No abstract available.
Cesarean Section* ; Female ; Fetal Blood* ; Humans ; Infant, Newborn* ; Pregnancy

No abstract available.
Female ; Humans ; Vaginosis, Bacterial*

Raynaud's syndrome causes discolorization, ischemic claudication(pain) and necrosis of the digits through insufficiency in the circulation which is induced by intermittent spasms of the digital arteries. From January, 2002 to December, 2004, 10 patients were surgically treated for Raynaud's syndrome. 9 patients were female and 1 patient was male. 2 patients showed unilateral involvement, 8 patients were operated on both hands. 6 patients had necrotic changes on the finger tips due to the disease. Ages ranged from 21 to 60 with an average of 39.1. Ischemic pain, discolorization, and cold intolerance of the digits were the common symptoms. All patients were evaluated with color doppler before the surgery. Two different procedures were applied according to the severity of the disease: Patients with decreased circulation received, what we call a limited digital sympathectomy, i.e. stripping of the adventitia of the ulnar, radial and common digital arteries. An extended procedure, radical digital sympathectomy, was performed on patients with a complete block of circulation. Stripping of the adventitia in these patients also involved the proper digital arteries. Symptoms like discolorization, ischemic pain, and cold intolerance improved immediately after the surgery. The patients did not suffer from pain even with exposure to cold weather. We conclude that digital sympathectomy could improve the symptoms in Raynaud's patients who do not respond to conservative treatment such as calcium channel blocker and other vasodilators.
Adventitia ; Arteries ; Calcium Channels ; Female ; Fingers ; Hand ; Humans ; Male ; Necrosis ; Spasm ; Sympathectomy* ; Vasodilator Agents ; Weather

BACKGROUND: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates. METHODS: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. RESULTS: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital, 101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). CONCLUSION: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.
Death Certificates* ; Education ; Emergencies ; Mortality ; Retrospective Studies ; Seoul

OBJECTIVE: To ananlyze the direct effect of nitric oxide (NO), generated from sodium prusside (SNP) on the embryo developments in reproductive process. DESIGN: ova from mouse were treated to allow fertilization in in vitro culture. And the samples of fertilized ova were alloted into five alliqutos. Each alliquot was cultured in media treated with either concentration at 0 (n=92), 25microM (n=84), 50microM (n=80), 100microM (n=77), 500microM (n=54) of SNP. Main Outcome MEASURE: Rates of embryonal cell cleavages, viability and cell morphology were assessed during in vitro fertilization and culture. RESULTS: As analyse the cell cleavage at 24 hours after in vitro culture of fertilised egg in variuos NO concentration, all of egg cells of each alliquot were developed to 2~4 cell stage. But the alliquot of egg cells treated with 500microM, which were totally degenerated. And also all embryonal cells of each alliquot were developed to 8 cell stage and morula stage on culture continuosly. And the embryonal cells of each alliquot were analysed at 24 and 48 hours following the in vitro culture. The rates of cell fragmentation and fusion were 4.2+/-3.4% in control group which is not treated with NO, while experimental groups was high, as rated 23.4+/-6.2% in 25microM, 28.2+/-5.7% in 50microM and 32.1+/-6.4% in 100microM concentration of NO. Accordingly the rate of abnormal morphology of embryonal cell in control was lower significantly than that in each alliquot of experimental groups (p<0.05). And the degenerated rates of embryonal cells were 0% in control, 17.8+/-6.7% in 25microM, 23.6+/-4.7% in 50microM and 26.8+/-11.2% in 100microM at 8 cells and morula on culture of 48 and 72 hours. On the examination of embryonal cells developed to blastocyst through in vitro culture, the rates of degenerated cells were 16.8+/-7.2% in control, 37.5+/-6.2% in 25microM, 73.4+/-4.6% in 50microM, 100% in 100microM. CONCLUSION: This results suggeted that the No in any concentrations is harmful on embryos in view of morphology as well as viability of cell, and the toxicity of No on embryo is stronger at condition in higher concentration of NO.
Animals ; Blastocyst ; Embryonic Structures ; Fertilization ; Fertilization in Vitro ; Mice* ; Morula ; Nitric Oxide* ; Outcome Assessment (Health Care) ; Ovum ; Sodium

OBJECTIVES: Socioeconomic status plays an important role in health care and disease prevention. This study aimed to examine the association between socioeconomic status, measured by education levels and household income, and gastric cancer screening. METHODS: A total of 21,220 community-dwelling adults aged 40 to 69 years within a defined geographic area participated in a community health survey in 2009 and 2010. The survey was conducted using a structured questionnaire by trained investigators who visited the subjects' households directly. Logistic regression analysis was used to determine the relationship between self-reported participation in gastric cancer screening and socioeconomic variables (education and household income). RESULTS: The gastric cancer screening rate was 52.1% for subjects in their forties, 63.7% for those in their fifties, and 67.3% for those in their sixties. In multivariate analysis, higher education and income levels were associated with higher rates of gastric cancer screening (high school vs. elementary school: odds ratio [OR] 1.41, 95 % confidence interval [CI] 1.26-1.58; highest income quartile vs. lowest income quartile: OR 1.62, 95% CI 1.44-1.84). The gradient between income and screening rate was more pronounced in the population aged 40 to 49 years than in the other age groups. CONCLUSIONS: This study demonstrates that lower socioeconomic status is associated with decreased participation in gastric cancer screening. Our findings suggest that the screening program should be focused on low-income and less-educated populations, especially among younger adults, to reduce health disparities.
Adult ; Delivery of Health Care ; Education ; Family Characteristics ; Health Surveys ; Humans ; Logistic Models ; Mass Screening* ; Multivariate Analysis ; Odds Ratio ; Research Personnel ; Social Class* ; Stomach Neoplasms* ; Surveys and Questionnaires

