To evaluate the predictive value of serum fibronectin and roll-over test for pregnancy induced hypertension (PIH), we studies 79 patients between the twenty-eighth and thirty-second week of gestation from October 1995 to May 1996. The results were as follows . 1) There was no significant difference of mean diastolic pressure difference in roll-over test and serum fibronectin levels between 13 PIH patients and 66 controls. Between two groups of patients, mean diastolic blood pressure differences were 14.3+/-3.9mmHg, 12.0+/-4.4mmHg and mean serum fibronectin levels were 231.2+/-90.8 pg/ml, 196.5+/-61.2 pg/ml respectively(p> 0.1). 2) For prediction of PIH, the sensitivity, the positive predictive value and the negative predictive value of roll-over test were 8%, 14% and 83%.
Blood Pressure ; Female ; Fibronectins* ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy*

This study was conducted to evaluate the effect of ambroxol on preventing the infantile respiratory distress syndrome (IRDS) in preterm birth at the Dept. of Obstetrics and Gynecology of Taegu Catholic Medical Center during the period from Jan. 1996 to Dec. 1996. Total of 68 cases were evaluated including 16 ambroxol group and 52 control group. The result were as follows : 1. In the comparison of preventing IRDS, there was 0 case of IRDS in ambroxol group and 7 cases of IRDS in control group (13.46 %). There was a significant difference between two groups (p<0.05). 2. The side effects of ambroxol after administration were nausea in 5 cases, headache in 3 cases, and chest discomfort in 4 cases, but these were not serious and self controlled. 3. There was no significant difference in neonatal morbidity between two groups (p > 0.05).
Ambroxol* ; Daegu ; Gynecology ; Headache ; Nausea ; Obstetrics ; Premature Birth ; Respiratory Distress Syndrome, Newborn* ; Thorax

OBJECTIVE: The purpose of this study was to research the physiologic effects of pregnancy on lower extremity venous hemodynamics. METHODS: Forty-eight limbs of twenty four women in third trimester were studied with air plethysmography (APG) and duplex scan. The 48 limbs were divided into two groups three separate times using three sets of criteria, parity, weight gain and symptoms (leg swelling, varicose, telangiectasia). Each set of two groups was then compared by hemodynamic results (venous filling index (VFI), ejection fraction (EF), ambulatory venous pressure (AVP)) of APG. Nine of them had follow up test after delivery. RESULTS: None of twenty four women had thrombosis or reflux in duplex scan evaluation. Forty two limbs (87.5%) in VFI testing, thirty nine limbs (81.2%) in EF testing and forty one limbs (85.4%) in AVP testing showed normal value. There were no significant statistical differences in hemodynamic parameter between any of the two groups divided by parity or weight gain or symptoms. CONCLUSION: Although the belief that the mechanical effects of the gravid uterus plays important role in causing venous disease of pregnant women, over eighty percent of pregnant women showed normal results in lower extremity venous hemodynmics study with APG. According to this studies parity, weight gain, venous symptoms do not affect hemodynamic conditions. Hormonal or other systemic factors must play a significant role in the development of venous disease.
Extremities ; Female ; Follow-Up Studies ; Hemodynamics* ; Humans ; Lower Extremity* ; Parity ; Plethysmography ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Reference Values ; Thrombosis ; Uterus ; Venous Pressure ; Weight Gain

