To evaluate the clinical efficacy of emergency cervical cerclage in the treatment of advanced cervical incompetence, a prospective clinical trial was performed in 18 patients with advanced cervical incompetence at 20 to 25 weeks gestation. Modified McDonalds operation with or without transabdominal amniocentesis was used for cervical cerclage. Pregnancy was prolonged for a sufficient time to deliver viable fetuses in 56.3% of patients. The median procedure-to-delivery interval was 8.6 (range 0.1 to 20.5) weeks for the entire group, and 13.9 (range 6.5 to 20.5) weeks for 9 patients who achieved live birth. The median gestational age at delivery was 38.6 (range 28.3 to 41.0) weeks for the live infants. The median birthweight of the live infants was 3062 g (range 1050 to 3620 g). The lack of significant matemal morbidity combined with the results for the fetus-infant supports further efforts in this area.
Amniocentesis ; Cerclage, Cervical ; Emergencies* ; Fetus ; Gestational Age ; Humans ; Infant ; Live Birth ; Pregnancy ; Prospective Studies

The objective of this study is to examine the correlation between the tolylene concentration in the work environment of organic solvents and the concentration of hippuric acid in urine of workers exposed toluene, and to acquire the fundamental materials of workers' health care and to assist the assessment of the biological permissible exposure limit. The control groups are 72 workers who had never been exposed to toluene and the case groups are 101 workers who had been exposed to toluene. This study was conducted to examine the correlation between the concentration of toluene in work environment and workers' hippuric acid concentration, to investigate the complaint difference of subjective symptoms by means of questionnaire, between the case groups and control groups. The results and conclusions are as follows: 1) The highest mean concentration of toluene in the air is 544.13+/-7.75 ppm in the Printing Department of mixing organic solvents. The concentrations of the others are 463.27+/-5.24 ppm in Department of mixture for organic solvents, and 393.56+/-45.69 ppm in the Printing Department(1), and 248.38+/-45.16 ppm in the Printing Department(2), and 159.38+/-18.51 ppm in the Printing Department(3). 2) The highest mean concentration of hippuric acid in urine is 6034.84+/-1298.35 mg/l in the Printing Department with mixing organic solvents. The concentrations of the others are 4798.44+/-784.53 mg/l in Department of mixture of organic solvents, and 2883.06+/-701.90 mg/l in the Printing Department(1), and 1449.98+/-905.19 mg/l in the Printing Department(2), and 598.52+/-299.43 mg/l in the Printing Department(3). 3) As the toluene concentration in the work environment becomes higher, the concentration of hippuric acid in urine also becomes higher. It is found that the coefficient of correlation between toluene concentration and the concentration of hippuric acid are positive (r=0.868, Y=7.18X+349.57). 4) It is found that the case groups complain of much more subjective symptoms than the control groups.
Delivery of Health Care ; Surveys and Questionnaires ; Solvents ; Toluene*

The association of major fetal malformations with amniotic bands has been known for many years. However, we are apt to ignore the possibility of amniotic band syndrome. In this case, fetal anencephaly was diagnosed at 17 weeks, menstrual age on the basis of sonographic findings. Following pregnancy termination, examination of the abortus rev- ealed the cerebral remnant which is similar to that found in dysraphic anencephaly, but collateral evidence of amniotic band was found. Therefore, when confronted with severe cranial or cerebral malformation amniotic band syndrome should be in the differential dia- gnosis.
Amniotic Band Syndrome* ; Anencephaly* ; Infant, Newborn ; Pregnancy ; Skin* ; Ultrasonography

