OBJECTIVE: Preterm labor and delivery is probably the largest problem in modern perinatology. The early diagnosis of preterm labor is crucial for prevention of preterm birth. To predict the onset of preterm labor, we examined the diagnostic performance of serial cervical assessment by transvaginal sonography. METHODS: In this prospective study, we performed transvaginal sonography at approximately 30 and 34 weeks of gestation in women with singleton pregnancies. Cervical parameters evaluated included endocervical length, the presence of funneling, funnel length and funnel width. We then assessed the relation between cervical parameters and the risk of spontaneous preterm labor. RESULTS: We examined 258 women at approximately 30 weeks of gestation and 247 of these women again at approximately 34 weeks. Spontaneous preterm labor occurred in 9 of women examined at 30 weeks(Group 1) and in 13 at 34 weeks(Group 2). The endocervical length was normally distributed at 30 and 34 weeks(mean +/-SD, 38.26+/-6.82mm and 35.63+/-7.35mm, respectively). The endocervical length decreased significantly from 30weeks to 34 weeks(p=0.0001). Both groups showed significantly shorter endocervical length(p <0.05) and groupl more presence of funneling than group of term pregnancy(p<0.05). Receiver-operator characteristic curve and multiple logistic regression analyses indicated that endocervical length <-30mm at 30 weeks and <-25mm at 34 showed highest diagnostic index in predicting the onset of preterm labor(p=0.0001). Conclusions: Serial transvaginal ultrasound assessment of endocervical length during early third trimester is a useful predictor of preterm labor and delivery in low-risk patients.
Early Diagnosis ; Female ; Humans ; Logistic Models ; Obstetric Labor, Premature* ; Perinatology ; Pregnancy ; Pregnancy Trimester, Third ; Premature Birth ; Prospective Studies ; Ultrasonography

INTRODUCTION: The prevalence of irritable bowel syndrome (IBS) after excluding organic disease has not been reported in Korea. METHODS: Of 5,605 participants in a health screening program, inclusion criteria were persons who underwent colonoscopy and completed questionnaires. Exclusion criteria were persons diagnosed with colon cancer, inflammatory bowel disease, previous colectomy, and abnormal results of thyroid function tests. IBS was defined by Rome III criteria. Physical and psychological stress was evaluated with visual analogue scales, ranging from 0 to 10. Risk factors for IBS were estimated with odds ratios (OR) and 95% confidence intervals (CI) using logistic regression analysis. RESULTS: The prevalence of IBS was 8.2% (5,605) in the total population and 9.1% (393/4,296) in the final study sample. IBS had a positive association with female sex (adjusted OR, 1.33; 95% CI, 1.00-1.79; p = 0.05) and current smoking (adjusted OR, 1.31; 95% CI, 1.00-1.71; p = 0.05). The prevalence of IBS increased with increased psychological stress (adjusted p for trend = 0.005) and decreased with increasing age (adjusted p for trend <0.001), with adjusted OR of 0.95 (95% CI, 0.68-1.33) for age of 40.0 to 49.9 years; 0.79 (95% CI, 0.54-1.15) for age of 50.0 to 59.9 years; and 0.51 (95% CI, 0.30-0.86) for age of 60 years or more, compared with age less than 40 years. Drinking status, body mass index, hypertension, diabetes, and use of sedatives had no association with IBS. CONCLUSIONS: The prevalence of IBS increased with decreasing age and increasing psychological stress, and was positively associated with female sex and current smoking.
Body Mass Index ; Colectomy ; Colonic Neoplasms ; Colonoscopy ; Drinking ; Female ; Humans ; Hypertension ; Hypnotics and Sedatives ; Inflammatory Bowel Diseases ; Irritable Bowel Syndrome ; Korea ; Logistic Models ; Mass Screening ; Odds Ratio ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Rome ; Smoke ; Smoking ; Stress, Psychological ; Thyroid Function Tests ; Weights and Measures

