OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

OBJECTIVE: To study the clinical characteristics on translocation of intrauterine device and the methods of removal. METHODS: A retrospective review was performed on 77 cases of translocation of intrauterine device from June 1994 to December 2002. RESULTS: Among 77 cases undergoing removal of intrauterine device, 17 cases (22.1%) were translocted intraperitoneally. Fifteen cases were removed by laparoscopy, 2 cases were by laparotomy and there was no specific postoperative complication. The incidence of intraperitoneal translocation was not related to the type of IUD. Between intrauterine and extrauterine translocation, the incidence of symptoms were not different, but low abdominal pain were slightly increased in extrauterine (35.3%) than intrauterine (10.0%) group. The time lapse after insertion of IUD was ranged from 1 month to 35 year, the mean duration was 9.39 year, that was not related to the incidence of intraperitoneal translocation. In the cases of extrauterine translocation, the mean hospital day was significantly increased (p=0.001), the mean duration was 2.5 day (1-7 day), compaired with 0.7 day (0-6 day) of the cases of not translocated. CONCLUSION: As the type of IUD or symptoms, it is difficult to anticipate the possibility of the intraperitoneal translocation of IUD. But, in cases of extrauterine translocation of intrauterine device, the incidence of low abdominal pain was slightly increased, and ring type IUD was rarely extrauterne translocated. So, it is necessary to further study what factors contribute the extrauterine translocation of IUD.
Abdominal Pain ; Incidence ; Intrauterine Devices* ; Laparoscopy ; Laparotomy ; Postoperative Complications ; Retrospective Studies

The breast cancer is the second most common malignancy in pregnancy after cervical cancer. Pregnancy- associated breast caner tends to show unfavorable prognosis, because it is diagnosed at more advanced stage due to delay of diagnosis and treatment. For appropriate management, collaboration with physicians and obstetricians should make precise decisions considering gestational weeks and cancer stage at the time of diagnosis in a point of view from mother and fetus. A case of successful gestation and delivery after chemotherapy in a woman with inflammatory breast cancer diagnosed in the second trimester is presented with review of literature.
Breast Neoplasms* ; Breast* ; Cooperative Behavior ; Diagnosis ; Drug Therapy ; Female ; Fetus ; Humans ; Inflammatory Breast Neoplasms ; Mothers ; Pregnancy ; Pregnancy Trimester, Second ; Prognosis ; Uterine Cervical Neoplasms

OBJECTIVE: To evaluate the changes of plasma MMP-2, -9 levels in preeclampsia between antepartum and postpartum periods, and compare with normotensive pregnant. METHODS: Plasma MMP-2, -9 levels were determined with enzyme-linked immunoassay in pregnant women with preeclampsia (n=20) compared to control group (normotensive pregnant women) matched by maternal age, gestational age, and parity (n=20). RESULTS: Women with preeclampsia presented significantly higher plasma level of MMP-2 before delivery [516.33 +/- 98.75 vs 384.55 +/- 93.84 (ng/mL), p=0.002]. In postpartum 24 hours, women with preeclampsia exhibited higher plasma MMP-2 level compared control group [534.77 +/- 158.67 vs 336.04 +/- 139.11 (ng/mL), p=0.002]. But the plasma level of MMP-9 was significantly lower in preeclampsia group before delivery [26.26 +/- 7.49 vs 45.00 +/- 20.31 (ng/mL), p=0.001]. In postpartum 24 hours, women with preeclampsia also speculated lower plasma MMP-9 level compared control group, but no existence of significance. CONCLUSION: Plasma MMP-2 concentration is significantly increased in preeclampsia before delivey and postpartum 24 hours. Plasma MMP-9 concentration is significantly decreased in preeclampsia before delivery.
Female ; Gestational Age ; Humans ; Immunoassay ; Maternal Age ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinase 9 ; Parity ; Plasma* ; Postpartum Period* ; Pre-Eclampsia* ; Pregnant Women

