The experimental study has been conducted in six townships of Koyang County, Kyonggi Province to identify more efficient methods of carrying the Intra-Uterine Device (IUD) into rural areas since May 1965, covering in all 76,810 inhabitants with 10,073 eligible women in 13,947 households. IUD acceptance rates are improved remarkably in two townships with activities of the mobile service and stationary clinic, impling that the IUD program could be intensified if IUD services are extended to the village either by mobile service or stationary services. The most of the eligible women wanting IUD in the future preferred to have IUD insertion by female physician on the before survey, but the results of the study shows no difference in IUD insertions by female and male physicians. Reasons to choose a clinic for IUD insertion are most likely to be accessibility or availability and reliability of the service with a little shyness problem. It indicates that the sex of physician inserter is not important in Korea. IUD termination rates are least for postpartum, and are trivially different between those inserted within ten days after onset of menstruation and those inserted later. IUD termination rates in terms of the qualification of inserter show that Ob-Gyn specialist is with the lowest termination rates, but it is interesting that nurse working alone with the postpartum cases did best of all and suggested that nurses can potentially insert IUD's as efficiently as do physicians if the proper training is given to them.
Attitude ; Female ; Human ; *Intrauterine Devices ; Korea ; Nurse-Patient Relations ; Physician-Patient Relations ; Pregnancy

No abstract available.
Estrogens* ; Fallopian Tubes* ; Female ; Humans* ; Progesterone* ; Receptors, Progesterone*

No abstract available.
Ascites ; Hydrops Fetalis* ; Pleural Effusion ; Ultrasonography

Toremifene is an anti-estrogen which has been shown to be effective in the treatment of breast cancer, and is thought to be a less uterotrophic agent than tamoxifen. The risk assessment concerning endometrial cancer has been inconclusive because of its rare use up to the mid-1990s. We report a case of an adenosarcoma, which is a very rare type of uterine malignancy, after toremifene treatment for 5 years in a breast cancer patient. After 1 year of toremifene use, the patient had a benign Mullerian adenofibroma. After an additional 4 years of toremifene treatment, the endometrial polypoid lesion was transformed into a Mullerian adenosarcoma. Although toremifene is a promising anti-estrogenic agent in the treatment of breast cancer patients, clinicians should not neglect the possibility of a uterine malignancy.
Adenofibroma ; Adenosarcoma ; Breast ; Breast Neoplasms ; Endometrial Neoplasms ; Female ; Humans ; Risk Assessment ; Tamoxifen ; Toremifene

BACKGROUND AND OBJECTIVES: This study sought to investigate operative and late mortality in aortic valve surgery and to identify risk factors for operative and late mortality. MATERIALS AND METHODS: We examined operative mode, operative and late mortality, and survival rate of aortic valve surgery performed at Asan Medical Center between June 1989 and December 1996. RESULTS: 227 patients (148 men) with a mean age 49+/-15 years underwent aortic valve surgery. Aortic valvular lesions were classified as dominant stenosis (n=66), dominant regurgitation (n=133), and balanced stenoinsufficiency (n=28) according to the echocardiographic findings. Surgical procedures were aortic valve replacement with mechanical prosthesis in 180 (79 %) and with bioprosthesis in 27 (12 %) and aortic valve repair in 20 (9 %). The overall operative mortality was 4.8 %. Bacterial endocarditis and long bypass time were independent factors associated with high operative mortality (p < 0.05). During follow up (mean 33+/-24 months) of operative survivors, there were 9 late deaths, 12 re-do operations, and 11 clinical events (bacterial endocarditis, stroke, major bleeding, and admission for heart failure). There was no single identifiable risk factor for late mortality but age was significantly associated with development of clinical event and late mortality (p < 0.05). One-, Three-, and Seven-years survival rate after successful operation were 98+/-1 %, 96+/-2 %, and 92+/-3 %, respectively. Late clinical event-free survival rate was 67+/-8 % at seven years after aortic valve surgery. CONCLUSIONS: Aortic valve surgery could be done with low operative and late mortality. Complications related with bacterial endocarditis and long-term anticoagulation therapy following valve replacement surgery still remained high, which needs further improvement.
Aortic Valve* ; Bioprosthesis ; Chungcheongnam-do ; Constriction, Pathologic ; Disease-Free Survival ; Echocardiography ; Endocarditis ; Endocarditis, Bacterial ; Follow-Up Studies ; Heart* ; Hemorrhage ; Humans ; Mortality ; Prostheses and Implants ; Risk Factors ; Stroke ; Survival Rate ; Survivors ; Thoracic Surgery*

