No abstract available.
Aged* ; Gallstones* ; Humans

OBJECTIVE: To evaluate the current status and new trends in gynelcological pelviscopy in Korea. METHODS: A survey was conducted and analyzed based on 20997 cases of operative pelviscopy hom May, 1985 to February, 1998 reported from twenty four university hospitals in Korea. RESULTS: The results obtained were ss followings; 1) 45.9 % of the total cases was 30 to 39 years old age group and it was the most dominant age group, 2) The previous operative history was found in 10.9% of the tota1 cases and included cesarean section(30.0%), ectopic pregnancy(20.3%), etc. 3) The operative indications were diagnostic(26.2%), myoma uteri(23.1%), ectopic pregnancy(21.4%), adnexal mass(18.4%), etc. In cases of diagnostic indication, the most common post-operative diagnosis of pelviscopic surgery was tubal pregnancy(30,6%). 4) The operative titles were salpingectomy(25.1%), hysterectomy(19.9%), salpinghorectomy(19.8%), etc. 5) The complications of operative pelviscopy were composed of subcutaneous emphysema(0.58%), preperitoneal bleeding(0.3%), bladder injury(0,3%), bowel injury(0.3%), etc. 6) lhe survey showed that 57.1% of the respondents desired more than 1 year of period for well peration between the operator and the assistant. 56.7% of respondents indicated that the surgical technique of the operator was the most important factor for a successful pelvisocopic surgery. 7) The most beneficial effect of the pelviscopy included the comfortableness of the patient(40.0%), cosmetic effect(22.8%), decrease of complications(14.2%), etc. CONCLUSION: The modem methods of operative pelviscopy have been successfully used in the treatment of gynecological disease. Today, pelviscopic surgery is being applied in almost all the cases of gynecological disease. Hence, the majority of pelviscopy techniques and pracedures being performed by surgeon must be taught in the controlled setting of a residency or a fellowship training program.
Adult ; Surveys and Questionnaires ; Diagnosis ; Education ; Fellowships and Scholarships ; Hospitals, University ; Humans ; Internship and Residency ; Korea* ; Modems ; Myoma ; Urinary Bladder

Although the diagnosis of primary tuberculous peritonitis in pregnancy is seems challenging because of protean manifestations and difficult surgical intervention, prompt diagnosis and treatment can minimize both maternal and fetal/neonatal mortality. We have experienced one case of this disease in 23-year-old primigravida in 24 weeks of gestation.
Diagnosis ; Humans ; Mortality ; Peritonitis, Tuberculous* ; Pregnancy* ; Young Adult

OBJECTIVE: This study is proposed to examine the relationship between bone loss after hormone replacement therapy for one year and initial bone markers. METHODS: One hundred postmenopausal women were studied for one year. At first visit, measurements were made of bone mineral density(BMD) at the lumbar spine and femoral neck, and of serum osteocalcin and urine deoxypyridinoline. After hormone replacement therapy was done for one year, BMD was rechecked. RESULTS: Serum osteocalcin was correlated with the rate of bone change(r=0.150, 0.262) and urine deoxypyridinoline was weakly correlated(r=-0.003, 0.038). The changes of femoral BMD in women with higher concentration of osteocalcin and deoxypyridinoline were significant different from those in women with normal concentration. At the lumbar spine, no significant differences were showed. In women with higher concentration of osteocalcin, the incidence of subjects with increased spine BMD was increased up to around 71.1%, which showed not significant increase compared with normal concentration of osteocalcin. And the incidence of increased spine BMD in women with higher concentration of osteocalcin was marked increased compared with the incidence of normal concentration. The level of the osteocalcin with increased spine BMD was 11.5+/-6.6 ng/ml, and the level with decreased spine BMD was 9.2+/-4.7 ng/ml, respectively. And the level of the deoxypyridinoline was 7.2+/-4.2 pmol/ mol cr in women with increased spine BMD and 7.2+/-2.7 pmol/ mol cr in women with decreased spine BMD, which was not statistically different. The concentration of deoxypyridinoline with increased and decreased in BMD in spine and femur was not statistically different. but the concentration of osteocalcin was 12.2 +/-5.5 ng/ml in significantly increased in BMD and 8.5 +/-4.5ng/ml in significantly decreased in BMD, which was showed significant different. CONCLUSION: Present study indicates that the serum osteocalcin more reflcets bone turnover changes at the menopause than deoxypyridinoline, however, the clinical utility of measurements of osteocalcin only to response to therapy is uncertain.
Bone Density* ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Incidence ; Menopause ; Osteocalcin ; Spine

