Cesarean hysterectomy remains a necessary procedure for life saving during intractable obstetric hemorrhage. The procedure itself is usually associated with considerable perioperative morbidity, especially when performed under emergency conditions. In this study, the outcomes of 15 cases of cesarean hysterectomy performed at Catholic university of Taegu-Hyosung hospital for 5 years from January, 1993 to December, 1997 were reviewed. There were 22,251 deliveries during this period, cesarean hysterectomy was performed in 13 of 5,753 cesarean section(0.22%) and in 2 of 16,698 vaginal deliveries(0.12%), so more frequently after cesarean section than vaginal deliveries. The age of patients varied from 23 to 39 years old. The higher the age of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of emergency cesarean hysterectomy was in uterine atony(53.3%), followed by placental disorders(33.3%), uterine rupture(6.7%), and uterine myoma with pregnancy (6.7%). All patients who had cesarean hysterectomy received transfusion from 3 pints to 13 pints. In aspect of fetal outcomes, live birth were 12 cases(80%), one case was fetal death in utero(6.6%), 2 infants were dead during the early neonatal period(13.3%) due to prematurity and RDS (respiratory distress syndrome), so the perinatal mortality rate was 20.0%. The postoperative complications were wound disruption, hematoma, febrile morbidity and disseminated intravascular coagulopathy.
Adult ; Cesarean Section ; Emergencies ; Female ; Fetal Death ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Infant ; Leiomyoma ; Live Birth ; Perinatal Mortality ; Postoperative Complications ; Pregnancy ; Wounds and Injuries

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

PURPOSE: The purpose of this study is to examine characteristics of implant surface with RBM and anodizing treatments, and to evaluate the responses of osteoblast-like cell (MG-63 cell). MATERIALS AND METHODS: Grade IV titanium disks were fabricated (Diameter 10 mm, thickness 3 mm). Anodizing treatment (ASD) group, RBM and anodizing treatment (RBM/ASD) group, control (machined surface) group were divided. In this study, osteoblast-like cell was used for experiments. The experiments consist of surface characteristics evaluation by FE-SEM images, energy dispersive spectroscopy and stereo-SEM. In order to evaluate cell adhesion evaluation by crystal violet assay and observe cells form by confocal laser microscopy. To assess cell proliferation by XTT assay, cell differentiation by RT-PCR and mineralization by Alizarin red S stain assay. ELISA analyzer was used for Quantitative evaluation. Comparative analysis was run by one-way ANOVA (SPSS version 18.0). Differences were considered statistically significant at P<.05. RESULTS: In ASD group and RBM/ASD group, the surface shape of the crater was observed and components of oxygen and phosphate ions in comparison with the control group were detected. The surface average roughness was obtained 0.08 +/- 0.04 microm in the control group, 0.52 +/- 0.14 microm in ASD group and 1.45 +/- 0.25 microm in RBM/ASD group. In cell response experiments, ASD group and RBM/ASD group were significantly higher values than control group in cell adhesion and mineralization phase, control group was the highest values in the proliferative phase. In RT-PCR experiments, RBM/ASD group was showed higher ALP activity than other groups. RBM/ASD group in comparison with ASD group was significantly higher value for cell adhesion and proliferation phase. CONCLUSION: In the limitation of this study, we are concluded that the surface treatment with RBM/ASD seems more effective than ASD alone or machined surface on cellular response.
Cell Adhesion ; Cell Differentiation ; Cell Proliferation ; Control Groups ; Enzyme-Linked Immunosorbent Assay ; Evaluation Studies as Topic ; Gentian Violet ; Ions ; Microscopy, Confocal ; Oxygen ; Spectrum Analysis ; Titanium

