• 제목/요약/키워드: Pre-Eclampsia

검색결과 19건 처리시간 0.024초

혈전성 미세혈관병증의 병리 (Pathology of Thrombotic Microangiopathy)

  • 설미영
    • Childhood Kidney Diseases
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    • 제17권1호
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    • pp.6-12
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    • 2013
  • 사구체에 면역글로불린은 음성이면서 C3 만 침착되는 경우, 다른 원인이 없는 경우 C3GN을 의심하여야 한다. 광학현미경으로는 세포의 증식이 있는 경우와 없는 경우가 있지만, 전자현미경으로는 EDD가 내피세포 밑으로 혹은 메산지움 등에 침착함을 확인하여야 한다. 대체보체경로의 조절이상이 원인임으로 혈청 C3 치를 비롯하여 CFH, CFI, CFB 등을 측정하여야 하며, C3 nephritic factor, antifactor H 자가항체 등을 조사하는 것이 필요하다. 보체 조절이상을 일으키는 유전자 돌연변이를 조사해 보아야 한다. 예후는 안정적이지만, 치료는 대증적이다. 이론적으로 보체의 활성화를 저지하는 약으로 가능할 것으로 생각되며, C5 항체인 eculizumab으로 치유된 보고도 있다.

자간전증 태반에서의 Norepinephrine Transporter(NET) 발현 (Expressions of Norepinephrine Transporter in Pre-eclamptic Placenta)

  • 나규환;이현정;정지은;김기진
    • 한국발생생물학회지:발생과생식
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    • 제14권2호
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    • pp.65-74
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    • 2010
  • 지금까지 태반에서 monoamine들을 재 흡수할 수 있는 몇 가지 membrane transporter들이 발현됨이 보고되었다. 그러나 카테콜라민 트렌스포터(norepinephrine transporter, NET)의 발현과 부인과 질환을 포함한 태반 발달과의 연관성에 관한 연구는 거의 보고된 것이 없다. 본 연구의 목적은 태반에서 NET의 발현을 동정하고, 그 기능을 알아보고자 하였다. 이를 위해 정상과 자간전증(preeclampsia) 태반에서 각각 NET 단백질을 동정하고, 영양막세포주인 HTR8-SV/neo 영양막 세포에 NET 유전자를 주입 후 그 기능을 분석하였다. NET 발현을 분석하고자 태반조직에서 다음과 같이 환자를 분류하여 semi-quantitative RT-PCR과 면역조직화학 방법을 사용하였다. 분만 고통이 없는 산모의 태반을 중심으로(none underwent labor): 1) 만기 정상 태반(term normal placenta)(n=15); 2) 만기 자간전증 태반(term with preeclamptic placenta)(n=15); 3) 중기 자간전증 태반(pre-term preeclamptic placenta)(n=11)을 수집하여, NET 발현을 RNA 수준에서 분석한 결과, mRNA 분석에서는 NET 유전자가 정상 태반 조직보다 자간전증 태반에서 낮게 발현되는 것을 확인하였다. 그러나 Western blot을 통한 NET 단백질의 변화는 거의 없는 것으로 확인되었다. HTR8-SV/neo 영양막세포를 이용하여, NET 유전자의 기능을 알아보고자 NET 유전자의 플라스미드(a plasmid vector for NET gene)와 siRNA(NET gene-specific siRNA)을 HTR8-SV/neo 영양막 세포에 24시간 동안 각각 핵 내 주입하고, NET 유전자 발현에 따른 침윤은 NET 유전자를 증가시킨 경우 대조군보다 2.5배(p<0.05) 촉진시키는 것으로 확인됐으며, NET 유전자를 감소시킨 경우는 침윤능력이 감소하는 경향이 관찰되었다. 또한 NET의 과도한 고발현 또는 저발현은 MMP-2와 MMP-9 발현과 활성을 저해하는 것이 관찰하였다. 따라서 자간전증에서 NET의 발현 감소는 영양막세포의 침윤능력을 억제하는 요인이 될 수 있다. 그러므로 이러한 결과들은 영양막세포의 침윤 기전뿐만 아니라 자간전증을 포함한 부인과 질환의 기초 연구에 지침을 제공할 것이다.

