Comparative analysis on the effectiveness of transvaginal radiofrequency myolysis for conservative management of leiomyoma and adenomyosis / 대한산부인과학회지

OBJECTIVE: To compare the clinical effectiveness of transvaginal radiofrequency myolysis of the patients with leiomyomas and the patients with adenomyosis which have similar clinical symptoms. METHODS: From May 2005 to May 2006 at Eulji university hospital, 108 women who were diagnosed of leiomyoma and adenomyosis had undergone transvaginal radiofrequency myolysis. Before and after the procedure size, number of uterine myomas, location and the volume of the leiomyomas and adenomyosis were measured by ultrasound. And on every visit after the procedure improvement of the symptom was checked by questionnaire of the symptom and life quality. Using Wilcoxon signed ranked test, the statistical significance was proved and the P value lower than 0.05 was judged to be significant. RESULTS: 76 women with leiomyoma who had undergone transvaginal radiofrequency myolysis, were followed up 1 month, 3 months, 6 months and 9 months after the procedure. The average maximal diameter of the myoma was decreased by 14.6%, 23.3%, 30.6%, 33.6% respectively, and the average volume was decreased by 35.7%, 53.3%, 67.3%, 72.2% respectively. 32 women with adenomyosis who had undergone transvaginal radiofrequency myolysis were followed up, at the same period after the procedure. The average maximal diameter of the adenomyosis was decreased by 8.9%, 13.6%, 14.6%, 11.9% respectively, and the average volume was decreased by 22.6%, 30.0%, 32.3%, 28.4% respectively. Before and after the procedure the symptom score was 62.3, 52.2, 40.6, 32.6, 28.6 respectively, and the quality of life score was 68.9, 78.1, 82.9, 85.7, 87.3 respectively in the leiomyoma group. In the adenomyosis group, before and after the procedure the symptom score was 77.7, 37.6, 30.6, 54.4, 67.5 respectively, and the quality of life score was 48.1, 76.5, 85.5, 66.5, 55.1 respectively. CONCLUSION: Transvaginal radiofrequent myolysis had benefits in conserving the uterus, and was less invasive, and had great effect on the reducing the size of the leiomyoma and improving the symptoms, and also returning to normal life pattern was earlier. But in women with adenomyosis the symptoms were worsened after approximately 6 to 9 months after the procedure. Therefore additional research and follow-up is required and a strict criterion is needed.

A Case of Placenta Increta in the Uterine Sacculation which was Treated with Conservative Methods / 대한주산의학회잡지

Uterine sacculation is a very rare complication associated with pregnancy in which a part of the uterine wall balloons, and it is difficult to diagnose because it is usually asymptomatic. It frequently contains the placenta and sometimes may be involved with the trapped placenta after delivery due to its structural characteristic. It is impossible to remove the retained placenta in the sac by using usual methods such as manual delivery or curettage so most of patients with it end up with having a laparotomy. Especially, if the placenta in it is accompanied by abnormal adherence of the placenta or serious hemorrhage, hysterectomy should be considered. Currently several conservative methods for the retained placenta including selective uterine artery embolization and administration of methotrexate have been introduced and these may be tried to treat the retained placenta in the uterine sacculation for avoiding operation and preserving future reproductive potential in selective cases. We experienced a case of placenta increta in the uterine sacculation that was diagnosed first during cesarian section and was treated with selective uterine artery embolization followed by methotrexate administration. This case is reported with a brief review of the literatures.

A Case of Placenta Increta in the Uterine Sacculation which was Treated with Conservative Methods / 대한주산의학회잡지

Uterine sacculation is a very rare complication associated with pregnancy in which a part of the uterine wall balloons, and it is difficult to diagnose because it is usually asymptomatic. It frequently contains the placenta and sometimes may be involved with the trapped placenta after delivery due to its structural characteristic. It is impossible to remove the retained placenta in the sac by using usual methods such as manual delivery or curettage so most of patients with it end up with having a laparotomy. Especially, if the placenta in it is accompanied by abnormal adherence of the placenta or serious hemorrhage, hysterectomy should be considered. Currently several conservative methods for the retained placenta including selective uterine artery embolization and administration of methotrexate have been introduced and these may be tried to treat the retained placenta in the uterine sacculation for avoiding operation and preserving future reproductive potential in selective cases. We experienced a case of placenta increta in the uterine sacculation that was diagnosed first during cesarian section and was treated with selective uterine artery embolization followed by methotrexate administration. This case is reported with a brief review of the literatures.

