• Title/Summary/Keyword: Obstetrics & Gynecology

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A Gelatinase A Isoform, GA110, of Human Follicular Fluid Is Degraded by the Bovine Oviductal Fluid Component (소의 수란관액에 의한 사람 난포액의 Gelatinase A 동위효소인 GA110의 분해)

  • Kim, Min-Jung;Kim, Ji-Young;Leec, Seung-Jae;Yoon, Yong-Dal;Cho, Dong-Jae;Kim, Hae-Kwon
    • Development and Reproduction
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    • v.5 no.1
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    • pp.23-33
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    • 2001
  • When mammalian oocytes ovulate into the oviduct, associating follicular fluid components are exposed to the oviductal environment, possibly resulting in the mutual interaction between fillicu1ar and oviductal fluids. In the Present study, we have demonstrated for the first time that components of fallicular fluid could be modified by the oviductal fluid. Gelatin zymographic analyses of human follicular fluid (hFF) obtained from IVF patients showed consistently the presence of 110 kDa gelatinase (GA110) in addition to many bands among which 62 kDa gelatinase was predominant. Addition of EDTA or phenanfhroline to the gelatinase substrate buffer during gel incubation abolished GA110 band whereas phenylmethylsulffnyl fluoride (PMSF) did not. In contrast, bovine oviductal fluid(bOF) exhibited only 62 kDa gelatinase. Surprisingly, when bOF was added to hFF in 1:1 ratio and then the mixture was incubated for 3 h at 37$^{\circ}$C, GA110 of hFF disappeared. Disappearance of GA110 by bOF was observed even within 30 min after mixing with hFF. Addition of aminophenylmercuric acetate (APMA) to hFF also abolished enzymatic activity of GA110 but increased the activityof 62 kDa gelatinase. However, APMA abolished many other gelatinases as well unlike bOF. Interestingly, treatment of hFF with EDTA for 3 h remarkably increased the enzymatic activity of GA110 but not that of other gelatinases. Addition of phenanthroline, PMSF or soybean trypsin inhibitor (SBTI) did not affect overall gelatinase activities. Again, addition of bOF to the hFF pretreated with any of the above proteinase inhibitors abolished the appearance of GA110. Human serum also showed GAI 10 of which activity was greatlyenhanced by EDTA treatment. Similar to hFF, serum GA110 also disappeared by the addition of bOF. Human granulosa cell homogenate did not reveal any appreciable gelatinase activity except 92 kDa gelatinase. Anti-human gelatinase A antibody reacted with 62 kDa gelatinase of hFF. Based upon these results, it is concluded that bOF could selectively degrade an isoform of gelatinase A present in hFF and human serum.

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Effect of Cryopreservation of Sibling 2PN Zygotes on Cumulative Delivery Rates in the Human IVF-ET Program (전핵 시기에서의 수정란 동결이 체외수정 및 배아이식술에서의 누적 분만율에 미치는 영향)