Supplementing punicalagin reduces oxidative stress markers and restores angiogenic balance in a rat model of pregnancy-induced hypertension

  • Wang, Yujue;Huang, Mengwei;Yang, Xiaofeng;Yang, Zhongmei;Li, Lingling;Mei, Jie
    • The Korean Journal of Physiology and Pharmacology
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    • 제22권4호
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    • pp.409-417
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    • 2018
  • Pre-eclampsia (PE) is a pregnancy disorder that is characterised by severe hypertension and increased risks of foetal and maternal mortality. The aetiology of PE not completely understood; however, maternal nutrition and oxidative stress play important roles in the development of hypertension. The treatment options for PE are currently limited to anti-hypertensive drugs. Punicalagin, a polyphenol present in pomegranate juice, has a range of bioactive properties. The effects of supplementation with punicalagin on angiogenesis and oxidative stress in pregnant rats with induced hypertension were investigated. The pregnant rats were randomly divided into five experimental groups (n=12 per group). Hypertension was induced using an oral dose of NG-nitro-L-arginine methyl ester (L-NAME, 50 mg/kg/day) on days 14-19 of pregnancy. Punicalagin (25, 50 or 100 mg/kg) was given orally on days 14-21 of pregnancy. Punicalagin treatment at the tested doses significantly reduced diastolic, systolic, and mean arterial blood pressure in L-NAME treated rats from day 14. Punicalagin also restored angiogenic balance by increasing the expression of vascular endothelial growth factor and downregulating vascular endothelial growth factor receptor-1/fms-like tyrosine kinase-1. Punicalagin, significantly increased the placental nitric oxide levels as compared to PE group. The increased levels of oxidative stress in rats with PE were markedly decreased by treatment with punicalagin. Punicalagin at the tested doses markedly (p<0.05) enhanced the placental antioxidant capacity in L-NAME-treated rats. The raised catalase activity observed following L-NAME induction was significantly (p<0.05) and restored to normal activity levels in punicalagin treatment. Further, 100 mg dose of punicalagin exhibited higher protective effects as compared to lower doses of 25 and 50 mg. This study shows that supplementation with punicalagin decreased blood pressure and oxidative stress and restored angiogenic balance in pregnant rats with induced PE.

Neuronal Nitric Oxide-mediated Cytotoxicity in Trophoblast Cells Induced by Increase of Intracellular Calcium

  • Shin, Mi-Kyung;Kwon, Yong-Hyun;Shin, Jong-Chul;Yang, Dong-Eun;Lee, Sung-Keun;Kang, Ju-Hee;Park, Chang-Shin
    • Molecular & Cellular Toxicology
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    • 제4권1호
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    • pp.16-21
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    • 2008
  • Cell death of trophoblast, particularly by abnormal release of physiological nitric oxide (NO) has been known to be a causative factor of pre-eclampsia. In the present study, effects of intracellular calcium increase enhancing the activity of NO synthases (neuronal NO synthase, nNOS in this trophoblast cells) on the cell death were examined in a human placental full-term cell line (HT-1). Furthermore, we analyzed the possible mechanisms underlying the augmentation of $Ca^{++}$-mediated NOS activity mediated by protein kinases like PKC, PKA, or CaM-KII. In experiments for cell toxicity, a calcium ionophore (ionomycin $10{\mu}M$) enhanced cell death confirmed by MTT assay, and increased significantly nNOS activity determined with a hemoglobin oxidation assay. This cell death was partially protected by pre-treatment of 7-nitroindazole (7-NI, $10{\mu}M$ and $100{\mu}M$), a nNOS-specific inhibitor. Additionally, $Ca^{++}$-ionophore -induced increase of nNOS activity also was partially normalized by pre-treatment of specific inhibitors of protein kinases, PKC, PKA or CaM-KII. Therefore, we suggest that an increase of calcium influx, leading to the activation of nNOS activity, which in turn may result in the death of trophoblast cells by involvement of signaling mechanisms of protein kinases.

