Repeat cesarean section is one of the leading causes to make increasing a rate of cesarean section. Trial of labor TOL after cesarean section is attempt to reduce the rate of repeat cesarean section. Trial of labor has been well established as a safe alternative in carefully selected women with transverse scars in the lower uterine segment. This study was based on 104 cases of delivery with prior cesarean birth at the Chonbuk National University Hospital from January, 1991 to June, 1997. The results were as follows: 1) Among 1400 cases with previous cesarean delivery, trial of labor was done in 104 cases (7.4%). Among 104 cases, vaginal birth was successfully completed in 96 cases (92.3%). 2) Among 28 cases with PGE2, vaginal tablet, vaginal delivery was done in 23 cases (82.1%). 3) Among 22 cases with more than 4 of Bishop score, vaginal delivery was done in 21 cases (95.5%), and among 6 cases with less than 3 of Bishop score, vaginal delivery was done only 2 cases (33.3%). 4) There was no matemal death or uterine rupture in the cases of trial of labor, But in 2 cases, uterine dehiscence was observed in 4 cases and postpartal bleeding (more than 400ml) was developed. 5) In the cases of cesarean section, mean of hospital day was 7 days and medical fee was about 400,000 won. In the cases of vaginal birth after cesarean section, mean of hospital day was 2.6 days and medical fee was about 100,000 won. In condusion, vaginal birth after cesarean section is safe and effective alternative to elective repeat cesarean section and also the use of PGE, vaginal tablet is so effective to increase success rate of vaginal delivery. After all, positive these trials might decrease cesarean rate and increase maternal health and quality of medical care.
Cesarean Section ; Cesarean Section, Repeat ; Cicatrix ; Dinoprostone ; Fees, Medical ; Female ; Hemorrhage ; Humans ; Jeollabuk-do ; Maternal Health ; Parturition ; Pregnancy ; Prostaglandins E ; Trial of Labor ; Uterine Rupture ; Vaginal Birth after Cesarean* ; Vaginal Creams, Foams, and Jellies

OBJECTIVE: The purpose of this study was to evaluate the performance of OSTA (Osteoporosis Self assessment Tool for Asian) in Korean peri- and postmenopausal women. DESIGN AND METHODS: Total 1488 peri- and postmenopausal women over 45 years were included from Menopause Clinic in Chung-Ang University Hospital. Femoral neck BMD was measured by using DEXA (Lunar DPXIQ #7055). Three categories of bone status were defined by BMD based on the WHO definition. OSTA index values were calculated by using only 2 components such as age and weight. Three risk categories (high, medium, low) were classified according to index values. RESULTS: Seven hundred thirty women tested comprising 49.1% of all subject had low BMD (10.6% osteoporosis, 38.5% osteopenia respectively). The combined medium and high risk groups had a high prevalence (447/557=80.3%) of low bone mass. The medium and high risk groups had 85.5% of a high specificity, and 61.2% of a good sensitivity for identifying low bone mass. The medium and high risk groups also had 87.9% of a high sensitivity, and 68.5% of a good specificity for identifying osteoporosis. CONCLUSION: OSTA is a simple tool and easy to use, because it requires only age and weight. The OSTA risk tool performed well for identifying low bone mass, especially osteoporosis in Korean peri- and postmenopausal women.
Bone Diseases, Metabolic ; Female ; Femur Neck ; Humans ; Menopause ; Osteoporosis* ; Prevalence ; Self-Assessment* ; Sensitivity and Specificity