  • Kim, Myo-Kyung;Lee, Sun-Hee;Choi, Su-Jin;Choi, Hye-Won;Park, Dong-Wook;Lim, Chun-Kyu;Song, In-Ok;Lee, Hyoung-Song
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.329-338
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    • 2010
  • Objective: This study was carried out to know whether cryopreservation of sibling 2PN zygotes could increase the cumulative delivery rates in the patients who had less than 10 fertilized zygotes. Methods: A retrospective analysis was performed in 138 in vitro fertilization-embryo transfer (IVF-ET) cycles with less than 10 fertilized zygotes during January 2003 to December 2007 in Cheil General Hospital. These cycles were divided into two groups. In Group I (n=86), all fertilized embryos were cultured to transfer on day 3 without cryopreserved embryos at the 2PN stage. In Group II (n=52), among fertilized zygotes, some sibling zygotes were frozen at the 2PN stage, the remainder were cultured to transfer. Clinical outcomes in fresh ET cycles and cumulative ongoing pregnancy rates after subsequent frozen-thawed (FT)-ET cycles were compared. Results: There were no significant differences in female mean age, number of retrieved oocytes and total fertilized embryos between two groups, Number of cultured embryos was significantly lower in Group II ($5.2{\pm}0.5$) than in Group I ($8.4{\pm}0.7$) (p<0.01). Also, number of transferred embryos was significantly lower in Group II ($3.3{\pm}0.6$) compared with Group I ($3.6{\pm}0.6$) (p<0.01). ${\beta}$-hCG positive rates and delivery rates (51.2 vs. 46.2 % and 41.9 vs. 34.6 %, respectively) after fresh ET were slightly higher in Group I than in Group II. However, the differences were not statistically significant. Also, the cumulative delivery rates after subsequent FT-ET cycles were not significantly different between Group I (48.8%) and Group II (50.0%). Conclusion: This study showed that cryopreservation of sibling 2PN zygotes from patients who had less than 10 zygotes in the fresh ET cycles did not increase cumulative delivery outcomes. But, it could provide an alternative choice for patients due to offering more chance for embryo transfers if pregnancy was failed in fresh IVF-ET cycles.

Radiation Therapy Results of Invasive Cervical Carcinoma Found After Inappropriate Hysterectomy (부적절한 수술루 침윤성 자궁경부암의 방사선치료 결과)

  • Choi Doo Ho;Kim Eun Seog;Nam Kae Hyun;Huh Seung Jae
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.211-219
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    • 1996
  • Purpose : Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. Materials and Methods : Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcinoma in situ (38 cases), severe dysplasia (2), myoma (6), uterine bleeding (4), uterine prolapse (2). and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy from August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients received ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. Results : Overall 5-year survival rate and relapse-free survival rate werer $83.8\%$, $86.9\%$ respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were $90.9\%$, $88.8\%$, $38.4\%$, and $100\%$ respectively There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cancer (stage IA) had no treatment related failure Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. Conclusion : Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy Survivals for patients with gross disease remained after inappropriate hysterectomy was poor, So, early cancer detection and Proper management with precise pretreatment s1aging is necessary to avoid inadherent hysterectomy especially in the cases of gross residual disease.

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Genotypic and Phenotypic Characteristics of Staphylococcus aureus Isolates from Lettuces and Raw Milk (상추와 원유에서 분리한 황색 포도상구균의 유전형 및 표현형 특징)

  • Jung, Hye-Jin;Cho, Joon-Il;Park, Sung-Hee;Ha, Sang-Do;Lee, Kyu-Ho;Kim, Cheol-Ho;Song, Eun-Seop;Chung, Duck-Hwa;Kim, Min-Gon;Kim, Kwang-Yup;Kim, Keun-Sung
    • Korean Journal of Food Science and Technology
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    • v.37 no.1
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    • pp.134-141
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    • 2005
  • To characterize genotypic and phenotypic traits of Staphylococcus aureus isolates (n = 86) from lettuces and raw milk, major virulence-associated genes and antibiotic susceptibility were detected using PCR-based methods and disk diffusion method, respectively. All isolates possessed coagulase gene and showed five polymorphism types [500 bp (2.4%), 580 bp (17.4%), 660 bp (61.6%), 740 bp (17.4%), and 820 bp (1.2%)] due to variable numbers of tandem repeats present within the gene. Two or three different loci of hemolysin gene family were dominant in isolates, 47 of which (55%) possessed combination of hla/hld/hlg-2 genes as the most prevalent types. Among enterotoxin-encoding genes, sea was detected from 32 isolates (37%), sed from 1 isolate (1%), and sea and sed genes were co-detected from 4 isolates (5%), whereas seb, sec, and tsst-1 genes were not detected. All isolates were susceptible to ciprofloxacin, trimethoprim/sulfamethoxazole, oxacillin, and vancomycin, 85 isolates (99%) to penicillin G, 54 isolates (63%) to chloramphenicol, 51 isolates (59%) to erythromycin, and 7 isolates (8%) to clindamycin. Among resistant isolates, seven displayed multiantibiotic-resistance against two different antibiotics.

