Usefulness of Maternal Serum Amyloid A as a Predictor of Tocolytic Failure in Preterm Delivery

Objective: This study is directed to determine whether the concentrations of serum amyloid A (SAA) in maternal serum could be used to predict a tocolytic failure in preterm delivery, by comparing with other factors associated with inflammation. Methods: A total of 100 pregnant women from September, 2000 to August, 2001 received continuous prenatal care and underwent delivery in our hospital was enrolled in the study. Gestational age was ranged between 20 and 37 weeks. Subjects were divided into four groups (group I, no preterm labor and no premature rupture of membranes [n=38]; group II, premature rupture of membranes and no preterm labor [n=12]; group III, preterm labor and no premature rupture of membranes [n=34]; Group IV, preterm labor and premature rupture of membranes [n=16]). The levels of SAA, CRP, ESR, and WBC count were measured in maternal serum. Results: SAA levles, CRP levels, and WBC count in patients with tocolytic failure were significantly higher than those in patients without tocolytic failure. SAA and CRP appeared to be significant factors by logistic regression analysis. From the ROC curve analysis of maternal SAA for the prediction of tocolytic failure, we set 6 mg/L as a cut-off value in this study. Sensitivity, specificity, positive predictive value, and negative predictive value were 76%, 72%, 47.5%, and 90%, respectively. As for CRP, 0.59 mg/dL was set as a cut-off value, and sensitivity, specificity, positive predictive value, and negative predictive value were 72%, 81.3%, 56.3%, and 89.7%, respectively. When cut-off values for both SAA and CRP were applied at the same time, sensitivity, specificity, positive predictive value, and negative predictive value were 60%, 92%, 71.4%, and 87.3%, respectively. Conclusion: This study showed that the measurement of maternal serum amyloid A may be a fast, non-invasive diagnostic method in the prediction of tocolytic failure in preterm delivery.ope

Expression pattern of Aromatase Cytochrome P450 in Adenomyosis

Objective: To determine whether local estrogen production takes place in adenomyosis and in normal endometrium. Methods: The study included 23 cases of adenomyosis and 17 cases of normal uterine endometrium obtained through hysterectomy or curettage at Kangnam Cha Hospital. The frozen tissue specimens were examined by immunohistochemistry using P450 arom. Results: P450 arom was immunolocalized exclusively in the cytoplasm of glandular cells of adenomyotic tissue. However, no apparent staining was observed in stromal cells. Aromatase was expressed in the ectopic glands (82.6%), but also in the eutopic endometrium of patients with adenomyosis (23.5%). In the case of normal endometrium, P450arom was not detected. Conclusion: These results suggest that the aromatase activity is correlated to the pathophysiology of adenomyosis.ope

Apoptosis and Peripheral Benzodiazepin Receptor (PBR) Expression inHuman Granulosa-Luteal Cells by GnRH-agonist

Objective: To investigate whether GnRH-agonist (GnRH-Ag) using in IVF-ET affects apoptosis of human granulosa-luteal cells and expression of peripheral benzodiazepine receptor (PBR) protein involved in the apoptosis of the cells. Methods: Granulosa-luteal cells obtained during oocyte retrieval were cultured and treated with 10-5M GnRH-Ag. Apoptosis of the cells by the treatment was confirmed using DNA fragmentation analysis 24 h after culture. The presence of PBR protein within the cells was examined by immunofluorescence staining and the expression of the protein was analyzed by Western blotting. In addition, it was measured for progesterone and nitric oxide (NO) produced by granulosa-luteal cells after GnRH-Ag treatment. To evaluate the relationship between NO production and PBR expression, sodium nitroprusside (SNP) as a NO donor was added in media and investigated the expression of PBR protein by Western blotting. Results: Apoptosis increased in the granulosa-luteal cells 24 h after GnRH-Ag treatment, whereas the expression of PBR protein significantly decreased. Furthermore, the production of progesterone and nitric oxide (NO) by the cells significantly fell from 12 h after the treatment. In the results of Western blotting after SNP treatment, the expression of PBR protein increased in the treatment with SNP alone to the granulosa-luteal cells, but was suppressed in the treatment with GnRH-Ag and SNP. Additionally, the staining result of PBR protein in the cells showed the even distribution of it through the cell. Conclusion: These results demonstrate that GnRH-Ag treatment induces apoptosis, decreasing expression of PBR protein and NO production in human granulosa-luteal cells. The present study suggests that one of the apoptosis mechanism of human granulosa-luteal cells by GnRH-Ag might be a signal transduction pathway via NO and PBR.ope

