PURPOSE: To estimate the prevalence of acute appendicitis and the relationship between pregnancy and acute appendicitis among South Korean women in 2009. METHODS: This was a cross-sectional study over 1 year period using a national registry data. We analyzed a national patient sample (n = 1,116,040) from a database complied by the South Korean National Health Insurance in 2009. RESULTS: We identified 15,974 cases of acute appendicitis from 2009. The prevalence rate of acute appendicitis was 228 +/- 2 per 100,000 persons. The prevalence in men was higher than in women. The peak prevalence of the disease in both genders occurred in patients aged 10 to 14 years. After that, prevalence declined with age. The prevalence of acute appendicitis in women aged 20 to 39 years was negatively associated with age and pregnancy (P < 0.001) but was not associated with socioeconomic status. The prevalence of perforated appendicitis cases by age is represented by a U-shaped curve. The prevalence was highest in people less than five years of age and in people older than 60 years. CONCLUSION: We found that the prevalence of acute appendicitis decreased with increasing age after early teens, and that the prevalence of acute appendicitis in pregnant women was lower than in nonpregnant women.
Adolescent ; Aged ; Aging ; Appendicitis ; Cross-Sectional Studies ; Female ; Humans ; Male ; National Health Programs ; Pregnancy ; Pregnant Women ; Prevalence ; Social Class

OBJECTIVES: The microdose of gonadotrophin-releasing hormone agonist (GnRHa) has been suggested as a beneficial method of ovulation induction for poor responders. However, the effect of microdose of GnRHa itself has not been evaluated yet. We performed a prospective sutdy to assess the effect of microdose of GnRHa (5 microgram of triptorelin acetate) on the luteinizing hormone (LH) and follicle stimulating hormone (FSH). Secondary objective of this study is to assess how long the down-regulation of gonadotrophin secretion by microdose GnRHa persists. METHODS: Five microgram of triptorelin was injected daily into five normally menstruating women for 7 days starting from cycle day 3. The blood sample was drawn for 12h with 4h interval, then for 6days with 4 h interval and once a day for 14days, In next cycle, same amount of triptorelin was injected into the same subjects daily for 3 days. The blood sample was drawn twice a day for 20days. Serum FSH, LH and extradiol level was measured. RESULTS: The serum LH and FSH level increased rapidly after injection of first GnRHa. The FSH level reached peak (27.53+/-6.34 IU/l) in 5h while LH level reached peak (34.35+/-7.18 IU/l) in 4h. The flare of gonadotrophins persisted even after second and third day injection of GnRHa, although the peak levels were not as high as first injection. The down regulation of gonadotrophin was established in 4-5 days. The estradiol level increased for 4-5 days then decreased. When GnRHa was given for 7days, the estradiol level began to rise 7-8 days after last injection; when given for 3days, the estradiol level began to rise 3-6 days after last injection. CONCLUSION: Even with ultra-low dose of GnRHa, the down-regulation of gonadotrophin could be achieved. The flare-up of gonadotrophin would persist for 3days with this dose. The duration of down regulation was influenced by the duration of GnRHa administration.
Down-Regulation ; Estradiol* ; Female ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans ; Luteinizing Hormone ; Ovulation Induction ; Prospective Studies ; Triptorelin Pamoate

