OBJECTIVES: To evaluate the effect of transdermal estrogen on arterial tone. METHODS: In 30 postmenopausal women, doppler ultrasound was used to assess blood flow characteristics in internal carotid arteries. As the pulsatility index(PI) represents impedance to blood flow distal to the point of sampling, pulsatility index of internal carotid artery was measured from the flow velocity waveform. Patients were studied pretreatment and at weeks 8, 12, and 24 of treatment with transdermal estradiol 50microgram/day. RESULTS: Blood pressure was not changed during transdermal estrogen replacement therapy. Serum estradiol was increased from 13.4+/-13.7pg/ml to 55.8+/-32.8pg/ml with week 8 of treatment and it was maintained until week 24. The mean pulsatility index was fallen to 0.1+/-0.1 during week 8 of therapy and a significant reduction in PI was maintained until week 24(p=0.0001). CONCLUSION: We believe that transdermal estrogen replacement therapy affects on the arterial tone and prevents cardiovascular disease in postmenopausal women.
Blood Pressure ; Cardiovascular Diseases ; Carotid Artery, Internal* ; Electric Impedance ; Estradiol ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Ultrasonography

OBJECTIVES: A retrospective study was performed to clarify the change of lumbar bone mineral density(BMD) according to the duration of hormone replacement therapy(HRT) and the other factors such as age, years since menopause(YSM) and initial BMD in postmenopausal women. METHODS: From January, 1995 to December, 1998 we measured lumbar bone mineral density in 100 postmenopausal women in the department of obstetrics and gynecology, Inha University Hospital. These women had been followed for 2 years after taking HRT. We investigated whether there were any relation between the duration of HRT, age, YSM, initial BMD and change of BMD. RESULTS: Lumbar BMD was increased 2.06% after one year of HRT(p=0.0001) but there was no change of BMD at the 2nd year of HRT(p=0.847). The response to HRT was greatest in those who were oldest(r=0.209 ; p=0.039) and furthest YSM(r=0.209; p=0.039), and consequently among those who had the lowest BMD(r=0.590 ; p=0.0001). CONCLUSION: The bone mass was increased upto 2.06% at the 1st year of HRT but no more progressive increase was occurred. It suggest that intensive HRT is needed at 1st year of therapy. The risk of fracture is not decreased to that of the healthy population inspite of HRT, so the earlier therapy is necessary to prevent osteoporotic fracture despite of intervention.
Bone Density* ; Female ; Gynecology ; Hormone Replacement Therapy* ; Humans ; Obstetrics ; Osteoporotic Fractures ; Retrospective Studies

OBJECTIVE: To understand the difference of defecation physiology between postpartum and postoperative women. METHODS: Between July 1998 to April 1999, we performed defecogram and pudendal nerve motor latency to 31 women, who were 8 postoperative women, 9 post cesarean-section state women, and 14 normal vaginal delivery-state women. RESULTS: According to the defecogram results, only squeezing angles of the anorectal angle were significantly increased(96.0 vs 72.3, 74.9 degree) in normal vaginal delivery-state women compared to post cesarean-section state and postoperative women, but rest and evacuation angles were not. And to pudendal nerve latency, there were no statistically significant difference. CONCLUSION: We concluded that the pudendal plexus was damaged during labor, therefore its ability to control puborectalis muscle was damaged. So, the anorectal angles of squeezing of postpartum women were significantly increased, compared to those of post cesarean section women or postoperative women.
Cesarean Section ; Defecation* ; Female ; Humans ; Physiology* ; Postpartum Period* ; Pregnancy ; Pudendal Nerve*

A new diagnosis-related group (DRG) based payment system has been implemented in most public hospitals in Korea. We investigated the effects of the new DRG system and its incentive policy on the utilization rate of diagnostic laboratory tests. Three groups were categorized; 36 hospitals under the new DRG system (participant group), 72 hospitals (control-1) matching with 36 participants according to the number of beds, and 42 tertiary hospitals (control-2). The patients of acute myocardial infarction, cerebral infarction, type 2 diabetes mellitus, and gonarthrosis receiving total arthroplasty were included. We analyzed the mean length of stay and the number of diagnostic laboratory tests conducted during hospitalization of the three groups according to the new DRG system and the incentive policy rates under the new DRG system. Before participating in the new DRG system, the number of diagnostic laboratory tests in the participant group was less than that in the two control groups for all four diseases. However, although the participant group’s length of stay decreased under the new DRG system, the number of diagnostic laboratory tests increased as the maximum incentive policy rate increased. The increment of the number of diagnostic laboratory tests was prominent in the period of a maximum of 35% incentive policy rates. Finally, the number of diagnostic laboratory tests of the participant group was similar to or exceeded that of the control-2 group. The new DRG system’s incentive policy rates played a driving force on the increased utilization rate of the diagnostic laboratory test. For preparing in advance for the change in incentive policy rates, monitoring and guidelines for the utilization of diagnostic laboratory tests are necessary.