OBJECTIVE: To evaluate the effect of Mcdonald's cerclage and postoperative care on perinatal outcome in patient with incompetent cervix and bulging fetal membranes. METHODS: In the descriptive study, the charts of 78 patients admitted from 1993 to 1997 with a diagnosis of incompetent cervix and cervical dilatation (3cm) were reviewed, Mcdonald's cerclage rate, predisposing factor, fetal salvage by time, factors of falled operation, delivery type were analyzed. RESULTS: The results of the study were as follows; The incidence of II OC was 0.4% of 18702 case, the mean age was 31.9 years old, the average number of gravida was 2.9, the fetal salvage rate was 83.3%, the predisposing factor was previous history of midtrimester termination(56.4%), dilation and curettage(19.2%), unknown(14.1%) etc, the fetal salvage by time was the highest success rate(88.9%) revealed with period from 14th to 16th weeks of gestation, the factors of falled operation were preterm labor(76.9%), PROM(15.4%), infection(7.7%), and delivery type was vaginal delivery in 36 case(55.4%), cesarean section in 29 case(44.6%). CONCLUSION: We concluded that fetal salvage rate was greatly increased when Mcdonald operation was done from 14th to 16th week of gestation if midtrimester abortion and dilatation and curettage were experienced, Even though we have not compared experimental group with control group, upper part of Mcdonald cerclage, no exposure of suture material, benzol conium dressing, bed rest were increased to fetal salvage rate.
Bandages ; Bed Rest ; Benzene ; Causality ; Cervix Uteri* ; Cesarean Section ; Conium ; Diagnosis ; Dilatation and Curettage ; Extraembryonic Membranes ; Female ; Humans ; Incidence ; Labor Stage, First ; Postoperative Care ; Pregnancy ; Pregnancy Trimester, Second ; Sutures ; Uterine Cervical Incompetence

No abstract available.
Humans

No abstract available.
Mass Screening* ; Uterine Cervical Neoplasms*

Postoperative bleeding is a common complication in cardiac surgery using cardiopulmonary by- pass(CPB) and thrombocytopenia and platelet dysfunction, as well as inadequate surgical hemostasis are cited as a cause. To evaluate the effect of routine use of platelet to prevent postoperative bleeding, auther compared the patients with and without platelet administration of 1 unit/10kg. Routine coagulation tests(RCT) and Thromboelastographs were compared to evaluate the effects of CPB and platelet administration. Also postoperative bleeding amounts were compared. PT and aPTT of RCT were prolonged and fibrinogen was decreased after CPB with no effect with platelet administration. Platelet count was decreased after CPB and recovered in number reaching the pre-CPB level with platelet. R, K, and a of TEG parameters showed no differences after CBP even with platelet. MA, the index of platelet function, remained in the normal range and became hypercoagulable with platelet administration. There was no difference in bleeding amounts between two groups. According to the results, routine administration of platelet after CPB in cardiac surgery is not recommended.
Blood Platelets* ; Cardiopulmonary Bypass* ; Fibrinogen ; Hemorrhage ; Hemostasis, Surgical ; Humans ; Platelet Count ; Platelet Transfusion ; Reference Values ; Thoracic Surgery* ; Thrombocytopenia

OBJECTIVE: Recently, the incidence of elderly primipara is increasing. Thus, impact of old age on pregnancy outcomes became important. Our purpose was to assess the effect of maternal age on pregnancy outcomes. METHODS: 73 cases of the elderly primipara over 35 years at the department of obstetrics and gynecology, Chon-ju presbyterian medical center, from Jan. 1, 1995 to Dec. 31, 1998, were compared with 73 cases randomly chosen young primiparas during same period. RESULTS: Elderly primipara had higher rate of infertility and spontaneous abortion history, antenatal complications, cesarean section, poorer neonatal outcome than young primipara. CONCLUSION: The pregnancy outcome of elderly primipara is considered to be less favorable than those of young primipara. Careful antenatal and intrapartal care should be performed for the elderly primipara. We think that many clinical study of congenital anomaly in elderly primipara will be necessary.
Abortion, Spontaneous ; Aged* ; Cesarean Section ; Female ; Gynecology ; Humans ; Incidence ; Infertility ; Jeollabuk-do ; Maternal Age ; Obstetrics ; Pregnancy Outcome ; Pregnancy* ; Protestantism ; Statistics as Topic*