OBJECTIVE: The purpose of this study was to evaluate the relationship between parathyroid hormone (PTH), vitamin D status, bone mineral density (BMD) and bone turnover markers in Korean postmenopausal women. METHODS: The subjects were 263 healthy postmenopausal women recruited in Seoul, Korea. The research was performed from January to March, 1999. Serum PTH level was measured with immunoradiometric assay (IRMA). Serum 25 (OH) vitamin D concentration was measured by radioimmunoassay (RIA) for the evaluation of vitamin D nutritional status. The averages of BMD were attained from the 2nd and 3rd lumbar spine. Two serum levels of bone turnover markers such as osteocalcin and N- telopeptide were also measured by IRMA and enzyme linked immunosorbent assay (ELISA) respectively. RESULTS: Severe, moderate, mild vitamin D deficiency and normal vitamin D status groups were found in 16 (6.1%), 94 (35.7%), 127 (48.3%), and 26 (9.9%) subjects respectively. Among the four groups, no significant differences were found in terms of age, weight, height, bady mass index (BMI). The serum vitamin D levels were 3.18 +/- 1.5 ng/ml, 7.8 +/- 1.4 ng/ml, 13.9 +/- 2.7 ng/ml 25.2 +/- 1.3 ng/ml in severe, moderate, mild, vitamin D deficiency and normal vitamin D status group respectively. Serum PTH levels were 28.6 +/- 14.9 pg/ ml, 22.7 +/- 10.4 pg/ml, 19.5 +/- 12.9 pg/ml, 15.1 +/- 10.3 pg/ml in severe, moderate, mild vitamin D deficiency and normal vitamin D, respectively, and a siginificant difference was found (p<0.05). In comparison with the normal vitamin D group, PTH concentration level was significantly increased by 90.1%, 50.4%, 29.4%, in severe, moderate, mild vitamin D deficiency groups respectively (p<0.05). The serum PTH concentration and 25 (OH) vitamin D were inversely related (r=-0.219, p<0.05). The correlations between the serum PTH level and other factors, such as age, weight, height, BMI, BMD, and bone turnover markers, were insignificant. CONCLUSION: Korean postmenopausal women showed an increase in serum PTH levels in case of vitamin D deficiency, and about 90% of women were suffering from vitamin D deficiency. Therefore, it is recommendable to prescribe the supplemental vitamin D for the most of Korean postmenopausal women.
Bone Density ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoradiometric Assay ; Korea ; Nutritional Status ; Osteocalcin ; Parathyroid Hormone* ; Radioimmunoassay ; Seoul ; Spine ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

PURPOSE: The insulin-like growth factor-I receptor (IGF-IR) is a member of the transmembrane tyrosine kinase family that regulates various biological processes. These processes include maintaining optimal cell growth, establishing and maintaining the transformed phenotype, tumorigenesis for several types of cells, and antiapoptosis. This study investigated the immunohistochemical expression of IGF-IR in relation with the expression of the estrogen receptor (ER), the progesteron receptor (PR), proliferative activity (Ki-67) as well as with the other conventional clinicopathlogical parameters in breast cancer. METHODS: This study was performed on paraffin sections from 64 invasive ductal breast carcinoma specimens by immunohistochemistry using rabbit polyclonal antibodies to the IGF-I receptor. RESULTS: IGF-IR expression was detected in 56 (87.5%) cases. The immunohistochemical stains for the IGF-IR were scored according to a semi quantitative scoring system. IGF-IR staining was positively correlated with the ER status, but not significantly with the PR, lymph node status, tumor size, histological grade, and proliferative activity. The Ki-67 labeling index showed a significant correlation with the tumor grade and ER status. CONCLUSION: The IGF-IR may play a role in estrogen-mediated growth and the pathogenesis of breast cancer.
Antibodies ; Biological Processes ; Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Coloring Agents ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Paraffin ; Phenotype ; Protein-Tyrosine Kinases ; Receptor, IGF Type 1

No abstract available.
Nevus*

Joubert syndrome first described by Joubert et al. in 1969 is a very rare congenital disorder, characterized by episodic hyperpnea, abnormal eye movement, hypotonia, ataxia, and mental retardation. This syndrome generally represents as autosomal recessive inheritance and main neuropathological finding is agenesis or aplasia of the cerebellar vermis. This patient represents significant generalized muscle hypotonia which is not affected by any other tone-modifying maneuvers. And so there is no significant neuromotor improvement with neurodevelopmental treatment such as Bobath method, Vojta method, or proprioceptive nerve facilitation technique and so on. We report the Joubert syndrome showing typical features with delayed development.
Ataxia ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Eye Movements ; Humans ; Intellectual Disability ; Muscle Hypotonia* ; Wills

