No abstract available.
Birth Certificates* ; Parturition*

OBJECTIVE: Multiple birth implicates the important health and social problems such as preterm birth, low birth weight, high perinatal mortality, and increased medical cost. This study was performed to investigate the multiple birth rate in Korea using the birth certificate data. METHODS: Retrospective review and analysis of data from Korean birth certificate in 1996. RESULTS: Multiple birth rate was 1.4% of total births(683,043 cases). Mean birth weight was 3.29+/-0.47kg for singleton birth and 2.57+/-0.58kg for multiple birth. Mean gestational age was 39.56+/-1.32 weeks for singleton birth and 37.47+/-2.41 weeks for multiple birth. Rate of low birth weight (< 2.5kg) was 14 times higher for multiple birth compared with that of singleton birth, and rate of preterm birth(< 37 weeks) was 10 times higher. Multiple logistic regression analysis was performed to examine the relationship between multiple birth and selected variables including maternal age, job and birth order. As the odds ratio(OR) was 2.47(95% CI: 2.34 - 2.59, p<0.001) for the second birth, and 5.31(95% CI: 4.99 - 5.65, p<0.001) for the third and over birth compared with the first birth, there was a significant correlation between multiple birth and birth order. CONCLUSIONS: Based on the birth certificate data in 1996, the incidence of twin and higher order multiple birth was 1.7%, and a significant correlation between multiple birth and birth order was revealed. Further studies are necessary to elucidate the etiology and prognosis of multiple birth and the developmental problems from birth to adolescence.
Adolescent ; Birth Certificates* ; Birth Order ; Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Logistic Models ; Maternal Age ; Multiple Birth Offspring* ; Parturition* ; Perinatal Mortality ; Pregnancy ; Premature Birth ; Prognosis ; Retrospective Studies ; Social Problems ; Twins

Since the introduction of laparoscopic surgery in 1950's, pelviscopic surgery has been established as a popularly used surgical modality in many areas due to the wide spread of minimally invasive surgery in 1980's. In spite of its many advantages compared to laparotomy, pelviscopic surgery is accompanied by many complications caused by equipments or anesthesia as various methods have been developed. Common complications include the injury of major and abdominal wall vessels, intestines, bladder and ureter, incisional hernia, heat injury by electricity, gas embolism, shoulder pain, pneumothorax, subcutaneous emphysema, and venous thrombosis. The frequency of complications is known to be 0.2-10.3%, and the half happens during the process of gas insufflation needle or trocar insertion. Order to prevent the complications, the operators should observe the safety regulations and perform the surgical procedures according the detailed operation principles. The patients with contraindications such as intestinal obstruction, hernia, severe cardiovascular diseases or peritonitis and extreme ages, should be avoided. The operators should be prepared for the expected complications by preoperatively evaluating the risk factors such as history of abdominal surgery, obesity, and heart and lung diseases. In addition, they should be well aware of biophysics of instruments, be experienced, and follow the basic safety rules such as the precautions about unnoticeable electrical damage of neighboring tissues.
Abdominal Wall ; Anesthesia ; Biophysics ; Cardiovascular Diseases ; Electricity ; Embolism, Air ; Heart ; Hernia ; Hot Temperature ; Humans ; Insufflation ; Intestinal Obstruction ; Intestines ; Laparoscopy ; Laparotomy ; Lung Diseases ; Needles ; Obesity ; Peritonitis ; Pneumothorax ; Risk Factors ; Shoulder Pain ; Social Control, Formal ; Subcutaneous Emphysema ; Surgical Instruments ; Surgical Procedures, Minimally Invasive ; Ureter ; Urinary Bladder ; Venous Thrombosis

OBJECTIVES: The effects of superovulation on the expression of mRNA and protein of TIMP-3 and MMP-9 in murine endometrium were assessed. METHODS: Using murine pregnant uteri of gestation day (g.d.) 4, 5 and 6 after injection of PMSG 5 and 10 IU, the effects of superovulation were assessed and compared with those of natural pregnancy and pseudopregnancy groups using quantitative competitive RT-PCR and immunohistochemical staining. RESULTS: Expression of TIMP-3 mRNA and protein showed an increase in PMSG groups and pseudopregnancy group, while there was no difference in MMP-9 expression between natural pregnancy and PMSG, pseudopregnancy groups on g.d. 4 through g.d. 6. CONCLUSIONS: This study suggests that ovarian hyperstimulation by gonadotropin, which produces many oocytes and embryos, may have a detrimental effect on embryonic implantation and its relevant endometrial remodeling process by increase in expression of TIMP-3 in murine endometrium.
Animals ; Embryonic Structures ; Endometrium* ; Female ; Gonadotropins ; Mice ; Oocytes ; Pregnancy ; Pseudopregnancy ; RNA, Messenger ; Superovulation* ; Tissue Inhibitor of Metalloproteinase-3 ; Uterus