Laparoscopic assisted vaginal hysterectomy for large uterus; the comparison of conventional LAVH with LH / 부인종양

OBJECTIVE: To compare clinical results of laparoscopic assisted vaginal hysterectomy for uteri weighing 500 g or more with less than 500 g. And we compared clinical results between laparoscopic coagulation of uterine vessel (LH) and conventional LAVH. METHODS: We reviewed medical records of 296 patient who underwent LAVH from February 2004 to May 2006. They were divided into two groups, uteri weighing greater than 500 g and less than 500 g. And each group was divided into two groups, LH and conventional LAVH. Each groups were compared by operative time, hemoglobin change, complication, transfusion and hospital days. RESULTS: Operation time ,hemoglobin change on the 1st postoperative day and transfusion were significant greater in the uteri > or =500 g group than in the or =500 g group, there was no signicant difference in hospital days, operative time, hemoglobin change on the 1st postoperative day. However, hemoglobin change was smaller in the LH group than conventional LAVH group on the 4th postoperative day. CONCLUSION: This study demonstrates that despite the increased operating time and blood loss, LAVH can be safely performed for large uterus. However, surgeons need to be aware of high risk of blood transfusion. Modification of surgical method can decrease operating time and blood loss in LAVH.

Tailored selective termination in second trimester in twin pregnancy / 대한산부인과학회지

OBJECTIVE: Recently, selective termination is employed in multifetal pregnancies, in the presence of an abnormal fetus, or in the complication of twin pregnancies. The purpose of this study is to evaluate effectiveness, safety of the tailored selective termination in multifetal pregnancies. METHODS: This study was retrospective and involved six cases. Indication of termination were 3 cases of structural anomalies (anencephaly, encephalocele, body stalk anomaly), 1 case of chromosomal anomaly (21 trisomy) and 2 cases of monochorionic twin complications (acardiac twin, twin to twin transfusion syndrome). RESULTS: We used KCL injection in 4 cases, they were all confirmed dichorionic twin, and in 2 cases of monochorionic twin, we used alcohol ablation of intra-abdominal umbilical artery in 1 case, and radiofrequency ablation of the cord in 1 case. CONCLUSION: All procedures were successful, and all normal infants were delivered in 3rd trimester. Tailored selective termination in 2nd trimester is effective and safe in abnormal multifetal pregnancies.

The comparison of laparoscopic assisted vaginal hysterectomy, total vaginal hysterectomy and total abdominal hysterectomy / 대한산부인과학회지

OBJECTIVE: To compare the clinical results for women undergoing total abdominal hysterectomy (TAH), laparoscopic assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). METHODS: We reviewed the medical records of patients who underwent TAH (n=97), LAVH (n=112) and TVH (n=95) from June 2002 to June 2005. We compared and evaluated patient's characteristics, previous abdominal operation histories, indication of hysterectomy, uterine weight, operative time, perioperative hemoglobin and hematocrit change, the degree of postoperative pain, hospital stay and complications. RESULTS: The patient's characteristic (age, weight, height, parity, perioperative hemoglobin and hematocrit change, complication rate) had no statistical difference in all three groups. In the TVH group, the rate of previous abdominal operations (25%) was significantly lower than TAH (56%), and LAVH (40%) (p=0.023). The mean uterine weight was the heaviest in TAH group (443.6+/-407.3 g), compared to LAVH group (301.9+/-133.9 g) and TVH group (225.3+/-91.8 g) (p<0.001). Operative time was the longest for LAVH group (p=0.001), and there was no significant difference between TAH group and TVH group (p=0.087). The TAH group had the highest postoperative pain scale and the length of hospital stay. The LAVH group and TVH group had almost the same postoperative pain scale and the length of hospital stay. CONCLUSION: Both LAVH and TVH had the following advantages compared with total abdominal hysterectomy: less pain, shorter hospital stay, cosmetic advantages. But limited operation field in TVH and expensive operative cost in LAVH were disadvantages. Specific guidelines for determining the route of hysterectomy result in decreased morbidity and lower costs, and thus the gynecologist can ensure that the patient receives the best possible surgical care.

