Flow cytometric analyms was performed to investigate any relationship between DNA content and clinical outcome in 32 complete hydatidiform moles (CHMs) and 12 partial hydatidiform moles (PHMs). Twenty three and nine of the 32 CHMs were diploid and aneuploid moles, respectively. Of these 23 diploid CHMs, eight (34.8%) regressed spontaneausly and 15 (65.2%) progressed to persiatent gestatiaoal trophoblastic disease (PGTD). Among nine aneuploid CHMs studied, six (66.7%) underwent spontaneous regremion and three (33.3%) required treatment for peraistent GTI). The twelve PHMs consiated of 9 diploid and 3 aneuploid moles, Three of the rune diploid moles (33.3%) remitted complelely, while the remaining 6(66.7%) progressed to PGTD. All aneuploid PHIMs underwent spontaneous remission. The S-phase of cell cycle in the CHMs studied was more frequent in those that progressed to persiatent GTDs, while G0/G1 was more frequent in those that remitted spontanemusly. The PHMs atudied failed to show any significant relationship between the phases of cell cycle and disease prognosis. Our results suggest the potentia] use of DNA ploidy and cell cycle analysis in prerlicting clinical outcome and thus in selecting cases for prophylactic chernotherapy.
Aneuploidy ; Cell Cycle ; Diploidy ; DNA* ; Female ; Flow Cytometry* ; Hydatidiform Mole* ; Ploidies ; Pregnancy ; Prognosis* ; Remission, Spontaneous ; Trophoblasts

BACKGROUND: Oxygen concentrators are convenient to operate and economical for patients with chronic obstructive pulmonary disease (COPD). However, oxygen concentrators are not manufactured domestically and the COPD patients are currently treated with imported oxygen concentrators. To evaluate the efficacy and safety of domestically developed prototype oxygen concentrator before clinical application, the efficacy and safety of the domestic oxygen concentrator were evaluate by comparing with the imported one. Meterial and METHODS: The clinical tests were performed on 36 hyperhydrosis patients from April 1999 to August 1999. Domestic and imported oxygen concentrators were in turn applied to the same patient, who inspired oxygen for 60 minutes at a rate of 3 liters per minute through nasal prong. The oxygen concentrator, which was applied first, was randomly allocated. The arterial partial oxygen pressure (PaO2) was estimated to compare the efficacy; and the carboxy hemoglobin(COHb), pH, arterial CO2 partial pressure, pulse rate, blood pressure, and respiration rate to compare the safety before and after applying each oxygen concentrator. A student t-test was used to analyze the results. RESULTS: In respect to efficacy, the difference in the change of PaO2 before and after the application between two concentrators was not statistically significant. In respect to safety, the differences in the changes of COHb, pH, partial pressure of arterial CO2, pulse rate, blood pressure, respiration rate between two concentrators were also not statistically significant. CONCLUSION: The domestically developed oxygen concentrator, showed satisfactory efficacy and safety when compared with the imported one.
Blood Pressure ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Oxygen* ; Partial Pressure ; Pulmonary Disease, Chronic Obstructive ; Respiratory Rate

