OBJECTIVES: To determine changes in the incidence and pattern of eclampsia in Il Sin Christian Hospital over a 46-year period. METHODS: Information was collected from medical records of the 1910 eclamptic patients among 233,613 deliveries in Il Sin Christian Hospital from Jan. 1 1953 to Dec. 31 1998. Incidence, presentation, and management of eclampsia were reviewed retrospectively, and maternal mortality rate and perinatal mortality rate were calculated. Statistical analysis was done by Chi-squared and Fisher's exact test through two by two tables looking at relative changes between each study period. RESULTS: The overall incidence of eclampsia was 81.8 per 10,000 deliveries. The incidence of eclampsia had increased from 137.3/10,000 in 1953-1962 to 278.4/10,000 in 1963-1972, but the rate had reduced to 6.5/10,000 in 1993-1998. There was a statistically significant fall in the rate of eclampsia every decade between 1973 and 1992, but there has been steady decrease in the last study period. Convulsion occurred antepartum in 54% of patients, intrapartum in 29% and postpartum in 17%. With the reduction in the proportion of antepartum eclampsia, there has been a relative increase in that of intrapartum and postpartum eclampsia. Maternal death occurred in 59 cases among eclampsia, and maternal mortality rate was 3.1%. Maternal mortality rate had significantly decresed from 11.1% in 1953-1962 to 3.8% in 1963-1972, and there has been no maternal death from eclampsia since 1986. Postpartum eclampsia had increased death risk compared with antepartum or intrapartum eclampsia. There were 280 cases of perinatal death and overall perinatal mortality rate was 144.1 per 1000 deliveries. There was a significant decrease in the rate from 243.2/1000 in 1953-1962 to 141.5/1000 in 1963-1972, but the rate has risen steadily since 1983. CONCLUSIONS: With the improvement in antenatal care and management of eclampsia, the incidence of eclampsia and its associated maternal mortality has decreased over the last 46 years. But eclampsia still remains a significant complication of pregnancy with high maternal and perinatal mortality.
Eclampsia* ; Female ; Humans ; Incidence ; Maternal Death ; Maternal Mortality ; Medical Records ; Perinatal Mortality ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Seizures

OBJECTIVE: To evaluate the relationship of single umbilical artery with congenital anomaly, chromosomal anomaly & pregnancy outcome. METHODS: From January 1993 to December 2000, 143 cases of single umbilical artery were observed among 72,194 total deliveries at Ilsin christian hospital. Pregnancy and perinatal outcome data were retrieved by review of the medical records. RESULTS: The incidence of single umbilical artery (SUA) was 0.2% (143 cases). Isolated SUA without any anomaly were 89 cases (62.2%), SUA with anomaly were 42 cases (29.4%) ; with multiple anomaly were 20 (14%) and stillbirth were 12 (8.4%). Cardiovascular & musculoskeletal system anomalies were common congenital anomalies, 35.7% respectively. Among the 86 cases (60.1%) of chromosomal studies, chromosomal anomalies were observed in 4 cases (2.8%) ; 2 cases were Trisomy 18, 2 cases were 45,XX,-13,-14,+t (13q:14q), 46,XY,t(1:9) (q11:q11). No chromosomal anomaly was observed in isolated SUA without any other anomaly. On 74cases with obstetric complication, intrauterine growth restriction (n=27, 20.6%), preterm birth (n=12, 10%), hydramnios (n=11, 8.4%), oligohydramnios (n=7, 5.3%), preeclampsia (n=6, 4.6%), maternal gestational DM (n=5, 3.8%) were observed. CONCLUSION: When a single umbilical artery is identified during antenatal care, careful search such as targeted ultrasonography & fetal echocardiography should be taken for associated anomaly, and chromosomal study should be considered in case of SUA with any anomaly.
Echocardiography ; Female ; Fetus* ; Humans ; Incidence ; Infant, Newborn* ; Medical Records ; Musculoskeletal System ; Oligohydramnios ; Polyhydramnios ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Single Umbilical Artery* ; Stillbirth ; Trisomy ; Ultrasonography

Urinary tract endometriosis is rare, especially suburethral endometriosis with symptoms of dysuria and urgency is very rare. We report a case of successful surgically treated suburethral endometriosis through the Retzius space.
Dysuria ; Endometriosis ; Female ; Urinary Tract

