BACKGROUND: In order to determine the clinical usefulness of the MicroScan (Siemens Healthcare Diagnostics, USA) MICroSTREP plus antimicrobial panel (MICroSTREP) for testing antimicrobial susceptibility of beta-hemolytic streptococci (BHS) and viridans group streptococci (VGS), we compared the accuracy of MICroSTREP with that of the CLSI reference method. METHODS: Seventy-five BHS and 59 VGS isolates were tested for antimicrobial susceptibility to ampicillin, penicillin, cefotaxime, meropenem, erythromycin, clindamycin, levofloxacin, and vancomycin by using MICroSTREP and the CLSI agar dilution method. RESULTS: The overall essential agreement with regard to minimum inhibitory concentrations (MICs) (within +/-1 double dilution) between MICroSTREP and the CLSI reference method was 98.2%, and categorical agreement (CA) was 96.9%. For the BHS isolates, the CA for erythromycin was 96.0%, whereas that for cefotaxime, meropenem, levofloxacin, and vancomycin (for ampicillin, penicillin, and clindamycin; 98.7%) was 100%. For the VGS isolates, the CA for penicillin was 84.7% and that for erythromycin, clindamycin, and vancomycin (for meropenem, 86.5%; for ampicillin, 88.1%; and for cefotaxime and levofloxacin, 96.6%) was 100%. All categorical errors of penicillin and ampicillin in the VGS isolates were minor. CONCLUSIONS: The accuracy of MICroSTREP is comparable to that of the CLSI reference method, suggesting that this panel can be effective for testing antimicrobial susceptibility of BHS and VGS.
Anti-Bacterial Agents/*pharmacology ; Drug Resistance, Bacterial ; Humans ; Microbial Sensitivity Tests ; Reagent Kits, Diagnostic ; Streptococcal Infections/microbiology ; Streptococcus/*drug effects/isolation & purification ; Viridans Streptococci/*drug effects/isolation & purification

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*

OBJECTIVE: A cytogenetic survey of the mentally retarded children in Seoul City Welfare Center for the Mentally Retarded and St Peter school has been undertaken. METHODS: The chromosome analysis was carried out in 92 males and in 66 females as a total of 158 cases. RESULTS: Abnormal karyotypes were observed in 22.2% of the total cases (35/158). Autosome and sex chromosome anomaly were observed in 20.3%(32/158) and 1.9%(3/158) respectively. Of 35 cases of anomaly, 91.4%(32/35) was autosome anomaly and 8.6%(3/35), sex chromosome anomaly. CONCLUSION: Down syndrome karyotype was the most frequent anomaly among autosome anomalies which was 62.5%(20/32) and other autosome anomalies were observed in 37.5%(12/32).
Abnormal Karyotype ; Child* ; Cytogenetics* ; Down Syndrome ; Female ; Humans ; Karyotype ; Male ; Mentally Disabled Persons* ; Seoul ; Sex Chromosomes

OBJECTIVE: A polymerase chain reaction (PCR) was developed in the detection of Chlamydia(C) trachomatis, Mycoplasma(M) hominis and Ureaplasma(U) urealyticum, which have been common causes of sexual transmitted diseases in the female genital tracts and in neonatal infection. To investigate tbe frequency of these organisms in the female genital tract infection and to know any association of these infections with clinical manifestations, PCR was performed. METHODS: PCR was performed in 300 cases of vaginal swabs and 154 paraffin embedded tissues including 50 cases of chronic endometritis, 50 cases of cleonic salpingitis, 50 cases of ectopic tubal pregnancy and 4 cases of normal endometrium. RESULTS: Among 300 cases of vaginal swabs, C. trachomatis, M. hominis and U. urealyticum were detected in 1.3%, 4.0%, and 29.6%, respectively. Mixed infection was found in 12.0%. the overall positive rate was 47.0%. The cytologic features from C. trachomatis, M. hominis and U. urealyticum positive patients revealed no specific findings. The clinical manifestations between positive and negative cases for these organisms had no differences. In tissue samples, only C. trachomatis was detected 2% of chronic endometritis, 8% of chronic salpingitis and 4% of ectopic tubal pregnancy. CONCLUSION: With the above results, it suggests C. trachomatis can evoke an ascending chronic infection of the female genital tracts and ectopic tubal pegnancy,
Chlamydia trachomatis* ; Chlamydia* ; Coinfection ; Endometritis ; Endometrium ; Female* ; Humans ; Mycoplasma hominis* ; Mycoplasma* ; Paraffin* ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Reproductive Tract Infections* ; Salpingitis ; Ureaplasma urealyticum* ; Ureaplasma*

