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.

The aim of this study was to investigate whether serum levels of anti-Mullerian hormone (AMH) and inhibin B at ovulation triggering day correlate with the number of immature oocytes obtained from stimulated in vitro fertilization (IVF) cycles. Fiftynine consecutive cycles of ovarian hyperstimulation and IVF were selected from 45 women who had tubal (n=18) or unexplained infertility (n=27) and obtained at least one oocyte. Serum levels of AMH and inhibin B at ovulation triggering day were measured by enzyme-linked immunosorbent assay (ELISA). Univariate analysis and multiple regressions revealed that serum AMH or inhibin B levels were significantly correlated with immature oocyte count and the correlation coefficients were higher compared to the mature oocyte count. Serum AMH and inhibin B levels on triggering day seems to be more closely related with the immature oocyte count and thus could be good predictors to determine the immature oocyte count in IVF cycle.
Adult ; Anti-Mullerian Hormone/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; *Fertilization in Vitro ; Humans ; Inhibins/*blood ; *Oocyte Retrieval ; *Ovulation Induction ; Regression Analysis

OBJECTIVE: The purpose of this study was to evaluate the effect of hormone replacement therapy on endometrial thickness in postmenopausal women and to assess the difference in endometrial thickness by the type of hormone replacement therapy (HRT). MATERIALS AND METHODS: Endometrial thickness was measured in 258 postmenopausal women before and/or during 12 months of HRT. The subjects were grouped into the sequential therapy group (Group 1, 72 women) and continuous combined therapy group (Group 2, 186 women). Group 1 received 0.625 mg of conjugate equine estrogen (CEE) daily with cyclic addition of medroxyprogesterone acetate (MPA, 10 mg/day for 12 days per month). Group 2 received 0.625 mg of CEE with daily addition of MPA (2.5 mg/day). RESULTS: The sequential group showed no significant change in endometrial thickness during HRT compared to that before HRT. However, a significant increase in endometrial thickness was found in the continuous combined group at 12 months of treatment. Before HRT, the endometrial thickness in the continuous combined group was thinner than that of the sequential group. During 12 months of treatment, there was no difference in endometrial thickness between the types of HRT. And the proportion of patients with endometrial thickness of 8mm or greater at 12 months of treatment did not differ significantly from that before treatment in both groups. CONCLUSION: Sequential HRT did not influence the endometrial thickness during treatment. However, continuous combined HRT increased the endometrial thickness during 12 months of treatment compared to that before treatment. The different endometrial responses to each HRT regimen may be due to the difference in endometrial thickness before treatment in each group.
Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone Acetate