No abstract available.
Clomiphene*

Background/Aims: Asthma is not a single disease but, rather, a heterogeneous inf lammatory disorder with various pathogenic mechanisms. We analyzed the associations between the cellular profile of sputum and the serum levels of inflammatory mediators/cytokines in a cohort of adult asthmatics. Methods: We recruited 421 adult asthmatic patients. All subjects were classified into four groups according to their sputum cellular profiles: G1, eosinophilic; G2, mixed granulocytic; G3, neutrophilic; and G4, paucigranulocytic. Serum levels of cytokines and mediators including periostin, eosinophil-derived neurotoxin (EDN), S100A9, and folliculin were quantified. Results: Among 421 patients, G1 accounted for 149 (35.4%), G2 for 71 (16.9%), G3 for 155 (36.8%), and G4 for 46 (10.9%). Serum periostin and EDN levels were significantly higher in G1 (p = 0.004, and p = 0.031) than in the others. Serum S100A9 levels were elevated in G2 and G3 (p = 0.008). Serum folliculin levels differed significantly among the four groups, with the highest level in G4 (p = 0.042). To identify G1 from G1 plus G2 groups, the optimal serum cut-off levels were 1.71 ng/mL for periostin, and 1.61 ng/mL for EDN. When these two parameters were combined, the sensitivity was 76.0% and the specificity was 64.3% (area under the curve, 0.701; p = 0.004). Conclusions The serum periostin and EDN levels may be used as predictors to discriminate the eosinophilic asthma group from patients having eosinophilic or mixed granulocytic asthma, and the serum folliculin level is significantly elevated in patients with paucigranulocytic asthma compared to those with different inflammatory cell profile.

With the recent development of next-generation sequencing technology, the microbiome in the body is being revealed in detail. It is also possible to describe the normal vaginal microenvironment and, more specifically, any changes in pregnancy. Moreover, we present the hypothesis that the microbiome is a contributing factor to preterm birth (PTB).Current Concepts: High estrogen status stimulates the maturation and proliferation of vaginal epithelial cells and the accumulation of glycogen, which promotes lactic acid production and maintains the vaginal environment at an acidic pH. The vaginas of most premenopausal women are predominantly colonized by Lactobacillus which plays an important role in local defense. Recently, it has also been reported that there are several specific types of Lactobacillus species, while other anaerobes, including Gardnerella and Atopobium also coexist in the vagina. Vaginal dysbiosis is defined as various expressions of microorganisms, secretion of specific metabolites, and changes in pH. During pregnancy, a multitude of microbiome changes occur in the oral cavity, gut, vagina, and placenta. The risk of PTB increases if the microbiome changes to one of dysbiosis. It is possible to analyze the characteristic microbiome composition related to PTB and to develop biomarkers predicting PTB. It is necessary to educate patients based on these findings.Discussion and Conclusion: Microbiome analysis has contributed significantly to understanding the association between women’s vaginal health and PTB. Continued research will also contribute to public health by assisting in the prediction and prevention of PTB.

PURPOSE:Chronic intractable sinusitis is a sinus infection persisting for more than 3 months and characterized by refractoriness to conventional treatment. Despite much research on pathogenesis and treatment, its prevalence is reported to be on the increase and the management of chronic sinusitis has also become increasingly problematic for pediatricians. So we evaluated the effectiveness of treatments targetted the causes and followed the course of childhood chronic sinusitis persisting for more than 3 months despite maximal medical therapy. METHODS:We followed up 41 patients diagnosed as chronic intractable sinusitis between January 1998 and December 2002 at the Department of Pediatrics, Kangnam General Hospital (Seoul Medical Center). The mean age was 4 years and the female to male ratio was 1.2:1. The duration of follow-up was 4.2 years. From medical records and questionnaires, a composite symptom score and medication use outcome (good/bad result) was created by assigning points to each category of symptom score and use of medication. Nasal endoscopy, allergy skin prick test, and serum immunoglobulin level checks were performed in all patients. CT scans were done in 3 patients and saccharin tests for diagnosis of ciliary dysfunction in 6 patients. A 24 hour pH mornitoring, esophagography, and upper GI endoscopy were done in 1 patient, respectively. RESULTS:Adenoidectomy was done in 17 patients. Fifteen patients with adenoidectomies were assessed to have good results. Among them, 4 patients had concommitant alleric rhinitis treatments, 1 patient a GERD treatment. Two patients with adenoidectomies were assessed to have bad results. Twenty-four patients without adenoidectomies were assessed to have good results. Among the 7 patients with underlying allergic rhinitis, 4 patients improved after immunotherapy. Two patients had polypectomies and 15 patients improved with medical management of sinusitis. One patients had functional endoscopic sinus surgery. CONCLUSION:If medical treatments with management of underlying diseases including immunotherapy, GERD management, and adenoidectomy are done, functional endoscopic sinus surgery is rarely necessary for treatment of chronic sinusitis in children.
Adenoidectomy ; Child* ; Diagnosis ; Endoscopy ; Female ; Follow-Up Studies ; Gastroesophageal Reflux ; Hospitals, General ; Humans ; Hydrogen-Ion Concentration ; Hypersensitivity ; Immunoglobulins ; Immunotherapy ; Male ; Medical Records ; Pediatrics ; Prevalence ; Surveys and Questionnaires ; Rhinitis ; Saccharin ; Sinusitis* ; Skin ; Tomography, X-Ray Computed

