This review summarizes the epidemiology of cancer of the female reproductive system and associated lifestyle factors. It also assesses the available evidence for occupational factors associated with these cancers. Cervical, endometrial, and ovarian cancers are relatively common, and cause significant cancer morbidity and mortality worldwide, whereas vulvar, vaginal, fallopian tube cancers, and choriocarcinomas are very rare. As several lifestyle factors are known to play a major role in the etiology of these cancers, very few published studies have investigated possible relationships with occupational factors. Some occupational exposures have been associated with increased risks of these cancers, but apart from the available evidence on the relationships between asbestos fibers and ovarian cancer, and tetrachloroethylene and cervical cancer, the data is rather scarce. Given the multifactorial nature of cancers of the female reproductive system, it is of the utmost importance to conduct occupational studies that will gather detailed data on potential individual confounding factors, in particular reproductive history and other factors that influence the body's hormonal environment, together with information on socio-economic status and lifestyle factors, including physical activity from multiple sources. Studies on the mechanisms of carcinogenesis in the female reproductive organs are also needed in order to elucidate the possible role of chemical exposures in the development of these cancers.
Kim, Jongsoo;Yun, Hyo Jung;Lee, Ji-Yeon;Kim, Myoung Hee
대한의생명과학회지
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제21권1호
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pp.15-22
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2015
Dexamethasone, a synthetic glucocorticoid (GC), is clinically administered to woman at risk for premature labor to induce fetal lung maturation. However, exposure to repeated or excess GCs leads to intrauterine growth restriction (IUGR) and subsequently increases risk of psychiatric and cardio-metabolic diseases in later life through fetal programming mechanisms. GCs are key mediators of stress responses, therefore, maternal nutrient restriction or psychological stress during pregnancy also causes negative impacts on birth and neurodevelopment outcome of fetuses, and other congenital defects, such as craniofacial and skeletal abnormalities. In this study, to examine the effect of prenatal stress on fetal skeletal development, dexamethasone (1 mg/kg [DEX1] or 10 mg/kg [DEX10] maternal body weight per day) was administered intraperitoneally at gestational day 7.5~9.5 and the skeletons were prepared from embryos at day 18.5. Seven out of eighteen (39%) embryos treated with DEX10 showed axial skeletal abnormalities in either the T13 or L1 vertebrae. In addition, examination of the sternum revealed that xiphoid process, the protrusive triangular part of the lower end of the sternum, was bent more outward or inward in DEX group embryos. In conclusion, our findings suggest a possible link to the understanding of the effect of uterine environment to the fetal skeletal features.
Early extra-uterine development of the newborn infant has the potential for clarifying important questions of nature and care taking environment. In this study, tactile and auditory stimulation is used on .a group of infants to determine the effects of their response. Infants were tested by EKG at 24∼48 hrs after birth ana all they are free from complication. Stimuli presented were-touch and sound (40dB, 70dB and 40∼70dB). The result of the study were as follows: 1) The heart rate was seen to depend on their sleep-wake state. (light sleep ; 125/min, eyes: open & motor activity increase ; 151/min crying ; 185/min). 2) The heart rate affected by tactile & auditory stimulus. The heart rate response was acceleration above the prestimulus level. (tactile, 231min increase, auditory ; 16∼21/min increase), and heart rate change was seen to depend on prestimulus rate. (γ=.73) 3) There was a decrease in heart rate when they were soothe. (touch ; 24.8sec, 21/min decrease, pacifier ; 14.5sec, 26/min decrease) and significant difference in time between touch and pacifier (t= 1.76, p<0.05). This result support the evaluation of newborn infant's sensory abilitics, and has even begin to influence changes in nursing care. But systemic monitoring of newborn infants response would. further define.
Purpose: To provide accurate information on induced labor and find strategies to enhance women's childbirth satisfaction. Methods: Participants were pregnant women expected to have normal vaginal delivery. A total of 113 women with induced labor and 61 women with spontaneous labor were surveyed. Data were collected using a questionnaire and electronic medical records. Results: The following variables related to labor progress showed significant differences between the induced labor group and the spontaneous labor group: length of the first stage of labor in primigravidas, use of analgesic, incidence of uterine hyperstimulation, incidence of fetal distress, and medical treatment for the expectant mother. Delivery type and the incidence of postpartum complications showed significant difference between the two groups. Induced labor women's childbirth satisfaction was mainly affected by the process of labor whereas spontaneous labor women's childbirth satisfaction was affected by the outcome of childbirth. Conclusion: Medical staff should have accurate information on the risk of induced labor and the benefits of a natural delivery. Moreover, medical staff should provide necessary information and environment for women to participate in the decision-making process.
