• Title/Summary/Keyword: Pregnancy disease

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Cystatin C as a novel predictor of preterm labor in severe preeclampsia

  • Wattanavaekin, Krittanont;Kitporntheranunt, Maethaphan;Kreepala, Chatchai
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.338-346
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    • 2018
  • Background: The most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes. Methods: Our cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes. Results: Twenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity. Conclusion: GFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

Significance of Low Serum Urea Nitrogen Concentrations (저혈청요소질소치의 의의)

  • Kim, Chung-Sook;Kim, Kyung-Dong;Kim, Dae-Chul
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.159-165
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    • 1990
  • The prevalence of low serum urea nitrogen concentrations (< 6mg/dL) in our patient population was 3.8% (452 per 11,911 determinations), representing 372 individual cases. Of these, 323 of the patients charts were located, reviewed, and classified into disease groups. Malignant tumor was found in 25.1% of the 323 patients, the remaining patients without malignant tumor had various clinical conditions; pregnancy (19.5%), infectious diseases (12.1%), trauma (10.2%), cerebrovascular accident (62%), hepatopathy (5.3%), and miscellaneous conditions (21.6%). The prevalence in female and young aged patients under 5 years was considered due to the lower reference range in these groups than in that of female adult groups, and moreover pregnancy is another superimposing factor in the former group. In regards to the causes of this condition, our study corresponded well to the textbook cited etiology of the low serum nitrogen concentration, although malnutrition and hepatopathy were inverted in their incidental order. We postulated, through the present study, that the low serum urea nitrogen concentration is not pathognomonic findings to suggest specific disease or conditions, but rather to reflect patient's general conditions such as hydration, nutrition, or administration of certain drugs.

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Preimplantation genetic diagnosis for Charcot-Marie-Tooth disease

  • Lee, Hyoung-Song;Kim, Min Jee;Ko, Duck Sung;Jeon, Eun Jin;Kim, Jin Young;Kang, Inn Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.4
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    • pp.163-168
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    • 2013
  • Objective: Preimplantation genetic diagnosis (PGD) is an assisted reproductive technique for couples carrying genetic risks. Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy, with a prevalence rate of 1/2,500. In this study, we report on our experience with PGD cycles performed for CMT types 1A and 2F. Methods: Before clinical PGD, we assessed the amplification rate and allele drop-out (ADO) rate of multiplex fluorescent polymerase chain reaction (PCR) followed by fragment analysis or sequencing using single lymphocytes. We performed six cycles of PGD for CMT1A and one cycle for CMT2F. Results: Two duplex and two triplex protocols were developed according to the available markers for each CMT1A couple. Depending on the PCR protocols, the amplification rates and ADO rates ranged from 90.0% to 98.3% and 0.0% to 11.1%, respectively. For CMT2F, the amplification rates and ADO rates were 93.3% and 4.8%, respectively. In case of CMT1A, 60 out of 63 embryos (95.2%) were diagnosed and 13 out of 21 unaffected embryos were transferred in five cycles. Two pregnancies were achieved and three babies were delivered without any complications. In the case of CMT2F, a total of eight embryos were analyzed and diagnosed. Seven embryos were diagnosed as unaffected and four embryos were transferred, resulting in a twin pregnancy. Two healthy babies were delivered. Conclusion: This is the first report of successful pregnancy and delivery after specific PGD for CMT disease in Korea. Our PGD procedure could provide healthy babies to couples with a high risk of transmitting genetic diseases.

Acute Type a Aortic Dissection during Pregnancy (임신중 발생한 급성 대동맥박리증)

  • Kim, Ki-Chool;Ahn, Hyuk;Chae, Hurn;Rho, Joon-Ryang;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.26 no.2
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    • pp.154-157
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    • 1993
  • Aortic dissection of the young woman without Marfan disease is related, in most instances, to pregnancy. We experienced a case of acute type A aortic dissection. The patient was 25 years old woman in 35 weeks of gestational age without evidence of Marfan's syndrome. The challenge of management was successfully met by delivery of the fetus first, followed by aorta surgery. 42 minutes of total circulatory arrest and 104 minutes of total aortic cross clamp time were needed. 34 minutes of selective cerebral perfusion via right axillary artery was used. The patient had uneventful hospital course and was discharged with her healthy baby on 15 th postoperative day.

