Assessment about the measles elimination from cases and outbreaks, 2002-2007: Assessment about the measles elimination / 소아과

PURPOSE: We assessed about the measles elimination in Korea according to analyzing national data on measles cases for 2002-2007. METHODS: We estimated the effective reproduction number according to the proportion of imported cases and outbreak size. RESULTS: Eleven cases, thirteen cases, six cases, six cases, 25 cases (60.0% were linked to 1 outbreak of 15 cases), and 180 cases (55.6% were linked 11 outbreaks of 2, 2, 2, 3, 3, 3, 5, 9, 9, 12, 50 cases) were reported in 2002, 2003, 2004, 2005, 2006 and 2007, respectively. In 2002-2007, R is 0.95 by imported case and 0.43 by outbreak sizes. In 2007, multiple chains of transmission occurred in hospital. Most of cases were below 4 ages and unvaccinated. We didn't find most of the infection source. CONCLUSION: We should prevent outbreak of susceptibility pocket like nosocomial infection, conduct reliable routine surveillance and epidemiological investigation to solve a problem of the measles elimination.

Epidemiological Investigation of a Measles Outbreak in a Preschool in Incheon, Korea, 2006 / 예방의학회지

OBJECTIVES: This study describes a plan that was designed to prevent a measles outbreak that showed a changed outbreak pattern. This study is based on the epidemiological investigation of a measles outbreak in a preschool in Incheon, Korea, 2006. METHODS: The subjects were 152 students at a preschool where a measles outbreak occurred. A questionnaire survey was conducted and serological testing for measlesspecific IgM was preformed. RESULTS: Of the fifteen confirmed, identified cases, eleven patients had been vaccinated with one dose, one patient had received two doses and three patients were unvaccinated. The three unvaccinated cases consisted of one 5-year-old child, one 3-year-old child and one 16-month-old infant. For the cases with one dose of the vaccination, there were 11 cases, which consisted of six 5-year-old children, two 4-year-old children, two 3-year-old children and one 2-year-old child. The case with two doses of the vaccination was one 4-year-old child. The attack rate of measles was 100% in the 0-dose group, 11.2% in the 1-dose group and 2.0% in the 2-dose group. The vaccine's efficacy was 88.8% in the 1-dose group and 98.0% in the 2-dose group. The vaccine effectiveness for the 2-dose group was higher than that of the 1-dose group. CONCLUSIONS: High coverage with a 2-dose vaccination should be maintained, and the vaccination should be given at the suitable time to prevent a measles outbreak with a changed outbreak pattern.

Analysis of expression of survivin, caspase 3, and p53 protein in cervical neoplasia comparing with Ki-67 index / 부인종양

OBJECTIVE: The aim of this study was to determine the role of survivin, caspase 3, p53 and Ki-67 expression in the carcinogenesis of cervical carcinoma and aggressiveness of cervical intraepithelial neoplasia (CIN). METHODS: The pathology specimens of 94 patients with a diagnosis of Low grade CIN (31 cases), High grade CINL (32 cases) and squamous cell carcinoma (31 cases) were evaluated immunohistochemically for the expression of survivin, caspase 3, p53 and Ki-67 in paraffin sections. RESULTS: Survivin, p53 and Ki-67 expressions were progressively increased in accordance with the increasing degree of malignancy, but caspase 3 immunoreactivity was higher in high grade CIN than in low grade CIN and invasive cervical cancers. There was no significant difference between Ki-67 index and survivin, caspase 3 and p53 expression with the increasing degree of malignancy. The Ki-67 index was closely related to p53 overexpression in invasive cervical carcinoma group. CONCLUSION: A sequential increase of survivin, p53, and Ki-67 was observed in paralleling the progression of grade of CIN and cervical cancer. In addition, caspase 3 expression increased proportionally to the low-grade CIN to high grade CIN.

A Case of Discovery of Heterotopic Pregnancy After Missed Abortion / 대한산부인과학회지

Heterotopic pregnancy, the potentially fatal condition in which simultaneous gestations occurs at two or more implantation sites, was first reported in 1708 as an autopsy finding. In natural conception cycles it is a rare event, occuring less than 1:30,000 pregnancies. However, with assisted reproduction techniques, this incidence increase. Also the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, former tubal surgery. We report a case of discovery of heterotopic pregnancy after missed abortion with brief review of literature.