Ginsan, a botanic polysaccharide extracted from Panax ginseng, has recently been reported to modulate mucosal immune response. In this study, we investigated the protective effect of Ginsan against fatal Vibrio vulnificus mucosal infection. A lethal dose of V. vulnificus (1.0 x 106 CFU/mouse) was nasally inoculated to mice. The bacterial count in the nasal associated lymphoid tissue (NALT) of the mouse was significantly reduced in the Ginsan-treated group. The Ginsan-treated group showed improved survival compared to the control group (100% vs 18%). To elucidate the effect of Ginsan on modulating host immune response, cytokine mRNA expressions involved in mediating inflammation were determined by semiquantitative RT-PCR in the NALTs of the infected mice. Most of the cytokine mRNAs were similarly expressed as the control group. However, COX-1 mRNA expression level was higher in Ginsan-treated group compared to the control group. The protective effect of Ginsan was antagonized by treating with a specific COX-1 inhibitor, SC-560. Thus, these data suggest that the protective effect of Ginsan against V. vulnificus infection is partly mediated by modulating COX-1 expression.
Animals ; Bacterial Load ; Immunity, Mucosal ; Inflammation ; Lymphoid Tissue ; Mice ; Negotiating ; Panax ; Polysaccharides ; Pyrazoles ; RNA, Messenger ; Vibrio ; Vibrio Infections ; Vibrio vulnificus

BACKGROUND AND OBJECTIVES: Elevated intracellular calcium level is known to play important roles in the apoptotic pathway. IP3 receptor (ligand-gated channels that release Ca2+ from intracellular stores) is emerging as a key site for regulation of apoptosis. 2-Aminoethoxydiphenyl borate (2-APB) is one of the reliable IP3 receptor antagonists. We examined the effect of 2-APB on gentamicin ototoxicity in vitro, using the HEI-OC1 cell line. MATERIALS AND METHOD: HEI-OC1 cells were trWWeated with 100micrometer gentamicin. Using a CaspACE assay, we measured the caspases-3 activity in the gentamicin treated hair cells with and without 2-APB pre-incubation. We also observed intra-cellular calcium concentrations in HEI-OC1 cells using a confocal microscopy (calcium green-1 stain). Live cell imaging was performed by using fluorescence video-time lapse system. RESULTS: Cytosolic calcium elevation by gentamicin was remarkably inhibited by 2-APB. Caspases-3 activities of gentamicin treated cells were higher than those of the control. After incubation with 2-APB, caspases-3 activities and cell death of gentamicin treated cells were shown to decrease. CONCLUSION: 2-APB reduces Caspases-3 activity in the gentamicin treated HEI-OC1 cells by inhibition of cytosolic calcium increase.
Apoptosis ; Calcium ; Caspase 3 ; Cell Death ; Cell Line ; Cytosol ; Fluorescence ; Gentamicins* ; Hair ; Inositol 1,4,5-Trisphosphate Receptors* ; Microscopy, Confocal

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the 6th Clinical Practice Guidelines in 2019. Targets of glycemic, blood pressure, and lipid control in type 2 diabetes mellitus (T2DM) were updated. The obese and overweight population is increasing steadily in Korea, and half of the Koreans with diabetes are obese. Evidence-based recommendations for weight-loss therapy for obesity management as treatment for hyperglycemia in T2DM were provided. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations.
Blood Pressure ; Diabetes Mellitus, Type 2 ; Diagnosis ; Glucagon-Like Peptide 1 ; Humans ; Hyperglycemia ; Korea ; Obesity ; Overweight

BACKGROUND AND OBJECTIVES: Antibiotic prophylaxis of infective endocarditis is required before high-risk procedures in patient with high-risk heart diseases. Although guidelines for the prevention of infective endocarditis were proposed by the American Heart Association in 1997, compliance to these recommendations has not been evaluated in Korea. SUBJECTS AND METHODS: This was a retrospective, multicentered study in 8 Korean university hospitals. Patients with high-risk heart diseases, having undergone invasive dental procedures between Jan. 1, 2000 and Dec. 31, 2003, were enrolled. The medical and dental records of the patients were reviewed to evaluate whether the prophylaxis had been appropriate. RESULTS: Of the initial 4,912 patients, 184 that had been treated with invasive dental procedures (255 total episodes, mean 1.4/patient) were evaluated. The most common high-risk heart disease was a prosthetic heart valve (233 procedures), followed by a previous history of infective endocarditis (22 procedures), cyanotic heart diseases (5 procedures) and systemic pulmonic venous shunts (2 procedures). Antibiotic prophylaxis was performed in 231 procedures (90.8%). Amoxicillin was the most common antibiotic used for prophylaxis (88.6%); however, the adequate dosage (2 gm) was administered in only 56% of these cases. Therefore, the appropriate prophylaxis, according to the AHA recommendations, was performed in only 14.1% (36 procedures). The mean duration of prophylaxis and number of antibiotic doses were 2.40 days (2.40+/-2.44) and 7.97 doses (7.97+/-7.18), respectively. A previous history of infective endocarditis (p=0.03) and dental extraction (p<0.01) resulted in a longer duration of prophylaxis. CONCLUSION: Only 14.1% of the high risk group procedures were given appropriate antibiotic prophylaxis according to the AHA recommendations. These data suggest that protocol-based education of both doctors and patients is required for appropriate antimicrobial therapy during high-risk procedures for the prevention of infective endocarditis in patients with high-risk heart disease.
American Heart Association ; Amoxicillin ; Antibiotic Prophylaxis ; Compliance ; Dental Records ; Education ; Endocarditis* ; Heart Diseases ; Heart Valves ; Hospitals, University ; Humans ; Korea ; Retrospective Studies