OBJECTIVE: To understand the difference of defecation physiology between postpartum and postoperative women. METHODS: Between July 1998 to April 1999, we performed defecogram and pudendal nerve motor latency to 31 women, who were 8 postoperative women, 9 post cesarean-section state women, and 14 normal vaginal delivery-state women. RESULTS: According to the defecogram results, only squeezing angles of the anorectal angle were significantly increased(96.0 vs 72.3, 74.9 degree) in normal vaginal delivery-state women compared to post cesarean-section state and postoperative women, but rest and evacuation angles were not. And to pudendal nerve latency, there were no statistically significant difference. CONCLUSION: We concluded that the pudendal plexus was damaged during labor, therefore its ability to control puborectalis muscle was damaged. So, the anorectal angles of squeezing of postpartum women were significantly increased, compared to those of post cesarean section women or postoperative women.
Cesarean Section ; Defecation* ; Female ; Humans ; Physiology* ; Postpartum Period* ; Pregnancy ; Pudendal Nerve*

Citrin deficiency caused by the SLC25A13 gene mutations is associated with both neonatal-onset type II citrullinemia (CTLN2), also known as neonatal intrahepatic cholestasis caused by citrin deficiency and adult-onset CTLN2. Neonatal-onset CTLN2 is an autosomal recessive disorder characterized by poor growth, intrahepatic cholestasis, and increased serum citrulline. A 16-days old infant with hyperammonemia was referred for evaluation of increased plasma citrulline diagnosed using tandem mass spectrometry. Blood amino acid analysis showed significant elevation of citrulline. Mild elevation in serum galactose levels had been found. DNA analysis of the SLC25A13 gene in this patient showed two novel compound heterozygous mutations, c.221C>T in exon4 and c.1645C in exon16 (p.[Ser74Phe]+[Gln549X]). We suggest that infants with a high serum citrulline level on a tandem mass screening test are candidates for gene analysis and blood amino acid analysis for neonatal-onset CTLN2.
Calcium-Binding Proteins ; Cholestasis, Intrahepatic ; Citrulline ; Citrullinemia ; DNA ; Galactose ; Heterozygote ; Humans ; Hyperammonemia ; Infant ; Infant, Newborn ; Mass Screening ; Organic Anion Transporters ; Plasma ; Tandem Mass Spectrometry

OBJECTIVES: Leptin is a 16-kD protein encoded by the ob/ob gene and represent the amount of body fat. In pregnancy, it is thought to act in intrauterine fetal growth and energy metabolism. In this study, we investigated the effect of gestational age, fetal sex, maternal body mass index (BMI), and fetal weight estimated by ultrasound on amniotic fluid and maternal serum leptin levels at mid-trimester, respectively. METHODS: Amniotic fluid and maternal blood sampling were collected from women who was performed for genetic amniocentesis at mid-trimester (n = 26). Leptin concentrations were measured by a specific radioimmunoassay (RIA) employing human recombinant leptin. Mean gestational age was 18.19+/-1.77 weeks. Mean maternal BMI was 23.83 +/-5.12kg/m2. Male fetus was 10, and female 16. Mean fetal weight estimated by ultrasound was 254.42+/-83.80gm. RESULTS: Mean maternal leptin level( 12.49+/-4.46 ng/mL) was significantly higher than mean amniotic leptin level(5.06+/-3.20 ng/mL)( p = 0.0001) at mid-trimester. But there was no significant correlationship between maternal and amniotic leptin levels( p = 0.1376). Maternal leptin concentrations at mid-trimester were correlated positively with maternal BMI(y = 2.24 + 0.43 x, R2 = 0.494, p = 0.0103). In contrast, leptin levels in amniotic fluid did not correlate with maternal leptin levels, gestational age, fetal sex, maternal BMI, and fetal weight estimated by ultrasound respectively. CONCLUSION: Maternal leptin level was higher than amniotic leptin level and could represent maternal fat mass. It was suggested that amniotic leptin level was not associated with several factors such as maternal, fetal, and amniotic factors.
Adipose Tissue ; Amniocentesis ; Amniotic Fluid* ; Body Mass Index ; Energy Metabolism ; Female ; Fetal Development ; Fetal Weight* ; Fetus ; Gestational Age* ; Humans ; Leptin* ; Male ; Pregnancy ; Radioimmunoassay ; Ultrasonography*

