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: The last decade has focused on healing as the major outcome of burn management with little attention paid to other important patient-centered outcomes, such as pain. Traditional standard dressings using silver sulfadiazine cream and vaseline gauze may result in significant pain at dressing change, wound dryness, increase necessity for dressing change, and also traumatizing the skin and wound bed. In this paper we introduce Mepitel(R), a new silicone dressing material showing satisfactory result than previous traditional standard dressings in burn dressing. METHODS: We conducted a prospective, observational study of 15 adult patients with second degree burn. At the arrive, we initially applied Mepitel(R) after bullae aspiration and changed the cover dressing depending on the degree of exudate from burn while still applying Mepitel(R) for 3 days. After dressing change, pain intensity was measured on an 11-point numeric rating scale. RESULTS: Mean time to wound reepithelization was 10.2 days and mean pain scores on a 11-point scale associated with dressing changes was 5.2 while requiring 0.5 intravenous narcotic administrations per dressing change. CONCLUSION: Mepitel(R) is a new grid like silicone coated nylon dressing containing no additional biologic compounds. The advantages of the Mepitel(R) are easy of use, non-adhesion to the wound, very good tolerance, keep moisture of wound and absence of pain during dressing change. This product has been used in our clinics and this paper serves as a report on our experiences with it.
Adult ; Bandages ; Blister ; Burns ; Exudates and Transudates ; Humans ; Nylons ; Petrolatum ; Prospective Studies ; Silicones ; Silver Sulfadiazine ; Skin

OBJECTIVES: Previous studies have suggested that some personality characteristics are associated with the onset, prognosis and social function in schizophrenia patients. However few is known about the personality and affective characteristic of genetic high risk group (GHR) for schizophrenia. This study aimed to investigate the personality and the affective characteristic of GHR group for schizophrenia. METHODS: Participants were 54 healthy controls (HC), 26 subjects with GHR for schizophrenia and 28 subjects with first episode psychosis (FEP). We performed three self-report questionnaires; NEO-Personality Inventory-Revised, State and Anger Expression Inventory and Positive Affect and Negative Affect Schedule. RESULTS: The GHR group showed higher score in agreeableness item than the HC (p=0.028). In extraversion item, the FEP group showed significantly lower scores than the HC (p=0.001). The GHR group showed lower scores in neuroticism item compared with FEP group in trend level. The FEP group showed higher trait-anger, lower positive affect and higher negative affect compared with the others. CONCLUSION: The GHR group seem to share certain vulnerable personality and affective characteristics for schizophrenia with the FEP group. On the other hands, the GHR group appeared to be more agreeable than the other groups, which might act as the compensation for other impaired functions.
Anger ; Anxiety Disorders ; Compensation and Redress ; Extraversion (Psychology) ; Hand ; Humans ; Polytetrafluoroethylene ; Prognosis ; Psychotic Disorders ; Schizophrenia

Anti-Xga is a rarely occurring antibody, and only two cases with this antibody have been reported in Koreans. We describe here another example of anti-Xga which was detected in a 47-year-old male. The patient suffered from burn injury on the 20% of body surface area, acute renal failure, and ulcer bleeding. Unexpected antibody identification test demonstrated anti-Xga, which was reactive only by antiglobulin phase, and the reaction disappeared after the treatment with bromelin. The red cell phenotype of this patient was Xg(a-). Fourteen units of packed red blood cell were transfused without any adverse reactions. It has an important clinical concern in safe transfusion practice to determine the specificity and the clinical significance of blood group alloantibodies.
Acute Kidney Injury ; Body Surface Area ; Bromelains ; Burns ; Erythrocytes ; Hemorrhage ; Humans ; Isoantibodies ; Male ; Middle Aged ; Phenotype ; Sensitivity and Specificity ; Ulcer

PURPOSE: Gastrointestinal stromal tumors (GISTs) are of a mesenchymal origin, and they arise predominantly from the gastrointestinal tract. This study aims to aid the post operative management of GIST patients by analyzing the clinical and immunopathological features of recurrent GISTs. METHODS: We enrolled 98 GIST patients who had been operated on for their primary tumor from 1987 to 2001 at the Catholic Medical Center. Among them, 28 patients had clinical and radiological features that were proved to be recurrence, and the patients' survival rates were compared according to the treatment modalities. RESULTS: When the maximum length of tumor was shorter and the mitotic index lower, then these patients had higher disease free survival rates and lower recurrence rates. The Ki-67 negative group had lower recurrence rates than their Ki-67 positive counterparts. Recurrence was mostly observed as liver metastasis. The mean length of time to recur was 22.96 months. Fifteen patients received additional treatments such as surgery, chemotherapy and radiation therapy, but there was no significant difference in survival rates when they were compared to the 13 patients who did not receive further treatments. CONCLUSION: Of the patients diagnosed with GIST after surgery, those with worse prognostic factors, i.e. a bigger tumor size and higher mitotic index, require more meticulous surveillance for tumor recurrence, and especially for liver recurrence, which was the most common recurrence site, during the follow up exams. In addition, although there have not been any remarkably effective treatments for the recurrent GIST patients, further researches for new therapy such as STI-571 is mandated.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Imatinib Mesylate ; Liver ; Mitotic Index ; Neoplasm Metastasis ; Recurrence ; Survival Rate

