• Clinical and Experimental Pediatrics
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• 제48권2호
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• pp.143-147
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• 2005

목 적 : 갑상선 기능은 여러 질환이나 스트레스에 의해서 영향을 받는 것으로 알려져 있다. 저자들은 분만 전과 분만 동안의 여러 인자와 제대혈 갑상선자극호르몬 및 갑상선호르몬 농도와의 상관관계를 알아보고자 본 연구를 시행하였다. 방 법 : 총 130명의 신생아를 대상으로 분만 즉시 제대혈을 10 mL 채취하여 갑상선자극호르몬, $T_3$와 유리 $T_4$ 농도를 방사면역학적 방법(CIS bio international kit, Germany)으로 측정하였다. 재태연령, 출생체중, 가사, 분만방식, 산모의 당뇨병 유무, 산모의 전자간증 유무 등에 따라 갑상선자극호르몬과 갑상선 호르몬 농도를 비교하였다. 결 과 : 1) 제대혈 갑상선자극호르몬 농도는 재태연령 34주 이하 $1.73{\pm}0.48{\mu}IU/mL$, 34주-37주 $2.60{\pm}0.51{\mu}IU/mL$, 38주 이상 $4.26{\pm}0.40{\mu}IU/mL$으로 재태연령의 증가에 따라 증가하였다(P<0.05). 2) 분만형태를 비교하면 질식 분만 군 $4.42{\pm}0.66{\mu}IU/mL$, 제왕절개 분만 군 $3.31{\pm}0.33{\mu}IU/mL$로 질식 분만 군에서 높았다(P<0.05). 3) 가사에 따른 갑상선자극호르몬 농도는 가사가 있는 군 $5.18{\pm}0.93{\mu}IU/mL$로 가사가 없는 군 $2.97{\pm}0.84{\mu}IU/mL$에 비해 유의하게 높았다(P<0.05). 4) 산모의 당뇨병에 따른 갑상선자극호르몬 농도는 당뇨병 군 $8.91{\pm}1.25{\mu}IU/mL$, 없는 군 $4.32{\pm}0.42{\mu}IU/mL$으로 산모 당뇨병 동반시 유의하게 높았다(P<0.05). 5) 산모에게 전자간증이 있는 군의 갑상선자극호르몬 농도는 $5.28{\pm}0.42{\mu}IU/mL$, 없는 군 $3.65{\pm}0.46{\mu}IU/mL$에 비해 유의하게 높았다(P<0.05). 6) $T_3$와 유리 $T_4$ 농도는 가사 군에서 없는 군보다 유의하게 낮았다(P<0.05). 7) 각 변수 간의 영향을 배제하였을때 임신주수, 1분 Apgar 점수, 산모의 당뇨병만이 독립적으로 제대혈의 갑상선자극호르몬 농도에 영향을 미치는 것으로 나타났다. 결 론 : 제대혈 갑상선자극호르몬 및 갑상선호르몬 농도는 산모의 당뇨병이나 산모 전자간증과 같은 분만 전 요인과 태아에게 저산소증을 초래할 수 있는 분만시 스트레스와 밀접한 연관이 있다.

• Journal of Genetic Medicine
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• 제8권2호
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• pp.113-118
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• 2011

목적: Corticotropin-releasing hormone receptor type 1(CRHR1)은 자간전증과 같은 비정상적인 태반의 기능을 가지는 산모에서 감소되어 나타나며, 그것의 발현이나 기능은 유전적으로 영향을 받는다. 이번 연구의 목표는 한국인에서 CRHR1 유전자 다형성인 c.33+8199C>T과 자간전증 사이의 연관성을 조사하는 것이었다. 대상 및 방법: CRHR1 유전자 다형성은 SNapShot kit와 ABI Prism3100 Genetic analyzer를 이용하여 203명의 자간전증 임산부와 211명의 정상 임산부에서 측정되었고, 유전자 다형성과 자간전증 위험도 사이의 연관성을 분석하였다. 결과: CRHR1 유전자 다형성의 유전자형과 대립유전자 빈도는 자간전증 임산부와 정상 임산부 사이에 다르지 않았다. 자간전증 발생 위험도는 분석된 유전자 다형성의 드문 대립 형질(C)을 지닌 이종접합 유전자형(TC)이나 동형접합 유전자형(CC)을 수반하는 그룹에서 증가되지 않았다. CRHR1 유전자의 동형접합 유전자형(CC)을 수반하는 그룹에서 중증 자간전증과 조기 자간전증과 같은 자간전증의 합병증 발병 위험에도 차이가 없었다. 결론: 이 연구는CRHR1 유전자 다형성인 c.33+8199C>T가 한국인 임신부의 자간전증 발생과 연관이 없음을 나타낸다.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.356-365
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• 2018

Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.