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

  • 이종성;전수연;최종호;이유진;차동현;김기진
    • Clinical and Experimental Reproductive Medicine
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    • 제37권3호
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    • pp.217-229
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    • 2010
  • 목 적: 영양막세포의 과도한 세포자멸사는 태반의 발달뿐 아니라 산과 질환을 유발하는 요인으로 알려져 있다. X-linked inhibitor of apoptosis (XIAP)은 임신 기간 동안 영양막세포의 세포자멸사와 관련되어 있다고 알려져 있으나, 자간전증을 유발하는 인자인 저산소성과의 관계에 관한 연구는 미흡한 실정이다. 본 연구의 목적은 XIAP가 정상 태반과 자간전증 산모의 태반에서 발현 양상의 차이를 분석하고, 저산소 상태에 노출된 HTR-8/SVneo 영양막세포주에서의 XIAP 기능을 분석하고자 하였다. 연구방법: XIAP 발현을 분석하고자, 정상 태반 (n=15), 중기 자간전증 태반 (n=11), 그리고 말기 자간전증 태반 (n=15) 조직을 수집하여 RT-PCR, 면역조직화학법, 그리고 Western blot 등을 실시하였다. 저산소성 상태에서 XIAP의 기능을 확인하고자 HTR-8/SVneo 영양막세포주에 1% 산소가 공급되는 hypoxia 상태에 노출시킨 뒤 12시간, 24시간 후에 각 세포자멸사 관련 유전자들의 발현을 fluorescence-activated cell sorting (FACS)와 Western blot 분석 등을 실시하였다. 결 과: XIAP는 태반의 합포영양막세포와 포합체결절에서 발현이 관찰되었으며, 정상 태반보다 자간전증 태반에서의 발현이 현저히 감소됨이 관찰되었다 (p<0.05). 또한, 저산소 상태에 노출된 HTR-8/SVneo 영양막세포주에서 감소된 XIAP 발현은 세포질에서 핵으로의 이동에 따라 세포자멸사를 유발하는 단백질들의 발현이 증가됨이 관찰되었다. 결 론: XIAP의 발현은 태반 발달 및 자간전증 태반에서 XIAP 유전자의 발현은 감소되었으며, XIAP의 저하로 인한 caspase-9의 증가가 자간전증 태반에서의 세포자멸사는 더 많이 유도되었음을 확인할 수 있었다. 또한, 저산소 상태에 의해 XIAP의 발현이 감소되었으며, XIAP 단백질의 세포질에서 핵으로의 위치 변화는 영양막세포의 세포자멸사에 중요한 역할을 하는 것이 관찰되었고, 이는 자간전증의 진단에 유용한 마커로써의 활용되기 위한 기본적인 자료로 활용될 수 있을 것으로 판단된다.

Association between neonatal jaundice and autism spectrum disorders among children: a meta-analysis

  • Jenabi, Ensiyeh;Bashirian, Saeid;Khazaei, Salman
    • Clinical and Experimental Pediatrics
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    • 제63권1호
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    • pp.8-13
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    • 2020
  • Autism spectrum disorder is a common neurodevelopmental disorder with an unknown etiology. The correlation between neonatal jaundice and the risk of developing autism spectrum disorder was investigated previously. Some studies showed significant associations, whereas others demonstrated no association. In this meta-analysis, we pooled the results of observational studies to examine the association between neonatal jaundice and the risk of autism spectrum disorder among children. We identified all studies published through April 2018 by conducting a literature search using Web of Science, PubMed, and Scopus databases as well as the reference lists of the retrieved studies. The pooled odds ratios (ORs), rate ratio (RR), and their 95% confidence intervals (CIs) were calculated as random effect estimates of association among studies. We conducted a subgroup analysis to explore any potential sources of intergroup heterogeneity. The pooled estimates of OR and RR showed a considerable correlation between neonatal jaundice and ASD among children (OR, 1.35; 95% CI, 1.02-1.68) and (RR, 1.39; 95% CI, 1.05-1.74). A larger effect size was shown in the pooled estimated crude OR than in the adjusted OR (1.75 [0.96-2.54] vs. 1.19 [1.07-1.30]). This study showed that neonatal jaundice may be associated with ASD and may increase the risk of ASD among children.

저출생 체중아 분마에 대한 임상적 고찰 (Clinical Observation on Delivery of Low Birth Weight Unfant)