Relationship between Parathyroid Hormone, Vitamin D and Bone Turnover Markers in Korean Postmenopausal Women / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate the relationship between parathyroid hormone (PTH), vitamin D status, bone mineral density (BMD) and bone turnover markers in Korean postmenopausal women. METHODS: The subjects were 263 healthy postmenopausal women recruited in Seoul, Korea. The research was performed from January to March, 1999. Serum PTH level was measured with immunoradiometric assay (IRMA). Serum 25 (OH) vitamin D concentration was measured by radioimmunoassay (RIA) for the evaluation of vitamin D nutritional status. The averages of BMD were attained from the 2nd and 3rd lumbar spine. Two serum levels of bone turnover markers such as osteocalcin and N- telopeptide were also measured by IRMA and enzyme linked immunosorbent assay (ELISA) respectively. RESULTS: Severe, moderate, mild vitamin D deficiency and normal vitamin D status groups were found in 16 (6.1%), 94 (35.7%), 127 (48.3%), and 26 (9.9%) subjects respectively. Among the four groups, no significant differences were found in terms of age, weight, height, bady mass index (BMI). The serum vitamin D levels were 3.18 +/- 1.5 ng/ml, 7.8 +/- 1.4 ng/ml, 13.9 +/- 2.7 ng/ml 25.2 +/- 1.3 ng/ml in severe, moderate, mild, vitamin D deficiency and normal vitamin D status group respectively. Serum PTH levels were 28.6 +/- 14.9 pg/ ml, 22.7 +/- 10.4 pg/ml, 19.5 +/- 12.9 pg/ml, 15.1 +/- 10.3 pg/ml in severe, moderate, mild vitamin D deficiency and normal vitamin D, respectively, and a siginificant difference was found (p<0.05). In comparison with the normal vitamin D group, PTH concentration level was significantly increased by 90.1%, 50.4%, 29.4%, in severe, moderate, mild vitamin D deficiency groups respectively (p<0.05). The serum PTH concentration and 25 (OH) vitamin D were inversely related (r=-0.219, p<0.05). The correlations between the serum PTH level and other factors, such as age, weight, height, BMI, BMD, and bone turnover markers, were insignificant. CONCLUSION: Korean postmenopausal women showed an increase in serum PTH levels in case of vitamin D deficiency, and about 90% of women were suffering from vitamin D deficiency. Therefore, it is recommendable to prescribe the supplemental vitamin D for the most of Korean postmenopausal women.

The Validational study of OSTA (Osteoporosis Self Assessment Tool for Asian) for Prediction of Osteoporosis in Korean Post- and Perimenopausal Women / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate the performance of OSTA (Osteoporosis Self assessment Tool for Asian) in Korean peri- and postmenopausal women. DESIGN AND METHODS: Total 1488 peri- and postmenopausal women over 45 years were included from Menopause Clinic in Chung-Ang University Hospital. Femoral neck BMD was measured by using DEXA (Lunar DPXIQ #7055). Three categories of bone status were defined by BMD based on the WHO definition. OSTA index values were calculated by using only 2 components such as age and weight. Three risk categories (high, medium, low) were classified according to index values. RESULTS: Seven hundred thirty women tested comprising 49.1% of all subject had low BMD (10.6% osteoporosis, 38.5% osteopenia respectively). The combined medium and high risk groups had a high prevalence (447/557=80.3%) of low bone mass. The medium and high risk groups had 85.5% of a high specificity, and 61.2% of a good sensitivity for identifying low bone mass. The medium and high risk groups also had 87.9% of a high sensitivity, and 68.5% of a good specificity for identifying osteoporosis. CONCLUSION: OSTA is a simple tool and easy to use, because it requires only age and weight. The OSTA risk tool performed well for identifying low bone mass, especially osteoporosis in Korean peri- and postmenopausal women.

Comparison study of Le Fort colpocleisis and total vaginal hysterectomy for prolapses uteri / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to evaluate and compare the Le Fort colpocleisis and conventional total vaginal hysterectomy in the uterine prolapse patients in the medically compromised or elderly patients. METHODS: This study was to analyze the data from 16 patients with uterine prolapse undergone Le Fort colpocleisis at the department of obstetrics and gynecology, Chung-ang university hospital from January 1991 to December 2000, and 36 patients with uterine prolapse undergone total vaginal hysterectomy from January 1999 to December 2000. We compared the age of patients, operation time, type of anesthesia, estimated blood loss, changes in hemoglobin, duration of hospitalization, occurrence of febrile morbidity, and medical complications based on the medical records. RESULTS: The mean operation time of 16 patients undergone Le Fort colpocleisis with uterine prolapse was 51+/-18 minutes, the estimated blood loss was 175+/-134 cc, hemoglobin change was 1.72+/-1.14 mg/dl, the mean days of hospitalization was 7.2+/-2.8 days, and the febrile illness occurred in 2 patients. In this group, general anesthesia was used in 10 patients (75%), local anesthesia in 4 patients (25%), and spinal and epidural anesthesia in 1 case respectively. The mean operation time of 11 patients undergone total vaginal hysterectomy with uterine prolapse was 86+/-29 minutes, the estimated blood loss was 366+/-154 cc, hemoglobin change was 2.36+/-1.22 mg/dl, the mean days of hospitalization was 7.8+/-1.6 days, and the febrile illness occurred in 3 patients. General anesthesia was done in total vaginal hysterectomy group and vulva hematoma was developed in 1 case postoperatively. There are significant difference (p<0.01) between the Le Fort colpocleisis and total vaginal hysterectomy in operational time, estimated blood loss, and type of anesthesia, but no significant difference in days of hospitalization, febrile morbidity. CONCLUSION: The assessment of Le Fort colpoclesis in uterine prolapse offers signinficant benefits in elderly or compromised patients and the method is safe for operation.