The Effect of Isoflavone Supplementation on Plasma Biochemical Parameters of Women with Polycystic Ovary Syndrome

OBJECTIVE: This study was performed to evaluate the effect of isoflavone supplementation on hormone levels, lipid profiles and total antioxidant status in patients with polycystic ovary syndrome. METHODS: Total 11 women with polycystic ovary syndrome were supplemented daily with 150mg of isoflavone for 6 months. Blood samples were collected 0, 3, and 6 months after supplement of isoflavone for analysis of LH, FSH, E2, testosterone, free testosterone, SHBG levels, serum lipid profiles, and total antioxidant status (TAS). RESULTS: After 6 months isoflavone supplementation, the hormone levels did not change significantly. Serum lipid profiles did not show any significant change in total cholesterol, LDL-cholesterol, triglyceride, lipoprotein(a), and free fatty acid levels. However, there was significant increase in HDLcholesterol (p<0.05) for 3 months. Total antioxidant status was increased significantly after isoflavone supplementation for 6 months (p<0.05). CONCLUSION: Isoflavone supplementation showed positive effects on the HDL-cholesterol and total antioxidant status. it is implicated that isoflavone supplementation will may have a effect on cardiovascular disease in patients with polycystic ovary syndrome.ope

Increased telomerase activity and human telomerase reverse transcriptase mRNA expression in the endometrium of patients with endometriosis

BACKGROUND: Endometriosis is considered a frequent, benign disease with the ability to undergo neoplastic processes. The aim of this study was to evaluate the limitless replication potential of the endometrium in patients with endometriosis by examining human telomerase reverse transcriptase (hTERT) mRNA expression and telomerase activity. METHODS: Endometrium samples from 30 endometriosis patients and 30 patients without endometriosis were obtained via endometrial biopsy. The expression of hTERT mRNA was determined by real-time RT-PCR assay, and telomerase activity was measured by telomerase repeat amplification protocol (TRAP) assay. RESULTS: The mean normalized hTERT (N hTERT) mRNA level was significantly higher in the endometriosis than in the control group (P = 0.013). The mean hTERT mRNA levels during the proliferative phase and during the secretory phase were higher in the endometriosis group than in the control group, although the difference was only significant for the secretory phase (P = 0.036). We found a prominent difference in endometrial telomerase activity between moderate-to-severe endometriosis and the control group (P = 0.048). The levels of hTERT mRNA and telomerase activity increased as the disease became more severe (P = 0.038, P = 0.016). CONCLUSIONS: This study showed the overexpression of hTERT mRNA and telomerase activity in the endometrium of endometriosis patients. These finding suggest that replication potential of endometrial cells may have an important role in the pathogenesis of endometriosis.ope

Cell Cycle Signaling Pathway by Cyclins-CDKs and CDKIs in Endometriosis

Objective : To determine whether oxidants are formed as part of the cisplatin-induced apoptotic process, intracellular markers of oxidative stress were examined. Methods : Apoptotic death of HeLa cells by cisplatin was confirmed by flow cytometry. Results : The pre-treatment with glutathione (GSH) significantly attenuated cisplatin-induced apoptosis through the reduction of reactive oxygen species (ROS) accumulation and diminished caspases-3 and 9 protease activity. Furthermore, z-VAD-fink, an inhibitor of pan-caspase, effectively inhibited the activation of caspases and prevented apoptosis by cisplatin, although cisplatin-induced ROS generation was not attenuated. Conclusion : These data indicate that ROS may play a role as an upstream mediator of caspases. Taken together, our results suggest that oxidative stress mediates cisplatin-induced apoptosis in HeLa cells.ope