Effects of Social Support, Sleep Quality, and Oral Health Impact Profile on Depression among Pregnant Women (일부 임신부의 사회적 지지, 수면의 질 및 구강건강영향지수가 우울수준에 미치는 영향)

  • Han, Se-Young;Han, Yang-Keum
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.134-141
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    • 2017
  • This study examined 191 pregnant women before delivery in an obstetrics and gynecology clinic in North Gyeongsang Province from May to September 2016 by using a questionnaire after obtaining informed consent for voluntary participation in the study. The study was performed to investigate the association of depression with sociodemographic characteristics, pregnancy-related characteristics, social support, sleep quality and Oral Health Impact Profile (OHIP) in pregnant women. The prevalence of depression among the pregnant women was 25.1% in the healthy group and 74.9% in the depression group. The depression level was significantly higher in women in the depression group who were unsatisfied with their marriage life, had no occupation, had lower social support, had poor sleep quality and had higher OHIP scores. The results of the logistic regression analysis indicated that, the risk ratio for more severe depression was significantly higher in the group with no experience of miscarriage and induced childbirth than in the group with childbirth experience. Conversely, the risk ratio for more severe depression was significantly lower in the group with high social support than in the group with low social support. Depression in the respondents significantly positively correlated with sleep quality and OHIP score but significantly negatively correlated with social support. The multiple regression analysis revealed that the depression level was significantly higher by 22.3% among pregnant women with lower marital satisfaction, no childbirth experience, lower social support and higher OHIP scores. In summary, depression was related to marital satisfaction, childbirth experience, social support, and OHIP score, among others, in pregnant women in this study. Therefore, further investigation is warranted to construct programs and measures that will help build positive thinking by designing and verifying a three-dimensional study model by taking into consideration various variables to reduce the incidence of depression in pregnant women.

A Comparison of Minilaparotomy and Laparoscopic Sterilization (Minilaparotomy 불임술(不妊術)과 복강경불임술(腹腔鏡不妊術)에 관(關)한 비교연구(比較硏究))

