Objectives: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. Methods: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. Results: Total homocysteine level was significantly higher in MTHFR 677TT genotype ($9.80{\pm}3.87{\mu}mol/L$) than MTHFR 677CC genotype ($8.14{\pm}1.74{\mu}mol/L$) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA ($8.42{\pm}2.65{\mu}mol/L$) and 1298CC ($6.09{\pm}0.32{\mu}mol/L$; p=0.2058) and, TSER 2R2R ($8.61{\pm}1.68{\mu}mol/L$) and 3R3R ($8.05{\pm}2.81{\mu}mol/L$; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest ($11.47{\pm}4.66{\mu}mol/L$) in individuals with TSER 3R3R ($8.05{\pm}2.81{\mu}mol/L$) and MTHFR 677TT ($9.80{\pm}3.87{\mu}mol/L$) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes ($7.69{\pm}1.77{\mu}mol/L$) had lower plasma homocysteine levels than TSER 2R2R ($8.61{\pm}1.68{\mu}mol/L$) and MTHR 677CC ($8.14{\pm}1.74{\mu}mol/L$) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. Conclusion: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Objectives: The purpose of these cases is to report the effects of Korean medicine on two women with recurrent miscarriage.Methods: One women who had recurrent miscarriage with myoma uteri was 39 years old. She was treated with herbal medicine and acupuncture until intrauterine pregnancy (IUP) 14 wks. the other who had recurrent miscarriage with adenomyosis was 40 years old. she was also treated with these until IUP 11 wks.Results: After treatment, one women delivered successfully by normal full term spontaneous delivery. The other succeeded in normal pregnancy and she is 15 weeks pregnant.Conclusions: Two cases show that Korean Medicine has effects on recurrent miscarriage with old age and underlying diseases.
This study assessed behavioral characteristics of 73 normal neonates in Daegu area using the NBAS. Being one of few studies on this topic, the study is to document and to accumulate data on the neonatal behaviors of Korean babies. Overall scores were at moderate levels in 6 behavioral clusters including Habituation, Social Interactive, Motor System, State Organization, and State Regulation. Autonomic Stability showed relative stableness. Scores of Orientation were higher in neonates of working mothers and rural mothers. Neonates of mothers with no abortion history have higher scores in Motor System and State Organization. Score of State Organization was higher in neonates of mothers with no habitual use of amenity during their pregnancy. Scores of Habituation and State Organization, as well as scores of Motor System with State Organization, State Regulation and Autonomic Stability were positively correlated. Scores of Habituation and State Organization indicate that babies are agreeable and even tameable that is advantageous for attachment to caregiver.
Herbal medicines are widely used for centuries to treat illness and improve health in Asia and the use of these remedies has become a worldwide form of alternative therapy. However, there is very limited evidence from randomized controlled trials to support the efficacy of the vast majority of herbal products. Of the commonly used herbal medicines, systemic clinical experiences and promising experiments in animals have found potential evidence of efficacy for six herbal medicines (Unkei-to, Hachimijio-gan, Keishi-bukuryo-gan, Toki-shakuyaku-san, Shakuyaku-kanzo-to, Sairei-to) in the treatment for female reproductive dysfunction. Because herbs may contain potent bioactive substances, the physician should have an opportunity to outline more stringent regulation, similar to over-the counter drug.
Purpose : Cuscuta chinensis Lam. is utilized extensively as important medicines for threatened abortion habitual abortion. However, objective data related to an embryo is not existed until now. Therefore, this study is focused to find out stability of Cuscuta chinensis Lam. about an embryo during pregnancy based on data related to stability of nerve cell and antioxydative effect by using neural cell line, PC 12 cell. Methods : Experimentation concerns cytotoxic effects and antioxydative effect through methods such as MTT ssay, western botting after abstracting an undiluted solution from domestic Cuscuta chinensis Lam. Results : 1. As a result of experimentation on MTT assay according to each magnification from Cuscuta chinensis Lam. extraction solution with different abstraction methods, cytotoxic effect is not observed to all extract except an undiluted solution which is abstracted from MeOH stiring. Also, an undiluted solution in stiring with MeOH could not confirm whether come from Cuscuta chinensis Lam. or not. 2. As a result of revelation of Bax and GSK-3${\beta}$ which is responsive to the first stage from general stress in order to observe antioxydative effects of Cuscuta chinensis Lam. revelation of Bax by Cuscuta chinensis Lam. appeared to decrease. Conclusion : Cytotoxic effects with Cuscuta chinensis Lam. about PC12 cell is not discovered and it assume that it would be anti apoptotic effect by ROS as Bax and GSK-3${\beta}$ inviable effect. In the future, this study could be used as basic data for additional research on Cuscuta chinensis Lam. and effect and stability of complicated prescriptions for keeping pregnancy.
