The incidence of ectpic pregnancy has increased rapidly over the past decade. Currently, the complications of this disorder make it one of the leading causes of maternal mortality and morbidity. In the late 1980s, reports of successful use of methotrexate (MTX) as a non surgical treatment for ectopic pregnancy (EP) also began to appear in the literature. With MTX emerging as a possible alternative management of selected women with an EP, an analysis of its comparative costs is now needed. We examined retrospectively the costs associated with management of EP in our hospital. We selected 30 women with EPand divided them into two groups of MTX treated group (n= l0) and surgically treated group (n=20). There were no statistically significant differences in the doctors fee, room, charge and cost of laboratory and radiologic examination between two groups. But We found significant reduction in cost with regard to pharmacy, injection, procedure and operation of MTX treated group compared to surgically treated group (p<0.05). Consequently the use of MTX for EP should still be considered investigational; we recognize and agree that the evolution of this remedial option should be based primarily on its ability to decrease morbidity and mortality rather than on its ability to reduce costs. If medical treatment proves to be effective, the potential cost savings demonstrated in this report will become an important influential factor on selecting alternative remedy.
Cost Savings ; Fees and Charges ; Female ; Humans ; Incidence ; Maternal Mortality ; Methotrexate ; Mortality ; Pharmacy ; Pregnancy ; Pregnancy, Ectopic* ; Retrospective Studies

No abstract available.
Female ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; Ovary*

No abstract available.
Animals ; Blastocyst* ; Insulin* ; Mice*

No abstract available.
Umbilical Cord*

OBJECTIVE: Elective surgical approaches and trauma cause changes in the production of different cytokines. The aim of this study was to evaluate the effects of laparoscopic surgery on the immune system of patients with gynecologic diseases. METHODS: We recruited the open surgery group (n=20) and laparoscopic surgery group (n=33). In a prospective study we examined the C-reactive protein (CRP) level, the production of the cytokines Interleukin-1beta (IL-1beta), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10) and TNF-alpha concentrations by ELISA. In addition the fibrinogen, transferrin, albumin, hemoglobin and hematocrit were measured. Statistical analysis was made by Mann-Whitney U test and Kruskal-Wallis test. RESULTS: There were significant statistical differences in the CRP, IL-6 and IL-8 between the open surgery group and laparoscopic surgery group after surgery. The CRP and IL-8 showed a more distinct increase in open surgery group 24 hours after surgery, the differences between the two surgical approaches were significant (p<0.05). CONCLUSION: Elective surgical approaches cause changes in the immune system, which can be evaluated by the reaction of cytokines. Laparoscopic surgery cause less activation of the CRP and IL-8 than open surgery.
C-Reactive Protein ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Female ; Fibrinogen ; Genital Diseases, Female* ; Hematocrit ; Humans ; Immune System* ; Interleukin-10 ; Interleukin-1beta ; Interleukin-6 ; Interleukin-8 ; Laparoscopy* ; Prospective Studies ; Transferrin ; Tumor Necrosis Factor-alpha

OBJECTIVE: This study was performed to prove the relationship between serum leptin level and bone mineral density of lumbar spine, femur neck and bone markers in postmenopausal Korean women. METHODS: We measured serum leptin, serum osteocalcin, urine deoxypyridinoline levels and bone mineral density of lumbar spine, femur neck in 88 premenopausal and 118 postmenopausal women who visited St. Vincent Hospital of Catholic University of Korea from March 1st, 2007 to December 31th, 2007. RESULTS: Statistically significant correlation was shown between serum leptin level and body mass index (BMI) in both premenopausal (r= 0.343, P<0.0001) and postmenopausal women (r=0.360, P<0.0001). And no significant correlation was observed between serum leptin level and bone mineral density (BMD) of lumbar spine and femur neck in premenopausal women (r=0.013, P=0.107 and r=0.004, P=0.425, respectively), but in postmenopausal women, there was a positive correlation between serum leptin and lumbar spinal BMD (r=0.085, P=0.02). But after the adjustment with age and BMI, the serum leptin and BMD of lumbar spine did not showed a significantly correlation in the same group (r=0.088, P=0.939). Also, no significant correlations were observed between serum leptin level and serum osteocalcin and urine deoxypyridinoline in premenopausal (r=0.004, P=0.566 and r=0.002, P=0.707, respectively) and postmenopausal women (r=0.026, P=0.096 and r=0.000, P=0.933, respectively). CONCLUSIONS: In our study, there is no significant correlation between serum leptin level and bone mineral density and bone markers in premenopausal and postmenopausal Korean women. Our own data would suggest that leptin has both negative and positive effects in bone mass regulation. Furthermore, larger clinical studies are necessary to clarify leptin's role to assess the contribution of the central and peripheral role of leptin in the overall maintenance of bone turnover.
Amino Acids ; Body Mass Index ; Bone Density ; Female ; Femur Neck ; Humans ; Korea ; Leptin ; Osteocalcin ; Postmenopause ; Spine