OBJECTIVE: To evaluate the changes of plasma MMP-2, -9 levels in preeclampsia between antepartum and postpartum periods, and compare with normotensive pregnant. METHODS: Plasma MMP-2, -9 levels were determined with enzyme-linked immunoassay in pregnant women with preeclampsia (n=20) compared to control group (normotensive pregnant women) matched by maternal age, gestational age, and parity (n=20). RESULTS: Women with preeclampsia presented significantly higher plasma level of MMP-2 before delivery [516.33 +/- 98.75 vs 384.55 +/- 93.84 (ng/mL), p=0.002]. In postpartum 24 hours, women with preeclampsia exhibited higher plasma MMP-2 level compared control group [534.77 +/- 158.67 vs 336.04 +/- 139.11 (ng/mL), p=0.002]. But the plasma level of MMP-9 was significantly lower in preeclampsia group before delivery [26.26 +/- 7.49 vs 45.00 +/- 20.31 (ng/mL), p=0.001]. In postpartum 24 hours, women with preeclampsia also speculated lower plasma MMP-9 level compared control group, but no existence of significance. CONCLUSION: Plasma MMP-2 concentration is significantly increased in preeclampsia before delivey and postpartum 24 hours. Plasma MMP-9 concentration is significantly decreased in preeclampsia before delivery.
Female ; Gestational Age ; Humans ; Immunoassay ; Maternal Age ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinase 9 ; Parity ; Plasma* ; Postpartum Period* ; Pre-Eclampsia* ; Pregnant Women

BACKGROUND: In peritoneal dialysis patients, altered thyroid function was reported but the frequncy and pathophysiology were not well understood. The object of this study is to evaluate the effect of continuous ambulatory peritoneal dialysis (CAPD) on thyroid function by observing the frequency of primary thyroid dysfunction and the sequential change of thyroid function after CAPD. METHODS: In a cross-sectional study, thyroid function test (TFT) was done for 192 CAPD patients between Jan. 2001 and Jan. 2002. For another 38 CAPD patients, we observed the sequential change of thyroid function by performing TFT before and 6, 12, 24 months after CAPD. Thyroid hormones were quantitated after 200 mL sample of 24-hour dialysate effluent was lyophilized. TFTs were interpreted as subclinical hypothyroidism (sbhypo) when TSH is over 5 uIu/mL, mild hypothyroidism (mhypo) when TSH is between 5 and 10 uIu/mL with decreased fT4, and overt hypothyroidism (ohypo) when TSH level is over 10 uIu/mL with decreased fT4. RESULTS: Frequencies of normal thyroid function, sbhypo, mhypo and ohypo were 81.2%, 11%, 5.2%, and 2.6% respectively. Serum levels of TSH before and 6, 12, 24 months after CAPD were 2.6 +/- 0.1, 3.8 +/- 0.3, 4.2 +/- 0.5, 4.1 +/- 0.5 uIu/mL respectively and the frequencies of thyroid dysfunction including subclinical hypothyroidism were 6.4, 23.6, 26.3, 28.8% respectively, which showed the increasing tendency. Peritoneal loss of TSH was 11, 067 +/- 1, 776 uIu/day, and that of TT4 was 11.68 +/- 2.7 microgram/day. These were approximately 7%, and 10% of daily production rate. CONCLUSION: TSH increased after start of CAPD and thyroid dysfunction including subclinical hypothyoidism was observed in significant proportion of CAPD patients. Thyroid hormones were eliminated by peritoneal dialysis. It can be suggested that CAPD affects thyroid function. Clinical significance of the above observation needs further well-controlled study.
Cross-Sectional Studies ; Humans ; Hypothyroidism ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Hormones

Osteogenesis imperfecta (OI) is an inherited disease of connective tissue disorder which represents a phenotypically heterogeneous group of conditions that results from a number of genetic defects in the synthesis of type I collagen. A pregnancy associated with osteogenesis imperfecta is considered a high risk pregnancy because the disease is associated with various metabolic and hematologic disorders, as well as well-recongnized skeletal abnormalities. In addition to the mother with OI, the offspring has about a 25% to 50% chance of being affected, therefore genetic counseling before conception and prenatal diagnosis should be offered to all affected mothers. Patients with OI present a series of problems and require a multidisciplinary approach in their management. We present a case of parturient with osteogenesis imperfecta with brief review of literature.
Collagen Type I ; Connective Tissue ; Fertilization ; Genetic Counseling ; Heredity ; Humans ; Mothers ; Osteogenesis Imperfecta* ; Osteogenesis* ; Pregnancy* ; Pregnancy, High-Risk ; Prenatal Diagnosis