PURPOSE: This study attempted to characterize the muscle derived stem cells isolated from the primary cultured skeletal muscle of the rat gastrocnemius muscle; in addition, we modified the preplate method and then compared this to the original preplate method. MATERIALS AND METHODS: The hind limbs (gastrocnemius muscles) were removed from a 3-6 week olds SD-rat and the bone was dissected away. The muscle mass was finely minced and chopped using razor blades. In an original preplate method, the cells were dissociated using a triple enzyme mixture (collagenase XI, dipase and trypsin) for 1 hour at 37degreesC. The muscle cell extract was preplated on culture flasks as described by Dr. Qu (Qu et al., 1998). The pp1-pp4 cells were referred to as the early plate (EP) cells, and the pp5-pp6 cells were referred to as the late plate (LP) cells. When we modified the preplate method, the pp1-pp2 cells were called the early plate (EP) cells and the pp3-pp4 cells were called to late plate (LP) cells. The phenotypical characteristics of EP and LP cells were compared by immunostaining and FACS. RESULTS: In the original preplate methods, the early plate (EP) cells were mixed with myogenic cells (mostly fibroblasts, <15% desmin + cells) and the LP cells were highly purified muscle derived cells that contain pure myogenic cells (>90% desmin + cells). Yet in the modified preplate method, the muscle derived stem cells were determined to be CD34 (+ or -), CD45- and desmin- cells by immunohistochemical staining and FACS. CONCLUSIONS: In original methods, the LP cells exhibited stem cell properties (CD34+, less than 30%), and they were not from a hematogeous origin (CD45-), but rather, they were from a myogenic origin (desmin+). Yet in the modified preplate method, we purified the LP cells much earlier than the original method. The LP cells displayed CD34+(more than 50%), and CD45-; thus, we isolated more primitive (desmin-) cells.
Animals ; Desmin ; Extremities ; Fibroblasts ; Muscle Cells ; Muscle, Skeletal* ; Rats* ; Stem Cells*

PURPOSE: This study attempted to characterize the muscle derived stem cells isolated from the primary cultured skeletal muscle of the rat gastrocnemius muscle; in addition, we modified the preplate method and then compared this to the original preplate method. MATERIALS AND METHODS: The hind limbs (gastrocnemius muscles) were removed from a 3-6 week olds SD-rat and the bone was dissected away. The muscle mass was finely minced and chopped using razor blades. In an original preplate method, the cells were dissociated using a triple enzyme mixture (collagenase XI, dipase and trypsin) for 1 hour at 37degreesC. The muscle cell extract was preplated on culture flasks as described by Dr. Qu (Qu et al., 1998). The pp1-pp4 cells were referred to as the early plate (EP) cells, and the pp5-pp6 cells were referred to as the late plate (LP) cells. When we modified the preplate method, the pp1-pp2 cells were called the early plate (EP) cells and the pp3-pp4 cells were called to late plate (LP) cells. The phenotypical characteristics of EP and LP cells were compared by immunostaining and FACS. RESULTS: In the original preplate methods, the early plate (EP) cells were mixed with myogenic cells (mostly fibroblasts, <15% desmin + cells) and the LP cells were highly purified muscle derived cells that contain pure myogenic cells (>90% desmin + cells). Yet in the modified preplate method, the muscle derived stem cells were determined to be CD34 (+ or -), CD45- and desmin- cells by immunohistochemical staining and FACS. CONCLUSIONS: In original methods, the LP cells exhibited stem cell properties (CD34+, less than 30%), and they were not from a hematogeous origin (CD45-), but rather, they were from a myogenic origin (desmin+). Yet in the modified preplate method, we purified the LP cells much earlier than the original method. The LP cells displayed CD34+(more than 50%), and CD45-; thus, we isolated more primitive (desmin-) cells.
Animals ; Desmin ; Extremities ; Fibroblasts ; Muscle Cells ; Muscle, Skeletal* ; Rats* ; Stem Cells*

OBJECTIVE: The objective of this study is to report outcomes of apical and posterior pelvic organ prolapse repair using posterior transvaginal mesh kit. METHODS: Thirty four consecutive patients with apical or posterior pelvic organ prolapse over pelvic organ prolapse quantification (POP-Q) stage 2 were repaired by posterior transvaginal mesh kit at the Korea University Guro Hospital between July 2007 and June 2011. Postoperative follow-up visits were scheduled at 1, 6 months after surgery, with question about side effects and POP-Q exam. RESULTS: Thirty four consecutive patients who underwent posterior transvaginal mesh kit had completed 6 month follow up. The demographics are the mean age 65.9+/-8.6 years, the mean body mass index 26.4+/-3.0 kg/m2 and the mean parity 3.6+/-1.5. Overall anatomic cure rates of apical pelvic organ prolapse and rectocele were 91.7%, 92.6%, respectively. The Ap, Bp scores improved significantly after operation (p<0.01). No patient presented healing abnormality. CONCLUSION: Posterior transvaginal mesh kit is effective and safe for treatment of apical and posterior pelvic organ prolapse.
Body Mass Index ; Demography ; Female ; Follow-Up Studies ; Humans ; Korea ; Parity ; Pelvic Organ Prolapse ; Rectocele