BACKGROUND: Blood typing is an essential test for transfusion. Generally, blood typing is performed using a slide test, tube test or microcolumn agglutination test. The aims of this study were to develop a new blood typing kit using micromachining, microfluidics and microseparation methods, and to evaluate the clinical usefulness of the new blood typing kit. METHODS: We designed and manufactured a blood typing microchip using polydimethylsiloxane (PDMS), which contained a microchannel (25~200 micrometer). The blood sample and antisera to be tested were dropped on the microwell for movement and mixing by capillary action. Once agglutination occurred, the microchannel acts as a filter and the blood type was determined by observation by the naked eye. To evaluate the newtyping kit, we tested sensitivity using artificially diluted blood and compared the results of the new typing method with the slide and tube methods using 70 samples. RESULTS: The new blood typing kit could differentiate a +4~+2 agglutination reaction, but could not detect a +1 agglutination reaction as observed by the naked eye. Among 70 samples, the results of ABO and Rh typing by the new typing method (n=66, > or = +2 agglutination reaction by the column agglutination method) were in accord with the results of the tube and slide methods, but couldnot detect agglutination in all 4 clinical samples, below a +1 agglutination reaction. CONCLUSION: The new blood typing kit is inadequate for routine use in the clinical laboratory due to low sensitivity, but with further improvement, it can be used economically, conveniently and objectively for blood typing without any special equipment. Moreover, the microfludics and separation method may be broadly applicable in other tests using the hemagglutination method.
Agglutination ; Agglutination Tests ; Blood Grouping and Crossmatching* ; Capillary Action ; Hemagglutination ; Immune Sera ; Microfluidics* ; Microtechnology

No abstract available.
Embryonic Structures* ; Fluorescence* ; Humans* ; In Situ Hybridization* ; Preimplantation Diagnosis*

Two cases of ABO discrepancy were observed in thirty-year old woman with gall bladder abscess and fifty-five-year old woman with hepatocellular carcinoma. Their red cells were typed as group O and their serum had only anti-A antibody. Absence of A and B antigens on their RBCs were confirmed by adsorption elution test and saliva test. The B transferase activities were not demonstrated in their serum. Their ABO genotypes were O/O by sequence specific polymerase chain reaction. Their serum protein electrophoresis showed hypogammaglobulinemia pattern, and immunoglobulin levels (IgG, IgA, IgM) were decreased (39 mg/dL, 46 mg/dL, <5 mg/dL and 63 mg/dL, 65 mg/dL, 12 mg/dL, respectively).
Abscess ; Adsorption ; Agammaglobulinemia* ; Carcinoma, Hepatocellular ; Electrophoresis ; Female ; Genotype ; Humans ; Immunoglobulin A ; Immunoglobulins ; Polymerase Chain Reaction ; Saliva ; Transferases ; Urinary Bladder

Rapid growing mycobacterium grows in less than 7 days on most types of solid media including the Ogawa media. Ninety percent of human diseases caused by rapid growing mycobacterium are due to Mycobacterium abscessus, Mycobacterium chelonae and Mycobacterium fortuitum. We report an isolated case of wound infection due to M. abscessus following total knee replacement arthroplasty surgery. The patient has presented arthralgia and fever for 3 weeks. From the joint fluid aspirates, pale gram-positive beaded rods were found but cultures were negative after 24 hours. After 48 hours, microorganisms grew on blood agar plates as tiny pinpoint colonies and they had odor of freshly-turned soil. They gave a positive reaction in a partial acid fast, an acid-fast stain and a heat-stable catalase but gave a negative reaction to PCR for IS6110. They were identified as the M. chelonae group biochemically and confirmed as M. abscessus through PCR-restriction fragment length polymorphism using restriction endonuclease, BstE II. Because rapid-growing mycobacterium can grow on a blood agar plate, an acid-fast stain should be selectively conducted in addition to a Gram stain in a microbiology laboratory.
Agar ; Arthralgia ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Catalase ; DNA Restriction Enzymes ; Fever ; Humans ; Joints ; Knee Joint* ; Knee* ; Mycobacterium chelonae ; Mycobacterium fortuitum ; Mycobacterium* ; Odors ; Polymerase Chain Reaction ; Soil ; Wound Infection

PURPOSE: Prior abdomino-pelvic (AP) surgery makes colonoscopy difficult and can affect bowel preparation quality. However, bowel preparation quality has been found to vary according to prior AP surgery type. We examined the relationship of prior AP surgery type with bowel preparation quality in a large-scale retrospective cohort. MATERIALS AND METHODS: In the health screening cohort of the National Cancer Center, 12881 participants who underwent screening or surveillance colonoscopy between June 2007 and December 2014 were included. Personal data were collected by reviewing patient medical records. Bowel preparation quality was assessed using the Aronchick scale and was categorized as satisfactory for excellent to good bowel preparation or unsatisfactory for fair to inadequate bowel preparation. RESULTS: A total of 1557 (12.1%) participants had a history of AP surgery. The surgery types were colorectal surgery (n=44), gastric/small intestinal surgery (n=125), appendectomy/peritoneum/laparotomy (n=476), cesarean section (n=278), uterus/ovarian surgery (n=317), kidney/bladder/prostate surgery (n=19), or liver/pancreatobiliary surgery (n=96). The proportion of satisfactory bowel preparations was 70.7%. In multivariate analysis, unsatisfactory bowel preparation was related to gastric/small intestinal surgery (odds ratio=1.764, 95% confidence interval=1.230–2.532, p=0.002). However, the other surgery types did not affect bowel preparation quality. Current smoking, diabetes, and high body mass index were risk factors of unacceptable bowel preparation. CONCLUSION: Only gastric/small intestinal surgery was a potential risk factor for poor bowel preparation. Further research on patients with a history of gastric/small intestinal surgery to determine appropriate methods for adequate bowel preparation is mandatory.
Body Mass Index ; Cesarean Section ; Cohort Studies* ; Colonoscopy* ; Colorectal Surgery ; Female ; Humans ; Mass Screening ; Medical Records ; Multivariate Analysis ; Postoperative Period ; Pregnancy ; Retrospective Studies* ; Risk Factors ; Smoke ; Smoking

