No abstract available.
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BACKGROUND: The safety of ergonovine provocation for coronary vasospasm (CVS) performed outside the catheterization laboratory has been questioned. We sought to address the issues of safety, feasibility and clinical impact of noninvasive diagnosis of CVS. METHOD AND RESULTS: We retrospectively analyzed the results of bedside ergonovine provocation testing with monitoring of left ventricular regional wall motion abnormalities (RWMAs) by 2-dimensional echocardiography (ergonovine echocardiography, Erg Echo). After confirmation of no significant fixed epicardial coronary artery disease, 1,504 Erg Echo were performed in 1,372 patients from July 1991 to December 1997. Erg Echo was prematurely terminated in 13 patients (0.9%) due to limiting side effects unrelated with myocardial ischemia. Among 1,491 completed tests, 32% (477) showed positive results with development of RWMAs in 467 tests (98%) or ST displacement in ECG in 10 tests (2%). During the test, transient arrhythmias developed in 1.7% (26/1491) including transient ventricular tachycardia (2) and atrioventricular block (4), which were promptly reversed with nitroglycerin. There were no procedure-related death or development of myocardial infarction. On the basis of angiographic criteria in 218 patients, who also underwent invasive spasm provocation test during coronary angiography, the sensitivity and specificity of Erg Echo for the diagnosis of CVS were 93% and 91% respectively. From 1990 to 1997, total 2,073 spasm provocation tests were performed either during invasive coronary angiography in the catheterization or in the echocardiography laboratory. Since 1994, noninvasive Erg Echo became a more popular diagnostic method and comprised more than 95% of all spasm provocation tests in recent 3 years. Erg Echo was also performed safely in outpatient clinic setting without hospital admission in 34% (500/1491). CONCLUSIONS: Erg Echo is highly feasible, accurate and safe for diagnosis of CVS and can replace the invasive spasm provocation test during coronary angiography in the catheterization laboratory.
Ambulatory Care Facilities ; Arrhythmias, Cardiac ; Atrioventricular Block ; Catheterization ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vasospasm* ; Diagnosis* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Ergonovine* ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Nitroglycerin ; Retrospective Studies ; Sensitivity and Specificity ; Spasm ; Tachycardia, Ventricular

BACKGROUND: The safety of ergonovine provocation for coronary vasospasm (CVS) performed outside the catheterization laboratory has been questioned. We sought to address the issues of safety, feasibility and clinical impact of noninvasive diagnosis of CVS. METHOD AND RESULTS: We retrospectively analyzed the results of bedside ergonovine provocation testing with monitoring of left ventricular regional wall motion abnormalities (RWMAs) by 2-dimensional echocardiography (ergonovine echocardiography, Erg Echo). After confirmation of no significant fixed epicardial coronary artery disease, 1,504 Erg Echo were performed in 1,372 patients from July 1991 to December 1997. Erg Echo was prematurely terminated in 13 patients (0.9%) due to limiting side effects unrelated with myocardial ischemia. Among 1,491 completed tests, 32% (477) showed positive results with development of RWMAs in 467 tests (98%) or ST displacement in ECG in 10 tests (2%). During the test, transient arrhythmias developed in 1.7% (26/1491) including transient ventricular tachycardia (2) and atrioventricular block (4), which were promptly reversed with nitroglycerin. There were no procedure-related death or development of myocardial infarction. On the basis of angiographic criteria in 218 patients, who also underwent invasive spasm provocation test during coronary angiography, the sensitivity and specificity of Erg Echo for the diagnosis of CVS were 93% and 91% respectively. From 1990 to 1997, total 2,073 spasm provocation tests were performed either during invasive coronary angiography in the catheterization or in the echocardiography laboratory. Since 1994, noninvasive Erg Echo became a more popular diagnostic method and comprised more than 95% of all spasm provocation tests in recent 3 years. Erg Echo was also performed safely in outpatient clinic setting without hospital admission in 34% (500/1491). CONCLUSIONS: Erg Echo is highly feasible, accurate and safe for diagnosis of CVS and can replace the invasive spasm provocation test during coronary angiography in the catheterization laboratory.
Ambulatory Care Facilities ; Arrhythmias, Cardiac ; Atrioventricular Block ; Catheterization ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vasospasm* ; Diagnosis* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Ergonovine* ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Nitroglycerin ; Retrospective Studies ; Sensitivity and Specificity ; Spasm ; Tachycardia, Ventricular

