No abstract available.
Cell Proliferation* ; Female ; Humans ; Trophoblasts*

OBJECTIVE: To compare the abortion time, success rate and efficiency of application of intravaginal misoprostol versus intracervical laminaria insertion and intravenous sulprostone administration for mid-trimester pregnancy termination. MATERIAL: Patients requesting termination of second trimester pregnancy were randomized into two groups. In Group I, the women were given 200 microg tablet of misoprostol placed in the posterior vaginal fornix. In Group II, the women were given laminaria insertion in cervical canal with intravenous sulprostone administration. Altogether 50 subjects were recruited with 25 women in each group. RESULTS: The mean interval from start of induction to vaginal delivery was 1480.84+/-37.73 minutes in Group I and 1236.16+/-77.59 minutes in Group II(p=0.232). The success rate of termination within 48 hours in Group I and Group II were 84%, 92%(p=0.384). There were no significant differences in the mean interval time and success rates. Measurement of blood loss(differs in hemoglobin between the admission and postabortive 24 hours) shows in Group I(1.0352+/-0.5774) and in Group II(1.5640+/-0.8976). Mean changes in hemoglobin level were significantly lesser in the misoprostol group(p=0.017). No serious complication occurred. CONCLUSION: Intravaginal misoprostol appears to be acceptably safe and effective agents for second trimester pregnancy termination.
Female ; Humans ; Laminaria* ; Misoprostol* ; Pregnancy Trimester, Second ; Pregnancy*

Intramural pregnancy is one of the rarest form of ectopic pregnancy that only 20 cases have been reported in the world so far. Pathologically, the location of the gestational sac is completely isolated from the uterine cavity and entirely surrounded by myometrium without any contact of endometrium. Many reports noted that there would be possible relationship between the intramural pregnancy and prior uterine traumatic factor- curettage, cesarean section, myomectomy, salpingectomy, and manual removal of the placenta and so on. We have recently experienced a case of intramural pregnancy following curettage, managed completely by the laparoscopic excision and additive single dose intramuscular MTX treatment. So, we report this case with a brief review of the literature.
Animals ; Cesarean Section ; Curettage ; Endometrium ; Female ; Gestational Sac ; Mice ; Myometrium ; Placenta ; Pregnancy* ; Pregnancy, Ectopic ; Salpingectomy

Purpose: The prevalence of Group B Streptococcus (GBS) colonization in pregnant Korean women is increasing; however, nationwide studies are lacking. Therefore, we aimed to analyze regional colonization rates and antimicrobial susceptibility for GBS in pregnant Korean women through a nationwide survey. Materials and Methods: From January 2018 to December 2020, data from the Seoul Clinical Laboratories on vaginal swab cultures were retrospectively analyzed to detect maternal GBS carriers. Each swab specimen was inoculated onto a 5% blood agar plate and incubated at 35°C–37°C in a 5% CO 2 incubator for 24 h. GBS isolates were identified using a Microflex MALDI Biotyper. Antimicrobial susceptibility tests were performed using the Vitek 2 automated system. Results: The overall nationwide GBS colonization rate in pregnant Korean women was found to be 10.6% (3578/33721). The maternal GBS colonization rates ranged from 10.5%–10.8% over the 3-year study period. The GBS colonization rates by province, in descending order, were as follows: Jeolla-do, 13.2%; Gangwon-do, 12.0%; Chungcheong-do, 11.8%; Gyeonggi-do, 11.3%; Seoul, 10.2%; and Gyeongsang-do, 9.6%. During the study period, the resistance rates against chloramphenicol, levofloxacin, clindamycin, erythromycin, and tetracycline were 2.6%–2.7%, 18.2%–19.6%, 33.4%–35.7%, 35.6%–36.8%, and 50.5%–53.3%, respectively. Conclusion In pregnant Korean women, GBS colonization rates were in the range of 9.6%–13.2%, with Gyeongsang-do being the lowest and Jeolla-do the highest. The resistance rate against clindamycin was high (33.4%–35.7%). GBS colonization rates during pregnancy should be studied nationwide according to the Centers for Disease Control and Prevention-recommended guidelines with periodic antimicrobial resistance monitoring.

