The Level of Serum and Urinary Nephrin in Normal Pregnancy and Pregnancy with Subsequent Preeclampsia.

PURPOSE: The aim of this study was to evaluate serum and urinary nephrin levels of normal pregnancy to establish a standard reference value and to compare them with patients who subsequently developed preeclampsia (PE). MATERIALS AND METHODS: In this prospective study, 117 healthy singleton pregnancies were enrolled between 6 to 20 weeks of gestation at 2 participating medical centers during October 2010 to March 2012. Urine and serum samples were collected at the time of enrollment, each trimester, and at 4 to 6 weeks postpartum. Enzyme-linked immunosorbent assay for nephrin was performed and samples from patients who subsequently developed PE were compared to the normal patients. RESULTS: Of 117 patients initially enrolled, 99 patients delivered at the study centers and of those patients, 12 (12.1%) developed PE at a median gestational age of 34⁺4 weeks (range 29⁺5-36⁺6). In the normal patients (n=68), serum nephrin level decreased and urinary nephrin level increased during the latter of pregnancy. In 12 patients who subsequently developed PE, a significant rise in the 3rd trimester serum and urinary nephrin levels, compared to the controls, was observed (p<0.001), and this increase occurred 9 days prior to the onset of clinical disease. CONCLUSION: As the onset of PE was preceded by the rise in the serum and urinary nephrin in comparison to normal pregnancy, serum and urinary nephrin may be a useful predictive marker of PE.

Lymph node metastasis in a gynecologic malignancy.

A radical hysterectomy was performed on patients with stage IA2 to IIB cervical cancer. For these patients, many histopathological parameters have been reported to be prognostic factors of cervical cancer, such as a pelvic lymph node (PLN) metastasis, the histological subtype, the tumor diameter, the depth of the stromal invasion, a lymph-vascular space invasion (LVSI), a parametrial invasion, a corpus invasion and a vaginal invasion. Ovarian cancer is normally treated with cytoreductive surgery followed by chemotherapy. Although physicians have paid a great deal of attention to intraperitoneal disease, a substantial number of ovarian cancers have reported to involve the retroperitoneal lymph nodes. Therefore, a lymph node metastasis has been introduced into FIGO staging. However, the prognostic significance of a lymph node metastasis is controversial. In order to determine the possibility of individualizing a pelvic lymph node (PLN) dissection in patients with endometrial cancer, the relationship between PLN metastasis and the various prognostic factors was investigated. In this paper, various prognostic variables including a lymph node metastasis were analyzed in cervical cancer, endometrial cancer, and ovarian cancer.

Menopause and blood mercury levels: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011.

This study aimed to evaluate the association between menopause and blood mercury concentrations in South Korean women. Women aged ≥20 years who participated in the Korean National Health and Nutrition Examination Survey 2008-2011 were included in this study. Primary and secondary analyses included women aged ≥20 years (n = 1,642) and 45-55 years (i.e., perimenopausal; n = 325), respectively. For all analyses, the mercury levels were log-transformed. The linear regression model for mercury levels was adjusted for age, body mass index, household income, menopausal status, hormone replacement therapy, use of oral contraceptives, smoking history, alcohol intake, physical activity, number of pregnancies, serum ferritin levels, and fish consumption. After adjusting for covariates, log-transformed blood mercury levels were significantly lower in women who were menopausal [ß-coefficient -0.1488; 95 % confidence interval -0.2586, -0.0389; P = 0.01) than in those who were premenopausal. A similar relationship was identified in perimenopausal women (ß-coefficient -0.1753; 95 % confidence interval -0.3357, -0.015; P = 0.03). The blood mercury concentration was lower in postmenopausal women than in premenopausal women. There was a significant positive correlation between blood mercury concentrations and both the frequency of alcohol intake and serum ferritin levels.