OBJECTIVE: To investigate the association between endometriosis and polymorphisms of N-acetyl transferase 2 (NAT2), glutathione S-transferase M1 (GSTM1), and cytochrome P450 (CYP) 1A1 genes in Korean infertile patients. MATERIALS AND METHODS: A total of 303 infertile patients who had undertaken diagnostic laparoscopy during January, 2001 through December, 2003 at Samsung Cheil Hospital enrolled in this study. The patients were grouped according to laparoscopic findings: minimal to mild endometriosis (group I: n=147), moderate to severe endometriosis (group II: n=57), normal pelvic cavity (n=99). Peripheral blood was obtained and genomic DNA was extracted. The genotypes of each genes were analyzed using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). For NAT2, RFLP was used to detect the wild type (wt) and mutant (mt) alleles, enabling classification into slow (mt/mt) or fast (wt/wt or wt/mt) acetylation genotypes. For GSTM1, PCR was used to distinguish active (+/- or +/+) from null (-/-) genotypes. For CYP1A1, MspI digestion was used to detect the wild type (A1A1), heterozygote (A1A2) or mutant (A2A2) genotypes. RESULTS: The genotype frequencies of NAT2 slow acetylator was 12.8%, 10.9%, 12.8% in group I, group II and control, respectively. The genotype frequencies of GSTM1 null mutation was 55.3%, 41.8%, 53.2% in group I, group II and control, respectively. The genotype frequencies of CYP1A1 MspI polymorphism was 16.3%, 9.1%, 18.1% in group I, group II and control, respectively. No significant difference was observed between endometriosis and normal controls in the genotype frequencies of the NAT2, GSTM1, CYP1A1 MspI polymorphism. CONCLUSION: The NAT2, GSTM1, CYP1A1 gene polymorphism may not be associated with the susceptibility of endometriosis in Korean women.
Acetylation ; Alleles ; Classification ; Cytochrome P-450 CYP1A1 ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Digestion ; DNA ; Endometriosis* ; Female ; Genotype ; Glutathione Transferase* ; Glutathione* ; Heterozygote ; Humans ; Laparoscopy ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Transferases*

Intramural pregnancy is an unusual ectopic gestation located within the uterine wall, completely surrounded by myometrium and separate from the uterine cavity, fallopian tube, or round ligament. It is known to be difficult to diagnose, and associated with a high rate of uterine rupture. We report a case of intramural pregnancy in which early diagnosis was made and successful treatment was done by dilatation and curettage. Diagnostic laparoscopy confirmed the absence of uterine rupture during the procedure. Therefore, conservation of fertility can be possible with early diagnosis of intramural pregnancy. To our knowledge, this is the first case report of intramural pregnancy following IVF-ET in Korea.
Animals ; Dilatation and Curettage ; Early Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Fallopian Tubes ; Female ; Fertility ; Fertilization in Vitro* ; Korea ; Laparoscopy ; Mice ; Myometrium ; Pregnancy* ; Round Ligaments ; Uterine Rupture

