PURPOSE: This study was done to see whether neonates born to unmarried mothers have higher rates of prematurity, low birth weight, perinatal morbidity and mortality than normal married group. METHODS: 88 neonates of unmarried mothers who were admitted in our NICU during the 5-year period from January 1987 through December 1991 were evaluated, and as the control group served 276 neonates of married mothers in 12 randomly selected weeks extended over the year during the same period. In statistical analyses, all data were analyzed by x2 test, Student t-test, and regression equation. RESULTS: 1) Unmarried mothers were 19.9+/-2.5(SD) year-old, with the majority(64.8%) falling into to age group between 16 and 20 years, whereas the control group was significantly older with 28.8+/-3.9 years. 2) Sex ratio was 1.38 : 1, with male prepondering, mean gestational age 35.5+/-3.7 weeks and mean birth weight 2,240+/-640g, in the unmarried group, differing significantly from the control group with 38.5+/-37 weeks and 2,910+/-750g. 3) Incidences of prematurity and low birth weight (LBW) were 70.5% and 75.0%, and total mortality was 28.4%. These values were significantly higher than in the control group, with 22.5%, 32.2%, 7.2%, respectively, and prematurity and LBW rate were also significantly higher in both groups of the same maternal age. Birth weight of unmarried group was significantly lower than control group in the same gestational age. Gestational age, birth weight, mortality rate were not significantly correlated to maternal age in both unmarried and control groups. 4) For the neonates of unmarried mothers, the majority was delivered either by midwife or in local obstetric clinics, and most of them(57.9%) were delivered by induction. 5) Neonatal diseases were jaundice, respiratory distress syndrome(RDS) and infection in the decreasing order, and incidence of RDS was significantly higher than in control group. But the death rate of RDS only tended to be higher in the unmarried-group. CONCLUSIONS: The neonates born to unmarried mothers have significantly higher rates of prematurity, LBW and mortality, and lower birth weight than the control group in the same gestational age. For neonatal diseases, incidence of RDS was significantly higher, and its mortality was significantly higher in the unmarried-group. Awareness on the seriousness of the problems leading to preventive measures against juvenile and unmarried child births, along with improved managements of babies born to unmarried mothers are urgently advocated.
Birth Weight ; Child ; Gestational Age ; Humans ; Illegitimacy ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn* ; Jaundice ; Male ; Maternal Age ; Midwifery ; Mortality ; Mothers ; Parturition ; Sex Ratio ; Single Person*

We discovered two plastic tubes which were used as masturbating tools in the bladder. The following is a report of two young boys who slipped plastic tubes into the bladder through the urethra for the purpose of masturbation and lost them in the bladder while attempting to remove them. Case 1. : Y. D. S., 18 years-old, Admitted because of hematuria for 5 days. Cystoscopically, the bladder showed diffuse hyperemia and a coiled calcified plastic tube. It was removed by operation. The length of the tube was 0.58m and the diameter was O.4 cm. Case 2. : K. S. K., 18 years-old. Admitted because of urinary incontinence for 4 months. Cystoscopically. the bladder showed diffuse hyperemia and a coiled calcified plastic tube. It was removed by surgical operation. The length of the tube was 1.2m and the diameter was 0.5cm.
Adolescent ; Foreign Bodies* ; Hematuria ; Humans ; Hyperemia ; Masturbation ; Plastics ; Urethra ; Urinary Bladder* ; Urinary Incontinence

A 38-year-old man, with recurrent oral ulcers for 10 years, was admitted because of recent aggravation of odynophagia and sore throat. About 4 years earlier, he had been performed abdominal surgery for intestinal perforation. Gastrofiberscopic examination showed small round ulcers at hypiopharynx and 6cm sized longitudinal linear ulcer at mid esophagus. Biopsy specimens at mid-esophagus showed chronic inflammation. Besides oral ulcer, he had perianal ulcers and skin rashes. He was managed with steroid, colchicine and sulfasalazine under the diagnosis of esophageal involvement in Behcet's disease. After 3 months from discharge, esophagogram and gastrofiberscopic examination showed some improved appearance, but symptoms recurred for steroid tapering. He has been followed in much improved status for 8 months after discharge.
Adult ; Biopsy ; Colchicine ; Diagnosis ; Esophagus ; Exanthema ; Humans ; Inflammation ; Intestinal Perforation ; Oral Ulcer ; Pharyngitis ; Sulfasalazine ; Ulcer*