BACKGROUND: Triage and transportations are important and life-saving medical task performed at the site of mutiple-casualty incidents(MCIs). We pursued three road traffic accidents victims to find out any problem in triaging and transporting them, and to provide an information for equipping an local disaster planning. METHODS: The medical records of 70 consecutive patients who were transported to five emergency facilities in Kangnung, on three MCIs from 1998 to 2000, were analysed, retrospectively. The intervals and types of transport vehicles were analysed. We compared the prehospital time between severity-based groups, which were graded into 3 groups according to the Triage score(0, 1~8, 9). RESULTS: Among the 70 patients, 33 patients(47.1%), 21 patients(30%), and 16 patients(22.9%) were transported to Level I, Level II, and Level III trauma centers, respectively. The time elapsed from scenes to the Level I trauma center was significantly shorter(p=0.003) than to others, but no differences in the mean Triage score between trauma centers were seen(p>0.05). The 119 rescue services transported 58.6%(41 patients) of victims to emergency facilities, and 58.5%(24 patients) of them was concentrated to Level I. There were no significant differences in the prehospital time between three Triage score groups(p>0.05). CONCLUSION: There was no medical control such as triage and transportation in the cases of three MCIs. In the construction of emergency medical service system(EMSS) preparing MCIs or disasters, we suggest the integration and unification of 119 rescue services and emergency medical information centers for effective medical control. We propose to making a new and simple triage guideline. The prehospital personnel should be educated and disaster drills should be performed under the guideline.
Accidents, Traffic ; Disaster Planning ; Disasters ; Emergencies ; Emergency Medical Services ; Humans ; Information Centers ; Medical Records ; Retrospective Studies ; Transportation* ; Trauma Centers ; Triage*

No abstract available.
Seoul*

BACKGROUND: To manage the EMS(emergency medical services) system effectively, departments, such as fire stations, emergency information centers, hospitals, and The Ministry of Health and Welfare, should exchange information that they own and/or gather during patient care and/or transportation. Medical records and information are very important for continuing the patient's care and for deciding on a treatment plan, but medical information is not exchanged fully in spite of its importance. METHOD: We analyzed the transfer medical reports that were written by medical doctors who transferred emergency patients to our hospital. The contents and the accuracy of the transfer medical records were analyzed and graded into 4 groups. Group A was fully described and was equipped with diagnosis, laboratory data, X-ray films; group B had a diagnosis and full laboratory data; group C had a diagnosis, but only partial laboratory data; and group D had only a diagnosis. RESULTS: Among 38,214 patients who visited our hospital from Jan. 2001 to Jun. 2001, 7,031 cases were transferred from other hospitals with transfer medical records. According to the accuracy and important contents of the transfer records, Group A occupied 1.9%, group B 5.2%, group C 32.5%, and group D, with only a diagnosis, 60.4%. In the case of our hospital, we delivered all emergency medical information by written paper(transfer note), E-mail, and web-based information system(cyber-AMC) to the doctors concerned with managing the patient. However, 93% of the medical records of patients transferred from other hospital contained insufficient information to adequately care for the emergency patients. In addition, most of the transferred patients had been transorted without prior information about transportation. CONCLUSION: Within the near future, a medical information center equipped with a computerized system should be operated to exchange medical data. As most general hospitals are operating the OCS(order communication system), EMR(electronic medical record), telemedicine, and PACS(picture-archiving communication system), medical information can be exchanged freely in real time if a code standard and HL7(Health Level 7) can be established.
Clinical Laboratory Techniques ; Diagnosis ; Electronic Mail ; Emergencies* ; Fires ; Hospitals, General ; Humans ; Information Centers ; Medical Records ; Patient Care ; Telemedicine ; Transportation ; X-Ray Film

No abstract available.
Stroke ; Vision Disorders

The purpose of this study is to determine if distance stereoacuity could be used as an objective means of assessing control in intermittent exotropia. We evaluated distance stereoacuity in 37 patients with intermittent exotropia showing orthophoria postopratively using the Mentor B-VAT II Videoacuity tester. All patients had fusion at near but 14 of 31 patients(38%) had fusion at distance preoperatively. The mean preoperative distance stereoacuities were 216 seconds with binocular vision circle(BVC) and 351 seconds with binocular vision random dot E(BVRDE) ( p=0.0002). The postoperative improvement was statistically significant with BVC(p=0.001), not statistically significant with BVRDE(p=0.7). On our results it seems to be easier to know BVC than BVRDE in children. It suggests that the BVC is a useful test for assessing control in intermittent exotropia.
Child* ; Exotropia* ; Humans ; Mentors ; Vision, Binocular