Background/Aims: Systemic sclerosis (SSc) is associated with a wide range of gastrointestinal (GI) changes. The University of California–Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract (UCLA SCTC GIT 2.0) instrument is a self-administered GI assessment instrument for patients with SSc. We developed a Korean version of the UCLA SCTC GIT 2.0 instrument and evaluated its reliability and internal consistency. Methods: The participants were 37 Korean patients with SSc. Translation and cross-cultural adaptation of the UCLA SCTC GIT 2.0 were performed according to international standardized guidelines. We evaluated reproducibility by calculating the intraclass correlation coefficients and assessed the internal consistency of the Korean version of the UCLA SCTC GIT 2.0. We assessed its construct validity by evaluating its correlations with the Short Form Health Survey version 2 and EQ-5D scores by means of Spearman correlation analyses. Results: Patients with SSc were mostly women (89.19%) with a mean age of 52.2 years, median disease duration of 24 months, and median modified Rodnan total skin score of 4. The median total GIT score on the UCLA SCTC GIT 2.0 was 0.3. The UCLA SCTC GIT 2.0 Korean version showed excellent internal consistency (Cronbach’s α of total GIT score = 0.863). Most domains of the ULCA SCTC GIT 2.0 were correlated with those of the EuroQol (EQ)-5D score. Conclusions The Korean version of the UCLA SCTC GIT 2.0 has acceptable internal consistency, reliability, and validity. Therefore, it can be used to assess GIT involvement in Korean patients with SSc.

Restless leg syndrome (RLS) is characterized by intense restlessness and unpleasant creeping sensations deep inside the lower legs, occurring during periods of rest, evening and night. These symptoms can be improved by movement. There are two different phenotypes of RLS. One early-onset form starts before 36 years old. It has mostly a familial history, severe symptoms, and highly genetically determined. And it is a highly dependent to iron level of the brain. The other delayed-onset form starts after 36 years old, mostly secondary, without familial history, with a rapid evolution in two or three years. And it is associated with frequent low ferritin level of serum. Pathophysiology of RLS remains incompletely understood. However, advanced studies suggest that RLS may be generated by dopamine dysfunction locally within the central nervous system. Dopaminergic agonists are the treatment of choice, if the symptoms are severe. And iron therapy improves RLS symptoms in iron deprived patients. Early detection during pregnancy is needed because RLS gives an important impact on sleep efficiency and quality of life. Recently we have experienced a case of primary RLS patient diagnosed at 24+3 weeks, treated by dopaminergic agonist ropinirole and iron. We describe this case with a brief review of the literature.
Brain ; Central Nervous System ; Dopamine ; Dopamine Agonists ; Ferritins ; Humans ; Indoles ; Iron ; Leg ; Phenotype ; Pregnancy ; Psychomotor Agitation ; Quality of Life ; Sensation

BACKGROUND: Abacavir is a widely-used nucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus (HIV) infection. Mandatory postmarketing surveillance was conducted in Korea to monitor the safety and evaluate the effectiveness of Ziagen® (abacavir sulfate 300 mg; ViiV Healthcare, Middlesex, UK). MATERIALS AND METHODS: An open-label, multi-center, non-interventional postmarketing surveillance study was conducted from June 2010 to June 2016 to monitor the safety and effectiveness of Ziagen across 12 hospitals in Korea. Subjects older than 18 years taking Ziagen according to prescribing information were enrolled. The primary outcome was defined as the occurrence of any adverse events after Ziagen administration. Secondary outcomes included the occurrence of adverse drug reactions, occurrence of serious adverse events, and effectiveness of Ziagen administration. RESULTS: A total of 669 patients were enrolled in this study, with a total observation period of 1047.8 person-years. Of these, 90.7% of patients were male. The mean age of patients was 45.8±11.9 years. One-hundred ninety-six (29.3%) patients reported 315 adverse events, and four patients reported seven serious adverse events, without any fatal events. There was one potential case of an abacavir hypersensitivity reaction. Among the 97 adverse drug reactions that were reported from 75 patients, the most frequent adverse drug reactions included diarrhea (12 events), dyspepsia (10 events), and rash (9 events). No ischemic heart disease was observed. In the effectiveness analysis, 91% of patients achieved HIV-1 RNA under 50 copies/mL after 24 months of observation with abacavir administration. CONCLUSION: Our data showed the safety and effectiveness of Ziagen in a real-world setting. During the study period, Ziagen was well-tolerated, with one incident of a clinically suspected abacavir hypersensitivity reaction. The postmarketing surveillance of Ziagen did not highlight any new safety information. These data may be helpful in understanding abacavir and the HIV treatment practices in Korea.
Delivery of Health Care ; Diarrhea ; Drug-Related Side Effects and Adverse Reactions ; Dyspepsia ; Exanthema ; HIV ; HIV-1 ; Humans ; Hypersensitivity ; Korea ; Male ; Myocardial Ischemia ; Pharmacoepidemiology ; RNA ; RNA-Directed DNA Polymerase