OBJECTIVE: Oxytocin antagonists maybe useful in inhibiting the uterine contractions of preterm labor. One such compound is TT-235. The purpose of this study was to compare the resistance of TT-235 and oxytocin to enzymatic degradation by oxytocinase in pregnant human. METHODS: Blood samples from pregnant women not in labor were incubated in vitro with known amounts of oxytocin and TT-235. Samples were collected at 0, 15, 30, 45 and 60 minute intervals for oxytocin analysis and at 0, 10, 60 and 360 minutes for TT-235 analysis. Oxytocin was analyzed by radioimmunoassay after extraction while TT-235 was analyzed by radioreceptor assay. RESULTS: In human blood, oxytocin was readily metabolized with greater than 83% disappearance over the 60 minute incubation period. In contrast, TT-235 was stable up to 360 minutes of incubation. CONCLUSION: This study suggests that: (1) blood from pregnant human does contain oxytocinase at least in vitro; and (2) TT-235 was resistant to enzymatic degradation by human blood, implying that this oxytocin antagonist may have prolonged activity in vivo in humans.
Cystinyl Aminopeptidase ; Female ; Humans ; Metabolism* ; Obstetric Labor, Premature ; Oxytocin* ; Plasma* ; Pregnancy ; Pregnant Women* ; Radioimmunoassay ; Radioligand Assay ; Uterine Contraction ; Uterus

OBJECTIVE: The purpose of this study is to determine the effects of glutathione on cisplatin-induced cytotoxicity of human cervical carcinoma cell lines (SiHa: squamous cell carcinoma cell, CaSki: epidermoid metastatic carcinoma cell). METHODS: Human cervical carcinoma cells (SiHa, CaSki) were incubated with culture media (RPMI1640) in the presence of cisplatin and/or buthionine sulfoximine (BSO), as a inhibitor of gamma-glutamyl- cysteine synthetase, and/or glutathione (GSH) and/or 2-oxo 4-thiazolidine carboxylic acid (OTC). The viable cells were examined by using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) and was determined by spectrophotometer at 570 nm. RESULTS: The incubation of cervical cells with cisplatin resulted in an decreasing cells viability by dose response. The MTT reduction rate were not different by BSO (5 mM) treatment in cervical cell lines. The viable cells were increased significantly by glutathione (5 mM) or OTC (5 mM) in cisplatin-treated cell lines. CONCLUSION: gamma-glutamylcysteine synthetase inhibitor had no effect on cisplatin toxicity. GSH and OTC had effect on cisplatin cytotoxicity. So, These result suggested that cervical cancer line cells were more susceptive to protective effects of glutathione and OTC than BSO on cisplatin induced-toxicity.
Buthionine Sulfoximine ; Carcinoma, Squamous Cell ; Cell Line* ; Cisplatin ; Culture Media ; Cysteine ; Glutathione* ; Humans* ; Ligases ; Uterine Cervical Neoplasms*

Up to 5% of pregnant females experience chronic hypertension, which is linked to poor pregnancy outcomes, and along with hemorrhage, is considered one of the main causes of maternal morbidity and mortality. The combined occurrence of preeclampsia, cesarean sections, preterm birth, birth weight less than 2,500 g, neonatal unit admission, and perinatal death was higher in females with chronic hypertension. Pregnancy with systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-109 mmHg was considered to have mild-to-moderate chronic hypertension. Blood pressure management during pregnancy is a very important issue and is directly related to fetal growth and maternal health. Many studies have reported that antihypertensive therapy during pregnancy halves the incidence of severe hypertension in all types of hypertensive diseases. However, guidelines for optimal blood pressure management goals during pregnancy remain unclear. This is because the benefits to the mother from lowering blood pressure are uncertain, and there is a risk of fetal disorders due to the possibility of reduced uteroplacental blood flow. In light of a recently released CHAP (Chronic Hypertension and Pregnancy) randomized controlled trial, the purpose of this review was to provide a summary of the current recommendations for pregnant females with mild-to-moderate chronic hypertension.

Preeclampsia (PE) is a multisystem disorder that is an important cause of maternal and perinatal deaths. Currently, delivery is the only final treatment for PE. This practice is usually accompanied by premature birth, which inevitably increases neonatal morbidities. Aspirin is a non-selective non-steroidal anti-inflammatory drug that irreversibly inhibits cyclooxygenase enzymes involved in converting arachidonic acid to prostaglandins and thromboxane. Aspirin inhibits thromboxane A2 production via platelet aggregation, thereby increasing the prostacyclin/thromboxane A2 ratio and reducing platelet aggregation. Since the first case report of aspirin’s potential use during pregnancy was reported in 1978, many studies have attempted to confirm the effect of aspirin on PE, and the results have been controversial. However, this preventive strategy is generally accepted in clinical practice. As evidence for aspirin’s prevention of PE has been accumulating, a recent study investigated the effectiveness of aspirin at high doses of 150 mg, which is higher than before. However, there is an ongoing debate about how much aspirin should be used during pregnancy and when to start aspirin therapy. Guidelines for the use of prophylactic aspirin during pregnancy vary slightly among countries and groups. In this article, we review and summarize the evidence regarding the use of aspirin for PE prevention.

