In recent decades it has been proved that the success or failure of family planning program in developing countries has tremendous impact on the improvement of health, welfare, as well as the general socio-economic development. Therefore it is worth giving a review of family planning in Korea during the last two decades. We are happy to credit the voluntary leaders, particular1y from the public health sector of universities, who played a key pioneering role in the initiation of the organized effort and for the continued leadership in the development of the national program. The organization of 17,000 village level family planning mothers' clubs in 1968 is one of the most outstanding innovative achievements. Despite such long standing problems as very poor morale of the family planning workers, poor national health care network, and stubborn preference for boys, Korea has been fairly successful in achieving the demographic objectives by reducing the total fertility rate from 6.0 in 1960 to 2.7 in 1968, and by increasing the rate of family planning practice from 9% in 1964 to 49% in 1978.
Contraception/methods ; Family Planning/trends* ; Human ; Korea ; Population Control ; Population Density ; Voluntary Health Agencies

The purpose of this investigation was to provide an analysis of pregnancy outcomes among all married eligible women in a rural community. The target areas chosen were two townships on Kang Wha island. The study period lasted 24 months from April 1975 through March 1977. This paper presents the results of 1) a retrospective study 2) a prospective pregnancy followup study 3) a life table which provides the probabilities of pregnancy termination and estimated probabilities of fetal mortality. To obtain information on early pregnancies, all married eligible women were interviewed on their LMP at two months intervals. This enabled us to detect more pregnancies and fetal losses in earlier stages than would have been possible through customary reports from hospitals, registers of vital statistics and retrospective studies. All pregnancies reported in this study were identified through regular menstruation followup and subsequent confirmation of pregnancy in all cases where there was an amenorrhea for six weeks and more after the LMP using the pregnosticon test or other methods of pregnancy verification. All pregnancy terminations, losses to follow-up and continuing pregnancies at the end of the study period were then evaluated. Out of 1,106 pregnancies, 3l cases were lost to follow-up, 158 cases were pregnant at the end of the study period and 917 cases ended in deliveries during the study period. The estimates of the probability of normal pregnancy termination (pregnancy termination rates) are based on the number of terminations occurring in pregnancies exposed to termination risk during successive weeks of pregnancy. The pregnancy wastage rate turned out to be 23.6% in the retrospective study, 30.1% in the longitudinal study, and 34.5% in the life table. The estimated induced abortion rates were found to be negatively correlated with gestation period. The highest levels of induced abortion observed were 129 per 1,000 pregnancies under observation during the first 8 weeks of gestation and l47 induced abortions during the 9th-12th week of gestation. It could be shown by life table methodology that 87.1% of pregnancies continued beyond the 8th week and 72.7% beyond the l2th week. There after no remarkable change occured until the 37th-40th week, at the end of which period however, only 21.4% of the pregnancies continued. The life table technique allowed us to estimate that the cumulative rate of 1ive births from LMP to the end of pregnancy was 65.5%, induced abortion rate 29.5%, and stillbirth (including spontaneous abortion) rate was 5.0%. Also it appeared that, pregnancies which had continued throughout 8 weeks from LMP can be expected to continue on the average for 6.8 more months.
Abortion, Induced ; Actuarial Analysis ; Adolescent ; Adult ; Birth Rate ; Female ; Fetal Death/epidemiology ; Human ; Korea ; Pregnancy* ; Prospective Studies ; Retrospective Studies ; Rural Population

This is a report of 13 cases of surgically corrected ruptured aneurysm of the aortic sinus of Valsaha. The simultaneous trans-venous and trans-arterial catheterization and cineangiogram are the best diagnostic procedures. In 12 cases, the aneurysm originated from the right coronary sinus and only one from the noncoronary sinus. Eleven aneurysms ruptured into the right ventricle and 2 into the right atrium. Eight cases were associated with ventricular septa1 defect and 5 with aortic regurgitation. In three cases the Hancock porcine valve replacement was done. There was no surgical mortality.
Adolescent ; Adult ; Aortic Aneurysm/surgery* ; Aortic Rupture/diagnosis ; Aortic Rupture/surgery* ; Child ; Female ; Heart Catheterization ; Human ; Male ; Sinus of Valsalva/surgery*