BACKGROUND: The efficiency of leukocyte removal filter is influenced by many factors. But, filtration efficiency of leukocyte fragments was not well known. We performed this study to evaluate whether the filtration efficiency for packed red blood cells can be influenced by leukocyte fragments according to storage time. METHODS: Leukocyte fragments in packed red blood cells (three units) which were artificially made by incubation for 4 hrs at 56degrees C and each four units of packed red blood cells according to storage time (0 days, 10 days, 20 days, and 30 days) were filtered using Sepacell R-500A (Asahi medical Co, Japan). The leukocyte concentrations of the pre-leukodepleted samples were estimated using an automated hematology analyzer (XE-2100, Sysmex, Japan). The ratio between the number of normal leukocytes and leukocyte fragments on Wright Giemsa stained slide was used in the analysis. The leukocyte concentrations of the post-leukodepleted samples were performed by the conventional counting methods using Nageotte hemocytometer. RESULTS: The ratios of fragmented to total leukocytes in packed red blood cells at pre- and post leukoreduction according to storage times were 1.5% and 16.3% within 1 days, 4.5% and 30.0% at 10 days, 6.3% and 35.0% at 30 days, and 8.3% and 42.5% at 40 days, respectively. Leukoreduction efficiencies of normal leukocytes in packed red blood cells were 99.99 +/- 0.01%, 99.97 +/- 0.02%, 99.98 +/- 0.01%, and 99.86 +/- 0.09%, respectively. The 36.0% of leukocytes in packed red blood cells were changed to fragmented leukocytes, residual fragmented leukocytes ratio was 95.0% and filter efficiencies of normal leukocytes was low(99.28%, p<0.05). CONCLUSIONS: The leukodepleted efficiency for leukocyte fragments were lower than for normal leukocytes. Leukocytes fragments may be influenced to lower the leukodepleted efficiency of normal leukocytes with storage time elapse.
Azure Stains ; Erythrocytes ; Filtration ; Hematology ; Leukocytes*

Latrogenic gastric rupture is a rarely reported complication of cardiopulmonary resuscitation. Rupture can occur during chest compressions when the stomach is overinflated due to difficult airway management or esophageal intubation. The prognosis of gastric rupture is generally poor, so patients should undergo surgical treatment as soon as possible. We present the case report of a patient with an acute myocardial infarction who experienced gastric perforation and pneumoperitoneum after cardiopulmonary resuscitation.
Airway Management ; Cardiopulmonary Resuscitation* ; Humans ; Intubation ; Myocardial Infarction* ; Pneumoperitoneum* ; Prognosis ; Rupture ; Stomach ; Stomach Rupture* ; Thorax

Extracellular vesicles (EVs) not only eliminate unwanted molecular components, but also carry molecular cargo essential for specific intercellular communication mechanisms. As the molecular characteristics and biogenetical mechanisms of heterogeneous EVs are different, many studies have attempted to purify and characterize EVs. In particular, exosomal molecules, including proteins, lipids, and nucleic acids, have been suggested as disease biomarkers or therapeutic targets in various diseases. However, several unresolved issues and challenges remain despite these promising results, including source variability before the isolation of exosomes from body fluids, the contamination of proteins during isolation, and methodological issues related to the purification of exosomes. This paper reviews the general characteristics of EVs, particularly microvesicles and exosomes, along with their physiological roles and contribution to the pathogenesis of major diseases, several widely used methods to isolate exosomes, and challenges in the development of disease biomarkers using the molecular contents of EVs isolated from body fluids.
Biomarkers* ; Body Fluids ; Exosomes ; Extracellular Vesicles* ; Nucleic Acids