BACKGROUND: Antimicrobial resistance (AMR) is an issue not only with regard to public health, but also in terms of economic impact. AMR surveillance has mainly been carried out in general hospitals, and not in nursing hospitals. This study was conducted to investigate the AMR rate for bacterial strains isolated from nursing hospital samples.METHODS: Antimicrobial susceptibility testing (AST) results from a total of 23,518 bacterial isolates recovered from clinical specimens taken in 61 nursing hosals were analyzed. AST was conducted using Vitek 2 with AST cards specific for the bacterial strains.RESULTS: A total of 19,357 Gram-negative and 4,161 Gram-positive bacterial strains were isolated. Pseudomonas aeruginosa (n=6,384) and Escherichia coli (n=5,468) were the most prevalent bacterial species and, among Gram-positive bacteria, Staphylococcus aureus (n=1,565) was common. The AMR rate was high for the following strains: cefotaxime-resistant Klebsiella pneumoniae, 77.4%; cefotaxime-resistant E. coli, 70.6%; imipenem-resistant Acinetobacter baumannii, 90.3%; imipenem-resistant P. aeruginosa, 49.3%; oxacillin-resistant S. aureus, 81.1%, penicillin-resistant Enterococcus faecalis, 44.8%, and vancomycin-resistant Enterococcus faecium, 53.5%. AMR rate change varied by bacterial species and antimicrobial drug.CONCLUSION: AMR rates of major pathogens from nursing hospitals were higher than those from general hospitals with the exception of imipenem-resistant A. baumannii. Continuous monitoring and infection control strategies are needed.
Acinetobacter baumannii ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Gram-Positive Bacteria ; Hospitals, General ; Infection Control ; Klebsiella pneumoniae ; Nursing ; Pseudomonas aeruginosa ; Public Health ; Staphylococcus aureus

BACKGROUND: The Duromedics valve has been used in Korea since 1982, however, but there were no long term clinical results that have been reported. This paper presents the long term clinical results of Duromedics valve implanted in Seoul National University Hospital. MATERIAL AND METHOD: Between 1987 and 1988, 23 patients underwent cardiac valve replacement with Duromedics mechanical valve. There were 8 mitral valve replacements, 5 aortic valve replacements, one tricuspid valve replacement, 6 aortic and mitral valve replacements, and one mitral and tricuspid valve replacement. There were 12 men and 11 women. The mean age was 35+/-10(15~52) years. We evaluated the clinical performance of Duromedics cardiac prosthesis. RESULT: The early operative mortality was 4.3%(1/23) and the late morlatity was 4.3%(1/23). Causes of death were low cardiac output syndrome and structural valvular failure. The mean follow-up duration was 133+/-43(8~157) months. There were 3 reoperations. The causes of reoperations were thrombosis and structural failure and nonstructural valvular failure. The actuarial survival rate at 10 years was 90.9%. CONCLUSION: Although the number of patients was not sufficient for effective clinical study, the long term clinical results of Duromedics valve was relatively good and there was no structural defect in this mechanical valve. However, more research is needed in the future.
Aortic Valve ; Cardiac Output, Low ; Cause of Death ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valves ; Humans ; Korea ; Male ; Mitral Valve ; Mortality ; Prostheses and Implants ; Seoul ; Survival Rate ; Thrombosis ; Tricuspid Valve