OBJECTIVES: To study the distributions of pH and gas values in umbilical arterial(UA) blood of normal newborns following uncomplicated pregnancies and vaginal births. Methods: In 457 consecutive normal term infants who were born between March 1995 and June 1998, we examined the UA pH and blood gas values obtained immediately following delivery. Maternal inclusion criteria were defined as an uncomplicated singleton pregnancy and a normal full term spontaneous vaginal delivery. And also neonatal inclusion criteria were defined as a normal intrauterine growth appropriate for gestational age without any malformations and Apgar score of 7 or more at both one and five minutes after birth. Umbilical artery blood samples were collected at each birth and were evaluated for pH, carbon dioxide pressure (PaCO2), oxygen pressure (PaO2) and actual bicarbonate. RESULTS: Histogram of UA pH value resemble normal distribution curve. The lowest UA pH was 7.04 and the 10th percentile value was 7.23. The median UA pH was 7.31 and 5% was below 7.20. The lowest UA PaO2 was 4.6mmHg and the 10th percentile value was 11.5mmHg. The highest UA PaCO2 was 67.2mmHg and the 90th percentile value was 56.5mmHg. The lowest bicarbonate value was 13.2mmol/L and the 10th percentile value was 18.4mmol/L. CONCLUSION: The distributions of the UA pH and gas values of the collective of normal newborns were illustrated. None of the UA pH was below 7.0.
Apgar Score ; Blood Gas Analysis* ; Carbon Dioxide ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Oxygen ; Parturition ; Pregnancy ; Umbilical Arteries*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

OBJECTIVE: The purpose of this study is to reevaluate the prognostic factors by investigating the clinical and biological parameters concerned malignant gestational trophoblastic tumor in patients with hydatidiform mole. METHODS: From March 1995 to February 2000, 41 patients admitted to department of the Obstetrics and Gynecology, Yonsei University College of Medicine who were diagnosed with pathologically-proven gestational trophoblastic disease were selected. Parameters such as age, gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction were compared between malignant gestational trophoblastic tumor group and spontaneous remission group. RESULTS: Considering the clinical prognostic factors, the patients were divided into two age groups; the first group consisted of those older than 40 years of age and the second control group consisted of those under 40. The number of patients older than 40 in the spontaneous remission group and malignant gestational trophoblastic tumor group were 4(15.4%) and 7(46.7%), respectively, showing a significantly higher number in the group over 40years. Other parameters such as gravida, parity, presence of theca lutein cyst, ratio of uterine size to gestational age, hCG level, DNA ploidy, S-phase fraction showed no statistically significant difference between the two groups. CONCLUSION: The progression rate from hydatidiform mole to malignant gestational trophoblastic tumor was significantly higher in patients over 40 years of age. Therefore, more aggressive therapeutic approach should be considered in such patients.
DNA ; Female ; Gestational Age ; Gestational Trophoblastic Disease ; Gynecology ; Humans ; Hydatidiform Mole* ; Lutein ; Obstetrics ; Parity ; Ploidies ; Pregnancy ; Remission, Spontaneous ; Trophoblastic Neoplasms* ; Trophoblasts*

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PURPOSE: Influenza infection is a major public health concern, especially in young children and in high risk groups such as asthma patients. Traditionally, influenza vaccines are produced from infertilized eggs. Therefore, patients with severe egg allergy can show adverse reactions after vaccination and be dalayed in active immunization. The aim of this study was to determine the ovalbumin concentration of a commercially available influenza vaccines in Korea. METHODS: The ovalbumin content in each vaccine was determined by enzyme linked immunosorbent assay. The ovalbumin content was compared among the different manufactures, the different lot numbers and the same lot numbers of vaccines. The microtiter plates coated with goat anti-chicken egg albumin antibody were inoculated with serial diluted vaccines and ovalbumin. After incubation with horse radish peroxidase-conjugate rabbit anti-ovalbumin, absorbance was read at 450 nm and fitted to the standard curve. RESULTS: The highest ovalbumin content was 101.24 ng/mL, and the lowest ovalbumin content was 21.23 ng/mL. The amount of ovalbumin differed not only among the different vaccines, but also different lot numbers of individual vaccines and even the same lot numbers of vaccines. CONCLUSION: In none of the vaccines tested in our study, ovalbumin content reached the maximum values for ovalbumin (1.2 microgram/mL). Therefore, in severe egg allergic patients, our results provide the useful information on influenza vaccination.
Asthma ; Child ; Egg Hypersensitivity ; Eggs ; Enzyme-Linked Immunosorbent Assay ; Goats ; Horses ; Humans ; Hypersensitivity ; Influenza Vaccines ; Influenza, Human ; Korea ; Ovalbumin ; Ovum ; Public Health ; Raphanus ; Vaccination ; Vaccines

