Sumoylation, the conjugation of a small ubiquitin-like modifier (SUMO) protein to a target, has diverse cellular effects. However, the functional roles of the SUMO modification during myogenesis have not been fully elucidated. Here, we report that basal sumoylation of histone deacetylase 1 (HDAC1) enhances the deacetylation of MyoD in undifferentiated myoblasts, whereas further sumoylation of HDAC1 contributes to switching its binding partners from MyoD to Rb to induce myocyte differentiation. Differentiation in C2C12 skeletal myoblasts induced new immunoblot bands above HDAC1 that were gradually enhanced during differentiation. Using SUMO inhibitors and sumoylation assays, we showed that the upper band was caused by sumoylation of HDAC1 during differentiation. Basal deacetylase activity was not altered in the SUMO modification-resistant mutant HDAC1 K444/476R (HDAC1 2R). Either differentiation or transfection of SUMO1 increased HDAC1 activity that was attenuated in HDAC1 2R. Furthermore, HDAC1 2R failed to deacetylate MyoD. Binding of HDAC1 to MyoD was attenuated by K444/476R. Binding of HDAC1 to MyoD was gradually reduced after 2 days of differentiation. Transfection of SUMO1 induced dissociation of HDAC1 from MyoD but potentiated its binding to Rb. SUMO1 transfection further attenuated HDAC1-induced inhibition of muscle creatine kinase luciferase activity that was reversed in HDAC1 2R. HDAC1 2R failed to inhibit myogenesis and muscle gene expression. In conclusion, HDAC1 sumoylation plays a dual role in MyoD signaling: enhancement of HDAC1 deacetylation of MyoD in the basally sumoylated state of undifferentiated myoblasts and dissociation of HDAC1 from MyoD during myogenesis.
Creatine Kinase, MM Form ; Gene Expression ; Histone Deacetylase 1 ; Histone Deacetylases ; Histones ; Luciferases ; Muscle Cells ; Muscle Development ; Myoblasts ; Myoblasts, Skeletal ; Sumoylation ; Transfection

OBJECTIVE: To assess the clinical characteristics, laboratory findings, the maternal and neonatal complications between HELLP syndrome and severe preeclampsia. METHODS: We reviewed the material and neonatal charts of 34 pregnancies complicated by HELLP syndrome and 40 pregnancies complicated by severe preeclampsia managed at our hospital between January, 2001 and December, 2005. We compared the clinical characteristics, laboratory findings, the maternal and neonatal complications between two groups. Results were compared by student T test, chi-square test. RESULTS: Our study showed that in HELLP syndrome patients had the less gestational age at admission, gestational age at delivery, the lower platelet counts, the higher AST, ALT, LDH, and the longer hospitalization period than in severe preeclampsia. Steroid (dexamethasone) use, cesarean delivery rate and MgSO4 use were more frequent in HELLP syndrome than severe preeclampsia. Neonatal birth weight was lower with HELLP syndrome. There was no significant difference in maternal and neonatal complications. CONCLUSION: HELLP syndrome need to be recognized a unique form of severe preeclampsia. It was associated with serious maternal and fetal mortality, the appropriate management would be done by early diagnosis using laboratory tests.
Birth Weight ; Early Diagnosis ; Female ; Fetal Mortality ; Gestational Age ; HELLP Syndrome* ; Hospitalization ; Humans ; Platelet Count ; Pre-Eclampsia* ; Pregnancy

Placental abnormality is the important predisposing cause of intrauterine growth retardation. Massive subchorionic hematoma is defined as a large size of maternal blood clot that separates the chorionic plate from the villous chorion and can result in serious obstetrical complications. We report a case of massive subchorionic hematoma diagnosed prenatally, and propose an additional peculiar finding detectable on both the ultrasound and magnetic resonance images: a large hematoma in the subchorionic region at 17 weeks gestation. At 18 weeks 2 days gestation, the fetus was miscarried. The clinical and pathological findings were compatible with massive subchorionic hematoma. Recurrent massive subchorionic hematoma without thrombophilic finding was observed at the next pregnancy in 17 weeks 5 days by ultrasound. The patient was managed conservatively and had successful outcome at term. So we report the case with the brief review of literatures.
Chorion ; Fetal Growth Retardation ; Fetus ; Hematoma* ; Humans ; Pregnancy ; Ultrasonography