OBJECTIVE: The purpose of this study is to evaluate the uroflow parameters of the pregnant women before delivery and immediate postpartum period. METHODS: Forty four patients delivered by spontaneous vaginal delivery (NVD group) and 46 patients by Cesarean section (C/SEC group) and 28 non-pregnant young women (Control group) were included in this study. Uroflow were checked 1 day before and 2 days after delivery by Jupiter 8000 (FM Wiest(R)) uroflowmetry. Mean value of the uroflow parameters in each group was compared using ANOVA t-test. For continuous data, linear associations with each of the uroflow parameters were assessed using a Pearson correlation coefficient. RESULTS: Maximal (18.48+/-5.21 mL/sec) and mean flow rate (9.45+/-3.73 mL/sec) of pregnant women were lower than control group (22.75+/-5.14 mL/sec), and were not changed after delivery (18.79+/-6.03 mL/ sec). Total flow time of pregnant woman (14.06+/-6.09 sec) was longer than control group (8.05+/-5.32 sec) before delivery, and increased after delivery especially after cesarean delivery. Time to peak flow of pregnant women (8.44+/-9.48 sec) was shorter than control group (16.33+/-6.11 sec) before delivery, and was similar to control group after delivery. Total voided volume (121.39+/-50.17 mL) was less than control group before delivery, and was increased after delivery (246.77+/-127.42 mL). Total voided volume after delivery was not different with control group statistically. CONCLUSION: There was no statistically differences before and after delivery in maximal flow rate, but was lower than non-pregnant women. Total flow time was much prolonged after delivery, especially after cesarean delivery. Time to peak flow and voided volume were restored to levels of non-pregnant women after delivery.
Cesarean Section* ; Female ; Humans ; Postpartum Period ; Pregnancy ; Pregnant Women

Background: The purpose of this study was to evaluate the effect of patellar facet angle on pre- and postoperative patellofemoral alignment and the progress of arthritis of the patellofemoral joint in posterior-stabilized total knee arthroplasty (PS TKA) without patellar resurfacing. Methods: Patients who had a PS TKA for a varus osteoarthritic knee who were followed up for more than 2 years were included in this study. The radiologic and clinical outcomes were compared between 72 knees (group A) whose patellar facet angle was greater than 126° (> 126°) and 32 knees (group B) whose patellar facet angle was smaller than or equal to 126° (≤ 126°). For the radiologic assessment, the Kellgren-Lawrence grade, mechanical femorotibial angle, Insall-Salvati ratio, patellar tilt angle, patellar displacement and the osteosclerosis of the patellar ridge were evaluated. The range of motion (ROM) and patient-reported outcomes (the Knee Society knee score, the Knee Society function score, the Feller patellar score, and the Kujala patellofemoral score) were used for the clinical assessment. Results: The preoperative patellar tilt angle was 9.8° (standard deviation [SD] 5.5) and 14.6° (SD 4.1) in group A and group B, respectively, a significant difference (p < 0.001). Other preoperative radiologic parameters and preoperative patient-reported outcomes and ROM showed no significant difference between the two groups (all parameters (p> 0.05). At the last-follow-up, 22 knees (30.6%) showed progression of osteosclerosis of the patellar ridge in group A and 13 knees (40.6%) showed progression of osteosclerosis in group B (p = 0.371). The postoperative radiologic and clinical outcomes showed no significant difference between the two groups (all parameters,p > 0.05). Conclusions Although a narrow patellar facet angle was related to an increase of lateral tilting of the patella, it showed no impact on the preoperative clinical assessment. The radiologic and clinical outcomes evaluated after the PS TKA showed no statistical difference according to the patellar shape. Although the patellar shape evaluated by the patellar facet angle can partially affect the preoperative patellofemoral alignment, this study result indicated insignificant clinical relevance of the patellar shape in the PS TKA.

OBJECTIVES: Three-dimensional computed tomographic angiography(3D-CTA) is recently developed diagnostic imaging modality. We have studied this noninvasive method for possible role in replacing conventional angiography(CA) in the detection of aneurysms of the circle of Willis in patients with subarachnoid hemorrahge(SAH). METHODS: We studied retrospectively, the 100 patients with SAH or unruptured aneurysms admitted to our hospital from October 1997 to December 1998. Among there, 85 patients underwent CTA, 82 patients underwent CA and 67 patients underwent both of CTA and CA. 3D-CTA was obtained using maximum intensity projection(MIP) and shaded-surface display(SSD) reconstruction. RESULTS: Total 107 aneurysms were detected in 92 patients, and 64 aneurysms were detected in 67 patients underwent both CTA and CA. In five cases of those 67 cases, aneurysms were detected by CA but not by 3D-CTA. The detection rate of aneurysms(91.8%) and the detection rate of parent artery in cases of anterior communicating artery aneurysms(86.9%) with total 3D-CTA were relatively compatible with that of CA. But 3D-CTA was not enough in detection of posterior communicating artery aneurysms, internal carotid artery aneurysms as well as small sized aneurysm(<3mm). Conclusion : We consider CTA is valuable in as a screening test for cerebral aneurysm and follow-up test. And it is also valuable in early surgery for patients with aneurysmal rebleeding because of simple, quick, non-invasive method.
Aneurysm* ; Angiography* ; Arteries ; Carotid Artery, Internal ; Circle of Willis ; Diagnostic Imaging ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Mass Screening ; Parents ; Retrospective Studies ; Subarachnoid Hemorrhage*

