A pregnancy is considered postterm if it is beyond 294 days (42 complete weeks). Several investigators have demonstrated that postterm pregnancy may be accompanied by a rise in perinatal morbidity and/or mortality. Abnormalities such as meconium staining, cringenital anomalies, intrauterine growth retardation, postmaturity syndrome, fetal asphyxia have been reported in some cases of reduced amniotic fluid volume (oligohyramnios) which is commonly observed in postterm pregnancies. Amniotic fluid volume has been shown to decrease significantly as gestational age advances beyond term. Oligohydramnios has particular relevance to postterm pregnancies. Poor perinatal outcomes of oligohydramnios on postterm pregnancy have been reported by several authors. To date, however, the relationship between oligohydramnios in pastterm pregnancy and fetal outcome is debatable. The purpose of this clinical study was to evaluate the relationship between oligohydr- amnios and perinatal outcome in 64 cases of postterm pregnancies. Amniotic fluid index(AFI) values were measured semiweekly in 64 good dated, uncomplicated singleton pregnancies. AFI values were categorized into 2 groups. The group 1; patients whose final AFI value was above 5.0 cm; Group 2, patients whose AFI value fell below 5.0 cm. Adverse fetal outcome was defined by the presence of meconium staining, fetal heart rate decelerations, cesarean delivery for fetal distress, low Apgar score at 1 and 5 minutes, neonatal intensive care unit admission, and perinatal mortality. The fetal outcome was compared group 1 with group 2 and results obtained were as follows: 1. The incidence of oligohydramnios in postterm pregnancy was 54.7 %. The average diminution of amniotic fluid index was from 8.2 1.8 cm to 5.6+2.2 cm/week. 2. The incidence of meconium-staining in amniotic fluid was 40.6 % (Group 1: 20.7 %, Group 2: 57.1 %) and showed statistically significant difference between the two groups(p= 0.003). 3. The incidence of Apgar score less than 7 was 23.4% in 1 minute (Group 1: 13.8 %, Group 2: 31.4 %) and 4.7 % in 5 minutes(Group 1: 3.4%, Group 2: 5.7 %), respectively and showed no statistically significant difference between the two groups (p=0.140, p=1.000). 4. I'he incidence of cesarean delivery due to fetal distress was 12.5 % (Group 1: 6.9%, Group 2: 17.1 %) and showed no statistically significant difference between the two groups (p=0.275). 5. The incidence of admission to NICU was 12.5 % (Group 1: 6.9%, Group 2: 17.1 %) and showed no statistically significant difference between the two groups (p=0.275). Adverse fetal outcome was not uniformly observed in postterm pregnancies with oligohydramnios. Amniotic fluid index in oligohydramnios group as a single independent guide was not enough to predict fetal outcomes in postterm pregnancy without specific pathologic condition of fetus.
Amniotic Fluid* ; Apgar Score ; Asphyxia ; Deceleration ; Female ; Fetal Distress ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Heart Rate, Fetal ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Meconium ; Mortality ; Oligohydramnios ; Perinatal Mortality ; Pregnancy* ; Research Personnel

Recently hang-back recession is chosen instead of conventional recession to get better result in strabismus surgery. Jampolsky method, a popular method of hang-back recession, has some draw-backs; the extraocular muscle width can be decreased, the center of the muscle can be sagging posteriorly, and the amount of recession can be somewhat shortened than expected in operation. Accordingly, we devised a new modified hang-back recession and compared with Jampolsky method. Two months after respective operation in 7 albino rabbits, the width of the muscle comparing to preoperative condition, the amount of recession, and the sagging of middle part of the muscle were evalvated in comparison with the preoperative findings. The width of muscles was significantly shortened in Jampolsky method in comparison with preoperative condition (p<0.05), but not in our new method (p>0.05). The amount of recession by Jampolsky method was significantly shortened than expected in operation (p<0.05), but not by our new method (p>0.10). The significant sagging of the muscle was found with Jampolsky method (p<0.05), but not with our modified method (p>O.lO). In review of these findings, our new method is devoid of some draw backs of Jampolsky method.
Muscles ; Rabbits ; Strabismus

No abstract available.
Blotting, Western ; Cells, Cultured ; Connective Tissue Cells/drug effects/metabolism ; Endothelin-1/*biosynthesis ; Fibroblasts/*drug effects/metabolism ; Humans ; Transforming Growth Factor beta1/*pharmacology

There is a controversy in patella retention or resurfacing in total knee arthroplasty (TKA) till today. Authors studied 52 cases of 45 patients recieved total knee arthroplasty with patella retention (Group 1, twenty-five cases) or patella resurfacing (Group 2, twenty-seven cases) in patients with osteoarthritis. All operations were done by senior surgeon and the implants used were LCS type (33 cases), AMK type (12 cases), Genesis type (5 cases) and Tricon M type (2 cases). The indications of patella retention were small patella, nearly normal articular cartilage, minimal pre-operative patellofemoral pain, poor patellar bone quality and young patients. Patella retention were performed only with LCS prosthesis, which patella groove of the femoral component is deep and anatomical. The operative approaches used were medial parapatella approach in neutral or varus knee and lateral parapatella approch for severe valgus knee and tilting or lateral subluxation of the patella. The mean follow-up period was 24 months (range 12 months to 5 years). The method for clinical evaluation was Hospital for Special Surgery (HSS) knee scoring (consisted of pain, function, range of motion). The method for radiographical evaluation was Knee societys radiologic evaluation system for tibial and femoral alignment, and Keblishs method for patello-femoral congruence. The clinical HSS knee score was average 90.9 points in both groups, and 91.9 points in group 1, 90.0 points in group 2, and there was no statistically difference in HSS knee score between the two groups (P<0.05). The radiologic results had no significant difference in alignment and patello-femoral congruence between the two groups (P<0.05). But the complications were one case of patella fracture, one patella tendon rupture, one anterior instability and two cases of infection in group 2. In conclusion, the results of both groups were satisfactory. We think that it have relation to strict selection of the patients for patella retension and the use of prosthesis that the patella groove of femoral component is deep and anatomical.
Arthroplasty* ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Patella* ; Patellar Ligament ; Prostheses and Implants ; Rupture