A 77-year-old woman was admitted to this hospital for evaluation of chest pain for 3 days. On physical examination, icteric sclerae, inspiratory crackles on both lower lung field and normal heart sounds were observed. Electrocardiograms showed pathologic Q waves with ST elevations in the precordial leads(V1-V4). Chest X-rays showed mild pulmonary edema with anteroseptal wall akinesia. Cardiac enzyme studies were compatible with AMI. Hematologic investigation revealed severe thrombocytopenia and microangiopathic hemolytic anemia. Coagulation profiles were normal. Coombs test, sucrose lysis test, anti-platelet antibody and antinuclear antibody were all negative. Urinalysis showed albuminuria(+++) and microscopic hematuria. Initial therapy with aspirin, nitrate, morphine and prednisolone was started. Ten hours after admission, she developed agitation, aphagia and confusion with progression to coma. Computed tomography of the brain was normal. Five units of fresh frozen plasma were infused. After one day, platelet counts slightly increased. But cardiogenic shock ensued and she died despite cardiopulmonary resuscitation. AMI has not been reported in association with TTP. This patient had no risk factors for coronary artery disease and no previous history of angina. TTP was clinically diagnosed with confidence by excluding other known cause of microangiopathic hemolytic anemia with thrombocytopenia. Coronary angiogram and bone marrow examination could not be performed due to a rapidly fatal course. The etiology of AMI in this patient was not confirmed, but clinical evidence strongly supported etiologic association with TTP.
Aged ; Anemia, Hemolytic ; Antibodies, Antinuclear ; Aspirin ; Bone Marrow Examination ; Brain ; Cardiopulmonary Resuscitation ; Chest Pain ; Coma ; Coombs Test ; Coronary Artery Disease ; Dihydroergotamine ; Electrocardiography ; Female ; Heart Sounds ; Hematuria ; Humans ; Lung ; Morphine ; Myocardial Infarction ; Physical Examination ; Plasma ; Platelet Count ; Prednisolone ; Pulmonary Edema ; Purpura, Thrombotic Thrombocytopenic ; Respiratory Sounds ; Risk Factors ; Sclera ; Shock, Cardiogenic ; Sucrose ; Thorax ; Thrombocytopenia ; Urinalysis

PURPOSE: This study was performed to determine the physical and psychological effects of an urban forest-walking program for office workers. For many workers, sedentary lifestyles can lead to low levels of physical activity causing various health problems despite an increased interest in health promotion. METHODS: Fifty four office workers participated in this study. They were assigned to two groups (experimental group and control group) in random order and the experimental group performed 5 weeks of walking exercise based on Information-Motivation-Behavioral skills Model. The data were collected from October to November 2014. SPSS 21.0 was used for the statistical analysis. RESULTS: The results showed that the urban forest walking program had positive effects on the physical activity level (U=65.00, p <.001), health promotion behavior (t= - 2.20, p =.033), and quality of life (t= - 2.42, p =.020). However, there were no statistical differences in depression, waist size, body mass index, blood pressure, or bone density between the groups. CONCLUSION: The current findings of the study suggest the forest-walking program may have positive effects on improving physical activity, health promotion behavior, and quality of life. The program can be used as an effective and efficient strategy for physical and psychological health promotion for office workers.
Adult ; Blood Pressure/physiology ; Body Mass Index ; Body Size ; Bone Density/physiology ; Cities ; Depression/*pathology ; Female ; Forests ; *Health Promotion ; Humans ; Male ; Middle Aged ; Motor Activity ; *Quality of Life ; Sedentary Lifestyle ; Waist Circumference ; *Walking