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Partial molar pregnancy and coexisting fetus with Turner syndrome: Case report and literature review

  • Park, Ji Eun;Park, Ji Kwon;Cho, In Ae;Baek, Jong Chul
    • Journal of Genetic Medicine
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    • v.15 no.1
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    • pp.43-47
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    • 2018
  • Partial hydatidiform mole and coexisting fetus is a rare entity with antecedent high risk of maternal and fetal complications, and risk of persistent trophoblastic disease in later life. Here, we report a case of twin pregnancy with live fetus identified as 45,X and normal placenta and another partial mole. Ultrasound scan at 10 weeks showed a hydrops fetus with a focal area of multicystic placenta. The patient underwent chorionic villus sampling and amniocentesis for chromosomal analysis, and the result was 45,X. Based on these finding, the patient then underwent induced abortion. Pathological examination (immunohistochemical staining) of the placenta confirmed the partial mole. This report suggests that careful prenatal ultrasonography and appropriate karyotyping in a molar pregnancy and coexisting fetus enable early diagnosis and may be beneficial for prognosis.

Angiotensin receptor blocker induced fetopathy: two case reports and literature review

  • Jinwoon Joung;Heeyeon Cho
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.121-126
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    • 2023
  • The administration of angiotensin type 2 receptor blockers (ARBs) during pregnancy is known to cause ARB fetopathy, including renal insufficiency. We aimed to analyze the outcomes of two patients who survived ARB fetopathy and perform an accompanying literature review. Case 1 was exposed antenatally from a gestational age of 30 weeks to valsartan because of maternal pregnancy-induced hypertension. The patient presented with oliguria immediately after birth, and renal replacement therapy was administered for 24 days. Seven years after birth, renal function was indicative of stage 2 chronic kidney disease (CKD) with impaired urinary concentration. Case 2 had a maternal history of hypertension and transient ischemic attack and was treated with olmesartan until 30 weeks of pregnancy. Renal replacement therapy was performed for 4 days since birth. After 8 years, the patient is with CKD stage 2, with intact tubular function. Recent reports suggest that ARB fetopathy might manifest as renal tubular dysgenesis and nephrogenic diabetes insipidus, in contrast to mild alterations of glomerular filtration. Tubular dysfunction may induce CKD progression and growth retardation. Patients with ARB fetopathy should be monitored until adulthood. The ARB exposure period might be a critical factor in determining the severity and manifestations of fetopathy.

A Bibliographic Study on the Cause of Aphasia (음아의 원인(原因)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Han, Dae-Gil
    • The Journal of Internal Korean Medicine
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    • v.11 no.2
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    • pp.137-147
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    • 1990
  • I studied some important medical liter atures in order to examine the cause of Aphasia and found out some facts as follows : 1. Hwang Je Nae Kgong(黃帝內經) is more referred exogenous causes of disease of Aphasia than endogenous causes of disease. 2. Among many causes of Aphasia, exogenous causes of disease was cinsidered to be most common in Soh Shi Je Byong Won Hu chong Rhon(巢氏諸病源喉總論), which has had a wide influence down the ages. 3. Chon Keum Yo Bang(千金要方), Chi Tae Bhi Yo(外臺秘要), Tae Pyong Song Hye Bang(太平聖惠方), Song Je Chong Rok(聖濟總綠). Bu In Yang Bang(婦人良方) and so forth had been quoted from Hwang Je Nae Kyong and Soh Shi Je Byong Won Hu Chong Ron(巢氏諸病源喉總論). 4. In the ming dynasty had been quoted non-exo-endogenous causes of disease and the Kinds of Aphasia and prescription. 5. In the Choeun dynasty and the Ching dynasty, exogenous causes of disease was confined to the quotation of the books referred to above as well, but endogenous causes of disease was developed. 6. Today is refered kidney and Aphasia. The cause of Aphasia obtained was as follows. The exogenous cause of disease is wind, wind and cold, wind and heat. The endogenous cause of disease is pregnancy, heart block of postpartum, weakness of heart and kidney, impairment of seven modes of emotions, stagnation of phlegm and phlegm-fire, hemorrhage. The non exo-endogenous causes of disease is sing ballads and call out.

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Association between periodontitis and preterm birth and low birth weight (임부의 치주염이 조산 및 저체중아 출산에 미치는 영향)

  • Ha, Jung-Eun
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.2
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    • pp.155-163
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    • 2016
  • The purpose of the review article is to investigate the influence of periodontal diseases on preterm birth(PTB) and low birth weight(LBW). PTB and LBW are the main risk factors of infant mortality and a major public health problem. PTB is defined as delivery at less than 37 weeks and LBW is less than 2,500 grams. Over Approximately 60 percent of perinatal mortality results from PTB or LBW. Although the causes of PTB and LBW are not fully understood, infection is the leading cause of PTB and LBW. Periodontal diseases are serious disease burdens because they are caused by bacterial endotoxin, inflammatory reaction, and cytokine. The periodontal diseases are the predisposing factors of cerebrovascular and cardiovascular diseases including atherosclerosis. Over the past 15 years, previous studies revealed that periodontitis had adverse outcomes including PTB and LBW in pregnancy.