OBJECTIVE: To measure gynecologic resources required to care for women who have unscheduled vaginal bleeding while using hormone replacement therapy. MATERIALS AND METHODS: Between January 1996 to December 1998, women presenting with abnormal withdrawal bleeding on HRT were identified and associated clinic visits and gynecologic procedures were recorded during a mean follow-up of 2 years. RESULTS: Among women using cyclic HRT, 28.9% had> OR =1 visit for unscheduled vaginal bleeding 8.7% had> OR =1 endometrial biopsy. Among women using continuous combined HRT, 19.3% had> OR =1 visit for unscheduled vaginal bleeding and 6.4% had> OR =1 endometrial biopsy. The gynecologic procedures used in women using cyclic HRT were 20% of reassurance, 50% of ultrasonograpy, 30% of endometrial biopsy and in women using continuous combined HRT were 50% of reassurance, 16.6% of ultrasonograpy, 33.3% of endometrial biopsy. The results of endometrial biopsy were reported all the benign condition. CONCLUSION(S): Unscheduled vaginal bleeding markedly decreased after 12 months of therapy in women using continuous combined HRT but did not decline among those using cyclic HRT.
Ambulatory Care ; Biopsy ; Female ; Follow-Up Studies ; Hemorrhage ; Hormone Replacement Therapy* ; Humans ; Uterine Hemorrhage*

BACKGROUND: Obesity increases the risk of many chronic diseases and contributes to functional disabilities. We assessed the relationship among obesity and obesity related chronic disease and disability in Korean adults. METHODS: This study used data from the 2005 Korean National Health and Nutrition Examination Survey. A total of 5,462 persons (2,325 men, 3,137 women) aged 20 years and older were included in this analysis. Obesity was measured by body mass index and abdominal obesity was by waist circumference. Information on the presence of chronic diseases was based on the self-report of having been diagnosed by physicians. Functional disability was assessed using the Korean activities of daily living (K-ADL) and the Korean instrumental ADL (K-IADL) scales. RESULTS: The relationship between obesity and prevalence of obesity-related chronic diseases was higher in the older aged group (>60 years for men, >70 years for women) than in the younger aged group. Waist circumference was more related to a higher prevalence of chronic diseases than body mass index in the younger aged group. Abdominal obesity increased the risk (odds ratio, 2.59; 95% confidence interval, 1.19 to 5.66) of having limitation in activities of daily living for the younger aged men after adjustments for age, smoking status, presence of chronic diseases, and body mass index. Body mass index was not associated with disability in either men or women. CONCLUSION: The association between obesity and prevalence of chronic disease differed depending on age and sex. It is important to control abdominal obesity to prevent disability in younger aged men.
Activities of Daily Living ; Aged ; Body Mass Index ; Chronic Disease ; Humans ; Male ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Prevalence ; Smoke ; Smoking ; Waist Circumference

Few studies have evaluated the apoptosis-inducing efficacy of NaF on cancer cells in vitro but there has been no previous investigation of the apoptotic effects of NaF on human oral squamous cell carcinoma cells. In this study, we have investigated the mechanisms underlying the apoptotic response to NaF treatment in the YD9 human squamous cell carcinoma cell line. The viability of YD9 cells and their growth inhibition were assessed by MTT and clonogenic assays, respectively. Hoechst staining, DNA electrophoresis and TUNEL staining were conducted to detect apoptosis. YD9 cells were treated with NaF, and western blotting, immunocytochemistry, confocal microscopy, FACScan flow cytometry, and MMP and proteasome activity assays were performed sequentially. The NaF treatment resulted in a time- and dose-dependent decrease in YD9 cell viability, a dose-dependent inhibition of cell growth, and the induction of apoptotic cell death. The apoptotic response of these cells was manifested by nuclear condensation, DNA fragmentation, the reduction of MMP and proteasome activity, a decreased DNA content, the release of cytochrome c into the cytosol, the translocation of AIF and DFF40 (CAD) into the nucleus, a significant shift of the Bax/Bcl-2 ratio, and the activation of caspase-9, caspase-3, PARP, Lamin A/C and DFF45 (ICAD). Furthermore, NaF treatment resulted in the downregulation of G1 cell cyclerelated proteins, and upregulation of p53 and the Cdk inhibitor p27KIP1. Taken collectively, our present findings demonstrate that NaF strongly inhibits YD9 cell proliferation by modulating the expression of G1 cell cycle-related proteins and inducing apoptosis via mitochondrial and caspase pathways.
Apoptosis ; Blotting, Western ; Carcinoma, Squamous Cell ; Caspase 3 ; Caspase 9 ; Cell Death ; Cell Line ; Cell Proliferation ; Cell Survival ; Cytochromes c ; Cytosol ; DNA ; DNA Fragmentation ; Down-Regulation ; Electrophoresis ; Flow Cytometry ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Microscopy, Confocal ; Proteasome Endopeptidase Complex ; Proteins ; Up-Regulation