  • 송선호;최의순
    • 여성건강간호학회지
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    • 제5권2호
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    • pp.191-203
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    • 1999
  • A clinical study was made on 365 low birth weight infant and 406 normal birth weight infant who had been born at Kangnam St. mary's Hospital during past 3 years from Jan. 1, 1995 to Dec. 31, 1997. the data of this study were gathered through reviewing of medical records. 1. Comparison of general characteristic with of obstetric characteristic 1) Old maternal age, previous abortion and previous LBWI delivery in the group of low birth weight infant(LBWI) mother were more prevalent than those in the group of normal birth weight infant(NBWI)mother 2) Cesarean section, abnormal presentation and multiple pregnancy in the group of LBWI mother were prevalent than those in the group of NBWI mother. 3) regular antenartal care and visiting rate of tertiary hospital in the group of LBWI mother were more prevalent than those in the group of NBWI mother. 2. Frequency of low birth weight infant 1) Anmual average frequency of LBWI was 6.5% and monthly frequency was the highest in January and december. 2) The frequency of LBWI was the highest in 37-40wks of gestational age and was the highest in 2251-2500 gm of birth weight. 3) The frequency of congenital anomaly in the group of LBWI was more prevalent than that of NBWI. 3. Mortality rate of LBWI The mortality rate of LBWI was 9.2%. The highest mortality rate was noted before 27wks of gestational age, less than 1000gm of birth weight and within 12hrs of delivery. 4. The most common complication of pregnant women was pre-term labor, the most complication relating to placenta was premature rupture of membrane(PROM) and the most fetal complication was fetal distress in delivered LBWI. 5. Significant relating factors of low birth weight infant delivery were associated with maternal age, previous delivery, previous low birth weight delivery, pre-eclampsia, anemia, oligohydramnios, PROM, placenta previa, abruptio placenta, fetal sex, fetal distress and congenital anomaly.

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Periodontitis among poor rural Indian mothers increases the risk of low birth weight babies: a hospital-based case control study

  • Jacob, Pulikottil Shaju;Nath, Sonia
    • Journal of Periodontal and Implant Science
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    • 제44권2호
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    • pp.85-93
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    • 2014
  • Purpose: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. Methods: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ${\geq}2,500g$. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. Results: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). Conclusions: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.

저체중아 출생과 관련된 산모의 특성 연구 (The Study of Maternal Characteristics of Low Birth-Weight Infant)

  • 홍필순;박형숙
    • 여성건강간호학회지
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    • 제5권1호
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    • pp.80-95
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    • 1999
  • The purpose of this study was to investigate the characteristics of low birth-weight infants and their's mothers, and to identify the factors which influenced to delivery of L.B.W infants. The data derived from K. General Hospital and J. obs & gyn clinic in pusan from January, 1998 to August, 1998, which were from mothers of having B. W infants. The factors used for this study were characteristics of general, obstetrical, environmental aspects and physical and psychological life experiences during pregnancy. Analysis of data obtained were computerized statistically by using SPSS 7.5 WIN program. the data were analysed as number, frequency, percentage, t-test and ANOVA. The major results obtained of this study were as follows : 1) Gender that L.B.W infants were male in 47.2% and female in 52.8%, body weight of 2001~2500gm was above 8 in 68.5%, and below 5 in 1.8%. The L.B.W infants with complications were 7, which were 6.5%. The kinds of malformations were the Cleft palate & lip, Hyper-kalemia, Hypoglycemia, Meningocele, CHD, Down syndrome and each of them marked 0.9%. 2) In the general characteristics of pregnant women, the age group of 25~29 years was the most common as 46.3%. Over 35 years of age, elderly gravidas were in 7.5%. the height of 156~160cm was the most common as 52.8%. pregnant women of below 150cm height was in 3.7%. body weight of 51~55kg was the most common as 38%. pregnant women of below 45kg were in 19.4%. The women with smoking and drinking episodes during pregnancy were 1.9% and 25%. In the status of marriage, married women were in 95.4%, unmarried ones were in 1.9%, and unmarried couples were in 2.8%. Iin he obstetrical characteristics of pregnant women, pregnant women with gestational age under 37wks were in 45.4%, and the ones over 38wks were 54.6%. At the methods of delivery, normal spontaneous vaginal deliveries were in 51.9%, which were the most common, cesarian section deliveries were in 47.2%, and breech deliveries were in 0.9%. In the environmental characteristics of pregnant women, 40.8% of pregnant women lived in house or apartments with stairs, 23.1% of them lived in the high altitude. the pregnant women who ran a household without a helper were in 65.7%. In the pregnant women who had underwent life experiences of physical and psychological stress during pregnancy. life experiences of physical stresses were described as persistent fatigue due to lifestyle, traumatic experience, illness, move away with an effort, physical impact caused by discord. life experiments of psychological stresses were describeded as trouble with their husbands, discord with one's husband family, family problems, and conflicts due to environmental factors, etc. The number of the pregnant women who had complications during pregnancy was 32, which was 29.6% totally. Among them, pre-eclampsia was in 12.1% and the premature rupture of membrane in 7.4%. 3) In the analysis of the general, obstetrical, and circumstantial characteristics and L.B.W infants. There were statistical difference significantly between the gestational age of pregnant women(F=12.035, P=.000), and the status of marriage(F=3.207, P=.044), and maternal complication(t=2.344, P=.021) etc.

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