  • Bai, Byoung-Choo
    • Clinical and Experimental Reproductive Medicine
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    • v.4 no.1
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    • pp.17-25
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    • 1977
  • Anderson(1937), Power and Barnes(1941) reported a study concerning a method of tubal sterilization in association with peritoneoscopy or laparoscopy in which they cauterized the tubes. There appears to have been a hiatus of interest in sterilization (cold or hot) associated with laparoscopy until reintroduction by Palmer(1963), Frangenheim(1964) and Steptoe(1967). On the other hand, for interval female sterilization, however, minilaparotomy is relatively new. By Saunder and Munsick(1972), John Lyle(1974), Frank Stubb(1974), Vitoon(1973) and B.C. Bai(1975), their own technique for interval female sterilization requires 2.0 to 2.5cm, incision at the margin of the mons pubis. In Korea, female sterilization by means of minilaparotomy firstly reported by B.C. Bai using Bai's uterine elevator, of his own device, early in 1975. Recently inteval female sterilization by laparoscopy and minilaparotomy are widely accepted throughout the world especially in Asian countries. Minilaparotomy is carried out from 1974, laparoscopic sterilization from 1976, and in this study each of 250 cases of those were analysed and discussed for the comparison at Seoul Red Cross Hospital. (1) In the age distribution, numerous clients were in their age of $31{\sim}35$ in laparoscopy as well as minilaparotomy. Average 33.7 years in L and 33.2 years in M. (M=minilaparotomy, L=laparoscopic sterilization) (2) As regarding living children, women having 3 children represented the greatest number, 113 cases out of 250 in M group and 102 cases out of 250 in L group. Average No. of child are 2.9 in Land 3.1 in M. (3) Concidering the operation day in the menstrml cycle, the greatest number of cases, those who underwent tubal sterilization during the days of $26{\sim}$, next during the $6{\sim}10$ days of the cycle in both group. (4) Concidering the operation time, 188 cases by laparoscopy were performed in $6{\sim}10$ minutes, 33 cases within 5 minutes and 24 cases in $11{\sim}15$ minutes. Maximum 50 minutes, minimum 4 minutes and average 8.3 minutes. The majority of cases (154 cases) by minilaparotomy required $6{\sim}10$ minutes and 67 cases $11{\sim}15$ minutes, 6 cases within 5 minutes. Maximum 30 minutes, minimum 4 minutes and average 10.4, minutes. In both groups, most of the reasons for the extra length were surgical difficulties such as thick abdominal wall, pelvic adhesion, less cooperation of patients in early period of this study. (5) Hospital stay after operation in L group required $3{\sim}4$ hours in 125 cases, $2{\sim}3$ hours in 41 cases, $4{\sim}5$ hours in 32 cases out of 250. Maximum 8 hours, minimum 1 hour and average 3.8 hours. In M group hospital stay required $6{\sim}7$ hours in 100 cases, over 7 hours in 85 cases, $5{\sim}6$ hours in 46 cases and so on. Maximum 14 hours, minimum 2 hours and average 6.5 hours. (6) The time between operation and gas passing in the majority cases of both groups, were $12{\sim}36$ hours. A veragetime 20.3 hours in L and 27.2 in M. (7) Laparoscopic sterilization coincident with induced abortion were carried out in 27 cases, laparoscopy with minilaparotomy to control for mesosalpingeal hemorrhage in 1 case. Minilaparotomy coincident with induced abortion were performed in 65 cases, D and C whit polypectomy, menstrual regulatian, and remaval of IUD in 1 case respectively. (8) In L group, 1 case of mesosalpingeal hemorrhage, 1 case of abdominal wall infection were complicated during operation. In M group, 1 case of uterine perfaration, 1 case of abdominal wall infection, 1 case of hemorrhage from omentum and 1 case of bloody vaginal discharge were complicated. No intensive medical treatment was required for those minor complications in both groups. (9) No failure has been recognized and these two sterilization techniques might be the simple, safe and the most effective method for permanent contraception at present time. There is no significant clinical defference between L and M group in this study.

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Effect of Hypoxia-induced XIAP Expression on Apoptosis of Trophoblast Cells in Placenta (Hypoxia에 의한 X-linked Inhibitor of Apoptosis 발현이 태반 내 영양막세포의 세포자멸사에 미치는 영향)

  • Lee, Jong-Sung;Jeon, Su-Yeon;Choi, Jong-Ho;Lee, Yoo-Jin;Cha, Dong-Hyun;Kim, Gi-Jin
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.217-229
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    • 2010
  • Objective: Apoptosis plays an important role for the maintenance of the normal pregnancy. Expression of X-linked inhibitor of apoptosis (XIAP) is able to effectively prevent apoptosis and controls trophoblast cells death throughout placental development, but it is still unknown in the function of XIAP in trophoblast cells exposed to hypoxic condition, which is one of the factors causing preeclampsia. Therefore, we conducted to compare XIAP expression in normal and pre-eclamptic placenta tissues and analyzed the function of XIAP in HTR-8/SVneo trophoblast cell line exposed to hypoxic condition. Methods: The expression of XIAP was analyzed in placental tissues from the following groups of patients (none underwent labor): 1) term normal placenta (n=15); 2) term with pre-eclamptic placeneta (n=15); and 3) pre-term with pre-eclamptic placenta (n=11) using semi-quantitative RT-PCR, immunohistochemistry, and Western blot. In order to evaluate the function of XIAP in HTR-8/SVneo trophoblast cells under hypoxic condition, HIF-$1{\alpha}$ plasmids, and hypoxic condtion were transfected and treated into HTR-8/SVneo trophoblast cells for 24 hours, respectively. Results: We observed that XIAP are expressed in the syncytiotrophoblasts and syncytial knot of placental villi. The expression of XIAP was significantly decreased in preeclamptic placenta tissues than in normal placenta tissues without labor (p<0.05). Furthermore, we confirmed the XIAP expression in HTR-8/SVneo trophbolast cells exposed to hypoxia was translocated from cytoplasm into nucleus and decreased XIAP by hypoxic condition induced apoptosis in HTR-8/SVneo trophoblast cells through up-regulation of pro-apoptotic proteins. Conclusion: These results suggest that the expression of XIAP is involved in placental development as well as decreased expression of XIAP by hypoxia is associated with pre-eclampsia through inducing trophoblast cells apoptosis.