Since amniocentesis made prenatal diagnosis feasible in 1967, the method has been remarkably instrumental in obstetrical practice. A recent study conducted between 1980 and 1997 collected 11,000 amniocentesis procedures done at 10 university hospitals and tertiary centers in Korea. The study indicated that the use of amniocentesis on patients has increased steadily since 1980; however, the number has increased sharply for patients in the mid 1990's. In the 1980's, amniocentesis had been used primarily for patients in advanced maternal age groups (at least 35 years or older). In 1995, amniocentesis had been implemented for the detection of abnormal serum markers (37.6%), and by 1997, amniocentesis was involved in such diagnosis even more frequently (44.8%). Of the total number of uses, 270 (2.5%) involved the detection of chromosomal anomaly. In autosomal disorders, 96 Down syndrome, 33 Edward syndrome, and 6 Patau syndrome were diagnosed. In sex chromosomal anomaly, 10 Turner syndrome, and 10 Klinefelter syndrome were diagnosed. Added to that, 83 translocations, and 15 mosaicisms were diagnosed. Of the 322 cases with abnormal ultrasonographic findings, 21 (6.5%) resulted in chromosomal anomaly. The use of genetic amniocentesis as a prenatal diagnostic test for Korean women has risen 10-fold between 1988 and 1998. As stated earlier, amniocentesis had earlier been used primarily for those in advanced maternal age groups. Today, maternal serum markers and highly sensitive ultrasonic technology can detect many fetal anomalies which eventually necessitate amniocentesis.
Adult ; Amniocentesis* ; Chromosome Abnormalities/epidemiology* ; Female ; Gestational Age ; Human ; Korea/epidemiology ; Maternal Age ; Pregnancy ; Ultrasonography, Prenatal ; alpha-Fetoproteins/analysis

OBJECTIVE: This study was performed to find out mitochondrial deoxyribonucleic acid mutations in preeclampsia because Mendelian models fail to explain all the patterns of inheritance in preeclampsia. METHODS: Ten preeclampsia patients and two of their related family members who have the obstetric history of preeclampsia were studied. The mitochondrial transfer ribonucleic acidleu[UUR] gene was amplified using polymerase chain reaction, cut by a restriction endonuclease (Apa , and also sequenced to see the whole gene. RESULTS: There were neither the known mutation at Nucleotide 3243 nor other mutations on the mitochondrial transfer ribonucleic acidleu[UUR] gene in these objects. CONCLUSION: It seems that the known mutation of mitochondrial transfer ribonucleic acidleu[UUR] gene is not so frequently detected in preeclampsia of South Korean, But it could not be concluded how many South Korean women with preeclampsia have the mutation.
DNA ; DNA Restriction Enzymes ; Female ; Humans ; Point Mutation* ; Polymerase Chain Reaction ; Pre-Eclampsia* ; RNA* ; Wills

The cesarean section has been considered as one of the most prime and most commonly performed operations in the obstetrics and gynecology field. In fact, all cesarean sections have depended upon the operator`s experience. However, there have been several cases reported on new technique of cesarean section in many developed countries, but not in Korea until we started the recent research. We have developed a new type of cesarean section named FAST(Finger Assisted Stretching Technique) through study on strength/weakness of other operation techniques as well as many other researches we conducted in the past plus our own experiences. To find the differences on the following subjects; operating time, postoperative complication, and recovery period. We compared and analyzed data from using new and traditional techniques. We selected 120 patients(group A using FAST: 45 patients, group B using traditional technique: 75 patients) as samples for this study. Together, they were all conducted cesarean section at Korea University, Guro Hospital between May 1993 and December 1995. Student-t-test and chi-square test were used for statistical analysis. We consider that below 0.05 for P value is statistically significant. The results of comparative study between two groups are; 1. There was no comparative difference on average age: group A: 29.6(range 23~39, S/D 7.1) group B: 31.1(range 24~38, S/D 5.4) 2. There was a significant difference on average operation times: group A: 15.4 min.(range 11~19, S/D 3.6) group B: 41.3 min.(range 23~50, S/D 19) 3. There was a significant difference on average amount of bleeding: group A: 580 ml(range 450~750, S/D 101) group B: 916 ml(range 800~1000, S/D 99) 4. There was a significant difference on the value of hemoglobin before and after operation group A: 0.8 g/dl(range 0.4~1.6, S/D 0.25) group B: 1.9 g/dl(range 0.9~2.6, S/D 0.21) 5. There was a significant difference on average period of hospitalization: group A: 3.7 days(range 3~4, S/D 0.7) group B: 6.4 days(range 5~8, S/D 0.6) 6. No one from group A experienced any infection, but 3 cases of wound infection and 2 cases of voiding difficulty were reported from group B. 7. 11 cases from group A and 16 cases from group B had laparotomy for some other reasons, later. There was no adhesion found in group A, but adhesions found in 2 cases from group B.
Cesarean Section* ; Developed Countries ; Female ; Fingers* ; Gynecology ; Hemorrhage ; Hospitalization ; Humans ; Korea ; Laparotomy ; Obstetrics ; Postoperative Complications ; Pregnancy ; Wound Infection

