PURPOSE: An online system concerning bed and equipment availability in the referral centers was developed to prevent any delay in the transport of newborn infants to a referral center with adequate equipments. METHODS: A program using web user interface was developed by Developer 2000 and Oracle database under UNIX system. The availability of equipments in the NICU, patient's medical information, user's information were included. The program was tested on the server of the Yeungnam University Medical Center with personal computers as clients. RESULTS: The program consisted of six menus : bed and equipment availability, updating the data, contact numbers, patients' informations, users informations, others. After login, availability of beds and equipments were shown according to the selected area which was chosen by the user. Phone numbers of physicians at the referral center appear on a window newly opened by clicking on the hospital name where newborn patient will be transferred. Medical information about patients can be transmitted to the referral center. The data can be updated by the webmaster of the individual hospital, and new hospital, delivery mode, treatment modality can be added by the system operator. It took 5.1+/-0.7 seconds from connection to execution of the program when it was connected through local area network in the medical center, and 10.2+/-0.2 seconds after 15+/-0.9 seconds' connection time if it was connected by 56K dial-up modem. Conclusion : This program will be very useful if connection time were shortened, and shortage of the neonatal intensive care beds nationwide were resolved.
Academic Medical Centers ; Emergency Medical Service Communication Systems ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Local Area Networks ; Microcomputers ; Modems ; Online Systems* ; Referral and Consultation* ; Transportation of Patients

Prenatal diagnosis of Down syndrome requires an invasive test in women considered to be at high risk after screening. At present, there are variable screening tests. For a 5% false-positive rate, the sensitivities are approximately 20-30% for maternal age alone, 60-70% for maternal age and second-trimester maternal serum markers, 85% for maternal age with fetal nuchal translucency and maternal serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 11-14 weeks, and 94% for maternal age with fetal nuchal translucency and maternal serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 11-14 weeks following second-trimester maternal serum markers. This article examines the studies of screening for Down syndrome and summarizes the results from major studies reporting on the implementation of this method.
Biomarkers ; Chorionic Gonadotropin ; Down Syndrome* ; Female ; Humans ; Mass Screening ; Maternal Age ; Nuchal Translucency Measurement ; Pregnancy-Associated Plasma Protein-A ; Prenatal Diagnosis*

Neonatal intensive care in Korea has improved remarkably since the 1990s, but there is still a shortage of facilities and equipment in NICUs. Only 71.1% of the beds needed for neonatal intensive care are available. Mechanical ventilators are not appropriately distributed to the NICUs that are equipped to handle neonatal intensive care. The number of doctors is far too small, making the number of patients per doctor very high. Nurses, too, need to take care of 7.7 patients per nurse, making it very difficult to provide adequate intensive care. All this is caused by insufficient investment by the hospitals, which, in turn, is caused by inadequate reimbursement from health insurance. Therefore, a government-sponsored effort is necessary to bring the level of neonatal intensive care up to par.
Humans ; Infant, Newborn ; Insurance, Health ; Critical Care ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Investments ; Korea ; Ventilators, Mechanical

Although the advantages of breastfeeding, such as nutritional and immunologic support to the baby and improvement of emotional bonding between mother and baby, are well recognized, economic benefits of the breastfeeding are not emphasized. Breastfeeding help mothers save money to purchase breast milk substitutes and related equipments, such as bottles, nipples and sterilizers. It also reduces the incidences of common respiratory and gastrointestinal infection of babies, premenopausal breast cancer and ovarian cancer of mothers, and related hospital expenses. For employed mothers, a hospital visit due to illness of their babies can cause absence from their work places. For estimation of the economic advantages of breastfeeding in Korea, we surveyed the cost of the breast milk substitutes and related equipments. The yearly costs for the formulas were 763 thousand to 2.5 million wons, and for the equipment was 360 to 480 thousand wons. If the breastfeeding rate of the total population increased to 50%, 162-294 billion wons can be saved per year in this country by reducing the costs for the formula at the equipment. Total hospital expenses for the illness of babies can be reduced by 7.9-13.8 billion wons per year and hospital costs for maternal breast and ovarian cancers can be reduced by 24.8-57.7 billion wons per year. Durations of maternal absence from their work can be reduced to the value of 21.6-42.5 billion wons per year. In summary, by increasing breastfeeding rates in this country to 50%, 216.4-407.5 billion wons can be saved every year.
Breast ; Breast Feeding ; Breast Neoplasms ; Hospital Costs ; Humans ; Incidence ; Korea ; Milk, Human ; Mothers ; Nipples ; Object Attachment ; Ovarian Neoplasms ; Workplace