There had been a continuous evolution of lymphoma classification and recently a Revised European-American Lymphoma Classification was proposed by the International Lymphoma Study Group. This new classification often requires information on immunophenotypic and molecular biologic markers in addition to the usual histologic findings. Recent advances in the production of commercially available monoclonal antibodies reactive on formalin-fixed paraffin-embedded tissues provide us a great help to classify the non-Hodgkin's lymphoma. We have analyzed 31 low grade B-cell lymphomas by the schemes proposed by the International Lymphoma Study Group using antibodies to CD3, CD5, CD20, CD23, CD43, cyclin D1, and bcl-2 protein, and have analyzed the immunophenotypic features. Among 31 low grade B-cell lymphomas, 8 small lymphocytic lymphomas, 5 mantle cell lymphomas, 7 follicle center lymphomas (2 grade I, 3 grade II, and 2 grade III), and 11 marginal zone B-cell lymphomas (all of which were extranodal) were identified. Among 8 small lymphocytic lymphomas, 5 cases were positive for CD5; 6 cases were positive for CD23; 7 cases were positive for CD43; all 8 cases were negative for cyclin D1; and 7 cases were positive for bcl-2. Among 5 mantle cell lymphomas, 4 cases were positive for CD5 and CD43; all five cases were negative for CD23; 4 cases were positive for cyclin D1 and bcl-2. All 7 follicle center lymphomas were negative for CD5, CD43 and cyclin D1 and 2 cases were positive for CD23; and 6 cases were positive for bcl-2. All marginal zone B-cell lymphomas were negative for CD5, CD23 and cyclin D1; 3 cases were positive for CD43 and 9 cases were positive for bcl-2. Diagnostic utility for CD5 antigen detection on paraffin embedded tissue has a limitation due to weak antigen expression in tumor cells of B-cell lymphomas; however, still be useful in differentiating small lymphocytic lymphoma and mantle cell lymphoma from other B-cell lymphomas when applied in conjunction with CD43. CD23, CD43, and cyclin D1 appear to be of great help in differentiating subgroups of low grade B-cell lymphomas. Bcl-2, as known, is found to be useful to rule out reactive follicular hyperplasia.
Antibodies ; Antibodies, Monoclonal ; Antigens, CD5 ; B-Lymphocytes* ; Biomarkers ; Classification ; Cyclin D1 ; Hyperplasia ; Immunohistochemistry* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Paraffin*

Gastric lesion in familial polyposis coli is commonly presented with fundic gland hyperplastic polyps, but duodenal and gastric adenomas together with their carcinomatous transformation have been rarely described in familial polyposis coli mostly by case reports. We present three cases of gastric adenomas in familial polyposis coli with one in synchronous development of gastric adenocarcinoma in Korea. All three cases had the family history related to familial polyosis coli and received proctocolectomy because of synchronous development of colonic adenocarcinoma. One patient developed gastric polyposis and adenocarcinoma 8 years after colectomy, and the remaining two presented with multiple polyps either in the stomach or duodenum synchronously at the time of the diagnosis of familial polyposis coli with colonic adenocarcinoma. None disclosed any evidence of Gardner's syndrome. We conclude that association of gastric adenomas in familial oplyposis coli is not uncommon and gastric adenoma-carcinoma sequence is an another important participating mechanism to understand the histogenesis of gastric carcinoma in Korea.
Adenocarcinoma ; Adenoma

In comparison with normal cervix, mitosis occur more frequently in cervical intraepithelial neoplasia(CIN) and are seen at high levels, suggesting that CIN may be associated with a progressive dysfunction in proliferative activity of cervical cells. This study aims that expression of proliferative cell nuclear antigen(PCNA) was examined to determine proliferative activity at the cell of CIN. Sixty four colposcopic biopsies from patients with cytologically and/or colposcopically dtagnosed condyloma and CIN. The cases were classified as follows ; 19 as normal cervix and condyloma, 15 as CIN I, 16 as CIN II and 14 as CIN III. Immunohistochemical detection of PCNA was performed on paraffin sections by the streptavidin-biotin peroxidase method using the monoclonal antibody PC10. There was a statisically significant correlation between the CIN grade and the PCNA grade(p<0.05). In addition, the PCNA grade showed significant correlation with mitotic grade(p<0.05) and the CIN grade was also observed(p<0.05). This study suggests that the cell proliferation index as detected immunohistochemically using PCNA may be a useful adjunct to histopathological diagnosis of various grades of CIN.
Biopsy ; Cell Proliferation ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Diagnosis ; Female ; Humans ; Mitosis ; Paraffin ; Peroxidase ; Proliferating Cell Nuclear Antigen*

