ; Obstetric Labor, Premature ; Parturition ; Pregnancy ; Transforming Growth Factor beta2

The mechanisms responsible for the onset of preterm labor in women are poorly understood. It is widely accepted that increased biosynthesis of PGE2 by intrauterine tissues seems to be a key event in the initiation of preterm parturition.However, the mechanisms for the increased PG formation during parturition have not yet been explained.Growing evidednce suggesis an association between intraamniotic infection and preterm labor. It is suggested that bacterial products can signal the increased PG biosynthesis associated with parturition, and that decidua can induce the onset of preterm labor by using inflammatory mediators(for example, IL-1beta) produced in response to bacterial invasion. The purposes of this study were to determine the effect of LPS on the production of IL-1beta and PGE2 and to determine the inhibitory effect of anti-IL-1beta and TGF-beta2 on the production of IL-1beta and PGE2 BY HUMAN DECIDUAL CELLS. The results were as follows : 1. The production of PGE2 AND IL-beta by decidual cells after incubation with LPS for 24 hours culture significantly increased in comparison with controls, respectively. 2. The production of PGE2 by decidual cells after incubation with il-1beta for 24 hours culture significantly increased in comparision with controls. 3. The production of PGE2 by decidual cells after incubation with LPS and anti-IL-1beta for 24 hours culture significantly decreased in comparision with LPS treated groups, respectively. 4. The production of PGE2 by decidual cells after incubation with LPS and TGF-beta2 for 24 hours culture significantly decreased, but IL-1beta production significantly increased in comparision with LPS treated groups. In conclusion, LPS may induce the formation PGE2 through IL-1beta, and LPS induced preterm labor may be prevented by anti-IL-1beta and TGF-beta2.
Decidua ; Dinoprostone ; Female ; Humans* ; Interleukin-1beta ; Obstetric Labor, Premature ; Parturition ; Pregnancy ; Transforming Growth Factor beta2

This study was purosed to investigate maternal and fetal clinical parameters effecting on maternal serum alpha-fetoprotein(MSAFP) levels at late normal singleton pregnancies. The subjects of this study were 171 pregnant women with gestational age of 36 to 42 weeks, and didn`t have any medical or gynecologic diseases. They delivered fetuses within three days after blood test of MSAFP. MSAFP levels were measured by enzyme-immunoassay. The analysed clinical parameters included fetal sex, fetal weight, gestatioal age, maternal age, gravidity, parity, maternal weight and maternal total weight gain during pregnancy. The results were as follows: At uncomplicated late pregnancies, 1. Male fetus bearers had higher MSAFP(mean: 191.8 ng/ml, SD: 80.8 ng/ml, n=79) than female-fetus bearers(mean 153.6 ng/ml, SD 73.0 ng/ml, n=92)(p=0.0014). 2. Multiparas had higher MSAFP(mean: 192.7 ng/ml, SD: 77.9 ng/ml, n=80) than nulliparas(mean: 152.3 ng/ml, SD 75.1 ng/ml, n=91)(p=0.0007). 3. MSAFP did not have correlation with maternal age, maternal weight, maternal total wight gain during pregnancy, gestational age, fetal weight. According to the above results, fetal sex and parity are the factors that influences MSAFP levels at uncomplicated late pregnancies. So MSAFP values should be interpreted with cautions.
Female ; Fetal Weight ; Fetus ; Genital Diseases, Female ; Gestational Age ; Gravidity ; Hematologic Tests ; Humans ; Male ; Maternal Age ; Parity ; Pregnancy* ; Pregnant Women ; Weight Gain

OBJECT: This study was carried out to investigate the effect of pentoxifylline on in vitro fertillization and developmen of preimplantation stage of mouse embryos. MATERIAL AND METHODS:F1 hybrid mice was superovulated with PMSG/hCG and mouse oocytes were recruited. After the normal sperms were incubated with PTX before in vitro fertilization, it was observed whether the fertilization and embryo development was affected or not by the sperm preparation(washing, dilution and no washing or no dilution). And after 1-cell and 2-cell stage of mouse embryos were incubated with PTX, the development to hatching blastocyst was also observed. RESULTS: When in vitro fertilization was revealed by using the washed normal sperms after 0, 3.6 and 7.2 mM PTX incubation, the fertilization rates were 92.5%, 48.8%, 36.8%, respectively. So 3.6 and 7.2 mM groups presented significantly low fertilizatin rate, but the development rates were 93.9%, 85.0%, 95.2%, respectively. Therefore, there were no significant difference between each group. When in vitro fertilization was revealed by using the diluted normal sperms after 0, 3.6, and 7.2 mM PTX incubation, the fertilization rates were 58.6%, 5.4%, 9.4%, respectively. So 3.6 and 7.2 mM groups presented significantly low fertilization rate. The developmental rates were 88.2%, 100%, 100%. And there were no significant difference between each group. When in vitro fertilization was revealed by using the not washed and not diluted normal sperms after 0, 3.6 and 7.2 mM PTX incubation, the fertilizatin rates were 61.2%, 5.7%, 3.8%, respectively. 3.6 and 7.2 mM group presented significantly low fertilization rate. The development rates were 73.3%, 0%, 0%, respectively. So 3.6, 7.2 mM group presented significantly low developmental rate. After 1-cell stage of mouse embryos were incubated in 0, 5, 10, 50 nM of PTX, the development rates were not significantly different among them. After 2-cell stage of mouse embryos were incubated in 0, 5, 10, 50 nM of PTX, the development rates were not significantly different among them. CONCLUSION: In conclusion, when PTX is used in in vitro fertilization program with normal sperms, it may affect the fertilization and embryo development in high concentration. And if PTX concentration is very low, the developmental rate would not be affected. So PTX must not be used to normal sperms and where use of PTX is indicated, it is recommended that remainder PTX must be removed as completely as possible.
Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures ; Female ; Fertilization ; Fertilization in Vitro* ; Mice* ; Oocytes ; Pentoxifylline* ; Pregnancy ; Spermatozoa*