While constipation is a common symptom in Korea, there are no existing treatment guidelines. Although constipation may occur as a result of organic cause, there is no obstructive mucosal or structural cause in the vast majority of patients with constipation. The present paper deals with only the management of functional constipation: lifestyle changes; bulking agents and stool softeners; osmotic agents; stimulant laxatives; prokinetics; biofeedback and surgical treatments. Exercise and dietary fiber are helpful in some patients with constipation. Laxatives including bulking agents, stool softeners, osmotic agents, and stimulant laxatives have been found to be more effective than placebo at relieving symptoms of constipation. New enterokinetic agents that affect peristalsis through selective interaction with 5-hydroxytryptamine-4 receptors can be effective in patients with constipation who cannot get adequate relief from current laxatives. Biofeedback can relieve symptoms in selected patients with pelvic floor dyssynergia. Surgical treatments can be helpful in some patients with refractory constipation.
Biofeedback, Psychology ; Cathartics/therapeutic use ; Constipation/surgery/*therapy ; Dietary Fiber/therapeutic use ; Electric Stimulation Therapy ; Exercise Therapy ; Health Behavior ; Humans ; Laxatives/therapeutic use ; Serotonin 5-HT4 Receptor Antagonists/therapeutic use ; Surface-Active Agents/therapeutic use

PURPOSE: Influenza virus is one of the most important viruses that cause the respiratory infection seasonally. In April 2009, H1N1 was detected in America and Mexico and then there was pandemic in Korea. We investigated the difference of clinical and laboratory findings between the infections of H1N1 and Influenza B. METHODS: We have retrospectively studied the patients under age of 15 years who visited Inje University Sanggye Paik Hospital from August 2009 to April 2010. Evaluation for influenza infection was performed by rapid antigen test or multiplex reverse transcriptase polymerase chain reaction. Complete blood count with differential counts, C-reactive protein and chest X-ray were checked. RESULTS: Enrolled patients were 2,226 in H1N1-infected group and 288 in influenza B-infected group. Seasonal variation was that H1N1 in autumn and winter but influenza B in spring. The male-to-female sex ratio was same as 1.23 in each group. The mean age of H1N1-infected group was higher than influenza B-infected group (P<0.001). Fever was developed similarly in both groups (P=0.114). However, cough, sputum, rhinorrhea, vomiting, diarrhea, and headache were more prevalent in influenza B infection compared to H1N1 infection (P<0.001). Pneumonia development and admission rate were higher in influenza B infection compared to H1N1 infection (P<0.001, respectively). CONCLUSION: Although H1N1 infection spread rapidly, H1N1 caused not so severe symptoms than influenza B. Because of the possibility that influenza epidemic will develop repeatedly in the future, we need to evaluate more about different characteristics depending on the virus subtype and prepare for them.
Americas ; Blood Cell Count ; C-Reactive Protein ; Cough ; Diarrhea ; Fever ; Headache ; Humans ; Influenza, Human ; Korea ; Mexico ; Orthomyxoviridae ; Pandemics ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Seasons ; Sex Ratio ; Sputum ; Thorax ; Viruses ; Vomiting

BACKGROUND/AIMS: The serum Helicobacter pylori IgG antibody test has been widely used by primary care physicians for over two decades. We assessed its usefulness as a screening strategy for organic gastrointestinal disease in routine check-up. METHODS: We retrospectively reviewed the medical records of 10,080 subjects who received a routine check up at the Kangnam St. Mary's Hospital from January 2004 to April 2005. All subjects underwent the H. pylori IgG antibody test and upper gastrointestinal endoscopy or a barium contrast study. RESULTS: The overall seropositive rate for H. pylori detection was 61.0% (6,150/10,180). The 13C-urea breath test (UBT) was performed in 340 subjects. The H. pylori antibody test showed 55% accuracy in comparison to the standard 13C-UBT. The number of patients with peptic ulcer in the seropositive group was 475 (7.7%) compared to only 168 patients (4.3%) in the seronegative group (p<0.001). Stomach cancer was observed in eight (0.1%) and two (0.1%) patients in the seropositive and seronegative groups, respectively. The positive and negative likelihood ratios for the H. pylori IgG antibody test for peptic ulcer were 1.22 and 0.66, respectively, compared to 1.31 and 0.26 for stomach cancer. CONCLUSIONS: In view of its low accuracy and likelihood ratios, we do not recommend the H. pylori antibody test as a diagnostic tool for H. pylori infection or as a screening strategy for organic gastrointestinal disease during routine check-ups.
Barium ; Breath Tests ; Endoscopy, Gastrointestinal ; Gastrointestinal Diseases ; Helicobacter ; Helicobacter pylori ; Humans ; Immunoglobulin G ; Mass Screening ; Medical Records ; Peptic Ulcer ; Physicians, Primary Care ; Retrospective Studies ; Serologic Tests ; Stomach Neoplasms