OBJECTIVE: To evaluate the clinical effect and reproductive outcome of pelviscopic ovarian drilling in infertile patients with polycystic ovarian syndrome resistant to clomiphene citrate. METHODS: Twenty two patients involved in this study were taken pelviscopic ovarian drilling with needle electrocautery. Change of characteristic LH/FSH ratio before and after operative treatment, ovulation and pregnancy success were followed up. Paired t-test was applied for hormonal change (p<0.05). RESULTS: Thirteen of 14 patients (93%) treated only with pelviscopic ovarian drilling showed successful ovulation with or without clomiphene citrate and among these 10 patients (71%) were success in pregnancy and 9 patients delivered full term babies. When including patients who needed other assisted reproductive technique and specific medication of endometriosis 17 of 22 patients (77%) were successfully pregnant and 15 patients (68%) delivered healthy babies. The mean LH/FSH ratio 2.0+/-0.5 before treatment were decreased to 1.26+/-0.37 after treatment (p<0.05). Interestingly, among 22 patients, various degree endometriosis were found during pelviscopy and specific medication with GnRH analogue were followed. CONCLUSION: Pelviscopic ovarian drilling showed successful ovulation rate and effective reproductive outcome in clomiphene-resistant infertile patients with PCO. This surgical technique seems to be an alternative step for the management of clomiphene-resistant infertile patients with PCO and also for the diagnosis of possible high rate of endometriosis in these patents.
Clomiphene* ; Diagnosis ; Electrocoagulation ; Endometriosis ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Needles ; Ovulation ; Polycystic Ovary Syndrome* ; Pregnancy ; Reproductive Techniques, Assisted

BACKGROUND: The polymerase chain reaction(PCR) assay is rapid, sensitive analytical technique but has problem of high false-positive rate. We applied dUTP-UDG PCR (dU-PCR) method to prevent carryover contamination major source of high false positive in PCR assays, for detection of Mycobacterium tuberculosis. METHODS: The PCRs for detection of M. tuberculosis were performed with P1 and P2 primers based on IS6110 repeated sequence. FTC-2000 was used for capillary PCR and Uno-Thermoblock was used for heating block PCR. In order to evaluate the effect of dU-PCR controlling carryover contamination, PCRs were performed in the presence of UDG and the absence of UDG. To compare the sensitivity of usual dT-PCR with dU-PCR, chromosomal DNA of M. tuberculosis ranging 500pg to 0.5fg were amplified by dT-PCR and dU-PCR method using two different thermocycler, capillary and heating block type, respectively. RESULT: The dU-PCR using UDG prevented carryover contamination by amplicon DNA up to 500pg. By capillay PCR method, the lower limits of detectability of dT-PCR and dU-PCR were 0.5fg and 500fg, respectively, which indicates the sensitivity of dU-PCR was lower than dT-PCR. But by heating block method, the lower limits of detectability of both method of dU and dT-PCR were 0.5fg. So the sensitivity of dU-PCR was same as dT-PCR. CONCLUSION: The dU-PCR by heating-block method was sensitive test for detection of M. tuberculosis that effectively prevent carryover contamination by amplicon.
Capillaries ; DNA ; Heating ; Hot Temperature ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Tuberculosis

Bronchiectasis means a permanent abnormal dilatation of one or more large bronchi owing to destruction of theelastic and muscular components of the bronchial wall. Radiological study is the most importat and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for theprecise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases ofbronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years fromJanuary 1980 to Dec. 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34cases(70.8%) were male and 14 cases(29.2%) were female. Peak incidence was in second decade. 2. Chronic cough,productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts ofpneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases(47.9%).Others are no sign in 17 cases(35.4%), wheezing in 11 cases(22.9%) and digit clubbing in 3 cases(6.3%). 3. Thepresumed causes were composed of not known in 30 cases(62.5%) and complications of measles in 7 cases(14.6%),pertusis in 5 cases(10.4%) and pneumonia in 4 cases(8.3%). Two cases were Kartagener's syndrom and unilateralhyperlucent lung. 4. Plain chest roentgenographic findings were abnormal in 42 cases(87.5%) but normal in 6cases(12.5%). The most common radiological findings was accentuation of lung markings in 36 cases(85.7%) theothers are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies,decreased affected lung volume air-fluid level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases(22.9%) and the disease was much more often involved left lung than right. The mostcommonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segmentof the lower lobe. The type of bronchiectasis is cylindrical in 22 cases(45.8%), varicose in 11 cases(22.9%),saccular in 9 cases(18.8%) and mixed type in 6 cases(12.5%)
Bronchi ; Bronchiectasis ; Bronchography ; Chest Pain ; Diagnosis ; Dilatation ; Dyspnea ; Female ; Hemoptysis ; Humans ; Incidence ; Lung ; Male ; Measles ; Pneumonia ; Respiratory Sounds ; Retrospective Studies ; Sputum ; Thorax