BACKGROUND: The placenta from a pregnancy that is complicated by intrauterine growth retardation (IUGR) tends to be smaller than that from a normal pregnancy. To investigate this difference, we analyzed the telomerase activity, the proliferative activity and the mRNA levels of apoptosis mediators in placentas. METHODS: In 20 placentas from normal third-trimester pregnancies and 22 placentas form pregnancies that were complicated by IUGR, the telomerase activity was detected by a telomeric repeat amplification protocol assay. The proliferative activity was assessed by immunohistochemical staining using the MIB-1 monoclonal antibody. The expression of the apoptosis mediator was evaluated by semi-quantitative reverse transcription-polymerase chain reactions for fas and fas ligand. RESULTS: Telomerase activity was detected in 2 (10%) of 20 normal placentas, whereas it was not observed in all tested 13 placentas that were associated with IUGR. The proliferative activity was significantly low in the placentas that were associated with IUGR (7.44+/-2.96%), compared with the normal placentas (11.0+/-3.48%, p=0.002). There was no statistically significant difference in the mRNA levels of fas or fas ligand between two groups. CONCLUSIONS: Low telomerase and proliferative activities in the placenta may play a role in the pathogenesis of IUGR.
Apoptosis ; Fas Ligand Protein* ; Female ; Fetal Growth Retardation* ; Humans ; Placenta* ; Pregnancy ; RNA, Messenger ; Telomerase*

BACKGROUND: In general, increased body weight may be a risk factor for hypertension, diabetes, hyperlipidemia, and coronary heart disease. It is very difficult to lose weight especially in aged people. Osteoporosis is commonly developed in aged. Many reports revealed that obesity may prevent bone loss. The protective effect of obesity on bone has been ascribed to a high body fat content. Obese aged people can be very confused whether to decide to lose weight or not. METHODS: We evaluated 137 women aged over 60 who visited a health care center of a university hospital in Seoul from Jan. 1999 to Oct. 1999 to determine the effects of obesity on bone mineral density in aged Korean women. We measured anthropometrical characteristics, BMD of lumbar spine, markers of bone turnover, and FSH of the subjects. RESULTS: The results revealed that obese group had a greater BMD at lumbar spine, but the levels of FSH were noted to be lower than the non obese group. But, none of the markers of bone turnover showed significant differences between the two groups. BMI was positively correlated with BMD (r=0.455, P<0.001) by Pearson's correlation matrix. Also, the level of total alkaline phosphatase significantly had negative association with BMD. The level of FSH revealed that it had a negative correlation (r= 0.290, P<0.01) with BMI. CONCLUSION: We concluded that obesity might have a protective effect related with FSH. Prospective studies on endocrinologic association with BMD, bone markers, FSH and estradiol will be needed.
Adipose Tissue ; Alkaline Phosphatase ; Body Weight ; Bone Density* ; Coronary Disease ; Delivery of Health Care ; Estradiol ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Obesity* ; Osteoporosis ; Risk Factors ; Seoul ; Spine

BACKGROUND: This study was performed to accurately discover the correlation between the epidural depth and physical measurements. METHODS: We measured the L2-3, L3-4 epidural depth pre-marked on the needle shaft only when the block was successful. Correction of the depth was made by the angulation of the needle from the perpendicular line (with regard to both the x- and y-axis) to the skin. Height and weight from the medical record was noted and neck, waist, and hip circumferences of each subject was measured. Physical parameters such as waist/neck (waist circumference-to-neck circumference ratio), waist/height (waist circumference-to-height ratio), waist/hip (waist circumference-to-hip circumference ratio), weight/neck (weight- to-neck circumference ratio), weight/height (weight-to-height ratio) and body mass index (BMI) were calculated. Peason's correlation and a regression test between the epidural depth and the physical mea surements were performed. RESULTS: Significant correlation with epidural depth was found in weight, waist, hip, neck, BMI, waist/height, waist/hip, weight/neck, and weight/height. With the regression test, we found weight to be the most important for predicting epidural depth (R square = 0.330, P < 0.05). CONCLUSIONS: Weight has the highest predictive value for lumbar epidural depth.
Body Mass Index ; Hip ; Medical Records ; Neck ; Needles ; Skin