Clinical Efficacy of Clomiphene Citrate and Letrozole Combined with Gonadotropins for Superovulation in Patients with Clomiphene-Induced Thin Endometrium

Objective: The aim of this study was to compare the clinical efficacy of clomiphene citrate (CC) and letrozole combined with gonadotropins for controlled ovarian stimulation (COS) in patients with CC-induced thin endometrium Methods: Fifty-one intrauterine insemination cycles performed in patients who previously had a thin endometrium (<8 mm) to ovulation induction using CC were included in this study. A CC 100 mg/day (CC+gonadotropin group, n=26) or letrozole 2.5 or 5 mg/day (letrozole+gonadotropin group, n=25) was administered on day 3~7 of the menstrual cycle, combined with gonadotropins at dose 75~150 IU every other day starting on day 5~7. We compared total dose of gonadotropin used, endometrial thickness, endometrial pattern, number of follicles ${\geq}14\;mm$ on hCG day, pregnancy rate and multiple pregnancy rate between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: There were no significant differences in clinical characteristics such as age, duration of infertility, number of previous IUI cycles, basal serum hormone levels and cause of infertility between the two groups. In both groups, the endometrium was significantly thicker than that of previous ovulation induction cycles using CC. No significant differences were found in the total dose of gonadotropin used, day of hCG administration, the rate of triple endometrium and pregnancy rate. The number of follicles ${\geq}14\;mm$ was significantly lower ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03) and the endometrium on hCG day was significantly thicker ($7.7{\pm}1.5$ vs. $9.1{\pm}1.7$, p=0.001) in letrozole+gonadotropin group compared to CC+gonadotropin group. Conclusion: The clomiphene citrate and letrozole combined with gonadotropins appear to avoid the undesirable effects on the endometrium frequently seen with CC for ovulation induction. However, in terms of adequate endometrial development or optimal follicular growth, letrozole may be more beneficial than CC for gonadotropin-combined COS in patients with CC-induced thin endometrium. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.ope

The Influence of BMI on Clinical and Metabolic Characteristics in Patients with Polycystic Ovary Syndrome

Objectives: The aim of this study was to investigate the influence of body mass index (BMI) on clinical and metabolic characteristics in patients with polycystic ovary syndrome (PCOS). Methods: A total of 67 patients with PCOS were included in this study. Study subjects were divided into two groups according to BMI: women with BMI ≥23 ㎏/㎡(overweight/obese group, n=24) vs. women with BMI <23 ㎏/㎡ (normal-weight group, n=43). We compared clinical and metabolic characteristics including waist-to-hip ratio, serum lipid profiles, homeostatic model assessment of insulin resistance (HOMA-IR), fasting serum glucose/insulin ratio, postprandial 2 hours (PP2) serum insulin levels, total testosterone, sex hormone-binding globulin (SHBG), high-sensitivity C-reactive protein (hs-CRP) and homocysteine levels between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher’s exact test, where appropriate. Results: The overweight/obese group has a lower serum SHBG level (37.23±26.74 vs. 66.42±40.16 nmol/l, P= 0.004) and a higher free androgen index (5.83±3.85 vs. 3.57±2.30, P=0.002) than the normal-weight group. Fasting insulin (17.13±8.8 vs. 7.15±4.41 μIU/ml, P<0.001), PP2 insulin (76.81±43.66 vs. 47.98±49.77 uIU/ml, P=0.022) and the HOMA-IR (3.65±1.74 vs. 1.48±1.02, P<0.001) are significantly higher and fasting glucose/insulin ratio (6.59±4.84 vs. 15.18±7.48, P<0.001) are significantly lower in the overweight/obese group compared to those of the normal weight group. Serum triglyceride (125.00±105.34 vs. 77.56±41.69 mg/dl, P=0.036) and hs-CRP levels (3.53±4.23 vs. 0.85±0.70 mg/l, P=0.008) are significantly higher in the overweight/obese group. Conclusion: The overweight and obese women with PCOS are more closely related to hyperandrogenism, insulin resistance and chronic inflammation. These findings may indicate that they have an increased risk of metabolic and cardiovascular diseasesope