OBJECTIVE: To compare the diagnostic accuracy of ultrasonographic endometrial thickness with that of hysteroscopy, it is to establish the most appropriate method for the diagnosis of endometrial cancer and other endometrial diseases in postmenopausal women with abnormal uterine bleeding (AUB). METHODS: This retrospective study was conducted in 105 consecutive postmenopausal patients with AUB, who underwent ultrasonographic evaluation of endometrial thickness, hysteroscopy and endometrial biopsy. Evaluation of sensitivity and specificity was performed. RESULTS: Histologic findings for <4 mm level revealed that atrophy was present in 30 (71.4%) and in 1 case (2.4%) endometrial cancer was found; for > or =4 mm values polyps and myomas were present in 31 (49.2%) and there were 3 (4.8%) in endometrial cancer. Sensitivity and specificity for trans-vaginal ultrasound, with a cut-off value > or =4 mm, was 75% and 40.6%. CONCLUSIONS: Generally speaking, obstetrics & gynecologists know that endometrial aspiration biopsy is the routine method in postmenopausal women with AUB. However transvaginal ultrasound remains the first line diagnostic procedure in postmenopausal women without AUB. In case of endometrial thickness less than 4 mm, it is likely to miss the early stage endometrial cancer but trans-vaginal ultrasound remains the first line diagnostic procedure in postmenopausal women, because it is not invasive and has high sensitivity for detecting endometrial cancer and other endometrial disease; According to our experience, hysteroscopy with biopsy is mandatory in all postmenopausal women with AUB.
Atrophy ; Biopsy ; Biopsy, Needle ; Diagnosis ; Endometrial Neoplasms ; Female ; Hemorrhage* ; Humans ; Hysteroscopy* ; Myoma ; Obstetrics ; Polyps ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Uterine Diseases ; Uterine Hemorrhage

Phytobezoar is rare disease in the stomach and small bowel of the patient without underlying previous gastroenterologic pathology. Because it usually occurs secondarily to peptic ulcer surgery, poor mastication, diabetes mellitus, hypothyroidism and connetive tissue disease. In morden medicine, phytobezoars found in the stomach and/or intestines in humans, are known to be associated with considerable morbidity and even mortality. Patients with gastric bezoar present with chronic postprandial epigastic pain, nausea, and vomitihg. It is diagnosed by endoscopic examination or radiologic study and treated by surgical removal or non-surgical methods including conservative treatment, enzymatic dissolution, and endoscopic removal. We have experienced a case of small intestinal obstruction due to a fragment of gastric bezoar of the patient without underlying etiologic cause. So we report the case with a brief review of literatures.
Bezoars ; Diabetes Mellitus ; Humans ; Hypothyroidism ; Intestinal Obstruction* ; Intestines ; Mastication ; Mortality ; Nausea ; Pathology ; Peptic Ulcer ; Rare Diseases ; Stomach

Cedecea davisae is a motile, Gram-negative rod in the family Enterobacteriaceae which is positive for lipase, DNase and catalase, and negative for gelatinase and oxidase. This bacterium is rarely isolated in the clinical specimens. We isolated C. davisae from the ascitic fluid of a 49-year old male patient with liver cirrhosis who was diagnosed as acute bacterial peritonitis. Bacterial identification was performed by API 20E and VITEK. Antimicrobial susceptibility test showed that the isolate was susceptible to cefotaxime, piperacillin, and imipenem. Peritonitis of this patient was improved by imipenem therapy. This is the first reported case of peritonitis caused by this organism.
Ascitic Fluid ; Catalase ; Cefotaxime ; Deoxyribonucleases ; Enterobacteriaceae ; Gelatinases ; Humans ; Imipenem ; Lipase ; Liver Cirrhosis* ; Liver* ; Male ; Middle Aged ; Oxidoreductases ; Peritonitis* ; Piperacillin

PURPOSE: Chemokines are potent regulators of the host inflammatory or immune responses. Mucosal synthesis of chemokines may be important in the pathogenesis of mucosal inflammation in ulcerative colitis (UC). We performed this study to investigate the expression of C-X-C chemokine genes in UC. METHODS: Mucosal tissues were obtained from six normal controls and six UC patients by endoscopic biopsies. In patients with UC, mucosal tissues were separately obtained from both involved and uninvolved regions. RNA was extracted and mRNA levels of five C-X-C chemokines were determined by quantitative reverse transcription-PCR using internal RNA standards. RESULTS: Mucosal mRNA levels of all chemokines tested increased in the involved region of UC compared with the uninvolved region of UC or normal controls. CONCLUSION: Our data suggest that mucosal expression of C-X-C chemokines contributes to the pathogenesis of UC
Biopsy ; Chemokines ; Chemokines, CXC ; Colitis, Ulcerative* ; Colon* ; Humans ; Inflammation ; Mucous Membrane* ; RNA ; RNA, Messenger ; Ulcer*