BACKGROUND: Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women. METHODS: A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used. RESULTS: Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders. CONCLUSION: A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.
Adiponectin ; Body Mass Index ; Cohort Studies ; Confounding Factors (Epidemiology) ; Diabetes Mellitus ; Fasting ; Female ; Follow-Up Studies ; Glucose ; Humans ; Incidence ; Male ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea ; Waist Circumference

BACKGROUND/AIMS: Antispasmodics such as octylonium are widely used to manage irritable bowel syndrome (IBS) symptoms. However, the efficacy and safety of another antispasmodic, tiropramide, remain uncertain. We aimed to evaluate the efficacy and safety of tiropramide compared with octylonium in patients with IBS. METHODS: In this multicenter, randomized, non-inferiority trial, 287 patients with IBS (143 receiving tiropramide and 144 octylonium) were randomly allocated to either tiropramide 100 mg or octylonium 20 mg t.i.d (means 3 times a day) for 4 weeks. Primary endpoint was the mean change of abdominal pain from baseline assessed by visual analogue scales (VAS) score after 4 weeks of treatment. Secondary endpoints were the changes in abdominal pain from baseline at week 2 and in abdominal discomfort at weeks 2 and 4, using VAS scores, patient-reported symptom improvement including stool frequency and consistency, using symptom diaries, IBS-quality of life (IBS-QoL), and depression and anxiety, at week 4. RESULTS: The VAS scores of abdominal pain at week 4, were significantly decreased in both tiropramide and octylonium groups, but the change from baseline did not differ between the 2 groups (difference,-0.26 mm; 95% CI,-4.33-3.82; P = 0.901). Abdominal pain and discomfort assessed using VAS scores, diaries, and IBS-QoL were also improved by both treatments, and the changes from baseline did not differ. The incidence of adverse events was similar in the 2 groups, and no severe adverse events involving either drug were observed. CONCLUSIONS: Tiropramide is as effective as octylonium in managing abdominal pain in IBS, with a similar safety profile.
Abdominal Pain ; Anxiety ; Depression ; Humans ; Incidence ; Irritable Bowel Syndrome* ; Parasympatholytics ; Weights and Measures

While endovascular aneurysm repair (EVAR) is prevailing for the treatment of abdominal aortic aneurysm (AAA) in modern vascular practice, PURPOSE: we conducted nationwide questionnaire survey to investigate the current status of AAA treatment and their results in Korea. METHOD: We reviewed the replies from 28 hospitals (33 departments) to the questionnaire inquiring annual number, clinical features, mode of treatment and results of AAA patients during the period from Jan. 2000 to Jul. 2004. Results: 980 AAA patients were reported including 292 ruptured AAA (29.8%) and 688 non-ruptured AAA (70.2%). For treatment of AAA, 834 (85.1%) surgical repairs (SRs) and 111 (11.3%) endovascualr aneurysm repairs (EVARs) were performed while 35 patients (3.6%) died of AAA rupture before operation. The locations of AAA were infrarenal in 889 (90.7%), juxtarenal in 62 (6.3%), and suprarenal in 29 patients (3.0%). Among 834 patients undergoing SR, 577 patients (69.2%) had non-ruptured AAAs and 257 patients (30.8%) had ruptured AAAs. Mean operative mortality rate was 4.1% after elective SRs, 30.7% after SR for ruptured AAAs, and 2.3% after EVARs. The reported brand name of stent graft devices were various including domestic custom-made in 56 (50.5%), imported brand in 18 (16.2%) while 37 (33.3%) stent grafts were not reported their brand name. The frequencies of type I and III endoleaks after EVAR were reported 5.8% and 5.8% respectively in 86 patients with an available data. CONCLUSION: SR has been used as a major treatment option in Korea for the treatment of AAA patients while EVAR is increasing. The mortality rate of SR of AAA was comparable to western multi-center trial reports but mortality or morbidity rates of EVAR were unable to know in this questionnaire survey.
Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak ; Humans ; Korea* ; Mortality ; Questionnaires* ; Rupture ; Treatment Outcome