Browsing by Author "Nien, Jyh Kae"

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    A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for gestational age neonate
    (TAYLOR & FRANCIS LTD, 2008) Romero, Roberto; Nien, Jyh Kae; Espinoza, Jimmy; Todem, David; Fu, Wenjiang; Chung, Hwan; Kusanovic, Juan Pedro; Gotsch, Francesca; Erez, Offer; Mazaki Tovi, Shali; Gomez, Ricardo; Edwin, Sam; Chaiworapongsa, Tinnakorn; Levine, Richard J.; Karumanchi, S. Ananth
    Introduction. Accumulating evidence suggests that an imbalance between pro-angiogenic (i.e., vascular endothelial growth factor (VEGF) and placental growth factor (PlGF)) and anti-angiogenic factors (i.e., soluble VEGF receptor-1 (sVEGFR-1, also referred to as sFlt1)) is involved in the pathophysiology of preeclampsia (PE). Endoglin is a protein that regulates the pro-angiogenic effects of transforming growth factor , and its soluble form has recently been implicated in the pathophysiology of PE. The objective of this study was to determine if changes in maternal plasma concentration of these angiogenic and anti-angiogenic factors differ prior to development of disease among patients with normal pregnancies and those destined to develop PE (preterm and term) or to deliver a small for gestational age (SGA) neonate.
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    Could alterations in maternal plasma visfatin concentration participate in the phenotype definition of preeclampsia and SGA?
    (TAYLOR & FRANCIS LTD, 2010) Mazaki Tovi, Shali; Romero, Roberto; Kim, Sun Kwon; Vaisbuch, Edi; Kusanovic, Juan Pedro; Erez, Offer; Chaiworapongsa, Tinnakorn; Gotsch, Francesca; Mittal, Pooja; Nhan Chang, Chia Ling; Than, Nandor Gabor; Gomez, Ricardo; Nien, Jyh Kae; Edwin, Samuel S.; Pacora, Percy; Yeo, Lami; Hassan, Sonia S.
    Objective. Women with preeclampsia and those who delivered a small-for-gestational-age (SGA) neonate share several mechanisms of disease, including chronic uteroplacental ischemia and failure of physiologic transformation of the spiral arteries. However, the clinical manifestation of these obstetrical syndromes is remarkably different. It has been proposed that an altered maternal metabolic state, as well as a unique circulating cytokines milieu, predispose women to develop either preeclampsia or SGA. Compelling evidence suggests that adipose tissue orchestrates both metabolic pathways and immunological responses via the production of adipokines. Visfatin is a novel adipocytokine with metabolic and immunomodulating properties. The objective of this study was to determine whether preeclampsia and SGA are associated with alterations in maternal circulating visfatin concentrations.
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    Curva nacional de distribución de peso al nacer según edad gestacional. Chile, 1993 a 2000
    (2004) González P., Rogelio; Gómez M., Ricardo; Castro S., René; Nien, Jyh Kae; Merino O., Paulina; Etchegaray B., Alejandra; Carstens R., Mario; Medina H., Luis; Viviani García, Paola; Rojas T., Iván
    Background: The World Health Organization recently defined the criteria for constructing birth weight curves using population based data. Aim: To construct a national curve of weight, size and ponderal index at birth for Chile, following the criteria suggested by the World Health Organization (WHO) expert committee report from 1995. Material and methods: A national database from the Chilean Institute for Statistics was used. All alive singleton deliveries during the period from 1993 to 2000 were included. A birth weight curve for the total population as well as for size and ponderal index at birth was construted, including percentile distribution, mean and standard deviation of values for gestational age. Stratification by sex was performed. Results: A total of 2,049,446 singleton deliveries were analyzed. The 10 percentiles (raw data) for birth weight throughout gestation from 22 to 42 weeks were: 470, 520, 560, 630, 660, 749, 810, 926, 1,031, 1,160, 1,320, 1,480, 1,680, 1,920, 2,190, 2,500, 2,750, 2,910, 3,010, 3,080 and 3,090 g, respectively. Conclusions: A national birth weight for Chilean population (a predominant Hispanic population) was constructed. There are not differences between this curve and the standard proposed by WHO (population from California, USA) suggesting that under comparable perinatal indices, ethnicity is not a relevant factor determining birth weight.