• Advances in nano research
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• 제17권3호
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• pp.213-219
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• 2024

Nanotechnology is one of the critical factors involved in enhancing the sensitivity of serum biomarker detection. To explore the relationship between serum APN, Cystatin C and MMP-9 levels in patients with hypertension during pregnancy and the severity and prognosis of the disease. A total of 75 cases of hypertensive disorder complicating pregnancy (HDCP) patients who were admitted to the hospital from February 5, 2023 to May 9, 2024, were selected as the study group, and 70 healthy pregnant women who were in the same gestational week were selected as the control group. The serum APN, MMP-9 and Cys C levels of pregnant women and HDCP patients with different disease severity were compared between the two groups, and the receiver characteristic curve (ROC) was used to analyze its diagnostic value. The serum APN, MMP-9 and Cys C levels of HDCP patients with different prognosis were compared, and the factors affecting the prognosis of patients were analyzed by Logistic regression. Nanoparticles could aslo enable the sensitive detection and quantification of APN, Cystatin C, and MMP-9 in serum samples, thus increasing the accuracy of the study. The serum MMP-9 and Cys C levels of pregnant women in the study group were significantly increased, and the APN level was significantly decreased (P<0.05). Serum MMP-9 and Cys C levels in patients with pregnancy-induced hypertension, mild preeclampsia, and severe preeclampsia gradually increased (r=0.768, 0.766; P<0.001), and APN levels gradually decreased (r=-0.748, P< 0.001). In the diagnosis of patients with HDCP, the sensitivity, specificity and AUC of APN single diagnosis were 70.00%, 82.67% and 9.848 respectively. The sensitivity, specificity and AUC of MMP-9 single diagnosis were 82.86%, 74.67% and 298.300 respectively. The sensitivity, specificity and AUC of Cys C single diagnosis were 80.00%, 74.67% and 1.301 respectively. There were significant differences in age, BMI, parity, dysthymia, disease severity, APN, MMP-9 and Cys between patients with poor prognosis of HDCP and patients with good prognosis of HDCP (P<0.001). The patient's age, BMI, disease severity, APN, MMP-9 and Cys Cwere all related to HDCP. They were related risk factors of HDCP (P<0.05).

• Nutrition Research and Practice
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• 제5권1호
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• pp.3-10
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• 2011

Women's nutrition has received little attention in nutrition programming, even though clinical trials and intervention trials have suggested that dietary improvement or supplementation with several nutrients may improve their health, especially in low-income settings, the main focus of this paper. Most attention so far has focused on how improvements in maternal nutrition can improve health outcomes for infants and young children. Adequate vitamin D and calcium nutrition throughout life may reduce the risk of osteoporosis, and calcium supplementation during pregnancy may reduce preeclampsia and low birth weight. To reduce neural tube defects, additional folic acid and possibly vitamin $B_{12}$ need to be provided to non-deficient women before they know they are pregnant. This is best achieved by fortifying a staple food. It is unclear whether maternal vitamin A supplementation will lead to improved health outcomes for mother or child. Iron, iodine and zinc supplementation are widely needed for deficient women. Multimicronutrient supplementation (MMS) in place of the more common iron-folate supplements given in pregnancy in low-income countries may slightly increase birth weight, but its impact on neonatal mortality and other outcomes is unclear. More sustainable alternative approaches deserve greater research attention.