Dosage reinforcement of chemotherapeutic agent is thought to be a solution in treating many malignancies, including ovarian cancer and cervical cancer. The remission rate after administration of chemotherapeutic agents has a positive correlation with dosage and in cases where limitations were put on dosage, improved survival rate was achieved with dose-intensive therapy facilitated by autologous bone marrow transplantation(BMT) or the use of cytokines such as G-CSF. Our objectives are to evaluate therapeutic efficacy and toxicity of GM-CSF and to elucidate the effect of premedication which was administered to minimize the toxicity of the GM-CSF. Total number of patients entered into this study was fifty two and they are consisted of thirty seven patients of the uterine cervix, fourteen patients of ovarian cancer and one endometrial cancer patient. The increase in neutrophil count and WBC count was found to be statistically valid, but the changes in the number of platelets, hemoglobin, neutrophil and monocytes were not shown to be meaningful when statistics are brought in. Administration of GM-CSF resulted in mild toxicities such as myalgia, fever, skin reaction and neuropathy. But, one patient had grade 3 myalgia. Premedication brought about meaningful reductions in the toxicities of GM-CSF and can be used safely to reduce the toxicities.
Bone Marrow ; Cervix Uteri ; Cytokines ; Endometrial Neoplasms ; Female ; Fever ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Monocytes ; Myalgia ; Neutrophils ; Ovarian Neoplasms ; Premedication ; Skin ; Survival Rate ; Uterine Cervical Neoplasms

The addition of a monthly course of progesterone decrease the incidence of endometrialhyperplasia and endometrial carcinoma. The progesterones used in hormonal replacementtherapy(HRT) differ markedly in their progesteronic, androgenic and even estrogenicactivities. These characteristics may influence both symptomatic and metabolic side effects.The purpose of this study was to examine effect of bone and lipid metabolism inpostmenopausal women treated with conjugated equine estrogens plus dydrogesterone.A total 131 postmenopausal women(surgical menopause=95, natural menopause=36)and not-treated postmenopausal women(control=22) were invited to participate in thisstudy. Patients were divided into groups which had received conjugated equine estrogen(CEE)0.625 mg/day 21-day-cycle each month(n=20), CEE 0.625 mg/day plus Dydrogesterone 10mg/day 10-day-cycle each month(n=111), and no treatment control group(n=20).Serum lipid and lipoprotein(Triglyceride, Total cholesterol, High density lipoprotein, Lowdensity lipoprotein) and serum osteocalcin, urinary Deoxypyridinoline were examined in allpatients.There were no significant differences in bone and lipid metabolism between CEE andCEE plus Dydrogesterone groups.In conclusion, Dydrogesterone may be used safely in postmenopausal women withoutMetabolic side effect.
Cholesterol ; Dydrogesterone* ; Endometrial Neoplasms ; Estrogens, Conjugated (USP)* ; Female ; Hormone Replacement Therapy ; Humans ; Incidence ; Lipid Metabolism ; Lipoproteins ; Metabolism* ; Osteocalcin ; Progesterone

Prenatal diagnosis of genetic disorders is now an established part of routine antenatalcare. This is a study of our experience with 1,046 cases that have been undergone amniocentesisat the Guro Hospital of the Korea University Medical School from October 1983 toJune 1996. Advanced maternal age was by far the most common indication of amniocentesis.Chromosomal aberrations were diagnosed in 15 cases(1.4%) of which numerical aberrationwas 9 cases(60/0%) and structural aberration was 6 cases(40.0%). Autosomal aberrationwas observed in fourteen cases(93.3%) and sex chromosomal aberration was observedin one case(6.7%). Among the 14 autosomal aberrations, trisomy 21 was most common,being 5 cases, and one case of trisomy 13 and another case of trisomy 18 was found respectively.The others were 4 cases of translocation, one case of inversion and another case ofisochromosome. Sex chomosomal aberration case was only one and it was a Klinefeltersyndrome.
Amniocentesis* ; Chromosome Aberrations ; Down Syndrome ; Female ; Humans ; Korea ; Maternal Age ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis ; Schools, Medical ; Trisomy