Postpartum hemorrhage is an important cause of maternal mortality and morbidity. Especially uterine atony is the most common cause of postpartum hemorrhage. Conventional method to control postpartum uterine atonic bleeding is based on the use of oxytocin and ergot preparations. Prostaglandin F2alpha analogue such as carboprost can be used to promote contraction when these agents fail to produce uterine contraction. Prostaglandin E1 analogue, misoprostol has uterotonic effect by oral or vaginal administration. They are used to induce labor and first or mid trimester abortion. In postpartum uterine atonic bleeding, misoprostols cannot be used via oral or vaginal route. Recently we have experienced that postpartum uterine atonic bleedings unresponsive to conventional methods were controlled by rectal misoprostols. So we report these cases with a brief review of literatures.
Administration, Intravaginal ; Alprostadil ; Carboprost ; Dinoprost ; Hemorrhage* ; Maternal Mortality ; Misoprostol* ; Oxytocin ; Postpartum Hemorrhage ; Postpartum Period* ; Uterine Contraction ; Uterine Inertia

OBJECTIVES: Although phthalates like dibutyl phthalate (DBP) and di-2-ethylhexyl phthalate (DEHP) are commonly used as plasticizers and their metabolites are especially suspected of reproductive toxicity, little is known about occupational exposure to those phthalates. The aim of this study was to assess the utility of measuring the metabolite concentrations of DBP and DEHP in serum and urine samples as an indicator of occupational exposure to those phthalates. METHODS: Phthalate metabolites were analyzed by using column-switching high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS). RESULTS: We detected phthalate metabolites in serum and urine matrices at approximately 10-fold lower than the limit of detection of those metabolites in the same matrix by LC-MS/MS without column switching, which was sufficient to evaluate concentrations of phthalate metabolites for industrial workers and the general population. CONCLUSION: The accuracy and precision of the analytical method indicate that urinary metabolite determination can be a more acceptable biomarker for studying phthalate exposure and adverse health outcomes.
Biomarkers ; Chromatography, Liquid ; Dibutyl Phthalate ; Diethylhexyl Phthalate ; Humans ; Limit of Detection ; Occupational Exposure ; Phthalic Acids ; Plasticizers ; Plastics ; Tandem Mass Spectrometry

Phase-partitioning with Triton X-114 (TX114) was applied to the TSP antigen, which may be preferentially associated with the cell wall of M. tuberculosis. The hydrophilic protein components of the TSP antigen were successfully separated from integral hydrophobic macromolecules. To further characterize and examine the cellular immune response of the aqueous fraction of the TSP antigen (TSPa), the in vitro properties of the antigen were measured by lymphoproliferation; surface expression of IL-2 Ra on T lymphocytes was analyzed by flow cytometry; and the cytokine mRNA expression pattern was determined by RT-PCR. Significant lymphoproliferative responses to the TSPa antigen were observed in healthy tuberculin reactive donors after a 5 day in vitro stimulation. TSPa treatment of PBMCs from healthy tuberculin positive subjects for 5 days resulted in progressive augmentation of IFN-r, II 2, and IL-2Ra mRNA expression, as measured by RT-PCR, but considerably reduced IL-4 mRNA expression. In addition, the TSPa antigen stimulated more IL-12 p40 mRNA production than did the PPD antigen, and graduaBy suppressed IL- 10 mRNA expression. Moreover, the CD3' T cells of tuberculin positive subjects displayed a profound increase in their expression of the II 2Ru protein (39.0%) in response to the TSPa antigen. Proliferation was correlated with IL-2 and IL-2Ra mRNAs, but not correlated with distinct IFN-r or IL-12 p40 mRNA production. These findings strongly suggest that the TSPa antigen preferentially evokes the generation of a Thl-like immune response in healthy tuberculin reactors.
Cell Wall ; Flow Cytometry ; Humans* ; Immunity, Cellular* ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Mycobacterium tuberculosis* ; Mycobacterium* ; Neptune ; RNA, Messenger ; T-Lymphocytes ; Tissue Donors ; Tuberculin ; Tuberculosis

