To evaluate the possible functional role of serum during the process of parturition, 15 serum samples were collected and analyzed for the nickel concentrations in each 3 groups(Group 1 for the period during parturition, Group 2 for the period from delivery of fetus to delivery of placenta, and Group 3 for the period after delivery of placenta) of normal, uncomplicated full term vaginal delivery and one control group composed of healthy unmarried women in 3rd decades of age. Data revealed that average serum nickel concentration of Group 2(26.6 microgram/l) and Group 1(22.2 microgram/l) were significantly higher than that of Control group(13.7 microgram/l), but Group 3's(13.8 microgram/l) was almost same as Control group's. There were significant negative correlation between age and serum nickel concentration in group 2, and a tendency of higher nickel concentration in women who have no previous experiences of pregnancy than who have previous experiences of pregnancy, although it was not significant. These result could be indicative of close causal relationship between serum nickel concentration and the entire process of parturition.
Female ; Fetus ; Humans ; Nickel* ; Parturition ; Placenta ; Pregnancy ; Single Person

OBJECTIVE: In order to investigate more accurate patterns of intrauterine growth in twin fetuses, we constructed the twin-specific growth curve based on gestational age in live-born non-anomalous infants. METHODS: 563 twin pairs, 1,126 infants delivered between January 1994 and October 1999 were comprised our study population. The newborns were grouped according to gestational age and the median, 10th, 50th, and 90th percentile birth weight for each gestational week were calculated. Curves were plotted for the general population and for each gender and parity and compared with previously reported singleton's growth curve. RESULTS: After 32 weeks gestation, birth weight of twins falls below that of singleton, so that by 38 weeks the 50th percentile for twins falls below the singleton 10th percentile. This difference was also present among all subgroups of twins, such as gender and parity. And the mean birth weight in male twin infant was heavier than in female twin infant throughout all gestational week. CONCLUSION: The pattern of growth in twin infants differed from those of singleton. We recommend twin-specific growth curve for clinical use in the management of twin gestations.
Birth Weight ; Female ; Fetus ; Gestational Age* ; Humans ; Infant ; Infant, Newborn ; Male ; Parity ; Pregnancy ; Twins*

No abstract available.
Female ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy Trimester, Second*

OBJECTIVES: To evaluate whether the day of delivery for women with regular menstrual history was predicted best from the last menstrual period (LMP), crown rump length (CRL) and or biparietal diameter (BPD). METHODS: All of 561 women had estimated the day of delivery by LMP, CRL in the first trimester (In case of 217 women, it was available) and BPD in the second trimester. The accuracy of each method in predicting the day of delivery was determined. Those who were delivered after the spontaneous onset of labor were included. Differences among these methods were evaluated with nonparametric tests. RESULTS: The percentage of women who delivered within 3 days of the estimated day of delivery was 254(45.3%) and 216(38.5%) of the women with pregnancies by BPD and LMP, respectively. And within 7days of the estimated day were 408(72.7%), 390(69.5%) of the women from BPD and the LMP. In the women, the BPD estimate was significantly better predictor within the 7days of the day of delivery than LMP estimate (p=0.027). Compared to LMP estimate, CRL and BPD estimates seemed to be advanced the day of delivery about 2.6 days in CRL, and 0.9 days in BPD (p=0.004, p=0.034). But we could not find any advantage of the CRL measurement in first trimester than single BPD measurement in the second trimester for the predictor of the day of delivery. CONCLUSIONS: When the difference between the methods in predicting the day of delivery was less than 7 days, the BPD measurement was better than the last menstrual period.
Biometry* ; Crown-Rump Length ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Ultrasonography

Hiccup is caused by synchronous contractions of the diaphragmatic and intercostal muscles followed by the closure of the glottis. Intractable hiccup is defined as hiccup bouts lasting more than 48 hours or recurring despite various treatments. Recently we have experienced a case of postoperative intractable hiccup. We failed to stop intractable hiccup by pharmacological treatment, but succeeded by unilateral phrenic nerve block.
Glottis ; Hiccup* ; Humans ; Intercostal Muscles ; Nerve Block ; Phrenic Nerve*

Although intravesical instillation of Mycobacterium bovis bacillus Calmette-Guérin (BCG) is the most successful cancer immunotherapy for superficial bladder cancer, the serious side effects are frequently arisen by using live mycobacteria. To allow less toxic and more potent immunotherapeutic agents following intravesical BCG treatment for superficial bladder cancer, noninfectious immunotherapeutic drug instead of live BCG would be highly desirable. Recently, immune-enhancing adjuvants are considered an effective vaccine immunotherapy for cancer, providing enhanced antitumor effects and boosted immunity. The BCG-cell wall skeleton (BCG-CWS), the main immune active center of BCG, is a potent candidate as a noninfectious immunotherapeutic drug instead of live BCG against bladder cancer. However, the most limited application for anticancer therapy, it is difficult to formulate a water-soluble BCG-CWS due to the aggregation of BCG-CWS in both aqueous and nonaqueous solvents. To overcome the insolubility and improve the internalization of BCG-CWS into bladder cancer cells, it should be developed the lipid nanoparticulation of BCG-CWS, resulting in improved dispensability, stability, and small size. In addition, powerful technology of delivery systems should be applied to enhance the internalization of BCG-CWS, such as encapsulated into lipid nanoparticles using novel packaging methods. Here, we describe the progress in research on effects of BCG-CWS for cancer immunotherapy, development of lipid-based solvent, and packaging method using nanoparticles with drug delivery system.
Administration, Intravesical ; Bacillus ; Cell Wall Skeleton ; Drug Delivery Systems ; Immunotherapy ; Methods ; Mycobacterium bovis ; Nanoparticles ; Product Packaging ; Skeleton ; Solvents ; Urinary Bladder Neoplasms ; Urinary Bladder

