ObjectiveTo evaluate the clinical signifi cance of soluble fms-like tyrosine kinase1 (sFlt-1), soluble endoglin (sEng) and placental growth factor (PlGF) in preeclampsia. MethodsWe conducted a case-control study analyzing serum levels of sFlt-1, sEng and PlGF in women with preeclampsia (n=30) and normal pregnancy (n=30) in the third trimester.We calculated the sensitivity, specifi city, positive, and negative predictive values of each peptide in diagnosing preeclampsia. ResultsThe mean serum level of sFlt-1 and sEng in women with preeclampsia was significantly higher than normal pregnancy.But the mean serum level of PIGF had no signifi cant difference between two groups.The cut-off values of sFlt-1 and sEng showing differential signifi cance were 26.3 ng/mL and 21.1 ng/mL each.Then the sensitivity, specifi city, positive predictive value, negative predictive value was all over 80%.Serum levels of sFlt-1 and sEng were not signifi cantly different between intrauterine growth restriction (IUGR) and non-IUGR group among preeclamptic women. ConclusionSerum levels of both sFlt-1 and sEng may be useful in diagnosing patients with preeclampsia.The serum levels of these factors may not correlate with poor perinatal outcomes.
The relapse of leukemia is usually classified as hematologic relapse and extramedullary relapse. The most common sites of clinical extramedullary relapse are the central nervous systems (CNS) and gonads. However, the relapse in the uterus is very rare. We experienced a very unusual case of uterine relapse of acute lymphoblastic leukemia (ALL) after about a 6-year remission period. This female patient returned to our hospital with a two-month history of amenorrhea. Pelvic radiology confirmed an about 7 cm sized ill-defined ovoid mass in the uterus. There was no evidence of ALL relapse in the peripheral blood or CNS. The uterine biopsy showed diffused homogenous infiltration of numerous small round cells in uterine corpus, suggesting ALL relapse. The bone marrow study revealed 100% cellularity, most of which were lymphoblasts. Our patient received the bone marrow transplantation (BMT) and achieved the second complete remission (CR). Therefore, we here report our case with a brief review of literature.
본 연구에서는 국내 임상 현장에 우울증의 행동활성화를 소개하고자 지난 25년간 축적된 행동활성화의 근간이 되는 이론과 연구 결과들을 체계적으로 개관하였다. 행동활성화는 항우울제 및 인지치료와 대등한 치료효과를 나타낸다는 것이 보고되었고, 우울장애를 포함한다양한 임상군에서의 효과성 또한 밝혀지고 있다. 본 개관 논문에서는 행동활성화에 대한 최신 정의를 소개하고, 치료 및 이론이 발전해온 역사, 기저이론, 기저이론을 뒷받침하는 기초 연구결과, 8가지 핵심치료요소를 분석하여 기술하였다. 또한 우울증 환자를 대상으로 실시한 행동활성화의 효능 및 효과 연구, 비용-효율성 검증 연구결과를 포괄적으로 정리하였다. 나아가 행동활성화의 광범위한 보급을 위해 다양한 형태(예, 인터넷 기반 등)로 치료를 전달하는 최근의 시도와 그 효과 연구들, 그리고 공병을 지닌 다양한 환자 군을 대상으로 실시한 논문들을 개관하였다. 마지막으로 앞으로 국내에서의 행동활성화 효과성 연구뿐 아니라 지역사회에서 다양한 임상군에게 보급할 수 있는 방안을 포함하여, 향후 연구 방향에 대해 논의하였다.
Objective: Despite the general information of vaginal birth after cesarean section (VBAC), little is known about the duration of active labor in women attempting VBAC. The aim of this study was to compare the time length of active labor in women attempting VBAC compared with nulliparas or multiparas, and then, provide further insight for better management of labor. Methods: From January 1999 to December 2003, a total of 444 patients with VBAC were entered into the study. Women with two or more history of caesarean section or previous vaginal delivery were all excluded from the study. Time length of active labor in these patients was compared with 335 nulliparas and 218 multiparas consecutively visiting our unit for delivery in 2003. Results: For patients with VBAC, the duration of active and second phase were 184.8115.7, and 25.115.2 minutes, which was significantly shorter than nulliparas (p
The purpose of the current study was to propose a Korean-specific parameter set for calculating the risk of Down syndrome in the second trimester of pregnancy and to determine the screening performances of triple and quadruple tests in Korean women. Using the data on triple or quadruple screening from three hospitals in Korea during 7 yr, we re-converted the concentrations of four serum markers to multiple of median values according to gestational age and maternal weight. After re-calculating the risk of Down syndrome in each pregnancy by multiplying maternal age-specific risk by the likelihood ratio values for the serum markers, screening performances and optimal cut-off values of triple and quadruple tests were analyzed. Among 16,077 pregnancies, 23 cases had Down syndrome (1.4/1,000 deliveries). Compared to the previous program, the tests with new parameters had improved screening performance. The triple and quadruple tests had detection rates of 65.2% and 72.7%, respectively, at a false-positive rate of 5%. The optimal cut-off value for the quadruple and triple tests was 1:250. We have presented a Korean-specific parameter set for Down syndrome screening. The proposed screening test using this parameter set may improve the performance of Down syndrome screening for Korean women.