This quasi-experimental study was designed to investigate the effect of bedding control on the amount of house dust mite (HDM) allergens, asthma symptoms, and peak expiratory flow rate (PEFR) in asthmatics sensitive to HDMs. The subjects in the study were drawn from patients receiving treatment at the allergy clinics of three university-affiliated hospitals in Seoul. Forty-two patients without prior practice of the bedding control used in this study were selected. They commonly showed bronchial asthma caused by HDMs, and exhibited strong positive points (more than 3 points) in skin prick test (D. farinae, D. pteronyssinus), and positive response in both fluoro-allergosorbent test (FAST), and PC20 methacholine test. Of the subjects, alternatively, 22 were assigned to the experimental group and 20 to control group. Bedding control consisted of the use of outer cotton covers, boiling them for 10 minutes fortnightly, and disinfecting bedding by sunlight fortnightly. The experimental group was under bedding control for 4 weeks. The data were collected from October 2000 to January 2001. The results were as follows: 1. After bedding control, the total amount of HDM allergens decreased significantly in the experimental group. However there was no significant difference in the decrease of the amount of HDM allergens between the two groups. 2. Of the asthma symptoms, there was significant difference only in the decrease of the frequency of dyspnea, and in the increase of sleeping disturbance between the two groups after bedding control. 3. After bedding control, PEFR increased in the experimental group whereas it decreased in the control group. However, neither change was significant. The above findings indicate that bedding control improved several asthma symptoms in asthmatics sensitive to HDMs. Accordingly, we suggest that bedding control is adopted as a useful nursing intervention in the field.
Adult ; Aged ; Allergens/*analysis ; Animals ; Antigens, Dermatophagoides/analysis ; Asthma/*prevention & control ; *Bedding and Linens ; Dust ; Female ; Human ; Male ; Middle Aged ; Mites/*immunology ; *Peak Expiratory Flow Rate

The Internet is a massively expanding body of information which includes medical resources. It is easier than in the past for anyone with some knowledge and effort to access the Internet. Medical professionals as well as patients have a similar ability to research a medical topic through the Internet. As medical professionals, we are concerned whether the medical information found on the Internet by patients is current and accurate. There are relatively few reports that critically examine where patients and family members acquire medical information. To assess the accuracy and completeness of information regarding colposcopy on the Internet, we categorized and defined the information on the Internet through systematic study. We chose eight search engines available on the homepage of Explorer to search and analyze the information obtained from a search for the topic of colposcopy. In addition, we analyzed whether the colposcopy information contained peer-review or reference in order to evaluate its reliability. The numbers of uniform/universe resource locators (URLs) varied considerably, ranging from 11 to 23300, when we tested the search engines using different combinations of capitalization and spellings. Descriptions of information from 181 sites located by a search engine (Yahoo) were also evaluated into five types, ranging from diagnostic to anecdotal information. In terms of the peer-review system, inaccurate or misleading information was found on web pages which might lead patients to doubt and distrust their medical specialists whose information was contradictory to that which they had obtained themselves. We recognize that the Internet has a positive and potential power in partnership with medical professionals to educate patients, helping them to overcome their disease. Nevertheless, we suggest the need to take an active role in identifying the Web sites containing accurate medical information and evaluating their quality.
*Colposcopy ; Human ; *Internet ; *Medical Informatics

