During pregnancy, exposure to fine particulate matter (PM_2.5), particularly diesel exhaust particles (DEPs), elevates the risk of placental dysfunction-related pregnancy complications; however, the underlying cellular mechanisms have yet to be fully elucidated. The objective of this study was to assess the effects of PM_2.5 exposure on trophoblast functions and their interaction with endometrial stromal cells. We utilized a three-dimensional (3D) model in which human first-trimester trophoblasts (Sw71) formed blastocyst-like spheroids and were cultured with human endometrial stromal cells (HESCs). Trophoblast proliferation, migration, invasion, and 3D network formation following DEP exposure (0.5–20 μg/mL) were assessed using methyl thiazolyl diphenyl-tetrazolium bromide (MTT), wound healing, migration, and invasion assays. The expression levels of genes related to the epithelial-mesenchymal transition (EMT) were quantified by real-time reverse-transcription quantitative polymerase chain reaction (RT-qPCR). DEP exposure significantly inhibited trophoblast proliferation, migration, and invasion. DEP treatment dysregulated the EMT program by significantly decreasing the expression of key mesenchymal markers (SNAI1, SNAI2, SOX2, and KLF4) while upregulating epithelial markers. These changes may be related to inhibited trophoblast migration toward HESC monolayers and 3D invasive network formation. DEP directly impairs critical trophoblast functions that are essential for successful pregnancy. Disruption of the EMT program represents a molecular mechanism by which traffic-related air pollution contributes to placental dysfunction and pregnancy complications, highlighting the significant reproductive risks posed by ambient air pollution.

Objective: To compare perioperative outcomes between robotic and conventional total laparoscopic hysterectomy in terms of operative time, intraoperative blood loss, and postoperative recovery in surgically complex cases. Methods: This retrospective cohort study included patients that underwent total laparoscopic hysterectomy between 2020 and 2022. As robotic surgery was preferentially applied to more complex cases in an effort to minimize the risk of open conversion, propensity score matching based on uterine weight and history of abdominal surgery was performed. The normality of continuous variables was assessed using the Shapiro–Wilk test; non-normally distributed variables are reported as median [interquartile range] and compared using the Mann–Whitney U test. Multivariate linear regression with log-transformed estimated blood loss was conducted to evaluate the independent association of surgical approach with hemostatic outcomes. Results: After 1:1 matching, 93 patients were analyzed per group. Robotic surgery was associated with longer operative time but lower estimated blood loss when compared with conventional laparoscopy. Postoperative hemoglobin decline, length of hospital stay, and complication rates were comparable between groups. In multivariate analysis, uterine weight and operative time were the primary determinants of estimated blood loss; surgical approach showed a modest, independent association with lower log-transformed estimated blood loss after adjustment for these factors. Conclusions: Robotic and conventional total laparoscopic hysterectomy demonstrated comparable perioperative safety profiles with different operative trade-offs. Observed differences in estimated blood loss reflect complex interactions between surgical difficulty, operative time, and instrumentation rather than inherent platform superiority. These findings support an individualized approach to surgical modality selection based on case complexity, to minimize risk of intraoperative complication leading to open conversion.

Background: Preeclampsia, a condition of high blood pressure during pregnancy, is linked to microangiopathy in various organs and may contribute to cancer development. This study aimed to evaluate cancer risk in women with newly diagnosed preeclampsia. Methods: We conducted a nationwide, population-based retrospective study using data from the Korean National Health Insurance claims database (2008–2020). Women diagnosed with preeclampsia between 2009 and 2013 were compared to a control group who underwent appendectomy but did not have preeclampsia. Participants with a prior cancer diagnosis were excluded. Cancer occurrence was assessed using the International Classification of Diseases, 10th revision codes. Results: Data from 42,380 preeclampsia patients and 105,327 controls were analyzed. Cancer incidence rates were 333.1 per 100,000 person-years in the preeclampsia group and 377.0 in controls. Preeclampsia was associated with significantly higher risks of gallbladder and biliary tract cancers (HR 5.49, 95% CI 1.23–24.50), breast cancer (HR 1.17, 95% CI 1.02–1.34), and thyroid cancer (HR 1.21, 95% CI 1.10–1.34). However, it was linked to lower risks of ovarian cancer (HR 0.44, 95% CI 0.27–0.74) and leukemia (HR 0.36, 95% CI 0.16–0.81). All hazard ratios were adjusted for age, which differed substantially between the two groups; unadjusted incidence rates and age-adjusted hazard ratios therefore differed in direction for some sites. Conclusions: Preeclampsia was associated with an increased risk of certain cancers, including breast and thyroid cancers, and with a decreased risk of ovarian cancer and leukemia. Because the control group was older than the preeclampsia group, crude incidence rates and age-adjusted hazard ratios differed in direction; the age-adjusted estimates should therefore be regarded as the primary findings. Several site-specific associations, particularly those based on small event counts (e.g., gallbladder and biliary tract cancer), should be interpreted as exploratory and warrant replication.

Background: Korean red ginseng (KRG) is widely used as a dietary supplement, but its effects on uterine leiomyoma growth and reproductive hormones are unclear. We evaluated whether KRG affects leiomyoma growth, routine laboratory indices, or endocrine profiles in premenopausal women with uterine leiomyoma managed expectantly. Methods: In this single-center, double-blind, randomized, placebo-controlled, parallel-group trial, premenopausal women aged 20 to 45 years with a uterine leiomyoma of 1 to 8 cm suitable for expectant management were allocated 1:1 to KRG 3 g/d or matching placebo for 6 months. Participants, investigators, ultrasonography examiners, and analysts were blinded. The primary outcome was the between-group difference in the 6-month change in maximal diameter of the index leiomyoma on ultrasonography, analyzed by analysis of covariance adjusted for baseline diameter. Secondary outcomes were complete blood count, ferritin, liver enzymes, and reproductive hormones. Results: Between December 2015 and September 2019, 69 participants were randomized (placebo 34, KRG 35) and 61 completed the 6-month assessment (placebo 30, KRG 31); all 8 noncompletions were losses to follow-up. Maximal diameter increased modestly in both groups, with no significant between-group difference in change (mean difference −0.11 cm; 95% confidence interval: −0.33 to 0.12; P = .34); the upper confidence limit lay below the prespecified target difference of 0.33 cm. There were no significant between-group differences in laboratory changes or in baseline-, age-, and body mass index-adjusted log scale hormone ratios, and the multivariate hormone profile did not differ between groups (Pillai’s trace = 0.056; P = .68). In exploratory post hoc analyses, the internal correlation structure among hormone changes was similar in both arms. No treatment-related serious adverse event and no discontinuation for intolerance was documented, although adverse events were ascertained passively. Conclusion: In premenopausal women with uterine leiomyoma managed expectantly, 6 months of KRG supplementation did not meaningfully alter leiomyoma growth, routine laboratory indices, or reproductive hormone homeostasis compared with placebo. Within the constraints of a modest sample size, incomplete characterization of the study product, and passive adverse-event ascertainment, these findings do not establish the safety of KRG, and they support no conclusion regarding nonserious adverse effects.