PURPOSE: The insulin-like growth factor-I receptor (IGF-IR) is a member of the transmembrane tyrosine kinase family that regulates various biological processes. These processes include maintaining optimal cell growth, establishing and maintaining the transformed phenotype, tumorigenesis for several types of cells, and antiapoptosis. This study investigated the immunohistochemical expression of IGF-IR in relation with the expression of the estrogen receptor (ER), the progesteron receptor (PR), proliferative activity (Ki-67) as well as with the other conventional clinicopathlogical parameters in breast cancer. METHODS: This study was performed on paraffin sections from 64 invasive ductal breast carcinoma specimens by immunohistochemistry using rabbit polyclonal antibodies to the IGF-I receptor. RESULTS: IGF-IR expression was detected in 56 (87.5%) cases. The immunohistochemical stains for the IGF-IR were scored according to a semi quantitative scoring system. IGF-IR staining was positively correlated with the ER status, but not significantly with the PR, lymph node status, tumor size, histological grade, and proliferative activity. The Ki-67 labeling index showed a significant correlation with the tumor grade and ER status. CONCLUSION: The IGF-IR may play a role in estrogen-mediated growth and the pathogenesis of breast cancer.
Antibodies ; Biological Processes ; Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal* ; Coloring Agents ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Paraffin ; Phenotype ; Protein-Tyrosine Kinases ; Receptor, IGF Type 1

PURPOSE: The aim of this study was to evaluate observed changes in the prevalence of biopsy-proven Helicobacter pylori infection in Korean children with functional recurrent abdominal pain during the past 18 years. METHODS: Between July 1991 and December 2008, 1,194 children with functional recurrent abdominal pain (499 males and 695 females) 9.2+/-3.1 years of age were included. Upper gastrointestinal endoscopies were performed in all patients. H. pylori infection was assessed by the CLO test. Changes in the prevalence of the endoscopic diagnosis of H. pylori infection during 18 years were analyzed. RESULTS: The prevalence of H. pylori infection between 1991 and 1993, 1994 and 1996, 1997 and 1999, 2000 and 2002, 2003 and 2005, and 2006 and 2008 were 25.1% (56/223), 23.1% (45/195), 19.3% (28/145), 16.1% (39/242), 11.3% (24/213), and 10.8% (19/176), respectively; these serial decreases in the prevalence over 18 years were statistically significant (p<0.001). Regardless of gender and age, the prevalence of H. pylori infection decreased. This decrease was inversely related to socioeconomic improvement as represented by the per capita gross national income growth of Korea. CONCLUSION: The prevalence of H. pylori infection has decreased significantly for the past 18 years in Korean children. This decrease might be caused by an improvement in socioeconomic status.
Abdominal Pain ; Child ; Endoscopy, Gastrointestinal ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Prevalence ; Social Class

We observed a patient who had a unilateral leg edema soon after lumbar spine surgery in the prone position. Spine patients have a number of risk factors for developing deep vein thrombosis (DVT) after or during surgery. These factors are; lengthy operative procedures, prone positioning on certain frames, and prolonged bed rest after surgery. Like these patients, estrogen users for replacement or contraception are three to four times more likely to develop DVT than non-users. So, anesthesiologist should check the risk factors of DVT in hormone replacement therapy users before major spine surgery, and perform antithrombotic prophylaxis, including elastic stocking, pneumatic compression to the calf and thigh, and careful prone positioning to avoid compression of the inguinal area. A special survey should be performed to evaluate whether postmenopausal women should discontinue hormone use before major spine surgery.
Bed Rest ; Contraception ; Edema ; Estrogens ; Female ; Hormone Replacement Therapy ; Humans ; Leg ; Prone Position ; Risk Factors ; Spine* ; Stockings, Compression ; Surgical Procedures, Operative ; Thigh ; Venous Thrombosis*

This preliminary study was intended to clarify the effect of intraoperative fluid therapy on Acid-Base balance of the use of Hartmann's solution and 5% Dextrose solution. The arterial carbon dioxide partial pressure and oxygen partial pressure and pH are basic indices of the adequacy of ventilation in anesthetized patients, respiratory care and intensive care. In order to achieve this goal, the data collections were done at the Department of Anesthesia in Hanil Hospital from Mar., 1980 to Aug., 1980. The samplings, 20 cases, were included A.S.A. class I and II. We used 1,500 to 1,800cc/2hrs. of Hartmann's solution and 1,000cc/2hrs, of 5% Dextrose solution each 10 patients through the operative period. Observations were made for the followings; pH, PaCO2HCO-3. From the results of this study, there were no significant relationship between the use of 5% Dextrose solution and Hartmann's solution on Acid-Base balance during the intraoperative period.
Acid-Base Equilibrium* ; Anesthesia ; Carbon Dioxide ; Critical Care ; Fluid Therapy* ; Glucose* ; Humans ; Hydrogen-Ion Concentration ; Intraoperative Period ; Oxygen ; Partial Pressure ; Ventilation