Dexamethasone (DEX), one of the corticosteroid hormones, is one of the most common therapeutic strategies in ophthalmological treatment. Despite its widespread use and clinical efficiency, little is known regarding the specific effects of DEX on cell growth, differentiation and cell death in human trabecular meshwork cells. The presence of the glucocorticoid receptor (GR, dexamethasone receptor) in TM-5 cell line, which was derived from the primary human trabecular meshwork cells, was verified by RT-PCR and western blot analysis. The effects of DEX on the cellular proliferation of TM5 cells were measured by a BrdU incorporation assay. Western blot analysis were used to examine the effects of DEX on the Ras/MEK/ERK signaling pathway. The total Ras, MEK1/2 and ERK1/2 protein levels as well as the levels of activated (phosphorylated) form were both significantly increased by the DEX treatment for 5 days. Both MEK1/2 and ERK1/2 were significantly activated by phosphorylation after 10 minutes. The dependence of this increased cell proliferation on GR activation by DEX and the sustained activation of ERK was examined using RU486 (a GR inhibitor) and U0126 (a MEK inhibitor). Both RU486 and U0126 prevented the induction of cell proliferation by the DEX treatment in the TM5 cells. In conclusion this study demonstrated that GR is expressed in TM5 cells. Secondly, DEX treatment for 5 days stimulates cell proliferation in TM5 cells, and that this increased proliferation effect is mediated by the Ras/MEK/ERK pathway.
Cell Division/*drug effects ; Cells, Cultured ; Dexamethasone/*pharmacology ; Human ; Mitogen-Activated Protein Kinase Kinases/metabolism ; Mitogen-Activated Protein Kinases/metabolism ; Protein-Serine-Threonine Kinases/metabolism ; Protein-Tyrosine Kinase/metabolism ; Proto-Oncogene Proteins c-raf/metabolism ; Receptors, Glucocorticoid/physiology ; Trabecular Meshwork/cytology/*drug effects

Cutaneous dendritic cells (DCs), Langerhans cells (LCs) and dermal dendritic cells (DDCs), are present in an immature state. The maturation of DCs is crucial for initiating an immune response. Since HLA-DM has an important role for antigen presentation, an increase in HLA-DM expression according to the maturation of blood monocyte-derived dendritic cells (MoDCs), which have similar characteristics with DDCs, is expected. Therefore, the aim of this study was to determine whether or not HLA-DM expression in MoDCs is related to maturation at each culture day (from day 0 to day 13) by flow cytometry. This was compared with the functional changes related to the maturation of MoDCs. MoDCs were generated by culturing human peripheral blood monocytes in the presence of GM-CSF and IL-4 for 7 days, which were followed by subsequent treatment with a cytokine cocktail (GM-CSF, IL-4, IL-1beta, TNF-alpha, IL-6 and PGE2) for the maturation of MoDCs. The intracellular HLA-DM was expressed in the immature MoDC. A sudden 3 to 8 fold increase in the intracellular HLA-DM expression was observed after treatment with a cytokine cocktail. HLA-DM was weakly expressed on the surface of the immature MoDC, but it seemed to be decreased with maturation. This study indicated that the intracellular HLA-DM expression increased, but not on the MoDC surface during maturation. This was despite the fact that HLA-DM expression was noted not only on the surface but also in the intracellular in the MoDC.
Dendritic Cells/*immunology/physiology ; Endocytosis ; Flow Cytometry ; HLA-D Antigens/*analysis ; Human ; Monocytes/*physiology

This study aimed to determine the prevalence of anti- Toxoplasma gondii antibodies in haemodialysis patients with chronic renal failure (CRF). Methods: One hundred and seventy three haemodialysis patients, and 40 healthy controls, were studied for the prevalence of anti-Toxoplasma gondii antibodies by a micro enzyme-linked immunosorbent assay (ELISA). Anti-T. gondii IgG antibodies were detected in 97 (56.06%) haemodialysis patients and 8 (20%) controls with a statistical significance. In addition, anti-T. gondii IgM antibodies were detected in 1.73% of patients, but none of the controls. In conclusion, a high percentage of positivity for Toxoplasma antibodies in patients with CRF undergoing haemodialysis was noticed, thus parasitological surveys of CRF patients should be periodically performed to prevent the possible dissemination of toxoplasmosis through the dialysis procedure.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Antibodies, Protozoan/*blood ; Human ; Kidney Failure, Chronic/*immunology/therapy ; Middle Aged ; *Renal Dialysis ; Toxoplasma/*immunology