Clinical comparisons of laparoscopically assisted vaginal hysterectomy and total vaginal hysterectomy / 대한산부인과학회지

OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). METHODS: We reviewed the medical records of patients who underwent LAVH and TVH from January 2002 to December 2004 in 00 university hospital without the history of uterine prolapse or pelvic relaxation. We evaluated age, parity, previous abdominal operations, indication of hysterectomy, size of the uterus, operation time, hemoglobin change, hospital day, the degree of postoperative pain and initiation of diet and postoperative complications. RESULTS: The age and parity of the patients in both groups were not different statistically. There were history of previous abdominal operations in 20.8% of LAVH group and 25.3% of TVH group which didn't have statistic significance. Major indications of the operation were uterine myomas in both groups. The average weight of the extracted uterus were 272.9+/-114.5 gm and 225.6+/-87.0 gm in the LAVH group and the TVH group respectively which had significance, and the operation time were 81.1+/-23.4 minutes and 71.1+/-37.8 minutes respectively which had significance. There were no difference in the hemoglobin drop of the postoperative day 1, but the hemoglobin drop of the postoperative day 4 was larger in the LAVH group. Postoperative complications occurred more often in the TVH group (15.2%) than LAVH group (11.9%) but didn't have significance, and the complications were treated by conservative managements and observation of the progress. And also the hospital day, the degree of postoperative pain and initiation of diet had no significance. CONCLUSION: Both LAVH and TVH had no statistic difference in the postoperative morbidity and recuperation. Moreover the indications of operation for both surgeries had no statistic difference, but LAVH had a preference for the larger size of uterus. Furthermore in order to increase the satisfactions of patients and remedy the weak points of procedures, research on the indications and contra-indications between the operative approaches and training on the operative procedures are required.

A Case of Peripartum Cardiomyopathy associated with Preeclampsia superimposed on Idiopathic Thrombocytopenic Purpura / 대한산부인과학회지

Peripartum cardiomyopathy is a dilated cardiomyopathy of unexplained cause that occurs during the last trimester of pregnancy or within 5 months after delivery. And, It is a rare disease that has a frequency of 1 in 1,300-15,000 deliveries. It has not yet been reported that peripartum cardiomyopathy has occurred in an preeclampsia woman superimposed on idiopathic thrombocytopenic purpura. Moreover, the association between idiopathic thrombocytopenic purpura and peripartum cardiomyopathy has not been studied. Recently, we experienced a case of a woman who has undergone emergency Cesarean section due to complicated severe preeclampsia superimposed on idiopathic thrombocytopenic purpura. On the postoperative day, this patient developed respiratory distress and pumonary edema. Peripartum cardiomyopathy was diagnosed by echocardiography and we present with a brief review of literatures.

Clinical significance of Doppler velocimetry and oligohydramnios in intrauterine growth restriction / 대한산부인과학회지

OBJECTIVE: The aim of this study is to prove the clinical significance by evaluating pregnancy outcomes from intrauterine growth restriction using waves of the Doppler velocimetry of uterine and umbilical artery and amniotic fluid index. METHODS: Throughout the period of January 2000 to May 2005 at our hospital, we reviewed 127 cases diagnosed with intrauterine growth restriction after 24 weeks of pregnancy and the existences of diastolic notch of uterine artery (DNUT), absent or reversed end-diastolic velocity of umbilical artery (AEDV) and oligohydramnios were considered abnormal. We set the group that had no abnormal signs as the control group (62 cases), and respectively compared the groups that had oligohydramnios (24 cases), unilateral DNUT (27 cases), bilateral DNUT (10 cases) and AEDV (13 cases) with the control group. And we compared the groups that had only one abnormal sign, that is oligohydramnios (20 cases), bilateral DNUT (7 cases), AEDV (7 cases) and the group showing 2 or more complicated abnormal signs those above (9 cases) with the control group. RESULTS: Perinatal outcomes such as preterm birth, low birth weight, lower 5-min Apgar score (A/S), neonatal acidosis, admission rate of neonatal intensive care unit (NICU) and perinatal mortality were poor statistically in groups with DNUT, AEDV and oligohydramnios compared to those which have none of these abnormal signs. And those with DNUT had worse results when affected on both sides. And those with AEDV showed worse perinatal outcomes compared to those with bilateral DNUT or oligohydramnios; any overlapping of these abnormal signs indicated worse perinatal outcomes, which had statistic significance. CONCLUSION: Close observation of the fetal well-being by analysis on the wave velocimetry of the blood flow such as the uterine arteries and umbilical arteries and the measurement of the amniotic fluid volume enables predicting the perinatal prognosis of the intrauterine-growth restricted fetuses which may contribute in reducing the perinatal morbidity and mortality.

