OBJECTIVE: To investigate the effect of the type of placenta and the portion of umbilical cord insertion on birthweight and growth discordancy in twin pregnancies. METHODS: We selected 120 twins of 146 multiple pregnancies between March, 2000 and March, 2002, and one fetus of all cases at least weighed 500 g or more and over 24 weeks of gestation. The fetuses were included that 44 twins (88 fetuses) had monochorionic placentas and the 76 twins (152 fetuses) had dichorionic placentas. The dichorionic twins were divided into two groups; one (38 twins, 76 fetuses) showed the fused type of placenta and the other (38 twins, 76 fetuses) showed the separate type of placenta. The types of umbilical cord insertion were also divided into the central portion and the peripheral portion, the peripheral portion was defined within 2 cm of margin of placenta, and included marginal and velamentous insertion of umbilical cord. Stastical analysis were performed with Student t-test and runs test. p<0.05 was defined significantly. RESULTS: 1. The central type of umbilical cord insertion in dichorionic placenta was more frequent than that of monochorionic placenta (p<0.01). 2. The dichorionic infants, regardless the number of placenta, who weighed more than monochorionic infants at birth (p<0.01). 3. Twin pairs with over 25% of growth discordancy were 16 cases (13.3%), which included 9 cases (9/76, 11.8%) of dichorionic placenta and 7 cases (7/44, 15.9%) of monochorionic placenta. The severe growth discordancy was more commonly developed in monochorionic twins than dichorionic twins (p<0.01). 4. Perinatal deaths in twin pairs with over 25% of GD were 12 cases, which included 3 cases (3/18, 16.7%) of dichorions, and 9 cases (9/14, 64.3%) of monochorions. Therefore, perinatal death was showed more commonly in monochorinic twin infants (p<0.01). CONCLUSION: The type of umbilical cord insertion affected the birthweight of dichorionic separated infants. Monochorionic placenta attributed to more severe growth discordancy and increased perinatal death rate than the dichorionic placenta. Antenatal detection of chorionicity and the portion of umbilical cord insertion may improve the perinatal outcome.
Chorion ; Female ; Fetus ; Humans ; Infant ; Mortality ; Parturition ; Placenta* ; Pregnancy ; Pregnancy, Multiple ; Pregnancy, Twin* ; Umbilical Cord*

PURPOSE: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. METHODS: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. RESULTS: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. CONCLUSION: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.
Bile ; Bile Ducts, Intrahepatic ; Biliary Atresia* ; Biliary Tract ; Cholestasis ; Chungcheongnam-do ; Diagnosis* ; Early Intervention (Education) ; Hepatitis ; Humans ; Infant, Newborn ; Parenteral Nutrition, Total ; Radioactivity ; Radionuclide Imaging* ; Sensitivity and Specificity

The purpose of this study was to evaluate the canal configuration after shaping by ProFile, ProTaper and K-Flexofile in simulated resin canals with different angles of curvature. Three types of instruments were used : ProFile, ProTaper, K-Flexofile. Simulated root canals, which were made of epoxy resin, were prepared by ProFile, ProTaper with rotary instrument using a crown-down pressureless technique, and hand instrumentation was performed by K-Flexofile using a step-back technique. All simulated canals were prepared up to size 25 file at end-point of preparation. Pre and post instrumentation images were recorded with Scanner. Assessment of canal shape was completed with Image Analysis program. Measurements were made at 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 mm from the apex. At each level, outer canal width, inner canal width, total canal width, and amount of transportation from original axis were recorded. Instrument deformation and fracture were recorded. Data were analyzed by means of one-way ANOVA analysis of variance and the Sheffe's test. The result was that ProFile and ProTaper maintain original canal shape regardless of the increase of angle of curvature than K-Flexofile. ProFile show significantly less canal transportation and maintained original canal shape better than ProTaper.
Axis, Cervical Vertebra ; Dental Instruments ; Dental Pulp Cavity ; Transportation

OBJECTIVE: The aim of study was to compare incidence rate and causes of the preterm birth that are the major factor of newborn mortality and morbidity. METHODS: Respectively there were 428 preterm deliveries out of 5,309 deliveries, from January to August 1995, and there were 319 preterm deliveries out of 2,028 deliveries, from January to August 2000 at Gill hospital, a hospital in affiliation with Gachon Medical School. The data were collected by review of the hospital record and the statistical analysis was performed using paired T-tests, Oneway ANOVA, Fisher's exact test, and statistics significance was defined as p<0.05. RESULTS: The incidence rate of the preterm birth increased from 8.1%(428/5,309) in 1995 to 15.7%(319/2,028) in 2000. Unknown causes of preterm birth decreased from 25.5%(109) to 20.2%(66). PPROM(Preterm premature rupture of the membranes) decreased from 26.9%(115) to 22.9%(73). IIOC(Incompetent internal os of cervix) decreased from 9.7%(41) to 6.9%(22). Uterine anomaly decreased from 1.6%(7) to 1.0%(3). And other causes deceased from 8.9%(38) to 5.1%(16). Multiple pregnancy increased from 10.1%(44) to 17.6%(56). Fetal anomaly increased from 2.1%(9) to 6.3%(20). Pregnancy induced hypertension increased from 7.9%(34) to 13.3%(42). There was not much change for the placental disorder or for placental abruption which decreased from 7.3%(31) to 6.7%(21). According to the analysis, there is a noticeable decrement in IIOC but noticeable increase in multiple pregnancy, fetal anomaly and PIH. CONCLUSION: Comparing the data from the preterm birth of 1995 and 2000, the unknown cause of the preterm birth is understood more accordingly to the decrement of known cause. The increase of multiple pregnancy seems to be caused by better in vitro fertilization. The increase of fetal anomaly is most likely caused by drug abuse, environmental pollution, and prenatal diagnosis. Differ from the decrease of previous research, the increase of PIH is caused by the increase of incidence of the preterm birth and also patients moving from private hospital to 3rd party hospital. We hope that we can continuously research the cause of the preterm birth and use that basic information to decrease the death and disease rates of newborn infants
Abruptio Placentae ; Animals ; Environmental Pollution ; Female ; Fertilization in Vitro ; Gills ; Hope ; Hospital Records ; Hospitals, Private ; Humans ; Hypertension, Pregnancy-Induced ; Incidence* ; Infant, Newborn ; Mortality ; Pregnancy ; Pregnancy, Multiple ; Premature Birth* ; Prenatal Diagnosis ; Rupture ; Schools, Medical ; Substance-Related Disorders