PURPOSE: Apoptosis is active cell death which plays an important role in developing normal tissues. Various conditions such as genetic defects, drugs, ischemia or infections are known to induce apoptosis. We studied the effect of maternal infection on fetal brain development during pregnancy. METHODS: We treated 46 C3H pregnant mice with lipopolysaccharide (LPS) or phosphat-buffered saline and observed the changes in apoptosis and expression of bcl-2, bcl-xS, bax. The fetal brain tissues were removed 1-48 hours after LPS treatment. The number of apoptosis per 100 neurons and glial cells was counted in H&E stained tissue and was analyzed statistically. Immunohistochemical staining with primary antibodies of bcl-2, bcl-xS, bax was done and their expression was classified by the degree of staining. RESULTS: The number of apoptosis was increased significantly in both neurons and glial cells of LPS-treated group and its degree of staining was more remarkable in glial cells. Immunohisto chemistry for bcl-2, bcl-xS, bax oncoprotein revealed mildly decreased expression of bcl-2 and markedly increased expression of bax in both neurons and glial cells, but it was more remarkable in glial cells. Immunochemistry for bcl-xS revealed no expression in neurons and minimal expression of bcl-xS in glial cells in both study groups. CONCLUSOIN: We observed an increase in the number of apoptosis, mildly decreased expression of bcl-2 and markedly increased expression of bax in both neurons and glial cells of fetal brain after treating pregnant mice with LPS. Maternal infection during pregnancy may have profound effects on developing fetal brain.
Animals ; Antibodies ; Apoptosis* ; bcl-2-Associated X Protein* ; Brain* ; Cell Death ; Chemistry ; Immunochemistry ; Ischemia ; Mice* ; Neuroglia ; Neurons ; Pregnancy

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. THE SPECIFIC OBJECTIVES WERE: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i) FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the medically supervised deliveries, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. STUDY DESIGN: The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum "package" program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and "before and after" surveys were conducted to measure the change. SERVICE INPUT: This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. METHOD OF EVALUATION: a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed. b. Neverthless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the "intergration process" itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltructure, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable. Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. SUMMARY OF FINDINGS: A) PROGRAM EFFECTS AND IMPACT. 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 78% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller. 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) & delivery care (45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregnancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) EFFECTS ON INTERACTIVE LINKAGE. 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in carrying for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, 85-90% of the services provided by the health workers were other than FP/MCH, mainly for immunization such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs. 31%) and for more combined care (45% vs. 23%). C) ORGANIZATION FACTORS (ADMINISTRATIVE INTEGRATIVE ISSUES). 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub-center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwives's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea). 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through planning practice. 2) Goal consensus in FP/MCH should be made among the health workers & administrators, especially to emphasize the need of care of "wanted" child. But there is a long way to go to realize the "real" integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (ii) there should be a health sub-center director who can provide leadership training for managing the integrated program. There is a need for "organizational support", if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the management of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Workers, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.
Abortion, Induced ; Administrative Personnel ; Child ; Child Health ; Chungcheongnam-do ; Cohort Studies ; Community Health Workers ; Consensus ; Contraception ; Cooperative Behavior ; Delivery of Health Care ; Encephalitis ; Family Characteristics ; Family Health ; Family Planning Services* ; Female ; Hand ; Health Personnel ; Health Services ; House Calls ; Humans ; Immunization ; Infant ; Infant Mortality ; Insurance Benefits ; Clinical Trial* ; Jurisprudence ; Korea* ; Leadership ; Live Birth ; Local Government ; Midwifery ; Organization and Administration ; Parturition ; Population Growth ; Postnatal Care ; Pregnancy ; Prenatal Care ; Primary Health Care ; Referral and Consultation ; Social Control, Formal ; Specialization