A Clinical Study on the Incidental Pregnancies following Tubal Sterilization Surgery (난관불임술후 발생된 임신에 관한 임상적 고찰)

  • Suh, Byung-Hee;Lee, Jae-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.10 no.2
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    • pp.13-23
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    • 1983
  • In recent days, family planning is not only a problem limitted to our country but an important problem for the while world to solve. Up to present, various methods of sterilization have been developed for population control. When a patient with a previous tubal sterilization by operative method develops any symptoms and signs of pregnancy, we strongly consider it ectopic pregnancy and intrauterine pregnancy. As the cause of sterilization failure, we think that the tubal loop sloughs away and tubal ends either unite and recanalization results or heal and failure of union results in fistula. This present study considered of the 34 cases of ectopic pregnancies and 2 cases of intrauterine pregnancies after tubal sterilization by laparoscopy and Pomeroy's method, at the Dept. of Gynecol. in Kyung Hee University Hospital, during 6 years from Jan. 1977 to Dec. 1982. Authors take result in this study retrospectively. 1. Mean age was 33.7 years for the laparoscopic tubal sterilization group, 31.5 years for the Pomeroy tubal sterilization group. 2. The number of mean gravida and parity at the sterilization was 4.9, 2.8 for the laparoscopic tubal sterilization group, 4.2, 2.2 for the Pomeroy tubal sterilization group, :respectively. 3. The number of mean artificial abortion at the sterilization was all 2.2 for the laparoscopic and Pomeroy tubal sterilization groups. 4. Mean intervals from the tubal surgery to the incidental pregnancy was 3.2 years for the laparoscopic tubal sterilization group, and 3.8 years for the Pomeroy tubal sterilization group. 5. 63.3% of the laparoscopic tubal sterilization group had problem of inadequate tubal ligation, in comparison to having no inadequate problem in the Pomeroy tubal sterilization group. 6. The previous tubal sterilized scar was found to be 6 cases (17.6%) of inner portion, 15 cases (44.4%) of midportion, 13 cases (38.2%) of outer portion at the time of operation. The tubal site of ectopic pregnancy was found to be 23 cases (67.6%) of ampullary portion,S cases ( 4.7%) of isthmic and fimbrial portion, respectively. 7. The causes of table sterilization failure were, in order of frequency, technical error (19 cases), fistula formation (6 cases) and recanalization (5 cases) for the laparoscopic tubal sterilization group and fistula formation (2 cases), technical error (l case), recanalization (l case) fo the Pomeroy tubal sterilization group. 8. As the new applicated contraceptive method in incidental pregnant patient, Authors used 2 gravigard insertion for the two intrauterine pregnancy and 34 Pomeroys' tubal ligation, 2 total abdominal hysterectomy (due to associated pelvic inflammatory disease) for the 36 tubal pregnancy.

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A Study of clinical document in relation to Neuropsychiatric disease(Focusing of Ancient Chinese (Song<宋>, Keum<金>, Won<元>, Myung<明> clinical document) (신경정신과(神經精神科) 질환(疾患)과 관련(關聯)된 의안(醫案)의 연구(硏究) (중국(中國) 송(宋)$\cdot$금(金)$\cdot$원(元)$\cdot$명(明) 시대(時代) 의안(醫案)을 중심(中心)으로))

  • Kwon Bo-Hyung;Ku Byung-Su
    • Journal of Oriental Neuropsychiatry
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    • v.8 no.1
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    • pp.215-235
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    • 1997
  • according to study of clinical document in relation to Neuropsychiatric disease in Ancient Chinese(Song, Keum, Won, Myung) clinical document the result were obtained as follows. 1. A main point is Jeul-Jin<切診> in diagnosis, that is Hyun-Maeg<弦脈> is liver disease, Whual Mag<滑脈> is gallbladder disease, Sag Mag<數脈> is fever.2. Doctors in Song<宋>, Keum<金>,Won<元> enumerationed many diseases are cause by emotion.3. Oriental psychotherapy that Diseases caused by surprising must be cure by surprising is like to systematic desensitization in Westem.4. Oriental psychotherapy that pseudopsychosis must be cure by patient rely on doctor is like to suggestive therapy in western.5. It is similar to suggestive therapy in western medicine that Sadness ,anguish and frustration induce disease.6. Headache is caused by fever, energy deficience and angry.7. Imsomnia is not caused by hsart disease, but gallbladder or liver.8. Schizophrenia is caused by shocking and a sort of fever.9. Epilepsy is caused by a sort of fever, shocking and fetal disease.10 Schizophrenia(in case of manic state) is caused by fever and shocking, and imaginary pregnancy is considered as schizophrenia.

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