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Delayed postpartum regression of theca lutein cysts with maternal virilization: A case report

  • Kim, Sanghwa;Lee, Inha;Park, Eunhyang;Rhee, Yeo Jin;Kim, Kyeongmin;Aljassim, Aminah Ibrahim;Park, Joo Hyun;Lee, Jae Hoon;Yun, Bo Hyon;Seo, Seok Kyo;Cho, Sihyun;Choi, Young Sik;Lee, Byung Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.4
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    • pp.380-384
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    • 2021
  • Theca lutein cysts are rare, benign lesions responsible for gross cystic enlargement of both ovaries during pregnancy. This condition is also termed hyperreactio luteinalis. Elevated human chorionic gonadotropin (hCG) levels or states of hCG hypersensitivity seem to promote these changes, which in up to 30% of patients produce clinical signs of hyperandrogenism. Given the self-limiting course of theca lutein cysts, which are subject to spontaneous postpartum resolution, conservative treatment is the mainstay of patient management. Described herein is a rare case of theca lutein cysts with maternal virilization that failed to regress by 9 months after childbirth. Surgical intervention was eventually undertaken, necessitated by adnexal torsion.

Study on the families' participation need for labour women (산부가족의 분만참여 요구)

  • Chang, Soon-Book;Choi, Yun-Soon;Kim, Hae-Sook;Cho, Young-Sook;Lee, Hae-Woo
    • The Korean Nurse
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    • v.31 no.3
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    • pp.62-75
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    • 1992
  • This study was done to suggest basic modifications in the present situation for the family of women in labour which is a separation management method. The study design was a descriptive study. The number of the subjects were 80. they were husbands, mothers in law, and mothers of women in labour who were full term and for whom there were no complications, either for the mother or the fetus. Data collection was done with a structured questionnaire which was analyzed using frequencies. The results were as follows, 1. Most of the subjects(95.0%) wanted to participate in the labour process. 2. The subjects wanted to support the women in labour by way of encouraging(95.0%), consoling (95.0%), listening to(75.0%), praying with(68.8%), hand holding(97.5%), stroking(63.8%), helping with respiration control(50.0%), maintaining relaxation(46.3%), changing position(58.8%), and illustration (58.8 %). 3. The subjects answered that they expected their participation to have the effect of an easier labour course(52.5%), security for the women in labour(95.0%), and providing a better relationship between the women in labour(66.3%) and the new baby(55.0%). 4. The priority of the response as to who is the best supporter was husband, and mother of the women in labour in that order. It can be concluded that nurses maintained a management method which ignored the needs of the families of women in labour. If given consideration is to be given to these subjects, future programs should initiate ways to let the families participate in the labour process.

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Polymorphisms of 5, 10-Methylentetrahydrofolate Reductase (MTHFR C677T) and Methionine Synthase Reductase (MTRR A66G) as Maternal Risk Factors for Fetal Aneuploidy (태아의 염색체의 수적 이상을 유발하는 모계 위험인자로서 5, 10-Methylentetrahydrofolate Reductase (MTHFR C677T)와 Methionine Synthase Reductase (MTRR A66G) 유전자의 다형성 연구)

  • Kim, Do-Jin;Kim, Shin-Young;Park, So-Yeon;Kim, Jin-Woo;Kim, Moon-Young;Han, Joung-Yeol;Yang, Jae-Hyug;Ahn, Hyun-Kyong;Choi, Jun-Seek;Chung, Jin-Hoon;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.5 no.2
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    • pp.119-124
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    • 2008
  • Purpose: Aneuploidy is the cause of diseases such as Down syndrome or Edward syndrome and, more generally, is a major cause of mental retardation and fetal loss. The purpose of this study was to evaluate the association between MTHFR (C677T) or MTRR (A66G) polymorphisms and fetal aneuploidy. Materials and Methods: Data was collected from 37 women who had a fetus with aneuploidy (cases) and 78 women who had previously delivered at least two healthy children without aneuploidy and did not have a history of miscarriage or abnormal pregnancy (controls). The MTHFR (C677T) or MTRR (A66G) polymorphisms were analyzed by PCR-restriction fragment length polymorphism assay. Results: The frequencies of the MTHFR 677 CC, CT, and TT genotypes were 30.7%, 48.7%, and 20.6% in the control group and 37.8%, 48.6%, and 13.5% in the case group, respectively. There were no significant differences in genotype frequencies between the two groups. For the MTRR A66G polymorphism, the frequencies of the AA, AG and GG genotypes were 50%, 46.1%, and 3.9% in the control group and 13.5%, 81.1%, and 5.4% in case group, respectively. The frequency of the MTRR AG mutant was significantly increased in the case group, with an odds ratio of 6.5 (95% CI: 2.3-18.6, P<0.05). Conclusion: The results of this study suggest that mother carriers with the MTRR G allele have an increased risk of fetal aneuploidy, while the MTHFR T allele is not associated with increased risk of fetal aneuploidy. The MTRR A66G polymorphism may be a risk factor for producing a child with chromosomal aneuploidy.