Precise mechanism by which the fetus can escape from mother's immune rejection is not well understood yet over the last 50 years. The clarification of immune mechanism at the feto-maternal interface is very important, because this can be a common pathogenesis of various pathologic conditions including spontaneous abortion, habitual abortion fetal growth restriction preeclampsia, implantation failure after assisted reproductive techniques, and fetal death. In this review, current hypothetical contents were described with the priority of importance: 1) The center of this mechanism is cross-talk between the expression of HLA-C, E, G on the extravillous cytotrophoblasts and their receptors on decidual NK cell, 2) immunomodulation, 3) innate immunity is the main immunologic mechanism, 4) various mechanisms besides HLA system(eq. complement) may be associated. The overall balance of immunomodulation among these mechanisms should result in the outcome of each pregnancy. Further researches regarding the regulation of HLA system, roles of cytokines, complements should be followed in the future.
Purpose: To estimate the effect of oriental treatment on recurrent pregnancy loss, a retrospective analysis was done. Methods: Sixty-eight pregnant women at the $\bigcirc\bigcirc$ oriental clinic, Korea, from January 2005 to May 2009 diagnosed as recurrent pregnancy loss were included in this study. The sixty-eight patients received oriental treatment such as acupuncture, moxibution, herbal acupuncture and herbal prescriptions, divided into two groups: Group A- live birth(N=58) and Group B- abortion(N=10). The maternal age, parity, menstrual history, gynecological history and period of treatment were compared. To find out factors affecting the success of birth, we performed binary logistic regression analysis(SPSS ver. 14.0 for windows). Results: The live birth rate was 85.3%. The maternal age, parity, menstrual history, gynecological history and period of treatment were not different between two groups. Logistic regression analysis showed that the significant factors predicting the occurrence of miscarriage were advanced maternal age(${\geq}35$)(P=0.005, Odds Ratio[OR]=3.809, 95% Confidence Interval[95%CI]: 1.514-9.585) and suffering from gynecological problems(P=0.044, OR=4.048, 95%CI: 1.037-15.801). Conclusions: The results suggest that oriental treatment has effectiveness on recurrent pregnancy loss. Further study will be needed.
Objectives : A safety issue on acupuncture and moxibustion treatment during pregnancy is as important as effectiveness. To establish a rationale and research strategy for future studies, a traditional literature review was performed to summarize how and for what conditions acupuncture and moxibustion treatment was given during pregnancy. Methods : An extensive traditional literature search for acupuncture and moxibustion treatment during pregnancy was conducted in texts on acupuncture and moxibustion, obstetrics and gynecology, and comprehensive medical texts. Treatment conditions, methods, and contraindications were summarized and tabulated. Results : Twenty-eight books were included in our review. Most frequent description of acupuncture and moxibustion treatment use during pregnancy was for difficult delivery including breech presentations; commonly used acupuncture points for difficult labor included LI4, SP6, BL67, BL60, KI6, ST30, SP12, LR4, LR3, PC6, CV3, CV14, KI13, and GB21, indicating that they may have to be avoided during pregnancy. Descriptions of other symptoms or conditions were sparse. For habitual abortion or recurrent miscarriage, moxibustion on GV4, BL23, CV3, KI8, and KI2 was indicated. A combination of LI4 and SP6, and CV4 were contraindicated during pregnancy consistently across the reviewed books. Conclusions : Our traditional literature review has shown that the use of acupuncture and moxibustion treatment during pregnancy has been limited. Given that more and more pregnant women are interested in safe and effective treatment, further research of acupuncture's safety and efficacy during pregnancy is urgently needed.
Kim, Se-Hwa;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Kyung-Sub;Lee, Chang-Hoon;Jang, Jun-Bock
The Journal of Korean Obstetrics and Gynecology
/
v.27
no.4
/
pp.97-108
/
2014
Objectives: This study is to report the clinical effect of oriental medicine on a patient suffering from postabortal syndrome with somatic pain disorder, Qi deficiency and depression. Methods: The patient had a miscarriage by cervical incompetence in 24 weeks' gestation even though she had operated cervical cerclage in 20 weeks' gestation. The patient received herbal medication, acupuncture, moxibustion during 20 days of outpatient treatment. The clinical effects were evaluated through VAS (Visual Analogue Scale) and EPDS (Edinburgh Postnatal Depression Scale Test). Results: The clinical symptoms of somatic pain and Qi deficiency were reduced during the treatment. The EPDS score also decreased from 19 points (high risk level) to 8 points (low risk level). Conclusions: This case study showed that herbal medicine, acupuncture and moxibustion treatment appeared to effectively reduce postabortal syndrome. Since patients previously experienced cervical incompetence tend to have habitual abortion for next pregnancy, further long term observation and preventive treatment are needed in this case for next safe pregnancy and childbirth.
Journal of agricultural medicine and community health
/
v.15
no.2
/
pp.97-106
/
1990
1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.
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