OBJECTIVE: To compare the scores of the Bayley Scales of Infant Development second edition (BSID-II) and the third edition, Bayley-III, in children with suspected developmental delay and to determine the cutoff score for developmental delay in the Bayley-III. METHODS: Children younger than 42 months (n=62) with suspected developmental delay who visited our department between 2014 and 2015 were assessed with both the BSID-II and Bayley-III tests. RESULTS: The mean Bayley-III Cognitive Language Composite (CLC) score was 5.8 points higher than the mean BSID-II Mental Developmental Index (MDI) score, and the mean Bayley-III Motor Composite (MC) score was 7.9 points higher than the mean BSID-II Psychomotor Developmental Index (PDI) score. In receiver operating characteristic (ROC) analysis of a BSID-II MDI score < 70, Bayley-III CLC scores showed a cutoff of 78.0 (96.6% sensitivity and 93.9% specificity). In ROC analysis of a BSID-II PDI score < 70, the Bayley-III MC score showed a cutoff of 80. CONCLUSION: There was a strong correlation between the BSID-II and Bayley-III in children with suspected developmental delay. The Bayley-III identified fewer children with developmental delay. The recommended cutoff value for developmental delay increased from a BSID-II score of 70 to a Bayley-III CLC score of 78 and Bayley-III MC score of 80.
Child Development ; Child* ; Developmental Disabilities ; Humans ; ROC Curve ; Weights and Measures*

Objective: The purpose of this study is to determine the risk of breast cancer on women at menopause from postmenopausal hormone therapy using Korea's national health checkup and insurance data.Method: Using the national health checkup and insurance data provided by the National Health Insurance Service (NHIS), we selected women who were over 40 years and confirmed to have menopause during the interview from 2003 to 2011. These women were followed up for breast cancer until December 31, 2019. The control group was defined as women who never used hormone drug during from 2003 to 2019, and the Menopausal Hormone Therapy (MHT) group was defined as women who used menopausal hormone drug for over 6 months. Menopausal hormone drugs were classified tibolone, combined estrogen plus progestin by manufacture (CEPM) (Estradiol Hemihydrate/Drospirenone, Estradiol Hemihydrate/Drospirenone, Estradiol Hemihydrate/Norethisterone Acetate, Cyproterone Acetate/Estradiol Valerate, Estradiol Hemihydrate/Norethisterone Acetate, Estradiol Valerate/Norethisterone Acetate), estrogen (Conjugated Estrogens, Estradiol Valerate, Estradiol Hemihydrate), combined estrogen plus progestin by physician (CEPP) (Estrogen + Progesterone Micronized, Medroxyprogesterone Acetate, Dydrogesterone), Topical estrogen (Estradiol Hemihydrate patch or gel). The variables that may affect breast cancer were adjusted, such as age, body mass index, socioeconomic status, region, Charlson Comorbidity Index, parity, age at menarche, age at menopause, smoking, alcohol, physical exercise, period from menopause to inclusion time. Results: The control group, the tibolone group, CEPM group, the oral estrogen group, CEPP group, and the topical estrogen group were 920,783, 165,222, 107,088, 45,609, 5,633, and 1,729, respectively. In the Cox proportional hazard analysis with adjusted variables, the risk of breast cancer increased in CEPM group. {Hazard ratio [HR] 1.439, 95% confidence interval (CI) 1.374-1.507} However, there were no increase in the risk of breast cancer in the tibolone group, oral estrogen group, CEPP group and the topical estrogen group. (HR 0.968, 95% CI 0.925-1.012) (HR 1.002, 95% CI 0.929-1.081) (HR 0.929, 95% CI 0.75-1.15) (HR 1.139, 95% CI 0.809-1.603) There was no difference in the risk of breast cancer even with doubling the amount of tibolone used. (Over 5 mg: HR 1.306, 95% CI 0.326-5.226) The risk of breast cancer was lower in those in their 50s and 60s than in their 40s. (50s: HR 0.956, 95% CI 0.906-1.008) (60s: HR 0.846, 95% CI 0.776-0.922) As BMI increased, the risk of breast cancer increased. (25-29.9: HR 1.126, 95% CI 1.085-1.169) (30 or more: HR 1.356, 95% CI 1.258-1.462) There was an increased risk of breast cancer when menstrual age was 13 years or older. (HR 1.157, 95% CI 1.109-1.419) A history of smoking increased the risk of breast cancer (HR 1.254, 95% CI 1.109-1.419), and drinking history was not associated with breast cancer. Also, as the inclusion period from menopause increased, the risk of breast cancer decreased. (5-9 years: HR 0.918, 95% CI 0.879-0.959) (10 years or more: HR 0.846, 95% CI 0.791-0.904) Conclusion CEPM increased the risk of breast cancer. However, tibolone, oral estrogen, CEPP, and topical estrogen were not associated with breast cancer. The risk of breast cancer did not differ depending on the dose of tibolone.