OBJECTIVE: The study shows that the DFS is a questionnaire that almost effortlessly can be completed within 60-90 seconds during any moment of labor and delivery. The aim of the present study was to test the validity and reliability of the DFS, to identify its factor structure in Korea. METHODS: Review of the medical records from the department of obstetrics and gynecology from January to April 2005, a confirmed 51 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 22 primiparous and 29 multiparous women answered the Delivery Fear Scale (DFS) once during active labor, and the STAI (State-Trait Anxiety Inventory) after delivery. Reliability test to calculate Chronbach alpha and validity test to measure correlation between DFS and STAI was done. Then factor analysis was applied with the method of principal component analysis and varimax rotation. RESULTS: Korean version of DFS proved to be a reliable and valid scale statistically: Cronbach's alpha was 0.7182 in study. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The DFS measures fear during labor and delivery in an effortless and fast away. The development of the Korean version of DFS which is reliable and valid, and consists of three sub-factors may facilitate future research in the field.
Anxiety ; Diagnosis ; Female ; Gynecology ; Humans ; Korea ; Medical Records ; Obstetrics ; Parturition* ; Pregnancy ; Principal Component Analysis ; Surveys and Questionnaire ; Reproducibility of Results

OBJECTIVE: The purpose of this study was to establish the distribution and obstetric outcomes in women with congenital uterine malformations. METHODS: A review of the medical records from the department of obstetrics and gynecology from January 1995 to June 2004 were diagnosed 79 patients with congenital uterine malformations. All of the cases were divided into groups according to classification of ASRM (American Society for Reproductive Medicine), which is based on the degree of failure of normal development of the female genital tact. The obstetric outcomes were compared between the groups. Statistical processing of the material was carried with Pearson chi square test. RESULTS: 79 patientss with congenital uterine malformations were diagnosed by operation or imaging studies. Symmetric congenital uterine malformations, consisting of bicornuate uterus (45.6%), septate uterus (19.0%), and uterus didelphys (31.6%), were the most common, constituting 96.2% of the malformations. Two patients (2.5%) had unicornuate uterus and one patient (1.3%) had arcuate uterus. No cases of the agenesis type and T-shaped uteri were found. 196 pregnancies occurred in the 74 patients. Only 43.4% of the pregnancies reached term, while 8.2% resulted in preterm delivery, and 48.4% terminated as miscarriages. CONCLUSION: Obstetric complications occur more frequently among women with congenital uterine malformations than among women in general. Knowledge concerning of congenital uterine malformations is important in recognizing and managing the obstetric complications that may result.
Abortion, Spontaneous ; Classification ; Female ; Gynecology ; Humans ; Medical Records ; Obstetrics ; Pregnancy ; Uterus

OBJECTIVE: Pregnant women have various fears and expectations regarding the impending birth. Fears can influence the course of the delivery and post-partum period. The DFS (Delivery Fear Scale) measures fear during labor and delivery in an effortless and fast away. The aim of this study were to compare DFS score and parity, maternal age, history of abortion, baby gender during an early stage of active labor (cervix dilatation 3-5 centimeters). METHODS: Review of the medical records from the department of obstetrics and gynecology from January 2004 to December confirmed 151 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. 86 primiparous and 65 multiparous women answered the Delivery Fear Scale (DFS) once during active labor. Mann-Whitney test was applied to test possible differences between DFS and variable factors. Difference were considered to be statistically significant at p<0.05. RESULTS: Primiparous women had higher scores on the DFS than multiparous women during active labor. But DFS was not associated with maternal age, history of abortion, baby gender during an early stage of active labor. CONCLUSION: Women's psychological experiences during the actual process of labor and delivery are essential part of obstetrical care. Nevertheless, studies examining psychological variables concerning childbirth, are mostly performed before or after labor. The understanding of a fear during labor is to support the woman in labor in a way that decrease fear and the development of the DFS may facilitate future research in the field.
Diagnosis ; Dilatation ; Female ; Gynecology ; Humans ; Maternal Age ; Medical Records ; Obstetrics ; Parity ; Parturition ; Pregnancy ; Pregnant Women