Background/Aims: To eliminate hepatitis C virus (HCV) infection, improving public knowledge of and access to HCV screening and treatment is essential. The aim of this study was to evaluate the knowledge of and testing rate for HCV and the opinions about the inclusion of the HCV test in the National Health Examination (NHE) among the general population in South Korea. Methods: A telephone interview survey was conducted by an independent research company using a 16 item-questionnaire (demographics, knowledge of HCV, testing and results, need for screening) in May 2019. The sample population consisted of 1,003 adult Korean resi-dents adjusted by age, sex, and area according to the stan-dard Korean population in 2019. Results: Among the 1,003 participants (505 women, mean age of 47.9 years), 56.4% recognized HCV; 44.4% understood that HCV is transmit-table, and 56.8% thought that HCV is curable by medication. The recognition rate tended to increase with an increasing level of education. Testing for anti-HCV antibodies was re-ported by 91 people (9.1%); among them, 10 people (11.0%) reported a positive result, and eight people received treat-ment. The common reasons for HCV testing were a health check-up (58.5%), a physician’s recommendation (11.0%) and elevated liver enzyme levels (10.7%). The majority of the population (75.1%) agreed with the integration of HCV into the NHE. Conclusions The level of knowledge of HCV is suboptimal, and the self-reported testing rate for HCV is less than 10%; however, once HCV infection is diagnosed, the treatment rate seems to be high in South Korea. More active campaigns and effective screening are needed.

Cytomegalovirus(CMV) infections are common in immune compromised situations such as human immunodeficiency virus infection and organ transplantation. However CMV colitis had been rarely found in immunocompetent individuals. We experienced a case of an 83-year-old female patient, initially immune competent, who developed a massive lower gastrointestinal bleeding caused by CMV colitis. Previously, multiple antibiotics were used for nontuberculous Myco- bacterium and other bacterial infections after total knee arthroplasty. Colonoscopy revealed multiple ulcerations and mucosal congestion with hemorrhage. In spite of ganciclovir therapy, our patient did not recover.
Aged, 80 and over ; Anti-Bacterial Agents ; Arthroplasty ; Bacterial Infections ; Colitis ; Colonoscopy ; Cytomegalovirus ; Estrogens, Conjugated (USP) ; Female ; Ganciclovir ; Hemorrhage ; HIV ; Humans ; Knee ; Mycobacterium Infections, Nontuberculous ; Nontuberculous Mycobacteria ; Organ Transplantation ; Transplants ; Ulcer

BACKGROUND/AIMS: Bleeding still remains as one of the major medical problems in peptic ulcer diseases, despite of the advances in therapeutic options and endoscopic therapy. The aim of this study was to compare the clinical outcomes of bleeding peptic ulcer between two distinct periods in the past ten years. METHODS: We divided the among 10 years, we selected the two distinct periods; the first (1993~1995) and the second (2000~2002). The clinical and endoscopic characteristics in patients with bleeding peptic ulcer were compared between the two periods. We also analyzed the changes in the clinical outcomes as well. RESULTS: The age of patients during the second period was significantly older compare to the first period. In subgroup analysis, proportions of patients older than 60 years and of female patients were significantly higher in the second period. The percentage of the patients with co-morbid illness, such as diabetes mellitus, cardiovascular diseases, or users of non-steroidal anti-inflammatory drugs, was higher in the second period. Despite the decreasing the frequency of urgent surgery in the second period, there was no significant difference in the rate of re-bleeding and mortality between both periods. CONCLUSIONS: Despite the advances in therapeutic options in the second period, no significant difference was found in the prognosis of bleeding ulcer, compared to the first period. Old age, co-morbid illness, and increasing usage of NSAIDs has may contributed to this. Taken together, it might be more important to apply preventive measures to the patients who have risk factors for bleeding peptic ulcer.
Anti-Inflammatory Agents, Non-Steroidal ; Cardiovascular Diseases ; Diabetes Mellitus ; Female ; Hemorrhage* ; Humans ; Mortality ; Peptic Ulcer* ; Prognosis ; Risk Factors ; Ulcer

Congenital factor VII deficiency is a rare hemorrhagic disorder, and invasive procedures are likely to cause excessive bleeding in these patients. Endoscopic submucosal dissection (ESD) has been accepted as a curative treatment modality for gastric adenoma, early gastric cancer (EGC) and any other mucosal and submucosal tumors. The most important complications of ESD are bleeding and perforation. The use of antiplatelet agents or coagulopathies are risk factors for these complications. There are only few reports of successful ESD with coagulation disorders. We report a case of a 70-year-old female patient who was diagnosed with a gastric adenoma and factor VII deficiency. The patient was successfully treated with ESD. Before ESD, recombinant Coagulation factor VIIa was injected, and the procedure was performed successfully without any complications. In conclusion, ESD can be performed successfully in patients with factor VII deficiency, when recombinant human factor VIIa is administered properly.
Adenoma* ; Aged ; Endoscopy ; Factor VII Deficiency* ; Factor VIIa ; Female ; Hemorrhage ; Hemorrhagic Disorders ; Humans ; Platelet Aggregation Inhibitors ; Risk Factors ; Stomach Neoplasms