A case of placenta accreta successfully treated with methotrexate / 대한산부인과학회지

Placenta accreta is a rare condition and is associated with considerable maternal morbidity and mortality. Though hysterectomy is a definitive therapy, there are some occasions that conservation of the uterus is desired by the patient and bleeding is not excessive. We report a case successfully treated using methotrexate in patient whose placenta was not detached from the uterus with a brief review of literature.

A Case of Persistent Cloaca Diagnosed by Prenatal Sonography / 대한산부인과학회잡지

Persistent cloaca is a very rare congenital anomaly with a single common perineal opening for the genital urinary and gastrointestinal tract, which is caused by abnormal formation of the urorectal septum. It has an incidence of 1 in 50,000 to 1 in 125,000 births and is much more common in females and in twin pregnancies. Pathologic findings of persistent cloaca include dilated bowel, hydrocolpos, urethral obstruction, hydronephrosis and oligohydramnios caused by obstruction of the bladder, vagina and intestine. Failure of the paired m llerian ducts to fuse also usually results in duplication of the uterus and vagina. Currently, the diagnosis depends on the prenatal sonography but the diagnosis may be very difficult due to the complex nature of the anomaly and variable appearances. We present a case of persistent cloaca with one opening confirmed by autopsy after therapeutic termination which was initially diagnosed by prenatal sonography.

Affecting Factors of Outcome of CC/hMG Ovarian Stimulation and Intrauterine Insemination / 대한산부인과학회잡지

OBJECTIVE: We have attempted to identify prognostic factors regarding CC/hMG ovarian stimulation and IUI in infertility and to seek factors valuable in planning infertility treatment and predicting the success rate of IUI therapy in individual couples. METHODS: The variables selected for initial analysis were female age, duration of infertility, type and diagnosis of infertility, number of pre-ovulatory follicles (>or=16 mm, >or=18 mm follicles), thickness of the endometrium, number of the treatment cycles, result of semen analysis, ovarian stimulation protocol, number of IUI. A logistic regression method was used to identify significant variables that contribute to the success of CC/hMG/IUI treatment. RESULTS: Logistic regression analysis revealed four predictive variables as regards pregnancy: duration of infertility (p=0.011), infertility etiology (p=0.049), number of IUI (p=0.004), method of ovarian stimulation (p=0.042). A cause of infertility, especially ovarian dysfunction other than tubal factor, a shorter duration of infertility (<6 years) and CC/hMG minimal ovarian stimulation protocol with double IUI resulted in better treatment success in CC/hMG with IUI cycles. CONCLUSION: We concluded that careful patient selection criteria coupled with successful ovarian stimulation and increased sperm count in female reproductive tract is the model for CC/hMG/IUI sucess.

Identification of High Risk Group of HPV associated with Cervical Cancer in Korean Women / 대한산부인과학회잡지

OBJECTIVE: To identify genital HPV types and high risk group of HPV associated with cervical cancer in Korean women. METHODS: Both Pap test and HPV-DNA test using PCR assay were performed as screening test for cervical cancer in this clinic. When patients were positive in HPV-DNA test, HPV genotyping using sequencing method and cervical biopsy were performed. RESULTS: Frequent age group of HPV infection was 40 yrs (34.3%) and prevalence of HPV infection was 9.8%. Twenty-three types of HPV were detected. HPV 16 and 58 were detected in invasive cancer. HPV 16, 31, 33, 45, and 58 were detected in HSIL. HPV 6, 11, 18, 53, 59, and 66 were detected in LSIL. HPV 16 was most commonly detected in HSIL and invasive cancer. CONCLUSION: HPV 16, 31, 33, 45, and 58 are included in high risk group of HPV in Korean women. It may be very effective in early detection of cervical cancer to classify HPV types included in high risk group of cervical cancer in Korean women and to perform cervical biopsy in the patients who have high risk types of HPV infection.