Legal Analysis on Transaction System of Right to Use of State-owned Construction Land in China

중국의 도시토지사용제도는 1978년을 기점으로 많은 변화가 있었다. 이러한 변화는 개혁이전과 이후 다르게 나타나고 있다. 그리고 2007년 10월 1일부터 시행되고 있는 중국 《물권법》에서는 건설용지사용권을 용익물권의 일종으로 하여 하나의 장으로 규정하였다.《물권법》이외의 법률에서도 건설용지사용권을 규정하고 있다. 즉《헌 법》, 《토지관리법》, 《도시부동산관리법》, 《城鎭국유토지사용권출양과양도임시조 례》등을 들 수 있다. 일반적으로 건설용지사용은 국유토지를 이용하여 건축물⋅구축물과 그 부대시설을 건축하는 것을 말한다. 중국에서는 국유토지를 점유⋅사용할 수 있으며 그에 상응하는 수익을 얻을 수 있다. 이러한 건설용지사용권은 국가로부터 출양의 방식으로 획득된 다. 이는 1급 시장의 건설용지사용권의 원시취득이며, 2급 시장에서는 양도⋅교환⋅ 출자⋅증여 혹은 저당 등 승계방식으로 취득하게 된다. 1급 시장에서 건설용지사 용권은 입찰⋅경매⋅공시의 방식이며, 2급 시장에서는 양도⋅임대⋅저당의 방식으 로 유동이 된다. 이러한 건설용지사용권은 사실상 토지자원의 재배치와 생산요소의 합리적인 유동 이다. 오늘날 중국법률은 도시건설용지사용권 양도의 제한성 규정으로 인하여 불합 리하다. 토지투기가 성행하는 것은 토지의 개발정도에 근원하는 것이 아니고 토지시 장의 관리에 그 근원이 있다. 이로 인하여 토지 1급 시장과 토지 2급 시장 사이에 과대한 평가절상의 공간이 된다. 그러나 현재의 법률은 양도에 대해서만 엄격하게 제한을 하고 있어 근본적인 해결책은 아니다. 이러한 문제점과 대책을 강구하기 위 하여 건설용지사용권 유동의 법률규정, 건설용지사용권 유동이 유형 즉 양도⋅임대 ⋅저당, 그리고 건설용지사용 유동의 제한 등에 대하여 살펴볼 필요가 있다. 이러한 문제점의 근본적인 대책으로 건설용지사용권의 물권적 보호효력을 확보하기 위해서는 건설용지사용권 기제(機制)를 잘 이해하여야 한다. 그리고 건설용지사용권을 그에 따른 부동산 투자개발로서 양도⋅저당⋅임대 등에서 안정성을 확보하여 건설 용지사용권의 가격기능이 순조롭게 운영되고 토지시장이 자연스럽게 수립되면 건설 용지사용권의 유상제도가 실현될 수 있을 것이다.이 논문은 동아대학교 학술연구비 지원에 의하여 연구되었으며, 2010년 서울대학교 법 학연구소 주최의 국제학술대회(2010.6.11-12)에서 발표한 것을 수정⋅보완한 것임