OBJECTIVES: To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale: SSS) for routinely assessing the quality of service in psychiatric ward inpatients. METHODS: A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and university hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. RESULTS: Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. CONCLUSION: SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring satisfaction of psychiatric inpatients in Korea.
Age of Onset ; Alcoholics ; Attitude of Health Personnel ; Education ; Employment ; Hospitalization ; Hospitals, General ; Hospitals, Psychiatric ; Hospitals, University ; Humans ; Inpatients* ; Korea ; Length of Stay ; Marital Status ; Mood Disorders ; Patient Satisfaction ; Principal Component Analysis ; Psychotic Disorders ; Surveys and Questionnaires ; Reproducibility of Results ; Somatoform Disorders

BACKGROUND: This study is to evaluate the effectiveness and application of Lecompte procedure as a treatment for various complex cardiac anomalies with pulmonary outflow tract obstruction. Methods: Between July 1988 and December 1997, 44 patients underwent Lecompte procedure in Seoul National University Children's Hospital. The male to female ratio was 24 to 20 and the mean age was 29.2 months (range, 3 to 83). Of these patients, 28 (63.6%) had transposition of great arteries with ventricular septal defect and pulmonary stenosis (or pulmonary atresia), 14 (31.8%) had double outlet right ventricle with pulmonary stenosis (or pulmonary atresia), and so on. The principles of the technique are 1) extension of the ventricular septal defect or conal resection, 2) construction of a intracardiac tunnel connecting the left ventricle to the aorta, and 3) direct connection, without a prosthetic conduit, of the pulmonary trunk to the right ventricle. RESULTS: There were 3 in-hospital deaths and their causes were sustained hypoxia, myocardial failure, and sepsis, respectively. There was 1 late death due to sepsis. Reoperations were performed in 6 patients who had pulmonary outflow tract obstructions (4 cases), residual muscular ventricular septal defect (1 case), and recurrent septic vegetation (1 case). The cumulative survival rates by the Kaplan-Meier method were 92.7%, 92.7%, and 92.7% at 1, 2, and over 4 years. The reoperation free survival rates were 92.7%, 92.7%, and 70.2% at 1, 3, and over 5 years. Among the risk factors for the operative death, aortic cross clamping time had statistical significance (p<0.05) and all the risk factors for the recurrent pulmonary stenosis such as age, pulmonary artery index, and materials used for the pulmonary outflow tract reconstruction had no statistical significance (p>0.05). CONCLUSIONS: Our review suggests that Lecompte procedure is an effective treatment modality for various complex cardiac anomalies with pulmonary outflow tract obstruction. Repair in early age is possible and the rates of mortality and morbidity are also acceptable.
Anoxia ; Aorta ; Constriction ; Double Outlet Right Ventricle ; Female ; Heart Diseases* ; Heart Failure ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Heart* ; Humans ; Male ; Mortality ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Reoperation ; Risk Factors ; Seoul ; Sepsis ; Survival Rate ; Transposition of Great Vessels

No abstract available.

BACKGROUND: The changes in the epidemiology of native valve endocarditis have been known in western countries recent years due to the decrease in the inci-dence of rheumatic heart disease, increased longevity of patients with valvular or congenital heart diseases, and the increase in degenerative heart disease due to the in-crease in the average life span of the general popula-tion. In this study, we analyzed and compared the epide-miological and clinical characteristics of patients with na-tive valvular endocarditis fro two different time periods. METHODS: We compared native valve endocarditis patients diagnosed from 1979 - 1984(group I) with those diagnosed from 1991 - 1996(group II). We used modified Duke' s criteria for the diagnosis and statistical analysis was done using SPSS window program. RESULTS: In our study, mean age of the population was higher in group II and significantly larger number of patients were over the age of 50 in group II. Involve-ment of multiple valves with vegetations and peri-valvular abscess were found more frequently in group II. Also, significantly higher percentage of patients from group II underwent surgical treatment. CONCLUSION: The results of this study suggest that the epidemiolocaland clinical characteristics of infective endocarsitis in Korea may change to resemble those in western countries. Further studies regarding this subject are needed.
Abscess ; Diagnosis ; Endocarditis* ; Epidemiology ; Heart Diseases ; Humans ; Korea ; Longevity ; Rheumatic Heart Disease

Purpose: Trocar-site burns occurring during laparoscopic surgery have been reported in various cases, and several efforts to reduce them are underway. This study aimed to analyze the effect of capacitive coupling on trocar site by observing electrical and histological changes for electrical skin burn injury. Methods: To measure the electrical changes relating to capacitive coupling, the temperature, current, voltage, and impedance around the trocar were measured when an open circuit and a closed circuit were formed using insulation intact instruments and repeated after insulation failure. After the experiment, the tissue around the trocar was collected, and microscopic examination was performed. Results: When open circuits were formed with the intact insulation, the impedance was significantly reduced compared to the cases of closed circuits (142.0 Ω vs. 109.3 Ω, p = 0.040). When the power was 30 W and there was insulation failure, no significant difference was measured between the open circuit and the closed circuit (147.7 Ω vs. 130.7 Ω, p = 0.103). Collagen hyalinization, nuclear fragmentation, and coagulation necrosis suggesting burns were observed in the skin biopsy at the trocar insertion site. Conclusion This study demonstrated that even with a plastic trocar and electrosurgical instruments that have intact insulation, if an open circuit is formed, capacitive coupling increases, and trocar-site burn can occur. When using electrocautery, careful manipulation must be taken to avoid creating an open circuit to prevent capacitive coupling related to electrical skin burn.