OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

To evaluate the clinical and histopathological significance of the proliferative activity in neoplastic and non-neoplastic thyroid lesions, we analyzed the mitotic count and the proliferating cell nuclear antigen labeling index (PCNA-LI) by immunohistochemistry as the proliferation- related markers. In this study included were surgically removed normal thyroid tissue (27 cases), adenomatous goiter (15 cases), Hashimoto's thyroiditis (5 cases), follicular adenoma (13 cases), follicular carcinoma (7 cases), papillary carcinoma (44 cases), poorly differentiated carcinoma (2 cases) and undifferentiated carcinoma (3 cases). The median PCNA-LI was 0 in normal thyroid tissue, 0.5 in adenomatous goiter, 6.2 in Hashimoto's thyroiditis, 1.2 in follicular adenoma, 4.8 in follicular carcinoma, 8.5 in papillary carcinoma, 60.8 in poorly differentiated carcinoma, and 55.2 in undifferentiated carcinoma (p=0.0001). Although PCNA-LI was exceptionally high in Hashimoto's thyroiditis, it was suggested that PCNA-LI could be used as a marker differentiating benign lesions from malignant neoplasm. Also, it could differentiate follicular adenoma from follicular carcinoma. Except clinical stage (p=0.0397), PCNA-LI was not related with sex, size, histologic subtype, and lymph node metastasis in papillary carcinoma. The presence of mitosis differentiated the neoplastic thyroid lesions from the non-neoplastic lesions (p<0.05), however, it could not divide benign and malignant neoplasm. These results suggest that an evaluation of the proliferative activity can help to differentiate the thyroid lesions. In addition, there was no significant correlation between the value of PCNA-LI and the presence of mitosis. It can be recommended to evaluate both the mitotic count and the PCNA-LI for determining the proliferative activity of the thyroid lesions.
Adenoma ; Carcinoma ; Carcinoma, Papillary ; Goiter ; Immunohistochemistry ; Lymph Nodes ; Mitosis ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen* ; Thyroid Gland* ; Thyroiditis

OBJECTIVES: The purpose of this study was to compare awareness on scaling and satisfaction regarding national health insurance scaling to several general characteristics, to awareness of oral health, and to pre- and post-operative experience of the national health insurance dental scaling program. METHODS: The study was conducted over a 1 month period from August 1, 2014, to September 1, 2014. All subjects were asked to complete a self-administered questionnaire. A total of 261 questionnaires were used in the final analysis (incorrectly completed questionnaires were excluded). The data was subsequently analyzed (including t-test, one way ANOVA, and Pearson's correlation coefficient) using SPSS version 20.0. RESULTS: In total, 91.6% of respondents were aware of the national health insurance scaling program. Furthermore, 81.8% said that they were satisfied with national health insurance scaling. The majority of the respondents (69.0%) were also satisfied with the national health insurance scaling fee. Although 71.6% were satisfied with national health insurance scaling age, only 60.5% were satisfied with the frequency of national health insurance scaling. The disparity in the reported awareness on scaling and on national health insurance scaling was showed to be statistically significant (p<0.05). Moreover, the reported difference between satisfaction on national health insurance scaling and satisfaction with the scaling experience was also significant (p<0.05). Finally, there was a significant difference between reported awareness on scaling, awareness on national health insurance scaling, and satisfaction with national health insurance scaling (p<0.01). CONCLUSIONS: The results presented in this study reveal that awareness of scaling, awareness on national health insurance scaling and satisfaction with national health insurance scaling are important influencing factors. These results should be carefully considered in any plans to expand preventive dental healthcare clinics. In conclusion, a more systematic oral-health policy (especially regarding scaling) needs to be established to improve national oral health and quality of life.
Surveys and Questionnaires ; Delivery of Health Care ; Dental Scaling* ; Fees and Charges ; National Health Programs* ; Oral Health ; Quality of Life

No abstract available.
Granuloma* ; Intubation*

BACKGROUND/AIMS: The hepat it is C virus (HCV) genotypes have been shown to be differently distributed among distinct geographic areas and as sociated with different clinical present at ions. The aut hors investigated the distribution of HCV genotypes in Korean patients with chronic HCV infection and the as sociation of HCV genotypes with age, sex, severity of the liver disease, and the possible mode of transmission. METHODS: The study population consisted of 143 patients with chronic HCV infect ion: 13 with normal ALT , 78 with chronic hepatitis , 35 with cirrhosis , 17 with hepat ocellular car cinoma (HCC). HCV genotypes were determined by line probe assay. RESULTS: The principal HCV genotype was 1b ( 56%) and followed by 2a/ c ( 32%), mixed (8%), 2b ( 3%), and 1a (1%). Patients infected with type 1b and 2a/ c were older than those with ot her genotypes (p< 0.05). Genotype 1b tended to be more prevalent among patients with HCC ( 76% compared with 53% for patients with other liver diseases ; p=0.07). There was no significant relations hip bet ween genotypes and sex or mode of transmission. CONCLUSION: The most common HCV genotype in Korea was type 1b and followed by 2a/ 2c. Although patients infected with type 1b and 2a/c were older than those with other genotypes, there was no correlation between genotypes and sex, severity of liver disease, or mode of transmission.
Fibrosis ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Hip ; Humans ; Ions ; Korea ; Liver Diseases