To investigate the relationship between the endogenous steroid hormones and the lower urinary tract function in postmenopausal women. Thirty postmeopausal volunteer women who did not have lower urinary tract symptoms or hormone replacement therapy were enrolled in this study. Urodynamic studies included uroflowmetry, multi-channel cystometry, and urethral pressure profilometry were conducted. Gas Chromatography- Mass Spectroscopy (GC-MS) was used to measure the urinary endogenous steroid hormone metabolites. The relationship between the urinary profile of the endogenous steroids and the urodynamic parameters of these patients were investigated. The mean ages of the patients were 60.6 +/- 5.5 years, and the Body Mass Index (BMI) averaged 24.56 +/- 2.23 (kg/m2). Of the progesterone metabolites, pregnandiol was significantly related to the residual volume in the uroflowmetry and the functional urethral length parameters (R=0.98, p=0.000; R= -0.65, p=0.04). Pregnantriol was significantly related to the maximum flow rate, the residual volume in uroflowmetry, the maximum urethral closure pressure and the functional urethral length (R=-0.64, p=0.04; R=0.82, p=0.01; R=0.04, p=0.04; R=- 0.79, p=0.01). In the androgen metabolites, androstenedione, 5-AT, 11- keto Et, 11-betahydroxy Et, THS, and THE were significantly related to the residual volume in uroflowmetry (R=0.92, p=0.001; R=0.84, p=0.008; R=0.99, p=0.000; R=0.72, p=0.03; R=0.97, p=0.000; R=0.85, p=0.00). beta-THF/alpha-THF was significantly related to the maximum flow rate, the residual volume in uroflowmetry, the maximum urethral closure pressure and the functional urethral length (R=-0.76, p=0.02; R=0.67, p=0.04; R=0.74, p=0.02; R=-0.92, p=0.000). alpha-cortol was significantly related to the residual volume in uroflowmetry, the maximum urethral closure pressure and the functional urethral length (R=0.81, p=0.01; R=0.71, p=0.03; R=-0.87, p=0.000). Of the estrogen metabolites, estrone (E1) was significantly related to the normal desire to void (R=0.68, p=0.04) and 17 beta-estradiol/estrone was also significantly related to the normal and strong desire to void (R=-0.70, p=0.03 and R=-0.74, p=0.02, respectively). The urinary progesterone and androgen metabolite concentrations were positively related to the residual volume in uroflowmetry and positively or negatively related to MUCP and FUL. However, the urinary estrone concentration was positively related to the normal desire to void and 17 beta-estradiol/estrone was significantly related to the normal and strong desire to void.
Aged ; Androgens/*metabolism ; Bladder/physiology ; Estrogens/*metabolism ; Female ; Human ; Mass Fragmentography ; Middle Aged ; Postmenopause/*physiology ; Progesterone/metabolism ; Urethra/physiology ; *Urodynamics

This study consists of an analysis of the results of simple retrograde balloon dilation in the treatment of ureteral strictures for the evaluation of the long-term efficacy of this procedure, and the factors affecting its success rate. A prospective study was performed on 43 ureteral strictures (22 malignant, 21 benign) from 37 patients treated with retrograde balloon dilation from October 1997 to May 1999. After the stricture segments were dilated, ureteral stents were indwelled uniformly for 3 weeks. Strictures were postoperatively followed up radiographically at 1, 3, 6 and 12 months, and annually thereafter. Success was defined by symptomatic and radiographic improvement. The follow-up periods ranged from 8 to 57 months (mean 41 months). The success rates of the benign strictures at 12 and 36 months were much higher than those of the malignant strictures (67 and 57% vs., 18 and 14%, p=0.0009). While 56% and 47% of the patients with strictures shorter than 2cm were successful at 12 and 36 months, respectively, none with strictures longer than 2cm were successful at the same follow-up periods (p=0.0002). Of the successful benign cases with a shorter segment at 12 months, 12 out of 14 (86%) showed persistent long-term successes at the 36 months follow-up. Other prognostic factors, such as sex, age, location, disappearance of a waist, dilation time and grade of hydronephrosis, were not found to influence the success rate. A multivariate analysis revealed the etiology and stricture length were the only significant prognostic factors affecting the final outcome (p=0.030 and p=0.0262, respectively, by Cox's proportional hazards model). In consideration of its minimal invasiveness and acceptable long-term outcome, simple retrograde balloon dilation is an effective treatment modality for benign ureteral stricture with a short segment (< or= 2 cm), and a shorter duration of stenting (3-weeks) is viable.
Adult ; Aged ; Balloon Dilatation/*methods ; Female ; Human ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Stents ; Treatment Outcome ; Ureteral Obstruction/etiology/*therapy