PURPOSE: Neonatal lupus erythematosus (NLE) is a rare disorder caused by the transplacentally transmitted maternal autoantibodies. It is characterized by congenital complete atrioventricular block (CCAVB), skin lesion and less commonly hepatic and hematologic abnormalities. This study was designed to investigate the clinical characteristics and outcome of systemic lupus erythematosus (SLE) mothers and their neonates. METHODS: 29 neonates born to 25 SLE mothers were admitted to the Neonatal Intensive Care Unit of Chonnam University Hospital between January 1994 and June 2005. We investigate the medical records retrospectively. RESULTS: Among 25 SLE mothers, 32.4% had history of spontaneous abortion or stillbirth in previous pregnancy, and 7 (28.0%) of preeclampsia and 3 (12.0%) of premature rupture of membranes in present pregnancy. Among 29 newborns, 14 (48.2%) were premature, 4 (13.7%) were intrauterine growth retardation, and 11 (37.9%) were confirmed as NLE. Anti-SSA/Ro was positive in 13 (52.0%) of 25 examined neonates including 6 (85.7%) of 7 neonates with electrocardiographic abnormalities. Two cases of CCAVB were diagnosed during the pregnancy. One patient didn't show heart failure, he is on the followed up without medical treatment until 4 years of age. The other one showed heart failure, cardiac pacemaker was inserted at 7 days of age, dilated cardiomyopathy developed at 4 years of age. Five neonates with sinus bradycardia resolved spontaneously. One (3.4%) had typical lupus skin lesion with thrombocytopenia and elevated liver enzyme, one (3.4%) had leukopenia, and two (6.9%) had elevated liver enzymes only. CONCLUSIONS: With careful antenatal monitoring of SLE mothers and their fetuses, neonates should be monitored by autoantibody, EKG, and laboratory test.
Abortion, Spontaneous ; Atrioventricular Block ; Autoantibodies ; Bradycardia ; Cardiomyopathy, Dilated ; Electrocardiography ; Female ; Fetal Growth Retardation ; Fetus ; Heart Failure ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Jeollanam-do ; Leukopenia ; Liver ; Lupus Erythematosus, Systemic* ; Medical Records ; Membranes ; Mothers* ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Rupture ; Skin ; Stillbirth ; Thrombocytopenia

The incidence of fetal cardiac arrhythmia is approximately 1-3%. Sustatined fetal tachyarrhythmia may cause fetal hydrops and rnay lead to fetal death. We experienced a case of fetal atrial flutter without fetal hydrops at 34 weeks of gestation, which was diagnosed by fetal echocardiography. Transplacental fetal therapy with maternal digoxin administration resulted in restoration of normal fetal sinus rhythm. At birth, the infant showed normal electrocardiographic finding with normal Apgar scores.
Arrhythmias, Cardiac ; Atrial Flutter* ; Digoxin ; Echocardiography ; Electrocardiography ; Fetal Death ; Fetal Therapies ; Humans ; Hydrops Fetalis ; Incidence ; Infant ; Mothers* ; Parturition ; Pregnancy ; Tachycardia

Neutrophils are the predominant inflammatory cells found in vaginal discharges of patients infected with Trichomonas vaginalis. In this study, we examined superoxide anion (O2(.-)) production by neutrophils activated by T. vaginalis. Human neutrophils produced superoxide anions when stimulated with either a lysate of T. vaginalis, its membrane component (MC), or excretory-secretory product (ESP). To assess the role of trichomonad protease in production of superoxide anions by neutrophils, T. vaginalis lysate, ESP, and MC were each pretreated with a protease inhibitor cocktail before incubation with neutrophils. Superoxide anion production was significantly decreased by this treatment. Trichomonad growth was inhibited by preincubation with supernatants of neutrophils incubated for 3 hr with T. vaginalis lysate. Furthermore, myeloperoxidase (MPO) production by neutrophils was stimulated by live trichomonads. These results indicate that the production of superoxide anions and MPO by neutrophils stimulated with T. vaginalis may be a part of defense mechanisms of neutrophils in trichomoniasis.
Anions/*metabolism ; Female ; Humans ; Neutrophils/enzymology/*metabolism/parasitology ; Peroxidase/metabolism ; Superoxides/*metabolism ; Trichomonas Infections/enzymology/*metabolism/parasitology ; Trichomonas vaginalis/*isolation & purification/physiology