PURPOSE: Influenza infection is a major public health concern, especially in young children and in high risk groups such as asthma patients. Traditionally, influenza vaccines are produced from infertilized eggs. Therefore, patients with severe egg allergy can show adverse reactions after vaccination and be dalayed in active immunization. The aim of this study was to determine the ovalbumin concentration of a commercially available influenza vaccines in Korea. METHODS: The ovalbumin content in each vaccine was determined by enzyme linked immunosorbent assay. The ovalbumin content was compared among the different manufactures, the different lot numbers and the same lot numbers of vaccines. The microtiter plates coated with goat anti-chicken egg albumin antibody were inoculated with serial diluted vaccines and ovalbumin. After incubation with horse radish peroxidase-conjugate rabbit anti-ovalbumin, absorbance was read at 450 nm and fitted to the standard curve. RESULTS: The highest ovalbumin content was 101.24 ng/mL, and the lowest ovalbumin content was 21.23 ng/mL. The amount of ovalbumin differed not only among the different vaccines, but also different lot numbers of individual vaccines and even the same lot numbers of vaccines. CONCLUSION: In none of the vaccines tested in our study, ovalbumin content reached the maximum values for ovalbumin (1.2 microgram/mL). Therefore, in severe egg allergic patients, our results provide the useful information on influenza vaccination.
Asthma ; Child ; Egg Hypersensitivity ; Eggs ; Enzyme-Linked Immunosorbent Assay ; Goats ; Horses ; Humans ; Hypersensitivity ; Influenza Vaccines ; Influenza, Human ; Korea ; Ovalbumin ; Ovum ; Public Health ; Raphanus ; Vaccination ; Vaccines

OBJECTIVE: The ovarian cycle is characterized by repeating patterns of cellular proliferation and differentiation that accompany follicular development and the formation and regression of the corpus luteum (CL). That angiogenesis may play an important role in this process. Angiogenesis is supposed to be regulated by vascular endothelial growth factor (VEGF). The goal of the present investigation, therefore, was to determine whether the expression of VEGF was changed in the normally cycling human ovary. We also investigated VEGF expression in the regressed CL (ie, nonfunctiong CL) of normal term pregnancy to define the association with steroidogenic activity. To our knowledge there is no report available on VEGF expression in the CL of term pregnancy. METHODS: We assessed VEGF expression in ovaries obtained from, 26-42 yr of age, and from patients undergoing hysterectomy and salpingo-oophorectomy for nonendocrinological or nonovarian disorders. Tissue samples from premenopausal women included specimens from follicular (n=4) and luteal (n 4) phases. In addition, we studied ovarian specimens from pregnant women (n=3). Immunohistochemical analysis for VEGF was performed using a rabbit polyclonal antibody directed against human VEGF. RESULTS: These data demonstrate a development-related VEGF expression in the follicle and indirectly show that VEGF expression may be up to the existence of LH-receptor. And also, VEGF was overexpressed in the regressed CL of pregnant women compared with the functioning CL of nonpregnant cycles CONCLUSION: This study suggests that the intensity of VEGF expression is not correlated with steroidogenic activity, although both of them are stimulated by LH.
Cell Proliferation ; Corpus Luteum ; Female ; Humans* ; Hysterectomy ; Menstrual Cycle ; Ovarian Follicle ; Ovary* ; Pregnancy ; Pregnant Women ; Vascular Endothelial Growth Factor A*