PURPOSE: Aplasia cutis congenita (ACC) is a rare condition characterized by a localized absence of skin, and it can be associated with other congenital anomalies. This study was done to evaluate clinical course and outcome of ACC in neonates. METHODS: Based on the medical records, we retrospectively reviewed 8 neonates diagnosed with ACC at Cheil General Hospital and Women's Health Care Center, Kwandong university College of Medicine from January 2004 to December 2010. We classified ACC by Frieden's classification and analyzed the patient's demographic data, clinical course and outcome. RESULTS: Among 8 patients with ACC, 5 patients were classified to group 1; scalp ACC without anomalies and 3 patients to group 7; ACC localized to extremities without blistering. Defect size was from 0.3 cm to 1.5 cm, limited in the superficial skin or subcutaneous tissue without associated anomalies. Defects were healed under conservative treatment with mild scar formation within four months. CONCLUSION: ACC could be diagnosed easily through physical examination in neonates. All cases showed good clinical outcome without surgical treatment. However because of small numbers and small sized defects of cases, further study including lesions of large size is needed.
Blister ; Cicatrix ; Ectodermal Dysplasia ; Extremities ; Hospitals, General ; Humans ; Infant, Newborn ; Medical Records ; Physical Examination ; Prognosis ; Retrospective Studies ; Scalp ; Skin ; Subcutaneous Tissue ; Women's Health

In this study we investigate the expression pattern of mucin genes in the human testis and evaluate the relationship between the expression of mucin genes and impaired spermatogenesis in the human testis. Thirty human testis tissues were collected from patients undergoing diagnostic testicular biopsy to investigate the cause of infertility. One part of the tissue underwent histological observation, and the other part of the tissue was subjected to semiquantitative RT-PCR of mucin genes, that is, mucin1, 2, 3, 4, and 9. The relative amount of mucin mRNAs was calculated by densitometry using glyceraldehydes-3-phosphate dehydrogenase (GAPDH) as an internal control. The samples were histologically diagnosed as either obstructive azoospermia with normal spermatogenesis (n = 13) or non-obstructive azoospermia with impaired spermatogenesis (n = 17). In the human testis with normal spermatogenesis, mRNA expression of mucin1, 9, 13 and GAPDH were found, but RT-PCR products of mucin 2, 3 and 4 were not detected. In the testis with impaired spermatogenesis, however, RT-PCR product of mucin1 was not found. There was no difference in the other mucin mRNA expression patterns between the testis with either normal or impaired spermatogenesis. To our knowledge, this study is the first that has detected the mRNA of mucin9 and 13 in human testis. This study also shows that mucin1 expression might be closely related to spermatogenesis. Our findings should be substantiated by more direct evidence, such as mucin protein expression and localization.
Testis/*metabolism ; *Spermatogenesis ; Mucins/*genetics ; Middle Aged ; Male ; Humans ; Glycoproteins/genetics ; Antigens, Neoplasm ; Antigens/genetics ; Adult

BACKGROUND: Reperfusion in ischemia is believed to generate cytotoxic oxidative stress, which mediates reperfusion injury. These stress conditions can initiate lipid peroxidation and damage to proteins, as well as promote DNA strand breaks. As biliverdin and bilirubin produced by heme oxygenase isoform 1 (HO-1) have antioxidant properties, the production of both antioxidants by HO-1 may help increase the resistance of the ischemic brain to oxidative stress. In the present study, the survival effect of HO-1 was confirmed using hemin. METHODS: To confirm the roles of HO-1, carbon monoxide, and cyclic guanosine monophosphate further in the antioxidant effect of HO-1 and bilirubin, cells were treated with cycloheximide, desferoxamine, and zinc deuteroporphyrin IX 2,4 bis glycol, respectively. RESULTS: HO-1 itself acted as an antioxidant. Furthermore, iron, rather than carbon monoxide, was involved in the HO-1-mediated survival effect. HO-1 activity was also important in providing bilirubin as an antioxidant. CONCLUSION: Our results suggested that HO-1 helped to increase the resistance of the ischemic brain to oxidative stress.
Animals ; Antioxidants ; Bilirubin ; Biliverdine ; Brain* ; Carbon Monoxide ; Cycloheximide ; DNA ; Guanosine Monophosphate ; Heme ; Heme Oxygenase (Decyclizing) ; Hemin ; Iron ; Ischemia ; Lipid Peroxidation ; Microvessels* ; Oxidative Stress ; Oxygen* ; Oxygenases ; Rats* ; Reperfusion ; Reperfusion Injury ; Zinc