(The) clinical and statistical study on anemia during pregnancy

의학과/석사[한글] 임신중 빈혈은 일반적으로 혈색소량 10 gm/dl미만을 말하며 사회 경제적 수준에 따라 발생빈도의 차이가 있으며, 만성소모성질환 혹은 기생충감염 뿐 아니라 잦은 임신 또는 산과적 출혈은 임신중 빈혈의 원인이 된다고 보고하고 있다. 임신중 빈혈은 대부분의 경우 철분결핍성 또는 엽산의 결핍으로 오며, 혹은 두가지 원인을 동반하는 경우가 많고 엽산의 결핍이 있는 경우에는 임신중독증 및 분만후 이상출혈이 많은 것으로 보고 되어 있다. 본 연구는 1974년 7월부터 1775년 12월까지 만2년간 연세대학교 외과대학 부속 세브란스병원 산부인과에 입원 분만한 임신 20주 이상인 산모를 대상으로 조사분석하여 다음의 결과를 얻었다. 1. 빈혈의 발생빈도는 특진산모군에서 8.4%, 일반진료군에서 11.3%로 일반진료군에서 높았으며 산전진찰회수가 많을수록 감소하였다. 2. 빈혈의 발생빈도는 분만, 조산 및 유산경력이 많은 산모군에서 많았으며 특히 4회 이상 분만 혹은 유산한 산모군에서 급격히 증가하였다. 3. 빈혈의 발생빈도는 임신기간이 짧을수록 높았으며 특히 32주 이전에 조산한 산모군에서 급격히 증가하였다. 4. 빈혈의 발생빈도는 다태임신, 기생충감염 및 임신중독증이 있는 산모군에서 높았으며 임신빈혈이 있던 산모는, 산후출혈이 많았다. 5. 빈혈이 있는 산모군에서 분만후 합병증이 많았다. The Clinical and Statistical Study on Anemia during pregnancy Dong Je Cho, M.D. Department of Medical Science The Graduate School Yonsei University (Directed by Professor; Hyun Mo Kwak, M.D.) A hemoglobin concentration of 10gm/이 or less are generally accepted as a indication of the presence of anemia during pregnancy. The incidence of anemia during pregnancy is variable, depending on the socioeconomic status of the patients and many other factor. There are many responsible factors for the anemia during pregnancy, including chronic maternal disease, parasites infestation, repeated pregnancy abortion and many other factors. Majority of anemia during pregnancy are iron deficiency, folate deficiency or combination of both. this study is a clinical analysis and evaluation for the anemia during pregnancy on 3932 cases of pregnant women who were admitted and delivered after 20 weeks of gestation at Yonsei medical center from 1974 to 1975. The followings are the result of this study. 1. The incidence of anemia during pregnancy were 8.4% in private cases and 11.3% in clinic cases. 2. The incidence of anemia during pregnancy was increased with the number of antepartal visites. 3. The incidence of anemia during pregnancy was increased with the number of delivery or abortion. 4. The anemia during pregnancy was more frequent in premature group especially before 32 weeks of gestational age. 5. The anemia during pregnancy was more frequent in the group who had parasites infestation. 6. The anemia during pregnancy was frequently associated with toxemia. 7. The anemia during pregnancy was frequent in the multiple pregnancy. 8. Unusual postpartal hemorrhage was more frequent in anemia group. 9. The post partum complication were more frequent in anemia group. [영문] A hemoglobin concentration of 10gm/이 or less are generally accepted as a indication of the presence of anemia during pregnancy. The incidence of anemia during pregnancy is variable, depending on the socioeconomic status of the patients and many other factor. There are many responsible factors for the anemia during pregnancy, including chronic maternal disease, parasites infestation, repeated pregnancy abortion and many other factors. Majority of anemia during pregnancy are iron deficiency, folate deficiency or combination of both. this study is a clinical analysis and evaluation for the anemia during pregnancy on 3932 cases of pregnant women who were admitted and delivered after 20 weeks of gestation at Yonsei medical center from 1974 to 1975. The followings are the result of this study. 1. The incidence of anemia during pregnancy were 8.4% in private cases and 11.3% in clinic cases. 2. The incidence of anemia during pregnancy was increased with the number of antepartal visites. 3. The incidence of anemia during pregnancy was increased with the number of delivery or abortion. 4. The anemia during pregnancy was more frequent in premature group especially before 32 weeks of gestational age. 5. The anemia during pregnancy was more frequent in the group who had parasites infestation. 6. The anemia during pregnancy was frequently associated with toxemia. 7. The anemia during pregnancy was frequent in the multiple pregnancy. 8. Unusual postpartal hemorrhage was more frequent in anemia group. 9. The post partum complication were more frequent in anemia group.restrictio