Few studies have evaluated the apoptosis-inducing efficacy of NaF on cancer cells in vitro but there has been no previous investigation of the apoptotic effects of NaF on human oral squamous cell carcinoma cells. In this study, we have investigated the mechanisms underlying the apoptotic response to NaF treatment in the YD9 human squamous cell carcinoma cell line. The viability of YD9 cells and their growth inhibition were assessed by MTT and clonogenic assays, respectively. Hoechst staining, DNA electrophoresis and TUNEL staining were conducted to detect apoptosis. YD9 cells were treated with NaF, and western blotting, immunocytochemistry, confocal microscopy, FACScan flow cytometry, and MMP and proteasome activity assays were performed sequentially. The NaF treatment resulted in a time- and dose-dependent decrease in YD9 cell viability, a dose-dependent inhibition of cell growth, and the induction of apoptotic cell death. The apoptotic response of these cells was manifested by nuclear condensation, DNA fragmentation, the reduction of MMP and proteasome activity, a decreased DNA content, the release of cytochrome c into the cytosol, the translocation of AIF and DFF40 (CAD) into the nucleus, a significant shift of the Bax/Bcl-2 ratio, and the activation of caspase-9, caspase-3, PARP, Lamin A/C and DFF45 (ICAD). Furthermore, NaF treatment resulted in the downregulation of G1 cell cyclerelated proteins, and upregulation of p53 and the Cdk inhibitor p27KIP1. Taken collectively, our present findings demonstrate that NaF strongly inhibits YD9 cell proliferation by modulating the expression of G1 cell cycle-related proteins and inducing apoptosis via mitochondrial and caspase pathways.
Apoptosis ; Blotting, Western ; Carcinoma, Squamous Cell ; Caspase 3 ; Caspase 9 ; Cell Death ; Cell Line ; Cell Proliferation ; Cell Survival ; Cytochromes c ; Cytosol ; DNA ; DNA Fragmentation ; Down-Regulation ; Electrophoresis ; Flow Cytometry ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Microscopy, Confocal ; Proteasome Endopeptidase Complex ; Proteins ; Up-Regulation

BACKGROUND/AIMS: Benzodiazepine is generally used when sedation is required for endoscopy, while propofol, a phenol-derived intravenous anesthetic agent, appears to have a more suitable phamacokinetic profile. The aim of this study was to evaluate the effectiveness and safety of propofol as premedication for upper gastrointestinal endoscopy. METHODS: Between July 1998 and October 1998, 44 male patients and 70 female patients were involved in this study. The relative ease of upper gastrointestinal endoscopy, patient's tolerance, and amnestic effects on 64 patients with propofol was compared with 50 patients with non-sedation. Pulse rate and arterial oxygen saturation was monitored. The endoscopist and patients replied to a questionnaire. RESULTS: Patients receiving propofol tolerated endoscopy much more than patients with non-sedation (p<0.01). The change in pulse rate was less variable but arterial oxygen saturation showed a statistically significant decrease in patients receiving propofol (p<0.01). Propofol induced complete amnesia in 93.7% of the patients and partial anesthesia in 4.7%. Most of the patients receiving propofol accepted the same sedative methods in their next endoscopy (p<0.01). CONCLUSIONS: Propofol is highly effective, with a short recovery time and satisfaction of the patients, but careful monitoring is recommended because of its untoward effect of hypoxia. It is recommended that propofol be used as a premedication especially in patients who are apprehensive about a repeated endoscopy.
Amnesia ; Anesthesia ; Anoxia ; Benzodiazepines ; Endoscopy ; Endoscopy, Gastrointestinal* ; Female ; Heart Rate ; Humans ; Male ; Oxygen ; Premedication* ; Propofol* ; Surveys and Questionnaires