"The computer-based electronic academy of anatomy as the ideal goal", we made this concept to a reality by establishing ANATOMY forum in a nationwide bulletin board system. The concept of ANATOMY forum was designed at a small group meeting of members in Korean Association of Anatomist on October, 1992. Beginning on October 8, 1993, ANATOMY forum offers bulletins, file transfers and citizen band emulation for the anatomist as well as anyone who wants to join. We are providing library area for file transfer with four different library sections-EDUCATION, RESEARCH, INFORMATION OF ACADEMIC SOCIETY and ANATOMY IN GENERAL. In the bulletins we have two kinds of message area. One includes five message sections for the use of all members, consisting of NOTICE, LIBRARY INFORMATION, FOR MEDICAL PERSONNEL, QUESTION and ANSWER and MISCELLANEOUS NOTEBOOK. The another message area is for the executive use of anatomist, including five sections-EDUCATION, LABORATORY, RESTING PLACE, ACADEMIC SOCIETY and CONFERENCE ROOM. Currently we have 115 useful files in the library section, and more than 4,000 informative messages in the bulletins. The number of members of ANATOMY forum is now over than 1,000 including 48 anatomists of the most medical schools in Korea. The majority of the members are medical personnel and medical students. The ANATOMY forum is a group of people who wants to exchange ideas and informations on medical science and anatomy-related topics.
Anatomists ; Education* ; Group Processes ; Humans ; Korea ; Schools, Medical ; Students, Medical ; Telecommunications*

The purpose of this was to investigate the measurement of fluence dose map for the specific patient quality assurance. The measurement of fluence map was performed using 2D matrixx detector. The absorbed dose was measured by a glass detector, Gafchromic film and ion chamber in Hybrid Optimized VMAT Phantom (HOVP). For 2D Matrixx, the results of comparison were average passing rate 85.22%+/-1.7 (RT_Target), 89.96%+/-2.15 (LT_Target) and 95.14%+/-1.18 (G4). The dose difference was 11.72%+/-0.531, -11.47%+/-0.991, 7.81%+/-0.857, -4.14%+/-0.761 at the G1, G2, G3, G4. In HOVP, the results of comparison for film were average passing rate (3%, 3 mm) 93.64%+/-3.87, 90.82%+/-0.99. We were measured an absolute dose in steep gradient area G1, G2, G3, G4 using the glass detector. The difference between the measurement and calculation are 8.3% (G1), -5.4% (G2), 6.1% (G3), 7.2% (G4). The using an Ion-chamber were an average relative dose error -1.02%+/-0.222 (Rt_target), 0.96%+/-0.294 (Lt_target). Though we need a more study using a transmission detector. However, a measurement of real-time fluence map will be predicting a dose for real-time specific patient quality assurance in volume modulated arc therapy.
Chimera ; Glass ; Humans

Background: The Korean Society of Thoracic Radiology (KSTR) recently constructed a nation-wide coronavirus disease 2019 (COVID-19) database and imaging repository, referred to the Korean imaging cohort of COVID-19 (KICC-19) based on the collaborative efforts of its members. The purpose of this study was to provide a summary of the clinico-epidemiological data and imaging data of the KICC-19. Methods: The KSTR members at 17 COVID-19 referral centers retrospectively collected imaging data and clinical information of consecutive patients with reverse transcription polymerase chain reaction-proven COVID-19 in respiratory specimens from February 2020 through May 2020 who underwent diagnostic chest computed tomography (CT) or radiograph in each participating hospital. Results: The cohort consisted of 239 men and 283 women (mean age, 52.3 years; age range, 11–97 years). Of the 522 subjects, 201 (38.5%) had an underlying disease. The most common symptoms were fever (n = 292) and cough (n = 245). The 151 patients (28.9%) had lymphocytopenia, 86 had (16.5%) thrombocytopenia, and 227 patients (43.5%) had an elevated CRP at admission. The 121 (23.4%) needed nasal oxygen therapy or mechanical ventilation (n = 38; 7.3%), and 49 patients (9.4%) were admitted to an intensive care unit.Although most patients had cured, 21 patients (4.0%) died. The 465 (89.1%) subjects underwent a low to standard-dose chest CT scan at least once during hospitalization, resulting in a total of 658 CT scans. The 497 subjects (95.2%) underwent chest radiography at least once during hospitalization, which resulted in a total of 1,475 chest radiographs. Conclusion The KICC-19 was successfully established and comprised of 658 CT scans and 1,475 chest radiographs of 522 hospitalized Korean COVID-19 patients. The KICC-19 will provide a more comprehensive understanding of the clinical, epidemiological, and radiologic characteristics of patients with COVID-19.