• Clinical and Experimental Reproductive Medicine
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• 제41권3호
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• pp.97-107
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• 2014

The placenta is a temporary fetomaternal organ capable of supporting fetal growth and development during pregnancy. In particular, abnormal development and dysfunction of the placenta due to cha nges in the proliferation, differentiation, cell death, and invasion of trophoblasts induce several gynecological diseases as well as abnormal fetal development. Autophagy is a catalytic process that maintains cellular structures by recycling building blocks derived from damaged microorganelles or proteins resulting from digestion in lysosomes. Additionally, autophagy is necessary to maintain homeostasis during cellular growth, development, and differentiation, and to protect cells from nutritional deficiencies or factors related to metabolism inhibition. Induced autophagy by various environmental factors has a dual role: it facilitates cellular survival in normal conditions, but the cascade of cellular death is accelerated by over-activated autophagy. Therefore, cellular death by autophagy has been known as programmed cell death type II. Autophagy causes or inhibits cellular death via the other mechanism, apoptosis, which is programmed cell death type I. Recently, it has been reported that autophagy increases in placenta-related obstetrical diseases such as preeclampsia and intrauterine growth retardation, although the mechanisms are still unclear. In particular, abnormal autophagic mechanisms prevent trophoblast invasion and inhibit trophoblast functions. Therefore, the objectives of this review are to examine the characteristics and functions of autophagy and to investigate the role of autophagy in the placenta and the trophoblast as a regulator of cell death.

• Clinical and Experimental Reproductive Medicine
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• 제48권4호
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• pp.303-310
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• 2021

Decorin (DCN) is a proteoglycan belonging to the small leucine-rich proteoglycan family. It is composed of a protein core containing leucine repeats with a glycosaminoglycan chain consisting of either chondroitin sulfate or dermatan sulfate. DCN is a structural component of connective tissues that can bind to type I collagen. It plays a role in the assembly of the extracellular matrix (ECM), and it is related to fibrillogenesis. It can interact with fibronectin, thrombospondin, complement component C1, transforming growth factor (TGF), and epidermal growth factor receptor. Normal DCN expression regulates a wide range of cellular processes, including proliferation, migration, apoptosis, and autophagy, through interactions with various molecules. However, its aberrant expression is associated with oocyte maturation, oocyte quality, and poor extravillous trophoblast invasion of the uterus, which underlies the occurrence of preeclampsia and intrauterine growth restriction. Spatiotemporal hormonal control of successful pregnancy should regulate the concentration and activity of specific proteins such as proteoglycan participating in the ECM remodeling of trophoblastic and uterine cells in fetal membranes and uterus. At the human feto-maternal interface, TGF-β and DCN play crucial roles in the regulation of trophoblast invasion of the uterus. This review summarizes the role of the proteoglycan DCN as an important and multifunctional molecule in the physiological regulation of oocyte maturation and trophoblast migration. This review also shows that recombinant DCN proteins might be useful for substantiating diverse functions in both animal and in vitro models of oogenesis and implantation.

• 한국동물생명공학회지
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• 제37권1호
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• pp.2-12
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• 2022

Extracellular vesicles (EVs) are nanovesicles that carry bioactive cargoes of proteins, lipids, mRNAs, and miRNAs between living cells. Their role in cellular communication has gained the attention of several research reports globally in the last decade. EVs are critically involved in sperm functions, oocyte functions, fertilization, embryonic development, and pregnancy. The review summarizes the state-of-the-art of EVs research in the diagnostic and therapeutic (theranostic) potentials of the EVs during the pregnancy that might provide a solution for gestational disturbances such as implantation failure, maternal health problems, gestational diabetes, and preeclampsia. EVs can be found in all biological fluids of the fetus and the mother and would provide a non-invasive and excellent tool for diagnostic purposes. Moreover, we provide the current efforts in manufacturing and designing targeted therapeutics using synthetic and semi-synthetic nanovesicles mimicking the natural EVs for efficient drug delivery during pregnancy.

• 대한한방부인과학회지
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• 제36권4호
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• pp.21-39
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• 2023

Objectives: The purpose of this study is to review the overseas clinical study trends on Chinese Medicine treatment for Pre-eclampsia. Methods: We searched articles published from Pubmed, Embase and CNKI. The period was set from 2004 to 2023. Searched keywords were "Pre-eclampsia", "Preeclampsia", "Chinese medicine", "Herbal medicine", "子癎前期", "子癎前症", "中藥", "中醫". Results: 21 articles were finally selected. There were 16 RCTs, 3 case control studies, 2 case series. 2 articles used both acupuncture and western medicine, 19 articles used both herbal medicine and western medicine. 風池 (GB20), 太衝 (LR3), 足三里 (ST36) were the most frequently used acupoints, Paeoniae Radix alba (白芍藥) is the most frequently used in herbal medicine treatment. Conclusions: Our review found that chinese medicine combined with western medicine is more effective for alleviating symptoms of pre-eclampsia.

• 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.