PURPOSE: We report short-term results of radial head prosthesis using a unipolar loose fit stem in ten patients. MATERIALS AND METHODS: Ten patients with Mason type three radial head fracture, who received unipolar radial head arthroplasty from February 2010 to June 2011, were evaluated (mean follow-up: 22 months, range: 18-30 months). Subjects consisted of five men and five women. Range of elbow motion was measured. Mayo elbow performance index (MEPI) score was used for functional evaluation and periodic radiological imaging was performed to evaluate the stability of implant. RESULTS: After an average follow-up of 22 months, elbow stability was maintained in all cases, and the average range of motion of elbow flexion and extension was 6 to 130 degrees. Average range of pronation and supination was 66 and 74 degrees, respectively. MEPI score was evaluated as excellent in seven cases, and good in three cases. On final follow-up, radiological assessment showed implant stability in all cases without evidence of dislocation, subluxation, arthritis, periprosthetic osteolysis or heterotopic ossification. CONCLUSION: Based on our short-term follow-up, radial head arthroplasty with unipolar loose fit stem is a useful method for obtaining satisfactory outcome for unreducible comminuted radial head fractures.
Arthritis ; Arthroplasty* ; Dislocations ; Elbow ; Female ; Follow-Up Studies ; Head* ; Humans ; Male ; Ossification, Heterotopic ; Osteolysis ; Pronation ; Prostheses and Implants ; Range of Motion, Articular ; Supination

The purpose of this study was to compare surface roughness and morphologic changes after use of various plaque control devices to titanium implant surfaces. The study materials were 6 ITI titanium implants(Bonefit(R)) and 5 plaque control devices. 6 implants were divided into 6 different groups and instrumented by each plaque control devices as follows. 1) Group I : untreated control 2) Group II : Titanium curette(Titanium curette(R), 3i) 80 vertical/horizontal strokes 3) Group III : Plastic curette(Implacare(R), Hu-Friedy) 80 vertical/horizontal strokes 4) Group IV : Plastic tip-ultrasonic scaler(Amdent(R), Amdent) 160 seconds 5) Group V : Rotating interdental brush(Identobrush(R), Identoflex) 160 seconds 6) Group VI : Abrasive rubber cup polisher(Zircate(R), Prophy paste, Dentsply) 160 seconds. All specimens were prepared for evaluation by surface roughness tester, optical stereomicroscopy(OM) and scanning electron microscopy(SEM). The Ra and Rt mean values of the tested specimens were 1) Group I (Ra=0.170+/-0.007micrometer, Rt=1.297+/-0.016micrometer) 2) Group II (Ra=0.209+/-0.006micrometer, Rt=1.602+/-0.110micrometer) 3) Group III (Ra=0.179+/-0.001micrometer, Rt=1.429+/-0.055micrometer) 4) Group IV (Ra=0.182+/-0.005micrometer, Rt=1.511+/-0.085micrometer) 5) Group V (Ra=0.301+/-0.008micrometer, Rt=1.882+/-0.131micrometer) 6) Group VI (Ra=0.147+/-0.010micrometer, Rt=1.059+/-0.021micrometer) In Ra values, experimental group II, V, VI were statistically significant different when compared with control. OM and SEM observation showed that experimental group III, IV were minimal changes when compared with control and group VI was smoothest among other experimental groups. The results suggested that plastic curette and plastic tip-ultrasonic scaler were predictable devices to titanium implant surface.
Plastics ; Rubber ; Stroke ; Titanium*

STUDY DESIGN: Retrospective evaluation. PURPOSE: To compare quality of life in postmenopausal women with osteoporotic vertebral fractures (OVFs) who underwent vertebroplasty (VP) or kyphoplasty (KP). OVERVIEW OF LITERATURE: Patient with OVFs who do not respond to conservative treatment can be treated with VP or ballon KP for faster pain relief. There are controversies on which procedure is more effective. METHODS: Five hundred twenty-eight postmenopausal women in nationwide hospitals with age of 50 years or older who underwent VP of KP for OVFs were enrolled in this study. Health related quality of life was measured using the European Quality of Life 5 Domains (EQ-5D) and visual analogue scale (VAS). RESULTS: In the VP group, average EQ-5D dimension was 1.95 in mobility, 1.86 in self care, 2.02 in usual activity, 2.19 in pain, 1.69 in anxiety or depression. In the KP group, average EQ-5D dimension was 1.83 in mobility, 1.78 in self care, 1.98 in usual activity, 2.03 in pain, 1.55 in anxiety or depression. Quality of life of KP group was significantly better than that of the VP group in mobility (p=0.016), pain (p=0.001), and anxiety or depression (p=0.008). Average EQ-5D index of the VP and the KP group was 0.353 (+/-0.472) and 0.485 (+/-0.357), respectively. The EQ-5D index of the KP group was significantly (p<0.001) higher than that of the KP group. The difference of VAS between VP and KP group was not statistically significant (p=0.580). CONCLUSIONS: Quality of life in patient with OVFs who underwent KP was significantly better than that of patients who underwent VP.
Anxiety ; Depression ; Female ; Humans ; Kyphoplasty* ; Quality of Life* ; Retrospective Studies ; Self Care ; Vertebroplasty*