Lactobacillus species have been widely used in both human and animals to prevent or treat gastrointestinal disorders. Recently, it was reported that Lactobacillus spp. inhibited infections by respiratory and gastroenteric viruses; however, its mechanism is not clear. Lactobacillus spp. play direct and indirect roles in the inhibitory effects of viral replication. 1) In vitro study: Highest protection effects were showed with the known probiotics L. rhamnosus GG (LGG) and L. casei Shirota against both rotavirus (RV) and transmissible gastroenteritis virus (TGEV). 2) In vivo study: L. acidophilus had significant immunopotentiating effects, and was therefore recommended for use as a safe oral adjuvant for rotavirus vaccines in pigs. Oral administration of lactobacilli, such as LGG and L. gasseri, might protect a host animal from influenza virus (IFV) infection. Polysaccharides are regarded to be potentially useful and biologically active as an ingredient for pharmaceutical uses due to a variety of biological activities. Especially, sulphated polysaccharides exhibit broad-spectrum antiviral activity against enveloped viruses in vitro. With respect to human immunodeficiency virus type 1 (HIV-1), its in vitro antiviral activity is, specifically, the inhibition of virus-cell attachment, the first step in the infection process. Recently, it was reported that sulphated polysaccharides exhibited antiviral activity against HBV, HCMV, HSV and IFV. In conclusion, Lactobacillus spp. and polysaccharides with antiviral activity against diverse viruses are potential candidates as ingredients for probiotics and medicine candidate for the prevention and treatment of viral infections in animals and humans.
Administration, Oral ; Animals ; HIV-1 ; Humans ; Lactobacillus ; Orthomyxoviridae ; Polysaccharides ; Probiotics ; Resin Cements ; Rotavirus ; Rotavirus Vaccines ; Swine ; Transmissible gastroenteritis virus

Primary biliary cirrhosis (PBC) is characterized by histological findings of an immunoinflammatory destruction of small- and medium-sized bile ducts with progressive portal fibrosis, and the presence of anti-mitochondrial antibody (AMA) with a laboratory evidence of chronic cholestasis. The term "autoimmune cholangitis" (AIC) is used for a disease with the clinical and pathologic features of primary biliary cirrhosis (PBC) but with negative AMA and positive anti-nuclear antibody (ANA) tests. Eight cases of AIC and ten cases of PBC were reviewed in order to determine whether there was any difference between two diseases in clinico-pathologic aspects. All of the patients were female and the mean ages of AIC and PBC patients were 48 and 47 years, respectively. ANA test was positive in six of ten PBC paients and their mean titer was lower than that of AIC patients. IgM level was significantly higher in PBC group than in AIC group. No significant difference was found between two groups with respect to biochemical and histopathological features. Since the only consistently distinguishing features between these two conditions are the autoantibody profile (AMA vs ANA) and immunoglobulin level (IgM), these two conditions might be part of a spectrum. PBC can be considered to be the same as AMA-positive AIC or alternatively AIC to be the same as AMA-negative PBC.
Bile Ducts ; Cholangitis* ; Cholestasis ; Female ; Fibrosis ; Humans ; Immunoglobulin M ; Immunoglobulins ; Liver Cirrhosis, Biliary*

No abstract available.
Catheters*

A 37 year-old-woman was admitted to the hospital because of 15 days' duration of continuous fever. Routine studies for detection of fever foci were negative. Imaging studies revealed giant hemangioma of the liver with central thrombosis. The fever persisted for a period of 4 weeks, and subsided after conservative management. We report a case of hepatic hemangioma presenting with fever of unknown origin. The condition is very rare, but should be regarded as one of the causes of fever of unknown origin.
Adult ; Female ; Fever of Unknown Origin/*etiology ; Hemangioma/complications/*diagnosis ; Humans ; Liver Neoplasms/complications/*diagnosis

There are substantial variations of relative risks (RR) in smoking-related mortality by country and time. We hypothesized the RRs in smoking-related mortality might differ depending on serum concentrations of persistent organic pollutants (POPs). We evaluated the associations of cigarette smoking with total mortality in 610 elderly (aged > or = 70 yr) (702 elderly for organochlorine pesticides [OCPs]) after stratification by serum concentration of POPs, in the National Health and Nutrition Examination Survey (NHANES) 1999-2004 followed through 2006. Summary measures of POPs subclasses showed significant or marginally significant interaction with cigarette smoking on the risk of total mortality. P values for interaction were 0.069 for polychlorinated dibenzo-p-dioxins (PCDDs), 0.008 for polychlorinated biphenyls (PCBs), and 0.024 for OCPs. The effect of smoking on total mortality showed different patterns according to the serum concentration of some POPs. Former or current smokers had 1.4 to 2.9 times higher mortality rates compared with never smokers among participants with higher serum concentrations of POPs (2nd or 3rd tertiles). However, when the level of PCBs or OCPs were low (1st tertile), there were little positive associations between smoking and mortality. Our study suggests that the background exposure to several POPs may be related to variability in smoking-related total mortality.
Aged ; Aged, 80 and over ; Environmental Exposure ; Environmental Pollutants/*blood ; Female ; Humans ; Hydrocarbons, Chlorinated/blood ; Male ; Nutrition Surveys ; Pesticides/blood ; Polychlorinated Biphenyls/blood ; Proportional Hazards Models ; Risk ; Smoking/*mortality ; Tetrachlorodibenzodioxin/analogs & derivatives/blood