Identification of High Risk Group of HPV associated with Cervical Cancer in Korean Women / 대한산부인과학회잡지

OBJECTIVE: To identify genital HPV types and high risk group of HPV associated with cervical cancer in Korean women. METHODS: Both Pap test and HPV-DNA test using PCR assay were performed as screening test for cervical cancer in this clinic. When patients were positive in HPV-DNA test, HPV genotyping using sequencing method and cervical biopsy were performed. RESULTS: Frequent age group of HPV infection was 40 yrs (34.3%) and prevalence of HPV infection was 9.8%. Twenty-three types of HPV were detected. HPV 16 and 58 were detected in invasive cancer. HPV 16, 31, 33, 45, and 58 were detected in HSIL. HPV 6, 11, 18, 53, 59, and 66 were detected in LSIL. HPV 16 was most commonly detected in HSIL and invasive cancer. CONCLUSION: HPV 16, 31, 33, 45, and 58 are included in high risk group of HPV in Korean women. It may be very effective in early detection of cervical cancer to classify HPV types included in high risk group of cervical cancer in Korean women and to perform cervical biopsy in the patients who have high risk types of HPV infection.

Doppler findings and tocolytic effect of transdermal glyceryl trinitrate and intravenous ritodrine as tocolysis of preterm labor / 대한산부인과학회잡지

OBJECTIVE: This study was conducted to compare the safety and efficacy of transdermal glyceryl trinitrate (GTN) in initial therapy for preterm labor with those of intravenous ritodrine hydrochloride and the effects of tocolytics in uteroplacental circulation, as assessed by uterine artery doppler velocimetry. METHODS: Patients between 24 and 34 weeks gestation with documented preterm labor were randomly assigned to receive transdermal GTN (n=24) or intravenous ritodrine (n=35) as initial tocolytic therapy. Patients in the GTN group were administered 0.2 mg/h released transdermal patch on the pregnant women's abdomen directly. Patient in the ritodrine group were treated 0.025 mg/min as initial dose. The dose increased at 15 minute intervals until uterine contractions were inhibited or side effects become intolerable. The maximum recommended dose was 0.20 mg/min. The main outcome examined were failure of tocolysis, time to uterine quiescence, time gained in utero, and frequency of adverse effects. We obtained both right and left uterine artery doppler velocity waveform before and after tocolytics therapy. The mean values of the right and left uterine artery systolic and diastolic ratio were calculated and used for analysis. RESULTS: There were no significant difference in maternal demographic between the groups. Successful tocolysis was observed in 79.2% in the GTN group, and 85.7% in the ritodrine group (p=0.726). Time to uterine stop contraction was 5.5 +/- 5.3 hr in ritodrine group and 1.1 +/- 0.3 hr in GTN group. There were no different in time to gain in uterus between the two groups. The patient in the ritodrine group had more adverse side effects, mainly maternal tachycardia (p=0.002), chest pain and tremor (p=0.035). There was no significant difference in uterine S/D ratios between the pretherapy and posttherapy GTN group. However, we found statistically significant difference between the pretherapy and 24 hr-posttherapy in ritodrine group. CONCLUSION: Transdermal GTN was effective, safe, and well tolerable tocolytic agent. Patients who received ritodrine hydrochloride were more likely to have adverse effects. We also conclude that GTN do not affect uteroplacental circulations as measured by S/D ratios but ritodrine does. This results suggest that progressively increasing dose of ritodrin and GTN maybe associated with a statistically significant decrease S/D ratios. However, further investigations needs to be performed.

Comparison of IVF-ET Outcome after Various Therapeutic Approaches for Ovarian Endometriomas / 대한불임학회지

OBJECTIVE: To compare COH characteristics and IVF outcomes among IVF-ET patients who were treated with various therapeutic modalities for ovarian endometriomas and to propose effective pre-cyclic therapeutic modalities to improve IVF-ET outcomes in the patients with ovarian endometriomas. METHODS: All cases that had undergone IVF-ET after laparoscopy between January 1997 to August 2003 were reviewed. Forty-eight patients with tubal factor were assigned to Group I. Twenty seven, 22 and 38 patients diagnosed as severe pelvic adhesion with ovarian endometriomas by laparoscopy received only medical therapy (Group II), cyst aspiration (Group III), and sclerotherapy (Group IV), respectively. Laparoscopic cystectomy was performed in 20 patients (Group V). Resistance index was measured on day administering hCG. RESULTS: As compared with Group I, in Group II resistance index increased (p<0.05) but number of oocytes, good-quality oocyte ratio (mature and intermediate oocytes/total retrieval oocytes), fertilization rate, and embryo development rate decreased (p<0.05). In Group III fertilization rate and embryo development rate decreased (p<0.05). There was no difference between Group IV and Group I in all parameters except basal FSH which increased (p<0.05). In Group V basal FSH, and resistance increased (p<0.05) and number of oocytes and good-quality oocytes ratio decreased (p<0.05). CONCLUSION: Sclerotherapy is an effective therapeutic option which can be done prior to IVF-ET cycles in the patients with ovarian endometriomas. Further studies on a large scale are necessary to confirm these data.