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Risk Factors for Preterm Birth and Low Birth Weight Among Pregnant Indian Women: A Hospital-based Prospective Study

  • Tellapragada, Chaitanya;Eshwara, Vandana Kalwaje;Bhat, Parvati;Acharya, Shashidhar;Kamath, Asha;Bhat, Shashikala;Rao, Chythra;Nayak, Sathisha;Mukhopadhyay, Chiranjay
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.3
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    • pp.165-175
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    • 2016
  • Objectives: The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes. Methods: A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI). Results: Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent's intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height <1.50 m (ARR, 2.21; 95% CI, 1.1 to 4.1) were risk factors for PTB, while periodontitis (ARR, 3.38; 95% CI, 1.6 to 6.9), gestational hypertension (ARR, 3.70; 95% CI, 1.3 to 10.8), maternal height <1.50 m (ARR, 2.66; 95% CI, 1.3 to 5.1) and genital infection during later stages of pregnancy (ARR, 2.79; 95% CI, 1.2 to 6.1) were independent risk factors for LBW. Conclusions: Our study findings underscore the need to consider screening for potential genitourinary and periodontal infections during routine antenatal care in developing countries.

The Association between the Subjective Perception of the Regional Healthcare Environment and Unmet Medical Needs (지역의 의료서비스 환경에 대한 주관적 인식과 연간 미충족의료 발생 간의 연관성)

  • Seohyun Woo;Hyun Woo Moon;Yeong jun Lee;Sun jung Kim
    • Korea Journal of Hospital Management
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    • v.28 no.4
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    • pp.62-72
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    • 2023
  • Based on the basic ideology of health care, this study realized the seriousness of annual unmet medical need and conducted a study to confirm the relationship between the subjective perception of regional healthcare environment and unmet medical needs. The independent variable was classified into attitude 'satisfaction' and 'unsatisfaction' toward regional healthcare, and the dependent variable was classified as whether unmet medical needs occurred annually. Based on previous studies, the control variables were selected as demographic and socioeconomic characteristics that can affect the occurrence of unmet medical care annually and characteristics related to health behavior. Descriptive statistics were conducted for each variable on the extracted sample, and multivariate survey logistic regression analysis was conducted to confirm the association between variables. As a result, more unmet medical needs occurred annually than those who were satisfied with the medical services in the area where they lived. In addition, more unmet medical need occurred annually in "unsatisfied" households compared to households "satisfied" with local medical services. In residential areas, women live in "metropolis" and "rural areas" compared to "urban," women live in men, lower education levels, and poor subjective health levels, and less satisfied with local medical services. As such, the impact of environmental factors in the community on the use of health and medical services is one of the major areas of interest in the field of health science, such as health policy and social dynamics. Therefore, hospitals in each region need to make efforts in terms of hospital management to increase the overall satisfaction of medical services in the region by continuously monitoring the attitude of residents to achieve universal health security, and policymakers should also be interested and propose new policies.

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Risk factors for cytological progression in HPV 16 infected women with ASC-US or LSIL: The Korean HPV cohort

  • So, Kyeong A;Kim, Seon Ah;Lee, Yoo Kyung;Lee, In Ho;Lee, Ki Heon;Rhee, Jee Eun;Kee, Mee Kyung;Cho, Chi Heum;Hong, Sung Ran;Hwang, Chang Sun;Jeong, Mi Seon;Kim, Ki Tae;Ki, Moran;Hur, Soo Young;Park, Jong Sup;Kim, Tae Jin
    • Obstetrics & gynecology science
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    • v.61 no.6
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    • pp.662-668
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    • 2018
  • Objective This study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL). Methods We analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20-60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing. Results Of the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08-2.84; P=0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (P<0.001). Logistic regression analysis showed a significant relationship between cigarette smoking and cytological progression (RR, 4.15; 95% CI, 1.01-17.00). Conclusion The cytological progression rate in HPV 16-positive women with ASC-US or LSIL is higher than that in women infected with other HPV types. Additionally, cigarette smoking may play a role in cytological progression.

BTEX Exposure and its Health Effects in Pregnant Women Following the Hebei Spirit Oil Spill (허베이 스피릿호 유류유출사고 지역 산모의 BTEX 노출과 건강영향)

