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*

PURPOSE: Lower urinary tract symptoms and erectile dysfunction both have a profound impact on the quality of life elderly men, but there are few reports that would enable us to clearly elucidate the relation between them. We investigated the prevalence of erectile dysfunction and its correlation with the severity of lower urinary tract symptoms as judged by the International Prostatic Symptom Score (I-PSS). MATERIALS AND METHODS: The total sample was 855 men aged 30 years and older (653 aged over 50) in 31 randomly selected areas of Jeong-Eup, Korea. Two questionnaires were sent. The first, on sexual activities, was based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) and was composed of several questions on the frequency of sexual intercourse, erectile ability, and the degree of any erectile dysfunction. The second, for men over 50 years of age, was the I-PSS. We analyzed the results with multivariate logistic analysis using an SAS program running on a personal computer. RESULTS: The response rate was 71.3% (466/653), and data sexual activities and I-PSS from 304 men were suitable for analysis. The prevalence of erectile dysfunction, defined as inability to achieve an erection sufficient for penetration, was 58.9% (179/304), and increased with age: 37.2% in men in their 50s, 69.2% in men in their 60s, 83.3% in men in their 70s, ans 100% in men over age: 37.2% in men in their 50s, 69.2% in men in their 60s, 83.3% in men in their 70s, and 100% in men over age 80 (p = 0.001). According to the intensity of lower urinary tract symptoms - mild (0-7), moderate (8-19), and severe (20-35) - the prevalence of erectile dysfunction was 46.6% (75/161), 68.8% (75.109), and 85.3% (29.34), respectively, and the prevalence of complete erectile dysfunction was 8.7% (14.161), 20.2% (22.109), and 47.1% (16.34), respectively. After adjustment for age, there was a statistically significant correlation between the severity of lower urinary tract symptoms and erectile dysfunction with the odds ratios being 2.395 and 4.125 in the moderately and severely symptomatic groups. CONCLUSIONS: There was a significant correlation between the presence of lower urinary tract symptoms and erectile dysfunction. We suggest that these two conditions are closed related by pathophysiologic mechanism, although clinical and basic research should be advanced to clarify the relation between them.
Aged ; Aging ; Coitus ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiologic Studies* ; Erectile Dysfunction* ; Humans ; Jeollabuk-do* ; Korea* ; Lower Urinary Tract Symptoms* ; Male ; Mental Disorders ; Microcomputers ; Odds Ratio ; Prevalence ; Quality of Life ; Surveys and Questionnaires ; Running ; Sexual Behavior

PURPOSE: Lower urinary tract symptoms and erectile dysfunction both have a profound impact on the quality of life elderly men, but there are few reports that would enable us to clearly elucidate the relation between them. We investigated the prevalence of erectile dysfunction and its correlation with the severity of lower urinary tract symptoms as judged by the International Prostatic Symptom Score (I-PSS). MATERIALS AND METHODS: The total sample was 855 men aged 30 years and older (653 aged over 50) in 31 randomly selected areas of Jeong-Eup, Korea. Two questionnaires were sent. The first, on sexual activities, was based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) and was composed of several questions on the frequency of sexual intercourse, erectile ability, and the degree of any erectile dysfunction. The second, for men over 50 years of age, was the I-PSS. We analyzed the results with multivariate logistic analysis using an SAS program running on a personal computer. RESULTS: The response rate was 71.3% (466/653), and data sexual activities and I-PSS from 304 men were suitable for analysis. The prevalence of erectile dysfunction, defined as inability to achieve an erection sufficient for penetration, was 58.9% (179/304), and increased with age: 37.2% in men in their 50s, 69.2% in men in their 60s, 83.3% in men in their 70s, ans 100% in men over age: 37.2% in men in their 50s, 69.2% in men in their 60s, 83.3% in men in their 70s, and 100% in men over age 80 (p = 0.001). According to the intensity of lower urinary tract symptoms - mild (0-7), moderate (8-19), and severe (20-35) - the prevalence of erectile dysfunction was 46.6% (75/161), 68.8% (75.109), and 85.3% (29.34), respectively, and the prevalence of complete erectile dysfunction was 8.7% (14.161), 20.2% (22.109), and 47.1% (16.34), respectively. After adjustment for age, there was a statistically significant correlation between the severity of lower urinary tract symptoms and erectile dysfunction with the odds ratios being 2.395 and 4.125 in the moderately and severely symptomatic groups. CONCLUSIONS: There was a significant correlation between the presence of lower urinary tract symptoms and erectile dysfunction. We suggest that these two conditions are closed related by pathophysiologic mechanism, although clinical and basic research should be advanced to clarify the relation between them.
Aged ; Aging ; Coitus ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiologic Studies* ; Erectile Dysfunction* ; Humans ; Jeollabuk-do* ; Korea* ; Lower Urinary Tract Symptoms* ; Male ; Mental Disorders ; Microcomputers ; Odds Ratio ; Prevalence ; Quality of Life ; Surveys and Questionnaires ; Running ; Sexual Behavior