Two distinct hantaviruses have been isolated from Apodemus agrarius in 1976 and Rattus norvegicus in 1980 in Korea. Since our serosurveys conducted in 1994, a genetically distinct hantavirus from Apodemus peninsulae has been investigated. To isolate hantavirus from A. peninsulae captured in Korea, the lung homogenate of seropositive A. peninsulae inoculted Vero E6 cells. Viral antigen was detected in a progressively higher percentage of cells with subsequent passage after 80 days postinoculation. The new isolate from seropositive Apodemus peninsulae was designated Suchong virus after Suchong valley located in northeastern region of South Korea. Comparing with hantaan virus 76-118 strain, Suchong virus-1, 2, 3 and 4 showed the similarity of 71.0~91.8% at nucleotide and 90.9~94.8% at amino acid sequences in 231 nucleotides region of M segment, and the similarity of 75.1~81.0% at nucleotide and 97.5~100% at amino acid sequences in 237 nucleotides of S segment.
Amino Acid Sequence ; Animals ; Hantaan virus ; Hantavirus* ; Korea ; Lung ; Murinae* ; Nucleotides ; Population Characteristics* ; Rats

OBJECTIVE: Our purpose was to determine whether abnormal triple marker in the second trimester may be associated with adverse pregnancy outcomes. METHODS: Between November 1996 and April 1998, we evaluated 1,158 pregnant women undergoing second trimester triple marker screening tests who delivered at our hospital. The pregnancy outcomes of 48 women with false positive screens were compared with 1,158 screen negative controls. The pregnancy outcomes were obtained from hospital delivery records. RESULTS: Women with abnormal triple marker showed increased risks for low birth weight(p<0.01). But there was no significant differences between study and control groups with respect to preterm labor, pregnancy induced hypertension, oligohydroamnios, premature rupture of membrane, placenta previa, abruptio placenta, fetal death in utero. CONCLUSION: Abnormal triple marker in the second trimester was associated with low birth weight.
Female ; Fetal Death ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Low Birth Weight ; Infant, Newborn ; Mass Screening* ; Membranes ; Obstetric Labor, Premature ; Parturition ; Placenta ; Placenta Previa ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnancy, High-Risk* ; Pregnant Women ; Rupture

Among wild chipmunks, Tamias sibiricus, captured in Kyunggi and Kangwon province in Korea, 1997, seropositivity for Orientia tsutsugamushi was determined. Serological test for Orientia tsutsugamushi infection was performed using indirect immunofluorescent antibody technique (IFA). Of 243 wild chipmunks, 61 against Gilliam strain and 64 against Karp strain of Orientia tsutsugamushi were IFA positive. Seropositivity against Gilliam strain was shown 33.3% in Kyunggi and 23.5% in Kangwon province, and against Karp strain was shown 33.3% and 25.4%, respectively.
Gangwon-do ; Gyeonggi-do ; Korea* ; Orientia tsutsugamushi* ; Sciuridae* ; Serologic Tests

BACKGROUND: There is no guideline for the appropriate wavelength at which to measure the optical density (OD) value in broth microdilution antifungal susceptibility testing, although a spectrophotometric reading method is commonly used. The present study aimed to analyze the difference in the OD values over the range of visible light and to ascertain the optimal wavelength for the spectrophotometric method of microdilution testing. METHODS: We measured the OD of background blank controls of broth medium, antifungal agents, and inocula of five type strains using a Synergy HT multi-detection microplate reader at 5-nm intervals from 380 nm to 760 nm. We also estimated the OD differences between the 50% of growth control and blank control. RESULTS: The OD of the blank control showed a parabola shape with two peaks and steadily decreased at longer wavelengths. The curves of the antifungal agent were similar to those of blank controls, and the influence of each antifungal agent on the OD was minimal. For the difference in OD between 50% of growth control and the blank control, the curve was the opposite of the blank control, and the OD increased steadily at the wavelengths above 600 nm. CONCLUSIONS: The range between 600 nm and 700 nm was the optimal wavelength for broth microdilution antifungal susceptibility testing, although any wavelength within the visible light spectrum can be used.
Antifungal Agents/*chemistry ; Azoles/*chemistry ; Culture Media/*chemistry ; Flucytosine/*chemistry ; Microbial Sensitivity Tests ; Spectrophotometry/*methods