The association between abortion and postmenopausal mental health has not been clearly established in Asian women. The objective of this study was to evaluate the effect of abortion experiences on suicidal ideation and mental health in Korean postmenopausal women. This study included 5133 postmenopausal women registered in the Korean National Health and Nutrition Examination Survey between 2010 and 2012. Difference in suicidal ideation according to type and number of abortions was analyzed. We used survey multiple logistic regression analysis to evaluate the effect of abortion experiences on the risk for suicidal ideation expressed as adjusted odd ratios (ORs) with 95% confidence intervals (95%CIs). The risk of suicidal ideation was significantly higher in women who experienced more than three abortions (27.9%). While the incidence of suicidal ideation was not significantly affected by the number of spontaneous abortions (p = 0.718), suicidal ideation was significantly more frequent in women who had undergone ≥ three abortions (p = 0.003). After adjusting for demographic confounding factors, women who underwent ≥ three induced abortions had higher risk for suicidal ideation (OR: 1.510; 95% CI: 1.189–1.919; p = 0.031). This risk remained elevated even after controlling for depression (OR: 1.391; 95% CI: 1.1086–1.871, p = 0.002). Moreover, the risk of experiencing a depressive mood in daily life was also increased with increasing number of induced abortions even after controlling for depression (OR: 1.657; 95% CI: 1.274–2.156, p = 0.002). Undergoing three or more induced abortions during reproductive age was associated with postmenopausal suicidal ideation, stress, and depression. However, such association was not noted in those with spontaneous abortion, even in women with more miscarriages. Thus, clinicians should evaluate depression and suicidal ideation in women with multiple induced abortions.
'%3e%3cg id='b'%3e%3cpath id='a' stroke='%23000' stroke-width='2' d='M-6-25H6m-12 3H6m-12 3H6'/%3e%3cuse xlink:href='%23a' y='44'/%3e%3c/g%3e%3cpath stroke='%23fff' d='M0 17v10'/%3e%3ccircle r='12' fill='%23cd2e3a'/%3e%3cpath fill='%230047a0' d='M0-12A6 6 0 0 0 0 0a6 6 0 0 1 0 12 12 12 0 0 1 0-24z'/%3e%3c/g%3e%3cg transform='rotate(-123.69)'%3e%3cuse xlink:href='%23b'/%3e%3cpath stroke='%23fff' d='M0-23.5v3M0 17v3.5m0 3v3'/%3e%3c/g%3e%3c/svg%3e)
'/%3e%3cuse xlink:href='%23a' transform='rotate(72 0 0)'/%3e%3cuse xlink:href='%23a' transform='rotate(-72 0 0)'/%3e%3cuse xlink:href='%23a' transform='scale(-1 1) rotate(72)'/%3e%3c/g%3e%3c/defs%3e%3cpath fill='%23012169' d='M0 0h1200v600H0z'/%3e%3cpath stroke='%23FFF' stroke-width='60' d='m0 0 600 300M0 300 600 0' clip-path='url(%23b)'/%3e%3cpath stroke='%23C8102E' stroke-width='40' d='m0 0 600 300M0 300 600 0' clip-path='url(%23c)'/%3e%3cpath stroke='%23FFF' stroke-width='100' d='M300 0v300M0 150h600' clip-path='url(%23b)'/%3e%3cpath stroke='%23C8102E' stroke-width='60' d='M300 0v300M0 150h600' clip-path='url(%23b)'/%3e%3cuse xlink:href='%23d' fill='%23FFF' transform='matrix(45.4 0 0 45.4 900 120)'/%3e%3cuse xlink:href='%23d' fill='%23C8102E' transform='matrix(30 0 0 30 900 120)'/%3e%3cg transform='rotate(82 900 240)'%3e%3cuse xlink:href='%23d' fill='%23FFF' transform='rotate(-82 519.022 -457.666) scale(40.4)'/%3e%3cuse xlink:href='%23d' fill='%23C8102E' transform='rotate(-82 519.022 -457.666) scale(25)'/%3e%3c/g%3e%3cg transform='rotate(82 900 240)'%3e%3cuse xlink:href='%23d' fill='%23FFF' transform='rotate(-82 668.57 -327.666) scale(45.4)'/%3e%3cuse xlink:href='%23d' fill='%23C8102E' transform='rotate(-82 668.57 -327.666) scale(30)'/%3e%3c/g%3e%3cuse xlink:href='%23d' fill='%23FFF' transform='matrix(50.4 0 0 50.4 900 480)'/%3e%3cuse xlink:href='%23d' fill='%23C8102E' transform='matrix(35 0 0 35 900 480)'/%3e%3c/svg%3e)