OBJECTIVE: To describe the change of serum estradiol, follicul-stimulating hormone and testosterone after hysterectomy, and its difference according to the type of adnexal surgery in pre, and postmenopausal women. MATERIALS AND METHOD: Three hundred twenty four women presenting for hysterectomies for nononcologic reasons. We divide the women into four groups, who only hysterectomized, who with both adnexectomized, who with unilateral adnexectomized, and who with both salpingectomized. We collect the blood samples for serum estradiol and testosterone in preoperative day, 1 day after, 3 day after, 6 day after and 1 month after operation. And check FSH in a day before operation and 1month after operation. RESULT: Estradiol shows significant decrease in both adnectomy group compared to the unilateral adnexectomized and only hysterectomized. The both salpingectomized shows no difference with the both adnectomized. Testosterone shows no difference between groups in premenopausal women. In postmenopausal women, testosterone decreased 3 days after both adnexectomy compared to the only hysterectomized and the unilateral adnexectomized. The both salpingectomized shows no difference with the both adnexectomized. CONCLUSION: Testosterone decreases significantly in postmenopausal women after hysterectomy with both adnexectomy or both salpingectomy. So we think it was appropriate treatment to replace estrogen and testosterone in postmenopausal women who both adnexectomized or both salpingectomized.
Estradiol ; Estrogens ; Female ; Humans ; Hysterectomy ; Salpingectomy ; Testosterone

OBJECTIVE: To describe the change of serum estradiol, follicul-stimulating hormone and testosterone after hysterectomy, and its difference according to the type of adnexal surgery in pre, and postmenopausal women. MATERIALS AND METHOD: Three hundred twenty four women presenting for hysterectomies for nononcologic reasons. We divide the women into four groups, who only hysterectomized, who with both adnexectomized, who with unilateral adnexectomized, and who with both salpingectomized. We collect the blood samples for serum estradiol and testosterone in preoperative day, 1 day after, 3 day after, 6 day after and 1 month after operation. And check FSH in a day before operation and 1month after operation. RESULT: Estradiol shows significant decrease in both adnectomy group compared to the unilateral adnexectomized and only hysterectomized. The both salpingectomized shows no difference with the both adnectomized. Testosterone shows no difference between groups in premenopausal women. In postmenopausal women, testosterone decreased 3 days after both adnexectomy compared to the only hysterectomized and the unilateral adnexectomized. The both salpingectomized shows no difference with the both adnexectomized. CONCLUSION: Testosterone decreases significantly in postmenopausal women after hysterectomy with both adnexectomy or both salpingectomy. So we think it was appropriate treatment to replace estrogen and testosterone in postmenopausal women who both adnexectomized or both salpingectomized.
Estradiol ; Estrogens ; Female ; Humans ; Hysterectomy ; Salpingectomy ; Testosterone

OBJECTIVE: The aim of this study was to evaluate the concentration of serum VEGF and its relationship with the clinical parameters and the tumor markers in ovarian diseases. METHODS: We measured the serum VEGF concentrations by ELISA in 76 patients with benign ovarian disease, as well as 9 normal volunteers, 4 patients with ovarian borderline malignancy and 53 patients with ovarian cancer. RESULTS: There is a significant statistical difference between the serum VEGF levels in patients with benign ovarian disease (157.7+/-197.8 pg/ml) and ovarian cancer (344.7+/-372.2 pg/ml) (p<0.005). CONCLUSION: Serum VEGF may help in the differential diagnosis between benign and malignant ovarian disease. We suggest that serum VEGF may be useful as a diagnostic tool in ovarian disease.
Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Female ; Healthy Volunteers ; Humans ; Ovarian Diseases* ; Ovarian Neoplasms ; Biomarkers, Tumor ; Vascular Endothelial Growth Factor A*

OBJECTIVES: To determine the effects of magnesium sulfate on Caspase-3 and Vascular endothelial growth factor (VEGF) of human umbilical vein endothelial cells (HUVECs) under presence or absence of Tumor necrosis factor (TNF-alpha). METHODS: HUVECs were isolated from normal term umbilical cords and cultured in several physiolo gically relevant concentrations of magnesium sulfate with or without exposure of TNF-alpha. The concentrations of VEGF and caspase-3 were estimated by colorimetric assay and ELISA assay, respectively. RESULTS: The concentration of VEGF in HUVECs significantly increased in the presence of TNF-alpha compared with in the absence of TNF-alpha. However, the concentration of VEGF did not show significant difference in several concentrations of magnesium sulfate concentrations with addition of TNF-alpha and it showed the lowest concentration under 4 mM and 8 mM of magnesium sulfate concentration without addition of TNF-alpha. The concentration of caspase-3 in HUVECs did not show statistically significant difference with the addition of TNF-alpha and magnesium sulfate. CONCLUSION: TNF-alpha induce HUVECs to stimulate the VEGF, and magnesium sulfate might not have the effects on the expression of VEGF with addition of TNF-alpha However, the concentration for treatment of magnesium sulfate inhibits the expression of VEGF without addition of TNF-alpha. Magnesium sulfate might not have an effect of the expression of caspase-3 with or without addition of TNF-alpha.
Caspase 3* ; Enzyme-Linked Immunosorbent Assay ; Human Umbilical Vein Endothelial Cells ; Magnesium Sulfate* ; Magnesium* ; Tumor Necrosis Factor-alpha ; Umbilical Cord ; Umbilical Veins* ; Vascular Endothelial Growth Factor A*