  • Kim, Byung-Mi;Park, Eun-Kyo;LeeAn, So-Young;Ha, Mi-Na;Kim, Eun-Jung;Kwon, Ho-Jang;Hong, Yun-Chul;Jeong, Woo-Chul;Hur, Jong-Il;Cheong, Hae-Kwan;Yi, Jong-Heop;Kim, Jong-Ho;Lee, Bo-Eun;Seo, Ju-Hee;Chang, Moon-Hee;Ha, Eun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.2
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    • pp.96-103
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    • 2009
  • Objectives : We evaluated the health effects of exposure to BTEX(Benzene, Toluene, Ethylbenzene, m,p-Xylene, o-Xylene) in the Taean area after the Hebei Spirit oil spill. Methods : We used a questionnaire survey to look for health effects among 80 pregnant women 2 to 3 months following the Hebei Spirit oil spill. Their BTEX exposures were estimated using the CALPUFF method. We then used a multiple logistic regression analysis to evaluate the effects of BTEX exposure on the women s health effets. Results : Pregnant women who lived near the accident site reported more symptoms of eye irritation and headache than those who lived farther from the site. There was a trend of decreasing symptoms with an increase in distance from the spill site. Pregnant women exposed to higher ambient cumulative levels of Xylene were significantly more likely to report symptoms of the skin(OR 8.01 95% CI=1.74-36.76) in the first day after the accident and significantly more likely to report abdominal pain(OR 3.86 95% CI=1.02-14.59 for Ethylbenzene, OR 6.70 95% CI=1.82-24.62 for Xylene) during the 1st through 4th days following the accident. Conclusions : This study suggests that exposure to BTEX from an oil spill is correlated with an increased risk of health effects among pregnant women. This implies the need to take proper measures, including the development of a national policy for environmental health emergencies and a plan for studying the short- and long-term chronic health effects associated with such spills.

Clinical Evaluation of Human Papillomavirus Detection by careHPVTM Test on Physician-Samples and Self-Samples using The Indicating FTA Elute® Card

  • Wang, Shao-Ming;Hu, Shang-Ying;Chen, Feng;Chen, Wen;Zhao, Fang-Hui;Zhang, Yu-Qing;Ma, Xin-Ming;Qiao, You-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7085-7090
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    • 2014
  • Objective: To make the clinical evaluation of a solid-state human papillomavirus (HPV) sampling medium in combination with an economical HPV testing method ($careHPV^{TM}$) for cervical cancer screening. Methods: 396 women aged 25-65 years were enrolled for cervical cancer screening, and four samples were collected. Two samples were collected by woman themselves, among which one was stored in DCM preservative solution (called "liquid sample") and the other was applied on the Whatman Indicating FTA $Elute^{(R)}$ card (FTA card). Another two samples were collected by physician and stored in DCM preservative solution and FTA card, respectively. All the samples were detected by $careHPV^{TM}$ test. All the women were administered a colposcopy examination, and biopsies were taken for pathological confirmation if necessary. Results: FTA card demonstrated a comparable sensitivity of detecting high grade Cervical Intraepithelial Neoplasia (CIN) with the liquid sample carrier for self and physician-sampling, but showed a higher specificity than that of liquid sample carrier for self-sampling (FTA vs Liquid: 79.0% vs 71.6%, p=0.02). Generally, the FTA card had a comparable accuracy with that of Liquid-based medium by different sampling operators, with an area under the curve of 0.807 for physician &FTA, 0.781 for physician &Liquid, 0.728 for self & FTA, and 0.733 for self &Liquid (p>0.05). Conclusions: FTA card is a promising sample carrier for cervical cancer screening. With appropriate education programmes and further optimization of the experimental workflow, FTA card based self-collection in combination with centralized $careHPV^{TM}$ testing can help expand the coverage of cervical cancer screening in low-resource areas.

Expression of Osteopontin in Eutopic and Ectopic Endometrial Tissues in Endometriosis (자궁내막증 환자의 정상위치 및 이소성 자궁내막에서의 Osteopontin의 발현)

  • Koo, Yun-Hee;Kim, Chung-Hoon;Kim, Ji-Sun;Lee, Young-Jin;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.3
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    • pp.149-157
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    • 2007
  • Objective: This study was performed to compare the expression of osteopontin (OPN) mRNA and protein in the eutopic and ectopic endometrial tissues in women with endometriosis and endometrial tissues in women without endometriosis. Methods: A total of 32 women with histologically confirmed endometriosis were recruited for study group. For controls, 34 women undergoing operative treatment for cervical intraepithelial neoplasia (CIN) or benign gynecologic condition other than endometriosis were recruited. At the time of laparoscopy or laparotomy, a biopsy specimen was taken from the endometrial cavity and peritoneal endometrial implant or endometrioma whenever appropriate. We employed real time quantitative RT-PCR to quantify OPN mRNA expression of these tissues and performed western blot analysis to measure the quantity of OPN. Results: The expression of OPN mRNA was significantly higher in both eutopic and ectopic endometrial tissues of women with endometriosis than in endometrial tissues of controls during both proliferative and secretory phase. In the eutopic endometrial tissue of women with endometriosis, OPN mRNA expression significantly increased during the secretory phase compared to the proliferative phase in women with endometriosis as well as controls. However, in the ectopic endometrial tissue, OPN mRNA expression significantly decreased during the secretory phase compared to the proliferative phase. The expression of OPN protein was significantly higher in women with endometriosis than in controls. Conclusion: This study shows the marked expression of OPN mRNA and protein in eutopic and ectopic endometrial tissues in women with endometriosis may be associated with the adhesion and invasion of endometrial explants.