Kim, Juhye;Cha, Sunyeong;Lee, Min Young;Hwang, Yeon Jeong;Yang, Eunhyeok;Ryou, Chongsuk;Jung, Hyo-Il;Cheon, Yong-Pil
한국발생생물학회지:발생과생식
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제22권4호
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pp.379-391
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2018
Through the development of organic synthetic skill, chemicals that mimic signaling mediators such as steroid hormones have been exposed to the environment. Recently, it has become apparent that this circumstance should be further studied in the field of physiology. Estrogenic action of chronic low-dose nonylphenol (NP) and di-(2-ethylhexyl) phthalate (DEHP) in mouse uterus was assessed in this study. Ten to twelve-week-old female mice (CD-1) were fed drinking water containing NP (50 or $500{\mu}g/L$) or DEHP (133 or $1,330{\mu}g/L$) for 10 weeks. Uterine diameter, the thickness of myometrium and endometrium, and the height of luminal epithelial cells were measured and the number of glands were counted. The expression levels of the known $17{\beta}$-estradiol ($E_2$)-regulated genes were evaluated with real-time RT-PCR methodology. The ration of uterine weight to body weight increased in $133{\mu}g/L$ DEHP. Endometrial and myometrial thickness increased in 133 and $1,330{\mu}g/L$ DEHP treated groups, and in 50, $500{\mu}g/L$ NP and $133{\mu}g/L$ DEHP, respectively. The height of luminal epithelial cell decreased in NP groups. The numbers of luminal epithelial gland were decreased in NP groups but increased in $50{\mu}g/L$ DEHP group. The histological characters of glands were not different between groups. The mRNA expression profiles of the known $17{\beta}$-estradiol ($E_2$) downstream genes, Esr1, Esr2, Pgr, Lox, and Muc1, were also different between NP and DEHP groups. The expression levels dramatically increased in some genes by the NP or DEHP. Based on these results, it is suggested that the chronic low-dose NP or DEHP works as estrogen-like messengers in uterus with their own specific gene expression-regulation patterns.
The purpose of this study was to evaluate the effects on maternal-fetal attachment and self efficacy for delivery using the Taekyo-oriented prenatal class. This class is for 2 hours/week for 4 weeks. The program covers the contents of fetal growth and development including their responding ability, the importance of the uterine environment, sharing the motive and purpose of pregnancy, sharing experiences about pregnancy, sharing of prejudices against delivery, training of maternal-fetal interaction, understanding delivery, relaxation breathing techniques, maternity exercises, writing letters or prayers to the baby, and declaration of loving the baby. This study took place from March 4th to June 15th, 2000, in a university hospital and community care center, and was done by with a pretest-posttest design, with 55 pregnant women who were within 32-36 weeks pregnant and who agreed to participate in this study. Data was measured twice by self-report by the Cranley's Maternal-fetal Attachment Scale(MFAS, 1981), and the Shin's(1997) Self Efficacy for Delivery Scale at the beginning and at the completion of the class. Data was analyzed by SAS. The study results were: 1. The score of maternal-fetal attachment was significantly increased after the Taekyo perspective prenatal class than before the class. (t=7.389, p=0.000) 2. The score of self efficacy for delivery was significantly increased after the Taekyo perspective prenatal class than before the class. (t=8.885, p=0.000) The above results proved that the present Taekyo perspective prenatal education program was effective in increasing maternal-infant attachment and self efficacy for delivery. Therefore, it is concluded that the existing prenatal class should include Taekyo perspective elements. However, further study is needed to compare the effects with preexisted prenatal class.