The precore (G1896A) and core promoter (A1762T, G1764A) mutations of the hepatitis B virus gene are known to be associated with changes in immunologic phase or the progression to complicated liver disease in adults. We analyzed these mutations in chronically HBV-infected children. Serum was collected from 37 children with chronic HBV infection from March 2005 to September 2008. HBV DNA extraction and nested PCR were followed by sequencing of the PCR products. The children were 6.7 +/- 4.6 yr old. All of 37 children had HBV genotype C. Of the cohort, 31 (83.8%) were HBeAg-positive and 6 (16.2%) were HBeAg-negative; the former group comprised 18 (48.6%) who were in the immune-tolerance phase (ITP) and 13 (35.2%) in the immune-clearance phase (ICP). Most of the patients had HBV DNA levels of > 1.0 x 10(8) copies/mL. In the ITP group, only 1 (5.5%) had core promoter mutations, and none had the precore mutation. In the ICP group, only 2 (15.4%) had core promoter mutations; the remaining 6 patients had HBV DNA levels of < 2.0 x 10(3) copies/mL and no core promoter/precore mutations. The very low incidence of the precore/core promoter gene mutation, in children, suggests that these mutations may be the result of life-long chronic HBV infection.
Adolescent ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Child ; Child, Preschool ; Cohort Studies ; DNA, Viral/blood ; Female ; Genotype ; Hepatitis B Core Antigens/*genetics ; Hepatitis B virus/*genetics ; Hepatitis B, Chronic/immunology/*virology ; Humans ; Infant ; Male ; Mutation ; Promoter Regions, Genetic ; Sequence Analysis, DNA

No abstract available.

Prior to 1988, endometrial cancer was clinically staged but there was the considerable discrepancy between clinical and aetual stage. FIGO surgical staging classification of endometrial cancer(I988) provides the advanatage of recognizing the true disease distribution and extension, and more rational treatraent can be accomplished. This retrospective study was based on a clinical review of 73 patients with endometrial carcinoma from l982 through 1991 who underwent primary surgical evaluation. A11 cases were restaged ueing the newly adopted FIGO surgical staging. The distribution of FIGO clinical staging was as follows:85 patients(89.1%) were with stage I, 5(6.9%) with stage II, 2(2.7%) with stage III and 1(l.3%) with stage IV. Surgical restaging according new FlG0 classification reveald 56(76.7%) patients with stage I, 1(1.4%) with stage II, 14(19.2%) with stage III and 2(2.7%) with stage IV. Surgery upstaged 12.3% of clinical stage I patients, In clinical stage II patients, 80.0% was doenstaged. There wes no stage changing in cliaical stage III and IV patients. The acturial survival rates for surgical stages I a, I b, I c, and III were 80.0%, 77.2%, 68.4A%, and 35.0% respectively. By using FIGO surgical staging, the initial extent of endometrial cancer can be more accurately evaluated and we may predict prognosis and survival relatively well.
Classification ; Endometrial Neoplasms* ; Female ; Humans ; Prognosis ; Retrospective Studies ; Survival Rate

No abstract available.
Chronic Disease ; Glycemic Index

Breastfeeding is an ideal approach for physical and emotional development of babies, as well as recovery of mothers. A breastfeeding education for female students seems to be an effective intervention to increase the Korean women breastfeeding rate. The purpose of this study was to evaluate their knowledge, attitudes, and other related breastfeeding variables for developing a design for a pre-parental breastfeeding educational information for Korean female students of childbearing age. The sample consisted of 205 Korean female college students, ranging in age from 20 to 25 years old. In this study, a self-administered questionnaire included 6 pages with close-ended multiple-choice questions, and included a cover page with 15 questions on demographic characteristics and personal experiences related to breastfeeding. Data analysis was done utilizing inferential statistics using SPSS 12.0 computer program. The findings indicated that breastfeeding education programs should focus on the practical aspect of attitudes toward breastfeeding, and that educational information design should focus on the practical aspects of breastfeeding for all levels of students' education by nurses. Therefore, education for female college students seems to be an effective intervention to increase breastfeeding rate. This study is useful for descriptions of educational activities to help female students develop positive attitudes to breastfeed, to help these students have confidence toward breast-feeding in future by providing correct information and practical techniques on breastfeeding.
Breast Feeding ; Female ; Humans ; Mothers ; Software ; Statistics as Topic ; Surveys and Questionnaires