Malignant lymphomas of the female genital tract are rare. When it involves the female genital tract, information in the literature regarding the classification, treatment and diagnosis of malignant lymphoma are few. Non-Hodgkin lymphomas (NHL) of the female genital tract occurs primarily in the ovary (49%), uterus (11%), vagina (7%), and vulva (4%). The vulva as the primary location is a very rare occurrence. However, autopsy studies have shown that about 40% of women who die of non-Hodgkin's lymphoma had involvement of the uterus or ovaries. There have been many cases of high-stage lymphomas presenting as secondary involvement of the female genital tract, but when the primary involvement site is the vulva, the stage of lymphoma was most commonly stage IE or IIE. Therefore, physicians should keep in mind the possibility of the presence of a malignant neoplasm when the suspected Bartholin's gland tumor does not respond to treatment. The authors propose that thorough gynecological evaluation should be conducted as a routine screening method in female patients with suspected lymphoma. We represent a case of primary non-Hodgkin's lymphoma patient who was relatively young in age and who was consequently determined to be of a high stage.
Autopsy ; Classification ; Diagnosis ; Female ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Mass Screening ; Ovary ; Uterus ; Vagina ; Vulva*

OBJECTIVES: The objective of this study is to evaluate the efficacy of conization of the cervix in patients with cervical intraepithelial neoplasia. STUDY DESIGN: Cold-Knife conization was performed in total 436 patients from June 1994 to May 2000. Indications and complications of conization were studied. And the results of cervical cytology, cervical histology, colposcopic findings and pathologic diagnosis of conization specimens were evaluated in comparison with the pathologic diagnosis of hysterectomy specimens and follow-up check of the patients. RESULTS: Followings are results summarized. 1. Patients distribution according to cone biopsy results was 31.0% for CIS, 43.3% for CIN III, 14.7% for CIN II, 7.6% of CIN I, 3.4% for CNI, respectively. 2. The rate of agreement between colposcopy-directed biopsy and conization was 63.1%. 3. The positive rate of resection margin was 15.1%. 4. The recurrence rate in clear resection margin group was 7.0%. But there was no recurrence after hysterectomy in cases with positive resection margin of conization specimen, and the recurrence rate of positive resection margin without hysterectomy group was 10.5%. 5. The incidence of delayed hemorrhage (bleeding after 2 weeks) in hemostatic suture group and electric cauterization only group was 4.7% (13/279) and 15.6% (23/157), respectively. CONCLUSION: We conclude that conization of the cervix as the surgical treatment was effective in CIN patients with careful patient selection.
Biopsy ; Cautery ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Conization* ; Diagnosis ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Patient Selection ; Recurrence ; Sutures

OBJECTIVE: The Bethesda System (1991) recommended that the diagnosis of atypical squamous cells of undetermined significance (ASCUS) be qualified when possible to indicate whether a reactive process, or premalignant/malignant process, is favored. In order to evaluate the clinical significance of the qualification, we reviewed our hospital's experience with cervicovaginal smears diagnosed as ASCUS. METHOD: A retrospective study from June 1994 to December 2000 was performed on all cervicovaginal smears with the diagnosis of ASCUS. 3759 cases were included in study group. The 1200 cases of 3759 were not followed up. Histopathologic diagnosis and cervicovaginal smear results were reviewed and compared according to the qualification of ASCUS. The Chi-square test was used. RESULTS: Histopathologic diagnosis of low-grade squamous intraepithelial lesion (LGSIL) was seen in 46.1%, 47.8%, and 44.3% of the ASCUS FR, ASCUS FD and ASCUS NOS group, respectively. Histopathologic diagnosis of high-grade squamous intraepithelial lesion (HGSIL) was seen in 6.0%, 17.2% and 7.8% of the ASCUS FR, ASCUS FD and ASCUS NOS group, respectively. In ASCUS FR group, 1 invasive carcinoma was detected. In ASCUS FD group, 6 carcinoma in situ (CIS), 2 microinvasive carcinoma, 1 invasive carcinoma and 1 adenosquamous cell carcinoma were detected. In ASCUS NOS group, there were 20 CIS, 5 microinvasive carcinoma, 7 invasive carcinoma and 2 invasive adenocarcinoma. The ASCUS FD group demonstrated significant risk for SIL and more severe lesion but ASCUS FR and ASCUS NOS demonstrated no significant difference. CONCLUSION: ASCUS FD group has increased risk for detection of SIL or more severe lesion than ASCUS FR or ASCUS NOS group. But there were also significant number of SIL and even invasive cancer in ASCUS FR and ASCUS NOS group, so qualification of ASCUS was not useful for management and colposcopy-directed biopsy is advocated even in ASCUS FR group.
Adenocarcinoma ; Biopsy ; Carcinoma in Situ ; Diagnosis ; Retrospective Studies