The number of maternity care hospitals in underserved areas has been falling since 2004 because of business losses steming from low birth rates, inadequate insurance payments for obstetric services, and the shortage of obstetricians. However, the proportion of pregnant women at high risk in Korea has been increasing for decades because of the delay of marriage and the greater number of older pregnant women. High-risk pregnancies tend to lead to pregnancy complications and are associated with high-risk deliveries. An insufficient maternity care system for highrisk pregnant women in Korea has resulted in an increase in maternal mortality. The Ministry of Health and Welfare has supported the establishment of maternity care centers in underserved areas and regional perinatal centers to reduce maternal mortality. Even though the regional perinatal centers are a good system for reducing maternal mortality, they are limited in scope, in that they are not being established quickly on a nationwide scale to detect high-risk pregnancies earlier. This review briefly describes the current maternity care system for high-risk pregnancies and proposes a direction for the development of a health care delivery system between the regional perinatal centers and the maternity care system in underserved areas.
Accidental Falls ; Birth Rate ; Commerce ; Delivery of Health Care ; Female ; Humans ; Insurance ; Korea ; Marriage ; Maternal Mortality ; Pregnancy Complications ; Pregnancy, High-Risk ; Pregnant Women*

Because childbirth is a complex and difficult process, intensive preparation, and the immediate availability of emergency assistance during every step of delivery support to maternal safety. The World Health Organization recommends that pregnant women must be able to access the right care at the right time. Appropriate obstetricians is important factor for easy access during pregnancy. Especially, an increase in the number of specialists in maternal-fetal medicine would greatly improve the pregnancy outcomes of high-risk women. In 2013, a total of 2,274 obstetricians were employed in maternity hospitals and clinics in Korea. Their average age was 44.8 years and they will get older soon. By 2026, 740 junior obstetricians will join the maternity care system, but 916 senior obstetricians will have retired on night duty at hospital because of above 60 years of age. Thus, obstetrician numbers will fall by 176. Korea requires 2,338~3,507 obstetricians based on an annual number of deliveries per obstetrician in 2016. However, Korea has a shortage of obstetricians because of the low birth rate-induced business losses, inadequate payment system by the national health insurance program, and the quality-of-life preferences of young doctors. Ensuring an appropriate supply of obstetricians is essential for infrastructure of safe childbirth. I believe that adequate payment by the national health insurance program, and new medical insurance fees for management of high-risk pregnancies, will encourage young doctors to become obstetricians. The government should also introduce additional night duty fees and overseas training programs for young obstetricians.
Commerce ; Education ; Emergencies ; Fees and Charges ; Female ; Hospitals, Maternity ; Humans ; Insurance ; Korea* ; National Health Programs ; Parturition* ; Pregnancy ; Pregnancy Outcome ; Pregnancy, High-Risk ; Pregnant Women ; Specialization ; World Health Organization

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