OBJECTIVE: Cervical intraepithelial neoplasia (CIN) and invasive cervix cancer were detected in some cases of atypical squamous cells of undetermined significance (ASCUS) PAP smear. So it is reasonable to evaluate and manage ASCUS PAP smear. In this study, we attempted to assess the clinical significance of a cytologic diagnosis of ASCUS and determine the usefulness of HPV DNA chip test (which is a new diagnostic method for HPV) in management and evaluation of ASCUS patients. METHODS: This study was performed from November 2001 to June 2002 and included 48 cases of ASCUS. They were evaluated by HPV DNA chip test and the pathology was evaluated by punch biopsy, cone biopsy or hysterectomy. The result of type 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 and 69 in HPV DNA chip test were categorized as high risk. RESULTS: The rate of CIN II or above in ASCUS was 18.8% (9/48). The detection rate of high risk HPV DNA in ASCUS was 41.7% (20/48). The detection rate of high risk HPV DNA was 30.6% (11/36) in normal or reactive, 33.3% (1/3) in CIN I, 80% (4/5) in CIN II, 100% (2/2) in CIN III, 100% (2/2) in invasive cervix cancer. Higher the grade of pathology, more the detection rate of high risk HPV DNA chip test. The sensitivity for the prediction of CIN II or above by HPV DNA chip test was 88.9% and specificity was 69.2%, respectively. CONCLUSION: The use of HPV DNA chip test in patients with ASCUS may provide usefulness in detection of CIN II, CIN III and invasive cervix cancer.
Biopsy ; Cervical Intraepithelial Neoplasia ; Diagnosis ; DNA* ; Humans ; Hysterectomy ; Oligonucleotide Array Sequence Analysis* ; Pathology ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

BACKGROUND: This clinical study was conducted to compare pharmacokinetics of eperisone and aceclofenac of HCP1104, a new fixed dose combination drug with those in co-administration of eperisone 50 mg and aceclofenac 100 mg. The study used a partial replicated study design to characterize intra-subject variability of eperisone when co-administrated with aceclofenac. METHODS: A partial replicated crossover design was employed in 30 subjects. Each subject received a single dose of co-administration of eperisone 50 mg and aceclofenac 100 mg on two occasions and a single dose of 1 capsule of HCP1104. Blood samples were obtained for 24 hrs after dosing, and plasma was assayed for eperisone and aceclofenac by Liquid chromatography-electrospray ionization-mass spectrometry. RESULTS: Using an average bioequivalence criterion, the 90 % confidence limits for Ln-transformed Cmax and AUClast for aceclofenac fell wihin the acceptable range of 80 - 125 %. Point estimates of eperisone AUClast and Cmax were 1.0152 and 1.0490, respectively and the 90 % confidence interval for Cmax was 0.8499 - 1.3025. The within-subject coefficient of variation of Cmax for the reference was 50.198 %. Acceptance range for eperisone Cmax based on new bioequivalence guidance for highly variable drugs was extended to 0.6984 - 1.4319. CONCLUSION: The extent of exposure and rate of absorption of both eperisone and aceclofenac with a single dose of HCP1104 capsule were equivalent to those with co-administration of a marketed eperisone 50 mg tablet and a marketed aceclofenac 100 mg tablet under fasting conditions in healthy adult males.
Absorption ; Adult ; Cross-Over Studies* ; Fasting ; Humans ; Male ; Pharmacokinetics* ; Plasma ; Spectrum Analysis ; Therapeutic Equivalency*