Human pregnancy is a delicate and complex process where multiorgan interactions between two independent systems, the mother, and her fetus, maintain pregnancy. Intercellular interactions that can define homeostasis at the various cellular level between the two systems allow uninterrupted fetal growth and development until delivery. Interactions are needed for tissue remodeling during pregnancy at both fetal and maternal tissue layers. One of the mechanisms that help tissue remodeling is via cellular transitions where epithelial cells undergo a cyclic transition from epithelial to mesenchymal (EMT) and back from mesenchymal to epithelial (MET). Two major pregnancy-associated tissue systems that use EMT, and MET are the fetal membrane (amniochorion) amnion epithelial layer and cervical epithelial cells and will be reviewed here. EMT is often associated with localized inflammation, and it is a well-balanced process to facilitate tissue remodeling. Cyclic transition processes are important because a terminal state or the static state of EMT can cause accumulation of proinflammatory mesenchymal cells in the matrix regions of these tissues and increase localized inflammation that can cause tissue damage. Interactions that determine homeostasis are often controlled by both endocrine and paracrine mediators. Pregnancy maintenance hormone progesterone and its receptors are critical for maintaining the balance between EMT and MET. Increased intrauterine oxidative stress at term can force a static (terminal) EMT and increase inflammation that are physiologic processes that destabilize homeostasis that maintain pregnancy to promote labor and delivery of the fetus. However, conditions that can produce an untimely increase in EMT and inflammation can be pathologic. These tissue damages are often associated with adverse pregnancy complications such as preterm prelabor rupture of the membranes (pPROM) and spontaneous preterm birth (PTB). Therefore, an understanding of the biomolecular processes that maintain cyclic EMT-MET is critical to reducing the risk of pPROM and PTB. Extracellular vesicles (exosomes of 40-160 nm) that can carry various cargo are involved in cellular transitions as paracrine mediators. Exosomes can carry a variety of biomolecules as cargo. Studies specifically using exosomes from cells undergone EMT can carry a pro-inflammatory cargo and in a paracrine fashion can modify the neighboring tissue environment to cause enhancement of uterine inflammation.
Objectives : The uterus plays an important role in the woman's body. In Korean Medical literature, the uterus is mentioned in various contexts according to different perspectives on its meaning and function. An examination of these various contexts is crucial in understanding the meaning of the uterus and to better understand and approach woman's body. Methods : Aside from the most widely used term Jagung(子宮), there were various terms used to refer to the uterus. Based on a list of these terms, the Siku Qianshu collection of medical literatures was investigated. Contents related to the definition, shape, location, function were extracted and examined. Results : Among the findings, first, there were various terms referring to the uterus similar to contemporary understanding. Some of them referred to the uterus as a whole, while others referred to specific parts, one of which is the placenta. Some reflected a broader perspective on the meaning of the uterus. Second, the functions of the uterus could be summarized as gate keeping, and the maintenance of uterine environment that is related to menstruation, pregnancy, and childbirth. Third, based on the examination of the meaning of the uterus and its functions, perspectives on the uterus in Korean Medicine could be summarized into two. Conclusions : One viewed uterus as an organ dedicated to reproduction, similar to today's common understanding. According to this view, uterus is a special organ specific to women, which functions as an incubator for the fetus. The other viewed the uterus as an intangible source of life in the woman's body. As a general source of life to all human beings, it is not a passive organ but functions as an active source in woman's life phenomena. The two perspectives are not in conflict, but rather reflect the broad range of thought on the concept of the uterus in Korean Medicine. In today's biomedical society, the diversity and flexibility of these perspectives could shed light on medical practices that have resulted from extreme views on the woman's body.
Objectives : While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. Methods : Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. Results : Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. Conclusions : Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.
The purpose of the present study was to investigate the effect of IFN-${\tau}$ on prostaglandin synthesis, cyclooxygenase-2 (COX-2) gene expression in vitro and concentration of progesterone (P4) in endometrial cells. Epithelial and stromal cells cultured in vitro were isolated from bovine endometrium and stimulated with increasing doses of IFN-${\tau}$ (0, 0.02, 0.2 and 2 ug/ml). Human chorionic gonadotropin (hCG, 1.5 IU/ml) was used as a positive control. Prostaglandin $E_2$ and $F_{2{\alpha}}$ levels in the culture media were analyzed by enzyme immunoassays and total RNA was extracted from the cells for RT-PCR. P4 concentrations of blood samples were assayed by chemiluminescent immuno assays system. In epithelial cells, COX-2 gene expression was increased in the presence of IFN-${\tau}$ (p<0.05), but it was not significantly different in all groups of stromal cells except for 2 ug/ml IFN-${\tau}$ group (p<0.05). Although IFN-${\tau}$ did not affect $PGE_2$ and $PGF_{2{\alpha}}$ production in epithelial cells, it decreased $PGE_2$ and $PGF_{2{\alpha}}$ production significantly in stromal cells (p<0.05). In vivo experiment, blood concentration of P4 was significantly increased after addition of IFN-${\tau}$ (1 ug/ml). The results indicate that PG production was mediated by COX-2 expression in stromal cells but it was not affected in epithelial cells and this suggest that treatment of IFN-${\tau}$ could improve the implantation environment of uterine by maintenance of high P4 concentration.
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