It has been generally known that bone tissue responds to the mechanical stress with an adaptative change in the mass and the structure. Recently, the signal transduction pathways involved in fluid flow have been reported, and several mechanotransduction products were suggested. This study was designed to verify the prostaglandin E2(PGE2) and nitric oxide(NO) involving as the biomechanical transducing material of the osteoblast to the fluid flow stimuli. We have checked changes in PGE2 and NO production after applying fluid flow-induced shearing stress to the primary high-density monolayer cultures of chicken fetus osteoblasts. PGE2 and nitrite which is the stable end-product of nitric oxide oxidationas are measured spectrophotometrically, the former using enzyme immunoassay system and the latter using Griess reaction. As a result, PGE2 and NO production by osteoblast was increased after applying the fluid flow-induced shear stress: PGE2 production was increased accumulatively in response to the duration of stress. There were no significant changes in NO production after 6 hours of the stress, but production of NO was markedly increased only after 24 hours. From the above findings, it was confirmed that osteoblast increased the production of PGE2 and NO in respond to the fluid flow-induced shearing stress and that PGE2 production is an earlier response to mechanical stimuli than the production of NO.
Bone and Bones ; Chickens ; Dinoprostone* ; Fetus ; Immunoenzyme Techniques ; Nitric Oxide* ; Osteoblasts* ; Signal Transduction ; Stress, Mechanical

OBJECTIVE: Accumulation of advanced glycation end-products (AGE) and mitochondrial glycation is importantly implicated in the pathological changes of the brain associated with diabetic complications, Alzheimer disease, and aging. The present study was undertaken to determine whether sildenafil, a type 5 phosphodiesterase type (PDE-5) inhibitor, has beneficial effect on neuronal cells challenged with AGE-induced oxidative stress to preserve their mitochondrial functional integrity. METHODS: HT-22 hippocampal neuronal cells were exposed to AGE and changes in the mitochondrial functional parameters were determined. Pretreatment of cells with sildenafil effectively ameliorated these AGE-induced deterioration of mitochondrial functional integrity. RESULTS: AGE-treated cells lost their mitochondrial functional integrity which was estimated by their MTT reduction ability and intracellular ATP concentration. These cells exhibited stimulated generation of reactive oxygen species (ROS), disruption of mitochondrial membrane potential, induction of mitochondrial permeability transition, and release of the cytochrome C, activation of the caspase-3 accompanied by apoptosis. Western blot analyses and qRT-PCR demonstrated that sildenafil increased the expression level of the heme oxygenase-1 (HO-1). CoPP and bilirubin, an inducer of HO-1 and a metabolic product of HO-1, respectively, provided a similar protective effects. On the contrary, the HO-1 inhibitor ZnPP IX blocked the effect of sildenafil. Transfection with HO-1 siRNA significantly reduced the protective effect of sildenafil on the loss of MTT reduction ability and MPT induction in AGE-treated cells. CONCLUSION: Taken together, our results suggested that sildenafil provides beneficial effect to protect the HT-22 hippocampal neuronal cells against AGE-induced deterioration of mitochondrial integrity, and upregulation of HO-1 is involved in the underlying mechanism.
Adenosine Triphosphate ; Aging ; Alzheimer Disease ; Apoptosis ; Bilirubin ; Blotting, Western ; Brain ; Caspase 3 ; Cytochromes c ; Diabetes Complications ; Glycosylation End Products, Advanced ; Heme Oxygenase-1 ; Hippocampus ; Membrane Potential, Mitochondrial ; Mitochondria ; Neurons* ; Oxidative Stress ; Permeability ; Reactive Oxygen Species ; RNA, Small Interfering ; Transfection ; Up-Regulation ; Sildenafil Citrate

BACKGROUND: Nuss procedure used in pectus excavatum repair is preferred, because of its excellent effect from the cosmetic point of view and improved pulmonary function, but it cause severe pain due to thoracic expansion after the operation. This study was designed to evaluate effective fentanyl dose using an intravenous patient-controlled analgesia (IV-PCA) pump for pain control following pectus excavatum repair in pediatric patients. METHODS: Sixty patients undergoing elective thoracic surgery were randomly assigned to received fentanyl 0.5microgram/kg/hr (Group I, n = 20), 0.7microgram/kg/hr (Group II, n = 20), and 1.0microgram/kg/hr (Group III, n = 20) via an IV-PCA pump (basal, 1 ml/h; bolus, 0.5 ml; lock out interval, 30 min) after operation. A blind observer evaluated each patient using the Children's Hospital of Eastern Ontario pain scale (CHEOPS) and the faces scale (FS). Incidences of side effects and pain control satisfaction were assessed at postoperative 48 hrs. RESULTS: There were no significant differences in CHEOPS or FS score between the groups the postoperative 48 hrs period. CHEOPS and FS scores at 4 and 8 hrs in groups II and III were significantly lower than in group I (P<0.05), but all groups showed lower CHEOPS and FS scores during the first postoperative 48 hrs. Satisfaction of pain control assessment by mothers was significantly higher in groups II and III than in group I (P<0.05). CHEOPS and FS scores were highly correlated with each other (P<0.001). CONCLUSIONS: We conclude that infusion of fentanyl at 0.5microgram/kg/hr using an IV-PCA pump is effective for pain control of 5 years of age or older after Nuss procedure.
Analgesia, Patient-Controlled* ; Fentanyl* ; Funnel Chest* ; Humans ; Incidence ; Mothers ; Ontario ; Thoracic Surgery