Cordocentesis: Clinical Analysis of 112 Procedures / 대한산부인과학회잡지

OBJECTIVE: This study was performed to assess the safety and efficacy of the diagnostic cordocentesis in prenatal diagnosis. METHODS: Between March 1998 and February 2002, percutaneous umblical cord blood samplings under the ultrasonographic guidance were performed in 112 patients. We reviewed the medical records of 112 patients who were performed cordocentesis. RESULTS: Gestational age ranged between 17 and 36 weeks. The mean maternal age was 29.6 years and the mean gestational age at the time of cordocentesis was 27.8 weeks. Among the patients, 83 cases (74.1%) were done with the indication of abnormal sonographic finding and followed by rapid karyotyping. Pure fetal blood was successfully obtained in 105 cases of 112 cordocentesis (93.8%). 99 cases (88.4%) were done successfully at the first attempt. Chromosomal abnormalities were found in 9 of 103 fetuses (8.7%). Abnormal chromosomal patterns were found in 8 of 70 fetuses (11.4%) with structural anomalies detected by ultrasonography. The procedure-related complication, fetal bradycardia occured in 3 cases (2.7%). CONCLUSION: We conclude that cordocentesis is a useful, relatively safe, and effective procedure for prenatal diagnosis.

Prenatal diagnosis of spondylothoracic dysplasia (Jarcho-Levin syndrome) by ultrasound / 대한산부인과학회잡지

The Jarcho-Levin syndrome (spondylothoracic dysplasia) is a rare autosomal recessive disorder characterized by a short neck, short trunk and a constricted thorax due to multiple rib and vertebral defects. The small size of thorax in newborns frequently leads to respiratory insufficiency and death in neonates or infancy. We reports the prenatal diagnosis using ultrasonography of a fetus affected with spondylothoracic dysplasia, or Jarcho-Levin syndrome, in patient without a positive family history for this condition.

Prenatal diagnosis of spondylothoracic dysplasia (Jarcho-Levin syndrome) by ultrasound / 대한산부인과학회잡지

The Jarcho-Levin syndrome (spondylothoracic dysplasia) is a rare autosomal recessive disorder characterized by a short neck, short trunk and a constricted thorax due to multiple rib and vertebral defects. The small size of thorax in newborns frequently leads to respiratory insufficiency and death in neonates or infancy. We reports the prenatal diagnosis using ultrasonography of a fetus affected with spondylothoracic dysplasia, or Jarcho-Levin syndrome, in patient without a positive family history for this condition.

Compliance with lifestyle modification in patients with hypertension

BACKGROUND: Advising lifestyle modification to patients suffering from hypertension is important. However, how strictly hypertensive patients in korea are adherent to non-pharmacologic recommendation has not been well known. This study was performed to determine the compliance of hypertensive patients to the recommendation for life style modification and to find out on factors related to compliance. METHODS: Ninety-six patients, diagnosed as hypertensives between November 1997 and April 1998 in the Department of Family Medicine, Samsung Medical Center were educated on lifestyle modifications by their physicians during routine outpatient consult questionnaires inquiring of demographic and clinical characteristics, and health habits were Self administered done before and after the education. Blood pressure, height, and weight were measured repeatedly. The relationships between various characteristics and the compliance with lifestyle modification and follow-up visits were evaluated using Chi-square test and multiple logistic regression analysis. RESULTS: Among 96 patients, 47 patients (49.0%) attended for regular check-up two months after being diagnosed as hypertension. Being prescribed with antihypertensive agent, non-smoking, and doing regular exercise were the significant factors related to higher compliance with regular check-up. A total of 19 patients (40.4%) among 47 patients who have attended for regular check-up were adherent to the recommendation for modification of one or more health habits. The proportion of patients doing regular exercise increased significantly after education. Although 15 patients(53.6%) among 28 patients whose body mass indices were over 25 kg/m2 reported that they had made efforts to reduce body weight, no significant differences were observed in the change of body mass index between patients who reported their efforts for reducing body weight and those who did not. There was no association between various characteristics and compliance with lifestyle modification. CONCLUSIONS: Low compliance with recommendation for lifestyle modification during routine outpatient consultation and no association between various clinical and demographic characteristics and patient compliance suggests the necessity of developing special program and its active application to all hypertensive patients.