BACKGROUND: This study was designed to determine the seropositivity for rickettsial infection among wild rodents captured in farms of Kyunggi province and in mountains of Kangwon province in Korea. METHODS: A total of 513 wild rodents of 5 species were captured in 1997~1998. Serological evidence for rickettsial infection was obtained using Orientia tsutsugamushi antigens by indirect immunofluorescent antibody technique(IFA). RESULTS: 168 Apodemus agrarius, 35 Microtus fortis, 3 Micromis minutus and 2 Eothenomys regulus were captured in Kyunggi province, of which 32 Apodemusagrarius, 4 Microtus fortis, 1 Micromis minutus were IF antibody positive against O. tsutsugamushi. 196 Apodemus agrarius, 77 Apodemus peninsulae and 29 Eothenomys regulus were captured in Kangwon province, of which 4 Apodemus agrarius and 5 Apodemus peninsulae were positive. CONCLUSION: Seropositivity rate against O. tsutsugamushi of wild rodents captured in Kyunggi and Kangwon provinces were 19.6% and 3.0% by IFA tests, respectively.
Animals ; Arvicolinae ; Gangwon-do* ; Gyeonggi-do* ; Korea* ; Murinae ; Orientia tsutsugamushi ; Rodentia*

OBJECTIVE: To investigate the relationship between autonomic neuropathy and peripheral neuropathy through analysis of heart rate variability (HRV) in diabetic patients, and ultimately to investigate usefulness for HRV analysis for quantitative evaluation and prediction of diabetic autonomic neuropathy. METHOD: We performed nerve conduction study (NCS), H- reflex, and HRV test with 42 diabetic patients. We classified patients by presence of peripheral neuropathy and abnormality of H-reflex, respectively. By comparing standard deviation of RR interval (SDNN), high frequency (HF), low frequency (LF), very low frequency (VLF), and total power (whole level of frequency, TP) of HRV, we analyzed the relationship between these parameters and duration of diabetes, age, and results from NCS. RESULTS: There were significant differences of SDNN, HF, TP according to the presence or the absence of peripheral neuropathy. There were significant differences of SDNN, HF according to the presence or the absence of H-reflex abnormality. SDNN and HF had reversed-relationship to the degree of H-reflex abnormality. CONCLUSION: We expect HRV might be used as an efficient quantitative method to detect diabetic autonomic neuropathy and suggest HRV to be used for early detection of diabetic peripheral neuropathy.
Diabetic Neuropathies* ; Evaluation Studies as Topic* ; H-Reflex ; Heart Rate* ; Heart* ; Humans ; Neural Conduction ; Peripheral Nervous System Diseases ; Reflex

PURPOSE: The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS). MATERIALS AND METHODS: Radiographic data, Scoliosis Research Society (SRS) patient-based outcome questionnaires, and operative records were reviewed for forty-nine patients undergoing surgical treatment of scoliosis. The study group was divided into a 4.5 mm thin rod group (n = 24) and a 5.5 mm thick rod group (n = 25). The radiographic parameters that were analyzed included coronal curve correction, the most caudal instrumented vertebra tilt angle correction, coronal balance, and thoracic kyphosis. RESULTS: The major curve was corrected from 49.8degrees and 47.2degrees pre-operatively to 24.5degrees and 18.8degrees at the final follow-up for the thin and thick rod groups, respectively (50.8% vs. 60.2% correction). There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up. The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group. There were no major intraoperative complications in either group. CONCLUSION: Significant correction loss was observed in the thin rod system at the final follow-up though both groups had comparable correction immediately post-operative. Therefore, the thick rod with poly axial screw system helps to maintain post-operative correction.
Adolescent ; Adult ; *Bone Screws ; Female ; Humans ; Male ; Retrospective Studies ; Scoliosis/radiography/*surgery ; Thoracic Surgery, Video-Assisted/*methods ; Treatment Outcome