The purpose of this study was to investigate the relationship of cord blood levels of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) in preterm infants with maternal preeclampsia.

Thirty six preterm infants born at Ewha Womans University Mokdong Hospital from January 2006 to August 2006 were studied after prior parental consent at mid-pregnancy. sFlt-1, PlGF, and VEGF levels in the cord blood of preterm neonate, with or without maternal preeclampsia, were measured using enzyme-linked immunosorbent assay.

There was no difference in sFlt-1 between infants with and without maternal preeclampsia. Infants with maternal preeclampsia had significantly lower PlGF levels (P=0.035) and higher sFlt-1/PlGF ratio (P=0.080) with borderline significance. Cord blood VEGF levels were not related to maternal preeclampsia. Infants with maternal preeclampsia had lower birth weight (P=0.030), lower neonatal platelet count without statistical significance (P=0.064) and more likely to be small for gestational age (P=0.057). Neonatal platelet count was significantly correlated with cord blood PlGF levels (r=0.674, P=0.032).

Increased sFlt-1/PlGF ratio and decreased PlGF may not only be related to the pathophysiology of maternal preeclampsia but also affect the neonatal platelet count and birth weight.

Gastro-esophageal reflux disease(GERD) is increasing in Asian countries, but the majority of patients does not present with endoscopic abnormalities, the assessment of the symptom severity and quality of life, and their response to treatment, have become increasingly important. Our objectives were to develop and evaluate a questionnaire about Health-related quality of lif (HRQOL) related with gastrointestinal symptoms in patients with GERD.

Eighty eight, consecutive patients with GERD and 174 healthy subjects were enrolled in the study. GERD was defined by the presence of reflux symptom that are heartburn and acid reflux with occurring more than once per week with/without endoscopic reflux esophagitis. All subjects were examined with endoscopy and performed self-reported questionnaires that were modified Korean form of gastrointestinal symptom rating scale(KGSRS), newly developed instrument, and KSF-36(Korean version of Medical Outcomes Study Short Form), a conventional one. We compared the score of KGSRS between response group and non-response group after 2-weeks omeprazole trial for evaluation of discriminative validity of KGSRS.

Internal consistency for the KGSRS scales range from 0.58-0.84. The repeatability was confirmed by test-retest results(Pearson's correlation coefficients=0.62-0.80, p<0.01). The KGSRS scale scores were significantly correlated with those of KSF-36. It revealed construct validity. The total score of KGSRS in patients with GERD was significantly lower than control(376.1±51.3 vs. 433.5±42.0, p=0.000). There were significant differences for 4 symptom complex except diarrhea between response group and non-response group.

The KGSRS has good reliability and construct validity and discriminates symptom severity and frequency of patients with GERD.

This study was designed to develop the referral system of patient in small-sized industries and the medical delivery system in occupational health field.

We sampled randomly 5 workers per each company in 57 companies and investigated the healthcare utilization behavior, the need for referral system. The survey was done from April 1. 1998 to May 30. 1998 and the respondents were 213. On the basis of the results, we planned model for the referral system between Korean Industrial Health Association(KIHA) and Ewha Medical Center(EMC).

The complaints of the utilization of medical service are cumbersome process of registration and reservation, and discord between hours of duty and consultation. The referral system is needed in 76.7% of total respondents. 85.6% of workers want the night clinic, and 91.3% want to be included their family in this referral system.

We developed the referral system linking KIHA, EMC, and department of preventive medicine of Ewha Woman's University, which based on the result of survey. The service reflect the worker's the healthcare utilization behavior and need for referral system. The number of workers who referred by this system between Feb. 1998 and Jan. 1999 was 30, and replied by EMC after treating was 12. The number of referred patient is very law(30 spells), but the satisfaction of medical service is relatively high.

To promote the referral system, it is needed to propaganda the service of referral system to workers and managers of each company, to improve of quality of services of the hospital, and to establish the official referral system between department of preventive medicine of Ewha woman's university and each clinical department of Ewha Medical Center.