Purpose: We evaluated the relationship between previous hysterectomy for uterine fibroids and subsequent stress urinary incontinence (SUI). Methods: This study analyzed national health insurance data. The hysterectomy group (aged 40 to 59) comprised patients who underwent hysterectomy for uterine fibroids between January 1, 2011 and December 31, 2014, and the control group (aged 40 to 59) comprised patients who visited a medical facility for a checkup during the same time span. One-to-one propensity score matching was performed to balance confounders. SUI was defined as the need for SUI surgery accompanied by a diagnosis code for SUI. Results: After matching, 81,373 cases (hysterectomy group) and 81,373 controls (nonhysterectomy group) were enrolled. The mean follow-up period was 7.9 years for the cases and 7.8 years for the controls. The incidence of anti-incontinence surgery was slightly but significantly higher in the cases than in the controls (2.0% vs. 1.7%, P<0.001). Compared to the control group, abdominal hysterectomy significantly increased the likelihood of anti-incontinence surgery both before (hazard ratio [HR], 1.235; 95% confidence interval [CI], 1.116–1.365) and after adjusting for confounders (HR, 1.215; 95% CI, 1.097–1.347). In contrast, laparoscopic hysterectomy, laparoscopic hysterectomy with adnexal surgery, and abdominal hysterectomy with adnexal surgery were not associated with an increased rate of anti-incontinence surgery. The significant association between abdominal hysterectomy and an elevated rate of anti-incontinence surgery persisted even after stratifying patients by age group. Conclusions Prior abdominal hysterectomy without adnexal surgery was associated with an increased incidence of subsequent anti-urinary incontinence surgery.

BACKGROUND: In spite of the successful reperfusion therapy, coronary blood flow in infarcted myocardium was known to decrease for a long time. Abciximab is known to inhibit the final pathway of platelet aggregation and maintenance the large vessel patency. But abciximab may have another important effect beyond the these effect. TIMI frame count method is simple, reproducible, objective and quantitative index of coronary flow. We tried to define the effect of abciximab that used with primary angioplasty on the coronary blood flow using TIMI frame count methods. METHODS: We consecutively studied 30 patients who admitted for acute myocardial infarction without cardiogenic shock from September 1997 to August 1999. We analyzed the changes of corrected TIMI frame count(CTFC) between the baseline(immediate after the angioplasty) and follow-up(post-op 7th day) coronary angiogram and compared the results between the group of primary angioplasty with abciximab(abciximab group, n=1) and the group of primary angioplasty without abciximab(non-abciximab group, n=9). RESULTS: There were no differences between abciximab group and non-abciximab group in baseline characteristics, treatment modalities and angiographic results. According to the results of the comparison of deltaCTFC, changing rate of CTFC, deltavelocity and changing rate of velocity, there were significant improvement of the coronary blood flow in infarct related artery in the abciximab group than non-abciximab group. But there were no differences in the changes of coronary blood flow in non-infarct related artery between two groups. The frequency of major adverse coronary events during follow up periods(mean 6 months) were similar(9.1% and 5.2% each other, p>0.05). CONCLUSIONS: Abciximab used with primary angioplasty in acute myocardial infarction improved the coronary blood flow significantly in infarcted myocardium. This finding may be related that abciximab enhance the perfusion and function of microvasculature in infarcted myocardium.
Angioplasty* ; Arteries ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Microvessels ; Myocardial Infarction* ; Myocardium ; Perfusion ; Platelet Aggregation ; Reperfusion ; Shock, Cardiogenic