This study was conducted to assess the attitude of pregnant women toward delivery method, understanding of the reason for determining her own delivery method, participation in decision-making process and satisfaction with delivery method after labor. Study subjects were 693 pregnant women who had visited obstetric clinic for prenatal care in the last month of pregnancy in one general hospital and one obstetrics-gynecology specialty hospital in Taegu city from February 1 to March 31 in 1998. A questionnaire was administered before and after labor and a telephone interview was done one month after labor. Proportion of women who had health education and/or counselling about delivery method during prenatal care was 24.0% and this proportion was higher for women who had previous c-section(35.5%) than others. Women thought vaginal delivery is better than c-section for both maternal and baby's health regardless of previous delivery method. About 90% of primipara and multiparous women who had previous vaginal delivery wanted vaginal delivery for the index birth, while 85.6% of multiparous women who had previous c-section wanted repeat c-section. Reasons for choosing c-section in pregnant women who preferred vaginal delivery before labor were recommendation of doctors(81.9%), recommendation of husband(0.8%), agreement between doctor and pregnant woman(4.7%), and mother's demand(12.6%). Reasons for choosing vaginal delivery were mother's demand(30.6%) and no indication for c-section(67.2%). Reasons for choosing c-section in pregnant women who preferred c-section before labor were recommendation of doctors(76.2%), mother's demand(20.0%), recommendation of husband(1.3%), and agreement between doctor and pregnant woman(2.5%). Of the pregnant women who had c-section, by doctor's recommendation, the proportion of women who had heard detailed explanation about reason for c-section by doctor was 55.1%. Mother's statement about the reason for c-section was consistent with the medical record in 75.9%. However, over 5% points disparities were shown between mother's statement and medical record in cases of the repeat c-section and mother's demand. In primipara and multiparous women who had previous vaginal delivery, the delivery method for index birth had statistically significant association with the preference of delivery method before labor(p<0.05). All of the women who had previous c-section had delivered the index baby by c-section. Among mothers who had delivered the index baby vaginally, 84.9% of them were satisfied with their delivery method immediately after labor and 85.1% at 1 month after labor. However, mothers who had c-section stated that they are satisfied with c-section in 44.6% immediately after labor and 42.0% at 1 month after labor. Preferred delivery method for the next birth had statistically significant association with delivery method for the index birth both immediately after labor and in 1 month after labor. The proportion of mothers who prefer vaginal delivery for the next birth increased with the degree of satisfaction with the vaginal delivery for the index birth but the proportion of mothers who prefer c-section for the next birth was high and they did not change significantly with the degree of satisfaction with the c-section for the index birth. These results suggest that the current high technology-based, physician-centered prenatal and partritional cares need to be reoriented to the basic preventive and promotive technology-based, and mother-fetus-centered care. It is also suggested that active involvement of pregnant woman in decision-making process for the delivery method will increase the rate of vaginal birth after c-section and decrease c-section rate and improve the degree of maternal satisfaction after delivery.
Daegu ; Female ; Health Education ; Hospitals, General ; Humans ; Interviews as Topic ; Medical Records ; Mothers ; Parturition ; Pregnancy ; Pregnant Women* ; Prenatal Care ; Surveys and Questionnaires