To objectively compare the response of the palliative radiotherapy in bone metastatic patients which decreases pain and prevents pathologic fractures, we introduced and applied the RTOG pain and narcotic measure system. From Oct in 1991 to July in 1993, thirty-two patients with painful bone metastases, 17 of them were solitary lesions and others were multiple lesions, were treated with mainly 6 MV photon otherwise 15 MV photon. Radiation doses to bone metastatic sites ranged about from 2000 to 4600cGy. Responses of radiation therapy were compared with days of pre-RT, RT finish, 3, 6, 9 months after the start of RT and solitary versus multiple lesions and follow up scores according to the RTOG measure system. Survival analysis was done. Pain and narcotic score of the entire patients were 7.3, 7.8 at the pre-RT period and 2.6, 3.9 at the immediate or 2 weeks after RT, which was 64%, 50% decrement compared with the pre-RT score. Pain scores of 3, 6 and 9 months after the beginning of irradiation were 3.6, 3.7 and 3.3. The best response found in the breast and prostate primaries was 84%, 78% decrement of pain score as compared with pre-RT score (statistically insignificant). Median survival was 5.5 months and mean survival was 5 months. We conclude that the RTOG pain and narcotic measure system in relatively effective scale in the comparison of before and after palliative irradiation to the painful bone metastatic sites but more detailed parameters will be required in the narcotic scoring system. More aggressive but less or similar toxic radiotherapy is needed in the patients having relatively long life expected time.
Breast ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Neoplasm Metastasis ; Prostate ; Radiotherapy*

OBJECTIVE: Proteinuria is a major clinical manifestation as well as hypertension and generalized edema in pregnancy-induced hypertension(PIH) and it should be considered an important marker of perinatal outcome. We studied the impact of proteinuria on maternal and perinatal outcome according to the degree of urine protein in PIH. METHODS: Maternal urine protein and serum albumin levels were studied in 64 cases of PIH who were admitted to Department of Obstetrics and Gynecology, Pil-Dong Hospital, College of Medicine, Chung-Ang University for the period of 10 years from January 1, 1989 to December 31, 1998. RESULTS: Serum albumin level was 2.9+/-0.7g/dL in mild preeclampsia group and 2.7+/-0.7g/dL in severe peeclampsia group and there was a significant difference between them. Birth weight of infant was 3001+/-659g in mild preeclampsia group and 2446+/-878g in severe peeclampsia group, and there was a significant difference between them. 1 minute Apgar score was 8.4+/-2.4 and 7.6+/-3.4, respectively and there was a significant difference between them. 5 minute Apgar score was 9.5+/-1.8 and 8.4+/-2.9, respectively and there was a significant difference between them. There were several maternal complications above 2(+) urine protein and no maternal complications below 1(+) urine protein. Small for gestational age infant was more common above 2(+) urine protein than below 1(+) urine protein and fetal death was more common in 3(+) urine protein. CONCLUSIONS: There was a decreasing trend in gestational weeks at delivery as proteinuria become more severe and also in birth weight, 1 minute Apgar score and 5 minute Apgar score. Maternal and fetal complications were more common as proteinuria become more severe.
Apgar Score ; Birth Weight ; Edema ; Female ; Fetal Death ; Gestational Age ; Gynecology ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced* ; Infant ; Obstetrics ; Pre-Eclampsia ; Pregnancy ; Proteinuria* ; Serum Albumin