Efficacy of the Split Insemination Method Combining Conventional IVF and ICSI in Non-male Factor Infertile Couples with Normal Sperm Parameters (정상 정자 소견을 나타내는 불임 부부에서 일반적인 체외수정과 세포질내 정자주입술을 병행하는 분할 수정법의 효용성)

  • Hong, Seung-Bum;Park, Dong-Wook;Shin, Mi-Ra;Choi, Su-Jin;Lee, Sun-Hee;Song, In-Ok;Jun, Jin-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.4
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    • pp.305-312
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    • 2007
  • Objective: To evaluate the efficacy of split insemination method in treatments for non-male factor infertility. Method: Laboratory and clinical data were collected from 505 cycles of split insemination during 2002$\sim$2005 in our center. The subjects were non-male factor infertility such as endometriosis, tubal, uterine, PCOS and idiopathic infertility without any sperm defects. Retrieved oocytes were randomly divided, and inseminated by conventional IVF or ICSI. Fertilized zygotes were cultured for 2$\sim$5 days to ET date, and surplus zygotes and embryos were frozen for subsequent frozen-thawed ET cycles. Clinical outcomes according to insemination method were compared by statistical analysis. Results: The overall fertilization per retrieved oocytes was significantly higher in ICSI than that of conventional IVF in sibling oocytes (62.5$\pm$22.3% vs 52.9$\pm$28.0%, p<0.01). Total fertilization failure occurred only in 2 of 505 cycles (0.4%) in split insemination cycles. Incidence of fertilization failure and poor fertilization rate less than 30% by ICSI were significantly lower than those of conventional IVF (1.1% and 7.5% vs 8.5% and 22.0%, p<0.01). Delivery rates after transfer of fresh and thawed embryos from split insemination cycles were 40.0% (185/462) and 35.0% (55/157), respectively. There was no significant difference in the implantation and delivery rates of ET with embryos from conventional IVF or ICSI. Conclusion: Taken together, the split insemination method improves poor fertilization rates resulting in successful clinical outcomes and thus could be used for non-male factor infertile couples in human ART program.

Comparison of Maternal Fatty Acid Intake and Fatty Acid Composition of Serum Phospholipids Between Singleton and Twin Pregnancies (단태아와 쌍태아 모체의 임신 분기별 지방산 섭취와 혈청 인지질 지방산 조성 비교)

