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

No abstract available.
Birth Certificates* ; Parturition*

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

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.

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*

OBJECTIVES: To investigate the efficiency of superovulation with intrauterine insemination (IUI) in infertile patients. MATERIALS AND METHODS: Seventy-two cycles of superovulation with IUI in 48 infertile couples in which gonadotrophins were used for hyperstimulation were analysed retrospectively. RESULTS: Overall clinical pregnancy rate was 33.3% per cycle and 45.8% per patient. By the infertility factor, patients with endometriosis showed the lowest pregnancy rate (10%). Cumulative pregnancy rate (CPR), obtained by life-table analysis, increased as the number of cycles increased: 25.0% for one cycle, 33.3% for two cycle, 40% for three cycle and 50% for more than four cycle. CONCLUSIONS: Superovulation with IUI is an effective treatment modality in patients with subfecundity, and is worth while trying prior to in vitro fertilization procedure in those patients.
Endometriosis ; Family Characteristics ; Female ; Fertility ; Fertilization in Vitro ; Humans ; Infertility ; Insemination* ; Pregnancy Rate* ; Pregnancy* ; Retrospective Studies ; Superovulation*

OBJECTIVE: To investigate the influence of laparoscopic surgery on the natural conception rate in infertile women with endometriosis during the first year after the operation. METHODS: We retrospectively studied 43 infertile women with surgically proven endometriosis. The natural conception rate was investigated for the 12 months after the laparoscopy. RESULTS: The overall pregnancy rate was 41.9% (18/43). 66.7% (12/18) and 94.4% (17/18) of the patients conceived within postoperative 3 months and 6 months, respectively. The spontaneous pregnancy rate was not associated with the severity of endometriosis or laparoscopic findings or the type of surgery. The pregnancy rate for stage IV was relatively low (20.0%) compared to stage I, II, and III (35.7%, 44.4%, and 53.3%, respectively), although it did not reach statistical significance. CONCLUSION: Conservative surgical treatment with laparoscopy and a prompt attempt at natural conception may be effective for infertile patients with endometriosis.
Endometriosis ; Female ; Fertilization ; Humans ; Infertility ; Laparoscopy ; Pregnancy Rate ; Retrospective Studies