OBJECTIVE: For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been concerned about the low sensitivity of cervical cytology in detection of preclinical disease of the cervix. So cervicography is introduced. In order to find out the efficacy of cytology and cervicography in early diagnosis of cervical cancer, this study included 1028 patients who visited the Department of Obstetrics and Gynecology, Cho-sun University Hospital From December 1, 1995 to March 31, 1998. And we choosed 321 samples who underwent biopsies. METHODS: Women simultaneously underwent an exo and endo-cervical smear, and then two cervicography was obtained with applying 5% acetic acid. Because all of the subjects choosed in statistical analysis were examined by colposcopy or postoperative biopsies, the presence or abscence of disease was determined by the histologic findings. RESULTS: 1. The sensitivity and specificity of cytology was 55.4% and 86.6%. 2. The sensitivity and specificity of cervicography was 71.3% and 59.7%. 3. When cervicography and Papanicolaou smear were used conjointly, the sensitivity and specificity was 90.1% and 58.8%. 4. However the specificity of the combined test was lower than cytology alone, the sensitivity of the combined test was significantly higher. CONCLUSION: The double combined tests of Papanicolaou smear and Cervicography were very useful in the early diagnosis of cervical neoplasia.
Acetic Acid ; Biopsy ; Cervix Uteri ; Colposcopy ; Early Diagnosis ; Female ; Gynecology ; Humans ; Mass Screening* ; Mortality ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

This study was designed to investigate the effect of no-smoking on the pattern of medication for 30 re-admitted psychotic patents in the no-smoking(smoking-prohibited) ward, who had been admitted and medicated previously in the smoking (smoking-allowed) ward, in Wonju Christian Hospital, by comparing daily mean dosage of antipsychotics, benztropine mesylate, and propranolol administered in smoking state and in no-smoking state of the same patients. The results were as follows: 1) The mean hospital stay was reduced to 46.0 days in no-smoking ward compared to 61.1 days in smoking-allowed ward. This means mean admission period was reduced significantly(p<0.05) and over two thirds of all subjects experienced reduction of hospital stay from 2 days to 92 days. 2) A statistically significant difference was fecund in the dosage of antipsychotics in all subjects. Calculated in terms of chlorpromazine equivalent, the daily mean was 296.8+/-180.7mg in no-smoking state, and 395.0+/-232.2mg in smoking state(p<.01), 3) In schizophrenics(n=13), the daily mean dosage of benztropine mesylate was 0.56+/-.62mg in no-smoking state and 0.14+/-0.21mg in smoking state, showing a significant difference(p<.05). In bipolar group, the mean dosage in no-smoking ward was also smaller than in smoking ward, though not significant. 4) The difference of the daily mean dosage of propranolol between two states was not significant. In conclusion, in no-smoking state psychotic patients required less hospital stays and significantly lower dosage of antipsychotics, and the schizophrenics required significantly higher dosage of benztropine mesylate for extrapyramidal symptoms. The authors suggest that psychiatric patients should be encouraged to stop smoking and recommend that psychiatrists monitor smoking state of their psychotic patients for proper and efficient drug therapy.
Antipsychotic Agents* ; Benztropine* ; Chlorpromazine ; Drug Therapy ; Gangwon-do ; Humans ; Length of Stay ; Propranolol* ; Psychiatry ; Smoke ; Smoking

PURPOSE: There is no consensus about a definition of benign prostatic hyperplasia, but there are various definitions based on a combination of clinical parameters used to describe the properties of BPH: symptoms of prostatism, increase of prostate volume, and bladder outlet obstruction. The prevalence of clinical BPH in Asian was believed to be lower than Caucasian. The lower urinary tract symptoms associated with BPH in Korea was reported by some authors and it was similar to the results of other studies in western countries. We report the prevalence of BPH in Korean men through a community-based study in Jeong-Eup county, Korea. MATERIALS AND METHODS: A total of 653 men aged 50 and over in Jeong-Eup area, Korea was randomly selected for determination of the prevalence of BPH. The definition of BPH in this study was combination of moderate(8-19) to severe(>19) I-PSS, enlargement of the prostate over 30gms on digital rectal examination by one board certified urologist, and decreased peak flow rate below 15ml/sec. Men with abnormal digital rectal examination(DRE) and elevated serum prostate specific antigen(PSA) above 3.5ng/ml were undergone sextant prostate biopsy to exclude the prostate cancer. RESULTS: I-PSS questionnaires were completed in 431 men and the response rate was 66.1%. Based on I-PSS, 162 men(37.6%) had moderate symptoms and 51 men(11.9%) severe symptoms. Of 213 men with moderate to severe symptoms, 35.7% had enlarged prostate by DRE, and 63.1% decreased flow rate. The prevalence of BPH by the definition in this study was 4.3% in their fifties, 13.2% in sixties and 16.3% in seventies and over eighty(overall, 11.1%). The population-adjusted prevalence of BPH in Korean men aged 50 and over was 8.7%. A good correlation was found between the total symptom score and the quality of life score that is included in the I-PSS. CONCLUSIONS: Men with moderate to severe I-PSS was 49.5%, which was similar to the results from other studies in Caucasian and Japanese. The prevalence of BPH in Korea by aforementioned definition was 8.7%, which seems to be lower than Caucasian. This results suggest that approximately 1,600,000 Korean men had moderate to severe urinary symptoms and 300,000 clinical BPH by the definition in this study.
Asian Continental Ancestry Group ; Biopsy ; Consensus ; Digital Rectal Examination ; Humans ; Jeollabuk-do* ; Korea ; Lower Urinary Tract Symptoms ; Male ; Prevalence* ; Prostate ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Prostatism ; Quality of Life ; Surveys and Questionnaires ; Urinary Bladder Neck Obstruction