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    Evidence for a polarized Th1 response in the maternal circulation in women with preterm labor and intra-amniotic inflammation/infection
    (2006) Espinoza, Jimmy; Kusanovic, Juan Pedro; Hassan, Sonia; Edwin, Samuel S.; Gotsch, Francesca; Kim, Chong Jai; Than, Nandor Gabor; Erez, Offer; Nien, Jyh Kae; Gómez Mora, Ricardo Alberto; Yoon, Bo Hyun; Romer, Roberto
    OBJECTIVE: Most work examining the immune response to intra-amniotic infection has focused on the study of amniotic fluid (AF) cytokines. An adequate characterization of the full range of maternal pro- and antiinflammatory cytokines is lacking. This is important, because of emerging evidence that complications of infection result from an anti-inflammatory response. The purpose of this study was to characterize the maternal cytokine response in women with preterm labor with and without intra-amniotic infection/inflammation (IAI). STUDY DESIGN: This study focused on patients with preterm labor in the following groups: 1) term delivery (n = 157); 2) preterm delivery without IAI (n = 126); and 3) IAI (n = 50). IAI was defined as a positive AF culture or an elevated AF WBC count. Maternal plasma concentrations of interleukin (IL)-1b, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, interferon gamma, granulocyte-macrophage colony-stimulating factor, and tumor necrosis factor alpha were determined. A p!0.05 was considered significant. RESULTS: 1) Patients with IAI had higher plasma concentrations of IL-6 than those without IAI who delivered preterm [median: 12.5 pg/ml, range: 0-355.5 vs.7.4 pg/ml, range: 0.74-179.3; p = 0.04), and those who delivered at term (median: 5 pg/ml, range: 0-541.4; p = 0.01); 2) Patients with IAI had higher plasma concentrations of IL-8 than those who delivered at term (median:11.1 pg/ml, range: 0.29-82 vs. median: 6 pg/ml, range: 0.4-84.3; p = 0.02) but not than those without IAI who delivered preterm (median: 7.9, range: 1.3-90.2; pO0.05); and 3) There were no significant differences in the plasma concentrations of the rest of the cytokines (11 of 13) among groups. CONCLUSION: IL6 and IL8 are increased in the maternal circulation in cases of intra-amniotic infection/inflammation. The lack of a demonstrable anti-inflammatory response is in sharp contrast to what has been reported in non-pregnant patients
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    Plasma protein Z concentrations in pregnant women with idiopathic intrauterine bleeding and in women with spontaneous preterm labor
    (TAYLOR & FRANCIS LTD, 2007) Kusanovic, Juan Pedro; Espinoza, Jimmy; Romero, Roberto; Hoppensteadt, Debra; Nien, Jyh Kae; Kim, Chong Jai; Erez, Offer; Soto, Eleazar; Fareed, Jawed; Edwin, Sam; Chaiworapongsa, Tinnakorn; Than, Nador G.; Yoon, Bo Hyun; Gomez, Ricardo; Papp, Zoltan; Hassan, Sonia S.
    Objectives. Preterm parturition has been associated with decidual vascular disorders and excessive thrombin generation. The objective of this study was to examine maternal plasma concentrations of protein Z in normal pregnancies, as well as in those presenting with spontaneous preterm labor (PTL) and intrauterine bleeding during pregnancy.
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    The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age
    (TAYLOR & FRANCIS LTD, 2008) Erez, Offer; Romero, Roberto; Espinoza, Jimmy; Fu, Wenjiang; Todem, David; Kusanovic, Juan Pedro; Gotsch, Francesca; Edwin, Samuel; Nien, Jyh Kae; Chaiworapongsa, Tinnakorn; Mittal, Pooja; Mazaki Tovi, Shali; Than, Nandor Gabor; Gomez, Ricardo; Hassan, Sonia S.
    Introduction. An imbalance between angiogenic and anti-angiogenic factors has been proposed as central to the pathophysiology of preeclampsia (PE). Indeed, patients with PE and those delivering small-for-gestational age (SGA) neonates have higher plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and the soluble form of endoglin (s-Eng), as well as lower plasma concentrations of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) than do patients with normal pregnancies. Of note, this imbalance has been observed before the clinical presentation of PE or the delivery of an SGA neonate. The objective of this study was to determine if changes in the profile of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters are associated with a high risk for the subsequent development of PE and/or delivery of an SGA neonate.