OBJECTIVE: To analyze the clinical features and cytogenetic results of midtrimester amniocentesis. METHODS: We reviewed retrospectively medical records of 1,622 women who received amniocentesis from 1998 to 2003. The maternal age and gestational age at amniocentesis, indications, cytogenetic results and complications of amniocentesis were analyzed. RESULTS: A total of 1,653 cases of amniocentesis were performed in 1,590 singleton pregnancies and 32 twin pregnancies. The mean age at amniocentesis of singleton pregnancies was 33.5 +/- 4.3 years, and the most common age group was from 35 to 39 (38.6%) and those of twin pregnancies were 33.1 +/- 3.6 years and from 30 to 34 (50.0%), respectively. Majority of the cases (78.9%) were performed between 16th and 19th weeks of gestation. Advanced maternal age was the most common indication of amniocentesis (46.2%), followed by abnormal serum screening test (32.9%) and abnormal ultrasonographic findings (10.0%). Abnormal fetal karyotype results were identified in 34 cases (2.1%). 24 cases were numerical aberration and the other 10 cases were structural aberration. Trisomy 21 was the most common abnormal karyotype (23.5%). There was no abnormal karyotype results from 63 amniocentesis performed in twin pregnancies. Positive predictive value of abnormal ultrasonographic finding, advanced maternal age and abnormal serum screening test were 3.0%, 2.5%, 1.5% respectively. The procedure-related fetal death occurred in 7/1,353 (0.51%). CONCLUSION: Among the several indications of midtrimester amniocentesis, advanced maternal age was the most common indication, whereas abnormal ultrasonographic finding had the most powerful predictive value for abnormal fetal karyotype.
Abnormal Karyotype ; Amniocentesis* ; Cytogenetics* ; Down Syndrome ; Female ; Fetal Death ; Gestational Age ; Humans ; Karyotype ; Mass Screening ; Maternal Age ; Medical Records ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy, Twin ; Prenatal Diagnosis ; Retrospective Studies

Our recent study has provided that the in vitro SEC-induced proliferation of bovine T cells is preceded by a period of a non-proliferative immunoregulation of T cells that may be associated with cytokine production regulated by type 1 or type 2 T cells. Inversion of CD4+:CD8+ T cell ratio and induction of CD8+T cells with immunoregulatory activity could increase the probability of intracellular survival of Staphylococcus aureus (S. aureus). The increase of activated CD8+(ACT2+ BoCD8+) T cells in cows with mastitis caused by S. aureus may be associated with immune-regulatory function in the bovine mammary gland. The difference and similarity between bovine activated CD8+ T cells (CD8+ CD26+)and well-established human CD4+ CD25+ T regulatory (Tr)cells may help to reveal their unique immune regulatory system in the host infected with S. aureus.
Animals ; Cattle ; Cell Proliferation ; Female ; Lymphocyte Activation/immunology ; Mastitis, Bovine/*immunology/microbiology ; Staphylococcal Infections/immunology/*veterinary ; Staphylococcus/*immunology ; *Superantigens ; T-Lymphocytes/*immunology

OBJECTIVE: To evaluate the clinical characteristics and perinatal outcomes in relation to the latency period after preterm premature rupture of membrane (PPROM). METHODS: We analyzed retrospectively the 223 pregnant women with PPROM who delivered before 34 weeks of gestation in Samsung Seoul Hospital from January 1996 to October 2003. The study population was divided into six groups according to the larency from membrane rupture and delivery (group I: shorter than 6 hours, group II: 6~48 hours, group III: 2~4 days, group IV: 4~7 days, group V: 7~12 days, group VI: beyond 12 days). RESULTS: The mean gestational age (GA) at rupture was 29.6+/-2.6 weeks and the mean GA at delivery was 30.6+/-2.4 weeks. The median latency was 102 hours and 67% of patients delivered within 7 days. The latency was prolonged with GA at rupture before 30 weeks and used of tocolytics. After adjustment of GA at delivery, pathologic chorioamnionitis occurred more frequently in group V than group I. Respiratory distress syndrome occurred less frequently in group II and group IV than group I. Neonatal mortality rate was highest in group I, but the other neonatal morbidities were not significant differences. CONCLUSION: In PPROM with delivery before 34 weeks, prolongation of the latency longer than 6 hours seems to be beneficial for reducing neonatal RDS and mortality, but infectious morbidity seems to increase when the latency was prolonged longer than 7 days without any benefits for perinatal outcomes.
Chorioamnionitis ; Female ; Gestational Age ; Humans ; Infant ; Infant Mortality ; Latency Period (Psychology)* ; Membranes* ; Mortality ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Rupture* ; Seoul ; Tocolytic Agents

OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of methylphenidate HCL OROS extended-release (OROS-MPH) among children with attention deficit hyperactivity disorder (ADHD) who had been previously treated with methylphenidate HCL immediate-release (MPH-IR). METHODS: The sample included 102 children aged 6-12 (9.4+/-2.6) years who had been diagnosed with ADHD according the criteria of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; American Psychiatric Association, 1994) and who were attending seven centers in Korea. All participants had been medicated with a stable dose of MPH (10-60 mg/day) for at least 3 weeks before entry into the study. Doses of OROS-MPH were comparable to daily doses of MPH. Efficacy was assessed at baseline (day 0) and at day 28 with the Inattentive-Overactive with Aggression (IOWA) Conners Rating Scale, which was completed by parents/caregivers and teachers, the Peer Interaction Rating Items, which were completed by teachers, and the Clinical Global Impression (CGI) scale, which was completed by child psychiatrists. Paired t-tests were used, and P-values were set at the 0.05 level. RESULTS: Of the subjects, 92.2% were boys and 79.4% were students in the first to fourth grades of elementary school. 72% were diagnosed with the combined type of ADHD, 23% were diagnosed with the inattentive type, and 5% were diagnosed with the hyperactive-impulsive type. The results of the parents' responses to the Inattention/Hyperactivity (I/H) and Oppositional/Defiant (O/D) subscales of the IOWA Conners scale indicated statistically significant improvement in childrens behavior after 4 weeks of treatment with OROS-MPH (t=6.28, p<.001, t=4.12, p<.001). However, the teachers' responses to the Conners I/H and O/D subscales indicated no significant improvement at 4 weeks. The teachers also reported no significant improvements under the OROS-MPH compared with the MPH-IR condition with respect to peer interactions. Scores on the CGI scale showed that 46.1% of children with ADHD were rated by psychiatrists as "minimally improved", 27.5% as "much improved," 1.0% as "very much improved," 3.9% as "minimally worse," and 16.7% as showing "no change". Children exhibited significantly fewer tics with OROS-MPH treatment than with MPH-IR treatment (19.6% vs. 27.7%). We found no differences between in sleep and appetite problems according to medication. CONCLUSION: The results of this study indicated that an MPH-IR regimen can be successfully changed to a once-daily OROS-MPH regimen without any serious adverse effects. The changes in parent/caregiver IOWA Conners ratings suggested that OROS-MPH improved the control of symptoms after school, a finding that is consistent with the 12-h duration of action of this medication. Because the therapeutic effect of OROS-MPH is sufficiently longer than that of a b.i.d. dose of MPH-IR, OROS-MPH had significant positive effects on oppositional/defiant behavior in addition to its effects on the core symptoms of ADHD.
Aged ; Aggression ; Appetite ; Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Iowa ; Korea ; Methylphenidate ; Phenazines ; Psychiatry ; Tics

Background: A healthcare system’s collapse due to a pandemic, such as the coronavirus disease 2019 (COVID-19), can expose healthcare workers (HCWs) to various mental health problems. This study aimed to investigate the impact of the COVID-19 pandemic on the depression and anxiety of HCWs. Methods: A nationwide questionnaire-based survey was conducted on HCWs who worked in healthcare facilities and public health centers in Korea in December 2020. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure depression and anxiety. To investigate factors associated with depression and anxiety, stepwise multiple logistic regression analysis was performed. Results: A total of 1,425 participating HCWs were included. The mean depression score (PHQ-9) of HCWs before and after COVID-19 increased from 2.37 to 5.39, and the mean anxiety score (GAD-7) increased from 1.41 to 3.41. The proportion of HCWs with moderate to severe depression (PHQ-9 ≥ 10) increased from 3.8% before COVID-19 to 19.5% after COVID-19, whereas that of HCWs with moderate to severe anxiety (GAD-7 ≥ 10) increased from 2.0% to 10.1%. In our study, insomnia, chronic fatigue symptoms and physical symptoms after COVID-19, anxiety score (GAD-7) after COVID-19, living alone, and exhaustion were positively correlated with depression. Furthermore, post-traumatic stress symptoms, stress score (Global Assessment of Recent Stress), depression score (PHQ-9) after COVID-19, and exhaustion were positively correlated with anxiety. Conclusion In Korea, during the COVID-19 pandemic, HCWs commonly suffered from mental health problems, including depression and anxiety. Regularly checking the physical and mental health problems of HCWs during the COVID-19 pandemic is crucial, and social support and strategy are needed to reduce the heavy workload and psychological distress of HCWs.