As the 5-year survival rate increases up to 80% in pediatric cancer patients, the number of women patients with reduced gonadal function by chemotherapy and radiotherapy increases. The gonadal toxicity of pediatric patients varies highly according to the chemotherapeutic agent and the type of radiotherapy. Although American Society of Clinical Oncology published the guideline for fertility preservation, additional scientific and ethical concerns should be considered for clinical practice. In addition, only the experimental method can be applied for the prepubertal patients in contrast to the postpubertal patients. In this review, we will discuss some options for preserving fertility among women’s quality of life issues.
Drug Therapy ; Female* ; Fertility Preservation* ; Fertility* ; Gonads ; Humans ; Infertility, Female ; Medical Oncology ; Methods ; Quality of Life ; Radiotherapy ; Survival Rate ; Young Adult*

Sex steroid hormones play a major role in bone homeostasis. Therefore, the use of sex hormones or drugs may increase the risk of osteonecrosis of the jaw (ONJ), a complication caused by damaged bone homeostasis. However, few are known the impact of medications changing sex hormone levels on ONJ. The pathophysiology of ONJ is not clearly understood and many hypotheses exist: cessation of bone remodeling caused by its anti-resorptive effect on osteoclasts; compromised microcirculation due to medication affecting angiogenesis, including bisphosphonate; and impairment of defense mechanism toward local infection.The use of high-dose intravenous bisphosphonate in cancer patients is associated with a high prevalence of ONJ. Exogenous estrogen or androgen replacement was reported to be associated with ONJ. Polycystic ovarian syndrome (PCOS) patients demonstrate an androgen excess status, and androgen overproduction serves as a protective factor in the bone mineral density of young women. To date, there are no reports of ONJ occurrence due to androgen overproduction. In contrast, few reports on the occurrence of ONJ due to estrogen deficiency induced by drugs, such as selective estrogen receptor modulator (SERM), aromatase inhibitors, and gonadotropin-releasing hormone (GnRH) agonists, are available.Thus, the role of sex steroids in the development of ONJ is not known. Further studies are required to demonstrate the exact role of sex steroids in bone homeostasis and ONJ progression. In this review, we will discuss the relationship between medication associated with sex steroids and ONJ.

Fertility preservation (FP) is an effort to retain the fertility of cancer patients, and as an emerging discipline, it plays a central role in cancer care. Because of improvement in diagnostic and therapeutic strategies, an increasingly large number of patients are surviving with cancer. FP specialists should make an effort to spread the significance of FP among reproductive women with cancer and provide appropriate education both for associated physicians and for cancer patients who wish to preserve their fertility. Physicians who take part in the initial diagnosis and management of cancer should consider the importance of early referral of young cancer patients to FP specialists and take care of those patients by providing timely information and appropriate counseling. Individualized treatment strategies should be delivered depending on the patient's situation with appropriate team approach.
Counseling ; Female ; Fertility ; Fertility Preservation ; Humans ; Referral and Consultation ; Specialization

OBJECTIVE: To evaluate the relationship between parathyroid hormone (PTH) gene BstBI polymorphism, bone mineral density (BMD) and bone responsiveness to hormone replacement therapy (HRT). METHODS: PTH BstBI polymorphism was determined by restriction fragment length polymorphism (RFLP) in 444 postmenopausal Korean women. Among these women, 309 women received sequential HRT for 1 year. Serum bone alkaline phosphatase, CrossLaps, osteocalcin, calcitonin, and parathyroid hormone levels were measured by immunoassay and serum calcium and phosphorus levels by atomic absorptiometry. BMD at the lumbar spine and proximal femur was determined by dual energy X-ray absorptiometry before and after HRT of 1 year. RESULTS: PTH genotype frequencies were 81.1% for BB, 18.0% for Bb, and 1.2% for bb (uppercase letters signifying the absence and lowercase letters the presence of the restriction site). BMD at the femoral neck in women with the bb genotype was higher than that in women with the Bb or BB genotype respectively. Similar trend was found in BMD of lumbar spine and Ward's triangle. The PTH genotypes were not distributed differently between HRT-responders and HRT-nonresponders (women who lose more than 3% of bone mass per year) and were not related with annual percent change of BMD after HRT. There were no significant differences in levels of PTH, calcitonin, calcium, phophorus and bone turnover markers or their 6 month percentage changes after HRT among PTH genotypes. CONCLUSION: PTH BstBI polymorphism is not associated with bone responsiveness to HRT but BMD in Korean women.
Absorptiometry, Photon ; Alkaline Phosphatase ; Bone Density* ; Calcitonin ; Calcium ; Female ; Femur ; Femur Neck ; Genotype ; Hormone Replacement Therapy* ; Humans ; Immunoassay ; Osteocalcin ; Parathyroid Hormone* ; Phosphorus ; Polymorphism, Restriction Fragment Length ; Spine