PURPOSE: Vasoactive pharmacotherapy is now being widely used as practical and reliable method for the treatment of the patients with erectile dysfunction. The synergistic effect and low drug volume of each vasoactive drug in polypharmacotherapy for erectile dysfunction have made it possible to reduce both systemic and local complications with excellent success rate. We evaluated the treatment outcome of intracavernosal injection therapy with Trimix(the mixture of papaverine, phentolamine and prostaglandin E1). MATERIALS AND METHOD: From July 1993 to June 1997, 1000 patients with erectile dysfunction underwent a trial of intracavernous self injection therapy with Trimix(the mixture of papaverine 4.8mg, phentolamine 0.2mg and prostaglandin E1 1.8 microgram in 0.2ml). Underlying diseases were diabetes mellitus (33.1%), hypertension(7.5%) and others(12.3%). 471(47.1%) patients had no underlying disease. The volume of drug used ranged from 0.03 to 0.6ml(average: 0.18ml). RESULTS: After a mean follow-up of 10.9 months(3-44 months), 524 patients stayed on the home injection program. The drop-out rate was 47.6% with most of the cases during early home phase. The reasons for drop-out were inadequate response to medication, failure of injection, return of spontaneous erection, switch to other treatments, priapism, fear of needle or injection, loss of interest and economic reason. 88.3% of patients and 85.3% of the partners were satisfied wilts the result of home injection program. Priapism(3.9%), pain or discomfort(2.4%) and granuloma on injection site(1.5%) were noticeable complications, but corporal fibrosis and systemic side effect were not noticed. CONCLUSIONS: Trimix intracavernosal injection therapy is minimally invasive, simple, relatively safe and most of all, very effective method for the treatment of the patients with erectile dysfunction.
Alprostadil ; Diabetes Mellitus ; Drug Therapy ; Erectile Dysfunction* ; Fibrosis ; Follow-Up Studies* ; Granuloma ; Humans ; Male ; Needles ; Papaverine ; Phentolamine ; Priapism ; Treatment Outcome

OBJECTIVE: Since the accuracy of Pap smear for cervical neoplasm has been questioned, a number of adjunctive tests have been developed. The purpose of this study was to evaluate which protocol is the most effective screening test among cervical cytology (ThinPrep(R)), HPV DNA test (Hybrid capture(R) II) and cervicography. METHODS: We chose 252 patients who were underwent the biopsy among 829 patients who visited our hospital for cervical cancer screening test. These 252 patients were engaged in this study simultaneously. They underwent triple combined test [cervical cytology (ThinPrep(R)), HPV DNA test (Hybrid capture(R) II), cervicography] and colposcopic-directed biopsy or biopsy on operation for diagnostic evaluation. RESULTS: The triple combined test showed a sensitivity of 96.0%, while double combined test [cervical cytology (ThinPrep(R))+cervicography] showed a sensitivity of 89.0%, the other double combined test [cervical cytology (ThinPrep(R))+HPV DNA test (Hybrid capture(R) II)] showed a sensitivity of 86.7%. Cervicography showed a specificity of 75.4% (highest among the single test), positive predictability of 89.8% (also highest). CONCLUSION: The sensitivity of cervical cytology was markedly improved by combination with HPV DNA test and cervicography. So the triple combined tests which improved the high false negative rate of cervical cytology may be a new effective method as a cervical cancer screening test, if the effectiveness could be confirmed by mass screening study.
Biopsy ; DNA ; Human Papillomavirus DNA Tests* ; Humans ; Mass Screening* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

the ineidence of abdominal subcutaneous endometriosis is quite rare we have experienced one case of subcutaneous endometriosis. The typical clinical bistory and local findings of endometriasis enabk us to make the conect diagnosis. the treatment of choice is complete surgical excision of endometrial tissue and post operative medical therapy. This case was reported with a brief review of the comcemed literatures.
Diagnosis ; Endometriosis* ; Female ; Subcutaneous Tissue*