Virtually all monochorionic twin placentas contain vascular connections between the circulatory domains of each twin. In contrast, vascular anastomoses are generally thought not to occur in fused, dichorionic placentation. In the twin-to-twin transfusion syndrome (TTTS) one twin is preferentially perfused by blood from the cotwin via unbalanced placental vascular anastomoses. This vascular shunting results in twins born with discrepant weights, colors and hemoglobins. When one of the TTTS criteria was not present, the pregnancy was defined as "pseudo" TTTS. In pregnancies complicated by "pseudo" TTTS indicate that small twins have abnormal cord insertion more frequently than large twins. We present a case of vascular anastomoses in dichorionic diamniotic-fused placentas resulting in "pseudo" TTTS with a brief review of the literatures concerned.
Female ; Fetofetal Transfusion* ; Humans ; Placenta* ; Placentation ; Pregnancy ; Weights and Measures

Ovarian cysts are common incidental findings in term infants and, if unusually large, may result in dystocia, torsion, or rupture. We report the case in which serial sonographic examination revealed changing pattern of cystic ovarian mass from hypoechogenic to well defined multiseptated echogenic during pregnancy. Postnatal T2-weighted MR images revealed a multilocular with high signal density. After delivery a laparotomy was performed, and a twisted ovary measuring 6.7x5x4.5 cm was removed. Ovarian torsion was left-sided and had been almost autoamputated. The resected specimens were nontense, thin walled cysts, filled with hemorrhage like fluid. Histological examination demonstrated the presence of lymphangioma with widespread hemorrhage and necrosis. The neonate did well after the procedure.
Dystocia ; Female ; Hemorrhage ; Humans ; Incidental Findings ; Infant ; Infant, Newborn ; Laparotomy ; Lymphangioma ; Necrosis ; Ovarian Cysts* ; Ovary ; Pregnancy ; Rupture ; Ultrasonography*

OBJECTIVE: To determine whether severity of proteinuria or urinary protein fractional analysis correlates with adverse maternal and fetal outcomes in women with severe preeclampsia. METHODS: Thirty-six women diagnosed of severe preeclampsia from January, 2002 to April, 2003 were studied. The correlation between proteinuria or urinary albumin fraction, and maternal mean arterial pressure, neonatal birth weight, 1 minute apgar score were analyzed statistically. Thirty-six patients were divided into two groups according to the pattern of urinary protein fraction. One group was a selective proteinuria group if the albumin fraction was over 70%, and another was a non-selective proteinuria group if the fraction was below 70%. The maternal and neonatal outcomes were compared between the two groups. RESULTS: Significant positive correlation was observed between proteinuria and mean arterial pressure, between urinary albumin fraction and neonatal birth weight. Negative correlation was significantly present between proteinuria and neonatal birth weight, 1 minunte apgar score, between proteinuria and albunin fraction. Increased proteinuria, higher mean arterial pressure, higher serum uric acid level, lower creatinine clearance, lower neonatal birth weight, and lower 1 minunte Apgar score were observed in the non-selective proteinuria group than those in the selective proteinuria, although there was no statistical significance. CONCLUSION: With increasing proteinuria and decreasing albumin fraction, there is increased risk of adverse maternal and fetal outcome. Proteinuria fractional analysis by electrophresis might provide useful information regarding the prediction of pregnancy outcomes.
Apgar Score ; Arterial Pressure ; Birth Weight ; Creatinine ; Female ; Humans ; Pre-Eclampsia* ; Pregnancy ; Pregnancy Outcome ; Proteinuria ; Uric Acid

Otocephaly is a rare malformations comprising hypoplasia or absence of the mandible (agnathia), ventromedial displacement and often fusion of external ears (synotia or otocephaly), and hypoplasia of the oral cavity (microstomia) and tongue (hypoglassia). This developmental complex represents a malformation of the first and second branchial arches and occurs sometimes with holoprosencephaly. We present the ultrasound detection of otocephaly and holoprosencephaly with cyclopia in a fetus of 27 gestational weeks 6 days. The use of three-dimensional (3-D) ultrasound made additional diagnostic ultrasound tomograms possible, and the volume reconstructions improved the imaging and the understanding of the condition.
Branchial Region ; Diagnosis* ; Ear, External ; Fetus ; Holoprosencephaly ; Mandible ; Mouth ; Tongue ; Ultrasonography