No abstract available.
Aged* ; Humans

No abstract available.
Carcinoma, Squamous Cell* ; Vagina*

Schwannoma(Neurilemoma) is a neoplasm that can occur wherever schwann cells are present, that is, in any myelinated peripheral nerve, brain and sympathetic nerve. Schwannoma tends to occur usually in intraconal area, and it may arise at any point of the orbit, including the lacrimal sac and it may arise at sinus and gasserian ganglion. A 43 years old korean male had painless proptosis, which had developed for 1 month and was dignosed an schwannoma of left orbit. The tumor was excised totally. Histologic examination showed a combination of Antoni type A(dense, cellular) and Antoni type BOoose, edematous or necrotic) patterns.
Adult ; Brain ; Exophthalmos ; Humans ; Male ; Myelin Sheath ; Neurilemmoma ; Orbit* ; Peripheral Nerves ; Schwann Cells ; Trigeminal Ganglion

OBJECTIVE: The purpose of this retrospective study was to evaluate the effect of neoadjuvant chemotherapy followed by radical surgery compared with conventional radical surgery in stage Ib1 cervical cancer as to operative complications, the rate of lymph node metastasis, recurrence and overall five-year survival rates. METHODS: The study materal (98 cases of stage Ib1 cervical cancer) was divided into two groups; The one group was neoadjuvant chemotherapy (Cisplatin + 5-FU) followed by radical surgery (n = 41) and the other was the conventional radical surgery (n = 57) group. Reviewing records of operative and pathological reports and clinical findings, the outcome was statistically analyzed and compared. RESULTS: As to the complication, bladder dysfuntion was more frequent in neoadjuvant chemotherapy group, statistically significant.(43.9% vs 22.8%, P=0.034). No significant difference was found in the incidence of lymphnode metastasis (17% vs 17.5%, P=0.779) and overall five year survial rates(85.3% vs 87.7%, P=0.735). CONCLUSION: No benefical effect of neoadjuvant chemotherapy could be found on stage Ib1 cervical cancer in this retrospective study. However, well controlled longterm prospective study will be need to get firm conclusion.
Drug Therapy* ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms*

OBJECTIVE: To survey the clinical features, complications, prognostic factors and Five-year survival rates of 398 patients with invasive cervical cancer(stage Ib-IIb), subjected to radical hysterectomy and bilateral pelvic lymphadenectomy. METHODS: Medical records and pathologic reports were reviewed retrospectively on 398 cases, diagnosed and operated on during the period of Jan. 1988 - Dec. 1998. Five-year survival rates were estimated by the Kaplan-Meier method, and prognostic factors were assessed using Wilcoxon test. RESULTS: Of the 398 cases, 285 were in stage Ib(71.6%), 58 in stage IIa(14.5%), and 55 in stage IIb(13.8%). The mean age of patients was 48+/-9.9 years. Neoadjuvant chemotherapy was given to 200 patients(50.2%), Adjuvnat radiotherapy in 160 patients(40.2%) postoperatively. Operative complications occured in 121 patients(30%). Massive blood loss and bladder dysfuction were frequent complications(11.3% and 10.3%, respectively). Others were urinary tract infection(9.3%), wound infection(7.5%), lymphocyst(3.5%) and urinary tract fistula(0.7%), respectively. The Five-year survival rates for stage Ib, IIa, and IIb were 84.2, 82.8%, and 75.8%, respectively. Factors that affect the Five-year survival rates were cell type(small cell Vs other, P=0.0146), tumor size(< or = 3cm Vs >3cm, P=0.0425), depth of invasion( < or = 5gm Vs >5ne, P= 0.0007), response of chemotherapy(poor response Vs other, P= 0.0001), LN metastasis(1 Vs 2 Vs more, P=0.0001). CONCLUSION: Accumulating the clinical experience, we could improve results, reduce complications and speculated that the survival rates could be improved by neoadjuvant chemotherapy and/or adjuvant postoperative radiotherpy. Prospective randomized trials are needed to evaluate our approach and to be compared with concurrent chemoradiotherapy to definite its precise role in locally advanced cervical cancer.
Chemoradiotherapy ; Drug Therapy ; Humans ; Hysterectomy* ; Lymph Node Excision ; Medical Records ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Urinary Tract ; Uterine Cervical Neoplasms* ; Wounds and Injuries

Pars interarticularis fracture is a common finding in young soccer players with low back pain. Spondylolysis in young adults involves a defect of the pars interarticularis, occurring as a result of repeated hyperextension and rotation. Here, we describe the case of a 26-year-old male elite soccer player who was diagnosed with L3 spondylolysis 2 years previously. He visited Incheon Himchan Hospital again because of low back pain. Radiographs showed consecutive spondylolysis at the L3 and L4 levels. Physicians should be aware that repeated performance of athletic movements, such as those during soccer, might lead to consecutive levels of spondylolysis.
Adult ; Athletes ; Fractures, Stress ; Humans ; Incheon ; Low Back Pain ; Male ; Soccer* ; Spondylolysis* ; Sports ; Young Adult