  • Kwon, Seul-Ki;Lim, Soo-Jeoung;Shin, Joong-Sik;Jang, Sung-Hee;Ahn, Hong-Seok
    • Korean Journal of Community Nutrition
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    • v.13 no.4
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    • pp.555-564
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    • 2008
  • Essential fatty acids are important essential nutrients during pregnancy. The objective of this study was to compare fatty acid composition of serum phospholipids and essential fatty acid intakes between Korean pregnant women with a single baby and Korean pregnant women with twins. A total of 116 pregnant women who had maintained their health without any symptoms of pregnancy complications participated in the study. The subjects consisted of 57 women of singleton pregnancy and 58 women of twin pregnancy at the 1st, 2nd, or 3rd trimester of pregnancy. A 24-hour dietary recall was administered to each subject to obtain dietary information. The mean ages of the singleton pregnancy group and the twin pregnancy group were 31.44 years and 32.27 years, respectively, and the mean height values were 161.86 cm and 160.64 cm, respectively. The mean daily energy intakes in the singleton pregnancy group were 1639.95 kcal, 1904.71 kcal, and 1882.82 kcal for the 1st, 2nd, and 3rd trimester group, respectively. The mean daily energy intakes in the twin pregnancy group were 1745.99 kcal, 2203.46 kcal, and 2092.26 kcal for the 1st, 2nd, and 3rd trimester group, respectively. There were no significant differences in the mean fatty acid intakes by the type of pregnancy (i.e., singleton vs. twins) and the stage of pregnancy (i.e., 1st vs. 2nd vs. 3rd trimester). However, the mean total fatty acid intake of those at the 1st trimester among the singleton pregnancy group tended to be higher than that of those at the 1st trimester among the twin pregnancy group. Such a trend seemed to be retro-versed. That is, the mean total fatty acid intakes of the twin pregnancy group were higher compared to the singleton pregnancy group for the 2nd and 3rd trimester group. The LA and total n6 concentrations of serum phospholipids of the singleton pregnancy group were significantly higher as the gestational age increased(p<0.05). The $\alpha-LNA$(p<0.05), EPA(p<0.05), and total n3(p<0.001) concentrations of serum phospholipids of the twin pregnancy group were significantly lower as the gestational age increased. The $\alpha-LNA$ concentrations of serum phospholipids in the singleton pregnancy group at the 3rd trimester were significantly higher than that in the twin pregnancy group at the same trimester(p<0.05). The serum phospholipids levels of AA and DHA of the twin pregnancy group were generally higher compared to those of the singleton pregnancy group. Particularly the differences reached at the level of statistical significance for those at the 1st trimester(p<0.01). It is concluded that the study findings imply that fatty acid metabolism may meaningfully differ by the type and stage of pregnancy. Future research needs to be conducted to more elucidate grounding etiology and possible roles of dietary fatty acid intake levels in relation to the study findings.

The Role of the Endometrium and Embryo in Human Implantation (인간 착상 과정에 자궁내막과 배아의 역할)

  • Jee, Byung-Chul
    • Development and Reproduction
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    • v.13 no.1
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    • pp.1-11
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    • 2009
  • Implantation itself is governed by an array of endocrine, paracrine and autocrine modulators, of embryonic and maternal origin. Window of implantation is the unique temporal and spatial expression of factors allows the embryo to implant via signaling, appositioning, attachment, and invasion in a specific time frame of $2{\sim}4$ days. When the embryo has arrived in the uterine cavity, a preprogrammed sequence of events occurs, which involves the production and secretion of a multitude of biochemical factors such as cytokines, growth factors, and adhesion molecules by the endometrium and the embryo, thus leading to the formation of a receptive endometrium. Cytokines such as LIF, CSF-1, and IL-1 have all been shown to play important roles in the cascade of events that leads to implantation. Integrin, L-selectin ligands, glycodelin, mucin-1, HB-EGF and pinopodes are involved in appositioning and attachment. The embryo also produces cytokines and growth factors (ILs, VEGF) and receptors for endometrial signals such as LIF, CSF-1, IGF and HB-EGF. The immune system and angiogenesis play an important role. The usefulness of these factors to assess endometrial receptivity and to estimate the prognosis for pregnancy in natural and artificial cycles remains to be proven. Integrins, pinopodes, glycodelin and LIF (from biopsies) are promising candidates; from uterine flushings, glycodelin and LIF are also candidates. The ideal serum marker is not available, but VEGF, glycodelin and CSF have some clinical implications. Further evaluation that includes larger groups of infertile women and fertile controls are needed to elucidate whether their presence in plasma, flushing fluid, or endometrial samples can be used as some kind of a screening tool to assess endometrial function and prognosis for pregnancy before and after artificial reproductive therapy. A better understanding of their function in human implantation may lead to therapeutic intervention, thereby improving the success rate in reproduction treatment. New molecular techniques are becoming available for measuring both embryonic and endometrial changes prior to and during implantation. The use of predictive sets of markers may prove to be more reliable than a single marker. Ultimately, the aim is to use these tools to increase implantation in artificial cycles and consequently improve live-birth rates.

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