BACKGROUND/OBJECTIVES: This study was performed to investigate the association between the dietary intake of fish and shellfish, and omega-3 polyunsaturated fatty acids (PUFAs) and cardiovascular disease (CVD) risk factors in the middle-aged Korean female patients with Type 2 diabetes (T2D). SUBJECTS/METHODS: A cross-sectional analysis was performed with 356 female patients (means age: 55.5 years), who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire and analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. RESULTS: In a multiple regression analysis after the adjustment for confounding factors such as age, BMI, duration of diagnosed T2D, alcohol consumption, fiber intake, sodium intake, and total energy intake, fish and shellfish intake of the subjects was negatively associated with triglyceride and pulse wave velocity (PWV). Omega-3 PUFAs intake was negatively associated with triglyceride, systolic blood pressures, diastolic blood pressures, and PWV. The multiple logistic regression analysis with the covariates showed a significant inverse relationship between the omega-3 PUFAs consumption and prevalence of hypertriglyceridemia [OR (95% CI) for greater than the median compared to less than the median: 0.395 (0.207-0.753)]. CONCLUSIONS: These results suggest that the consumption of fish and shellfish, good sources of omega-3 PUFAs, may reduce the risk factors for CVD in the middle-aged female patients with T2D.
Alcohol Drinking ; Cardiovascular Diseases ; Cross-Sectional Studies ; Energy Intake ; Fatty Acids, Unsaturated ; Female* ; Humans ; Hypertriglyceridemia ; Korea ; Logistic Models ; Prevalence ; Pulse Wave Analysis ; Risk Factors* ; Seoul ; Shellfish* ; Sodium ; Triglycerides

BACKGROUND/OBJECTIVES: This study was aimed at examining the association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome (MetS) in Korean women with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A cross-sectional analysis was performed among 502 female T2DM patients (non-MetS group; n = 129, MetS group; n = 373) who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) and the data was analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. The intake of flavanones was estimated on the basis of the flavonoid database. RESULTS: In the multiple linear regression analysis after adjustment for confounding factors, daily flavanones intake was negatively associated with CVD risk factors such as total cholesterol, LDL-cholesterol, and apoB and apoB/apoA1 ratio only in the MetS group but not in the non-MetS group. Multiple logistic regression analysis revealed that the odds ratio for a higher apoB/apoA1 ratio above the median (> or = 0.74) was significantly low in the 4th quartile compared to that in the 1st quartile of dietary flavanones intake [OR: 0.477, 95% CI: 0.255-0.894, P for trend = 0.0377] in the MetS group. CONCLUSIONS: Dietary flavanones intake was inversely associated with the apoB/apoA1 ratio, suggesting a potential protective effect of flavanones against CVD in T2DM women with MetS.
Apolipoproteins ; Apolipoproteins B ; Cholesterol ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2* ; Female ; Flavanones* ; Humans ; Korea ; Linear Models ; Logistic Models ; Odds Ratio ; Risk Factors ; Seoul

BACKGROUND/OBJECTIVES: Complications of diabetes, such as cardiovascular disease, are associated with increased mortality among type 2 diabetes mellitus patients. Homocysteine has been recently identified as a predictor of cardiovascular disease-related complications in diabetes. We investigated whether or not supplementation with folic acid tablets can lower homocysteine levels and improve parameters related with vascular complications. SUBJECTS/METHODS: We conducted a non-randomized 8-week trial involving postmenopausal diabetic women (n = 25) supplemented with 800 µg of folic acid (400 µg twice a day) daily. Subjects' serum levels of folate, homocysteine, and vitamin B₁₂ were measured, along with vascular function and brachial-ankle pulse wave velocity. RESULTS: Folic acid supplementation significantly increased serum folate levels (P < 0.0001), reduced homocysteine levels (P < 0.0001), and increased vitamin B₁₂ levels (P = 0.0063). There were significant decreases in low-density lipoprotein cholesterol levels as well as the ratios of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol and total cholesterol to high-density lipoprotein cholesterol. Brachial-ankle pulse wave velocities were not altered by supplementation. Changes in serum vitamin B₁₂ after folic acid supplementation were negatively correlated with changes in brachial-ankle pulse wave velocity. CONCLUSIONS: In this study on postmenopausal Korean women with type 2 diabetes mellitus, folic acid supplementation reduced serum homocysteine levels, increased serum folate and vitamin B₁₂ levels, and lowered lipid parameters.
Cardiovascular Diseases ; Cholesterol ; Cholesterol, LDL ; Diabetes Mellitus, Type 2* ; Female ; Folic Acid* ; Homocysteine* ; Humans ; Lipoproteins ; Mortality ; Pulse Wave Analysis ; Tablets ; Vitamin B 12 ; Vitamins